ABSTRACT
Background: Liver biopsy plays a crucial role in evaluating allograft dysfunction. Comprehensive analysis of the histological spectrum of complications, particularly rejection, in different time zones is lacking. Aim: To evaluate the histological spectrum of rejection, in four time zones, in a large Living donor liver transplant series. Patients and Methods: Retrospective analysis of 313 biopsies for the last 10 years of living donor liver transplantation (LDLT) recipients. 123 of which had rejection as diagnosis, were redistributed in four time zones [1-early (<3), 2-intermediate (3–6), 3 and 4-late (6–12 and > 12) months] and were assessed for sixteen histological parameters. Results: Biopsies in time zone 1 (26.5%), 2 (20.7%), 3 (24.6%), and 4 (28.1%)] were nearly equal. Multiple coexistent complications existed in 12% of the cases. Rejection diagnosed in time zone groups: 1 = 22 (17.9%), 2 = 27 (22%), 3 = 36 (29.3%), and 4 = 38 (30.9%). Portal inflammation mixed type (P < 0.000), portal vein (P = 0.001) and hepatic vein endothelialitis (P < 0.000), portal eosinophils (P = 0.001), and lymphocytic bile duct damage (P = 0.01) were most pronounced in group 1. Perivenulitis without hepatic vein endothelialitis was observed (P = 0.03) in groups 3, whereas bile duct atypia (P = 0.01) and duct loss (P < 0.000) were observed in group 4. Multiple episodes of rejection displayed significant association with central perivenulitis (P = 0.002) and bile duct loss (P < 0.001). Conclusions: Histological analysis in large series of LDLT recipients highlights the spectrum of complications in different time zones. Late acute and chronic rejection occurred as early as 3 months posttransplant. Central perivenulitis and bile duct atrophy were associated with repeated episodes of rejection and deterioration.
ABSTRACT
Background: High blood pressure and proteinuria are the hallmarks of pre-eclampsia, which develops after the 20th week of pregnancy. Even while pre-pregnancy body mass index (BMI) has been linked to an increased risk of pre-eclampsia in multiple studies in India, very few studies examine the condition’s causes. This kind of research is lacking among the North Indian population. This cross-sectional study examines the factors contributing to pre-eclampsia in the North Indian population. It is possible to use this study’s findings to undertake appropriate actions. Aim and Objective: We sought to determine if pre-pregnancy BMI and pre-eclampsia are linked among pregnant women in the North Indian community. Materials and Methods: Participants (n = 270) were enrolled under the inclusion/exclusion criteria. A sphygmomanometer was manually used to measure the patient’s blood pressure. A positive dipstick test or the presence of 300 mg of protein in a 24-h urine sample was used to diagnose pre-eclampsia. A person’s weight and height were used to calculate their BMI (kg/m2). In India, the new weight-for-height ranges are: Underweight (18.5 kg/m2), normal or lean (18.5–22.9 kg/m2), overweight (23.0–24.9 kg/m2), and obese (25 kg/m2). Result: There were three obese pre-eclampsia patients (23–24.9 BMI) and eight pre-eclampsia patients with pre-pregnancy BMIs of 25 or higher, including three overweight patients. There were no patients with pre-eclampsia in the pre-pregnancy BMI groups of underweight (18.5) and normal (18.5–22.9). There were three cases of mild pre-eclampsia (MP) in women with a pre-pregnancy BMI of 30 or more. Still, no cases of severe pre-eclampsia (SP) or late onset preeclampsia (LOP) and no cases of early onset preeclampsia (EOP) were documented in the category of overweight women. Seven obese (25 BMI) pre-eclamptic women developed MP, whereas one patient developed MP following delivery. Seven cases of LOP, one case of SP, and one case of EOP were found in this category. Conclusion: A high pre-pregnancy BMI was found to be an independent risk factor for pre-eclampsia, and there was a link found between pre-eclampsia and a high pre-pregnancy BMI. Maintaining a healthy weight is essential for women in their reproductive years, and a healthy BMI can be maintained with proper monitoring, nutritional counseling, and other methods.
ABSTRACT
Aim: The aim of the present study was to assess the influence of different integrated crop management (ICM) practices on productivity, resource-use efficiency and energetics of pigeonpea crop so as to overcome various production- and climatic-vulnerabilities in Indo-Gangetic Plains Region (IGPR). Methodology: A study was conducted during Kharif 2017 in pigeonpea under pigeonpea–wheat cropping system at IARI, New Delhi, India to assess the influence of nine different ICM modules [Conventional tillage (CT) based: 04 (ICM1–ICM4); Conservation agriculture (CA) based: 04 (ICM5–ICM8); Organic agriculture based: 01 (ICM9)] on productivity, PAR interception, resource-use-efficiency and energetics in pigeonpea in randomized block design replicated thrice. Results: Pigeonpea seed yield was significantly higher in ICM7 (1.92 t ha-1) – a CA-based ICM module which was followed by ICM5, ICM8 and ICM6. In general, the CA based ICM modules showed an edge over CT based ICM modules with reference to growth, yield and PAR interception. The resource-use-efficiency indices like total water-use-efficiency (TWUE), irrigation water-use-efficiency (IWUE), economic water-productivity (WPE), partial factor productivity of applied nutrients (NPK) also exhibited same trend as that of seed yield with highest TWUE (2.96 kg ha-mm–1) and WPE (104.5 INR ha-mm–1) in ICM7 module. The energy output was highest in ICM7 (2, 23, 664 MJ ha-1) followed by ICM5, ICM8 and ICM6. The trend of energy-use-efficiency was ICM4>ICM2>ICM1>ICM3>ICM5>ICM7>ICM6>ICM8>ICM9, respectively. Interpretation: Conservation agriculture (CA) based modules like ICM7 can be recommended to the farmers for enhancing the plant growth, PAR interception, crop productivity, resource-use efficiency and energetics in pigeonpea alone or on pigeonpea-wheat cropping system basis in semi-arid Indo-Gangetic plains region (IGPR).