Spontaneous left main coronary artery dissection complicated by pseudoaneurysm formation in pregnancy: role of CT coronary angiography

We report a case of a 26-year-old female, who presented at 34 weeks of an uncomplicated pregnancy with an acute ST elevation anterior wall myocardial infarction. Cardiac catheterization suggested a left main coronary artery dissection with pseudoaneurysm formation. The patient's course was complicated by congestive heart failure. She was initially managed conservatively by a multidisciplinary team including heart failure specialists, obstetricians, and cardiovascular surgeons. 4 days after admission, her LMC was imaged by dual-source 64 slice Cardiac computed tomography, coronary dissection was identified extending to the lumen, and the presence of pseudoaneurysm was confirmed. She underwent subsequently a staged procedure, which included placement of an intra-aortic balloon pump, cesarean section, and coronary artery bypass grafting. This case illustrates the utility of coronary artery CT imaging to assess the complexity and stability of coronary artery dissections, thereby helping to determine the need for, and timing of revascularization procedures

The Effects of Rainfall and Temperature on Percolation through drain gauges

RESP-93

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Not AvailableIdentification of climate-smart nutrient management practices will overcome the ill effects of extreme climate variability on agricultural production under projected climate change scenarios. The rice–wheat cropping system is the major system used in India: using long-term yield data from Integrated Nutrient Management experiments on this system, the present study analysed trends in weather parameters and grain yield under different nutrient management practices. Twelve treatments with different combinations of inorganic (chemical fertilizer) and organic (farmyard manure (FYM), green manure (GM) and crop residue) sources of nutrients were compared with farmers’ conventional practices. A significant increasing trend was noticed for rainfall during the rice season at Kalyani and Navsari, of the order of 137·7 and 154·2 mm/decade, respectively. The highest increase in maximum temperature was seen at Palampur (1·62 °C/decade) followed by Ludhiana (1·14 °C/decade). At all the sites except Ludhiana and Kanpur, the yield of the rice–wheat system showed an increasing trend ranging from 0·08 t/ha/year in Jabalpur to 0·011 t/ha/year in Navsari, under the recommended dose of inorganic fertilizer application. A significant decreasing trend of 0·055 t/ha was found in Ludhiana. For most of the sites, a combination of half the recommended dose of inorganic fertilizer and either FYM or GM to provide the remainder of the N required was sufficient to maintain productivity. The top three climate-resilient integrated nutrient management practices were identified for all the study sites. Thus, the present study highlights the adaptive capacity of different integrated nutrient management practices to rainfall and temperature extremes under rice–wheat cropping system in distinctive agro-ecological zones of India.Not Availabl