Obstetric emergencies during the COVID-19 lockdown period: a case series

Obstetric emergencies during COVID-19 pandemic pose an enormous challenge to the concerned obstetrician. Risk stratification during obstetric triage will guide in the initial assessment & planning of further management to reduce maternal and fetal morbidity and mortality rates. As the health system adapts to cope with this pandemic, special attention needs to be given to the several moral and ethical dilemmas that may occur during patient care

Art and craft of episiotomy

Background: Episiotomy is the most common obstetric surgical procedure performed in labor room. Mediolateral and Midline episiotomies are the most common types. Post-delivery suture angle is the most important determinant factor which predicts the risk of anal sphincter injuries. Mediolateral episiotomy has a significantly lower risk of OASIS rate when compared to midline episiotomies. Aim of the study was to know whether mediolateral episiotomies are actually mediolateral and does the angle of episiotomy influences the risk of anal sphincter injuries, maternal/fetal complications in the perinatal period.Methods: An observational study was conducted on 250 postpartum patients admitted to our hospital. Details of episiotomy in relation to incision angle, length, depth and post suturing angle were noted within two days of delivery.Results: Among the subjects included there were 40.8 % incisions were RMLE, average length was 3.32cms, average suture angle is 28.69 degree. OASIS was seen in 19.5% cases more so with midline episiotomies.Conclusions: Episiotomy is an essential, must to know skill. Compulsory ssupervised clinical teaching and use of skill lab training can prevent potential detrimental consequences

Effect of isogenic-alloplasmic cytoplasmic male sterility system on grain yield traits in pearl millet

Pearl millet is a nutri-cereal and is grown predominantly by subsistence farmers in semi-arid regions of India and Africa. Considering highly cross pollination nature and availability of cytoplasmic male sterility (CMS), pearl millet hybrids are becoming a dominant cultivar type in India. Present study aims to assess the effect of isonucleus-alloplasmic, A1, A4 and A5 cytoplasmic male sterility system on agronomic performance of pearl millet hybrids. Five isogenic females each having 3 alloplasmic (A1, A4 and A5) cytoplasm were crossed with 6 male-parents to generate 120 hybrids and were evaluated in two contrasting season in splitsplit- plot design (SSPD). The significant cytoplasm per se and restorer per se indicate the both contribution to most of the traits, however, greater magnitude of contribution arises from restorers (74% grain yield; 95% 1000-grain weight). The significant hybrids × environment shows the mandatory of multi location testing for yield traits while non-significant of CMS × environment interactions reveals the greater stability of CMS. Further, no significant mean yield differences exhibited in A1, A4 and A5 hybrids (2.53-2.81 t ha-1) indicates not any adverse effect of cytoplasm on grain yield and associated traits. Also, diverse genetic backgrounds used in this study exhibited significant contributions to grain yield and its component traits. These results imply the prospects for utilization of potential alternative cytoplasm (A4 and A5) to widen the cytoplasm base together with development of counterpart restorers to produce future high-yielding hybrids

Genetic diversity analysis among advanced breeding lines in pearl millet for grain iron, zinc and agronomic traits

Evaluation of genetic diversity within breeding populations will help in parents’ diversification and identification of trait-specific inbred sources. Total of 294 inbreds were evaluated for grain iron (Fe), zinc (Zn) and agronomic traits in two contrasting seasons using alpha-lattice field design. There was a significant variability observed for all traits. Three-to-four-fold variability noticed for Fe (31-120 mg kg-1), Zn (19-88 mg kg-1), yield (0.6-2.6 tha-1) and 1000- grain weight (6-16 g 1000-1). The magnitude of genetic coefficient of variation explained by traits were varied in the order of Fe (25%)>Zn>TGW>PL>PH>GY>PG>DF (7%) and heritability (broad sense) was very high as >84% for all traits except grain yield (56%). Nine clusters formed at 90% genetic similarity. Clusters I to IV and VII had higher mean value for Fe density (78-100 mg kg-1) and agronomic traits. Highest number of genotypes grouped in cluster I (63) followed by cluster III (54) having higher yield,1000-grain weight, panicle girth, Fe and Zn. Top-10% of high-Fe lines had significantly higher Fe (64%), Zn (49%), grainweight (29%) and panicle girth (19%) than bottom-10% genotypes. This implies that high- Fe/Zn sources are available with eliteness and can be incorporated into any genetic background without compromising agronomic superiority. Higher heritability and genetic advance as percentage of mean were observed for Fe, Zn and grain-weight suggesting these traits are predominantly determined by additive gene and can be improved through selection

Effect of isonuclear-alloplasmic cytoplasmic male sterility system on grain yield traits in pearl millet

Pearl millet is a nutri-cereal and is grown predominantly by subsistence farmers in semi-arid regions of India and Africa. Considering it’s highly cross pollinated nature and availability of cytoplasmic male sterility (CMS), hybrids have become a dominant cultivar type in India. Present study aims to assess the effect of isonuclear alloplasmic A1, A4 and A5 CMS on agronomic performance of pearl millet hybrids. Five isogenic females each having 3 alloplasmic (A1, A4 and A5) cytoplasm were crossed with 6 male-parents to generate 120 hybrids. All these were evaluated in two contrasting seasons (E) in split-split-plot design. The significant cytoplasm per se and restorer per se indicate the both contribution to most of the traits, however, greater magnitude of contribution arises from restorers significantly (75%grain yield; 95% 1000-grain weight). The significant, hybrids x E shows the mandatory of multilocation testing for yield traits while non-significant of CMS × E interaction reveals the greater stability of CMS. Further, non-significant mean yield differences exhibited in A1, A4 and A5 hybrids (2.84-3.14 t ha–1) indicated no adverse effect of cytoplasm on grain yield and associated traits. Also, diverse genetic backgrounds used in this study displayed significant contributions to grain yield and its component traits. These results imply the prospects for utilization of potential alternative cytoplasm (A4 and A5) to widen the cytoplasm base together with development of counterpart restorers to produce future high-yielding hybrids

From manual curation to visualization of gene families and networks across Solanaceae plant species

High-quality manual annotation methods and practices need to be scaled to the increased rate of genomic data production. Curation based on gene families and gene networks is one approach that can significantly increase both curation efficiency and quality. The Sol Genomics Network (SGN; http://solgenomics.net) is a comparative genomics platform, with genetic, genomic and phenotypic information of the Solanaceae family and its closely related species that incorporates a community-based gene and phenotype curation system. In this article, we describe a manual curation system for gene families aimed at facilitating curation, querying and visualization of gene interaction patterns underlying complex biological processes, including an interface for efficiently capturing information from experiments with large data sets reported in the literature. Well-annotated multigene families are useful for further exploration of genome organization and gene evolution across species. As an example, we illustrate the system with the multigene transcription factor families, WRKY and Small Auxin Up-regulated RNA (SAUR), which both play important roles in responding to abiotic stresses in plants

Telemedicine During COVID-19 and Beyond: A Practical Guide and Best Practices Multidisciplinary Approach for the Orthopedic and Neurologic Pain Physical Examination.

BACKGROUND:The COVID pandemic has impacted almost every aspect of human interaction, causing global changes in financial, health care, and social environments for the foreseeable future. More than 1.3 million of the 4 million cases of COVID-19 confirmed globally as of May 2020 have been identified in the United States, testing the capacity and resilience of our hospitals and health care workers. The impacts of the ongoing pandemic, caused by a novel strain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have far-reaching implications for the future of our health care system and how we deliver routine care to patients. The adoption of social distancing during this pandemic has demonstrated efficacy in controlling the spread of this virus and has been the only proven means of infection control thus far. Social distancing has prompted hospital closures and the reduction of all non-COVID clinical visits, causing widespread financial despair to many outpatient centers. However, the need to treat patients for non-COVID problems remains important despite this pandemic, as care must continue to be delivered to patients despite their ability or desire to report to outpatient centers for their general care. Our national health care system has realized this need and has incentivized providers to adopt distance-based care in the form of telemedicine and video medicine visits. Many institutions have since incorporated these into their practices without financial penalty because of Medicare\u27s 1135 waiver, which currently reimburses telemedicine at the same rate as evaluation and management codes (E/M Codes). Although the financial burden has been alleviated by this policy, the practitioner remains accountable for providing proper assessment with this new modality of health care delivery. This is a challenge for most physicians, so our team of national experts has created a reference guide for musculoskeletal and neurologic examination selection to retrofit into the telemedicine experience. OBJECTIVES:To describe and illustrate musculoskeletal and neurologic examination techniques that can be used effectively in telemedicine. STUDY DESIGN:Consensus-based multispecialty guidelines. SETTING:Tertiary care center. METHODS:Literature review of the neck, shoulder, elbow, wrist, hand, lumbar, hip, and knee physical examinations were performed. A multidisciplinary team comprised of physical medicine and rehabilitation, orthopedics, rheumatology, neurology, and anesthesia experts evaluated each examination and provided consensus opinion to select the examinations most appropriate for telemedicine evaluation. The team also provided consensus opinion on how to modify some examinations to incorporate into a nonhealth care office setting. RESULTS:Sixty-nine examinations were selected by the consensus team. Household objects were identified that modified standard and validated examinations, which could facilitate the examinations.The consensus review team did not believe that the modified tests altered the validity of the standardized tests. LIMITATIONS:Examinations selected are not validated for telemedicine. Qualitative and quantitative analyses were not performed. CONCLUSIONS:The physical examination is an essential component for sound clinical judgment and patient care planning. The physical examinations described in this manuscript provide a comprehensive framework for the musculoskeletal and neurologic examination, which has been vetted by a committee of national experts for incorporation into the telemedicine evaluation