Inhibitory effects of tibial nerve stimulation on bladder neurophysiology in rats

Tibial nerve stimulation (TNS) is a form of peripheral neuromodulation which has been found effective in treating overactive bladder symptoms, with lesser side effects than first line pharmacotherapy. Despite its widespread clinical use, the underlying mechanism of action is not fully understood. Our aim was to study its effect on the bladder neurophysiology and the trigger mechanism of voiding in the overactive detrusor, simulated by acetic acid (AA) instillation. In urethane anaesthetized male Wistar rats, the tibial nerve was stimulated for 30 min at 5 Hz, pulse width 200 µs and amplitude approximately three times the threshold to induce a slight toe movement. The pressure at which a voiding contraction was triggered (pthres) did not change significantly between the pre- and post-TNS measurements in AA induced detrusor overactivity. It was found that TNS significantly reversed the effects of AA irritation by increasing the bladder compliance and the bladder volume at pthres, as well as suppressed the threshold afferent nerve activity. The slope of the linear relationship between pressure and the afferent activity increased after AA instillation and decreased significantly after stimulation. In addition to its well-known central inhibitory mechanisms, this study has demonstrated that TNS improves bladder storage capacity by delaying the onset of voiding, via an inhibitory effect on the bladder afferent signaling at the peripheral level

Sustainable Agroecosystems for Livelihood Security in Indian Himalayas

Agroforestry systems are an age-old practice in the Indian Himalayan region. Agroforestry deals with the combination of tree species with crop plants, fisheries, animals, bee keeping, and so on, and it is based on the principle of optimum utilization of land. Agrihorticulture, silvihorticulture, hortipastoral, and silvipastoral systems are diversified land use options for agroforestry in the hill region. The study was conducted at experimental farm Hawalbagh (29o36′N and 79o 40′ E, 1250 m amsl) of Vivekananda Parvatiya Krishi Anusandhan Sansthan, Almora, India. Study in an agri-horti system revealed that ragi (Eluesine coracana) and soybean (Glysine max) during kharif (rainy season) and wheat (Triticum estivum) and lentil (Lens esculenta) during rabi (winter season) can be grown successfully with pecan nut (Carya illinoinensis) tree without significant reduction in the yield of the crop. However, grain yield of these crops was numerically higher in the field without pecan nut tree. In fruit-based agri-horti system four fruit crops, hill lemon (Citrus limon), pear (Pyrus communis), plum (Prunus domestica), and apricot (Prunus armeniaca) were planted with soybean in kharif and dual purpose wheat during rabi season. During initial years, no significant effect on grain yield was observed with the presence of different fruit trees. Green forage yield varied from 4600 to 5900 kg/ha in different treatments. In different treatments, ginger (Zingiber officinale) and turmeric (Curcuma longa), turmeric and taro (Colocasia esculenta), and two varieties of turmeric (Pant Pitabh and Swarna) were grown under Grewia optiva, Quercus leucotrichophora, Bauhinia variegata, and Celtis australis. Turmeric and ginger produced significantly higher yield (12.04 and 7.99 t/ha) under oak. The highest rhizome yield was obtained under Quercus leucotrichophora (11,738 kg/ha) followed by Bauhinia variegata. Pant Pitabh gave significantly higher yield (10,860 kg/ha) than swarna. Improved systems with five tree species, that is, Grewia optiva, Quercus leucotrichophora, Bauhinia retusa, Melia azedarach, and Morus alba and four grasses, that is, Setaria kazugulla, Setaria nandi, Congo signal, and Broad leaf paspalum (Paspalum spp.) were tested under the silvipastoral system. Quercus leucotrichophora yielded (10,675 kg/ha) significantly higher green biomass than others, and the lowest green biomass was harvested from Grewia optiva. Among grasses, Setaria nandi produced the highest green forage (6234 kg/ha). Thus, in hilly terrain, planting of interspatial woody perennials, with least negative influences on the agronomic crops, seems productive in agroforestry system for settled farming. Therefore, agroforestry is a set of land use alternative, which if developed for resource poor farmers, can provide increased values and reduced risks and it should be made more popular in the rural areas

The frequency spectrum of bladder non-voiding activity as a trigger-event for conditional stimulation: Closed-loop inhibition of bladder contractions in rats

Aims: To test the hypothesis that the frequency of bladder non-voiding contractions (NVCs) can be used as a trigger event for closed-loop conditional inhibition of detrusor contractions via tibial nerve (TN) or dorsal penile nerve (DPN) stimulation. Methods: In urethane anaesthetized male Wistar rats, the bladder was filled continuously with saline to evoke contractions. To test the plausibility of conditional inhibition via the TN, electrical stimulation was switched on manually when the pressure increased above a threshold of 10 cmH20 above the baseline. For testing conditional stimulation via the DPN, the pressure signal was continuously stored and a baseline threshold, the area under the curve (AUC) of the amplitude spectrum in the 0.2–20 Hz range of a 5 s window at the beginning of filling was calculated. When the AUC of subsequent pressure windows superseded the baseline threshold, the DPN was automatically stimulated. Results: TN stimulation failed to inhibit evoked voiding contractions. The NVC frequency spectrum based DPN stimulation successfully inhibited 70% of the evoked contractions and resulted in a 45% increase in bladder capacity (BC). Conclusions: While, conditional TN stimulation failed to suppress bladder contractions, DPN stimulation, automatically triggered by an increased frequency of bladder non-voiding activity, resulted in bladder inhibition, and a consequential increase in BC. This study demonstrates the plausibility of using the frequency of NVCs as a trigger event for conditional inhibition of detrusor contractions

Climatic Variation and Its Impacts on Yield and Water Requirement of Crops in Indian Central Himalaya

Climate is most important factor affecting agriculture, and issues related to climate and its implications have attracted attention of policy makers globally. The farm sector, particularly marginal ecosystems in mountains are vulnerable because of unpredictable variation and severe sink limitations. Efforts to impart resilience to farm and its allied sector are an urgent need. The climatic parameters play very important role to determine type of crops, cattle rearing and the life style adopted by the people. Moreover, weather has a significant impact on crop growth and development. Weather plays a vital role and affects the production and productivity of the crops. According to an estimate, weather contributes 67% variation in productivity and rest of the factors (soil, nutrient and management practices etc.) accounts for 33%. Therefore, there is a need of in-depth analysis of each meteorological parameters and identification of their trend over the years in order to identify and adapt suitable agriculture practices, better adaptable crops, varieties and their duration, time of field preparation, sowing time and irrigation as per the climatic conditions of the region. This will lead farming community to plan strategies of agriculture operation to obtain optimum yield. The climatic data from the meteorological observatory of ICAR-VPKAS, Hawalbagh located at mid hill condition (1250 m amsl) were analyzed for different periods (annual, seasonal, monthly, weekly). It was revealed that rainfall is decreasing over the years but significant (P < 0.05) decrease was recorded at mid hills. The maximum temperature is increasing significantly (P < 0.05) during post-monsoon and winter season however decreasing in monsoon season whereas minimum temperature is decreasing round the year. These changes in rainfall and temperatures are affecting production and productivity of the crops, as hills are largely rainfed. In terms of crop water demand, there is no need to apply irrigation during the rainy season except the transplanted rice. However, during the winter season as there is more than 60% of water deficit to irrigate the crops. The proper understanding of climate is necessary to bring sustainability in hill agriculture by adjusting crop sowing window and other operations as per suitability of the climate

Neurophysiological modeling of bladder afferent activity in the rat overactive bladder model

The overactive bladder (OAB) is a syndrome-based urinary dysfunction characterized by “urgency, with or without urge incontinence, usually with frequency and nocturia”. Earlier we developed a mathematical model of bladder nerve activity during voiding in anesthetized rats and found that the nerve activity in the relaxation phase of voiding contractions was all afferent. In the present study, we applied this mathematical model to an acetic acid (AA) rat model of bladder overactivity to study the sensitivity of afferent fibers in intact nerves to bladder pressure and volume changes. The afferent activity in the filling phase and the slope, i.e., the sensitivity of the afferent fibers to pressure changes in the post-void relaxation phase, were found to be significantly higher in AA than in saline measurements, while the offset (nerve activity at pressure ~0) and maximum pressure were comparable. We have thus shown, for the first time, that the sensitivity of afferent fibers in the OAB can be studied without cutting nerves or preparation of single fibers. We conclude that bladder overactivity induced by AA in rats is neurogenic in origin and is caused by increased sensitivity of afferent sensors in the bladder wall

ELECtric Tibial nerve stimulation to Reduce Incontinence in Care homes: protocol for the ELECTRIC randomised trial

Background Urinary incontinence (UI) is highly prevalent in nursing and residential care homes (CH) and profoundly impacts on residents’ dignity and quality of life. Care homes predominantly use absorbent pads to contain UI rather than actively treat the condition. Transcutaneous posterior tibial nerve stimulation (TPTNS) is a non-invasive, safe, low-cost intervention with demonstrated effectiveness for reducing UI in adults. However, the effectiveness of TPTNS to treat UI in older adults living in care homes is not known. The ELECTRIC Trial aims to establish if a programme of TPTNS is a clinically effective treatment for UI in care home residents and investigate the associated costs and consequences. Methods This is a pragmatic, multicentre, placebo controlled randomised parallel group trial comparing effectiveness of TPTNS (target n=250) with sham stimulation (target n=250) in reducing volume of UI in CH residents. CH residents (men and women) with self- or staff- reported UI of more than once per week are eligible to take part, including those with cognitive impairment. Outcomes will be measured at 6, 12 and 18 weeks post randomisation using the following measures: 24-hour pad weight tests (PWT), post void residual urine (bladder scans), Patient Perception of Bladder Condition (PPBC), Minnesota Toileting Skills Questionnaire (MTSQ) and Dementia Quality of Life (DEMQOL). Economic evaluation based on a bespoke Resource Use Questionnaire will assess the costs of providing a programme of TPTNS. A concurrent process evaluation will investigate fidelity to the intervention and influencing factors and qualitative interviews will explore the experiences of TPTNS from the perspective of CH residents, family members, CH staff and managers. Discussion TPTNS is a non-invasive intervention that has demonstrated effectiveness in reducing UI in adults. The ELECTRIC Trial will involve CH staff delivering TPTNS to residents and establish whether TPTNS is more effective than sham stimulation for reducing the volume of UI in CH residents. Should TPTNS be shown to be an effective and acceptable treatment for UI in older adults in CHs, it will provide a safe, low-cost and dignified alternative to the current standard approach of containment and medication. Trial registration Clinical Trials.gov. NCT03248362. Registered on 14/08/2017. https://clinicaltrials.gov/ ISRCTN, ISRCTN 98415244. Registered on 25/04/2018. https://www.isrctn.com

A Prospective Observational Study to Evaluate the Prevalence and Clinical Correlation of Skin Lesions in Patients with Diabetes Mellitus

Background: Diabetes mellitus (DM) is a metabolic disorder corresponding to a relative-to-complete insulin deficiency.&nbsp; Materials and Methods: Evaluation of a total of 423 patients with confirmed diagnosis of diabetes mellitus reporting to OPD section of the hospital. The patients were evaluated for the presence of any skin lesion over a period of 12 months. The confirmation of diabetes was done using blood tests. Detail evaluation of demographic profile and clinical manifestations were carried out. A Performa was made and details of clinical examination were recorded separately. Prevalence of any type of cutaneous lesions was recorded. Results: The overall prevalence of skin lesions was 23.64 percent. 30 patients had type 1 DM and 70 patients had type 2 DM. Pruritis (n=30) and cutaneous infections (n=22) were most common cutaneous manifestations in patients with DM. Achordons were also common in diabetic patients. It was observed that fungal infections comprised of 68.18 % of cutaneous infections, bacterial infections comprised of 22.72 %. Viral infections were least common (9.1%). Conclusion:&nbsp; Within the limitations of the present study, it can be concluded that cutaneous infections and pruritis are significantly prevalent conditions in diabetic patients

Not Available

Not AvailableAlleviation of malnutrition has been known as one of the goal for achieving hunger-free world. It is recognized as Sustainable Development Goals-2 (SDG-2) out of 17 identified goals. The importance of nutritional and food security can be realized by the fact that out of 17 SDGs, 12 are related to nutrition signifying its value in health, education, employment and female empowerment sectors. Micronutrient deficiency remains hidden, especially in children of middle age and appears when it becomes severe. Around 155 million children of less than 5 years are stunted, whereas 52 million are wasted. Reducing anti-nutrients and promoting biofortified crops hold great promise for health and wellbeing of increasing human population and to combat micronutrient deficiency.Not Availabl

Not Available

Not AvailableAzolla is a multifaceted aquatic resource to ensure ecosystem sustainability in Himalayan region. High nutritious value (on a dry weight basis, it contains 25-30% protein, 10-15% minerals and 7-10% of amino acids, bioactive substances and biopolymers), and easily digestible nutritional composition makes it a highly efficient and effective feed for livestock and other animals. Nitrogen fixing potential of Azolla varies between 30 and 50 kg N ha−1 which designates Azolla as an important biological N source for agriculture and animal industry. Judicious application of azolla with Sesbania as green manure had valuable residual effects on subsequent wheat crops, enhance the ~ 50 to 60% crop productivity as compared to control conditions. Azolla exhibits high bioremediation potential for various heavy metals like cadmium, Chromium, Copper, and Zinc. Azolla mitigates greenhouse gas emission from agriculture. This review highlighted integrated approach using Azolla and its multiple uses that offers enormous public health, environmental, and cost benefits.Not Availabl