Development of EST-SSR markers in Bergenia ciliata using de novo transcriptome sequencing.

Bergenia ciliata (Haw.) Sternb. is an important herb predominantly found in the Indian Himalayan Region. It is widely used in medicines, healthcare systems, cosmetics, fodder, and ornamental purposes. The Illumina sequencing and de novo transcriptome assembly were carried out in B. ciliata to develop and identify simple sequence repeat markers. A total of 18 226 simple sequence repeats (SSRs) were identified wherein di-nucleotides were found to be abundant (47.88%), followed by mono-nucleotide (35.03%) and tri-nucleotide (15.88%) repeats. A total of 11 839 EST-SSR primers were designed, of which 96 primer pairs were commercially synthesized. Finally, 17 primer pairs revealed clear, distinct polymorphic bands, and these primers were validated with 40 diverse B. ciliata accessions. The present study revealed moderate level of genetic diversity (Ho = 0.389, He = 0.542, and PIC = 0.513). Furthermore, the transcriptome data and EST-SSR markers generated during the present investigation could be an important genetic resource for functional genomics, population studies, and conservation genetics of the genus Bergenia.

ERCP practice at a tertiary care hospital in Kashmir, North India: a large single-center cross-sectional study with focus on quality indicators, success rate, and indications.

Endoscopic retrograde cholangiopancreatography (ERCP) is the most technically demanding endoscopic procedure with significant adverse events that mandate appropriate training, competence and careful decision-making. The American Society for Gastrointestinal Endoscopy (ASGE) and the European Society of Gastrointestinal Endoscopy (ESGE) updated a list of quality indicators and performance measures for pancreatobiliary endoscopy. Nevertheless, real-life data are scarce, especially from developing countries. The study aimed to assess overall quality, procedural success, and indications of ERCP at our center. Methods: An audit of our endoscopy center at the start of the study for quality and performance indicators and a retrospective analysis of the 4 years of the prospectively maintained data of patients who underwent ERCP regarding procedural success and indications was done. Results: The study showed that ERCP is performed by meeting good quality standards, but structured training, sedation practice, and microbiological surveillance are subpar. A total of 3544 procedures were carried out with successful cannulation of the naive papilla in 93%, with 60% of procedures carried out on females, 80.5% of procedures done for benign diseases, and 19.5% on suspected or proven malignancy (47% men and 53% women) with perihilar obstruction being commonest in both sexes (32-33%) followed by carcinoma gallbladder in women (21%) and distal cholangiocarcinoma in men (27%). Among benign diseases (2711), 12% had benign pancreatic diseases, and 64.8% had common bile duct (CBD) stones, with 31% of CBD stones requiring more than one session for clearance. Conclusion: ERCP at our center is performed by meeting quality standards and by competent endoscopists with good procedural success. Improving sedation strategies, microbiological surveillance, and training programs remains an unmet need.

Impact of End-of-Life Nursing Education Consortium on Palliative Care Knowledge and Attitudes Towards Care of Dying of Nurses in India: A Quasi-Experimental Pre-post Study.

Palliative care (PC) training is conspicuously absent in Indian nursing curricula which is an obstacle to deliver quality end of life care (EOLC). End of life care nursing education consortium (ELNEC) aims to improve nursing staff knowledge and attitudes in PC and EOLC, however its impact on knowledge and attitudes has not been investigated in India. We aimed to assess the impact of ELNEC on the knowledge and attitudes of nurses in India towards PC and care of the dying. This prospective study included 108 registered nurses. A pre- and post-training questionnaire containing Palliative Care Quiz of Nursing (PCQN) and Frommelt Attitude toward Care of the Dying Scale Form B (FATCOD-B) was used to evaluate the PC knowledge and attitudes towards EOLC respectively. Subgroup analysis to delineate association of baseline knowledge and attitudes with gender, educational qualification or professional experience of working with patients with cancer or chronic life limiting illnesses were done. Pre-test FATCOD-B and PCQN scores of 110.81 ± 9.37 and 8.45 ± 1.88 reflect favorable attitudes towards care of dying not backed by sufficient PC knowledge respectively. The mean PCQN and FATCOD-B scores improved from 8.45 ± 1.88 to 10.16 ± 1.89 (P = .0001) and from 110.81 ± 9.37 to 119.47 ± 10.14 (P = .0001) respectively; implying a statistically significant improvement in PC knowledge and a more positive attitudes towards care of the dying. End of life care nursing education consortium is effective in improving practicing nurses' knowledge and attitudes toward PC and care of the dying.

Assessment and current dynamics of nutrients with reference to nitrogen attributes in subalpine forests of Western Himalaya, India.

Nitrogen is an essential macronutrient necessary for a variety of physiological processes in plants, available in numerous fractions, each of which has direct relationship with the area's environmental circumstances since it causes the formation of these fractions. Seasonal and altitudinal variations in nitrogen concentration were found to have a significant impact. The soil of the western Himalaya is rich in a variety of nutrients, notably nitrogen, which was a current source of worry. The study was conducted in north western Himalaya, and different fractions of nitrogen, viz., available nitrogen, total nitrogen, ammonical nitrogen, and nitrate nitrogen, were estimated with reference to different parameters. Annual retention potential was evaluated among various fractions, which yielded positive results, with Site 1 demonstrating the highest retention potential across all seasons. At various depths and seasons of the year, ammonical and nitrate nitrogen levels fluctuated. The findings revealed that the soil is rich in nitrogen fractions with variation directly related to changes in carbon dioxide concentration. Site 1 had the highest values of all the fractions and Site 4 the lowest, whereas the C/N ratio varied between sites. The study determined that nitrogen fractions were present in sufficient quantities and play an important role in the maintenance and growth of natural forests as well as in the reduction of carbon dioxide levels in the atmosphere.

Soil carbon pool and dynamics of different fractions in subalpine temperate coniferous forests of Western Himalaya, India.

Natural forests have the ability to sequester atmospheric carbon for a long time and fix it into the soil through a variety of processes such as decomposition and root respiration. The changing environment of alpine forests alters the characteristics of soil carbon, causing it to be divided into several components. The current study looked at soil carbon fractions and how they changed over time, both annually and seasonally, at different depths and along an altitudinal gradient. Seasonal sampling was carried out at three depths, with standard procedures employed to estimate the results of soil carbon fractions. The results showed that the surface layer (10 cm) had the highest value of all soil qualities such as SOC, Fraction I, Fraction II, Fraction III, SOM and active pool of carbon than the subsurface (20 cm and 30 cm) layers with autumn dominating the seasons. Site 1 had the highest value and Site 4 lowest, indicating that altitudinal variance had a direct relationship with distinct soil fractions. On an annual basis, the corresponding soil carbon fraction variation was examined, revealing the maximum retention capability at 30 cm of depth. According to the findings, the soils of the Western Himalayas have a high potential for carbon sequestration and conversion into various fractions, with significant annual and seasonal change due to changing environmental conditions.

Implementation of an Early Palliative Care Referral Program in Lung Cancer: A Quality Improvement Project at the Tata Memorial Hospital, Mumbai, India.

OBJECTIVES: Access to early palliative care (EPC) for all patients with metastatic lung cancer is yet to be achieved in spite of recommendations. This quality improvement (QI) project was initialized to improve the rates of such referrals from the thoracic oncology clinic for all new outpatients in a premier cancer center in India. MATERIALS AND METHODS: Change in the proportion of patients receiving referrals for EPC during and after intervention (April-May 2018), compared to baseline (January-March 2018) were explored. Interventions included understanding of the process flow, identification of key drivers, and root cause analysis which identified the gaps as lack of documentation for EPC. Teaching and encouraging staff at the clinic to incorporate referrals into all initial visits for patients with metastatic lung cancer were incorporated. RESULTS: The bundle of QI interventions increased referrals from an average of 50% to 75%, mean difference = 12.64 (standard deviation = 10.13) (95% confidence interval = 22.01-3.29), P = 0.016 (two-tailed) on paired sample test. CONCLUSION: Improved referral rates for EPC in a multidisciplinary cancer clinic is possible with a QI project. This project also identifies the importance of data documentation and patient information processes that can be targeted for improvement.

Dynamics of carbon storage and status of standing vegetation in temperate coniferous forest ecosystem of north western Himalaya India.

Natural ecosystems, which operate as a sink, play an important role in determining the concentration of CO2 in the atmosphere and have a large storage capacity, assisting in mitigation of problem that has a negative impact on the human population. Forests are one of the most important carbon sinks in the terrestrial ecosystem, with the best example being the Western Himalaya, where healthy and sustainable vegetation is prized. Standard methodology was adopted for assessing the different parameters of carbon related information to enumerate the status of carbon storage and its trend in sustaining the ecosystem of the area. The current research displays the annual increment and carbon dynamics in various vegetation components and levels. Trees, shrubs, and herbs help to fix atmospheric carbon in a variety of forms, including AGC, BGC, and TC. The concentration of carbon-fixing potential was measured on an annual and seasonal basis, with herbs having the highest mean annual increment, followed by shrubs and trees. Pinus wallichiana had the largest annual carbon stock change among trees, followed by Cedrus deodara, Picea smithiana, and Abies pindrow. P. wallichiana topped the increase percentage with 60.58%, followed by C. deodara 33.35%, P. smithiana 5.61%, and A. pindrow 0.45%. Litter was also investigated as a potential source of mitigation, with the best results observed during the autumn months. Natural coniferous forests provide a regulating ecological service in the region by maintaining carbon dioxide levels in the form of biomass, according to the study.