ISCCM Position Statement: Management of Severe Dengue in Intensive Care Unit.

Dengue is one of the commonest causes of undifferentiated acute febrile illness in India as well as South East Asia. Nearly two-fifths of the world population is at risk of infection, and nearly 96 million infections reported worldwide, it is a major cause of concern across the globe. The ISCCM leadership felt that there have been no new directives/guidelines except the MOH guidelines for the management of dengue fever since 2014. Under the auspices of the Indian Society of Critical Care Medicine (ISCCM), an expert group of 14 intensivists from across the country, was formed. The task force members formulated questions that needed to be answered. These questions were validated by the members of ISCCM attending research conclave 2023. All the members systematically searched PubMed, MEDLINE, and Science Direct for original articles on different aspects of dengue management between January 1, 2000, and July 1, 2023. From the collected articles, duplicates were removed. Based on the evidence collected, the expert group members prepared statements/answers to the questions. Since most of the evidence is of moderate to low quality, a consensus was generated amongst the members of the task force. Each statement was agreed upon by 70% of the task force. The statements presented in the article are consensus statements as answers to queries raised. How to cite this article: Bhalla A, Singh H, Suri V, Yaddanapudi L, Poddar B, Ghawat R, et al. ISCCM Position Statement: Management of Severe Dengue in Intensive Care Unit. Indian J Crit Care Med 2024;28(S2):S42-S58.

Sunrise in the eye: Bilateral superonasal lens subluxation in Marfan syndrome.

Aim: To describe the case of a patient with Marfan syndrome who had bilateral superonasal lens subluxation. Method: The case of a male patient, aged 18, who complained of having impaired vision in both eyes (BE) since he was a toddler, was presented. On examination of the patient, features suggestive of Marfan syndrome were revealed, as well as bilateral intraocular lens subluxation. Results: The patient was refracted and glasses were recommended, which improved his vision. The patient was referred to the cardiology, orthopedic, and dental departments for a multidisciplinary approach to prevent complications and further management. Discussion: Lens subluxation is frequently presented as a primary clinical manifestation of Marfan syndrome. It can vary from asymptomatic, which is seen only after pupillary dilation, to significant subluxation, in which the equator of the lens in the pupillary axis causes diplopia or decreased vision. Conclusion: This case underscored the importance of considering the rare feature of Marfan syndrome.

CMV neuroretinitis in an immunocompetent patient: a unique case report.

Aim: To report a case of cytomegalovirus (CMV) neuroretinitis observed in an immunocompetent patient. Materials and methods: The patient presented with a complaint of diminution of vision in both eyes (BE) and had a traumatic cataract in the right eye (RE). Fundus examination of the left eye (LE) revealed an active white, fluffy lesion with an overlying retinal hemorrhage patch with a macular star. The diagnosis of CMV neuroretinitis was established, and the patient commenced treatment with valganciclovir. Results: The patient exhibited no underlying risk factors. Subsequently, a positive response to oral valganciclovir treatment was observed. Discussion: Cytomegalovirus (CMV) neuroretinitis is typically associated with immunocompromised individuals, such as those with HIV/AIDS. The patient's presentation with a traumatic cataract in the right eye and a distinctive fundus appearance in the left eye posed a diagnostic challenge. The absence of common risk factors for CMV infection necessitated a thorough examination and consideration of rare infectious etiologies. The positive response to valganciclovir reinforces its efficacy in managing CMV-related ocular conditions. This case emphasized the necessity for ophthalmologists to maintain a high index of suspicion for CMV and other unusual pathogens when faced with neuroretinitis in patients who do not present with typical systemic immunosuppressive conditions. Early diagnosis and appropriate antiviral therapy prevent potential complications and preserve vision in such atypical presentations. Conclusion: This case underscores the importance of considering rare infectious agents in immunocompetent patients when encountering neuroretinitis, particularly in the absence of typical symptoms or signs of the disease. Abbreviations: CMV = Cytomegalovirus, BE = Both eyes, RE = Right eye, LE = Left eye, CBC = Complete Blood Count, ESR = Erythrocyte Sedimentation Rate, VDRL = Venereal Disease Research Laboratory, FTA-ABS = Fluorescent Treponemal Antibody Absorption, PPD = Purified Protein Derivative, ANA = Anti-Nuclear Antibodies, RF = Rheumatoid Factor, ACE = Anti Converting Enzyme, Ig G = Immunoglobulin G, HSV = Herpes simplex virus.

System of wheat intensification (SWI): Effects on lodging resistance, photosynthetic efficiency, soil biomes, and water productivity.

Intense cultivation with narrow row spacing in wheat, a common practice in the Indo-Gangetic plains of South Asia, renders the crop more susceptible to lodging during physiological maturity. This susceptibility, compounded by the use of traditional crop cultivars, has led to a substantial decline in overall crop productivity. In response to these challenges, a two-year field study on the system of wheat intensification (SWI) was conducted. The study involved three different cultivation methods in horizontal plots and four wheat genotypes in vertical plots, organized in a strip plot design. Our results exhibited that adoption of SWI at 20 cm × 20 cm resulted in significantly higher intercellular CO2 concentration (5.9-6.3%), transpiration rate (13.2-15.8%), stomatal conductance (55-59%), net photosynthetic rate (126-160%), and photosynthetically active radiation (PAR) interception (1.6-25.2%) over the existing conventional method (plant geometry 22.5 cm × continuous plant to plant spacing) of wheat cultivation. The lodging resistance capacity of both the lower and upper 3rd nodes was significantly higher in the SWI compared to other cultivation methods. Among different genotypes, HD 2967 demonstrated the highest recorded value for lodging resistance capacity, followed by HD 2851, HD 3086, and HD 2894. In addition, adoption of the SWI at 20 cm × 20 cm enhanced crop grain yield by 36.9-41.6%, and biological yield by 27.5-29.8%. Significantly higher soil dehydrogenase activity (12.06 µg TPF g-1 soil hr-1), arylsulfatase activity (82.8 µg p-nitro phenol g-1 soil hr-1), alkaline phosphatase activity (3.11 n moles ethylene g-1 soil hr-1), total polysaccharides, soil microbial biomass carbon, and soil chlorophyll content were also noted under SWI over conventional method of the production. Further, increased root volumes, surface root density and higher NPK uptake were recorded under SWI at 20×20 cm in comparison to rest of the treatments. Among the tested wheat genotypes, HD-2967 and HD-3086 had demonstrated notable increases in grain and biological yields, as well as improvements in the photosynthetically active radiation (PAR) and chlorophyll content. Therefore, adoption of SWI at 20 cm ×20 cm (square planting) with cultivars HD 2967 might be the best strategy for enhancing crop productivity and resource-use efficiency under the similar wheat growing conditions of India and similar agro-ecotypes of the globe.

Mismatch repair protein MLH1 suppresses replicative stress in BRCA2-deficient breast tumors.

Loss of BRCA2 (breast cancer 2) is lethal for normal cells. Yet it remains poorly understood how, in BRCA2 mutation carriers, cells undergoing loss of heterozygosity overcome the lethality and undergo tissue-specific neoplastic transformation. Here, we identified mismatch repair gene mutL homolog 1 (MLH1) as a genetic interactor of BRCA2 whose overexpression supports the viability of Brca2-null cells. Mechanistically, we showed that MLH1 interacts with Flap endonuclease 1 (FEN1) and competes to process the RNA flaps of Okazaki fragments. Together, they restrained the DNA2 nuclease activity on the reversed forks of lagging strands, leading to replication fork (RF) stability in BRCA2-deficient cells. In these cells, MLH1 also attenuated R-loops, allowing the progression of stable RFs, which suppressed genomic instability and supported cell viability. We demonstrated the significance of their genetic interaction by the lethality of Brca2-mutant mice and inhibition of Brca2-deficient tumor growth in mice by Mlh1 loss. Furthermore, we described estrogen as inducing MLH1 expression through estrogen receptor α (ERα), which might explain why the majority of BRCA2 mutation carriers develop ER-positive breast cancer. Taken together, our findings reveal a role of MLH1 in relieving replicative stress and show how it may contribute to the establishment of BRCA2-deficient breast tumors.

Changes in microbial community structure and yield responses with the use of nano-fertilizers of nitrogen and zinc in wheat-maize system.

The growing popularity of nano-fertilization around the world for enhancing yield and nutrient use efficiency has been realized, however its influence on soil microbial structure is not fully understood. The purpose of carrying out this study was to assess the combined effect of nano and conventional fertilizers on the soil biological indicators and crop yield in a wheat-maize system. The results indicate that the at par grain yield of wheat and maize was obtained with application of 75% of recommended nitrogen (N) with full dose of phosphorus (P) and potassium (K) through conventional fertilizers along with nano-N (nano-urea) or nano-N plus nano-Zn sprays and N100PK i.e. business as usual (recommended dose of fertilizer). Important soil microbial property like microbial biomass carbon was found statistically similar with nano fertilizer-based management (N75PK + nano-N, and N75PK + nano-N + nano-Zn) and conventional management (N100PK), during both wheat and maize seasons. The experimental data indicated that the application of foliar spray of nano-fertilizers along with 75% N as basal is a sustainable nutrient management approach with respect to growth, yield and rhizosphere biological activity. Furthermore, two foliar sprays of nano-N or nano-N + nano-Zn curtailed N requirement by 25%, furthermore enhanced soil microbial diversity and the microbial community structure. The specific microbial groups, including Actinobacteria, Bacteroidia, and Proteobacteria, were present in abundance and were positively correlated with wheat and maize yield and soil microbial biomass carbon. Thus, one of the best nutrient management approaches for sustaining productivity and maintaining sound microbial diversity in wheat-maize rotation is the combined use of nano-fertilizers and conventional fertilizers.

Complete genome sequence of S-type Mycobacterium avium subsp. paratuberculosis isolated from an organized goat herd in India.

The present report communicates the first complete genome sequence of S-type Mycobacterium avium subsp. paratuberculosis, isolated from an organised goat herd in Uttar Pradesh, India. Bacteria were isolated in pure culture on Herrold's egg yolk medium (HEYM) slants containing mycobactin J from the faecal sample collected per-rectally from a clinical diseased goat, and next-generation sequencing (NGS) revealed that the genome sequence length of the isolated strain named MAP-Gt-9 is 4,509,428 bp with no plasmid DNA, with a GC content of 69.5%, an N50 value of 125,474 bp, and an L50 value of 12, containing 4235 coding DNA sequences (CDSs), 44 tRNAs, 3 ncRNAs and 1 each 5S, 16S, 23S rRNA genes.

Quantitative measurement of retinal nerve fiber layer thickness and its correlation with optical coherence tomography angiography vascular biomarker changes in preclinical diabetic retinopathy.

PURPOSE: The present study was done to assess the use of optical coherence tomography angiography (OCTA) in detecting earlier stages of diabetic retinopathy and for the early management and effective blood glucose control in preclinical diabetic patients for preventing retinal nerve fiber layer (RNFL) thinning. METHODS: A tertiary care center-based prospective observational study was conducted from the year 2021 to 2022 in the Department of Ophthalmology. The study included 50 cases and 50 controls. The parameters analyzed by using OCTA (Topcon 3D OCT-1 Maestro2) were RNFL thickness and peripapillary vessel density. RESULTS: We found that the RNFL thickness in the temporal and superior disc in patients with preclinical diabetic retinopathy was significantly (0.041 and 0.044, respectively) decreased. The duration of diabetes and glycated hemoglobin (HbA1c) were the risk factors for peripapillary vessel density reduction in patients with preclinical diabetic retinopathy (P < 0.001). CONCLUSION: RNFL thinning is an early sign of retinal neurodegeneration and is associated with peripapillary vessel density reduction. Early management and effective blood glucose control in diabetes patients may be beneficial for preventing RNFL thinning in superior and temporal disc.

Optimizing polyhalite (POLY-4) use in the maize-wheat system: A comparative case study from upper and Trans Indo-Gangetic plains of India.

Increasing complexity in crop nutrient requirement in intensive crop production systems needs alternate multi-nutrient sources. Polyhalite (POLY-4) which contains 14% K2O along withcalcium (17% CaO), magnesium (6% MgO), and sulfur (19% S) can be a possible recourse in this regard. In maize-wheat systems, it was evaluated for productivity, profitability, nutrient usage, and nutrient use efficiency under Indo-Gangetic plain (IGP) zones for consecutive two years (2018-19 and 2019-20). The results revealed that 150% K through POLY-4 produced the maximum maize grain yield under the Trans Indo-Gangetic plains (TGP). The maize grain yield increased by 20.8% and 26.2% under 100% K (POLY-4) and 150% K (POLY-4) over No-K, respectively. But statistically, 100% K (POLY-4) stands similar with both 150% K (POLY-4) and 150% K through muriate of potash (MOP) and equivalent. The trends were noticed under upper Indo-Gangetic plain zones (UGP) also. Similarly, the maximum wheat grain yield (6.12 and 6.29 t/ha under TGP and UGP, respectively) was obtained under 150% K (POLY-4), and remained statistically at par with 100% K (POLY-4), but significantly higher than 150% K (MOP). Under both agro-ecologies i.e. TGP and UGP, the highest system productivity was obtained with recommended N, P, and 150% K application through POLY-4. The added return over NPK remained highest with 150% K (POLY-4) for both maize and wheat. However, higher partial factor productivity for N and S, agronomic, physiological, and translocation efficiencies were noticed under 150% K (POLY-4), and remained at par with 100% K (POLY-4). Increased system yield, added returns, partial factor productivity, agronomic, physiological, and translocation efficiencies under 100% K through POLY-4 (along with recommended N and P) proved its effectiveness as multi-nutrient source for the maize-wheat system under TGP and UGP.

Presumptive ocular tuberculosis: A case series of rare cases.

Ocular tuberculosis (TB) may present with various clinical manifestations and may involve any part of the eye. In 80% of cases, pulmonary involvement is not found. Here, we are presenting three cases of presumptive ocular TB with three rare manifestations. The first case is of bilateral retinal detachment involving one eye after another, the second case is of tubercular phlyctenular keratoconjunctivitis with keratolysis, and the third case is of bilateral neuroretinitis with extensive cerebral involvement. Despite the availability of various tests, clinical findings, tuberculin skin test, chest X-ray, and computed tomography of the chest is still the primary basis of diagnosis of ocular TB in the tubercular endemic area, even in rare cases.

Potential for yield and soil fertility improvement with integration of organics in nutrient management for finger millet under rainfed Alfisols of Southern India.

Finger millet (Eluesine coracana L.) is gaining importance as a food crop with the increasing emphasis on nutritional aspects and drought resilience. However, the average productivity of the crop has stagnated at around 2,000 kg ha-1 in India. Recently released nutrient responsive high yielding varieties are reported to respond better to application of fertilizers/manures. Further, substitution of chemical fertilizers with organic manures to maintain sustainable yields and improve soil health is gaining attention in recent years. Therefore, identifying the appropriate rate and source of nutrition is important to enhance the productivity of finger millet while improving the soil health. A field experiment was conducted during two rainy seasons (July-November, 2018 and 2019) to study the response of finger millet varieties to chemical fertilizers and farmyard manure (FYM) on growth, yields, N use efficiency, N uptake and on soil properties. Two varieties MR-1 and MR-6 were tested with four nutrient management practices viz., unamended control, 100% recommended dose of fertilizers (RDF; 40-20-20 kg NPK ha-1), 50% RDF + 50% recommended dose of nitrogen (RDN) as FYM and 100% RDN as FYM. Among the varieties, MR-6 outperformed MR-1 in terms of growth, yield, N use efficiency and N uptake. The yield enhancement was up to 22.6% in MR-6 compared to MR-1 across the nutrient management practices. Substituting FYM completely or half of the fertilizer dose increased the growth and yield of finger millet compared to application of chemical fertilizers alone. Similarly, the average biomass yield, ears m-2, grain yield, total N uptake and N use efficiency in response to nutrient management practices followed the order of 100% RDN as FYM > 50% RDF + 50% RDN as FYM > 100% RDF. The soil organic carbon, available N, P, K, and S improved by 25.0, 12.9, 5.7, 6.1, and 22.6%, respectively in the plots under higher rate of FYM application (8 Mg ha-1) compared to plots under chemical fertilizers alone. We conclude that substituting chemical fertilizers either completely or by up to 50% with organic manures supplies adequate amounts of nutrients, improves the yield of finger millet, economic returns, and soil properties.

Critical weather limits for paddy rice under diverse ecosystems of India.

Rice yields are largely influenced by variability in weather. Here, we demonstrate the effect of weather variables viz., maximum and minimum temperatures, rainfall, morning and evening relative humidity, bright sunshine hours on the yield of rice cv. Swarna, grown across five rice ecologies of India through field experiments during kharif (wet) season (Jun-Sept.). Critical thresholds of weather elements were identified for achieving above average, average and below average yield for each ecology. The investigation could determine how different weather elements individually and collectively affect rice yield in different rice ecosystems of India. While a sudden increase in minimum temperature by 8-10 °C (> 30 °C) during reproductive period resulted in 40-50 per cent yield reduction at Mohanpur, a sudden decrease (< 20 °C) caused yield decline at Dapoli. The higher yields may be attributed to a significant difference in bright sunshine hours between reproductive phases of above-average and below-average yield years (ranging from 2.8 to 7.8 hours during P5 stages and 1.7 to 5.1 during P4 stages). Rice cultivar Swarna performed differently at various sowing dates in a location as well as across locations (6650 kg ha-1 at Dapoli to 1101 kg ha-1 at Samastipur). It was also found that across all locations, the above average yield could be associated with higher range of maximum temperature compared to that of below average yield. Principal component analysis explained 77 per cent of cumulative variance among the variables at first growth stage, whereas 70 per cent at second growth stage followed by 74 per cent and 66 per cent at subsequent growth stages. We found that coastal locations, in contrast to inland ones, could maximize the yield potential of the cultivar Swarna, due to the longer duration of days between panicle initiation to physiological maturity. We anticipate that the location-specific thresholds of weather factors will encourage rice production techniques that are climate resilient.

Conjoint application of nano-urea with conventional fertilizers: An energy efficient and environmentally robust approach for sustainable crop production.

One of the biggest challenges to be addressed in world agriculture is low nitrogen (N) use efficiency (<40%). To address this issue, researchers have repeatedly underlined the need for greater emphasis on the development and promotion of energy efficient, and environmentally sound novel fertilizers, in addition to improved agronomic management to augment nutrient use efficiency for restoring soil fertility and increasing farm profit. Hence, a fixed plot field experiment was conducted to assess the economic and environmental competency of conventional fertilizers with and without nano-urea (novel fertilizer) in two predominant cropping systems viz., maize-wheat and pearl millet-mustard under semi-arid regions of India. Result indicates that the supply of 75% recommended N with conventional fertilizer along with nano-urea spray (N75PK+nano-urea) reduced the energy requirement by ~8-11% and increased energy use efficiency by ~6-9% over 100% nitrogen through prilled urea fertilizer (business as usual). Furthermore, the application of N75PK+ nano-urea exhibited ~14% higher economic yields in all the crops compared with N50PK+ nano-urea. Application of N75PK+nano-urea registered comparable soil N and dehydrogenase activities (35.8 µg TPF g-1 24 hrs-1 across all crops) over the conventional fertilization (N100PK). This indicates that application of foliar spray of nano-urea with 75% N is a soil supportive production approach. More interestingly, two foliar sprays of nano-urea curtailed nitrogen load by 25% without any yield penalty, besides reducing the greenhouse gases (GHG) emission from 164.2 to 416.5 kg CO2-eq ha-1 under different crops. Therefore, the application of nano-urea along with 75% N through prilled urea is an energy efficient, environmentally robust and economically feasible nutrient management approach for sustainable crop production.

Grain nitrogen content and productivity of rice and maize under variable doses of fertilizer nitrogen.

The rice-maize system is a dominant cropping system of south Asia and consumes a considerable amount of fertilizer. The indiscriminate use of fertilizer particularly nitrogen (N) is degrading the soil health and polluting the environment. Lower N-use efficiency is a major problem and needs to be improved for higher yield, lower cost of cultivation and better environment. The grain quality is also altered by the N-application as N is a major constituent of protein. Studies on the effect of N-application on grain N-content is still lacking. We hypothesised that optimization of N application would result in economising N dose, improving yield and NUE and improving grain quality. Under that context, a field experiment was conducted with different doses of fertilizer N for rice and maize. Fertilizer N was applied at the rate of 0, 40, 80, 120, 160, 200 and 240 kg ha-1 (N0-N240). An increase in grain yield was observed up to 80 and 160 kg ha-1 for rice and maize, respectively. The N content of grain increased with N rates and a significant increase was noted in N200 (1.42%) being at par with N240 (1.49%) but significantly higher than others by 13-32%. With an increase of each kilogram of N, the grain N content increased by 14 and 20 µg (microgram) for rice and maize, respectively. The leaf N content registered a decreasing trend with the progress of the crop growth for both rice and maize. The agronomic efficiency (AE) of N initially increased with an increase in the rate of fertilizer N followed by a decrease with higher doses of N. Unlike the AE, the partial factor productivity (PFP) of N decreased gradually with an increase in the rate of fertilizer N. The chlorophyll content of flag leaves also registered an increasing trend with an increasing rate of fertilizer N. On the surface soil (0-15 cm), the treatments which received lower (N0, N40) and higher (N240) fertilizer N recorded a comparatively higher total soil N than other treatments. The mean NUE was 0.42 and 0.75 for rice and maize, respectively. The study suggests an economic fertilizer N rate of 165 and 167 kg N ha-1, for rice and maize, respectively. It also concludes that the grain N content can be altered by N-application rates though more research is needed.

Base-resolution UV footprinting by sequencing reveals distinctive damage signatures for DNA-binding proteins.

Decades ago, it was shown that proteins binding to DNA can quantitatively alter the formation of DNA damage by UV light. This established the principle of UV footprinting for non-intrusive study of protein-DNA contacts in living cells, albeit at limited scale and precision. Here, we perform deep base-resolution quantification of the principal UV damage lesion, the cyclobutane pyrimidine dimer (CPD), at select human promoter regions using targeted CPD sequencing. Several transcription factors exhibited distinctive and repeatable damage signatures indicative of site occupancy, involving strong (up to 17-fold) position-specific elevations and reductions in CPD formation frequency relative to naked DNA. Positive damage modulation at some ETS transcription factor binding sites coincided at base level with melanoma somatic mutation hotspots. Our work provides proof of concept for the study of protein-DNA interactions at individual loci using light and sequencing, and reveals widespread and potent modulation of UV damage in regulatory regions.

Mapping of QTLs for morphophysiological and yield traits under water-deficit stress and well-watered conditions in maize.

Maize productivity is significantly impacted by drought; therefore, improvement of drought tolerance is a critical goal in maize breeding. To achieve this, a better understanding of the genetic basis of drought tolerance is necessary. Our study aimed to identify genomic regions associated with drought tolerance-related traits by phenotyping a mapping population of recombinant inbred lines (RILs) for two seasons under well-watered (WW) and water-deficit (WD) conditions. We also used single nucleotide polymorphism (SNP) genotyping through genotyping-by-sequencing to map these regions and attempted to identify candidate genes responsible for the observed phenotypic variation. Phenotyping of the RILs population revealed significant variability in most of the traits, with normal frequency distributions, indicating their polygenic nature. We generated a linkage map using 1,241 polymorphic SNPs distributed over 10 chromosomes (chrs), covering a total genetic distance of 5,471.55 cM. We identified 27 quantitative trait loci (QTLs) associated with various morphophysiological and yield-related traits, with 13 QTLs identified under WW conditions and 12 under WD conditions. We found one common major QTL (qCW2-1) for cob weight and a minor QTL (qCH1-1) for cob height that were consistently identified under both water regimes. We also detected one major and one minor QTL for the Normalized Difference Vegetation Index (NDVI) trait under WD conditions on chr 2, bin 2.10. Furthermore, we identified one major QTL (qCH1-2) and one minor QTL (qCH1-1) on chr 1 that were located at different genomic positions to those identified in earlier studies. We found co-localized QTLs for stomatal conductance and grain yield on chr 6 (qgs6-2 and qGY6-1), while co-localized QTLs for stomatal conductance and transpiration rate were identified on chr 7 (qgs7-1 and qTR7-1). We also attempted to identify the candidate genes responsible for the observed phenotypic variation; our analysis revealed that the major candidate genes associated with QTLs detected under water deficit conditions were related to growth and development, senescence, abscisic acid (ABA) signaling, signal transduction, and transporter activity in stress tolerance. The QTL regions identified in this study may be useful in designing markers that can be utilized in marker-assisted selection breeding. In addition, the putative candidate genes can be isolated and functionally characterized so that their role in imparting drought tolerance can be more fully understood.

Impact of organic and integrated production systems on yield and seed quality of rainfed crops and on soil properties.

Mineral and vitamin deficiencies together affect a greater number of human populations in the world than does protein malnutrition. Organic farming is reported to improve nutritional quality of food grains while also improving soil health. However, sufficient scientific information on several aspects of organic farming based on long-term studies is lacking particularly under rainfed conditions of India. The purpose of this study was to assess the long-term impact of organic and integrated production systems on crops yield and quality, economic returns and soil properties. The study was conducted with three crops, sunflower (Helianthus annuus L.), pigeonpea (Cajanus cajan L.), and greengram [Vigna radiata (L.) Wilczek] under three different production systems, control (use of chemical inputs alone), organic and integrated. The results of the 10-year study revealed that, the average production of integrated system was on par with organic management and recorded significantly higher pigeonpea equivalent yield (PEY) (827 kg ha-1) compared to control (chemical inputs) (748 kg ha-1). In general, the yield gap between organic and integrated production systems declined from fourth year for greengram and eighth year for sunflower, during the 10-year experimental period whereas the pigeonpea yield was similar under both production systems from first year. Plots under organic management had significantly lower bulk density (1.18 mg m-3), higher water holding capacity (38.72%) and porosity (53.79%) compared to integrated production system and control (chemical inputs). The soil organic C (SOC) content in the plots under organic production system was 32.6% more than the initial organic carbon of the soil (0.43%), with higher soil N (205.2 kg ha-1). Plots under integrated production system, however, had higher soil P (26.5 kg ha-1) compared with other treatments. The dehydrogenase activity (5.86 µg TPF g-1 soil h-1) and microbial biomass carbon (317.3 µg g-1 soil) content was higher in the plots under organic production system than under other systems. Organically produced pigeonpea and greengram seeds had similar protein content with that of integrated system, and higher K and micronutrient (Fe, Zn, Cu, and Mn) contents than other treatments. The results show the potential of organic production system in improving crop yields, soil properties and produce quality in semiarid rainfed areas.

Using diffusion of innovation framework with attitudinal factor to predict the future of mobility in the Indian market.

Rising temperatures across the world is posing a serious challenge to the longevity of earth's natural cycle. Use of private and conventional cars is growing year by year as standard of living continues to increase and affordability remaining no more of an issue for a significant proportion of the population. However, there has been a growing voice from segments of the society for a behavioural shift towards more sustainable modes of transport like usage of electric vehicles (EVs), mobility sharing and rental services and public transportation powered by electricity. One of the biggest importers of foreign crude oil, India, is reeling under immense pressure to reduce its carbon dioxide emissions and thereby contributing to environment protection. In India, the statistics or stock of EVs continues to remain poor when compared to its counterparts like China. Hence, this study is conducted to predict the influence of factors on purchase intention of consumers with respect to EVs in the Indian context. A questionnaire was prepared and circulated in New Delhi region to gather the responses people hold about this new technology based on the diffusion of innovation framework. The data of 225 respondents was analysed with the help of SPSS and AMOS software. Structural equation modelling technique was applied to test the hypotheses of this research. The results indicate that attitude has the most influential impact on purchase intention followed by related advantages but consumers also believe EVs to be complex in terms of their usability, limited availability and the absence of required public charging infrastructure. The mediating role of attitude between determinants of diffusion and purchase intention was also established except in the case of complexity. This study is contemporary and adds to the limited literature available on EV adoption in the Indian market by integrating attitudinal factor within the DOI framework. It also provides suitable insights to further the development of EVs in the domestic and global market.

A study of post-operative clinico-imaging status and visual outcome after idiopathic macular hole surgery with amniotic membrane plug.

Objective: The aim of this study was to determine the efficacy of hAM plug in the treatment of idiopathic macular hole and to see its post-operative visual improvement and anatomical apposition. Material and methods: 10 eyes of 10 patients who had idiopathic MH underwent a pars plana vitrectomy (PPV) with the hAM plug implanted in MH. The patients were followed up on 2nd day, 1st week, 3rd week, 6th week and 3rd month. Results: Final anatomical closure of MH was achieved in all the cases. BCVA improved from 0.91±0.11 logMAR to 0.28±0.06 logMAR after 3 months. No adverse event was documented in the specified period. Conclusion: hAM plug is an efficient method to treat and manage idiopathic MH with encouraging results both in terms of anatomical closure and visual acuity gain. Abbreviations: MH = Macular Hole, IOP = Intra Ocular Pressure, ILM = Internal Limiting Membrane, BCVA = Best Corrected Visual Acuity, OCT = Optical Coherence Tomography, LogMAR = Logarithm of Minimum Angle of Resolution, hAM = Human Amniotic Membrane, RPE = Retinal Pigment Epithelium.

Reply to Letter to the Editor: A Fatal Case of Acute Disseminated Encephalomyelitis-A Diagnosis to Ponder in Pandemic.

How to cite this article: Kumar A, Sabharwal P, Gupta P, Singh VK, Rao BK. Reply to Letter to the Editor: A Fatal Case of Acute Disseminated Encephalomyelitis-A Diagnosis to Ponder in Pandemic. Indian J Crit Care Med 2022;26(9):1062.