Clinical presentation and outcome of ectopic pregnancies in a tertiary care rural hospital

Background: Ectopic pregnancy is the commonest cause of the maternal morbidity and mortality in the first trimester of the pregnancy. The aim of this study was to see the clinical presentation, associated risk factors, mode of treatment and outcome.Methods: Retrospective study conducted in a tertiary care rural hospital. Women with diagnosis of ectopic pregnancy admitted between August 2016 to September 2018 were studied. Medical record files were scrutinized to get the details. Data was analyzed using Microsoft Office Excel (version 2007). Numerical data were subjected to descriptive analysis, with mean±standard deviation (SD) and categorical data as frequency and percentage.Results: Forty cases of ectopic pregnancy were included who were unbooked, non-smokers, married and belonged to rural areas. Eighty percent were in the age group of 20 to 30 years.  Maximum were gravida 3 or 4 with commonest presentation was pain, site was tubal. Laparotomy was done in 95% of women salpingectomy was the commonest surgical procedure done in 32 (80%) women. Salpingoophrectomy was done in one woman and lifesaving hysterectomy in 2 (5%) women for cervical and ruptured interstitial ectopic pregnancy one each. Blood transfusion was required in 28 (70%) women. No mortality was seen.Conclusions: Women of reproductive age group with pain abdomen and menstrual complaints, even without amenorrhoea, ectopic pregnancy should be ruled out. Treating reproductive tract infections / PID and offering contraceptives will decrease the incidence of ectopic pregnancy. Medical and paramedical staff should do the timely referral to higher centres

Effects of Two Different Catheter Ablation Techniques on Spectral Characteristics of Atrial Fibrillation

ObjectivesThe aim of this study was to determine the effects of circumferential pulmonary vein ablation (CPVA) and electrogram-guided ablation (EGA) on the spectral characteristics of atrial fibrillation (AF) and the relationship between changes in dominant frequency (DF) and clinical outcome.BackgroundCircumferential pulmonary vein ablation and EGA have been used to eliminate AF. Spectral analysis may identify high-frequency sources.MethodsIn 84 consecutive patients, CPVA (n = 42) or EGA (n = 42) was performed for paroxysmal (n = 49) or persistent (n = 35) AF. During EGA, complex electrograms were targeted. Lead V1and electrograms from the left atrium and coronary sinus were analyzed to determine the DF of AF before and after ablation.ResultsThe left atrial DF was higher in persistent (5.83 ± 0.86 Hz) than paroxysmal AF (5.33 ± 0.76 Hz, p = 0.03). There was a frequency gradient from the left atrium to the coronary sinus (p = 0.02). Circumferential pulmonary vein ablation and EGA resulted in a similar decrease in DF (18 ± 17% vs. 17 ± 15%, p = 0.8). During a mean follow-up of 9 ± 6 months, the change in DF after CPVA was similar among patients with and without recurrent AF. An acute decrease in DF after EGA was associated with freedom from recurrent AF only in patients with persistent AF (19 ± 14% vs. 3 ± 6%, p = 0.02).ConclusionsBoth CPVA and EGA decrease the DF of AF, consistent with elimination of high-frequency sources. Whereas the efficacy of EGA is associated with a decrease in DF in patients with persistent AF, the efficacy of CPVA is independent of changes in DF. This suggests that CPVA and EGA eliminate different mechanisms in the genesis of persistent AF

Interplay between actomyosin and E-cadherin dynamics regulates cell shape in the Drosophila embryonic epidermis

Precise regulation of cell shape is vital for building functional tissues. Here, we study the mechanisms which lead to the formation of highly elongated anisotropic epithelial cells in the Drosophila epidermis. We demonstrate that this cell shape is the result of two counteracting mechanisms at the cell surface which regulate the degree of elongation: actomyosin, which inhibits cell elongation downstream of RhoA signalling, and intercellular adhesion, modulated via clathrin-mediated endocytosis of E-cadherin, which promotes cell elongation downstream of the GTPase Arf1. We show that these two mechanisms do not act independently but are interconnected, with RhoA signalling reducing Arf1 recruitment to the plasma membrane. Additionally, cell adhesion itself regulates both mechanisms: p120-catenin, a regulator of intercellular adhesion, promotes the activity of both Arf1 and RhoA. Altogether, we uncover a complex network of interactions between cell-cell adhesion, the endocytic machinery, and the actomyosin cortex, and demonstrate how this network regulates cell shape in an epithelial tissue in vivo

Terminal heat stress in Indian mustard (Brassica juncea L.): Variation in dry matter accumulation, stem reserve mobilization, carbohydrates translocation and their correlation with seed yield

423-431The rapeseed mustard is one of the most important sources of edible oil in India and contributes 28.6% in total oilseed production. The mustard growing areas in India are experiencing the vast diversity in the agro climatic conditions. Here, we studied forty-nine advanced breeding lines of Brassica juncea L. for two consecutive years (2016-18) to examine the variations in the remobilization of assimilates from flowering to maturity stage and their contribution to seed filling under stressed environment. Further, we investigated the impact of high temperature on dry matter accumulation and partitioning from source to sink in Brassica germplasm. The synchronization between the seed filling stage and the onset of heat spell is critical event that determines the overall yield. Imbalances caused due to miss-matching of above events created hindrance in source-sink translocation, thus resulted in yield losses. Amount of remobilized dry matter, remobilization efficiency and remobilization percentage increased significantly, while the dry matter accumulation, total carbohydrates content and seed yield per plant declined in the late sown genotypes during both crop seasons. Reduced accumulation of photo assimilates under stress and higher sink demand resulted in more number of shriveled seeds leading to yield depression. The higher remobilization efficiency in late sown genotypes was strongly associated with dry matter at flowering that consequently tended to affect the final seed weight. This study will provide insights for better understanding of source-sink relationships in Indian mustard under heat stress and the differential remobilization efficiencies in the advanced breeding lines

Terminal heat stress in Indian mustard (Brassica juncea L.): Variation in dry matter accumulation, stem reserve mobilization, carbohydrates translocation and their correlation with seed yield

The rapeseed mustard is one of the most important sources of edible oil in India and contributes 28.6% in total oilseed production. The mustard growing areas in India are experiencing the vast diversity in the agro climatic conditions. Here, we studied forty-nine advanced breeding lines of Brassica juncea L. for two consecutive years (2016-18) to examine the variations in the remobilization of assimilates from flowering to maturity stage and their contribution to seed filling under stressed environment. Further, we investigated the impact of high temperature on dry matter accumulation and partitioning from source to sink in Brassica germplasm. The synchronization between the seed filling stage and the onset of heat spell is critical event that determines the overall yield. Imbalances caused due to miss-matching of above events created hindrance in source-sink translocation, thus resulted in yield losses. Amount of remobilized dry matter, remobilization efficiency and remobilization percentage increased significantly, while the dry matter accumulation, total carbohydrates content and seed yield per plant declined in the late sown genotypes during both crop seasons. Reduced accumulation of photo assimilates under stress and higher sink demand resulted in more number of shriveled seeds leading to yield depression. The higher remobilization efficiency in late sown genotypes was strongly associated with dry matter at flowering that consequently tended to affect the final seed weight. This study will provide insights for better understanding of source-sink relationships in Indian mustard under heat stress and the differential remobilization efficiencies in the advanced breeding lines

Effect of elevated temperature on phenology, growth, yield components and seed yield of Brassica juncea grown in temperature gradient tunnels (TGT)

Elevated temperature is one of the major production constraints of Indian mustard. The present study was aimed to estimate variations in phenology, yield attributes and seed yield under elevated temperature (ET) in temperature gradient tunnels (TGT) and open field for heat tolerance. Fourteen genotypes consisting of introgression lines and the mustard varieties were sown in TGT and open field for two consecutive winter seasons (2017-2019).The phenophases were shortened due to elevated temperature in TGT as compared to control except physiological maturity which was trailed by 17-18 days during both the years. Temperature affect was most severe on siliqua formation and seed filling. Among growth parameters only length of main shoot suffered reduction whereas yield contributing parameters like siliqua on main shoot, siliquae plant-1, seeds siliqua-1 and 1000 seed weight along with biomass, seed yield and  harvest index suffered significant decline in TGT. Average temperature had positive correlation with all phenological parameters except flowering completion, growth parameters except number of primary and secondary branches while yield attributes only with 1000 seed weight, biomass and seed yield under TGT. Interestingly, number of primary branches had significant negative correlation with average temperature under both control (r=-0.59*) and TGT (-0.61*). Phenological traits had strong relationship with seed yield under TGT. However, seed yield had strong relationship with growth parameters, yield attributes under control except for number of primary branches. Biomass had strong relationship with seed yield under both TGT (R2= 0.51) and control (R2= 0.43). Two years testing revealed introgression lines (JA24 and JA53) and varieties (JD6 and Giriraj) tolerant to heat stress

Recent Development and Review on Botanicals from Plants to Stored Grains

There have been numerous reports of insect infestations being connected to grains that have been stored. Almost all species multiply at astonishingly fast rates and may even reproduce sexually. About 10-15% of the grain is destroyed, and the remaining portion is tainted with unpleasant smells and scents. Beetles (Callosobrunchus sp., Trogoderma granarium, and Tribolium confusum), weevils (Sitophilus oryzae, S. granarius, etc.), moths (Corcyra cephalonica), rats, and weevils are the main pests of stored grains. Botanical extracts have antifeedant and arrestant properties, kill and repel pests, and have an impact on insect growth and development. The indiscriminate and ongoing use of pesticides has resulted in the accumulation of hazardous residues on food grains used for human consumption as well as the emergence of resistant breeds of pests. Recently, attention has been focused on using plant products as a novel strategy for protecting grains in many parts of the world. The bioactivity of plant derivatives against several pests found in storage has already been reported in numerous scientific literature. Because of their generally safe antimicrobial properties, higher plants like neem have also been utilized as antibacterials against storage pests. People have utilized a variety of herbs and spices (such as turmeric, garlic, and cloves, among others) to manage storage pests. Plant-based products might be able to address issues with synthetic pesticides like resistance, cost, availability, and health hazards. More study is required to determine the effectiveness of biocontrol and the practical applicability of botanical insecticides. It is important to do biosafety studies to determine how dangerous they are to people, animals, and crop plants. As different insect life stages cause financial harm and degrade the quality of food grains and food products, infestation of stored grains is a highly important issue. Due to unmanaged environmental conditions and subpar warehousing technologies, numerous stored grain insect pests infest food grains in farmer stores and public warehouses. However, very specific and more suitable current measures should be applied to control the expanding insect population. Since the beginning of time, botanicals have been employed to protect stored goods from prevalent pests. By acting as chemosterilants or insect growth and development inhibitors, they operate as repellents, anti feedants, toxicants, and natural grain protectants

Mycobacterium tuberculosis strain with deletions in menT3 and menT4 is attenuated and confers protection in mice and guinea pigs

Abstract The genome of Mycobacterium tuberculosis encodes for a large repertoire of toxin-antitoxin systems. In the present study, MenT3 and MenT4 toxins belonging to MenAT subfamily of TA systems have been functionally characterized. We demonstrate that ectopic expression of these toxins inhibits bacterial growth and this is rescued upon co-expression of their cognate antitoxins. Here, we show that simultaneous deletion of menT3 and menT4 results in enhanced susceptibility of M. tuberculosis upon exposure to oxidative stress and attenuated growth in guinea pigs and mice. We observed reduced expression of transcripts encoding for proteins that are essential or required for intracellular growth in mid-log phase cultures of ΔmenT4ΔT3 compared to parental strain. Further, the transcript levels of proteins involved in efficient bacterial clearance were increased in lung tissues of ΔmenT4ΔT3 infected mice relative to parental strain infected mice. We show that immunization of mice and guinea pigs with ΔmenT4ΔT3 confers significant protection against M. tuberculosis infection. Remarkably, immunization of mice with ΔmenT4ΔT3 results in increased antigen-specific TH1 bias and activated memory T cell response. We conclude that MenT3 and MenT4 are important for M. tuberculosis pathogenicity and strains lacking menT3 and menT4 have the potential to be explored further as vaccine candidates

Inorganic polyphosphate accumulation suppresses the dormancy response and virulence in Mycobacterium tuberculosis

Stringent response pathways involving inorganic polyphosphate (PolyP) play an essential role in bacterial stress adaptation and virulence. The intracellular levels of PolyP are modulated by the activities of polyphosphate kinase-1 (PPK1), polyphosphate kinase-2 (PPK2), and exopolyphosphatases (PPXs). The genome of Mycobacterium tuberculosis encodes two functional PPXs, and simultaneous deletion of ppx1 and ppx2 results in a defect in biofilm formation. We demonstrate here that these PPXs cumulatively contribute to the ability of M. tuberculosis to survive in nutrient-limiting, low-oxygen growth conditions and also in macrophages. Characterization of single (Delta ppx2) and double knockout (dkppx) strains of M. tuberculosis indicated that PPX-mediated PolyP degradation is essential for establishing bacterial infection in guinea pigs. RNA-Seq-based transcriptional profiling revealed that relative to the parental strain, the expression levels of DosR regulon-regulated dormancy genes were significantly reduced in the dkppx mutant strain. In concordance, we also provide evidence that PolyP inhibits the autophosphorylation activities associated with DosT and DosS sensor kinases. The results in this study uncover that enzymes involved in PolyP homeostasis play a critical role in M. tuberculosis physiology and virulence and are attractive targets for developing more effective therapeutic interventions

Global burden of stroke and risk factors in 188 countries, during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Background - The contribution of modifiable risk factors to the increasing global and regional burden of stroke is unclear, but knowledge about this contribution is crucial for informing stroke prevention strategies. We used data from the Global Burden of Disease Study 2013 (GBD 2013) to estimate the population-attributable fraction (PAF) of stroke-related disability-adjusted life-years (DALYs) associated with potentially modifiable environmental, occupational, behavioural, physiological, and metabolic risk factors in different age and sex groups worldwide and in high-income countries and low-income and middle-income countries, from 1990 to 2013. Methods - We used data on stroke-related DALYs, risk factors, and PAF from the GBD 2013 Study to estimate the burden of stroke by age and sex (with corresponding 95% uncertainty intervals [UI]) in 188 countries, as measured with stroke-related DALYs in 1990 and 2013. We evaluated attributable DALYs for 17 risk factors (air pollution and environmental, dietary, physical activity, tobacco smoke, and physiological) and six clusters of risk factors by use of three inputs: risk factor exposure, relative risks, and the theoretical minimum risk exposure level. For most risk factors, we synthesised data for exposure with a Bayesian meta-regression method (DisMod-MR) or spatial-temporal Gaussian process regression. We based relative risks on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks, such as high body-mass index (BMI), through other risks, such as high systolic blood pressure (SBP) and high total cholesterol. Findings - Globally, 90·5% (95% UI 88·5–92·2) of the stroke burden (as measured in DALYs) was attributable to the modifiable risk factors analysed, including 74·2% (95% UI 70·7–76·7) due to behavioural factors (smoking, poor diet, and low physical activity). Clusters of metabolic factors (high SBP, high BMI, high fasting plasma glucose, high total cholesterol, and low glomerular filtration rate; 72·4%, 95% UI 70·2–73·5) and environmental factors (air pollution and lead exposure; 33·4%, 95% UI 32·4–34·3) were the second and third largest contributors to DALYs. Globally, 29·2% (95% UI 28·2–29·6) of the burden of stroke was attributed to air pollution. Although globally there were no significant differences between sexes in the proportion of stroke burden due to behavioural, environmental, and metabolic risk clusters, in the low-income and middle-income countries, the PAF of behavioural risk clusters in males was greater than in females. The PAF of all risk factors increased from 1990 to 2013 (except for second-hand smoking and household air pollution from solid fuels) and varied significantly between countries. Interpretation - Our results suggest that more than 90% of the stroke burden is attributable to modifiable risk factors, and achieving control of behavioural and metabolic risk factors could avert more than three-quarters of the global stroke burden. Air pollution has emerged as a significant contributor to global stroke burden, especially in low-income and middle-income countries, and therefore reducing exposure to air pollution should be one of the main priorities to reduce stroke burden in these countries