Laparoscopy and the impalpable testes: diagnosis, treatment options and the literature

Background: Laparoscopy is the best available tool and method to manage impalpable undescended testes; management of the impalpable testis often pose a significant diagnostic and therapeutic challenge to a surgeon. The aim of this work was to elucidate and present the sensitivity and the value of laparoscopy, as a surgeon’s tool, for the diagnosis and treatment of the impalpable testis.Methods: From November 2015 to December 2018, 56 patients with 60 impalpable testes were operated upon by laparoscopic approach by a single surgeon. One-stage Fowler-Stephens laparoscopic orchidopexy was performed in 14 cases, while two-stage Fowler-Stephens laparoscopic orchidopexy was performed in 16 cases and Vessel-Intact Laparoscopic Orchidopexy (VILO) was done in 22 cases. In 2 cases vessel and vas was entering through deep ring and inguinal orchidopexy was done. Blind ending vessel/vas was noticed in 4 cases (vanishing/absent testes). Laparoscopic orchidectomy was required in 2 patients for nubin. No case of disorder of sexual dysfunction was (DSD) was found.Results: Laparoscopy was successfully completed in all the cases. 34 testicles were impalpable on right side, 18 on left side and other 4 cases (8 testicles) were bilaterally impalpable. Laparoscopic orchidopexy was carried out for 36 testes at the same. 16 needed a staged procedure. Orchidectomy was done in 2 cases/testes. In 4 cases testes was absent/vanishing. In 2 cases testes was canalicular, standard inguinal orchidopexy was done. The mean operative time was 48 minutes. Patients were allowed oral fluids 6 hours of the operation and were discharged at one day after the procedure.  None of the patients had wound infection. Patients were followed up for a mean period of 12 months. At follow-up, all but one of the testes were well down in the bottom of the scrotum. In one patient, the testis was in a high scrotal position. All testes were of normal size, no atrophy was seen so far and no malignant change is suspected in any case so far. No severe morbidity or death was observed in our study.Conclusions: Laparoscopy offers surgeons a safe and reliable diagnostic and therapeutic option to patients with impalpable testes. No other imaging investigation is required, if well versed with basic laparoscopy. Intra-abdominal dissection allows more testes to be brought down to the scrotum. Even when open orchidopexy is being done for intra-canalicular testes in a child, it is advisable to be ready with laparoscopy if necessary, at the same time, in case open surgery fails to mobilize the testicular vessels adequately. The procedure is best viewed as laparoscopy-assisted; as Orchidopexy has to be done in a conventional manner

Efficacy of Various Treatment Modalities on Patientrelated Outcome in Hospitalized COVID-19 Patients –A Retrospective Study

Background: The outbreak of coronavirus disease 2019 (COVID-19) caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in China, in December 2019, and was declared a pandemic by WHO on March 11, 2020. The treatment is evolving and is mostly supportive in nature. Material and methods: This was a single-center retrospective study that included confirmed COVID-19 cases treated at our institute (a tertiary care hospital in Jammu and Kashmir, India), between March 2020 and December 2020. Patients with age more than 18 years were included in the study. Results: On evaluating the effect of various drug therapies used in management of COVID-19 patients of all severity, use of remdesivir and famotidine was associated with significantly higher odds of survival. In subgroup of patients with severe disease, use of systemic steroids was associated with significantly higher odds of survival in addition to remdesivir and famotidine. In patients with severe COVID-19 illness, likelihood of survival was significantly higher in those who received combination of systemic steroids plus remdesivir compared to steroids and remdesivir alone. Conclusion: Steroids were effective in severe COVID-19 illness and the combination of steroids and remdesivir was more effective in severe illness. There is a need to undertake more large scale prospective randomized trials to determine the most effective drug therapies to treat the sick patients and prevent worsening of mild cases

Effect of Phosphorus and Zinc on Fodder Yield and Quality of Leguminous Fodder: Berseem (Trifolium alexandrinum L.)

The contribution of the livestock sector to the Indian Economy is 4.11% of its total GDP and it is nearly 25.6% for total agricultural GDP. Small and marginal farmers are mainly attached to the mixed farming of field crops and dairy animals. Farmers get regular income from their dairy unit and also use dairy animals as economic security. Though India comes under the highest livestock populated countries, the production of milk is lower than expected because of improper feeding quality. Through the last two decades, the demand and price of milk both increase gradually, and farmers are not getting that much profit because of their dependency on ready cattle food. The gross profit after the selling of milk is nearly equal to the feeding expenditure. For the use of paddy straw as dry fodder, the quality and quantity of milk production are decreased. So, green fodder is the best option for livestock as it contains adequate nutrients as well as crude fibre. Among the fodder and forage crops, berseem is the second maximum cultivated fodder crop which possesses a 2 million ha area of fodder crops in India. There are several advantages of berseem as a fodder crop such as a short-duration crop, multi-cut nature, the capability of higher biomass production, the presence of a good amount of crude protein, cellulose, total digestible nutrients and succulent nature. Though Phosphorus and zinc play an antagonistic effect on each other, both are required for the growth and development of berseem crops. From cellular respiration to enzymatic reactions, phosphorus is essential for completing several metabolic activities. Zinc is related to yield and fodder quality by completing plant metabolisms like carbohydrates and auxin production. Adequate management practice is required to maintain the concentration of both nutrients at an optimum level. In Indian soil, zinc is deficient and phosphorus is mostly present in organic form. So, the use of biofertilizers will be effective to convert those complex nutrients form into simple and available for the plant

Vertigo: A Precursor Of Stroke: Role Of An Otolaryngologist.

ABSTRACT: Vertigo is usually of benign nature but can be a precursor of a very fatal outcome. Many patients with multiple vascular risk factors and seemingly benign isolated episodes of vertigo have occasionally been seen to develop an ischaemic event (stroke) by various researchers.As the bulk of vertigo patients (nearly 80%)are treated by otolaryngologists,some of these patients with constitutive risk factors could be at actual risk of stroke, so early identification of such patients becomes necessary. This is a retrospective study of 92 stroke patients admitted in SHMS hospital, Srinagar(2009-2011) who were reviewed and enquired for any history of true vertigo episodes prior to or at onset of stroke.Study included 64 male patients and 28 female patients with about 65%of the patients falling in the age group of 51-70 years. History of transient ischaemic attacks were reported in 9 patients while vertigo(single and multiple episodes) was seen in 24 patients prior to stroke in this study Vertigo should be regarded a precursor of stroke in patients with multiple vascular risk factors and they should be evaluated for veretebrobasilar insufficiency by MRI/MRA at an earliest so that preventive measures can be adopted in time. Vertigo is the illusion of movement of the body or the environment 1. Although commonly classified into peripheral and central vertigo,there are diseases with possible central and peripheral involment (infectious,auto immune,vascula

Carbon-Based Synthesized Materials for CO₂ Adsorption and Conversion: Its Potential for Carbon Recycling

During the last half-century, the CO2 concentration in the world’s atmosphere has increased from 310 p.p.m. to over 380 p.p.m. This is due to the widespread usage of fossil fuels as a main source of energy. Modeling forecasts have shown that this trend will continue to rise and reducing CO2 emissions is a challenging task for multi-stakeholders, including research institutions. The UN Climate Change Conference in Glasgow (COP26) has stressed that stakeholders need to work together to achieve a NetZero target. Technologies involving absorbents for the capture of CO2 from a gas mixture are energy-intensive. Carbon adsorption and conversion (CAC) approaches have been gaining attention recently since these technologies can mitigate CO2 emissions. In this review, materials ranging from advanced carbon-based materials to natural resources-based materials will be reviewed. Adsorption and conversion capacities as well as the scalability possibility of these technologies for solving the CO2 emission problem will be investigated. The review, therefore, is timely and meaningful concerning the net zero emission targets set by countries and developmental organizations worldwide

Different Weed Management Techniques in Maize (Zea mays L.): A Review

Farmers are subjected to yield loss due to different reasons including weed invasion. As weed management is a major approach different methods are incorporated for their management like cultural, mechanical and chemical, etc. Different strategies are required for eradication as cultural methods can’t be used in large area as application of herbicide or tillage methods are found effective in such conditions. Use of compatible herbicides is necessary as they have different way of approach to weeds as different weed species are observed on field. From this review it is concluded that cultural as well as chemical means both are effective when used in a significant manner and application is done according to land area taken into consideration

Comparative Analysis of Rice and Weeds and Their Nutrient Partitioning under Various Establishment Methods and Weed Management Practices in Temperate Environment

A research trial was conducted at Agronomy Farm (SKUAST-K, Wadura, Jammu & Kashmir), during kharif 2017 and 2018 to evaluate nutrient removal in rice under various rice establishment methods and weed control measures. The study comprised of two factors: rice establishment techniques {Transplanting (TPR); Direct seeding (DSR) and System of rice intensification (SRI)} as main plot treatments and weed control measures {Butachlor @ 1500 g a.i ha−1 (B); Penoxsulam @ 22.5 g a.i ha−1 (P); Pyrazosulfuron ethyl + Pretilachlor @ 15 and 600 g a.i ha−1 (PP); Bensulfuron methyl + Pretilachlor @ 60 and 600 g a.i ha−1 (BP); 2 Conoweeding/Hand Weeding (CW/HW); Weed free (WF) and weedy check (WC)} as sub-plot treatments meant to evaluate the best establishment method and weed management practice for rice. Over DSR and transplanted rice, the SRI technique yielded a significant increase in dry biomass accumulation (17.04 and 17.20 t ha−1) and grain (7.92 and 8.17 t ha−1) and straw (9.60 and 10.17 t ha−1) yields. Penoxsulam herbicide significantly showed higher grain and straw yield of 8.19 and 8.28 t ha−1 and 10.13 and 10.44 t ha−1, respectively, than other weed management measures by comparing the means using critical difference. TPR excelled in reducing dry weed biomass more than other established methods. All herbicides considerably reduced dry weed biomass, but Penoxsulam herbicide showed the greatest reduction in dry weed biomass and proved superior against complex weed flora. Weeds showed maximum contribution towards total Biomass under DSR, among rice establishment techniques. In contrast, among different weed control measures, it was maximum in weedy check treatment (Untreated Control) and minimum in penoxsulam treatment. SRI significantly excelled in crop (grain and straw) nutrient uptake compared to the DSR and TPR method, although different crop establishment techniques non-significantly influenced nutrient concentrations. Furthermore, penoxsulam treatment demonstrated higher crop (grain and straw) nutrient uptake among the various weed management measures. However, available soil nutrients were observed among establishment techniques, highest in DSR and lowest in SRI. Moreover, direct-seeded rice excelled SRI and transplanted rice in weed nutrient uptake, and among the different herbicidal treatments, penoxsulam recorded the lowest uptake in weeds. Nutrient budgeting demonstrated that DSR showed the maximum percentage of nutrient removal by weeds, and the minimum ratio was in TPR. In contrast, the lowest rate of nutrients removed via weeds were seen in penoxsulam application under various weed management measures

Leaf Color Chart (LCC)-Based Precision Nitrogen Management for Assessing Phenology, Agrometeorological Indices and Sustainable Yield of Hybrid Maize Genotypes under Temperate Climate

Excessive nitrogenous fertilization in years resulted in larger nitrogen and profit losses. This problem can be reduced by using need-based and time-specific nitrogen management. Therefore, a field experiment was carried out during the Kharif season of 2019 and 2020 in order to evaluate the impact of precision nitrogen management on the phenology, yield and agrometeorological indices of hybrid maize genotypes at the Agronomy Research Farm, FoA Wadura, Sopore, SKUAST-Kashmir. The experiment was carried out in split-plot design consisting of maize hybrids (Shalimar Maize Hybrid-2 Vivek-45 and Kanchan-517) as main plot treatments and precision nitrogen management (T1: Control, T2: Recommended N, T3: 25% N as basal ≤ LCC 3@20 kg N ha−1, T4: 25% N as basal ≤ LCC 3@30 kg N ha−1, T5: 25% N as basal ≤ LCC 4@20 kg N ha−1, T6: 25% N as basal ≤ LCC 4@30 kg N ha−1, T7: 25% N as basal ≤ LCC 5@20 kg N ha−1 and T8: 25% N as basal ≤ LCC 5@30 kg N ha−1) as sub-plot treatments. Results demonstrated that maize hybrids showed a non-significant difference in attaining different phenophases during both years. However, Shalimar Maize Hybrid-2 demonstrated higher grain (62.35 and 60.65 q ha−1) and biological yield (170.26 and 165.86 q ha−1), a higher number of days to attain different phenological stages in comparison to Vivek-45 and Kanchan-517 thereby achieved higher heat units, PTUs, HTUs, PTI. The application of nitrogen through LCC ≤ 5@30 kg N ha−1 noted higher grain yield (61.27 and 59.13 q ha−1) and biological yield (171.30 and 166.13 q ha−1) during 2019 and 2020 respectively. Higher values of Growing degree days (GDD), Heliothermal units (HTU), Photothermal units (PTU), Phenothermal index (PTI), heat use efficiency (HUE) and radiation use efficiency (RUE) were observed in the application of nitrogen through LCC ≤ 5@30 kg N ha−1 and required the highest number of days to reach different phenophases than other treatments during crop growing seasons of 2019 and 2020. The results demonstrated that Nitrogen application based on LCC ≤ 5@30 proved effective and should be adopted in maize hybrids especially in Shalimar Maize Hybrid-2 to attain higher yield under the temperate climate of Kashmir Valley

Real-Time Nitrogen Application of Rice Varieties Based on Leaf Colour Chart under System of Rice Intensification in Temperate Climate

Increasing nitrogen use efficiency in rice intensification (SRI) is pivotal to achieving high crop yield and reducing nitrogen losses. To find the critical value of the leaf color chart (LCC) for real-time nitrogen (N) application in rice varieties under SRI, a field experiment was laid at the Research Farm, Faculty of Agriculture, Wadura, SKAUST-Kashmir in Kharif between 2019 and 2020. The experiment comprised two cultivars (SR-3 and SR-4) and eight LCC-based nitrogen managements (control, recommended dose of nitrogen (RDF), and three LCC scores (≤3, ≤4, ≤5 each with 20 and 30 kg N ha−1). SR-4 produced significantly higher values for growth and yield parameters, producing higher grain yield (7.02 and 6.86 t ha−1) compared to SR-3 (6.49 and 6.36 t ha−1) between 2019 and 2020, respectively. An LCC value of 5 with 30 kg N ha−1 produced maximum grain yield (7.84 and 7.70 t ha−1) in 2019 and 2020, respectively, which were statistically at par with the LCC value of 5 with 20 kg Nha−1. Pooled data revealed that the highest B: C ratio of 1.55 was recorded in cultivar SR-4 with an LCC value of 5 with 30 kg N ha−1. Furthermore, agronomic and recovery efficiency of nitrogen remained maximum in LCC 5 with 20 kg N ha−1 for both years. Grain yield recorded in LCC 3 20 kg N ha−1 was similar to recommended nitrogen. The present study highlighted the need-based N application through LCC and proved effective in increasing the N-use efficiency and yield in rice

Estimation of yield, phenology and agro-meteorological indices of Quality Protein Maize (Zea mays L.) under different nutrient omissions in temperate ecology of Kashmir

The major yield governing factors especially under rainfed ecosystem are the agro-meteorological indices. Hence, an experiment was conducted in 2021 kharif season to examine the impact of nutrient omission on phenology, yield and agro-meteorological indices of Quality Protein Maize (QPM) under the North Western Himalayas of India at the Agronomy farm of FoA (Faculty of Agriculture), Wadoora, Sopore, SKUAST-Kashmir. Eight treatments were used in the experiment viz. (T1-Absolute control, T2-N120P75K40, T3-N120P75K40Zn5S10, T4-P75K40Zn5S10 (-N), T5-N120K40Zn5S10 (-P), T6-N120P75Zn5S10 (-K), T7-N120P75K40S10 (-Zn) and T8-N120P75K40Zn5 (-S)), using a randomized complete block design with three replications. Results demonstrated that recommended dose of fertilizer plus zinc and sulphur (T3-N120P75K40Zn5S10) noted higher grain (9.78 t ha−1) and biological (22.05 t ha−1) yield, a longer period of time to reach various phonological stages thereby achieved maximum heat units or growing degree days (GDD), heliothermal units (HTU), photo-thermal units (PTU), pheno-thermal index (PTI) and heat use efficiency (HUE). Nitrogen was the most limiting nutrient thereby accumulating least heat units and HUE. The agrometeorological indices could be therefore helpful in predicting the phenology and maize yield. The outcomes of the experiment showed that using the recommended fertilizer dosage plus zinc and sulphur in QPM should be adopted to attain higher yield under the North Western Himalayas of India, However, additional agro-ecological study is required to further validate the findings