Marketable Surplus and Price-Spread for Maize in Hamirpur District of Himachal Pradesh

A study has been conducted on the production, marketed surplus, disposal channels, margins and price-spread for maize cultivation in the Hamirpur district of Himachal Pradesh. A multi-stage stratified sampling technique has been used to select the sample of blocks (2), villages (10) and maize growers (120) for the year 2001-02. The study on factors affecting marketed surplus, and cost & margins in the marketing of maize has revealed that farm-level marketable surplus is comprised of 53.21 per cent of the total production. The practices of storing maize for sometime and selling at a later date for higher price have led to storage losses to the extent of 0.16 quintal (2.80% of marketable surplus). Much of the marketable surplus of maize (66.92%) was disposed of by a majority of farmers (74.56%) during the first quarter (October- December). Producer → Local trader → WS/ CA → Processor/ Consumer has been found as the main channel in the marketing of maize followed by about 71.93 per cent farmers, accounting for about 70 per cent of the produce. The producer’s share in consumer’s rupee has been estimated at 78.01 per cent in this channel.Agricultural and Food Policy,

Organochlorine residues in tissues of marine fauna along the coast of Kenya-Mombasa Island

Soft tissues of species of marine fauna; crabs (Crustacea), oysters (Pelecypoda, Bivalvia), sea stars (Asterroidea), sea urchin (Echinoidea) and bony fishes (Osteichtyes) sampled along the Kenya-Mombasa coastal region were analyzed to determine the levels of organochlorine pesticides (OCPs). Analysis was done using gas chromatography with an electron capture detector. This study showed that marine fauna accumulated some OCPs in their tissues, 1,2,3,4,5,6-hexachlorocyclohexane (BHC) being the most common of the OCPs. These findings highlight evidence of pollution of marine fauna at the Kenyan coastal sites. It is necessary to have thorough waste management programs as a strategy to minimize marine pollution.  KEY WORDS: Environmental samples; Marine samples; Kenya-Mombasa coastline; Marine fauna, Organochlorine, Pesticides  Bull. Chem. Soc. Ethiop. 2007, 21(1), 145-149.

Combined Pulmonary Fibrosis and Emphysema in a welder

Combined pulmonary fibrosis and emphysema (CPFE) syndrome is an uncommon entity characterised by emphysema of the upper lobes and diffuse fibrosis of the lower lobes and carries a bad prognosis with the onset of pulmonary hypertension. Lung involvement due to exposures suffered by welders is generally considered benign though, rarely, a diffuse interstitial fibrotic disease has been reported. CPFE syndrome has however never been reported in welders. A 65-year-old man, welder by occupation and an ex-smoker, presented with progressive exertional dyspnoea associated with dry cough noticed for the last four months. On examination, there was mild tachypnea, clubbing and bilateral basal velcro crepitations on chest auscultation. Lung function test revealed mild mixed ventilatory impairment with severe diffusion defect. HRCT chest showed bilateral upper lobe emphysema and diffuse interstitial fibrosis in the lower lobes. Transbronchial lung biopsy revealed interstitial fibrosis, chronic inflammation and iron deposits. A diagnosis of combined pulmonary fibrosis with emphysema (CPFE) with interstitial pulmonary siderofibrosis (IPS) was established. A review of literature did not show any other report of a similar nature

Incidence, Risk Factors, and Outcomes of Patients Who Develop Mucosal Barrier Injury-Laboratory Confirmed Bloodstream Infections in the First 100 Days after Allogeneic Hematopoietic Stem Cell Transplant

Importance: Patients undergoing hematopoietic stem cell transplant (HSCT) are at risk for bloodstream infection (BSI) secondary to translocation of bacteria through the injured mucosa, termed mucosal barrier injury-laboratory confirmed bloodstream infection (MBI-LCBI), in addition to BSI secondary to indwelling catheters and infection at other sites (BSI-other). Objective: To determine the incidence, timing, risk factors, and outcomes of patients who develop MBI-LCBI in the first 100 days after HSCT. Design, Setting, and Participants: A case-cohort retrospective analysis was performed using data from the Center for International Blood and Marrow Transplant Research database on 16875 consecutive pediatric and adult patients receiving a first allogeneic HSCT from January 1, 2009, to December 31, 2016. Patients were classified into 4 categories: MBI-LCBI (1481 [8.8%]), MBI-LCBI and BSI-other (698 [4.1%]), BSI-other only (2928 [17.4%]), and controls with no BSI (11768 [69.7%]). Statistical analysis was performed from April 5 to July 17, 2018. Main Outcomes and Measures: Demographic characteristics and outcomes, including overall survival, chronic graft-vs-host disease, and transplant-related mortality (only for patients with malignant disease), were compared among groups. Results: Of the 16875 patients in the study (9737 [57.7%] male; median [range] age, 47 [0.04-82] years) 13686 (81.1%) underwent HSCT for a malignant neoplasm, and 3189 (18.9%) underwent HSCT for a nonmalignant condition. The cumulative incidence of MBI-LCBI was 13% (99% CI, 12%-13%) by day 100, and the cumulative incidence of BSI-other was 21% (99% CI, 21%-22%) by day 100. Median (range) time from transplant to first MBI-LCBI was 8 (<1 to 98) days vs 29 (<1 to 100) days for BSI-other. Multivariable analysis revealed an increased risk of MBI-LCBI with poor Karnofsky/Lansky performance status (hazard ratio [HR], 1.21 [99% CI, 1.04-1.41]), cord blood grafts (HR, 2.89 [99% CI, 1.97-4.24]), myeloablative conditioning (HR, 1.46 [99% CI, 1.19-1.78]), and posttransplant cyclophosphamide graft-vs-host disease prophylaxis (HR, 1.85 [99% CI, 1.38-2.48]). One-year mortality was significantly higher for patients with MBI-LCBI (HR, 1.81 [99% CI, 1.56-2.12]), BSI-other (HR, 1.81 [99% CI, 1.60-2.06]), and MBI-LCBI plus BSI-other (HR, 2.65 [99% CI, 2.17-3.24]) compared with controls. Infection was more commonly reported as a cause of death for patients with MBI-LCBI (139 of 740 [18.8%]), BSI (251 of 1537 [16.3%]), and MBI-LCBI plus BSI (94 of 435 [21.6%]) than for controls (566 of 4740 [11.9%]). Conclusions and Relevance: In this cohort study, MBI-LCBI, in addition to any BSIs, were associated with significant morbidity and mortality after HSCT. Further investigation into risk reduction should be a clinical and scientific priority in this patient population

Comparative Analysis of Calcineurin Inhibitor-Based Methotrexate and Mycophenolate Mofetil-Containing Regimens for Prevention of Graft-versus-Host Disease after Reduced-Intensity Conditioning Allogeneic Transplantation

The combination of a calcineurin inhibitor (CNI) such as tacrolimus (TAC) or cyclosporine (CYSP) with methotrexate (MTX) or with mycophenolate mofetil (MMF) has been commonly used for graft-versus-host disease (GVHD) prophylaxis after reduced-intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (alloHCT), but there are limited data comparing efficacy of the 2 regimens. We evaluated 1564 adult patients who underwent RIC alloHCT for acute myelogenous leukemia (AML) and acute lymphoblastic leukemia (ALL), chronic myelogenous leukemia (CML), and myelodysplastic syndrome (MDS) from 2000 to 2013 using HLA-identical sibling (matched related donor [MRD]) or unrelated donor (URD) peripheral blood graft and received CYSP or TAC with MTX or MMF for GVHD prophylaxis. Primary outcomes of the study were acute and chronic GVHD and overall survival (OS). The study divided the patient population into 4 cohorts based on regimen: MMF-TAC, MMF-CYSP, MTX-TAC, and MTX-CYSP. In the URD group, MMF-CYSP was associated with increased risk of grade II to IV acute GVHD (relative risk [RR], 1.78; P <.001) and grade III to IV acute GVHD (RR, 1.93; P =.006) compared with MTX-TAC. In the URD group, use of MMF-TAC (versus MTX-TAC) lead to higher nonrelapse mortality. (hazard ratio, 1.48; P =.008). In either group, no there was no difference in chronic GVHD, disease-free survival, and OS among the GVHD prophylaxis regimens. For RIC alloHCT using MRD, there are no differences in outcomes based on GVHD prophylaxis. However, with URD RIC alloHCT, MMF-CYSP was inferior to MTX-based regimens for acute GVHD prevention, but all the regimens were equivalent in terms of chronic GVHD and OS. Prospective studies, targeting URD recipients are needed to confirm these results

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Marketable Surplus and Price-Spread for Maize in Hamirpur District of Himachal Pradesh

A study has been conducted on the production, marketed surplus, disposal channels, margins and price-spread for maize cultivation in the Hamirpur district of Himachal Pradesh. A multi-stage stratified sampling technique has been used to select the sample of blocks (2), villages (10) and maize growers (120) for the year 2001-02. The study on factors affecting marketed surplus, and cost & margins in the marketing of maize has revealed that farm-level marketable surplus is comprised of 53.21 per cent of the total production. The practices of storing maize for sometime and selling at a later date for higher price have led to storage losses to the extent of 0.16 quintal (2.80% of marketable surplus). Much of the marketable surplus of maize (66.92%) was disposed of by a majority of farmers (74.56%) during the first quarter (October- December). Producer → Local trader → WS/ CA → Processor/ Consumer has been found as the main channel in the marketing of maize followed by about 71.93 per cent farmers, accounting for about 70 per cent of the produce. The producer’s share in consumer’s rupee has been estimated at 78.01 per cent in this channel

Intraoperative change in P-wave polarity, an accidental finding: Anaesthesiologist’s dilemma

Arrhythmias are commonly observed in the intraoperative period. These could arise due to varied reasons and are treated accordingly. However certain situations are encountered where arrhythmias are transient and do not cause any haemodynamic instability. We report a case of 61 year old female posted for an orthopaedic procedure where intraoperative changing p wave polarity was noticed on monitor. Since, the patient was asymptomatic and haemodynamically stable, we decided to proceed with a spinal anaesthetic after much dilemma. The intraoperative period went uneventful with continued changes in p wave polarity