Early Outcome of On-pump Versus Off-pump Elective Surgical Revascularization in Patients with Prior ST-Segment Elevation Myocardial Infarction.

Coronary artery bypass graft surgery (CABG) is a proven treatment for coronary artery disease. History of a ST-elevation myocardial infarction (STEMI) is considered an independent risk factor for CABG irrespective of timing for an emergency or elective surgery. Patients with STEMI are candidates for both On-pump and Off-pump CABG procedures. This paper discusses the possible best option for elective surgical revascularization in patients with prior STEMI. This prospective clinical trial of 60 eligible patients with prior STEMI was conducted in a Tertiary Care Hospital from April 2018 to March 2019. Among them, 30 patients underwent off-pump (Group A) and 30 patients underwent on-pump (Group B) CABG procedures. Outcomes between both groups were observed from surgery to 1 month postoperatively. Data was analysed by the software statistical program for social science (SPSS 25.0 Inc). The surgery was successful in both groups of patients. Differences were observed by mean number of grafts per patient (2.77±0.43 vs. 3.10±0.71) and duration of operation (4.41±0.35 hours vs. 5.71±0.48 hours). An improvement in Left Ventricular Ejection Fraction (LVEF %) was observed in both groups postoperatively (17.98% vs. 10.98%) and the postoperative LVEF% at different time points were found statistically significant (p<0.05) over preoperative LVEF%. Multivariable stepwise logistic regression analysis correlated on-pump CABG with prolonged need for ionotropic support, need for blood transfusion, longer hospital stay and less improvement in LVEF%. The study supports the Off-pump CABG as a better surgical option over on-pump CABG in patients with prior STEMI.

Bt Eggplant Project in Bangladesh: History, Present Status, and Future Direction.

The purpose of this article is to provide information on the history, accomplishments, and future direction of the Bt brinjal (eggplant) program in Bangladesh, formerly under the Agricultural Biotechnology Support Project II, now the South Asia Eggplant Improvement Partnership (SAEIP). The India-based Maharashtra Hybrid Seed Company (Mahyco) developed an eggplant expressing Cry1Ac (EE-1) for control of the eggplant fruit and shoot borer (EFSB). In a partnership among Mahyco, USAID, Sathguru Management Consultants and Cornell University EE-1 was provided to the Bangladesh Agricultural Research Institute (BARI) who bred it into local varieties. After regulatory approval, four varieties were distributed to 20 farmers who harvested Bt brinjal in 2014. Adoption in subsequent years has increased rapidly so that, in 2018, 27,012 farmers used this technology. This article provides background information on the process leading up to current adoption levels, the level of control of EFSB achieved and the economic benefits of Bt brinjal. Efforts on stewardship, farmer training and communication are discussed. In order to ensure the long-term future of the partnership, we discuss the need to enhance involvement of the private sector in the production and stewardship of Bt eggplant. Bt brinjal is the first genetically engineered crop to be commercially released in Bangladesh, and other GE crops are in the pipeline. Hence, success of the Bt brinjal partnership is likely to affect the future of other GE crops in Bangladesh, as well as other parts of the world where biotechnology is needed for food security and environmental safety.