Acceptability of contraceptive methods in lactating mothers in a tertiary centre

Background: High fertility rate, high maternal mortality and high infant mortality rates are the shared problems of the all the developing countries of the world. According to Directorate of Health Services surveys, 40% of women who intend to use a family planning method in the first year postpartum are not using one. Contraceptive use is negligible among postpartum women, particularly young mothers. We aimed  to determine the reasons for acceptability, non-acceptability, side effects and continuation  of four contraceptive methods condoms, Depotmedroxyprogesterone acetate, (DMPA), copper intrauterine  contraceptive devices (IUCD), progesterone only pills (POPs) in lactating mother after 6 weeks of delivery. Methods: A total of 200 healthy nursing mothers, who needed contraception were enrolled in this prospective observational study. Women were explained about all four contraceptive methods used for the study. The reason for accepting a particular method was sought. The study participant were followed up at third and sixth month and side effects, failure rate, continuation rates, reasons for discontinuation of method were assessed. Results: The most acceptable method was condom (40.5%) followed by DMPA (31%), IUCD (20.5%) and POPs (8%). The most common reason for selection of condom was fear of side effects with other methods (66%). Long acting method like DMPA and IUCD has good continuation rate of 87% and 85% respectively. Failure of contraception was seen only with condoms (2.8%). Conclusions: This study showed condoms was most acceptable method but had failure whereas DMPA and Cu-IUCD have high continuation rate with no failure

Are we really decreasing maternal mortality rate or we are just pushing mothers to late maternal deaths?

Maternal mortality remains a global concern, and India has made substantial strides in reducing maternal mortality rates (MMR) by about 70%, from 398 /lakh live births in 1997-98 to 99 /lakh live births in 2020. However, it is recognized that maternal mortality represents only tip of iceberg. For every woman who dies, many more survive with severe morbidities, and their long-term outcomes often go unrecorded. Therefore, to truly evaluate maternal health services, it is essential to analyze the long-term outcomes of women discharged with morbidities resulting from complications of pregnancy and childbirth, known as maternal near-miss cases

Impact of climate change on medicinal and aromatic plants: Review

There has been worldwide changes in seasonal patterns, weather events, temperature ranges, and other related phenomena and all have been analyzed in partial, reported and attributed to global climate change. The negative impacts of climate change will become much more intense and frequent in the future—particularly if environmentally destructive human activities continue unabated, warned categorically by a number of experts in a wide range of scientific disciplines and interests. Medicinal and aromatic plants (MAPs) are not immune to the effects of climate change like all other living members of the biosphere. Clear signals are coming on climate change impact which is causing noticeable effects on the lifecycles and distributions of the world’s vegetation, including wild MAPs across the world. This in turn causing some MAPs endemic to geographic regions or ecosystems which could put them at risk and are particularly vulnerable to climate change. Such serious issues and challenges are a continuous concern with regard to the survival and genetic integrity of some MAPs and are being discussed within various forum and platform. Further, such issues of climate change will definitely pose a more prominent or immediate threat to MAP species than other threats, however, scientists do not know whether climate change has the potential to exert increasing pressures  upon MAP species and populations. Climate change impact may have a tremendous possible effect on MAPs particularly significant due to their value within traditional systems of medicine and as economically useful plants. At this stage, the future effects of climate change are largely uncertain more so with MAPs, but current evidence suggests that these phenomena are having an impact on MAPs and that there are some potential threats worthy of concern and discussion

Role of imaging modalities in diagnosis of silent caesarean scar ectopic pregnancy after ovulation induction: a case report

There has been an increased prevalence of ectopic pregnancies in the present scenario attributing to 1.5-2% of all pregnancies. Caesarean scar pregnancies are rare, occurring in approximately 1 in 2000 pregnancies, although the incidence is increasing. The increasing rate of caesarean scar ectopic pregnancies mirrors the increasing rate of caesarean delivery. Disruption of the endometrium and myometrium after caesarean delivery predisposes to improper implantation at the site of the prior hysterotomy. Without normal surrounding myometrium, untreated caesarean scar ectopic pregnancies can result in uterine rupture with severe maternal hemorrhage and death. Although ultrasound remains the primary imaging modality for this diagnosis, MRI may be useful in the setting of equivocal cases and also may aid in the detection of possible placental implantation or bladder wall invasion. An MRI may provide additional confirmation of the ultrasound findings and characterize the myometrial interface if the pregnancy is difficult to distinguish from other pregnancy complications such as a cervical ectopic pregnancy or consideration for expectant management of pregnancy is considered

Improvement in nitrogen use efficiency: physiological and molecular approacheses

Nitrogen deficiency in agricultural systems is a world-wide problem. It is true of the Indian scenario as well. The utilization efficiency of nitrogenous fertilizers under field conditions is poor. This results in loss of a costly input and accentuates the environmental degradation. In this paper, the present status of our knowledge on physiological and molecular approaches to improve nitrogen utilization efficiency at the level of its uptake, assimilation and relationship to photosynthesis, a major factor determining biomass and grain yield, is discussed. The work done in the authors' laboratory for over a decade is summarized. It is hoped that better understanding will help to apply the tools of molecular biology to genetically manipulate the crop plants so as to enhance yields at low inputs of nitrogen

Influence of elevated carbon dioxide and ammonium nutrition on growth and nitrogen metabolism in wheat (Triticum aestivum)

Growth under elevated CO2 (EC) conditions inhibits nitrate (NO3-) assimilation in crop plants, hence ammonium (NH4+) nutrition is beneficial compared to NO3– nutrition under EC conditions. In the present study, an attempt was made to compare the suitability NH4 + vs mixed NH4 + + NO3 – nutrition in wheat (Triticum aestivum L.). Wheat seedlings supplied with NH4+ alone or with both NH4+ + NO3– as nitrogen (N) source and grown under ambient (380 μl/l, AC) or elevated (600±50 μl/l, EC) CO2 conditions were analyzed for growth and biochemical parameters. Plants receiving only NH4+ as N source showed significant reduction in growth parameters. The negative effects of NH4+ nutrition were manifested in form of reduced root length, root surface area and thinner leaves under EC. Negative effects of NH4+ nutrition were ameliorated in plants receiving mixed NH4 + + NO3 – nutrition. Supplementing NO3 – -N with NH4+ -N led to the enhancement of various morphological and biochemical parameters in EC grown plants. Activity and gene expression of the enzymes, nitrate reductase and glutamine synthetase was significantly higher in plants supplied with both NH4+ + NO3– ions and grown in EC, as compared to plants grown in AC, resulting in lesser reduction in N content of the EC grown plants. Our study indicates that mixed NH4+ + NO3– nutrition will be more suitable for wheat cultivation under high CO2 conditions in future

Physiological and molecular alterations in plants exposed to high [CO2] under phosphorus stress

Atmospheric [CO2] has increased substantially in recent decades and will continue to do so, whereas the availability of phosphorus (P) is limited and unlikely to increase in the future. P is a non-renewable resource, and it is essential to every form of life. P is a key plant nutrient controlling the responsiveness of photosynthesis to [CO2]. Increases in [CO2] typically results in increased biomass through stimulation of net photosynthesis, and hence enhance the demand for P uptake. However, most soils contain low concentrations of available P. Therefore, low P is one of the major growth-limiting factors for plants in many agricultural and natural ecosystems. The adaptive responses of plants to [CO2] and P availability encompass alterations at morphological, physiological, biochemical and molecular levels. In general low P reduces growth, whereas high [CO2] enhances it particularly in C3 plants. Photosynthetic capacity is often enhanced under high [CO2] with sufficient P supply through modulation of enzyme activities involved in carbon fixation such as ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco). However, high [CO2] with low P availability results in enhanced dry matter partitioning towards roots. Alterations in below-ground processes including root morphology, exudation and mycorrhizal association are influenced by [CO2] and P availability. Under high P availability, elevated [CO2] improves the uptake of P from soil. In contrast, under low P availability, high [CO2] mainly improves the efficiency with which plants produce biomass per unit P. At molecular level, the spatio-temporal regulation of genes involved in plant adaptation to low P and high [CO2] has been studied individually in various plant species. Genome-wide expression profiling of high [CO2] grown plants revealed hormonal regulation of biomass accumulation through complex transcriptional networks. Similarly, differential transcriptional regulatory networks are involved in P-limitation responses in plants. Analysis of expression patterns of some typical P-limitation induced genes under high [CO2] suggests that long-term exposure of plants to high [CO2] would have a tendency to stimulate similar transcriptional responses as observed under P-limitation. However, studies on the combined effect of high [CO2] and low P on gene expression are scarce. Such studies would provide insights into the development of P efficient crops in the context of anticipated increases in atmospheric [CO2]

Coupling oxidative signals to protein phosphorylation via methionine oxidation in Arabidopsis

The mechanisms involved in sensing oxidative signalling molecules, such as H2O2, in plant and animal cells are not completely understood. In the present study, we tested the postulate that oxidation of Met (methionine) to MetSO (Met sulfoxide) can couple oxidative signals to changes in protein phosphorylation. We demonstrate that when a Met residue functions as a hydrophobic recognition element within a phosphorylation motif, its oxidation can strongly inhibit peptide phosphorylation in vitro. This is shown to occur with recombinant soybean CDPKs (calcium-dependent protein kinases) and human AMPK (AMP-dependent protein kinase). To determine whether this effect may occur in vivo, we monitored the phosphorylation status of Arabidopsis leaf NR (nitrate reductase) on Ser534 using modification-specific antibodies. NR was a candidate protein for this mechanism because Met538, located at the P+4 position, serves as a hydrophobic recognition element for phosphorylation of Ser534 and its oxidation substantially inhibits phosphorylation of Ser534 in vitro. Two lines of evidence suggest that Met oxidation may inhibit phosphorylation of NR-Ser534 in vivo. First, phosphorylation of NR at the Ser534 site was sensitive to exogenous H2O2 and secondly, phosphorylation in normal darkened leaves was increased by overexpression of the cytosolic MetSO-repair enzyme PMSRA3 (peptide MetSO reductase A3). These results are consistent with the notion that oxidation of surface-exposed Met residues in kinase substrate proteins, such as NR, can inhibit the phosphorylation of nearby sites and thereby couple oxidative signals to changes in protein phosphorylation