A case control study on s. uric acid and s. creatinine level in pre-eclampsia patients of a tertiary care hospital in Jabalpur district of Central India

Background: Pre-eclampsia is a multisystem disorder of pregnancy which is characterized by hypertension with proteinuria after 20 weeks of gestation in previously normotensive and non proteinuric pregnant women. Pre-eclampsia associated with intrauterine growth retardation, preterm birth, maternal and perinatal death. Serum creatinine and uric acid has been shown to play a significant role in the pathogenesis of the disease and often precede clinical manifestations. This study compares the serum creatinine and uric acid in pre -eclampsia case and normal pregnant women and to assess its role in pre-eclampsia.Methods: 158 patients of which 79 pre-eclampsia (cases) and 79 (controls) were selected randomly and were matched with their gestational age in patient who Attending ANC clinic at Department of Obstretics and Gynecology in March 2016 to August 2017. Lipid profile was estimated by the Randox imola is a compact fully automated clinical chemistry analyser.Results: Authors observed that pre-eclampsia is more common in young age pregnant women with low socioeconomic status with strenuous activities. The mean age was 24.51±3.707 years. The mean serum creatinine and urice acid value is analysed in pre-eclampia cases and compared with control group showing significantly increase (p<0.0001).Conclusions: Young age, nullyparity, low socio economic status specially labour occupation, with derangment of Serum creatinine in pregnant women were found to be more prone to develop pre-eclampsia. Proper history tacking, examination and estimation of serum creatinine and uric acid may be helpful for early diagnosis and management of pre–eclampsia in order to prevent fetal and maternal complications especially in nulliparous women

Understanding future water challenges in a highly regulated Indian river basin — modelling the impact of climate change on the hydrology of the upper Narmada

The Narmada river basin is a highly regulated catchment in central India, supporting a population of over 16 million people. In such extensively modified hydrological systems, the influence of anthropogenic alterations is often underrepresented or excluded entirely by large-scale hydrological models. The Global Water Availability Assessment (GWAVA) model is applied to the Upper Narmada, with all major dams, water abstractions and irrigation command areas included, which allows for the development of a holistic methodology for the assessment of water resources in the basin. The model is driven with 17 Global Circulation Models (GCMs) from the Coupled Model Intercomparison Project Phase 5 (CMIP5) ensemble to assess the impact of climate change on water resources in the basin for the period 2031–2060. The study finds that the hydrological regime within the basin is likely to intensify over the next half-century as a result of future climate change, causing long-term increases in monsoon season flow across the Upper Narmada. Climate is expected to have little impact on dry season flows, in comparison to water demand intensification over the same period, which may lead to increased water stress in parts of the basin

Twenty-first-century glacio-hydrological changes in the Himalayan headwater Beas River basin

The Himalayan Mountains are the source region of one of the world's largest supplies of freshwater. The changes in glacier melt may lead to droughts as well as floods in the Himalayan basins, which are vulnerable to hydrological changes. This study used an integrated glacio-hydrological model, the Glacier and Snow Melt – WASMOD model (GSM-WASMOD), for hydrological projections under 21st century climate change by two ensembles of four global climate models (GCMs) under two Representative Concentration Pathways (RCP4.5 and RCP8.5) and two bias-correction methods (i.e., the daily bias correction (DBC) and the local intensity scaling (LOCI)) in order to assess the future hydrological changes in the Himalayan Beas basin up to Pandoh Dam (upper Beas basin). Besides, the glacier extent loss during the 21st century was also investigated as part of the glacio-hydrological modeling as an ensemble simulation. In addition, a high-resolution WRF precipitation dataset suggested much heavier winter precipitation over the high-altitude ungauged area, which was used for precipitation correction in the study. The glacio-hydrological modeling shows that the glacier ablation accounted for about 5&thinsp;% of the annual total runoff during 1986–2004 in this area. Under climate change, the temperature will increase by 1.8–2.8&thinsp;∘C at the middle of the century (2046–2065), and by 2.3–5.4&thinsp;∘C until the end of the century (2080–2099). It is very likely that the upper Beas basin will get warmer and wetter compared to the historical period. In this study, the glacier extent in the upper Beas basin is projected to decrease over the range of 63&thinsp;%–87&thinsp;% by the middle of the century and 89&thinsp;%–100&thinsp;% at the end of the century compared to the glacier extent in 2005. This loss in glacier area will in general result in a reduction in glacier discharge in the future, while the future streamflow is most likely to have a slight increase because of the increase in both precipitation and temperature under all the scenarios. However, there is widespread uncertainty regarding the changes in total discharge in the future, including the seasonality and magnitude. In general, the largest increase in river total discharge also has the largest spread. The uncertainty in future hydrological change is not only from GCMs, but also from the bias-correction methods and hydrological modeling. A decrease in discharge is found in July from DBC, while it is opposite for LOCI. Besides, there is a decrease in evaporation in September from DBC, which cannot be seen from LOCI. The study helps to understand the hydrological impacts of climate change in northern India and contributes to stakeholder and policymaker engagement in the management of future water resources in northern India.</p

The Indian COSMOS Network (ICON): validating L-band remote sensing and modelled soil moisture data products

Availability of global satellite based Soil Moisture (SM) data has promoted the emergence of many applications in climate studies, agricultural water resource management and hydrology. In this context, validation of the global data set is of substance. Remote sensing measurements which are representative of an area covering 100 m2 to tens of km2 rarely match with in situ SM measurements at point scale due to scale difference. In this paper we present the new Indian Cosmic Ray Network (ICON) and compare it’s data with remotely sensed SM at different depths. ICON is the first network in India of the kind. It is operational since 2016 and consist of seven sites equipped with the COSMOS instrument. This instrument is based on the Cosmic Ray Neutron Probe (CRNP) technique which uses non-invasive neutron counts as a measure of soil moisture. It provides in situ measurements over an area with a radius of 150–250 m. This intermediate scale soil moisture is of interest for the validation of satellite SM. We compare the COSMOS derived soil moisture to surface soil moisture (SSM) and root zone soil moisture (RZSM) derived from SMOS, SMAP and GLDAS_Noah. The comparison with surface soil moisture products yield that the SMAP_L4_SSM showed best performance over all the sites with correlation (R) values ranging from 0.76 to 0.90. RZSM on the other hand from all products showed lesser performances. RZSM for GLDAS and SMAP_L4 products show that the results are better for the top layer R = 0.75 to 0.89 and 0.75 to 0.90 respectively than the deeper layers R = 0.26 to 0.92 and 0.6 to 0.8 respectively in all sites in India. The ICON network will be a useful tool for the calibration and validation activities for future SM missions like the NASA-ISRO Synthetic Aperture Radar (NISAR)

Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2\ub75th percentile and 100 as the 97\ub75th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59\ub74 (IQR 35\ub74–67\ub73), ranging from a low of 11\ub76 (95% uncertainty interval 9\ub76–14\ub70) to a high of 84\ub79 (83\ub71–86\ub77). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030

Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017.

BACKGROUND: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of 'leaving no one behind', it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990-2017, projected indicators to 2030, and analysed global attainment. METHODS: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0-100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator

Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

© 2018 The Author(s). Background: Assessments of age-specifc mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Afairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specifc mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in diferent components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings: Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation: This analysis of age-sex-specifc mortality shows that there are remarkably complex patterns in population mortality across countries. The fndings of this study highlight global successes, such as the large decline in under-5 mortality, which refects signifcant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing