Feto maternal outcome in placenta previa and morbidly adherent placenta

Background: Placenta forms the most important link between the developing foetus and the mother. The placenta's health is crucial for the foetus' proper growth and development. The outcome of pregnancy is changed when there is a change in the placental location or architecture for both the mother and the foetus. No matter the cause, placenta previa increases maternal and foetal risks by several times. Aim and objectives of current study are to investigate the incidence of placenta previa in hospital obstetric patients and the maternal and fetal outcome in cases of placenta previa. Methods: 100 patients delivered in the Govt. Medical College, Kota with cases of placenta previa. Risk factors like Gestational age at the onset of bleeding, expectant management, gestational age at delivery and the mode of delivery. The birth weight and APGAR score of the newborn were observed. Results: The risk of placenta previa is 3 time higher in multigravida than primigravida. 52% chances of placenta previa with male babies. Peak incidence of bleeding is noted around 34-36 weeks. 92% of placenta previa cases were delivered LSCS. PPH was main morbidity out of all morbidities. 55% of babies were less than 2.4 Kg. 44% were anterior, 38% posterior and rest 6% central placenta previa. Conclusions: Placenta previa poses a serious risk to both the mother and the foetus, whether it is accidentally discovered by ultrasound or as a result of a clinical emergency like a haemorrhage in the mother. The best outcome can be achieved with an accurate diagnosis, prudent expectant management, blood transfusion as necessary, and prompt delivery.

A prospective randomized comparative study on fractures of lower third of both bones of the leg treated by interlock nailing of tibia with or without fixation of fibula

Background: In the treatment of fractures of the distal third of tibia and fibula treated by interlocking nail of tibia, the role of fixing the fibular fracture is not clearly defined. This study was conducted to assess the benefits of fixation of fibular fracture in distal third leg bones fractures.Methods: 95 patients were enrolled into study and divided randomly into two groups based on whether fibula fixed or not with interlock intramedullary nailing tibia. Patients were followed for an average period of 11 months both radiologically and clinically.Results: We observed that the average valgus angulation was significantly less (P =0.001) in the group where fibula was fixed. The outcome of the two groups for clinical ankle score, time of union and complication showed no difference (P ≥0.05). Conclusions: We concluded that fixation of fibula decrease the malalignment of tibia in distal third fractures of tibia and fibula treated with interlocking nail of tibia.

Genetic variability and character association in bread wheat (Triticum aestivum)

Forty seven released varieties of common bread wheat (Triticum aestivum L.) were evaluated during rabi 2007-08 to 2010-11 for four years under irrigated conditions at Directorate of Seed Research, Mau. Analysis of variance on 12 quantitative characters was carried out and pooled analysis was conducted over the seasons. The mean, range, phenotypic, genotypic and environmental variance, genotypic and phenotypic coefficient of variation, heritability in broad sense and genetic advance were calculated. Path coefficient analysis was carried out using correlation coefficients to establish the inter-relationship and direct and indirect contributions of component traits towards grain yield. Analysis of variance revealed the considerable amount of genetic variability in genotypes for all the traits. High genetic advance (GA) coupled with moderate to high heritability for grains/ spike and 1000-seed weight indicated the effectiveness of selection for these traits. Number of grains/spikelet, grain yield/spike and effective tillers/m2 were positively associated with grain yield. Similarly, effective tillers/m2, number of grains/spike and grain yield/spike had higher phenotypic and genotypic direct effects on grain yield/m2, revealing that indirect selection for these traits would be effective in improving the grain yield. The higher direct and indirect contribution of grains/spike, tillers/m2, 1000-seed weight, spikelets/spike and grains/spikelet towards total grain yield would be of great use for indirect selection for yield improvement

Nutrient Supplying Potential of Crop Residues in Indian Agriculture

The Indian agriculture sector has seen tremendous changes over the period. The country’s food grain production has increased from just 50 million tons (mt) in the 1950s to 308 mt at present, around a sixfold rise. All of this could become possible due to the introduction of green revolution technologies in the 1970s and onwards, such as the introduction of high-yielding varieties, chemical fertilizers, pesticides, selective herbicides, and improvement of irrigation facilities with improved agronomic management. According to an estimate, chemical fertilizers alone account for 50% of growth in the country’s foodgrain production. In the early 1950s, total fertilizer consumption in India was just 0.069 mt, which has increased to 2.25 mt in 1970–71 and 32.5 mt at present. This about 14.4 times rise in fertilizer consumption since the 1970s level to the present highlights the role of fertilizers and nutrient management in Indian agriculture. However, a continuous increase in fertilizer consumption over the year has invited many secondary agricultural problems, such as multi-nutrient deficiency, increased cost of production, and declining factor productivity of fertilizers. Imbalance and overuse use of fertilizers, along with increased cropping intensity and reduced recycling of residues are some of the reasons for such problems. Increased agricultural production also generates a large volume of surplus residue, which often creates problems for farmers. It is well-understood facts from various research studies that crop residues are the hidden treasurer of all the essential nutrients and organic carbon. This chapter highlights the potential of crop residue in nutrient recycling in India and the availability of surplus crop residue

Nanotechnology Synergised Immunoengineering for Cancer

Novel strategies modulating the immune system yielded enhanced anticancer responses and improved cancer survival. Nevertheless, the success rate of immunotherapy in cancer treatment has been below expectation(s) due to unpredictable efficacy and off-target effects from systemic dosing of immunotherapeutic. As a result, there is an unmet clinical need for improving conventional immunotherapy. Nanotechnology offers several new strategies, multimodality, and multiplex biological targeting advantage to overcome many of these challenges. These efforts enable programming the pharmacodynamics, pharmacokinetics, delivery of immunomodulatory agents/co-delivery of compounds to prime at the tumor sites for improved therapeutic benefits. This review provides an overview of the design and clinical principles of biomaterials driven nanotechnology and their potential use in personalized nanomedicines, vaccines, localized tumor modulation, and delivery strategies for cancer immunotherapy. In this review, we also summarize the latest highlights and recent advances in combinatorial therapies avail in the treatment of cold and complicated tumors. It also presents key steps and parameters implemented for clinical success. Finally, we analyse, discuss, and provide clinical perspectives on the integrated opportunities of nanotechnology and immunology to achieve synergistic and durable responses in cancer treatment

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

Exploring the potential of enhanced organic formulations for boosting crop productivity, nutrient utilization efficiency, and profitability in baby corn-Kabuli gram-vegetable cowpea cropping system

The preparation of enriched formulation by integrating of agricultural wastes such as paddy husk ash (PHA) and potato peel with organic fertilizer such as farmyard manure (FYM), compost can enrich the soil with essential plant nutrients, leading to higher yields in subsequent crops and potentially reducing the dependence on farmyard manure/compost alone. However, there is lack of adequate research findings regarding the impact of different formulations generated from agricultural waste on productivity, nutrient utilization efficiency and profitability of baby corn-kabuli gram-vegetable cowpea cropping system. Therefore, a two-year field experiment (2020–2022) was conducted ICAR-IARI, New Delhi with baby corn-kabuli gram-vegetable cowpea cropping system. Seven nutrient sources were tested in Randomized Block Design and replicate thrice.The results showed that treatment T4 (100% recommended dose of nitrogen (RDN) through PHA based formulation) had significant effect on crop yield grown in rotation, followed by treatment T6 (100% RDN through potato peel compost (PPC) based formulation) and T2 (100% RDN through FYM). The increase in yield was 75.0, 44.3 and 33.1% during first year and 72.6, 45.9 and 31.0% during second year, respectively, over control. Treatment T4 also significantly enhanced system uptake of N, P and K as well as system gross returns and net returns, resulting in 65.6, 84.9, 69.5, 50.7 and 55.2% higher returns during first year and 68.6, 80.5, 73.9, 50.0 and 54.2% higher returns during second year, respectively, over control. Furthermore, treatment T4 significantly improved agronomic nitrogen use efficiency and apparent recovery by 151.6 and 2.0% in baby corn, 74.2 and 1.5% in kabuli gram, 55.7 and 13.9% in veg cowpea over T7, respectively, averaged across two years of study. Based on these results, it is recommended to adopt (T4) 100% RDN through PHA based formulation, and (T6) 100% RDN through PPC based formulation in the area with a shortage of FYM but with the availability of rice husk ash or pototo peels for sustainable utilization of the agricultural wastes and improving the agricultural sustainability

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention