Integrated nutrient management and formulation of fertilizer prescription equation for recommendation of fertilizers for potato on alluvial soils of eastern India

Aim: To develop economically viable integrated fertilizer prescription equation for recommendation of fertilizers in potato on alluvial soils of Eastern India.Methodology: Soil test crop response (STCR) experiments on potato were conducted in alluvial soils of Eastern India during 2016-17 to assess the relationship between yield and availability of plant nutrients for developing fertilizer prescriptions of desired yield targets. The decision on optimum fertilizer doses for varying yield targets were made on the basis of crop nutrient requirement per quintal of potato production, soil efficiency, fertilizer efficiency, and FYM efficiency computed from field experimental data. The optimum fertilizer doses for different yield targets were validated in farmers’ field for economic and environmental benefits as compared to general recommended doses of fertilizers and farmers’ practice. Results: Targeted yield equation for potato for alluvial soil of Eastern India was developed based on soil test values, nutrient requirement and contribution of NPK from soil and fertilizer sources as well as FYM. The prescription based fertilizer application along with FYM increased tuber yield of potato in farmers’ field. Validity of the yield target for 22 and 24 t ha-1 was tested in farmer’s fields and variation in potato yield obtained from targeted yield was 7.6% to 9.8%. Interpretation: Fertilizer prescription equations and ready reckoner developed for potato will be useful in alluvial soils of Eastern India for large scale recommendations and in regions with similar soil and agro-climatic conditions. By following ready reckoner, a farmer can save 61 kg N, 55 kg P2O5 and 44 kg K2O ha-1 over general recommended dose, approximately equal to Rs. 4800/- per hectare.

Comprehensive Drought Analysis Using Statistical and Meteorological Indices Approach: A Case Study of Badin, Sindh

Drought is a global phenomenon that can occur in any ecological zone and render significant damages to both the natural environment and human lives. However, hydro-climatic stresses are growing distinctly in the arid zones across the globe. Literature suggests that the analysis of a long-term data-set could help in strengthening of mitigation planes and rationalization of disaster management policies. Thus, the present study is aimed to analyze the evidence-based historical drought events happened in arid-zone Badin, Pakistan and predict its occurrence and severity for the next 82 years (2018-2099). Drought indices viz standardized precipitation index and reconnaissance drought index have been used to detect the severity of the drought events. Thirty years (1988 to 2017) past data of precipitation and temperature were used to categorize the drought severity and validated against the local data. Climate projections based on RCP 4.5 and 8.5 made at 25x25 km resolution used for future drought analysis. The results demonstrate that the region faced severe to extreme drought in 1990-91 and 2001-04. While, in future 2020-21, 2036-37, 2038-39 would be the extreme driest years under RCP 4.5 and 2029-30, 2089-90 under RCP 8.5. Further insight revealed that the average annual temperature has increased and precipitation has decreased w.r.t the base year 1988. It is concluded that drought detection with SPI and RDI is suitable and drought prediction with the RCP 4.5 and 8.5 could be a better option.

L-isoleucine-supplemented Oral Rehydration Solution in the Treatment of Acute Diarrhoea in Children: A Randomized Controlled Trial.

Antimicrobial peptides represent an important component of the innate immune defenses of living organisms, including humans. They are broad-spectrum surface-acting agents secreted by the epithelial cells of the body in response to infection. Recently, L-isoleucine and its analogues have been found to induce antimicrobial peptides. The objectives of the study were to examine if addition of L-isoleucine to oral rehydration salts (ORS) solution would reduce stool output and/or duration of acute diarrhoea in children and induce antimicrobial peptides in intestine. This double-blind randomized controlled trial was conducted at the Dhaka Hospital of ICDDR,B. Fifty male children, aged 6-36 months, with acute diarrhoea and some dehydration, attending the hospital, were included in the study. Twenty-five children received L-isoleucine (2 g/L)-added ORS (study), and 25 received ORS without L-isoleucine (control). Stool weight, ORS intake, and duration of diarrhoea were the primary outcomes. There was a trend in reduction in mean±standard deviation (SD) daily stool output (g) of children in the L-isoleucine group from day 2 but it was significant on day 3 (388±261 vs 653±446; the difference between mean [95% confidence interval (CI) (-)265 (-509, -20); p=0.035]. Although the cumulative stool output from day 1 to day 3 reduced by 26% in the isoleucine group, it was not significant. Also, there was a trend in reduction in the mean±SD intake of ORS solution (mL) in the L-isoleucine group but it was significant only on day 1 (410±169 vs 564±301), the difference between mean (95% CI) (-)154 (-288, -18); p=0.04. The duration (hours) of diarrhoea was similar in both the groups. A gradual increase in stool concentrations of ß-defensin 2 and 3 was noted but they were not significantly different between the groups. L-isoleucine-supplemented ORS might be beneficial in reducing stool output and ORS intake in children with acute watery diarrhoea. A further study is warranted to substantiate the therapeutic effect of L-isoleucine.

Mortality in Patients Treated for Tuberculous Pericarditis in Sub-Saharan Africa

Objective: To determine the mortality rate and its predictors in patients with a presumptive diagnosis of tuberculous pericarditis in sub-Saharan Africa. Design: Between 1 March 2004 and 31 October 2004; we enrolled 185 consecutive patients with presumed tuberculous pericarditis from 15 referral hospitals in Cameroon; Nigeria; and South Africa; and observed them during the 6-month course of antituberculosis treatment for the major outcome of mortality. This was an observational study; with the diagnosis and management of each patient left at the discretion of the attending physician. Using Cox regression; we have assessed the effect of clinical and therapeutic characteristics (recorded at baseline) on mortality during follow-up. Results: We obtained the vital status of 174 (94) patients (median age 33; range 14-87 years). The overall mortality rate was 26. Mortality was higher in patients who had clinical features of HIV infection than in those who did not (40versus 17; P=0.001). Independent predictors of death during follow-up were: (1) a proven non-tuberculosis final diagnosis (hazard ratio [HR] 5.35; 95confidence interval 1.76 to 16.25); (2) the presence of clinical signs of HIV infection (HR 2.28; 1.14-4.56); (3) co-existent pulmonary tuberculosis (HR 2.33; 1.20-4.54); and (4) older age (HR 1.02; 1.01-1.05). There was also a trend towards an increase in death rate in patients with haemodynamic instability (HR 1.80; 0.90-3.58) and a decrease in those who underwent pericardiocentesis (HR 0.34; 0.10-1.19). Conclusion : A presumptive diagnosis of tuberculous pericarditis is associated with a high mortality in sub-Saharan Africans. Attention to rapid aetiological diagnosis of pericardial effusion and treatment of concomitant HIV infection may reduce the high mortality associated with the disease

Introduction of routine zinc therapy for children with diarrhoea: evaluation of safety.

On 8 May 2004, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommended routine administration of zinc in the management of children, aged less than five years, with acute diarrhoea. In making the recommendation, WHO and UNICEF also suggested careful monitoring for adverse events associated with routine administration of zinc, particularly unusual or excess vomiting. The study assessed, in a phase IV trial, i.e. post-marketing surveillance of zinc, the occurrence of adverse events during the first hour after the administration of the first dose of zinc in children with acute or persistent diarrhoea. The study was conducted at the Dhaka Hospital of ICDDR,B and at an outpatient clinic operated by a local health NGO-Progoti Samaj Kallyan Protisthan (PSKP), Dhaka, Bangladesh. Eligible children, aged 3-59 months, were treated with 20 mg of zinc sulphate provided in a dispersible tablet formulation. The children were observed for 60 minutes following the initial treatment with zinc for adverse events, with particular attention given to vomiting or regurgitation. During the one-year observation period, 42,440 children (male 57% and female 43%) received zinc, and 20,246 (47.8%) of them were observed. Regurgitation and/or vomiting occurred in 4,392 (21.8%) of the children; 90.8% of these children had vomiting only once, 8.7% twice, and 0.5% more than twice. No children revisited the hospital for recurrent vomiting following their discharge. A significant proportion of infants and children may experience vomiting or regurgitation, usually once, following the administration of the first dose of zinc. This is a transient phenomenon that did not impact on continuation of treatment with zinc.

Low osmolar oral rehydration salts solution in the treatment of acute watery diarrhoea in neonates and young infants: a randomized, controlled clinical trial.

To compare the efficacy and safety of low osmolar oral rehydration salts solution (ORS-75) (mmol/L: Na+ 75, osmolarity 245) with that of World Health Organization-recommended ORS (ORS-90) (mmol/L: Na+ 90, osmolarity 311 ) in the treatment of acute watery diarrhoea in neonates and very young infants, a randomized double-blind, controlled clinical trial was carried out at the Clinical Research and Service Centre of ICDDR,B: Centre for Health and Population Research, Dhaka, Bangladesh, during January 1998-December 1999. Infants, aged < or = 2 months, presenting with a history of watery diarrhoea of < or = 72 hours, with no or some dehydration and without any systemic illness, were randomly assigned to receive either ORS-75 or ORS-90 for the correction and subsequent prevention of dehydration. Infants were studied for a maximum of five days. Total stool output, stool frequency, and requirement for ORS were outcome measures. Serum electrolytes were measured at 24 hours after admission to monitor serum sodium imbalance. Seventy-three infants received ORS-75, and 71 received ORS-90. Both the groups were comparable in their baseline characteristics. Diarrhoea resolved within five days in 53% and 66% of infants receiving ORS-75 and ORS-90 respectively (p = 0.3). Total stool volume [median (inter-quartile range) 132 (65-280) vs 139 (70-259) g/kg, p = 0.9], during the study period, was not significantly different between the two groups. Total stool frequency [31 (16-51) vs 35 (16-53), p = 0.9] and total ORS intake [192 (96-374) vs 209 (134-317) mL/kg, p = 0.7] were similar between the groups. No infants developed late evidence of hypernatraemia, irrespective of treatment. The results of the study indicate that ORS-75 is as safe as standard ORS-90 in the treatment of acute watery diarrhoea in neonates and very young infants and is effective in correcting and preventing dehydration.

Characteristics of children hospitalized with severe dehydration and persistent diarrhoea in Bangladesh.

The study analyzed data from a systematic sample of children, aged less than five years, who presented with persistent diarrhoea (diarrhoea of more than 14 days duration). It aims to differentiate (a) non-severe persistent diarrhoea (with no or mild dehydration) and (b) severe persistent diarrhoea (with moderate or severe dehydration), and to identify individual characteristics associated with severe persistent diarrhoea. In total, 7,505 patients, who represented a 4% systematic sample of the patient population, were seen during January 1993-December 1995. Of them, 297 (4%) presented with persistent diarrhoea. The male:female ratio was 2:1. Eighty-three percent of them had mild or no dehydration, and 17% had moderate or severe dehydration. Severe malnutrition of the study patients defined as weight-for-age z-score < -3, weight-for-length z-score < -3 and length-for-age z-score < -3 were 33.9%, 9.7%, and 22.7% respectively. Only 3% had oedematous malnutrition, and 11% had xerophthalmia. Factors independently associated with severe persistent diarrhoea by logistic regression analyses were: number of watery stool > 10 times during the last 24 hours prior to admission (OR, 10.0; CI, 1.2-87, p = 0.03), lower respiratory tract infection (OR, 111; CI, 4.2-2955, p = 0.004), and lack of mothers' education (OR, 7.8; CI, 1.4-41.9, p = 0.016) after controlling for confounders. Awareness and health education of mothers or caregivers and better case management during acute diarrhoeal episode might prevent the development of severe persistent diarrhoea in young children. In addition, children with severe persistent diarrhoea might need special attention to have adequate rehydration and control of extraintestinal infections, including respiratory tract infection.

Hepatitis B infection in Bangladeshi mothers and infants.

In order to estimate the relative importance of perinatal transmission of hepatitis B in rural Bangladesh a cross-sectional study was carried out. Paired-serum samples of infants aged 2-8 months old, a group of new born, and their mothers were tested for hepatitis B markers using a commercial ELISA test kit. In total, 107 (32.4%) positive for HBcAg, 18 (5.4%) for HBsAg, and 4 (1.2%) for HbeAg. Of the infants, 35 (10.5%) positive for HBcAg, 1 (0.3%) for HBsAg, and none for HBeAg. Of the 18 HBsAg positive mothers, 4 (22%) were HBeAg positive. All 14 children of mothers who were HBeAg negative were negative for HBsAg. Only one out of four (25%) of children of HBeAg positive mothers were HBsAg carriers (8 months old), and in three children transmission did not occur (two 8 months, one 6 months old). This survey indicates that hepatitis B is prevalent in rural Bangladesh and that the perinatal transmission mode may be relatively low.

Health behavior, perceptions, practices, and decision making: sub-national and socio-demographic differentials in Bangladesh, 1995.

The study examines health behavior, perceptions, practices, and decision making using data from the 1995 Health and Demographic Survey conducted by the Bangladesh Bureau of Statistics. Knowledge about causes of diarrhea and food contamination were higher than knowledge about causes of nightblindness and worm infestation but this knowledge is inadequate. The household's economic condition and the respondent's education were found to be positively associated with disease knowledge and food contamination; the same is also true for health behavior and practices. Sub-national variation in disease knowledge and food contamination exists but did not correspond always with the health behavior and practices. Decisions regarding treatment of disease were made by the husband and wife together in two-thirds of the cases, however, it was not uniform across socio-demographic and sub-national categories.

Role of a large plasmid in mediation of multiple drug resistance in Salmonella typhi and paratyphi A in Bangladesh.

From 405 patients of suspected typhoid fever, 94 Salmonella typhi and 17 Salmonella paratyphi A, were isolated from blood and/or stool at the Institute of Postgraduate Medicine and Research, Dhaka during March 1992 to February 1993. Forty seven percent of the isolates were resistant to multiple drugs which included amoxicillin, ampicillin, chloramphenicol and co-trimoxazole. A large plasmid of 140 MDa was isolated from 73% of multidrug resistant (MDR) strains. However, no plasmid was isolated from any of the strains sensitive to above mentioned antibiotics. Majority of MDR Salmonella transferred resistance to E. coli K-12 (Lac+, F-, NxR.) by conjugation method. The transconjugants were similarly resistant to multiple drugs. All Salmonella were sensitive to ciprofloxacin and ceftriaxone.

Study of complications in hypertensive patients having irregular treatment.

One hundred cases of hypertensive complications due to irregular drug-therapy were studied in medicine units of Dhaka Medical College Hospital for the period of one year from February 7, 1989 to February 6, 1990. Among those stroke had headed the list (48%) manifesting in various ways e.g. cerebral haemorrhage with focal neurological signs--hemiplegia, hemiperesis, aphasia etc. Hypertension associated with varying degrees of cardiac ischaemias and heart failure was seen in 14% and 10% cases respectively. Highest incidence of complications was seen in 1-5 years after detection of hypertension with mean age of 55 +/- 18.70 years. Out of 48 cases of strokes, smoker were 41 (75.92%). Regarding reasons of noncompliance of drugs, personal carelessness was the prominent one (47%). Among the risk-factors for atherosclerosis family history tops the list (66%). Diabetes coexists with hypertension in 13% cases. Ocular complications were seen in 06% cases of malignant hypertension with variable retinal changes.