POLITICAL HISTORY OF LADAKH ( Pre 9th to 12th CE)

Ladakh is the Northern most division of Indian Union which falls in Jammu and Kashmir state. Generally the recorded history of Ladakh begins with the coming of Tibetans to Ladakh in the late 9th CE. This paper is an attempt to string together the Pre 9th political history and the post 9th political history of Ladakh till 12th CE. For this purpose folk lore and oral traditions have been employed as well in order to logically fill the lacunae in the pre 9th CE history of Ladakh. This paper also provides a geographical glimpse of Ladakh. Key Words: Ladakh, Geographical, Political, Chronicle, Tibet, Ladakhi Kingdom

Concept of Compassion in Buddhism, Its Ethical Implication in the Contemporary World

Buddhism is often considered as a path for purification vissudhimagga. During an era of empire building and extreme asceticism, it advocated a middle path based on moral perfection. Compassion in Buddhism enjoys an exalted position and its embodiment, Bodhisattva is highly venerated. This concept finds its applicability more in the contemporary era of materialistic race and political chaos, degrading social norms and decaying moral values. This paper is an attempt to analyze the possibility of compassion as a tool to restore peace and prosperity in the contemporary world. Keywords: Compassion, Buddhism, Violence, materialistic race, global peace, humanity, terrorism. DOI: 10.7176/JCSD/49-04 Publication date:June 30th 201

Reactive Oxygen Species, Oxidative Damage and Their Production, Detection in Common Bean (<em>Phaseolus vulgaris</em> L.) under Water Stress Conditions

Reactive oxygen species (ROS) being small and highly reactive oxygen containing molecules play significant role in intracellular signaling and regulation. Various environmental stresses lead to excessive production of ROS causing progressive oxidative damage and ultimately cell death. This increased ROS production is, however, tightly controlled by a versatile and cooperative antioxidant system that modulates intracellular ROS concentration and controls the cell’s redox status. Furthermore, ROS enhancement under stress serves as an alarm signal, triggering acclimatory/defense responses via specific signal transduction pathways involving H2O2 as a secondary messenger. Nevertheless, if water stress is prolonged over to a certain extent, ROS production will overwhelm the scavenging action of the anti-oxidant system resulting in extensive cellular damage and death. DAB (3,3′-diaminobenzidine) test serves as an effective assessment of oxidative damage under stress. It clearly differentiates the lines on the basis of darker staining of leaves under water stress. The lines showing greater per cent reduction in yield parameters show greater staining in DAB assay underlining the reliability of using this assay as a reliable supplement to phenotyping protocols for characterizing large germplasm sets

Development of protein rich pregelatinized whole grain cereal bar enriched with nontraditional ingredient: Nutritional, phytochemical, textural, and sensory characterization

This study was aimed to use extrusion cooking as a pretreatment for non-conventional seeds (Indian horse chestnut flour) to blend them with whole grain flours (whole wheat flour, whole barley flour, and whole corn flour) for the development of a pregelatinized cereal bar (PCB). In this study, date paste (7.5–17.5%) and walnut grits (2.5–12.5%) were incorporated at varying levels to prepare PCB. The PCB was evaluated for its nutritional, color, textural (both three-point bending test and TPA), antioxidant activity, and sensory attributes. The flexural modulus, rupture stress, and fracture strain of PCB increased with the incorporation of a higher proportion of date paste. The protein and fiber content in PCB increased from 7.74 to 9.13% and 4.81 to 5.59% with the incorporation of walnut grits and date paste, respectively. The DPPH, total phenolic content, and water activity of PCB were determined, which progressively enhanced with increased levels of walnut grits and date paste. The correlation between sensory attributes and instrumental texture on PCB was also investigated. The correlation results showed a significant (p < 0.05) positive correlation between texture analysis and sensory hardness, springiness, adhesiveness, and negatively correlated to instrumental and sensory cohesiveness. For sensorial attributes, all PCB samples presented average scores of 7/10 and 4/5 for buying intention. Therefore, whole grain extrudates, date paste, and walnut grits can be efficiently used to develop PCB with improved nutritional, nutraceutical, and economic values

Chitosan- hypothalamic hormonal analogue nanoconjugates enhanced the reproductive performance in Indian major carp, Labeo rohita

The current study reports the potential of chitosan nanoparticles for the efficient delivery of hypothalamic hormonal analogue in Labeo rohita, aiming to improve reproductive performance. Here salmon gonadotropin-releasing hormone analogue (sGnRH-a) was conjugated with chitosan nanoparticles (ChN-sGnRH-a) to evaluate its efficiency in enhancing the reproductive gene expression, hormones as well as the overall reproductive output in L. rohita. A total of 54 pairs of brooders were selected and divided into six treatments viz; C0: Negative Control (fish injected with bare chitosan nanoparticles), C: Positive Control (fish injected with Gonopro-FH®, a commercially available inducing hormone, at a dose of 0.2 ml/kg body weight of fish), T1: fish injected with ChN-sGnRH-a at a dose of 0.2 ml/kg, T2: T1 + 10 mg/ml domperidone, T3: fish injected with ChN-sGnRH-a at a dose of 0.1 ml/kg, T4: T3 + 10 mg/ml domperidone. In T2 and T4 treatments, serum hormones, Testosterone (T); Estradiol (E2); Vitellogenin (Vtg); and 17α, 20β-dihydroxyprogesterone (17α, 20β-DHP) showed the sustained elevation. The means of reproductive traits like fecundity, fertilization rate, pseudo-gonadosomatic index and spawning rate were significantly (P&lt;0.05) higher in T2 treatment, while no significant difference was found between C and T4 treatment. The mRNA expression level of follicle-stimulating hormone (fshβ), luteinizing hormone (lhβ) and their cognate receptors was significantly better in T2 treatment, while no significant difference was found between T4 and C treatments. Further, the histological analysis of ovaries showed increased post-ovulatory follicles in C, T2 and T4 treatments. The results indicate that ChN-sGnRH-a could help in reducing the recommended dose of sGnRH-a without affecting the reproductive performance in L. rohita females. The sustained releasing mechanism of this formulation may be used as an induced breeding strategy in female L. rohita broodstock

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Molecular Cloning of Apicoplast-Targeted Plasmodium falciparum DNA Gyrase Genes: Unique Intrinsic ATPase Activity and ATP-Independent Dimerization of PfGyrB Subunit

DNA gyrase, a typical type II topoisomerase that can introduce negative supercoils in DNA, is essential for replication and transcription in prokaryotes. The apicomplexan parasite Plasmodium falciparum contains the genes for both gyrase A and gyrase B in its genome. Due to the large sizes of both proteins and the unusual codon usage of the highly AT-rich P. falciparum gyrA (PfgyrA) and PfgyrB genes, it has so far been impossible to characterize these proteins, which could be excellent drug targets. Here, we report the cloning, expression, and functional characterization of full-length PfGyrB and functional domains of PfGyrA. Unlike Escherichia coli GyrB, PfGyrB shows strong intrinsic ATPase activity and follows a linear pattern of ATP hydrolysis characteristic of dimer formation in the absence of ATP analogues. These unique features have not been reported for any known gyrase so far. The PfgyrB gene complemented the E. coli gyrase temperature-sensitive strain, and, together with the N-terminal domain of PfGyrA, it showed typical DNA cleavage activity. Furthermore, PfGyrA contains a unique leucine heptad repeat that might be responsible for dimerization. These results confirm the presence of DNA gyrase in eukaryotes and confer great potential for drug development and organelle DNA replication in the deadliest human malarial parasite, P. falciparum