Noninvasive Prediction of Large Esophageal Varices in Chronic Liver Disease Patients

<b>Background/Aim:</b> Esophageal varices (EVs) are a serious consequence of portal hypertension in patients with liver diseases. Several studies have evaluated possible noninvasive markers of EVs to reduce the number of unnecessary endoscopies in patients with cirrhosis but without varices. This prospective study was conducted to evaluate noninvasive predictors of large varices (LV). <b> Patients and Methods: </b> The study analyzed 106 patients with liver diseases from January 2007 to March 2008. Relevant clinical parameters assessed included Child-Pugh class, ascites and splenomegaly. Laboratory parameters like hemoglobin level, platelet count, prothrombin time, serum bilirubin, albumin and ultrasonographic characteristics like splenic size, splenic vein size, portal vein diameter were assessed. Univariate and multivariate analysis was done on the data for predictors of large EVs.<b> Results:</b> Incidence of large varices was seen in 41&#x0025;. On multivariate analysis, independent predictors for the presence of LV were palpable spleen, low platelet count, spleen size&#62; 13.8 mm, portal vein&#62; 13 mm, splenic vein&#62; 11.5 mm. The receiver operating characteristic (ROC) curve showed 0.883 area under curve. Platelet spleen diameter ratio 909 had a sensitivity and specificity of 88.5&#x0025;, 83&#x0025; respectively.<b> Conclusion: </b> Thrombocytopenia, large spleen size, portal vein size and platelet spleen diameter ratio strongly predicts large number of EVs

Source-Sink Alterations in Rice Fallow Adaptive Blackgram Variety ADT3 for Enhancement of Yield and Quality of Seed

Seed Production of rice fallow blackgram variety, ADT3 has limitations due to inherent issues of soil fertility, climate change and thermo sensitivity results in poor flowering, reduced pod setting and poor seed filling. Macro and micro nutrients application during critical stages of growth were tried to improve the seed yield and quality in rice fallow blackgram variety ADT3. The combined foliar spraying of 0.5% NPK (macro) and 0.2% chelated micro nutrients mixture (Fe 2.5%, Mn 1.0%, Zn 3.0%, Cu 1.0%, Mo 0.1% and B 0.5%), were sprayed on 15th (Vegetative phase), 30th (Reproductive phase), 45th ( Flowering and pod formation phase) days after germination improved the growth and seed parameters viz., plant height, number of branches, number of pods per plant, number of seeds per pod, filled seed % which resulted in increased seed yield in rice fallow blackgram variety, ADT3. Response of macro and micro nutrients through foliar mode revealed the lack of soil fertility resulting in poor uptake of macro and micro nutrients. Foliar application induced uniform flowering and synchronous maturity of pods with least shattering which would facilitate mechanical harvesting. Foliar application of macro and micro nutrients phenotypically altered the source-sink which greatly influenced the yield of seed, germination and seedling quality parameters

Pharmaceutical care for asthma patients: A Developing Country′s Experience

Objective: This study aims at the outcome of providing pharmaceutical care service for asthma patients through an active partnership between clinical pharmacist and patients, for an optimal pharmacotherapy and a better quality of life (QoL). Methods: In this controlled clinical trial, which was conducted for 8 months (2009) in the Institute of Pulmonary Medicine and Research Centre of a 550-bedded multispecialty tertiary care teaching hospital in India, all patients diagnosed with asthma at least 6 months before getting enrolled in this study were included (n = 66). Patients were divided into the intervention group who received pharmaceutical care through asthma education, medication counselling, instructions on lifestyle modifications, asthma care diary, etc., and the control group who were not provided any pharmaceutical care. Asthma control in the two groups was assessed using Asthma Control Test (ACT) at regular intervals. QoL in both groups was assessed at regular intervals using standardized Asthma Quality of Life Questionnaire (AQLQ). Findings: The mean AQLQ scores for the intervention group at the baseline were changed to significantly higher amounts in the final visit indicating overall, activity, symptoms, emotional, and environmental domains, respectively (P < 0.05). The mean ACT scores for intervention group at baseline were also increased in statistically significant amounts in the final visit for all the five ACT questions (P < 0.05). Conclusion: Our pharmaceutical care program showed a positive impact in improving patient′s asthma-related QoL, lung function, and asthma control. By providing structured pharmaceutical care, clinical pharmacists can help asthma patients to achieve desired health outcomes