Submyomatous Cornual Pregnancy : Managed surgically after failed medical management

Cornual pregnancy constitutes an emergency while its diagnosis and management remain a challenge. Anatomical abnormalities in the uterus, such as fibroids in the cornual region, make the management even more difficult. A nulliparous patient presented with an ectopic pregnancy at the right cornua under a huge fibroid. Despite multiple doses of methotrexate for a cornual ectopic gestation, the serum beta human chorionic gonadotropin (β-hcG) levels doubled on the fifth day and a viable fetus was demonstrated on imaging. Thus surgical intervention in the form of laparoscopy followed by laparotomy, myomectomy of a large cornual fibroid and cornuostomy was performed. The serum beta human chorionic gonadotropin result was negative three weeks later. Surgical intervention in the form of myomectomy and cornuostomy was necessary to preserve fertility in this unusual presentation of cornual ectopic pregnancy.

AstroSat-CZTI detection of variable prompt emission polarization in GRB 171010A

We present spectro-polarimetric analysis of \thisgrb\ using data from \asat, \fermi, and \swift, to provide insights into the physical mechanisms of the prompt radiation and the jet geometry. Prompt emission from \thisgrb\ was very bright (fluence $>10^{-4}$~ergs~cm$^{-2}$) and had a complex structure composed of the superimposition of several pulses. The energy spectra deviate from the typical Band function to show a low energy peak $\sim 15$~keV --- which we interpret as a power-law with two breaks, with a synchrotron origin. Alternately, the prompt spectra can also be interpreted as Comptonized emission, or a blackbody combined with a Band function. Time-resolved analysis confirms the presence of the low energy component, while the peak energy is found to be confined in the range of 100--200~keV. Afterglow emission detected by \fermi-LAT is typical of an external shock model, and we constrain the initial Lorentz factor using the peak time of the emission. \swift-XRT measurements of the afterglow show an indication for a jet break, allowing us to constrain the jet opening angle to $>$ 6\degr. Detection of a large number of Compton scattered events by \asat-CZTI provides an opportunity to study hard X-ray polarization of the prompt emission. We find that the burst has high, time-variable polarization, with the emission {\bf have higher polarization} at energies above the peak energy. We discuss all observations in the context of GRB models and polarization arising due to {\bf due to physical or geometric effects:} synchrotron emission from multiple shocks with ordered or random magnetic fields, Poynting flux dominated jet undergoing abrupt magnetic dissipation, sub-photospheric dissipation, a jet consisting of fragmented fireballs, and the Comptonization model.Comment: Accepted for publication in Ap

Mapping regional risks from climate change for rainfed rice cultivation in India

Global warming is predicted to increase in the future, with detrimental consequences for rainfed crops that are dependent on natural rainfall (i.e. non-irrigated). Given that many crops grown under rainfed conditions support the livelihoods of low-income farmers, it is important to highlight the vulnerability of rainfed areas to climate change in order to anticipate potential risks to food security. In this paper, we focus on India, where ~ 50% of rice is grown under rainfed conditions, and we employ statistical models (climate envelope models (CEMs) and boosted regression trees (BRTs)) to map changes in climate suitability for rainfed rice cultivation at a regional level (~ 18 × 18 km cell resolution) under projected future (2050) climate change (IPCC RCPs 2.6 and 8.5, using three GCMs: BCC-CSM1.1, MIROC-ESM-CHEM, and HadGEM2-ES). We quantify the occurrence of rice (whether or not rainfed rice is commonly grown, using CEMs) and rice extent (area under cultivation, using BRTs) during the summer monsoon in relation to four climate variables that affect rice growth and yield namely ratio of precipitation to evapotranspiration (PER), maximum and minimum temperatures (Tmax and Tmin), and total rainfall during harvesting. Our models described the occurrence and extent of rice very well (CEMs for occurrence, ensemble AUC = 0.92; BRTs for extent, Pearson's r = 0.87). PER was the most important predictor of rainfed rice occurrence, and it was positively related to rainfed rice area, but all four climate variables were important for determining the extent of rice cultivation. Our models project that 15%–40% of current rainfed rice growing areas will be at risk (i.e. decline in climate suitability or become completely unsuitable). However, our models project considerable variation across India in the impact of future climate change: eastern and northern India are the locations most at risk, but parts of central and western India may benefit from increased precipitation. Hence our CEM and BRT models agree on the locations most at risk, but there is less consensus about the degree of risk at these locations. Our results help to identify locations where livelihoods of low-income farmers and regional food security may be threatened in the next few decades by climate changes. The use of more drought-resilient rice varieties and better irrigation infrastructure in these regions may help to reduce these impacts and reduce the vulnerability of farmers dependent on rainfed cropping

A Multicenter, Randomized, Placebo‐Controlled Trial of Atorvastatin for the Primary Prevention of Cardiovascular Events in Patients With Rheumatoid Arthritis

Objective: Rheumatoid arthritis (RA) is associated with increased cardiovascular event (CVE) risk. The impact of statins in RA is not established. We assessed whether atorvastatin is superior to placebo for the primary prevention of CVEs in RA patients. Methods: A randomized, double‐blind, placebo‐controlled trial was designed to detect a 32% CVE risk reduction based on an estimated 1.6% per annum event rate with 80% power at P 50 years or with a disease duration of >10 years who did not have clinical atherosclerosis, diabetes, or myopathy received atorvastatin 40 mg daily or matching placebo. The primary end point was a composite of cardiovascular death, myocardial infarction, stroke, transient ischemic attack, or any arterial revascularization. Secondary and tertiary end points included plasma lipids and safety. Results: A total of 3,002 patients (mean age 61 years; 74% female) were followed up for a median of 2.51 years (interquartile range [IQR] 1.90, 3.49 years) (7,827 patient‐years). The study was terminated early due to a lower than expected event rate (0.70% per annum). Of the 1,504 patients receiving atorvastatin, 24 (1.6%) experienced a primary end point, compared with 36 (2.4%) of the 1,498 receiving placebo (hazard ratio [HR] 0.66 [95% confidence interval (95% CI) 0.39, 1.11]; P = 0.115 and adjusted HR 0.60 [95% CI 0.32, 1.15]; P = 0.127). At trial end, patients receiving atorvastatin had a mean ± SD low‐density lipoprotein (LDL) cholesterol level 0.77 ± 0.04 mmoles/liter lower than those receiving placebo (P < 0.0001). C‐reactive protein level was also significantly lower in the atorvastatin group than the placebo group (median 2.59 mg/liter [IQR 0.94, 6.08] versus 3.60 mg/liter [IQR 1.47, 7.49]; P < 0.0001). CVE risk reduction per mmole/liter reduction in LDL cholesterol was 42% (95% CI −14%, 70%). The rates of adverse events in the atorvastatin group (n = 298 [19.8%]) and placebo group (n = 292 [19.5%]) were similar. Conclusion: Atorvastatin 40 mg daily is safe and results in a significantly greater reduction of LDL cholesterol level than placebo in patients with RA. The 34% CVE risk reduction is consistent with the Cholesterol Treatment Trialists’ Collaboration meta‐analysis of statin effects in other populations

Metastatic Malignant Melanoma during Pregnancy: Case report and a Review of the literature

Malignant melanoma is one of the most rapidly increasing cancers and, when it occurs during pregnancy, it can frequently metastasise to the placenta and the foetus. Earlier reports suggested a rapid progress of the disease during pregnancy with a poor prognosis; however, recent controlled studies found that stage for stage, the prognosis of melanoma during pregnancy is similar to that in a non-pregnant state. Early diagnosis and prompt treatment can avoid a tragic outcome

Optimization of spatial statistical approaches to identify land use/land cover change hot spots of Pune region of Maharashtra using remote sensing and GIS techniques

This study investigated land use/land cover change (LULCC) dynamics using temporal satellite images and spatial statistical cluster analysis approaches in order to identify potential LULCC hot spots in the Pune region. LULCC hot spot classes defined as new, progressive and non-progressive were derived from Gi* scores. Results indicate that progressive hot spots have experienced high growth in terms of urban built-up areas (20.67% in 1972–1992 and 19.44% in 1992–2012), industrial areas (0.73% in 1972–1992 and 3.46% in 1992–2012) and fallow lands (4.35% in 1972–1992 and −6.38% in 1992–2012). It was also noticed that about 28.26% of areas near the city were identified as new hot spots after 1992. Hence, non-significant change areas were identified as non-progressive after 1992. The study demonstrated that LULCC hot spot mapping through the integrated spatial statistical approach was an effective approach for analysing the direction, rate, spatial pattern and spatial relationship of LULCC

Not Available

Not AvailableSoil degradation in India is estimated to be occurring on 147 million hectares (Mha) of land, including 94 Mha from water erosion, 16 Mha from acidification, 14 Mha from flooding, 9 Mha from wind erosion, 6 Mha from salinity, and 7 Mha from a combination of factors. This is extremely serious because India supports 18% of the world’s human population and 15% of the world’s livestock population, but has only 2.4% of the world’s land area. Despite its low proportional land area, India ranks second worldwide in farm output. Agriculture, forestry, and fisheries account for 17% of the gross domestic product and employs about 50% of the total workforce of the country. Causes of soil degradation are both natural and human-induced. Natural causes include earthquakes, tsunamis, droughts, avalanches, landslides, volcanic eruptions, floods, tornadoes, and wildfires. Human-induced soil degradation results from land clearing and deforestation, inappropriate agricultural practices, improper management of industrial effluents and wastes, over-grazing, careless management of forests, surface mining, urban sprawl, and commercial/industrial development. Inappropriate agricultural practices include excessive tillage and use of heavy machinery, excessive and unbalanced use of inorganic fertilizers, poor irrigation and water management techniques, pesticide overuse, inadequate crop residue and/or organic carbon inputs, and poor crop cycle planning. Some underlying social causes of soil degradation in India are land shortage, decline in per capita land availability, economic pressure on land, land tenancy, poverty, and population increase. In this review of land degradation in India, we summarize (1) the main causes of soil degradation in different agro-climatic regions; (2) research results documenting both soil degradation and soil health improvement in various agricultural systems; and (3) potential solutions to improve soil health in different regions using a variety of conservation agricultural approaches.Not Availabl

Not Available

Not AvailableSoil degradation in India is estimated to be occurring on 147 million hectares (Mha) of land, including 94 Mha from water erosion, 16 Mha from acidification, 14 Mha from flooding, 9 Mha from wind erosion, 6 Mha from salinity, and 7 Mha from a combination of factors. This is extremely serious because India supports 18% of theworld’s human population and 15% of the world’s livestock population, but has only 2.4% of the world’s land area. Despite its low proportional land area, India ranks second worldwide in farm output. Agriculture, forestry, and fisheries account for 17% of the gross domestic product and employs about 50% of the total workforce of the country. Causes of soil degradation are both natural and human-induced. Natural causes include earthquakes, tsunamis, droughts, avalanches, landslides, volcanic eruptions, floods, tornadoes, and wildfires. Human-induced soil degradation results from land clearing and deforestation, inappropriate agricultural practices, improper management of industrial effluents and wastes, over-grazing, careless management of forests, surface mining, urban sprawl, and commercial/industrial development. Inappropriate agricultural practices include excessive tillage and use of heavy machinery, excessive and unbalanced use of inorganic fertilizers, poor irrigation and water management techniques, pesticide overuse, inadequate crop residue and/or organic carbon inputs, and poor crop cycle planning. Some underlying social causes of soil degradation in India are land shortage, decline in per capita land availability, econompressure on land, land tenancy, poverty, and population increase. In this review of land degradation in India, we summarize (1) the main causes of soil degradation in different agro-climatic regions; (2) research results documenting both soil degradation and soil health improvement in various agricultural systems; and (3) potential solutions to improvesoil health in different regions using a variety of conservation agricultural approaches.Not Availabl

Soil Degradation in India: Challenges and Potential Solutions

Soil degradation in India is estimated to be occurring on 147 million hectares (Mha) of land, including 94 Mha from water erosion, 16 Mha from acidification, 14 Mha from flooding, 9 Mha from wind erosion, 6 Mha from salinity, and 7 Mha from a combination of factors. This is extremely serious because India supports 18% of the world’s human population and 15% of the world’s livestock population, but has only 2.4% of the world’s land area. Despite its low proportional land area, India ranks second worldwide in farm output. Agriculture, forestry, and fisheries account for 17% of the gross domestic product and employs about 50% of the total workforce of the country. Causes of soil degradation are both natural and human-induced. Natural causes include earthquakes, tsunamis, droughts, avalanches, landslides, volcanic eruptions, floods, tornadoes, and wildfires. Human-induced soil degradation results from land clearing and deforestation, inappropriate agricultural practices, improper management of industrial effluents and wastes, over-grazing, careless management of forests, surface mining, urban sprawl, and commercial/industrial development. Inappropriate agricultural practices include excessive tillage and use of heavy machinery, excessive and unbalanced use of inorganic fertilizers, poor irrigation and water management techniques, pesticide overuse, inadequate crop residue and/or organic carbon inputs, and poor crop cycle planning. Some underlying social causes of soil degradation in India are land shortage, decline in per capita land availability, economic pressure on land, land tenancy, poverty, and population increase. In this review of land degradation in India, we summarize (1) the main causes of soil degradation in different agro-climatic regions; (2) research results documenting both soil degradation and soil health improvement in various agricultural systems; and (3) potential solutions to improve soil health in different regions using a variety of conservation agricultural approaches

Not Available

Not AvailableSoil degradation in India is estimated to be occurring on 147 million hectares (Mha) of land, including 94 Mha from water erosion, 16 Mha from acidification, 14 Mha from flooding, 9 Mha from wind erosion, 6 Mha from salinity, and 7 Mha from a combination of factors. This is extremely serious because India supports 18% of theworld’s human population and 15% of the world’s livestock population, but has only 2.4% of the world’s land area. Despite its low proportional land area, India ranks second worldwide in farm output. Agriculture, forestry, and fisheries account for 17% of the gross domestic product and employs about 50% of the total workforce of the country. Causes of soil degradation are both natural and human-induced. Natural causes include earthquakes, tsunamis, droughts, avalanches, landslides, volcanic eruptions, floods, tornadoes, and wildfires. Human-induced soil degradation results from land clearing and deforestation, inappropriate agricultural practices, improper management of industrial effluents and wastes, over-grazing, careless management of forests, surface mining, urban sprawl, and commercial/industrial development. Inappropriate agricultural practices include excessive tillage and use of heavy machinery, excessive and unbalanced use of inorganic fertilizers, poor irrigation and water management techniques, pesticide overuse, inadequate crop residue and/or organic carbon inputs, and poor crop cycle planning. Some underlying social causes of soil degradation in India are land shortage, decline in per capita land availability, econompressure on land, land tenancy, poverty, and population increase. In this review of land degradation in India, we summarize (1) the main causes of soil degradation in different agro-climatic regions; (2) research results documenting both soil degradation and soil health improvement in various agricultural systems; and (3) potential solutions to improvesoil health in different regions using a variety of conservation agricultural approaches.Not Availabl