Blood transfusion practices in obstetrics and gynecology: study of indications as a measure to prevent maternal morbidity and mortality

Background: This is a study of rational use of blood transfusion in a tertiary care center. So, this study was done to find out the indications of blood transfusion in department of obstetrics and gynaecology and measures to minimize the requirement of blood transfusion to reduce maternal mortality and morbidity.Methods: This is a retrospective study in department of obstetrics and gynaecologyin Muzaffarnagar Medical College, Muzaffarnagar, U.P. in collaboration with the department of pathology including blood bank for the duration of 1 year i.e. 1st January, 2017 to 31st December, 2017.  Total transfusions in 1 year were 706 of which 406 were in obstetrics and 300 were in gynecology.Results: In our study maximum 16.20% blood transfusions were given during cesarean section in third trimester in unbooked cases who came with severe anemia in labour. Others were APH (12%) and abortions (13.05%). This shows that anemia is still a major cause of maternal mortality and morbidity in India. In Gynecological cases blood transfusion was more in third parity and above indicating that perimenopausal women were also more susceptible for anemia due to disease of perimenopausal age group like AUB and fibroid.Conclusions: Maximum number of transfusions specially PRBC in obstetrics were of moderate to severe anemia, mainly to the patients who were term or in labor and of high-risk pregnancies, who were unbooked with no antenatal care. In Gynecology cases, blood transfusion was of perimenopausal or menopausal group with moderate anemia. This comes to the conclusion that all preventive measures should be taken in females from womb to tomb to correct anemia and this will indirectly help to prevent maternal and perinatal morbidity and mortality

RATIONALITY BEHIND AYURVEDA COMPOUND FORMULATIONS- A BIRDS EYE VIEW

Ayurveda is Indian heritage system of medicine gifted by ancient Acharya. It provides scientific approach for dealing human health issues with tools of nature like herbs, minerals, metals etc. It states that every substance in the universe can be applied as medicine with the help of Yukti or logical approach of physicians. In present era, whole world is looking towards Ayurveda for its novel natural healing modalities to get relief from their ailments whether physical or mental. Hence here is the need for development of more numbers of Ayurveda formulations to overcome the different health hazard. Moreover invention of more formulations for newly developed diseases like cancer, AIDs, dengue etc. is also needed. But these herbal preparations also face problems like adulteration, non-availability in a particular area or extinction of herbs due to excessive use of a particular herb. On this background present study was undertaken to analyse the fundamental rationality behind Ayurveda formulations mentioned in various ancient transcripts. Literary data regarding evolving a formulation was scrutinized with examples of important formulations mentioned in various texts. This study results out that for developing a particular formulation, factors like availability, palatability, potency, safety, efficacy etc. should be considered.

A non-linear approach to the establishment of local biological control agent production units: a case study of fall armyworm in Bangladesh

Abstract Background Strides have been made in Bangladesh to promote the utilisation of biological control agents (BCAs), however farmer utilisation remains sub-optimal. The establishment of local BCA production hubs, although touted as a panacea to this problem, has no proven business case. This study makes the case for a non-linear business model. Methods Qualitative and quantitative data from maize growing areas in Bangladesh was collected via telephone interviews from key informants representing four key stakeholders—national research institute, regional research stations, farmer producer organisations and agro-dealers. Results Farmer uptake of BCAs in Bangladesh for FAW management is hindered by several factors—lack of BCAs availability in local markets, negative farmer and agro-dealer perceptions, poor input industry linkages for the supply of BCAs products to agro-dealers and inadequate institutional finances for capacity building of and technical support by research scientists and extension agents. Given these challenges to BCAs uptake, an innovation systems-based business model that links researchers, extensionists, agro-dealers and farmer producer organizations  in a non-linear pathway is proposed for Bangladesh. This translates into the establishment of local BCA production hubs owner-managed by farm entrepreneurs, with scientists providing them with nucleus culture, while extension services provide technical support for quality assurance. The interaction between all stakeholders is non-linear with all actors intellectually consulted and engaged, with technical capacity on BCAs available for any actor requiring it. Multi-disciplinary research, that takes into account feedback from stakeholders, complements the process thus generating robust and relevant knowledge for feedbacking to improve the business model, capacity building initiatives and farmer engagement. Conclusions Mentoring and capacity building leveraged via engagement of research institutions; and demonstration of technology use and guidance utilising extension services and agro-dealer networks, will promote the utilisation of BCAs for FAW management and enable local farm entrepreneurs to meet the increased demand via establishment of local BCA production hubs

Biopesticides Manual

This manual aims to make information resources and technical advice available in order to support the deployment of biopesticides, which include microbials (e.g. bacteria, algae, protozoa, viruses and fungi), macrobials (e.g. predatory insects, parasitoids and beneficial nematodes), botanicals, and semiochemicals. It is intended to be a one-stop shop to address the information needs of the key groups who are responsible for selecting, sourcing and using biopesticides in the tobacco production system. Chapter 2 provides information for decision makers to support selection of biopesticide active substances. It also provides guidelines for trial managers on experimental design, data collection and reporting. Chapter 3 provides guidance for sourcing biopesticides. It also includes manuals for the local production of three types of biopesticide: Trichogramma; neem [Azadirachta indica]; and fungal biopesticides such as Trichoderma. Chapter 4 presents training materials to provide an overview of biopesticides in general together with detailed information on how to work with the key biopesticides that have already been used successfully to manage key pests in tobacco

Risk of Aneurysm Rupture (ROAR) study: protocol for a long-term, longitudinal, UK multicentre study of unruptured intracranial aneurysms

Introduction Unruptured intracranial aneurysms (UIA) are common in the adult population, but only a relatively small proportion will rupture. It is therefore essential to have accurate estimates of rupture risk to target treatment towards those who stand to benefit and avoid exposing patients to the risks of unnecessary treatment. The best available UIA natural history data are the PHASES study. However, this has never been validated and given the known heterogeneity in the populations, methods and biases of the constituent studies, there is a need to do so. There are also many potential predictors not considered in PHASES that require evaluation, and the estimated rupture risk is largely based on short-term follow-up (mostly 1 year). The aims of this study are to: (1) test the accuracy of PHASES in a UK population, (2) evaluate additional predictors of rupture and (3) assess long-term UIA rupture rates.Methods and analysis The Risk of Aneurysm Rupture study is a longitudinal multicentre study that will identify patients with known UIA seen in neurosurgery units. Patients will have baseline demographics and aneurysm characteristics collected by their neurosurgery unit and then a single aggregated national cohort will be linked to databases of hospital admissions and deaths to identify all patients who may have subsequently suffered a subarachnoid haemorrhage. All matched admissions and deaths will be checked against medical records to confirm the diagnosis of aneurysmal subarachnoid haemorrhage. The target sample size is 20 000 patients. The primary outcome will be aneurysm rupture resulting in hospital admission or death. Cox regression models will be built to test each of the study’s aims.Ethics and dissemination Ethical approval has been given by South Central Hampshire A Research Ethics Committee (21SC0064) and Confidentiality Advisory Group support (21CAG0033) provided under Section 251 of the NHS Act 2006. The results will be disseminated in peer-reviewed journals.Trial registration number ISRCTN17658526