Study on permanent tubal sterilisation in a semi-urban based medical college hospital

Background: Tubal sterilisation is a permanent method of contraception in use for many years. Main objective of our study is to find the acceptance of permanent method of tubal sterilisation in women delivering in a semi-urban based medical college hospital.Methods: Retrospective analysis was carried to find the number of women undergoing tubal sterilisation in our hospital for period of one year from April 2015 to March 2016.Results: Total women delivered over a period of one year were 10959 out of them 2619 women underwent tubal sterilisation. Analysis showed acceptance was high when combined with lower segment cesarian section (LSCS) and more among women in the age of 20-29 years.Conclusions: The present study showed the acceptance of tubal sterilisation following vaginal delivery to undergo mini lap is still low compared to concurrent sterilisation with LSCS. High order births are still prevalent in semi-urban based hospitals. Not only motivation, also regular review of registers that update the eligible couples, identification of complications and timely referral to higher centers will help in achieving the goal of bringing down the number of high order birth which in turn will reducing the maternal and perinatal mortality and morbidity

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions. Funding: Bill & Melinda Gates Foundation

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

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Not AvailableConogethes sp. is a large taxon that infests more than 120 wild and cultivated host plants across the world. So far, several scientists have studied this group of moth pests to appreciate the genetic variability in the genus; however, owing the complexity at genetic and ecological levels, it has become difficult to understand this group of moths. Till date 24 species have been deposited in the Barcode of Life Data (BOLD) system. In order to study the molecular diversity of Conogethes, multiple markers have been used world over. However, several researchers have revealed that combined analysis of molecular markers and morphological data with field observations may constitute powerful evidence for proper identification of pest species in this problematic taxa. Precise identification would then be utilized for developing realistic practices for the management of Conogethes sp. in diversified cultivated ecosystems.Not Availabl

SOIL PROPERTIES AND BIOLOGICAL ACTIVITY AS INFLUENCED BY NUTRIENT MANAGEMENT IN RICE- FALLOW SORGHUM

A field experiment was conducted to observe the effect of inorganics, bio-fertilizers and FYM applied to rice-fallow sorghum on soil properties and biological activity at Agricultural College Farm, Bapatla during 2012. Soil samples were collected at flowering and harvest of the crop and were analysed for bulk density (BD), porosity, pH, electrical conductivity (EC), organic carbon, N, P, K and micronutrients by standard methods. Results indicated that the soil properties viz., bulk density, porosity, pH and EC were not markedly influenced by the imposed treatments, while significantly high organic carbon was recorded in FYM treated plots. There was a significant influence of the treatments on available nitrogen and phosphorus, but not on potassium. Among micronutrients (Cu, Zn, Mn and Fe), the treatmental influence was significantly related to Fe only. Addition of inorganics in combination with organics and bio-fertilizers proved to be more efficient in improving the microbial population and enzyme activities (urease and dehydrogenase) significantly

Breeding and genomics approaches for improving productivity gains in chickpea under changing climate

Chickpea is a well-recognized global grain legume that plays an important role for providing plant-based protein security to global human population. Given the rising uncertainties in global climate coupled with growing occurrence of various pests and diseases and a range of abiotic stresses, global chickpea production is seriously challenged. Therefore, conventional breeding approaches are not adequate to meet the rising demand for chickpea. Evolving genomic technologies have yielded considerable success in accelerating molecular breeding program in various crops. To this end, unprecedented advances in genome sequencing technologies facilitated largely by next-generation sequencing (NGS) technologies have allowed decoding of whole genome sequences of both cultivated and wild species of chickpea. These developments have opened up great opportunity to improve the efficiency of chickpea breeding programs through deployment of large-scale genomic tools. Efforts are underway to re-sequence multiple genomes for identifying new haplotypes of traits of breeding importance in the crop from wider germplasm resources such as the core collection and reference sets. Taken together, these massive genomic resources including the high-density genotyping assays have allowed chickpea breeders to embrace modern breeding techniques like genomic selection (GS) for enhancing genetic gain. This chapter focuses on the genomics-assisted improvement of chickpea, with an emphasis on the traits that impart resilience to changing climate. In addition to genomics, we highlight progress and possibilities of transgenic research for improving tolerance against biotic and abiotic stress resistance in chickpea. Moreover, the introduction of novel breeding schemes such as “speed breeding”, CRISPR/Cas9-based genome editing holds great promise for accelerating the genetic gains projected to meet the ever-increasing demand for plant-based proteins

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Not AvailableLandraces are the varieties nurtured and cultivated by the farmers through traditional method of selection over the decades. The “landrace” is a primitive cultivar grown by farmers and their successors since ancient times. Directorate of Sorghum Research (DSR), Hyderabad and Sorghum Research Station, Sardarkrushinagar Dantiwada Agricultural University (SDAU), Deesa, Gujarat has explored different areas of Gujarat state and collected 147 sorghum accessions. The important landraces are Chachadia, Char, Deshi, Deshi Malwan, Gundri, Jawari, Kamal Parva, Maklani, Malwan, Poru, Rajka Jowar, Solapuri, Sundi jowar, Sundia, Utavali and Wagad. Forty-six accessions were collected from Kutch district, followed by Banaskanta (30), Patan (13), Surat, Surendrapur, Ahmednagar (each 7), Bhavanagar, Junagadh, Mahesana (each 6), Jamnagar, Sabarkantha (each 4), Bharuch, Dang (each 3) Vadodara, Porbandar (each 2) and Marilia comprisiong only one accession. These accessions were classified into basic races viz., bicolor (18), durra (67), bicolor-guinea (1), caudatum (1), durra-bicolor (19), durra-caudatum (2) and guinea-caudatum (1). Variability among the collections is very high. Farmers mainly use their traditional deshi sorghum. Most of the accessions are tall (88) in plant height, semi compact ear head (79), bold seeded (126) and white coloured seed (61) to pearly white (40). Out of these E 182 (IC 568399), E 183 (IC 568400), E 184 (IC 568401), E 160 (IC 568377), E 161 (IC 568378), E 162 (IC 568379), E 163 (IC 568380), ERN 26 (IC 568541), ERN 27 (IC 568542) and ERN 28 (IC 568543) accessions are identified as salinity tolerant. EJN 4 (IC 585174) is very early flowering and matures at 75 days with tolerant to disease and drought. ERN 1 (IC 568516) is dual type and E 173 (IC 568390) and E 158 (IC 568375) are sweet sorghum type. Majority of the accessions are used as fodder.Not Availabl