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Characterization of crop-growing environments in relation to crop's genotypic performance is crucial to harness positive genotype-by-environment interactions (GEI) in systematic breeding programs. Given that, the study aimed to delineate the impact of diverse environments on crop phenology and yield traits of dwarf-statured field pea, pinpointing location(s) favoring higher yield and distinctiveness within breeding lines. We tested twelve field pea breeding lines across twenty locations in India, covering Central Zone (CZ), North Western Plain Zone (NWPZ), North Eastern Plain Zone (NEPZ), and Northern Hill Zone (NHZ). Across these locations, maximum and minimum temperatures during flowering (TMAXF, TMINF) and reproductive period (TMAXRP, TMINRP) ranged 18.9-28.3, 3.3-18.0, 15.0-30.8, and 7.9-22.1oC, respectively. Meanwhile, notable variations in phenological and agronomic traits (coefficient of variation) were observed: flowering (31%), days to maturity (21%), reproductive period (18%), grain yield (48%), and 100-seed weight (18%). Combined ANOVA demonstrated an oversized impact of environment (81%) on yield, while genotype and GEI effects were 2% and 14%, respectively. The variables TMINF, TMINRP, and cumulative growing degree-day showed positive correlations with yield, while extended vegetative and maturity durations negatively influenced yield (p < 0.05). Additionally, linear mixed-models and PCA results explained that instability in crop phenology had significant influence on field pea yield. Seed weight was markedly varied within the locations (9.9-20.8 g) and both higher and lower seed weights were associated with lower yields (Optimal = 17.1 g). HA-GGE biplot-based on environment focus-scaling demonstrated three mega-environments and specific locations viz. Kota (CZ), SK Nagar (CZ), Raipur (CZ), Sehore (CZ), and Pantnagar (NWPZ) as the ideal testing-environments with high efficiency in selecting new genotypes with wider adaptability. The study findings highlight distinct impact of environments on crop phenology and agronomic traits of field pea (dwarf-type), hold substantial value in designing efficient field pea (dwarf-type) breeding program at mega-environment scale.
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OBJECTIVE: Patients with Sheehan syndrome (SS) are predisposed to coronary artery disease (CAD) due to risk factors like abdominal obesity, dyslipidemia and chronic inflammation. In addition to estimate CAD risk enhancers like high sensitive C reactive protein (hsCRP), apolipoprotein B (ApoB) and lipoprotein A [Lp(a)], this study applies Framingham risk score (FRS) and coronary artery calcium (CAC) score to compute a 10-year probability of cardiovascular (CV) events in SS patients. DESIGN: Case-control study Sixty-three SS patients, on a stable hormonal replacement treatment except for growth hormone and 65 age, body mass index and parity-matched controls. MEASUREMENTS: Measurement of serum hsCRP, ApoB and Lp(a) and estimation of CAC with 16-row multislice computed tomography scanner. RESULTS: The concentrations of hsCRP, ApoB and Lp(a) were significantly higher in SS patients than in controls (p < .01). After calculating FRS, 95.2% of SS patients were classified as low risk, 4.8% as intermediate risk and all controls were classified as low risk for probable CV events. CAC was detected in 50.7% SS patients and 7.6% controls (p = .006). According to the CAC score, 26.9% SS patients were classified as at risk (CAC > 10) for incident CV events as against 1.6% controls. The mean Multi-Ethnic Study of Atherosclerosis (MESA) score was significantly higher in patients with SS than controls. CAC corelated significantly with fasting blood glucose (r = .316), ApoB (r = .549), LP(a) (r = .310) and FRS (r = .294). CONCLUSION: Significant number of asymptomatic SS patients have high coronary artery calcium score and are classified at risk for CAD.
Subject(s)
Coronary Artery Disease , Hypopituitarism , Vascular Calcification , Humans , C-Reactive Protein/metabolism , Calcium , Case-Control Studies , Coronary Artery Disease/etiology , Coronary Artery Disease/metabolism , Coronary Vessels , Prevalence , Risk Factors , Vascular Calcification/etiology , Vascular Calcification/metabolism , Hypopituitarism/complicationsABSTRACT
Objective: To describe the changes in tuberculosis case notifications by the private sector after implementation of the Joint Effort for Elimination of Tuberculosis project in India in 2018. Methods: We retrieved data from the project recorded in India's national tuberculosis surveillance system. We analysed data on 95 project districts in six states (Andhra Pradesh, Himachal Pradesh, Karnataka, Punjab including Chandigarh, Telangana and West Bengal) to assess changes in the number of tuberculosis notifications, private provider notifiers and microbiological confirmations of cases from 2017 (baseline) to 2019. We compared case notification rates in districts where the project was implemented with the rates in districts where it was not. Findings: From 2017 to 2019, tuberculosis notifications increased by 138.1% (from 44 695 to 106 404), and case notification rates more than doubled from 20 to 44 per 100 000 population. The number of private notifiers increased by over threefold, from 2912 to 9525, during this period. The number of microbiologically confirmed pulmonary and extra-pulmonary tuberculosis cases notified increased by more than two times (from 10 780 to 25 384) and nearly three times (from 1477 to 4096), respectively. The districts where the project was implemented showed a 150.3% increase in case notification rates per 100 000 population from 2017 to 2019 (from 16.8 to 41.9) while in non-project districts, this increase was only 89.8% (from 6.1 to 11.6). Conclusion: The substantial increase in tuberculosis notifications demonstrate the value of the project in engaging the private sector. Scaling up these interventions is important to consolidate and extend these gains towards tuberculosis elimination.
Subject(s)
Tuberculosis, Extrapulmonary , Tuberculosis , Humans , India/epidemiology , Tuberculosis/epidemiology , Tuberculosis/prevention & control , Private Sector , RecordsABSTRACT
The present investigation was performed to evaluate the variability of the essential oil composition present in the seed extract of Kala zeera (Bunium persicum Bioss.) obtained from different geographical zones of Northwestern-Himalayan using Gas Chromatography-Mass Spectrum (GC-MS). The results of the GC-MS analysis revealed significant differences in the essential oil content. Significant variability was observed in the chemical constituents of the essential oils mainly for p-cymene, D-limonene, Gamma-terpinene, Cumic aldehyde and 1, 4-p-menthadien-7-al. Among these compounds, the highest average percentage across the locations was observed for gamma-terpinene (32.08%) which was followed by cumic aldehyde (25.07%), and 1, 4-p-menthadien-7-al (15.45%). Principal component analysis (PCA) also grouped the 4 highly significant compounds i.e., p-Cymene, Gamma-Terpinene, Cumic aldehyde, and 1,4-p-Menthadien-7-al into same cluster which are mainly distributed in Shalimar Kalazeera-1, and Atholi Kishtwar zones. The highest value of gamma-terpinene was recorded in Atholi accession (40.66%). However, among climatic zones Zabarwan Srinagar and Shalimar Kalazeera-1 was found to have highly positive significant correlation (0.99). The cophenetic correlation coefficient (c) was found to be 0.8334 during hierarchical clustering for 12 essential oil compounds showing that our results are highly correlated. Network analysis also showed the overlapping pattern and similar interaction between the 12 compounds as shown by hierarchical clustering analysis. From the results, it could be concluded that existence of variability among the various bioactive compounds of B. persicum which are probably to be incorporated to the potential list of drugs and may serve as good genetic source for various modern breeding programs.
Subject(s)
Apiaceae , Oils, Volatile , Oils, Volatile/chemistry , Plant Breeding , Apiaceae/chemistry , AldehydesABSTRACT
Aims: This study was conducted to compare the safety and efficacy of microwire assisted technique with contrast venography guided axillary venipuncture in patients undergoing cardiovascular implantable electronic device (CIED) implantation. Methods and results: This prospective randomized study included 212 consecutive adult patients undergoing CIED implantation at our institute between 2013 and 2015. Patients were randomized to either venography guided technique (Group I; n = 105) or microwire assisted technique (Group II; n = 107) for axillary venipuncture. In Group I axillary venogram was used as a roadmap for guiding the puncture. In Group II, a 0.014 inch hydrophilic coronary guidewire ('microwire') was introduced through the ipsilateral antecubital vein and puncture needle was aimed to hit the microwire over the first or second rib. Outcome measures including technical success rates; number of attempts to successful puncture; puncture duration; fluoroscopy times and adverse events were compared in the two groups. Overall success rates were similar in both groups (97.4% in Group I and 100% in Group II, P = 0.061). We demonstrated significantly higher first attempt success rates; shorter puncture durations and fluoroscopy times; and lower number of attempts to successful puncture with microwire assisted technique (89.3% vs. 65.6%; 36.7 ± 23.1 s vs. 67.8 ± 44.9 s; 62.4 ± 35.3 s vs. 118.9 ± 63.2 s; and 1.21 ± 0.82 vs. 2.16 ± 1.54 respectively, P < 0.001). Adverse event rates were significantly lower with microwire assisted technique (0.9% vs. 8.6%, P = 0.009). Conclusion: Microwire assisted technique is a simple, quicker, safer and more efficacious alternative to contrast venography guided axillary venipuncture.
Subject(s)
Axillary Vein/diagnostic imaging , Catheterization, Peripheral/methods , Defibrillators, Implantable , Pacemaker, Artificial , Phlebography , Prosthesis Implantation/instrumentation , Prosthesis Implantation/methods , Radiography, Interventional/methods , Aged , Cardiac Resynchronization Therapy Devices , Catheterization, Peripheral/adverse effects , Female , Humans , India , Male , Middle Aged , Phlebography/adverse effects , Prospective Studies , Prosthesis Implantation/adverse effects , Punctures , Radiography, Interventional/adverse effects , Risk Factors , Time Factors , Treatment OutcomeABSTRACT
Persistent left superior vena cava (PLSVC) draining into coronary sinus is typically detected incidentally during transcatheter interventions using left subclavian venous approach. In our experience, we have encountered this anomaly on a few occasions and in all these cases we successfully implanted leads in the right ventricle (RV) by shaping the stylet into a "U-shaped" or "pigtail-shaped" curve. Herein, we report a case of an adult male who underwent successful dual-chamber pacemaker implantation via PLSVC through left axillary venous approach. In this case, we were unable to deliver the lead into RV using aforementioned stylets. As an innovation, we used a "three-dimensional alpha curve"-shaped stylet that facilitated an easy entry of pacing lead into the RV.
Subject(s)
Pacemaker, Artificial , Vena Cava, Superior/abnormalities , Humans , Male , Middle Aged , Prosthesis Implantation/methodsABSTRACT
Transcutaneous or transvenous pacing of the right ventricle is performed as a routine practice for patients received with symptomatic bradycardia or complete heart block with relative ease in cath lab. However, more and more patients are received with multiple comorbidities, critical condition, and difficult vascular access. In this article, we describe a patient with difficult venous access with tricuspid regurgitation and displaced the right ventricular pacemaker temporary lead undergoing coronary angiography who was managed with emergent nonconventional left ventricular pacing.
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INTRODUCTION: The challenges posed by high altitude are particularly significant in terms of cardiovascular health. There are currently no data available on acute coronary syndrome (ACS) among Amarnath pilgrims. The objective of this study was to investigate the clinical and angiographic profiles of ACS among Amarnath pilgrims, focusing on demographic characteristics, risk factors, types of ACS, clinical presentation, angiographic findings, and in-hospital outcomes. By examining these aspects, we aimed to provide insights into the unique challenges faced by pilgrims during their spiritual journey and to identify potential strategies for improving the prevention and management of ACS in this population. Methods: This was a hospital-based, prospective, observational study that included patients who had participated in the pilgrimage and presented with ACS between 2022 and 2023. Results: Sixty patients were recruited for the study, with a mean age of 51.19 ± 11.17 years. Of these, 43 (71.7%) were male. Risk factors identified in the study included hypertension in 35 (58.3%), smoking in 23 (38.3%), diabetes mellitus in 18 (30%), and dyslipidemia in 25 (41.6%) patients. ST-elevation myocardial infarction (STEMI) was present in 46 (76.66%) patients, Anterior wall myocardial infarction (AWMI) occurred in 29 (48.3%), inferior wall myocardial infarction (IWMI) in 15 (25%), and high lateral wall myocardial infarction (HLWMI) in two (3.3%) patients. Of the 60 patients, 19 (31.6%) were in Killip class I, 16 (26.6%) were in class II, and 25 (41.6%) were in classes III or IV. The average time from the onset of symptoms to hospitalization was 7.6 ± 3.1 hours, significantly higher in those with Killip class III or IV (9.3 ± 3.6 vs. 5.4 ± 2.7 hours, p = 0.01). There were nine (15%) in-hospital deaths, and in the multivariate analysis, advanced Killip class (p = 0.04) and delays in hospitalization of more than six hours (p = 0.03) were found to be significant predictors of mortality. CONCLUSION: In conclusion, 40% of patients presented in the advanced Killip class, and 15% experienced in-hospital mortality. The average time from the onset of symptoms to hospitalization was significantly higher for those categorized in the advanced Killip classes. Our study highlights a significant association between advanced Killip class, delay in hospitalization, and in-hospital mortality among Amarnath pilgrims with ACS, underscoring the importance of timely intervention. It is recommended that appropriate measures be taken to improve patient outcomes in these cases.
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BACKGROUND: Left ventricular ejection fraction falls when the myocardium has already lost a significant portion of its functional capacity. There are conflicting data on whether diastolic dysfunction precedes systolic dysfunction after cardiotoxic chemotherapy. We aimed to study systolic and diastolic dysfunction after cardiotoxic chemotherapy and whether diastolic dysfunction can predict subsequent risk of systolic dysfunction. It was an observational prospective cohort study, and patients receiving cardiotoxic chemotherapy were included. Baseline, demographic, and clinical details were recorded. Echocardiographic measurements of left ventricular systolic function, global longitudinal strain, and diastolic function were noted at baseline, three months, and 6 months. RESULTS: We included eighty patients. The mean age of the patients was 54.92 ± 7.6 years, predominantly females (80%). The mean left ventricular ejection fraction fell from 64.92 ± 1.96 to 60.97 ± 4.94 at 6 months. Low ejection fraction was seen in 8 (10%) patients at 6 months. The mean global longitudinal strain (GLS) at baseline was - 18.81 ± 0.797 and fell to - 17.65 ± 2.057 at 6 months, with 12 (15%) patients having low GLS (< - 18). Grade 1 diastolic dysfunction was seen in 22 (27.5%) patients, and grade 2 diastolic dysfunction was seen in 3 (3.8%) patients at 6 months. There was a significant decrease in E/A ratio (inflow early diastolic velocity/Inflow late diastolic velocity), mitral tissue Doppler velocity, and an increase in isovolumic relaxation time, mitral valve deceleration time, and E/e' (inflow early diastolic velocity/tissue Doppler mitral annular velocity), at three months and 6 months. Ejection fraction at 6 months was significantly and negatively correlated with diastolic dysfunction at three months (r = - 0.595, p = 0.02). CONCLUSIONS: Cardiotoxic chemotherapy is associated with early diastolic dysfunction. Early diastolic dysfunction predicts subsequent left ventricular systolic dysfunction.
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INTRODUCTION: Identifying an Infarct-related artery (IRA)in Non-STEMI is sometimes tricky. Besides, myocardial infarction with non-obstructive coronary arteries (MINOCA) mimickers are often labeled as myocardial infarction. Late Gadolinium enhancement (LGE) on cardiac MRI can help in identifying IRA besides MINOCA mimickers. AIMS: To study the role of LGE on cardiac MRI(CMR) in NSTEMI. MATERIAL METHODS: It was a prospective observational, double-blinded study. 70 NSTEMI patients were prospectively enrolled over two years. CMR was done before coronary angiography (CAG) during the index hospitalization. Matching was done between IRA selected by CAG and IRA as determined by LGE on MRI. RESULTS: Mean age was 58 ± 15 years. CAG could not identify IRA in 38.6% (n = 27) patients. In this patient group, LGE-CMR identified IRA in 48.1% (n = 13) & a new non-CAD diagnosis was identified in 18.5% (n = 5) patients. IRA was identified in 61.4% (n = 43) by CAG & in this patient group, LGE-CMR identified a different IRA in 6.9% (n = 3) patients. LGE-CMR also identified a new non-CAD diagnosis in 11.6% (n = 5) of patients from this group. Overall, LGE-CMR led to a new IRA diagnosis in 23% (n = 16) patients & a diagnosis of non-ischemic pathogenesis in 14% (n = 10) patients. Non-Ischemic diagnosis on CMR included stress cardiomyopathy in 3, myocarditis in 6, and infiltrative disorder in 1 patient. CONCLUSION: CMR leads to new IRA diagnoses or non-ischemic pathogenesis in one-third of the cohort.
Subject(s)
Coronary Angiography , Coronary Vessels , Magnetic Resonance Imaging, Cine , Non-ST Elevated Myocardial Infarction , Humans , Male , Female , Middle Aged , Prospective Studies , Magnetic Resonance Imaging, Cine/methods , Double-Blind Method , Non-ST Elevated Myocardial Infarction/diagnosis , Coronary Vessels/diagnostic imaging , Contrast Media , Diagnosis, Differential , Electrocardiography , Follow-Up Studies , Reproducibility of ResultsABSTRACT
Autoimmune polyglandular syndrome type 1 (APS1) - characterized by the triad of mucocutaneous candidiasis, hypoparathyroidism, and primary adrenal insufficiency - is an uncommon entity. In this case report we describe the case of a young girl who presented with classic features of APS1 and dilated cardiomyopathy, which were missed during her presentation to the children's hospital. Her condition improved only when appropriate replacement therapy in the form of calcium, calcitriol and hydrocortisone was instituted. Hypocalcemia and hypocortisol state are curable causes of myocardial dysfunction and subsequent congestive cardiac failure, and should always be considered in the differential diagnosis of resistant congestive cardiac failure, especially in children. To the best of our knowledge, cardiomyopathy in the setting of APS1 has never been described previously and can remain unrecognized for a long time and present with life threatening complications.
Subject(s)
Cardiomyopathy, Dilated/complications , Hydrocortisone/deficiency , Hypocalcemia/etiology , Polyendocrinopathies, Autoimmune/complications , Calcium/therapeutic use , Cardiomyopathy, Dilated/drug therapy , Child , Female , Humans , Hydrocortisone/therapeutic use , Hypocalcemia/drug therapy , Magnetic Resonance Imaging , Polyendocrinopathies, Autoimmune/drug therapy , Polyendocrinopathies, Autoimmune/pathology , Remission Induction , Treatment OutcomeABSTRACT
BACKGROUND: Hemolysis after Patent ductus arteriosus (PDA) device closure is rare. Although in most cases, hemolysis settles on its own; however, in some cases it may not settle spontaneously and may require additional procedures like putting additional coils, gel foam or thrombin instillation, balloon occlusion, or removing it surgically. We report a case of adult PDA device closure who persisted with hemolysis and was managed by transcatheter retrieval. CASE PRESENTATION: A 52-year-old gentleman presented to us with a diagnosis of large PDA with operable hemodynamics. Descending thoracic aortic Angio showed a large 11 mm PDA. Transcatheter device closure was done in the same sitting with a 16 × 14 Amplatzer Ductal Occluder I(ADO) device,;however, after device release, the aortic end of the device was not fully formed and there was residual flow. The next morning patient started with gross hematuria with persistent residual flow. We tried to manage with conservative means including hydration, and blood transfusion; however, residual flow persisted for 10 days and his hemoglobin dropped from 13 gm/dl preprocedural to 7 gm/dl, creatinine increased from 0.5 mg/dl to 1.9 mg/dl, bilirubin increased to 3.5 mg/dl & urine showed hemoglobinuria. As the patient continued to deteriorate it was planned to retrieve the device by transcatheter approach. 10 French amplatzer sheath was parked in the pulmonary artery near the ductus. We tried with a combination of multiple catheters and Gooseneck snare (10 mm) and finally, we successfully retrieved with a combination of Multipurpose (MP) catheter and 10 mm Gooseneck snare. After that, we closed the defect successfully with a double disk device (muscular Ventricular septal defect 14 mm Amplatzer). The patient's hematuria settled and was discharged after 2 days with normal hemoglobin and creatinine. CONCLUSIONS: Patent ductus arteriosus ADO 1 device should not be released if the aortic end of the disk is not fully formed Patient should be carefully monitored for hemolysis if evidence of residual shunt and given supportive treatment. If conservative treatment fails, residual flow needs to be eliminated. Transcatheter retrieval although technically challenging is a feasible treatment. A muscular VSD device is a good alternative to the usual PDA device to close PDA, especially in adults.
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BACKGROUND AND AIM: Interpretation of imaging modalities depends on robust normal reference limits. Ethnicity is an essential determinant of cardiac chamber sizes. Though few studies from India have focused on this research, it has yet to include the Kashmiri population. We aimed to study normal echocardiographic values of healthy Kashmiri adults and compare them with Western and Indian studies. METHODS: It was a prospective observational study on healthy adults of Kashmir Valley. A comprehensive echocardiographic analysis following standardized protocols was performed. RESULTS: A total of 2245 study participants were analyzed. The mean age was 32.52±11.55 years. There were 1100 (49%) males. Males had higher absolute left ventricular volumes and mass, left atrial volumes, right ventricular diameter, and aortic size, while females had higher absolute left ventricular ejection fraction and early and late diastolic mitral inflow velocities. Males had higher indexed left ventricular end-systolic volume, while females had higher indexed left ventricular end diastole diameter, aorta diameter, right ventricle, and left and right atrial sizes. Left ventricular mass and diastolic parameters were significantly associated with age. Compared with the American Society of Echocardiography/European Association of Cardiovascular Imaging, absolute values of left ventricle size, volumes, mass, right ventricle size, aortic size, and left and right atrial size were higher than those in our study. Our study population had a higher left ventricle ejection fraction. Among indexed parameters, left ventricle volumes, left ventricle systolic diameter, aortic annulus, and left and right atrial volumes were still significantly higher in Western data. While comparing with Indian data, we noted significant regional differences. CONCLUSION: We provide normal reference values for our local population. We noted significant differences with Western as well as other Indian populations. Our study highlights the need for developing ethnic-specific reference values of various echocardiographic measurements.
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Objectives: Very few studies have been done on Venous stenosis following the first transvenous cardiac device implantation. We aimed to assess the prevalence and predictors of Venous stenosis/Occlusion following the first transvenous cardiac device implantation with venous angiography at one year of follow-up. Methods: This study was a single-center prospective, observational study. Demographic, clinical, procedural, and device data was collected. All patients underwent a preimplant contrast and repeated venography at twelve months to look for upper limb venous anatomy, obstruction, or collaterals. Results: A total of 146 patients were included in the final analysis. 60 (41 %) patients developed some degree of venous stenosis. Most patients had mild to moderate stenosis, and almost all were asymptomatic. Among patient-related factors increasing age (64.66 ± 10.07 vs 60.91 ± 11.94 years p = 0.04), presence of hypertension (50.5 % vs 19.6 % p = 0.0004), diabetes (73 % vs 29.6 % p = 0.000) and dyslipidemia (66.7 % vs 36.3 p = 0.009) were significantly associated with Venous stenosis/occlusion. Among procedure-related factors, larger total lead diameter (3.88 ± 1.09 vs. 3.50 ± 1.03 mm p = 0.03) and implantation of biventricular devices (p = 0.0037) seem to be significantly associated with venous obstruction. In logistic regression analysis, hypertension (p = 0.018), total lead diameter (p = 0.024), and use of CRT-P/CRTD/ICD (p = 0.03) remained significant predictors of severe venous stenosis. Conclusions: Our study demonstrates venous obstruction in 40 % of cardiac implantable electronic device patients at one-year follow-up. Most patients have mild to moderate stenosis, and almost all are asymptomatic. Increasing age, hypertension, diabetes, dyslipidemia, larger total lead diameter, and implantation of biventricular devices are significantly associated with venous obstruction.
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Grain legumes play a crucial role in human nutrition and as a staple crop for low-income farmers in developing and underdeveloped nations, contributing to overall food security and agroecosystem services. Viral diseases are major biotic stresses that severely challenge global grain legume production. In this review, we discuss how exploring naturally resistant grain legume genotypes within germplasm, landraces, and crop wild relatives could be used as promising, economically viable, and eco-environmentally friendly solution to reduce yield losses. Studies based on Mendelian and classical genetics have enhanced our understanding of key genetic determinants that govern resistance to various viral diseases in grain legumes. Recent advances in molecular marker technology and genomic resources have enabled us to identify genomic regions controlling viral disease resistance in various grain legumes using techniques such as QTL mapping, genome-wide association studies, whole-genome resequencing, pangenome and 'omics' approaches. These comprehensive genomic resources have expedited the adoption of genomics-assisted breeding for developing virus-resistant grain legumes. Concurrently, progress in functional genomics, especially transcriptomics, has helped unravel underlying candidate gene(s) and their roles in viral disease resistance in legumes. This review also examines the progress in genetic engineering-based strategies, including RNA interference, and the potential of synthetic biology techniques, such as synthetic promoters and synthetic transcription factors, for creating viral-resistant grain legumes. It also elaborates on the prospects and limitations of cutting-edge breeding technologies and emerging biotechnological tools (e.g., genomic selection, rapid generation advances, and CRISPR/Cas9-based genome editing tool) in developing virus-disease-resistant grain legumes to ensure global food security.
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BACKGROUND AND OBJECTIVES: Ambulatory blood pressure (BP) monitoring has become useful in the diagnosis and management of hypertensive individuals. In this study we tried to know the role of office and ambulatory BP in treated hypertensive patients. METHODS AND PATIENTS: Prospective cohort of 561 treated hypertensive patients were enrolled in the study. Hypertension definitions were according to JNC 8 classification. Office BP and ambulatory BP monitoring was done according to defined protocol. RESULTS: From a subgroup of 158 treated hypertensive patients, 91(16.2%) patients were having white coat hypertension (p value 0.00 by Pearson chi square test). In a subset of 403 patients who were having controlled BP on the day of enrolment as well as on the day of attaching ambulatory BP monitor; 98 (17.4%) patients were having masked uncontrolled hypertension (MUCH). In addition there was very significant percentage of non-dippers and reverse dippers. In our study we found that office BP has a moderate to low specificity and sensitivity and low negative predictive value for overall control in treated hypertensive patients. CONCLUSION: Ambulatory BP monitoring should be included in the management protocol of treated hypertensive patients, for the optimal BP control.
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Hypertension , Masked Hypertension , White Coat Hypertension , Humans , Blood Pressure , Blood Pressure Monitoring, Ambulatory , Prospective Studies , Hypertension/diagnosis , Hypertension/drug therapy , White Coat Hypertension/diagnosis , Masked Hypertension/diagnosis , Masked Hypertension/drug therapy , Antihypertensive Agents/therapeutic useABSTRACT
Plants are sensitive to changes projected in climates, such as elevated carbon dioxide (eCO2), high temperature (T), and drought stress (DS), which affect crop growth, development, and yield. These stresses, either alone or in combination, affect all aspects of sweetpotato plant growth and development, including storage root development and yield. We tested three sweetpotato cultivars (Beauregard, Hatteras, and LA1188) responses to eight treatments (Control, DS, T, eCO2, DS + T, T + eCO2, DS + eCO2, DS + T + eCO2). All treatments were imposed 36 days after transplanting (DAP) and continued for 47 days. Treatments substantially affected gas exchange, photosynthetic pigments, growth, and storage root components. Cultivars differed considerably for many of the measured parameters. The most significant negative impact of DS was recorded for the shoot and root weights. The combination of DS + T had a significant negative effect on storage root parameters. eCO2 alleviated some of the damaging effects of DS and high T in sweetpotato. For instance, eCO2 alone or combined with DS increased the storage root weights by 22% or 42% across all three cultivars, respectively. Based on the stress response index, cultivar "Hatteras" was most tolerant to individual and interactive stresses, and "LA 1188" was sensitive. Our findings suggest that eCO2 negates the negative impact of T or DS on the growth and yield of sweetpotato. We identified a set of individual and interactive stress-tolerant traits that can help select stress cultivars or breed new lines for future environments.
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OBJECTIVE: To compare the safety and efficacy of valsartan/sacubitril (angiotensin receptor neprilysin inhibitor [ARNI]) against enalapril (angiotensin-converting enzyme inhibitor [ACEI]) in patients with acute heart failure at 6-month follow-up. METHODS: In this prospective, single centre, and observational study conducted between September 2017 and February 2020 in India, patients with acute decompensated heart failure with reduced ejection fraction (<40%) were included. Patients were divided in two groups: valsartan/sacubitril (ARNI) group and enalapril (ACEI). Patients were followed up for at least 6 months after administration of first dose and were evaluated for safety, efficacy, and tolerability of target drug. Student's independent t-test was employed for comparing continuous variables. Chi-square test or Fisher's exact test, whichever appropriate, was applied for comparing categorical variables. RESULTS: A total of 200 patients were included in the present study, 100 each in ARNI and ACEI group. The mean age of the population was 61.2 ± 8.4 years and 62.6 ± 8.6 years in ARNI group and ACEI group, respectively. The mean maximum tolerated dose by population in ARNI group was 203.6 mg and 8.9 mg in ACEI group. Readmission for heart failure were seen significantly higher in ACEI group than ARNI group (p value = 0.001). Parameters like ejection fraction, left ventricular end diastolic and systolic dimensions, 6 min walk test and Kansas City Cardiomyopathy Questionnaires (KCCQ) showed p values < 0.05 between the groups. CONCLUSION: The ARNI study group showed better safety and efficacy outcomes at the end of 6 months follow-up compared to ACEI group.
Subject(s)
Enalapril , Heart Failure , Aged , Aminobutyrates , Angiotensin Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Antihypertensive Agents , Biphenyl Compounds , Drug Combinations , Enalapril/therapeutic use , Heart Failure/drug therapy , Humans , Middle Aged , Prospective Studies , Receptors, Angiotensin , Stroke Volume , Tetrazoles , Treatment Outcome , ValsartanABSTRACT
Screening for drought tolerance requires precise techniques like phonemics, which is an emerging science aimed at non-destructive methods allowing large-scale screening of genotypes. Large-scale screening complements genomic efforts to identify genes relevant for crop improvement. Thirty maize inbred lines from various sources (exotic and indigenous) maintained at Dryland Agriculture Research Station were used in the current study. In the automated plant transport and imaging systems (LemnaTec Scanalyzer system for large plants), top and side view images were taken of the VIS (visible) and NIR (near infrared) range of the light spectrum to capture phenes. All images were obtained with a thermal imager. All sensors were used to collect images one day after shifting the pots from the greenhouse for 11 days. Image processing was done using pre-processing, segmentation and flowered by features' extraction. Different surrogate traits such as pixel area, plant aspect ratio, convex hull ratio and calliper length were estimated. A strong association was found between canopy temperature and above ground biomass under stress conditions. Promising lines in different surrogates will be utilized in breeding programmes to develop mapping populations for traits of interest related to drought resilience, in terms of improved tissue water status and mapping of genes/QTLs for drought traits.
Subject(s)
Droughts , Zea mays/physiology , Biomass , Crops, Agricultural , Genotype , Image Processing, Computer-Assisted , Phenotype , Plant Shoots/growth & development , Plant Shoots/physiology , Quantitative Trait Loci , Water/physiology , Zea mays/genetics , Zea mays/growth & developmentABSTRACT
BACKGROUND: This study was aimed at exploring the clinical profile, angiographic characteristics and procedural outcomes in patients undergoing PCI at our institute. METHODS: This prospective observational study included all consecutive patients who underwent PCI at our hospital between January 2014 and December 2015. Data including clinico-demographic profile, angiographic details and lesion characteristics were recorded in all patients. Procedural details including devices and drugs used, procedure related complications, and in-hospital outcomes of these patients were analysed. RESULTS: A total of 624 patients (mean age- 59.30±11.17years) with 84.8% males and 15.2% females were included in the study. Smoking and hypertension were the most common risk factors, present in 79.8% and 74.8% patients respectively. Diabetes mellitus, dyslipidemia, and obesity were observed in 24.5%, 26.1%, and 25.0% patients respectively. Anterior wall MI was the most common mode of presentation (32.1%). Single Vessel Disease (SVD) was most common angiographic pattern, observed in 50.3% patients; left anterior descending artery (LAD) was the most frequently involved vessel (65.9%); and type B lesions were most prevalent (52.3%). Most of the procedures were elective (61.4%) and femoral route was used in the majority (82.6%). Drug eluting stents were deployed in 99.1% of the cases. The overall procedural success rate was 93.6%. Procedural mortality was 1.0% and periprocedural complications occurred in 9.9% patients. CONCLUSION: This first prospective PCI registry from the state of Jammu & Kashmir provides an insight into the patterns of CAD among Kashmiri population, and highlights the spectrum of PCIs performed with their outcomes.