Beneficial Remedies of Ayurvedic Medicines Against Allopathic Drugs In Peptic Ulcer

Ayurveda has long been regarded as the most dependable and secure medical system. The effectiveness of Ayurvedic Remedies becomes evident after a certain period of time. These remedies operate by enhancing the immune response or eliciting antagonistic reactions. Ayurvedic treatments utilize substances derived from plants, marine sources, and minerals. These remedies tend to have minimal to no observed side effects due to their natural origin. Here, we compared the Allopathic therapies with Ayurvedic remedies for Peptic Ulcer disease

Effect of planting periods on production potential of potato (Solanum tuberosum) varieties under aeroponics

An experiment was conducted during 2017–18 in the aeroponic unit of ICAR-Central Potato Research Institute in Shimla, Himachal Pradesh, to evaluate 3 potato (Solanum tuberosum L.) cultivar’s, viz. Kufri Mohan, Kufri Lauvkar and Kufri Himalini growth and production behaviour under 2 different planting periods spaced 10 days apart during the autumnal season. The yield per plant and the total number of mini-tubers were shown to be strongly impacted by the planting season as well as the cultivar, according to the findings. The average number of tubers harvested was 32.7/plant in early (10th September) planting as against 21.2 mini-tubers/plant in late (20th September). Similarly, yield per plant was significantly higher (67.67 g/plant) with early planting than with late planting (35.99 g/plant). The production behaviour of the potato varieties under consideration varied significantly. The maximum yield/plant and mini-tuber numbers were recorded in Kufri Lauvkar (34.17 and 73.12 g/plant, respectively), which were significantly higher than the remaining 2 cultivars, which were statistically at par for both the number of yield/plant and minitubers. A delay in the planting of 10 days under aeroponics results in a significant reduction not only in the vigour of plants but subsequently in the number as well as weight of mini-tubers harvested. Thus, for attaining higher rates of multiplication under aeroponics during the autumn season, planting should not be delayed beyond 10th September in a hilly temperate wet zone

ENDOPHYTES FROM THE AQUATIC PLANT NELUMBO NUCIFERA: DIVERSITY PROFILE AND ACTIVITY CHARACTERIZATION

Objective: Endophytes represent a niche habitat for the study of novel bio-and chemo diversity. Nelumbo nucifera is an aquatic plant that has not been characterized for endophyte diversity. This study was undertaken with the objective of isolating endophytes from submerged and aerial part of N. nucifera, study the diversity profile of the isolated endophytes and their antimicrobial, antioxidant, and siderophore production capacity.Methods: Endophytes were isolated from aerial and submerged parts of N. nucifera on different media (Starch Casein Nitrate, Glucose Yeast Extract, Nutrient and Potato Dextrose agar). These were further characterized for morphology (colony characteristics, Gram reaction), physiological characteristics (carbon, nitrogen utilization) and activity (antimicrobial, antioxidant, siderophore production). After dereplication, twelve isolates were studied further.Results: All endophyte isolates were Gram-positive bacteria, and one was a fungus. Isolate L-300 showed the highest antioxidant capacity (238 AAE g FW-1) and L-201 least (10 AAE g FW-1. Antimicrobial activity was exhibited against bacteria and fungal targets, with 50% endophytes active against both bacteria and fungi. Isolates L-003 and L-207 exhibited activity against Gram-negative clinical isolates as also fungi. Siderophore production was shown by 58% isolates with L-208 showing maximum activity.Conclusion: This is the first report on profiling of endophytes from N. nucifera. Results show that aquatic plants harbor diverse microbial population. Many promising isolates (such as L-003, L-211, L-214 and L-300) have been characterized in this study and results obtained of antioxidant, antimicrobial and siderophore production capacity demonstrate further utility in polypharmacological studies for identifying compounds of pharmaceutical and other industrial interest.Â

A decade of climate-smart agriculture in major agri-food systems: Earthworm abundance and soil physico-biochemical properties

Earthworms (EWs) could be a viable indicator of soil biology and agri-food system management. The influence of climate-smart agriculture (CSA)-based sustainable intensification practices (zero tillage, crop rotations, crop residue retention, and precision water and nutrients application) on earthworms’ (EWs) populations and soil physico-biochemical properties of rice-wheat cropping system in the Indo-Gangetic plains of South Asia was investigated. This study investigates the effect of 10-years adoption of various CSA practices on the abundance of earthworms and physical and biochemical properties of the soil and EWs’ casts (EWC). Five scenarios (Sc) were included: conventionally managed rice-wheat system (farmers’ practices, Sc1), CSA-based rice-wheat-mungbean system with flood irrigation (FI) (Sc2) and subsurface drip irrigation (SDI) (Sc3), CSA-based maize-wheat-mungbean system with FI (Sc4), and SDI (Sc5). Results revealed that EWs were absent under Sc1, while the 10-year adoption of CSA-based scenarios (mean of Sc2–5) increased EWs’ density and biomass to be 257.7 no. m−2 and 36.05 g m−2, respectively. CSA-based maize scenarios (Sc4 and Sc5) attained higher EWs’ density and biomass over rice-based CSA scenarios (Sc2 and Sc4). Also, SDI-based scenarios (Sc3 and Sc5) recorded higher EWs’ density and biomass over FI (Sc2 and Sc4). Maize-based CSA with SDI recorded the highest EWs’ density and EWs’ biomass. The higher total organic carbon in EWC (1.91%) than in the bulk soil of CSA-based scenarios (0.98%) and farmers’ practices (0.65%) suggests the shift of crop residue to a stable SOC (in EWC). EWC contained significant amounts of C and available NPK under CSA practices, which were nil under Sc1. All CSA-based scenarios attained higher enzymes activities over Sc1. CSA-based scenarios, in particular, maize-based scenarios using SDI, improved EWs’ proliferation, SOC, and nutrients storage (in soil and EWC) and showed a better choice for the IGP farmers with respect to C sequestration, soil quality, and nutrient availability

Initiating antiretrovirals during tuberculosis treatment: a drug safety review

Introduction: Integrating HIV and tuberculosis (TB) treatment can reduce mortality substantially. Practical barriers to treatment integration still exist and include safety concerns related to concomitant drug use because of drug interactions and additive toxicities. Altered therapeutic concentrations may influence the chances of treatment success or toxicity. Areas covered: The available data on drug-drug interactions between the rifamycin class of anti-mycobacterials and the non-nucleoside reverse transcriptase inhibitor and the protease inhibitor classes of antiretrovirals are discussed with recommendations for integrated use. Additive drug toxicities, the impact of immune reconstitution inflammatory syndrome (IRIS) and the latest data on survival benefits of integrating treatment are elucidated. Expert opinion: Deferring treatment of HIV to avoid drug interactions with TB treatment or the occurrence of IRIS is not necessary. In the integrated management of TB-HIV co-infection, rational drug combinations aimed at reducing toxicities while effecting TB cure and suppressing HIV viral load are possible

Integration of antiretroviral therapy with tuberculosis treatment.

Background. We previously reported that integrating antiretroviral therapy (ART) with tuberculosis treatment reduces mortality. However, the timing for the initiation of ART during tuberculosis treatment remains unresolved. Methods. We conducted a three-group, open-label, randomized, controlled trial in South Africa involving 642 ambulatory patients, all with tuberculosis (confirmed by a positive sputum smear for acid-fast bacilli), human immunodeficiency virus infection, and a CD4+ T-cell count of less than 500 per cubic millimeter. Findings in the earlier- ART group (ART initiated within 4 weeks after the start of tuberculosis treatment, 214 patients) and later-ART group (ART initiated during the first 4 weeks of the continuation phase of tuberculosis treatment, 215 patients) are presented here. Results. At baseline, the median CD4+ T-cell count was 150 per cubic millimeter, and the median viral load was 161,000 copies per milliliter, with no significant differences between the two groups. The incidence rate of the acquired immunodeficiency syndrome (AIDS) or death was 6.9 cases per 100 person-years in the earlier-ART group (18 cases) as compared with 7.8 per 100 person-years in the later-ART group (19 cases) (incidence-rate ratio, 0.89; 95% confidence interval [CI], 0.44 to 1.79; P = 0.73). However, among patients with CD4+ T-cell counts of less than 50 per cubic millimeter, the incidence rates of AIDS or death were 8.5 and 26.3 cases per 100 person-years, respectively (incidence-rate ratio, 0.32; 95% CI, 0.07 to 1.13; P = 0.06). The incidence rates of the immune reconstitution inflammatory syndrome (IRIS) were 20.1 and 7.7 cases per 100 person-years, respectively (incidence-rate ratio, 2.62; 95% CI, 1.48 to 4.82; P<0.001). Adverse events requiring a switching of antiretroviral drugs occurred in 10 patients in the earlier-ART group and 1 patient in the later-ART group (P = 0.006). Conclusions. Early initiation of ART in patients with CD4+ T-cell counts of less than 50 per cubic millimeter increased AIDS-free survival. Deferral of the initiation of ART to the first 4 weeks of the continuation phase of tuberculosis therapy in those with higher CD4+ T-cell counts reduced the risks of IRIS and other adverse events related to ART without increasing the risk of AIDS or death

Bundling subsurface drip irrigation with no-till provides a window to integrate mung bean with intensive cereal systems for improving resource use efficiency

The future of South Asia’s major production system (rice–wheat rotation) is at stake due to continuously aggravating pressure on groundwater aquifers and other natural resources which will further intensify with climate change. Traditional practices, conventional tillage (CT) residue burning, and indiscriminate use of groundwater with flood irrigation are the major drivers of the non-sustainability of rice–wheat (RW) system in northwest (NW) India. For designing sustainable practices in intensive cereal systems, we conducted a study on bundled practices (zero tillage, residue mulch, precise irrigation, and mung bean integration) based on multi-indicator (system productivity, profitability, and efficiency of water, nitrogen, and energy) analysis in RW system. The study showed that bundling conservation agriculture (CA) practices with subsurface drip irrigation (SDI) saved ~70 and 45% (3-year mean) of irrigation water in rice and wheat, respectively, compared to farmers’ practice/CT practice (pooled data of Sc1 and Sc2; 1,035 and 318 mm ha−1). On a 3-year system basis, CA with SDI scenarios (mean of Sc5–Sc8) saved 35.4% irrigation water under RW systems compared to their respective CA with flood irrigation (FI) scenarios (mean of Sc3 and Sc4) during the investigation irrespective of residue management. CA with FI system increased the water productivity (WPi) and its use efficiency (WUE) by ~52 and 12.3% (3-year mean), whereas SDI improved by 221.2 and 39.2% compared to farmers practice (Sc1; 0.69 kg grain m−3 and 21.39 kg grain ha−1 cm−1), respectively. Based on the 3-year mean, CA with SDI (mean of Sc5–Sc8) recorded −2.5% rice yield, whereas wheat yield was +25% compared to farmers practice (Sc1; 5.44 and 3.79 Mg ha−1) and rice and wheat yield under CA with flood irrigation were increased by +7 and + 11%, compared to their respective CT practices. Mung bean integration in Sc7 and Sc8 contributed to ~26% in crop productivity and profitability compared to farmers’ practice (Sc1) as SDI facilitated advancing the sowing time by 1 week. On a system basis, CA with SDI improved energy use efficiency (EUE) by ~70% and partial factor productivity of N by 18.4% compared to CT practices. In the RW system of NW India, CA with SDI for precise water and N management proved to be a profitable solution to address the problems of groundwater, residue burning, sustainable intensification, and input (water and energy) use with the potential for replication in large areas in NW India

Unique features and clinical importance of acute alloreactive immune responses

Allogeneic stem cell transplantation (allo-SCT) can cure some patients with hematopoietic malignancy, but this relies on the development of a donor T cell alloreactive immune response. T cell activity in the first 2 weeks after allo-SCT is crucial in determining outcome, despite the clinical effects of the early alloreactive immune response often not appearing until later. However, the effect of the allogeneic environment on T cells is difficult to study at this time point due to the effects of profound lymphopenia. We approached this problem by comparing T cells at week 2 after allograft to T cells from autograft patients. Allograft T cells were present in small numbers but displayed intense proliferation with spontaneous cytokine production. Oligoclonal expansions at week 2 came to represent a substantial fraction of the established T cell pool and were recruited into tissues affected by graft-versus-host disease. Transcriptional analysis uncovered a range of potential targets for immune manipulation, including OX40L, TWEAK, and CD70. These findings reveal that recognition of alloantigen drives naive T cells toward a unique phenotype. Moreover, they demonstrate that early clonal T cell responses are recruited to sites of subsequent tissue damage and provide a range of targets for potential therapeutic immunomodulation

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme