Clinicopathological Profile and Surgical Treatment of Abdominal Tuberculosis: A Single Centre Experience in Northwestern Tanzania.

Abdominal tuberculosis continues to be a major public health problem worldwide and poses diagnostic and therapeutic challenges to general surgeons practicing in resource-limited countries. This study was conducted to describe the clinicopathological profile and outcome of surgical treatment of abdominal tuberculosis in our setting and compare with what is described in literature. A prospective descriptive study of patients who presented with abdominal tuberculosis was conducted at Bugando Medical Centre (BMC) in northwestern Tanzania from January 2006 to February 2012. Ethical approval to conduct the study was obtained from relevant authorities. Statistical data analysis was performed using SPSS version 17.0. Out of 256 patients enrolled in the study, males outnumbered females. The median age was 28 years (range = 16-68 years). The majority of patients (77.3%) had primary abdominal tuberculosis. A total of 127 (49.6%) patients presented with intestinal obstruction, 106 (41.4%) with peritonitis, 17 (6.6%) with abdominal masses and 6 (2.3%) patients with multiple fistulae in ano. Forty-eight (18.8%) patients were HIV positive. A total of 212 (82.8%) patients underwent surgical treatment for abdominal tuberculosis. Bands /adhesions (58.5%) were the most common operative findings. Ileo-caecal region was the most common bowel involved in 122 (57.5%) patients. Release of adhesions and bands was the most frequent surgical procedure performed in 58.5% of cases. Complication and mortality rates were 29.7% and 18.8% respectively. The overall median length of hospital stay was 32 days and was significantly longer in patients with complications (p < 0.001). Advanced age (age ≥ 65 years), co-morbid illness, late presentation, HIV positivity and CD4+ count < 200 cells/μl were statistically significantly associated with mortality (p < 0.0001). The follow up of patients were generally poor as only 37.5% of patients were available for follow up at twelve months after discharge. Abdominal tuberculosis constitutes a major public health problem in our environment and presents a diagnostic challenge requiring a high index of clinical suspicion. Early diagnosis, early anti-tuberculous therapy and surgical treatment of the associated complications are essential for survival

Acute effects of cigarette smoking on inflammation in healthy intermittent smokers

BACKGROUND: Chronic smoking is the main risk factor for chronic obstructive pulmonary disease. Knowledge on the response to the initial smoke exposures might enhance the understanding of changes due to chronic smoking, since repetitive acute smoke effects may cumulate and lead to irreversible lung damage. METHODS: We investigated acute effects of smoking on inflammation in 16 healthy intermittent smokers in an open randomised cross-over study. We compared effects of smoking of two cigarettes on inflammatory markers in exhaled air, induced sputum, blood and urine at 0, 1, 3, 6, 12, 24, 48, 96 and 192 hours and outcomes without smoking. All sputum and blood parameters were log transformed and analysed using a linear mixed effect model. RESULTS: Significant findings were: Smoking increased exhaled carbon monoxide between 0 and 1 hour, and induced a greater decrease in blood eosinophils and sputum lymphocytes between 0 and 3 hours compared to non-smoking. Compared to non-smoking, smoking induced a greater interleukin-8 release from stimulated blood cells between 0 and 3 hours, and a greater increase in sputum lymphocytes and neutrophils between 3 and 12 hours. CONCLUSION: We conclude that besides an increase in inflammation, as known from chronic smoking, there is also a suppressive effect of smoking two cigarettes on particular inflammatory parameters

Altered Patterns of Gene Expression Underlying the Enhanced Immunogenicity of Radiation-Attenuated Schistosomes

Schistosoma mansoni is a blood-dwelling parasitic worm that causes schistosomiasis in humans throughout Africa and parts of South America. A vaccine would enhance attempts to control and eradicate the disease that currently relies on treatment with a single drug. Although a manufactured vaccine has yet to generate high levels of protection, this can be achieved with infective parasite larvae that have been disabled by exposure to radiation. How these weakened parasites are able to induce protective immunity when normal parasites do not, is the question addressed by our experiments. We have used a technique of gene expression profiling to compare the patterns in normal and disabled parasites, over the period when they would trigger an immune response in the host. We found that only a handful of genes were differentially expressed, all of them diminished in the disabled parasite. However, a more sensitive technique to examine groups of genes revealed that those involved in nervous system and muscle function were depressed in the disabled parasites. We suggest that reduced mobility of these larvae permits them longer contact with the immune system, thus enabling a strong protective immune response to develop

Targeted Next-Generation Sequencing Analysis of 1,000 Individuals with Intellectual Disability.

To identify genetic causes of intellectual disability (ID), we screened a cohort of 986 individuals with moderate to severe ID for variants in 565 known or candidate ID-associated genes using targeted next-generation sequencing. Likely pathogenic rare variants were found in ∼11% of the cases (113 variants in 107/986 individuals: ∼8% of the individuals had a likely pathogenic loss-of-function [LoF] variant, whereas ∼3% had a known pathogenic missense variant). Variants in SETD5, ATRX, CUL4B, MECP2, and ARID1B were the most common causes of ID. This study assessed the value of sequencing a cohort of probands to provide a molecular diagnosis of ID, without the availability of DNA from both parents for de novo sequence analysis. This modeling is clinically relevant as 28% of all UK families with dependent children are single parent households. In conclusion, to diagnose patients with ID in the absence of parental DNA, we recommend investigation of all LoF variants in known genes that cause ID and assessment of a limited list of proven pathogenic missense variants in these genes. This will provide 11% additional diagnostic yield beyond the 10%-15% yield from array CGH alone.Action Medical Research (SP4640); the Birth Defect Foundation (RG45448); the Cambridge National Institute for Health Research Biomedical Research Centre (RG64219); the NIHR Rare Diseases BioResource (RBAG163); Wellcome Trust award WT091310; The Cell lines and DNA bank of Rett Syndrome, X-linked mental retardation and other genetic diseases (member of the Telethon Network of Genetic Biobanks (project no. GTB12001); the Genetic Origins of Congenital Heart Disease Study (GO-CHD)- funded by British Heart Foundation (BHF)This is the final version of the article. It first appeared from Wiley via http://dx.doi.org/10.1002/humu.2290

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Not AvailableRice is a major cereal crop in Himachal Pradesh, a Himalayan state of India, wherepaddy acreage is about 78,000 ha with a low average yield of 19.62 q ha−1due torainfed upland farming. High seeding rates and poor resource-use efficiency of con-ventional fertilizer nitrogen (N) management practices in rainfed upland paddy havealso been major production constraints in rainfed upland ecosystems. To validate andrefine the production technology on seed rate and fertilizer N management, the FarmScience Centre, Sundernagar, India, conducted numerous on-farm trials (OFTs) dur-ing 2006–2010 under an on-farm participatory technology development approach toenhance resource use efficiency through these resource conservation technologies andboost the paddy productivity in the region. Results of two OFTs conducted during Kharif2006 in the Mandi District of Himachal Pradesh on different seed rates under differentsowing methods on VL Dhan-221 and Sukaradhan-1 (HPR-1156) cultivars suitable forrainfed upland conditions revealed that the seed rate at 80 kg ha−1sown in rows 20 cmapart resulted in the greatest average paddy productivity to the tune of 25.6 q ha−1besides greater profitability, followed by a seed rate at 60 kg ha−1sown in rows 20 cmapart (25.2 q ha−1), over the earlier State Agricultural University (SAU)–recommendedpractice, that is, seed rate at 100 kg ha−1in rows 20 cm apart. This refinement in theseed rate was accepted by the participating farmers of the region. The greatest averagebenefit/cost (B/C) ratio was observed in plots with seed rate at 60 kg ha−1sown inrows 20 cm apart. Based on these results and data compilation from other locations ofthe state, now the SAU has refined the seed rate from earlier recommendation of 100 kgha−1to 60 kg ha−1in rows 20 cm apart as well as 80 kg ha−1through broadcast methodunder rainfed upland paddy in Himachal Pradesh. Results of two OFTs conducted dur-ing Kharif 2009 on integrated nutrient management in rainfed upland paddy revealedthat farmyard manure (FYM) at 10 t ha−1+nitrogen, phosphorus, and potassium (N, P,K) at 15:30:30 kg ha−1at sowing followed by 15 kg N ha−115 days after sowing (DAS)and remaining the N [i.e., 30 kg N ha−1] at tillering (45–50 DAS) resulted in the great-est grain yield of 29.85 and 31.67 q ha−1in VL Dhan-221 and HPR-1156, respectively,with respective greater yields of 35.99 and 36.51% over farmers’ practice, besides bet-ter profitability. To further standardize fertilizer N split doses and assess their effecton paddy productivity, another OFT was conducted during Kharif 2010 under rainfedupland paddy conditions in HPR-1156. The results revealed that NPK at 60:30:30 kgha−1(whole of P and K as basal, 50% N at 15 DAS, 25% N each at 45–50 DAS and 70–75 DAS splits) resulted in better grain yield (34.3 q ha−1) and net profitability(`29,786 ha−1) over other treatments. Overall, it is concluded that these resource con-servation technologies developed under the OFT participatory approach can enhancethe rainfed upland paddy productivity and strongly show that there is dire need to splitthe N requirement of rainfed upland paddy in 2–3 splits to reduce the fertilizer N losses,enhance resource-use efficiency, and increase productivity and profitability in HimachalPradesh, IndiaNot Availabl

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Not AvailableIn addition to agriculture, livestock plays an important role in strengthening ruraleconomy of hill farming communities in northwestern (NW) Himalayas, where greenfodder shortage in winter months is a major production constraint for milch animals.Recently released dual-purpose early-sown wheat cultivar VL-829 holds great poten-tial to provide plenty of green fodder in lean winter months following appropriateagrotechnology in Himachal Pradesh, Uttrakhand, and Jammu and Kashmir states ofIndia in NW Himalayas. To validate the performance and profitability of recently gen-erated agrotechnology on forage cutting and nitrogen (N) management in dual-purposewheat VL-829 in wet temperate NW Himalayas under on-farm participatory mode, twoon-farm trials were conducted both under rainfed and irrigated conditions during Rabi2006–2007 and Rabi 2007–2008, using three agrotechnologies. Agrotechnology imbed-ded with nitrogen, phosphorus, and potassium (NPK) at 80:40:40 kg ha−1+20 kg Nha−1(25% greater N) at green forage cut at 85 days after sowing (DAS) +seed rate at125 kg ha−1(25% greater seed rate) was proved as an appropriate agrotechnology forharnessing the ability of dual-purpose wheat VL-829 to harvest additional green forageyield of 58.75 and 92 q ha−1under rainfed and irrigated conditions, respectively, withrespective slight grain yield reduction by 4.76 and 8.89% over check [no forage cut +80:40:40 kg N, P, and K ha−1+seed rate at 100 kg ha−1]. This agrotechnology stan-dardized under on-farm participatory mode again fetched greatest gross and net returnsover other treatments owing to additional income due to green fodder. Overall, appro-priate agrotechnology on forage cutting and N management in dual-purpose wheatresulted in comparatively greater grain and straw yield with additional green fodderbesides the greatest profitability. Therefore, with agronomical interventions coupledwith farmers’ participation in different agroecological microniches of NW Himalayas,both grain yield stability and additional green fodder potential of dual-purpose wheatVL-829 may enhance significantly. This would thereby provide hill farmers with betteroptions to sustain their small-scale agriculture and livestock rearing for sustaining theirfarm livelihood in mountainous terrains of wet temperate NW HimalayasNot Availabl

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Not AvailableFrontline demonstrations technology-transfer program (FLD-TTP) in pulses is a noble initiative of the government of India for higher technology adoption to bridge yield gaps. Thus, a study was conducted in Himachal Pradesh, India, on pulse productivity and profitability enhancement using proven technology besides yield gap analysis under FLD-TTP. Extension yield gaps varied by 485–550, 210–460, 470–640, 290–320, 494–600, and 277–512 kg ha−1 in blackgram (Vigna mungo), kidneybean (Phaseolus vulgaris), pigeonpea (Cajanus cajan), cowpea (Vigna sinensis), chickpea (Cicer arietinum), and lentil (Lens culinaris), respectively, in the current study. Greater technology gaps were registered in cowpea and chickpea and the least in kidneybean. It was inferred that by adopting improved pulse production technology, pulse productivity can be raised by 97–128, 39–82, 112–129, 59–65, 130–141, and 67–126% in blackgram, kidneybean, pigeonpea, cowpea, chickpea, and lentil, respectively. Improved technology package has also enhanced profitability and additional returns enhancing incremental benefit–cost ratio (1.25–7.21). Technology indexes in blackgram (34.3–34.7%), kidneybean (32–37.5%), pigeonpea (47–50.6%), cowpea (68.8–73%), chickpea (59–65%), and lentil (44.3–60.2%) revealed that demonstrated technology under FLD-TTP is quite feasible in prevailing farming situations in Himachal Pradesh, but it strongly emphasizes educating farmers intensively to adopt available technology. Improved technology has also raised water-use-efficiency in Kharif (0.89–1.32 kg ha−1 mm) and Rabi pulses (2.41–5.62 kg ha−1 mm). Overall, FLD-TTP has great potential to scale up pulse productivity and farmers’ livelihoods in Himachal Pradesh and collateral farming situations in the developing world to enhance agricultural production.Not Availabl

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Not AvailableBalh Valley in the northwestern Himalayas in India is well known for cultivation of high-value cash crops and vegetables. The Indo-German Agricultural Project executed four decades ago in the valley has been the driving force for agrarian development in the valley, but crops are still grown under nutrient-starved conditions, giving low productivity compared to national averages. To demonstrate and disseminate the integrated nutrient management (INM) technology in the irrigated ecosystem of Balh Valley, efforts were funded by the Indian Farmers' Fertilizers Cooperative Limited (IFFCO) to develop sustainable crop production systems under cash crops and vegetables following an appropriate technology transfer model by Krishi Vigyan Kendra (KVK), Sundernagar, India. For effective technology transfer, field demonstrations, method demonstrations, farmers' training camps, field days, and numerous field conventions were organized in addition to extending soil testing, literature supply, promotional seed and fertilizer input supply, and training of agro-cooperative society personnel who deal with seed and fertilizer input supply in the region. The greater extension gaps in tomato–blackgram and potato–Kharif onion crop sequences indicated need for effective technology transfer tools for high adoption of technology in these production systems in the valley. Potato–Kharif onion cropping system using INM technology resulted in greater system productivity in terms of blackgram equivalent yield (76.7q ha−1) and gross (3,06,920 ha−1) and net returns (2,22,295 ha−1), followed by tomato–blackgram and green pea–okra production systems, respectively, using an appropriate technology transfer model. The study also revealed improvement in available nitrogen (N)–phosphorus (P)–potassium (K) and organic carbon (C) pool of the soils besides crop productivity and profitability in field trials under INM practices over farmers' practiced plots. Knowledge before the study about soil testing, dose and time of application of organics, chemical fertilizers, and their integrated use ranged from 9 to 41%, whereas knowledge increases after the study ranged between 55 to 88%. The INM technology adoption rate after 1 year of project completion ranged between 66 to 70%, whereas soil testing was done by only 35% of farmers. Thus, INM technology adoption rate was greater following the appropriate technology transfer model based on critical analyses of fertilizer use, existing production systems, and appropriate interventions for technology transfer. This comprehensive study under the IFFCO-KVK Collaborative Project attempts to highlight that an effective technology transfer model can play a key role in adoption of INM technology for sustainable production systems in the developing world, especially for resource- and knowledge-poor farmers of collateral socio agroeconomic environments of developing nations.Not Availabl