Genotype x Environment Interaction and Yield-Stability Analysis of Rice (Oryza sativa L.) Grown in Salt Affected Soil

This study was conducted during Kharif, 2019 At the Students Instructional Farm, MES and Agronomy Farm of A.N.D.U.A.T., Kumarganj, Ayodhya, the trials were set up in RBD with three replications. The experimental material comprised of 25 genotypes of rice were evaluated for 11 quantitative traits under three different environmental locations. High significant mean squares were found for all eleven research characteristics in the environment-specific analysis of variance and the pooled analysis of variance for three environments encompassing one crop season. T-3, Kavery Sampoorna, NDRK-11-27, Moti Gold, and NDRK-11-29 under irrigated circumstances were the genotypes demonstrating high mean performance for grain yield per plant and some of its significant components when considering the mean performance of genotypes under various environmental situations. Out of 25 genotypes tested in three conditions, T-3, Kavery Sampoorna, and NDRK-11-27 had the maximum grain yield per plant.In path coefficient analysis highest positive direct effects on grain yield per plant was exerted by L/B ratio (0.281), followed by panicle length (0.167), number of fertile spikelet per plant (0.092) and days to 50% flowering (0.037). On the other hand, negative direct effects on grain yield per plant was exerted by plant height (-0.255), leaf area index (-0.195), spikelet fertility (-0.187), biological yield per plant and harvest index (-0.126) and productive tillers / plant (-0.049). Positive indirect effects on spikelet fertility was recorded via biological yield per plant (0.040) followed by panicle length via biological yield per plant (0.264), productive tiller per plant biological yield per plant (0.021) and plant height via biological yield per plant (0.011).Considering the mean performance and stability parameters, three high yielding genotypes T-3, Kavery Sampoorna and NDRK-11-27 merit due consideration for recommending their exploitation as cultivars or varieties for commercial cultivation and/or as donor for hybridization programme for wide range of environments pertaining especially to different environments. In addition to these genotypes, several other genotypes exhibiting high or average mean performance, desirable non- linear response and stable nature for different characters may also be useful for exploitation as parents in hybridization programme as donors for characters for which they showed superiority even if they had average or low grain yield per plant.

Protocol-based Surgical Intervention to Manage Ventricular Septal Rupture from a Tier Two City

ABSTRACT Introduction: This study analyzes the outcome of a protocol-based surgical approach for ventricular septal rupture (VSR). The study also clarifies the appropriate time for intervention. Methods: This is a single-center retrospective analysis of all VSR cases evaluated between February 2006 and March 2020. Cases were managed using the same protocol. Patients were divided into two cohorts - early (those in whom our protocol was instituted within 24 hours of diagnosis) and delayed (intervention between 24 hours and seven days after diagnosis). All-cause mortality was considered as the outcome. Results: The mean age of presentation was 60.1 years, and 75.9% of the patients were men. Cardiogenic shock was the most common mode of presentation. Our analysis validates that once a patient develops VSR, age, sex, comorbidities, left ventricular function, and renal failure at the time of presentation do not have a statistically significant impact on the outcome. The sole factor to have an impact on the outcome was time of intervention. All patients in the delayed cohort expired after surgery, which dragged the overall mortality to 34.5%, whereas 95% of patients in the early cohort are still on follow-up. The mortality in this group was 5% (P≤0.001). Conclusion: Early surgical intervention has proven benefits over delayed approach. Surgical intervention in the early part of the disease reduces the risk and thus improves the outcome. The extreme rarity makes VSR an uncommon entity among surgeons. A protocol-based approach makes the team adapt to this unfamiliar situation better.

Vitamin-D deficiency, the hidden pandemic in sunshine sufficient countries,exacerbating hypocalcaemia in a health worker undergoing thyroidectomy - a global perspective and review of literature

Introduction: Vitamin D deficiency (VDD) is common in young adults even in sunlight sufficient countries. It manifests with subtle and trivial symptoms that are often ignored. Nutritional deficiency due to improper dietary habits, poverty, long hours at work and study are factors. The lockdown during COVID has exacerbated the incidence. We had a patient with VDD who became symptomatic after routine thyroidectomy prompting our review into literature on the global health perspective of VDD. Material and method: - A 21-year-old nursing student developed hypocalcaemia within 24 hours after a routine thyroidectomy. VDD was detected and patient improved after supplementation. Literature was reviewed from Pubmed database for the medical aspects of the problem, from Government archives like the Scientific Advisory Committee on Nutrition, ICMR etc for cause and medical archives including those of paediatric and general health for the impact of disease at the state, national and global level. A global health problem list was prepared and data was reviewed. Discussion: Vitamin D is protective against respiratory infections due to viral aetiology including COVID. However, complete lockdown to prevent spread of COVID, online learning, and work from home culture has reduced sunlight exposure and increased incidence of VDD. Post thyroidectomy hypocalcaemia is common in VDD. Conclusion: Since there is a high prevalence of asymptomatic VDD even in sunshine sufficient countries, it is recommended to screen all patients especially young adults for VDD during routine preoperative work up.

An alternative method for reconstructing anterior segmental mandibulectomy defects with a plate and pectoral major muscle flap

Background: Reconstruction of anterior segmental mandibulectomy still remains a challenge. Osteocutaneous free flap remains the ideal choice of reconstruction because it restores cosmesis and function. The use of other locoregional flaps compromises cosmesis and function. Here, we have introduced a unique technique of reconstruction with lingual cortex mandibular plate as an alternate choice for free flap. Method: Six patients aged 12–62 years underwent oncological resection for oral cancer which involved the anterior segment of the mandible. Following resection, they underwent lingual cortex mandibular plating with pectoralis major myocutaneous flap reconstruction. Adjuvant radiotherapy was delivered to all patients. Results: The mean bony defect was 9.2 cm. There were no significant perioperative events related to the surgery. None required tracheostomy and all were safely extubated with no post-surgical complications. The cosmetic and functional outcomes were acceptable. Following the completion of radiotherapy with a median follow-up of 11 months, Plate exposure occurred in one patient. Conclusion: The technique is cheap, quick and simple, and can be effectively applied in resource-constrained and demanding situations. It is possible to consider this as an alternative treatment strategy for osteocutaneous free flap in anterior segmental defects

Allergic Rhinitis: A Critical Modern Review

Allergic rhinitis addresses a hyperactivity of the resistant framework in any case harmless particles making a fiery reaction where none is required. Allergic Rhinitis is clinically represented by a mixture of two or additional nasal symptoms: running, blocking, itching and sneezing. Allergic rhinitis is regularly partitioned by age, seriousness, and duration of symptoms. Investigation represents how epidemiologic evaluations on the commonness of hypersensitive or allergic rhinitis shift considerably with whether both clinical appraisal and testing were utilized to make the determination. The treatment of allergic rhinitis should combine allergen avoidance, pharmacotherapy and allergen immunotherapy. Treatments of allergic rhinitis include intranasal corticosteroids, oral and topical antihistamines, decongestants, intranasal cromolyn, intranasal anticholinergics. First-generation and Second-generation oral antihistamines and intranasal corticosteroids are the most effective modality for treating allergic rhinitis. Immunotherapy is an efficient immune-modulating treatment that ought to be counseled if pharmacologic medical care for allergic rhinitis isn't effective or not tolerated. This article provides an overview of the prevalence, pathophysiology, diagnosis, and appropriate management of the allergic rhinitis.

Preparation and validation of a new questionnaire to study faculty perception of online teaching - Use of Cronbach’s alpha and pilot.

Background: The COVID-19 pandemic has forced educators to shift to virtual online classes. Teachers being major stakeholders in the medical teaching-learning process, it becomes important to understand their perception towards this new endeavour. It will make this transition beneficial to the learners. Objectives: To document the process of validation of a new questionnaire devised to study the perception of medical undergraduate teaching faculty towards online classes, using Cronbach’s alpha, and the subsequent pilot for the same. Results: At initial validation, Cronbach’s alpha was not acceptable (0.65) for the questionnaire. One item was scored low by two validators and was removed. Three items were given poor rating for lay out, clarity and feasibility and required editing. The Cronbach’s alpha after revision was 0.92 (acceptable). Pilot study was conducted. Based on the proportion of positive perception (36.4%) regarding ongoing online teaching programme, conducted on 11 teaching faculty with 10% absolute precision and 95% confidence, the minimum sample size for the main study was calculated to be 89. This was feasible from the point of view of total faculty strength. Conclusion: Research work involving a new tool, such as questionnaire, must utilize the statistical tool Cronbach’s alpha for validation, and pilot study for estimating the sample size and testing the content validity.

Submental nodal metastasis in papillary carcinoma of the thyroid

Papillary carcinoma of thyroid (PCT) commonly shows metastasis to central and lateral cervical compartment neck nodes. Submental nodes are rarely involved by PCT. Thus, its management is not clear. We report two young men who presented with submental nodal metastasis from PCT. Both underwent total thyroidectomy with central compartment neck dissection and modified radical neck dissection (MRND). Probable factors which might influence submental nodal metastasis are analyzed. We conclude that physicians should be aware of the possibility of submental nodal metastasis from PCT. A selective approach for neck dissection can be an alternative to MRND, reducing the morbidity in management of such cases.

Evaluation of efficacy of BIORAD D10TM testing system in detection of beta thalassaemia carrier

Background: Hemoglobinopathies especially thalassaemia and its interaction with HbE and HbS are significant cause of morbidity and mortality in our country. With no feasible treatment, prevention of cases by carrier detection is the only option for successful reduction of the disease burden. VARIANT hemoglobin testing system BIORAD using principle of cation exchange chromatography has been in use and considered as gold standard for carrier detection. The purpose of this study is to compare the efficacy of a different, cheaper instrument; D10 by the same manufacturer BIORAD for carrier detection in beta thalassaemia.Methods: Patients diagnosed as beta thalassaemia carrier by VARIANT hemoglobin testing system (HbA2 value between 4.0-9.0) were retested using D10 instrument and checked for agreement.Results: There was good correlation between VARIANT and D-10 methods with Intraclass correlation coefficient 0.832 (95% Confidence Interval 0.756-0.884). Bland-Altman analysis showed mean bias of +0.3526 (95% CI -0.3958 to +1.101).Conclusions: Although further study is needed with larger sample size for assessment of sensitivity and specificity of D10 instrument, it is evident from this study that this instrument can be an effective and cheaper alternative of VARIANT hemoglobin testing system.

Diagnostic Dilemma For An Unusual Presentation Of Thyroid Malignancy

Diagnosis is a crucial element for prompt identification and treatment of serious diseases. Thyroid malignancy presenting as brain metastasis is a rare entity while presenting as colon metastasis is extremely rare. Here, we discuss the difficulty faced with the diagnosis of the same. We report the case of a 66-year-old male, who was a known diabetic and hypertensive and presented with the complaint of the right facial nerve weakness. On evaluation, he was found to have an extradural lesion in the right petrous bone. He underwent pre/retrosigmoid craniotomy and subtotal decompression of lesion. Histopathology showed metastatic adenocarcinoma. He underwent positron emission tomography/computed tomography scan, which showed metabolically active foci in the posterior cranial fossa, ascending colon, manubrium sterni, and lung. Colonoscopy demonstrated a polyp in the ascending colon, biopsy of which revealed metastasis from the thyroid. Later, he was found to have a nodule of 1 cm in the right lobe of thyroid. Total thyroidectomy was done and the histopathology showed a multifocal papillary carcinoma thyroid follicular variant with tall cell areas and capsular invasion.

Clinical Features of Influenza and Acute Respiratory Illness in Older Adults at Least 50 Years of Age in an Outpatient Setting in the Republic of Korea: a Prospective, Observational, Cohort Study

Two prospective, multi-centre, observational studies (GlaxoSmithKline [GSK] identifier No. 110938 and 112519) were performed over 2 influenza seasons (2007–2008 and 2008–2009) in the Republic of Korea (ROK) with the aim to evaluate the burden of laboratory-confirmed influenza (LCI) in patients ≥ 50 years of age seeking medical attention for acute respiratory illness (ARI). The median participant age was 58 years in the 2007–2008 season and 60 years in the 2008–2009 season. LCI was observed in 101/346 (29.2%) of ARI patients in the 2007–2008 season and in 166/443 (37.5%) of ARI patients in the 2008–2009 season. Compared to patients with non-influenza ARI, those with LCI had higher rates of decreased daily activities (60.4% vs. 32.9% in 2007–2008 and 46.4% vs. 25.8% in 2008–2009), work absenteeism (51.1% vs. 25.6% and 14.4% vs. 7.7%), and longer duration of illness. These results indicated that influenza is an important cause of ARI in adults aged 50 and older causing more severe illness than non-influenza related ARI.

Red cell distribution width and high sensitivity C-reactive protein as risk markers in hypertension.

Background: Even though red cell distribution width (RDW) and C reactive protein (CRP) are considered as markers of inflammation and cardiac injury studies on the diagnostic and/or prognostic applications of these parameters as renal markers in hypertension (HT) are scanty. Objective: To evaluate the association, if any, between RDW and high sensitive CRP (hs-CRP) with renal complication in HT. Materials and Methods: One hundred and twenty patients with clinically proved hypertension under treatment formed the test group and 60 age and sex matched healthy adults formed the control group. . Blood collected in EDTA was used for complete blood cell count (CBC). Serum was separated immediately after clotting and is used for the estimation of hs-CRP by particle enhanced immunonephelometry. Results: A significant elevation in hs-CRP was observed in both the male and female patients with HT compared to the control group. In the case of RDW even though the values were higher in the test group than control, the elevation was significant only in the male test subjects indicating they are at a higher risk than the females. Conclusion: The elevation of hs-CRP and RDW in the test group suggest that inflammation may be one of the cause or effect of hypertension. Long term inflammation may lead to chronic kidney disease and cardiovascular disease hence monitoring of these markers may be of use in predicting the outcome of hypertension.

Pathogenesis and management of diabetic foot--a review.

In the present article, the pathophysiology, evaluation and management guidelines of diabetic foot infections are reviewed with a view to reducing the medical morbidity, psychological distress and financial costs.