Tillage and nutrient management influence net global warming potential and greenhouse gas intensity in soybean-wheat cropping system

Conservation tillage has proven advantageous in improving soil health and productivity. However, the greenhouse gases (GHGs) emission and intensity from different conservation tillage and nutrient management systems under Indian conditions are less understood. Therefore, here, we compared the effect of tillage and nutrient management on GHGs emissions, net global warming potential (NGWP), and greenhouse gas intensity (GHGI) from a field experiment under five years in a soybean-wheat cropping system in the Vertisols. The tillage treatments comprised of reduced tillage (RT) and no tillage (NT). The three nutrient management treatments included application of 100% NPK (T1), 100% NPK + 1.0 Mg FYM-C ha-1 (T2), 100% NPK +2.0 Mg FYM-C ha-1 (T3). The results showed significantly higher SOC sequestration under NT (1388 kg ha-1 yr-1) followed byRT (1134 kg ha-1 yr-1) with application of FYM (2.0 Mg C ha-1) (T3) every year. Across tillage, integrated nutrient management(T2 and T3) lowered NGWP and GHGI compared to NPK (T1). The GHGI of NT system was less by 33% compared to RT. The results suggest that GHGs mitigation and sustained food production in the soybean-wheat system can be achieved in NT and RT with integrated use of organic and inorganic fertilizer as the major component of nutrient management.

Artificial intelligence and dichotomy on benefits and challenges: what do healthcare providers say?

Background: In a developing country like India, with a vibrant information technology (IT) sector, employing Artificial Intelligence (AI) should be carefully weighed before its introduction in healthcare with relation to perception of healthcare providers (HCP's/Doctors).  Methods: This qualitative study was conducted in medical college and affiliated hospital in India. Initially a pilot study was conducted for reliability and internal consistency of questionnaire. Thereafter, pre-tested questionnaire was distributed to 153 healthcare providers and their responses were analyzed on SPSS version 20.0 (IBM) to identify the demographic and job-related differences in their perception regarding the benefits and challenges of using AI in healthcare.Results: Most of respondent were agreed upon the benefits of using AI in healthcare and most cited benefits were speedy decision making, better resource utilization and improvement in staff satisfaction. Similarly most cited challenges were lack of training on AI enabled machines, lack of skilled technical support, high cost of AI and data privacy issue. Further, Age and Job experience were significantly associated with benefits like timely and speedy decision making, improvement in the patient and staff satisfaction respectively. Furthermore, Age, Department, Job experience, Job profile were significantly associated with challenges like high cost of AI, lack of skilled technical support, lack of training in AI enabled machines and lack of trust in AI among patients.Conclusions: Significant challenges of using AI in healthcare with demographic and job related variable based on the results of this research paper need to be resolved first in order to overcome the initial resistance in employing AI in healthcare.

The Effects of Calcium and Vitamin D Supplementation on Blood Glucose and Markers of Inflammation in Non Diabetic Adults

Introduction: Type 2 Diabetes mellitus is associated with considerable morbidity and mortality and its prevalence has been increasing globally. Present study was undertaken to see the effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in non-diabetic adults. Aim of the study: To compare the effects of combined calcium and vitamin D supplementation versus placebo on blood glucose and markers of inflammation in non-diabetic adults. Material and methods: 120 non-diabetic patients fulfilling the inclusion and exclusion criteria coming to OPD/wards of MGUMST, Jaipur were recruited. They were subjected to two study groups with two treatment arms, one group with normal fasting blood glucose and other group with impaired fasting blood glucose. Results: The effects of calcium and vitamin D supplementation on fasting blood sugar and CRP were statistically significant in impaired fasting blood glucose group. Conclusion: Supplementation with vitamin D and calcium improves blood glucose and markers of inflammation.

Decrease Incidence of Blood Transfusion In Hip Arthroplasty Patients Due To Combined Blood Saving Measures

Background: Hip arthritis is a common and crippling disease causing severe pain, deformity and significant disability. Worldwide arthroplasty is among the commonest orthopaedic surgeries of degenerated hip that can result in considerable blood loss. This results in a postoperative decline in haemoglobin levels of 3.0 to 4.0 gram/decilitre from preoperative haemoglobin levels of 14.0 gram/decilitre on an average. Postoperative anaemia may seriously decrease functional mobility in the early postoperative phase following total hip arthroplasty. In recent years there has been an increasing awareness and positive attitude toward blood-saving measures. Blood-saving techniques can be broadly divided into preoperative, intraoperative and postoperative measures in total hip arthroplasty. Our aim is to assess the Decrease incidence of blood transfusion in hip arthroplasty patients due to combined blood saving measures. Methods: The study was a hospital based prospective observational study conducted during the period of March 2015 to august 2017 in the department of orthopedics, Patna medical college and hospital, Patna. Patients between the age of 50-85 years were included who underwent total hip arthroplasty between March 2015 to august 2017 in the department of orthopedics, Patna medical college and hospital, Patna. Patients were selected as per inclusion and exclusion. Surgery was done. Preoperative, intraoperative and postoperative blood saving modality was used in total hip arthroplasty. Blood loss and Blood transfusion assessment was done. Results: In this study out of 38 patients, Female were 26 (68.4%) and Male were 12 (31.6%). 26.3 % (10/38) patients were between 50-60 years of age, 47.4 % (18/38) between 61-70 years of age, 21.0 % (8/38) between 71-80 years of age and 5.3 % (2/38) patients above 81 years of age. left total hip replacement was done in 14/38 (36.8%), right total hip replacement was done in 24/38(63.2%) patients.Anaesthesia given was: Combined spinal epidural=22/38(57.9%), spinal anaesthesia+ block=12/38 (31.6 %), spinal anaesthesia=2/38 (5.3 %), general anaesthesia+ block=2/38 (5.3 %). Mean diastolic blood pressure was 81.60 millimetre of mercury pre op and intra op 71.11. Mean systolic blood pressure was 135.51 millimetre of mercury pre op and intra op 98.02. In this study only 1 patient out of 38 patients were subjected to blood transfusion accounting to 2.6 % which was statistically significant. Conclusion:Use of combined blood saving measures helps to decrease incidence of blood transfusion in arthroplasty. Due to low incidence of blood transfusion, blood related adverse event is prevented. There was statistically significant reduction in haemoglobin level after operation. There was statistically significant reduction in haematocrit level after operation.

Role Of Bone Mineral Density To Asses Osteoporosis At Tertiary Centre In Men

Background: Osteoporosis is highly prevalent, with an estimated 30 million women diagnosed to have osteoporosis. A bone mineral density (BMD) test measures how much calcium and other types of minerals are present in a section of bone. The absolute amount of bone as measured by bone mineral density (BMD) testing generally correlates with bone strength and its ability to bear weight. Osteoporosis is a progressive bone disease that is characterized by a decrease in bone mass and density and that leads to an increased risk of fractures. Osteoporosis is defined by the World Health Organization (WHO) as a bone mineral density that lies 2.5 standard deviations or more below the a T-score of <-2.5SD.(average of young, healthy adults) as measured by dual-energy X-ray absorptiometry. Quantitative ultrasound (QUS) of bone is a technique for assessing bone microarchitecture in addition to bone mass. QUS has many advantages compared with traditional densitometry, including lack of radiation, cost and potential portability. Methods:Retrospective study was done in 1220 male patients in department of orthopedics, Patna medical college and hospital, Patna presenting with back pain, history of fracture after minor trauma, alcoholics, patient on drugs like steroids and chronic smokers. The study does not include the patients having fractures due to road traffic accidents or pathological fractures associated with primary or secondary bone tumors. The BMD estimation of these patients was done by quantitative ultrsonography of the calcaneal bone and the analysis done on the basis of T –scores.. Results: 1220 patients were included in the study from department of orthopedics, Patna medical college and hospital, Patna. Patients were in the age group of 25-75 yrs. Among these 30% (n=366) were between 25-40yrs, 45% (n=550) between 41-60yrs and 25% (n=304) between 61-75 yrs. Commonest presenting symptom in the study population was Backache which was60% (n=732). 30% (366) presented with generalized bone pain and 10% (122) patients had a history of fracture after trivial trauma. Of the 1220 patients included in the study 45% (n=550) were osteoporotic, 29% (n=354) were osteopenia and severe osteoporosis 10%. Majority of the osteoporotic patients fell in the age group of 41-60 yrs. Conclusion:Our study shows that the osteoporosis and osteopenia is more common in males in the age group of 40-60 yrs. Early detection and prompt treatment is required to prevent pathological fractures. Quantitative ultrsonography is one of the most effective tools for early detection of osteopenia and osteoporosis as this is cost effective, lacks radiation exposure and yields good results, comparable to other diagnostic tools like DEXA scan.

Prevalence of HIV and VDRL seropositivity in blood donors of Delhi.

Blood transfusion has been the transmission mechanism in 15 per cent of total patients infected with human immunodeficiency virus (HIV). A few reports are available regarding the trend of HIV seropositivity in northern India. Prevalence of VDRL (venereal disease research laboratory) reactivity varies from 0.8-15 per cent in blood donors. We present data on the prevalence and trends of infection with HIV 1 and 2 and VDRL reactivity in blood donors in Delhi. Between 2000-2002, a total of 76089 (voluntary and replacement) donors were screened. Majority (82.4%) were replacement donors. Seropositivity for HIV and VDRL was seen in 0.54 and 2.6 per cent of donors respectively. The percentage of seropositivity for HIV and VDRL was significantly higher in replacement donors (P<0.001). It is suggested that extensive donor selection and a voluntary donor service would reduce the number of infectious donors significantly. Non-renumerated repeat voluntary donor services are urgently required to lower the prevalence of transmissible infections. While the need to change to a voluntary donor service and devising effective donor screening cannot be over emphasized, there is also a need to mandate HIV antigen detection in India.

Infectious markers in blood donors of East Delhi: prevalence and trends.

All blood donors Voluntary and Replacement who have donated blood in the centre or in the voluntary blood donation camps, were analyzed for the prevalence of infectious markers over a period of 3 years from 1997 to 1999. A total of 52500 blood units were collected and screened for hepatitis B surface antigen (HBsAg), antibodies to HIV I and II and VDRL reactivity. Seropositivity was 471 (0.8%) for HIV I and II, 963 (1.8%) for HbsAg, 1449 (2.76%) for VDRL and 64 (0.5%) for anti HCV. Voluntary donors were comparatively safe. The seropositivity for HIV showed increasing trend between 1997 to 1999.

Seroprevalence of cytomegalovirus among voluntary blood donors in Delhi, India.

Cytomegalovirus (CMV) is known to be a significant cause of morbidity and mortality following blood transfusion in children and immunocompromised adults. In India, it is not mandatory to screen donated blood for CMV in blood banks. Very few studies have been conducted in India to estimate the seroprevalence of this infection in voluntary blood donors. This study was conducted to estimate the seroprevalence of CMV among voluntary blood donors in Delhi, India. In this study, none of 200 donors tested positive for CMV IgM antibody, but 95% were positive for CMV IgG antibody. There was no statistically significant difference in seropositivity of CMV based on distribution of age. Of the 200 donors, 3% tested positive for HBsAg, 1% for HIV, 2% for hepatitis C virus, and 4.5% for syphilis. Since about 95% of blood donors in India are seropositive for CMV, it would seem superfluous to screen blood donors for CMV, as very few seronegative blood units would be available for transfusion. Other preventive strategies, such as leukoreduction, etc., could be more appropriate and cost-effective for the prevention of transmission of CMV through infected blood to immunosuppressed individuals.