24 research outputs found
Customized vacuum assisted closure therapy of wounds as a simple and cost-effective technique of wound closure-a prospective observational study from underdeveloped world
Background: Aim of the study was to study the efficacy and cost-effectiveness of indigenously designed customized vacuum assisted closure (VAC) of wounds in our patients. The management of difficult to heal wounds has been the main force that led to the development of advanced gadgets for their management. The technique of vacuum assisted closure has revolutionized the management of difficult to heal wounds and delivers better results as compared to conventional technique. Our aim was to assess the efficacy and cost effectiveness of customized VAC therapy.Methods: This prospective study was conducted in the department of surgery and allied specialties, GMC Srinagar, from June 2018 and September 2020. During this period, 80 patients were subjected to VAC therapy and were included in this study.Results: VAC dressing was used in 80 patients. 55 were males and 25 were females. Most of the wounds in our study were located over lower limbs (70%). RTA was the most common mode of injury followed by fall from height. After the VAC therapy, 78.8% patients were managed by STSG, 11.3% by flap cover, 6.3% by secondary suturing and 3.8% healed by secondary intention. Pain was experienced by 30% of the patients, 7.5% had hypoalbuminemia, 3.8% had surrounding skin maceration. The average total cost of the VAC therapy was 863.13 (±399.82) Indian rupees (11.76 USD). The mean duration of hospital stay for our patients was 22 days.Conclusions: Customized VAC Therapy has revolutionary potential in the management of the difficult to treat wounds as far as its safety, speed and cost effectiveness is considered especially in a setup of poor income nations like ours
The anti-angiogenic and cytotoxic effects of the boswellic acid analog BA145 are potentiated by autophagy inhibitors
Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial
Background
Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy
Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial
Background:
Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events.
Methods:
The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627).
Findings:
Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92).
Interpretation:
These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention
Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial
Background:
Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events.
Methods:
The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627).
Findings:
Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92).
Interpretation:
These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention
Comprehensive transcriptome analysis of Crocus sativus for discovery and expression of genes involved in apocarotenoid biosynthesis
Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial
BACKGROUND: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. METHODS: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). FINDINGS: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29-146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0- 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25-1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39-1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65-1·60]; p=0·92). INTERPRETATION: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention. FUNDING: British Heart Foundation
Genetic studies in brown sarson (Brassica rapa L.)
The present investigation on brown sarson (Brassica rapa L.) was carried out to generate information on genetic variability, degree of interrelationship and combining ability (general and specific), nature and magnitude of gene effects and heterosis for yield of 11 morpho-agronomic and quality traits. The experimental material comprised of a diallel set involving 10 diverse lines excluding reciprocals. Significant variability and GxE interaction was observed for all the traits indicating that the behaviour of parents and crosses was not similar in the random set of environments. The experimental material was evaluated in a randomized complete block design with two replications over two locations namely Regional Rice and Research Station, Khudwani (E1) and Experimental Farm, Division of Plant Breeding & Genetics, Shalimar (E2) of SKUAST-K during rabi 2008-09. The data was recorded on days to 50% flowering, plant height (cm), primary branches plant-1, secondary branches plant-1, number of siliquae on main raceme, number of siliquae plant-1, number of seeds siliqua-1, days to maturity, 1000-seed weight (g), seed yield plant-1 (g), oil content (%) and harvest index (%).
Phenotypic and genotypic coefficient of variation was high for seed yield plant-1 followed by primary branches plant-1, secondary branches plant-1, number of seeds siliqua-1 and moderate for secondary branches plant-1 and days to maturity. The expected genetic gain (% of mean) was highest for secondary branches plant-1 followed by seed yield plant-1, number of siliqua plant-1, primary branches plant-1, 1000-seed weight and number of seeds siliqua-1. The lowest genetic gain was observed for days to 50% flowering followed by days to maturity.
Seed yield plant-1 exhibited a significant positive genotypic and phenotypic correlation with all the component traits studied. However, it was negatively correlated with maturity days and oil content at both the levels. For yield components significant positive association was revealed between number of siliqua plant-1 and seed yield plant-1, 1000-seed weight and number of seeds siliqua-1, seed yield plant-1 and harvest index both at phenotypic and genotypic levels.
The mean values were used for statistical analysis and estimation of genetic parameters following diallel analysis. Analysis of variance revealed significant differences among the parents and their crosses for all the traits in the individual environment and the data pooled over environments. The variance due to GCA and SCA was significant for all the traits which showed that both were important in the inheritance of the traits. Significant interaction between combining ability effects and environments were observed for all the traits. The estimates of dominance variance were higher in magnitude than their corresponding additive genetic variance in the individual as well as pooled analysis indicating preponderance of non-additive gene action. Estimates of average degree of dominance revealed preponderance of overdominance for all the traits. None of the parents was found to be a good general combiner simultaneously for all traits. However, CR-1617 was identified as a good general combiner for most of the traits viz., days to 50 per cent flowering, plant height (cm), secondary branches plant-1, number of siliquae on main raceme, number of siliquae plant-1, days to maturity, 1000-seed weight and seed yield plant-1, CR-2871 was the best general combiner for oil content and CR-2630 for harvest index. Overall ranking of genotypes revealed that genotypes CR-1617, CR-2638, CR-2677, CR-1607, CR-1480, KOS-1 and KS-101 could be useful sources of elite alleles based on their general combining effects. The most promising crosses that revealed highly positive and significant SCA effects for yield and yield attributing traits were CR-1485 x CR-1607, CR-1485 x CR-2871, CR-1480 x CR-2677, CR-2871 x KOS-1, CR-2638 x KOS-1, CR-2677 x KOS-1 and CR-2677 x KS-101 (E1, E2 and pooled analysis). The component analysis indicated preponderance of non-additive gene effects in the inheritance of all the traits. Net dominance effect over all loci in heterozygotes ( ) was significant and positive for all traits indicating unidirectional dominance, which was also confirmed from the value of / that indicated asymmetrical gene distribution. The value of KD/KR was more than one indicating presence of excess of dominant genes in parents, which was also verified by / value in almost all the cases. The graphical analysis indicated overdominance in case of 1000-seed weight and oil content (E1, E2 and pooled analysis) whereas, partial to complete dominance was observed for rest of the traits. Significant value of t2 alongwith significant deviation of regression coefficient from unity, indicated presence of non-allelic interactions, for secondary branches plant-1 and number of siliquae on main raceme, low to moderate estimates of heritability (narrow sense) were recorded. Significant and desirable mid and better parent heterosis was observed for most of the traits. The maximum heterosis for seed yield plant-1 was registered in CR-1485 x CR-1607, CR-1677 x KS-101, CR-1485 x CR-2871, CR-2677 x KS-101 and CR-1607 x CR-2677 (mid and better parent estimates). Higher magnitude of mid and better parent heterosis in the favourable direction for seed yield and component traits suggested the possibility of yield enhancement in brown sarson through the exploitation of heterosis breeding provided an economically feasible method is available for production of commercial hybrids
Image_4_Viral metatranscriptomic approach to study the diversity of virus(es) associated with Common Bean (Phaseolus vulgaris L.) in the North-Western Himalayan region of India.JPEG
Plant viruses are a major threat to legume production worldwide. In recent years, new virus strains have emerged with increasing frequencies in various legume cropping systems, which demands the development of cutting-edge virus surveillance techniques. In this study, we surveyed the common bean fields of Kashmir valley for virus infection using a total of 140 symptomatic and non-symptomatic leaf samples collected from different locations. The genetic diversity of viruses was examined by high-throughput sequencing (HTS) with three viruses being identified, namely, Bean Common Mosaic Virus (BCMV), Bean Common Mosaic Necrosis Virus (BCMNV), and Clover Yellow Vein Virus (ClYVV). BCMNV and ClYVV are new reports from India. De novo assembly of transcriptome constructed near-complete genomes of these viruses. RT-PCR results confirmed the presence of these viruses with an emerge incidence of 56. 4% for BCMV, 27.1% for BCMNV and 16.4 for ClYVV in the valley. Several samples were found to contain multiple virus infections with BCMV being the most predominant. Recombination events were detected in the genomes of BCMV and ClYVV, but not BCMNV. Phylogenetic and pairwise identity matrix evidence suggests viral import from multiple countries. Our results demonstrate that HTS followed by multiplex PCR assay is a simple, rapid, and reliable approach for simultaneous diagnosis of plant viruses.</p
Image_2_Viral metatranscriptomic approach to study the diversity of virus(es) associated with Common Bean (Phaseolus vulgaris L.) in the North-Western Himalayan region of India.JPEG
Plant viruses are a major threat to legume production worldwide. In recent years, new virus strains have emerged with increasing frequencies in various legume cropping systems, which demands the development of cutting-edge virus surveillance techniques. In this study, we surveyed the common bean fields of Kashmir valley for virus infection using a total of 140 symptomatic and non-symptomatic leaf samples collected from different locations. The genetic diversity of viruses was examined by high-throughput sequencing (HTS) with three viruses being identified, namely, Bean Common Mosaic Virus (BCMV), Bean Common Mosaic Necrosis Virus (BCMNV), and Clover Yellow Vein Virus (ClYVV). BCMNV and ClYVV are new reports from India. De novo assembly of transcriptome constructed near-complete genomes of these viruses. RT-PCR results confirmed the presence of these viruses with an emerge incidence of 56. 4% for BCMV, 27.1% for BCMNV and 16.4 for ClYVV in the valley. Several samples were found to contain multiple virus infections with BCMV being the most predominant. Recombination events were detected in the genomes of BCMV and ClYVV, but not BCMNV. Phylogenetic and pairwise identity matrix evidence suggests viral import from multiple countries. Our results demonstrate that HTS followed by multiplex PCR assay is a simple, rapid, and reliable approach for simultaneous diagnosis of plant viruses.</p