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ABSTRACT Hemoglobinopathies constitute one of the most common inherited hematological disorders in the world with an increasing global disease burden each year. One among them is sickle cell disease with diverse genotypes and wide phenotypic heterogenity. Many subgroups exist within the umbrella of sickle cell disease. Hb S/DPunjab, a rare hemoglobinopathy, is one of them, mimics sickle cell disease, and is discussed in the present study. We describe one such unusual clinical case of a young child who presented with intermittent fever and joint problems. The study case was found to have Hb S/DPunjab by high performance liquid chromatography. Clinical and hematological details of this rare condition is only briefly discussed in the literature. Precise diagnosis can be made using high performance liquid chromatography in conjunction with family studies.
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Barley (Hordeum vulgare L.) is one of the earliest cultivated cereals and a foundational crop of ancient agriculture. After rice, maize, and wheat, barley is the fourth most widely cultivated cereal crop in the world. It is cultivated in numerous developed and developing nations, where it frequently faces severe drought stress. Every year, droughts afflict the entire planet, frequently with catastrophic effects on crop production. Many crop modification projects have primarily targeted on the enhancement of drought resistance. However, progress toward this objective has been modest due to complexity of the trait, variability and unpredictability of the drought conditions in the field, and diversified drought tolerance mechanisms employed by plants. Barley is regarded as the most drought-resistant grain crop. It serves as an uncomplicated genetic model for studying drought tolerance mechanisms along with the associated agronomic and physiological traits. Several morphological, physiological, biochemical, molecular and quality traits were identified from various barley varieties and used to improve performance under drought stress. The present report is a comprehensive review that intends to give morphological, physiological, biochemical and genomic insights into the modulation of drought stress responses in barley and provide a thorough picture of drought tolerance mechanism.
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A trial was conducted at the Vegetable Research Farm, Department of Horticulture, Naini Agricultural Institute, Sam Higginbottom University of Agriculture, Technology & Sciences,Prayagraj (UP) during 2022. This study investigates the “Effect of Plant Growth Regulators (GA3 and NAA) on growth, yield and quality of Tomato (Solanum Lycopersicum L.).” The purpose of the study is to evaluate the plants in terms of various parameters such as plant height, survival percentage, days to first flowering, days to 50% flowering, number of flower clusters per plant, number of fruit set per cluster, number of fruits per plant, fruit weight, fruit yield per plant, fruit yield per hectare, total soluble solids (TSS), ascorbic acid, and benefit-cost ratio. The results of thestudy indicate that the application of increased percentage of NAA and GA3 significantly improvedthe growth and yield tomatoes. The highest fruit yield, fruit weight, TSS, and ascorbic acid contentwere observed in the plants treated with GA3 @60ppm + NAA @60ppm. The benefit- cost ratio wasalso found to be higher in the treated plants compared to the control. Overall, the study suggests thatthe application of GA3 @60ppm + NAA @60ppm can be an effective and sustainable method for enhancing the growth, yield, and quality of Tomatoes.
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Information about soil properties helps the farmers to adopt e?ective and e?cient farming practices, which can increase higher yields with optimum usage of farm resources. An attempt has been made in this paper to predict soil properties using geospatial kriging approaches. This study mainly focuses on predicting soil pH using different kriging methods. Soil pH dramatically affects many other soil processes, such as nitrification and denitrification, mineralization, precipitation, and dissolution of soil organic matter. Total of seven kriging semivariogram models, namely spherical, circular, exponential, Gaussian, and linear, while two models of universal kriging, such as linear with linear drift and linear with quadratic drift, have been taken to interpolate the spatial soil pH. The performances of these entire models have been validated using mean error, and root mean square error. Spatial analysis revealed that Universal kriging outperformed ordinary kriging with less mean error and root mean square error, 0.016 and 0.52, respectively. The spatial analysis of soil mapping can be instrumental in adopting real-time and on-the-go soil precision practices.
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Dextrocardia with situs inversus is a rare heart condition with a genetic predisposition. Although most individuals lead a normal healthy life and usually, it is an incidental finding. Due to their unique anatomical variations and associated congenital variations, they may pose challenges to attending clinicians. We are hereby reporting a successful anesthetic management of the case of a 2.5-year-old child who presented for emergency laparotomy and on investigations, was found to have dextrocardia along with situs solitus.
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Introduction: Rheumatic mitral stenosis forms 88% of the heart diseases complicating pregnancy in the tertiary referral centre in India. Case report: 27 year old G4P2L2A1 with 39 weeks of gestation with Rheumatic Heart Disease with severe Mitral stenosis with moderate mitral regurgitation and tricuspid regurgitation was posted for elective caesarean delivery. After doing preanaesthetic evaluation patient was managed conservatively with iv diuretics and inj metoprolol and patient status improved from nyha iv to ii. After taking written high risk consent,the patient was taken on OT table with Pre op vitals PR-84/min, BP =110/67mmhg, Sp02=99% in room air and during Intraop course Induction was done after premedication with Inj Etomidate 12 mg IV and scoline 75mg IV and was intubated orotrachealy with RSI technique with ETT of 7.0mm Bilateral air entry confirmed and fixed at 19 cm at corner of mouth. Anaesthesia was maintained with O2 at 100%@5L/min and isoflurane at 0.4-0.6 and inj Atracurium 15+5+5 mg IV and Inj Fentanyl 40 µg IV. Inj.Esmolol 5 mg IV was given at regular intervals to control tachycardia. Tab sildenafil was given via ryles tube.After delivery of the baby,20 IU of oxytocin was given via IV infusion and Inj. Furosemide 40 mg IV was also given.Total fluid input was 300 ml and she had an output of 250 ml.She was also given usg guided b/l TAP block using 40 ml of 0.25% Ropivacaine.She was extubated after giving neostigmine 2.5mg and glycopyrrolate 0.5mg IV.she maintained SPO2 of 99% on room air and was shifted to recovery room and oxygen supplemented pos operatively @6L/minPost op vitals:PR=89/min,BP=120/74mmhg and SPO2=100% Conclusion: Rheumatic mitral stenosis complicating pregnancy is still a frequent cause of maternal death. A better understanding of the physiological changes in pregnancy and the pathological impact of mitral stenosis over pregnancy and a multidisciplinary approach in diagnosis and management reduce the mortality and morbidity
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The experimental trail was conducted at the farm of Rajasthan Agricultural Research Institute (RARI), Durgapura, Jaipur which is the sub campus of Sri Karan Narendra Agriculture University, Jobner, Jaipur (Raj.). In the research study, observed the effect of different liquid biofertilizers and fertility levels on growth, yield and quality of cluster bean (cymopsis tetragonoloba). The test crops were grown on field during July to November kharif-2018 and 2019. The experiment was raised in factorial randomized block design (FRBD). The treatments of experiment comprised of two factors (1) three treatment of fertility levels: 100 % recommended dose of fertilizers (F1), 75% RDF (F2) and 50 % RDF (F3) and eight treatment of liquid biofertilizer : Control-no biofertilizers (L0), Rhizobium (L1), PSB-phosphorus solubilizing bacteria (L2), KMB-potassium solubilizing bacteria (L 3), SSB-sulphur solubilizing bacteria (L 4) , Rhizobium + PSB (L 5 ), Rhizobium + PSB+ KMB (L 6 ) and Rhizobium + PSB+ KMB + SSB (L 7). Total number of treatments were 24 and replicated three times. The result observed that highest nutrient status found in the combination of 100 % RDF (F1) with Rhizobium + PSB+ KMB + SSB (L 7).
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Background: COVID-19 pandemic and quarantine of people who were tested positive made more cautious and anxious when being out in public. This study concentrates on the prevalence of panic and agoraphobia using panic and agoraphobia scale. Methods: Survey research study of 121 subjects using web-based data collection (Google form). Results: The result were obtained using panic and agoraphobia scale. Statistical analysis did not show considerable panic attack and agoraphobia in people who were tested positive for COVID-19. Conclusions: The study population did not show considerable panic attack and agoraphobia after being quarantined or hospitalised during 1st, 2nd and 3rd wave of COVID-19.
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Objectives:The uses of devices of electromagnetic waves(EMWs)are increasing day by day.Similarly,the gen-eration of the waves is increasing.The frequency spectrum of the generation of waves is also increased.In this manuscript,an analysis of the high frequency EMWs has been made by the electric fields generated due to the exposure of 5th generation(5 G)of mobile phones. Methods:Due to the emission of waves from the towers,the electric field is generated around the transmission tower of mobile phones.The electric fields are computed by the power of the transmission tower.The electric fields across the biological tissues/cells are also computed when the EMWs penetrate inside the body.The electric fields are made across the organs of different depths inside the body. Results:The induced electric fields inside the organs of the human beings are responsible for the absorption of energy from high frequency EMWs.The absorbed amount of energy from high frequency waves may become the cause of harmful effects on the life of organs of human beings. Conclusion:In this manuscript,after analysis of the computed electric fields inside the organs of human beings,it is concluded that the EMWs of 5 G spectrum of mobile phone towers may more harmful for the life of organs as 4th generation(4 G)spectrum of mobile phone waves.The energy absorption by the 4 G spectrum is lower than 5 G spectrum due to the range of frequency of waves.The effects on the pancreas,retina,skin,intestine,spleen,stomach and uterus are more than low water content organs like nails,bone,teeth etc.
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Mucormycosis has emerged as an important fungal infection with high associated mortality rates. Mucormycosis causes devastating angio-invasive fungal infections, primarily in patients with underlying risk factors. The prevalence of mortality associated with invasive Mucormycosis is high (>30-50%), with 90% mortality contributed by disseminated disease. Sudden rise in Mucormycosis cases during the COVID-19 pandemic came as a surprise to all. Lowered immunity due to COVID and associated conditions like diabetes, made the population susceptible to this dreaded disease. This disease led to both increase in morbidity and mortality among the general population. Aim of the Study : To interpret in detail the causes of mortality of patients presenting with COVID Associated Mucormycosis (CAM-19) at AIIMS Patna between May-November, 2021. Materials and Methods : An observational study of all patients who were treated for mucormycosis during the period of May 2021-Nov 2021 in ENT Department, AIIMS, Patna. During the period of study, 219 patients of RhinoOrbital-Cerebral Mucormycosis (ROCM) were admitted for treatment. Five patients had gone on Leave Against Medical Advice (LAMA). So, 214 patients were included in the study. Results : Among the 214 patients, 165 patients were treated surgically through both endoscopic and open approaches along with antifungal therapy management. 41 patients died during the hospital course of the treatment. The mortality rate of ROCM stood at 19.15% in our series. Pulmonary Mucormycosis had high mortality (100%). Diabetes is the most common risk factor. Multiple co-morbidities and extensive intracranial involvement had a strong association with mortality. Conclusion : The advanced stage of ROCM was associated with more deaths. Our series mortality rate of 19.15% is lower than most of the other documented mortality rates. Our results support that early aggressive surgical approach, antifungal therapy and multidisciplinary approach has reduced the mortality
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COVID-19 was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Since then, efforts were initiated to develop safe and effective vaccines. Till date, 11 vaccines have been included in the WHO’s emergency use list. The emergence and spread of variant strains of SARS-CoV-2 has altered the disease transmission dynamics, thus creating a need for continuously monitoring the real-world effectiveness of various vaccines and assessing their overall impact on disease control. To achieve this goal, the Indian Council of Medical Research (ICMR) along with the Ministry of Health and Family Welfare, Government of India, took the lead to develop the India COVID-19 Vaccination Tracker by synergizing three different public health databases: National COVID-19 testing database, CoWIN vaccination database and the COVID-19 India portal. A Vaccine Data Analytics Committee (VDAC) was constituted to advise on various modalities of the proposed tracker. The VDAC reviewed the data related to COVID-19 testing, vaccination and patient outcomes available in the three databases and selected relevant data points for inclusion in the tracker, following which databases were integrated, using common identifiers, wherever feasible. Multiple data filters were applied to retrieve information of all individuals ?18 yr who died after the acquisition of COVID-19 infection with or without vaccination, irrespective of the time between vaccination and test positivity. Vaccine effectiveness (VE) against the reduction of mortality and hospitalizations was initially assessed. As compared to the hospitalization data, mortality reporting was found to be much better in terms of correctness and completeness. Therefore, hospitalization data were not considered for analysis and presentation in the vaccine tracker. The vaccine tracker thus depicts VE against mortality, calculated by a cohort approach using person-time analysis. Incidence of COVID-19 deaths among one- and two-dose vaccine recipients was compared with that among unvaccinated groups, to estimate the rate ratios (RRs). VE was estimated as 96.6 and 97.5 per cent, with one and two doses of the vaccines, respectively, during the period of reporting. The India COVID-19 Vaccination Tracker was officially launched on September 9, 2021. The high VE against mortality, as demonstrated by the tracker, has helped aid in allaying vaccine hesitancy, augmenting and maintaining the momentum of India’s COVID-19 vaccination drive
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BACKGROUND Hand sanitizer (HS) has been increasingly used during the Covid-19 pandemic. We compared the telephonic calls received by the National Poisons Information Centre (NPIC), New Delhi, India, related to its unsafe exposure and inappropriate use during the lockdown and prelockdown periods. METHODS We analysed and compared telephonic call records of 3 months of pre-lockdown and 3 months of the lockdown and HS-related calls in different age groups and zones during these periods. RESULTS The centre received 4000 calls; of these 1583 (40%) were related to household products of which only 63 (4%) were related to HS. There was an 8-fold increase in the number of calls received at the NPIC during the lockdown compared to the pre-lockdown period seeking medical attention following unsafe exposure or inappropriate use of HS. More calls were received from the south and north zones and, in the majority of these cases, HS was ingested accidentally. In some cases, HS was ingested intentionally for suicide during the lockdown. CONCLUSIONS Our study shows that unsafe exposure of HS is common under conditions of stress as seen during the lockdown period of the Covid-19 pandemic. It should be kept out of reach of small children. Further, providing psychological help and counselling to older age groups under conditions of stress are important issues of concern.
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Background: UTI constitute a major public health problem in India accounting 2nd most common infection next to respiratory tract infection. They are responsible for increasing treatment cost and significant morbidity.Aim:-To determine the incidence of UTI, evaluation of pathogens responsible and their antimicrobial susceptibility pattern in the population.Methods:Urine samples were collected from 300 patients attending the OPD Patna medical college, Patna during the period of 18 months (January 2017 to June 2018) Antimicrobial sensitivity testing was done for the bacterial isolates present in the sample by Kirby- Bauer disc diffusion method. Only those samples were taken into consideration which develops count equal to or greater than 1*105CFU/ml as indicated by Kass.Results:Out of 300 samples collected 146 (48.66%)) yielded bacterial growth. Out of 146 culture isolates E.Coli was the most common pathogen followed by klebsiella, CoNS and staphylococcus. Antibiotic sensitivity was performed on all the isolates. It was observed that highest sensitivity was 49.31% to amikacin, gentamycin (45.89%), nitrofurantoin (38.35%) meropenem (27.39%).Conclusions:It was observed that high grade of resistance to ampicillin, cotrimoxazole, ciprofloxacin, cefuroxime, chloramphenicol, cefotaxime, cefazolin, amoxicillin + clavulanic acid and gentamycin is present as a result of misuse or improper use of antibiotic in the community. Hence urine culture is necessary for the diagnostic screening of UTI before the treatment.
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Docosanol is the only US Food and Drug Administration(FDA)approved over-the-counter topical product for treating recurrent oral-facial herpes simplex labialis.Validated analytical methods for docosanol are required to demonstrate the bioequivalence of docosanol topical products.A gas chromatography/selected ion monitoring mode mass spectrometry(GC/SIM-MS)method was developed and validated for docosanol determination in biological samples.Docosanol and isopropyl palmitate(internal standard)were separated on a high-polarity GC capillary column with(88％cyanopropy)aryl-polysiloxane employed as the stationary phase.The ions of m/z 83 and 256 were selected to monitor docosanol and isopropyl palmitate,respectively;the total run time was 20 min.The GC/SIM-MS method was validated in accordance with US FDA guidelines,and the results met the US FDA acceptance criteria.The docosanol calibration standards were linear in the 100-10000 ng/mL concentration range(R2＞0.994).The recoveries for docosanol from the receptor fluid and skin homogenates were＞93.2％and＞95.8％,respectively.The validated method was successfully applied to analyze ex vivo human cadaver skin permeation samples.On applying Abreva?cream tube and Abreva?cream pump,the amount of doco-sanol that penetrated human cadaver skin at 48 h was 21.5±7.01 and 24.0±6.95 ng/mg,respectively.Accordingly,we concluded that the validated GC/SIM-MS was sensitive,specific,and suitable for quantifying docosanol as a quality control tool.This method can be used for routine analysis as a cost-effective alternative to other techniques.
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Abstract Introduction Individual variability in the language outcomes of children with cochlear implantation (CI) is a major concern. In CI rehabilitation, there is lack of a protocol regarding uniform post-CI language assessment interval duration, which can ensure better understanding of the trajectory of language growth as well as optimize language outcomes by providing feedback in fine tuning the language intervention program. Objective To evaluate the receptive and expressive language in Hindi speaking children with up to 2 years of CI experience using revised receptive-expressive emergent language test-3ed. (REELT-3) at 6 months intervals and to compare it with that of children with normal hearing (NH). Methods The present study included 192 children divided in 2 groups, 96 children with CI (15.8 ± 6.7 months), and 96 age-matched children with NH (22.3 ± 7.9 months). A cross-sectional, prospective study design was used to measure the language ability score (LAS) at an interval of 6 months from the time of implantation (TIA), which is 0 to 6 months, 7 to 12 months, 13 to 18 months, and 19 to 24 months of CI usage. Results The two-way analysis of variance revealed that the LAS after 18 months of CI usage was similar to (F (3, 92) = 8.63, p= 0.19, ηp2 = 0.028) that of the children with NH. However, other demographic factors, for instance, gender (F (3, 92) = 1.73, p= 0.505, ηp2 = 0.002), parent's education, (F (3, 92) = 2.05, p= 0.937, ηp2 = 0.031), and financial background (F (3, 92) = 2.49, p= 0.351, ηp2 = 0.076) had no major impact on language. Conclusion Eighteen months of CI usage duration can potentially stimulate receptive and expressive language up to age-matched children with NH. A protocol of periodic assessment of language, at least of 6 months, may be developed to optimize language outcomes.
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Background: Peak expiratory flow rate (PEFR) is a measure of the maximum speed of exhalation after a deep inspiration. The peak expiratory flow is measured by a device named peak flow meter. This study concentrates on the correlation of the PEFR with the pectoral muscle length.Methods: It is a cross sectional study of 30 convenient samples based on gender distribution where the PEFR and pectoralis muscle length were measured in the subjects.Results: Statistical analysis shows that there is a significant correlation between right pectoralis major general muscle length and PEFR (p=0.030), left pectoralis major general muscle length and PEFR (p=0.014), right pectoralis major clavicular end muscle length with PEFR (p=0.010).Conclusions: There is a significant correlation between peak expiratory flow and pectoralis muscle length.
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Background and Objective: Glossopharyngeal nerve block (GNB) technique has been used as alternative of treatment of cancer and noncancer pain of the oral cavity. The objective of the study is to compare the two approaches (extraoral and intraoral) of GNB in patients of carcinoma of the tongue in terms of efficacy, duration, and complications. Materials and Methods: This was a prospective comparative randomized study over a period of 1 year. Fifty patients of either sex of ASA physical status and 2, between 21 and 70 years of age, suffering from carcinoma of the tongue, were selected. The patients were randomly divided into two groups. Group I received 4 mL of 0.5% bupivacaine combined with 40 mg, of triamcinolonacetonide by extraoral approach of GNB, and Group II received the same amount of drug by intraoral approach of GNB. Hemodynamic parameters, degree of pain relief using visual analog scale (VAS), number of attempts, effect on quality of life (QOL), and complication were noted during the performance of GNB. Results: Demographic profile in both groups was comparable. Rate of complication and number of attempts to complete intervention were higher in Group I, which was found to be statistically significant. However, mean VAS scores in Group I were significantly higher as compared to those in Group II during most of the study period starting from the 1st follow-up at 30 min to the 2nd month postintervention (P < 0.05). No statistically significant difference in mean QOL scores of two groups was observed for the entire study period except at 1 week when mean scores in Group I were higher as compared to those in Group II (P = 0.011). Conclusion: The intraoral approach of GNB was better with respect to pain control and improvement in QOL whereas the rate of complication and number of attempts was lower in extraoral approach of GNB
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Background: Hypertension is one of the most important non-communicable diseases. Although high blood pressure is a recognized risk factor for cardiovascular disease, the prevalence of hypertension still remains unclear for most populations. The objectives of the study were to estimate the prevalence of hypertension in rural area of Faizabad and to identify the associated risk factors for hypertension.Methods: This community-based cross sectional study was carried out among 300 adults from a randomly selected village in rural health training centre, Safdarganj who were aged 18 years and above over a period of 3 months from March 2019 to May 2019. Participants were interviewed and examined for the assessment of socio-demographic detail, behavioral and lifestyle risk factors of hypertension. Template generated in MS excel sheet and analysis was done on SPSS software.Results: Among 300 study participants, 45.3% were male and 54.7% were female. The prevalence of hypertension was observed to be 10.33%. It was found to be more common in males. Prevalence increased as the age increased. The prevalence of hypertension was high among obese and those consuming more than 2 spoons of salt every day.Conclusions: Prevalence of hypertension is different in different parts of the country. Higher age, male sex, tobacco use, obesity, less physical activity and high salt intake are significantly associated with hypertension.
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Background:After the decades of Dichlorodiphenyltrichloroethane (DDT) use, Phlebotomus argentipesreportedly developed resistance against it affecting every aspect of vector control at grass-root level. Although DDT based Indoor Residual Spray (IRS) has been replaced with Alphacypermethrine-a Synthetic Pyrethroid (SP) based insecticide, since 2016 butits successful implementation at the Visceral Leishmaniasis (VL) endemic regime of Bihar doesn’t cause much effect upon VL vector density. Furthermore, the outcomes of existing operational research works, it Original ResearchArticle had been observed that VL vectors are continuously changing its behavior under the pressure of insecticides. Methods: For validating the hypothesis, present study has been carried out at Vaishali and Patna being highly and semi-endemic sites respectively for quantifying the oriental behavior among VL vectors persuaded by the IRS and enforce them to remain alive and get trapped in light trap even after changed chemical composition of IRS i.e., SP-IRS from routine DDT-IRS. Results:Following results, a significant reduction in sand fly density (i.e., 33.09% and 29.16%) was observed for outdoor and indoor caught sand flies, collected with light trap and aspirator respectively. Significant higher no. of sand fly collection in terms of per light traps per night was recorded from the outdoor sites than thosefrom indoor habitat for each village of Vaishali and Saran district of Bihar. Higher no. of male sand flies than to that of female ones were collected from outdoor sites and only unfed female sand flies (i.e., 100%) were caught following SP-IRS from each study villages of Vaishali and Saran districts of Bihar.Conclusions:The results of higher no. of sand flies collection from the outdoor sites as compared with the indoor habitat validate the hypothesis of gradual shifting of habitat of VL vectors from endophilic to exophilic which is undoubtedly followed due to the fact of developed resistance among them against chemical constituent of IRS. Results provide very useful information about the sand fly dynamics under the impact of IRS and accordingly, advocates the combined approach of IRS along with insecticidal fogging together at a same time that could be an effective dividend for maximum VL vector control along for negotiating VL cases at par for longer duration during the maintenance phase at the VL foci.
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Hemophagocytic Lymphohistiocytosis (HLH) is a fatal hyperinflammatory syndrome characterized by histiocytic proliferation along with hemophagocytosis. HLH can be primary (inherited) or secondary, to any severe infection, malignancy or rheumatological disease. HLH, though rare, has also been noted in association with scrub typhus which is an acute febrile illness resulting from the bite of infected larval form of mite (also known as chigger). We hereby describe two cases of HLH associated with rickettsial infection (Oriental tsutsugamushi) in a 36-year-old male and in a 10-year-old male child. The former presented with high-grade fever and pruritic macular rash over abdomen. While the latter was presented with fever and decreased urinary output at the time of admission