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Background: Patients with ?-thalassemia major (TM) require lifelong blood transfusions, leading to iron overload, where active intervention is required. Aims and Objectives: The aim of the study was to evaluate real-world efficacy and safety of deferasirox (DFX) in TM patients at a tertiary care teaching hospital. Materials and Methods: A prospective observational study was conducted at thalassemia ward in a tertiary care teaching hospital in Gujarat for a period of 15 months from April 2021 to July 2022. A total of 100 patients were analyzed during the study period. Patient’s demographic profile, laboratory investigation, and treatment details were analyzed using descriptive statistics. Statistical analysis was done through the statistical software GraphPad Prism 9.4.1 (681). Results: A total of 100 patients were included in the study. A serial significant decrease in median serum ferritin levels was observed in >13 years age group after initiation of DFX. A significant increase in the median dose of DFX was observed at 12 months in the age group of 2–?13 years as compared to baseline (P < 0.05). Adverse reactions observed during the study were increased bilirubin level, increased alanine aminotransferase, and increased serum creatinine, rashes with itching, and arthralgia. Conclusion: A greater reduction in median serum ferritin levels was observed in the adult age group compared to pediatric patients.
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A study was conducted on wheat (Triticum aestivum L.) in laboratory at Acharya Narendra Deva University of Agriculture and Technology, Kumarganj, Ayodhya, Uttar Pradesh, during the 2019–20 for correlation and heritability analysis for seed quality under controlled conditions in wheat. In a wheat crop research, 30 germplasm were tested using three checks each for the parameters of seed weight, seed width, seed length, shoot length, root length, seedling length, seedling dry weight, germination (%), first count, final count, and vigour index-I and vigour index-II. In this study, the germplasm was assessed using parameters and the correlation coefficient. The vigour index-II demonstrated a very significant positive phenotypic connection with root length (0.828), final count (0.564), and first count (0.552), as well as a genotypically significant positive correlation with final count (1.165), root length (0.867), and first count (0.552). The high estimates (>15%) of phenotypic coefficient of variation (PCV) and genotypic coefficient of variation (GCV) were registered in the case of vigour index-I (PCV=17.36%, GCV=17.24%), shoot length (PCV=15.96%, GCV= 15.77%), seed width (PCV= 15.35%, GCV= 15.19%). The moderate estimate (10%) of PCV and GCV were recorded for root length (PCV=12.72%, GCV=12.56%), and seedling length (PCV= 11.46, GCV= 11.30).
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This research focuses on the functional characterization of 19 rhizobia strains isolated from Southern Rajasthan's Udaipur and Dungarpur districts, with an emphasis on their multiple Plant Growth Promoting (PGP) activities. Through a series of tests encompassing Indole-3-Acetic Acid (IAA) production, siderophore production, phosphate solubilization, ammonia production, and hydrogen cyanide (HCN) production, this study elucidates the diverse PGP potential of these rhizobia strains. The results showcase variations in IAA production, highlighting their ability to enhance root development and overall plant growth, while also revealing strains capable of siderophore production, indicating potential iron uptake facilitation. Furthermore, some strains exhibit phosphate solubilization, ammonia production, and HCN production capabilities, signifying their potential to improve nutrient availability and protect plants from pathogens. These findings underscore the promise of harnessing the PGP activities of these rhizobia strains for sustainable agricultural practices in Southern Rajasthan and similar agroecological regions, with implications for enhanced crop yields and soil health.
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Spine gourd (Momordica dioica Roxb., 2n = 2X= 28) is a nutritionally rich, perennial and dioecious cucurbit with good assortment of adaptability. Varieties of spine gourd improved germplasm/varieties collected from farmers' field and were sown in Completely Randomized Design (CRD) with Three replications at Acharya Narendra Deva University of Agriculture and Technology Ayodhya, Uttar Pradesh, India during monsoon season 2020. Biochemical characteristics of spine gourd analysis revealed that maximum Protein content (3.09mg/100g) was found in variety Kheri-3,1. Total free amino acid content (6.90mg/100g) was found in variety NDMD-2. Minimum protein content was found in the variety Arka Bharat (2.94mg/100g) and Total Free Amino acid content was reported in the variety Ambika-K-13,6 (6.27mg/100g). Based on observation, variety Kheri-3,1 and NDMD-2 were found superior in both Protein and Total Free Amino acid parameters followed by germplasm Arka Bharat and Ambika-13,6 respectively.
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The current investigation on the repercussions of drought stress on the growth parameters of the Moth bean (Vigna aconitifolia) has been carried out in a semi-field condition. Two sets of local moth bean cultivars (RMO-40: fifteen in each) were prepared, and one was subjected to terminal drought stress. The rest was maintained with proper watering as a control set. The treated plants were thoroughly evaluated based on leaf length, root length, and relative leaf water content in comparison with the control ones. The findings of this study reveal a significant impact of drought stress on moth bean's growth and physiological performance. Under drought conditions, treated plants exhibited considerable reductions in leaf length and root length compared to their well-watered counterparts. Additionally, the relative leaf water content declined under drought stress, indicating decreased water uptake and retention within the plants under stress. These outcomes underscore the vulnerability of moth bean to drought stress, emphasizing the urgency of developing efficient water management strategies and drought-resistant varieties to safeguard food security in regions where this legume serves as a staple crop. This research highlights the importance of understanding the adverse effects of drought stress on moth bean's growth parameters for sustainable agriculture and food production.
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Background: Breast cancer related Lymphedema (BCRL) in the respective arm is a common but serious negative sequel of breast cancer management. Risk factors include dissection of Axillary lymph nodes and irradiation of Regional lymph nodes. Nearly 20% of patients receiving treatment of breast cancer develop this complication and it has a negative impact on quality of life of the patient. Objective: Current study aims to equip the medical professionals with all the details needed for prevention, early detection, intervention and management of this hazardous late treatment related complication. Material and Methods: Total 350 breast cancer patients (with their consent) treated at Government Cancer Hospital, Indore in the Radiotherapy and Oncology Department, in period from January 2019till December 2021, with chest wall radiotherapy following subsequent hormonal therapy, as needed. Patients then analysed for occurrence of lymphedema. Subsequently, efforts were given for finding out the correlation between lymphedema and related treatment modality like adjuvant radiotherapy following definitive surgery with number of excised lymph nodes and number of involved lymph nodes, chemotherapy, hormonal therapy, subjective co-morbid condition (obesity, diabetes mellitus and high blood pressure). Results: Current study demonstrate a significant correlation of adjuvant radiotherapy, including progressive involvement of the lymph node stations, with radical or conservative breast surgery with lymph node dissection represents a statistically significant risk factor, with relative risk, RR=1.49 (95% CI=0.72–3.05), p<0.001. Subsequent increase in number of dissected lymph nodes shown a risk factor with statistical significance as relative risk for more than 25 removed lymph nodes, demonstrated significant risk of lymphedema than for 16-25 removed lymph nodes. Other analysed risk factors, which did not influence lymphedema development like, associated chemotherapy, hormonal therapy or presence of co-morbid illnesses. Conclusions: Arm lymphedema is a late sequel associated with carcinoma breast treatment using radiation or surgery, and quite capricious occurrence that can happen years after axillary clearance surgery. With the use of sentinel node sampling, could reduce the need of frank axillary clearance by showing either involvement of lymph node in axilla, so as to manage only by radiotherapy. That significantly reduces the risk of lymphedema from 16% with axillary clearance to 5% without dissection.
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Introduction: Cervical vertebrae constitute the skeletal framework of vertebral column in the region. The most important feature to identify the cervical vertebra is the presence of foramen transversarium. Vertebral artery, vertebral vein and sympathetic chain run through this foramen as a single unit. Compartmentalization or absence of the foramen may alter the course of these structures. Material and methods: The study was performed on 240 dry human cervical vertebrae of both sexes, which were collected from Anatomy department of MSYMCH, Meerut and HIMS, Varanasi. The variations in number and shape were observed, recorded and analyzed. The intact cervical vertebrae without any degenerative or traumatic disorders were included in this study. Result: Out of 240 cervical vertebrae, 63 vertebrae were found to have variations in the transverse foramina. Complete double transverse foramina were observed in 48 vertebrae (20%), out of which unilateral double foramina were found in 29 vertebrae (12%) and bilateral double foramina were found in 19 vertebrae (8%). Similarly, incomplete double transverse foramina were observed in 15 vertebrae (6%), of which the foramina were unilateral in 8 vertebrae (4%) and bilateral in 5 vertebrae (2%). Conclusion: In our study, we observed the double foramen transversarium in 26.25% of the cases. These variations may alter the course of vertebral artery. Presence of compartmentalization suggests the chances of compression of neurovascular bundle. Spicules of incomplete septation between the two foramina may pierce the vascular or neural structures resulting into vascular insufficiency or persisting pain. These findings may suggest a cue to the spinal surgeons in planning preoperative procedures for surgeries related to this region
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Posotoprative nausea and vomiting remains a persistent and distressing problem inspite of many advances on perioperative care and anti-emetic drugs. A newer antiemetic drug Granisetron has not been studied in patients undergoing gynaecological surgery under spinal anaesthesia
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Background: There are many accepted anesthesia techniques for elective foot surgery ranging from general anesthesia to regional anesthesia, regional anesthesia being the preferred method. Regional anesthesia techniques employed for foot surgery includes subarachnoid block, epidural anesthesia and ankle block. Objective: The present study is aimed at providing comparative analysis of ankle block with unilateral subarachnoid block for elective foot surgeries in terms of hemodynamic safety profile and post operative analgesia. Material and Methods: Study includes prospective analysis of 80 ASA II and III patients who underwent elective foot surgery. Patients were randomly divided into two groups of 40 each, Ankle block group (AB) and Unilateral subarachnoid group (US). The parameters recorded for study includes systolic blood pressure, diastolic blood pressure, heart rate, visual analogue scale for pain severity, time of first analgesic need and the complications. Results: There were minimal blood pressure changes and heart rate variability in AB group as compared to US group when compared with basal values (p<0.05). The time for first analgesic requirement is prolonged in AB group as compared to US group. The visual analogue scale score was assessed at 2nd ,4th and 6th hours for group AB were lowered as compared to group US (p <0.05).
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Ebola Virus Disease or Ebola Haemorrhagic Fever is one of the highly fatal viral disease caused by ebola virus in humans. Mortality rate as high as 90% is reported. Virus is transmitted to humans through bats and other animals infected from bats. Although Ebola Virus Disease is reported since 1976 but currently West Africa is facing the largest outbreak of disease with danger of spread to other parts of the world. More than 5000 cases with mortality of more than 2600 cases has been reported till the end of 3rd quarter of year 2014. There is no specific treatment and vaccination available till date. Mainstay for managing patient is supportive care with early fluid resuscitation and symptomatic treatment. Our main target is to prevent human transmission by educating and supporting the community.
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Ventilator-associated pneumonia (VAP) is a type of hospital acquired pneumonia commonly encountered in patients who receive mechanical ventilation and is associated with significant mortality and morbidity. VAP is associated with prolonged ventilation, increased antibiotic use, emergence of multidrug resistant organisms, prolonged critical care unit stay resulting in increased cost of care. It has been reported to occur in 9 to27 percent of all intubated patients. As per International Nosocomial Infection Control Consortium (INICC) report data summary, the overall rate of VAP was 13.6 per 1,000 ventilator days. Preventive measures, early diagnosis and treatment of VAP result in better outcome. The aim of this review was to search the literature for incidence, various risk factors, etiology, pathogenesis, treatment, and prevention of VAP. A literature search for VAP was done through the PUBMED/MEDLINE database. VAP is a commonly encountered nosocomial infection occurring in ventilated patients and is associated with increased mortality and morbidity. Outcome of patient with VAP depends on hospital setting, patient group, infection control policy, early diagnosis and judicious antibiotic use.
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Background: Pain is an unpleasant sensory or emotional experience usually occurs due to potential tissue damage associated with surgical trauma. Opioids and Non steroidal antiinflammatory drugs are commonly used to alleviate pain but both have their own limitations in clinical use. Objectives: This prospective randomized clinical trial was undertaken to evaluate the efficacy and quality of recovery with intravenous paracetamol versus tramadol for post operative analgesia after elective surgery. Material and Methods: 40 ASA I&II patients of age group 15-40 years scheduled for elective surgery under general anaesthesia were enrolled in the study. After premedication, patients were randomized into two groups. Following induction of general anaesthesia patients of group 1 [n=20] received 15mg/kg of IV paracetamol and group 2 [n=20] received 1.0 mg/kg of IV tramadol over 15 minutes. During measurements, modified hanallah pain observation scores, Aldret scores [readiness for discharge], Sedation scores and Time to first rescue analgesia were recorded every 5 minutes during the first 30 minutes, then every 10 minutes for the remaining 30 minutes of the PACUs stay and upto first 2 hours in the ward. Statistical Analysis was done using SPSS Software Ver. 17. Results: Results reveals there is statistically significant difference in mean postoperative observational pain score, aldret score and time to first rescue analgesia though the mean post operative nausea & vomiting incidence and sedation score between two groups are statistically non significant . Conclusion:Clinically intravenous paracetamol offers better analgesic benefits to the patients than that of tramadol and due to early recovery characterstics in paracetamol group, patients are discharged early in case of paracetamol group and thus are economically effective in day care surgeries.