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Abstract Background Stem rot, caused by the soil-borne pathogen Sclerotium rolfsii, pose a serious challenge in the groundnut (Arachis hypogaea L) cultivation. Although this disease is widespread globally but had most adverse impact in groundnut growing regions of United States, India, and Australia. The pathogen primarily targets the crown region of the plant, resulting in systemic collapse and potentially leading to yield losses up to 80%. Effective genetic control measures are essential to mitigate the impact of this disease on groundnut production. Realizing the time and resource-consuming complex field-based phenotyping, the availability of easy and repeatable phenotyping methods may fasten the process of donor and gene discovery efforts. Results Multi-season phenotyping was performed for stem rot on 184 minicore germplasm accessions, including checks, under two conditions: sick field screening and response to oxalic acid assay. This study demonstrated medium to high heritability (52–63% broad-sense heritability) and significant environmental influence (36%). The response to the oxalic acid assay showed a high proportion of similarity (approximately 80%) with the percent mortality observed in the sick field indicating an easy way of performing precise phenotyping. Notably, seven genotypes—ICG163, ICG721, ICG10479, ICG875, ICG11457, ICG111, and ICG2857—exhibited stable resistance, with less than 30% mortality against stem rot disease. Among these, ICG163, ICG875, and ICG111 displayed low mortality and consistent stability across multiple seasons in both the sick field and controlled conditions of the oxalic acid assay. Conclusions The oxalic acid assay developed in this study effectively complements field phenotyping, as a reliable method for assessing stem rot resistance. Seven resistant genotypes identified through this assay can be utilized for the introgression of stem rot resistance into elite genotypes. Given the significant influence of the environment on stem rot resistance, it is essential to implement multi-season phenotyping to obtain precise results. Furthermore, the response to oxalic acid serves as a valuable supplement to traditional field phenotyping, since maintaining uniform disease pressure during field screenings is often challenging.

Introduction: Peanut is susceptible to infection of Aspergillus fungi and conducive to aflatoxin contamination, hence developing aflatoxin-resistant variety is highly meaningful. Identifying functional genes or loci conferring aflatoxin resistance and molecular diagnostic marker are crucial for peanut breeding. Objectives: This work aims to (1) identify candidate gene for aflatoxin production resistance, (2) reveal the related resistance mechanism, and (3) develop diagnostic marker for resistance breeding program. Methods: Resistance to aflatoxin production in a recombined inbred line (RIL) population derived from a high-yielding variety Xuhua13 crossed with an aflatoxin-resistant genotype Zhonghua 6 was evaluated under artificial inoculation for three consecutive years. Both genetic linkage analysis and QTL-seq were conducted for QTL mapping. The candidate gene was further fine-mapped using a secondary segregation mapping population and validated by transgenic experiments. RNA-Seq analysis among resistant and susceptible RILs was used to reveal the resistance pathway for the candidate genes. Results: The major effect QTL qAFTRA07.1 for aflatoxin production resistance was mapped to a 1.98 Mbp interval. A gene, AhAftr1 (Arachis hypogaea Aflatoxin resistance 1), was detected structure variation (SV) in leucine rich repeat (LRR) domain of its production, and involved in disease resistance response through the effector-triggered immunity (ETI) pathway. Transgenic plants with overexpression of AhAftr1(ZH6) exhibited 57.3% aflatoxin reduction compared to that of AhAftr1(XH13). A molecular diagnostic marker AFTR.Del.A07 was developed based on the SV. Thirty-six lines, with aflatoxin content decrease by over 77.67% compared to the susceptible control Zhonghua12 (ZH12), were identified from a panel of peanut germplasm accessions and breeding lines through using AFTR.Del.A07. Conclusion: Our findings would provide insights of aflatoxin production resistance mechanisms and laid meaningful foundation for further breeding programs.

Background and Objectives: IFNγ is a pleiotropic cytokine and through the regulation of immunologically relevant genes, they coordinate a wide range of cellular programs.[1] As a potent pro-inflammatory cytokine, it plays a pivotal role to induce depigmentation in vitiligo. In this study, we aim to assess the role of IFNγ in the activity, duration and extent of the disease and the antagonistic action of IL-10 is also assessed in vitiligo. Materials and Methods: A case-control study was conducted with 100 study participants with 50 cases clinically diagnosed as Vitiligo and 50 controls. All patients underwent complete evaluation with detailed demographic parameters, history and physical examination. The severity of the disease was assessed clinically by Vitiligo Area Scoring Index (VASI) and Vitiligo Disease Activity Score (VIDA). And blood investigations done were IFN-γ and IL-10. Results: We observed significantly higher levels of serum IFNγ levels in the patient group when compared with those of the normal controls (p=0.002) and showed a positive correlation with the activity and severity of the disease with a significant VASI (p=0.05) and VIDA score (p=

Birds are indicators of biodiversity and ecosystem health and play an essential role in maintaining the balance of natural ecosystems. However, urbanization, deforestation, and technological advancements have severely affected bird habitats, leading to a significant decline in species diversity. Manual detection and recognition of bird species based on morphological and behavioral characteristics during birdwatching and surveys are challenging and require expertise, making deep learning a promising alternative. Deep learning techniques offer the advantage of automatic identification, which can significantly enhance the efficiency and accuracy of species recognition tasks. However, the black-box nature of these models presents a significant issue, as it is difficult to understand their internal decision-making processes, leading to concerns about their reliability and trustworthiness. This study addresses these issues by employing Explainable Artificial Intelligence (XAI) to enhance the transparency of deep learning models for bird species image classification. In this paper, a three-stage XAI-based approach is proposed, involving transfer learning, Local Interpretable Model-Agnostic Explanations (LIME), and Intersection over Union (IoU) scores to assess model performance. Six pretrained models are evaluated on the CUB 200-2011 dataset, with EfficientNetB0 achieving the highest accuracy (99.51%) and IoU score (0.43). Despite high accuracy, models such as InceptionResNetV2 and DenseNet201 showed lower IoU scores, raising trustworthiness concerns. This study underscores the importance of XAI in ensuring the transparency and reliability of Artificial Intelligence (AI) models in ecological applications.

Due to the pathogen’s ability to survive in the soil for longer durations, soil-borne diseases are often difficult to control. This study investigates the multifaceted impacts of biochar on the management of stem rot disease in groundnut and its influence on soil properties and microbial communities. The effects of biochar at different concentrations, such as 0%, 1%, 3%, and 5% on groundnut stem rot disease incited by Sclerotium rolfsii were evaluated thoroughly. Under laboratory conditions, biochar exhibited no direct inhibitory effects on S. rolfsii at varying concentrations but revealed an indirect suppression of sclerotial body production, suggesting a concentration-dependent influence on pathogen resting structures. Further, it was observed that biochar treatments effectively delayed symptom onset and reduced disease progression in groundnut plants, with significant variation observed among genotypes and biochar concentrations. Notably, interactions involving genotypes ICGV 171002 and ICGV 181035 with BC2 + Sr (3% conc. of biochar + S. rolfsii) and BC3 + Sr (5% conc. of biochar + S. rolfsii) treatments showed superior efficacy in disease reduction under controlled conditions. Field evaluations confirmed these findings, highlighting genotype-specific responses to biochar treatments. However, no significant difference was observed between BC2 + Sr (3%) and BC3 + Sr (5%) treatments in managing stem rot disease compared to controls. Biochar application significantly increased soil nutrient levels, including nitrogen, phosphorus, and potassium, and increased soil organic matter content, EC, pH, emphasizing its potential to improve soil fertility. Overall, these findings highlight the potential benefits of biochar for sustainable agriculture through disease management, soil nutrient enrichment, and microbial modulation, warranting further investigation into optimal application strategies across different agricultural contexts.

Aspiration of scarf pins is a common problem in specific geographical locations where the Muslim population is high, especially in countries like Egypt, Bangladesh, Middle Eastern countries, and certain regions in India. This condition is also referred to as hijab-pin syndrome. We discuss the largest experience of flexible bronchoscopic extraction of aspirated scarf pins from the tracheobronchial tree. A multicenter retrospective observational study was conducted on 146 patients from 4 different centers in Egypt, Bangladesh, India, and Germany. Flexible bronchoscopy was successful in the extraction of aspirated scarf pins in all 146/146 patients with a 100% success rate. 136/146 (93.15%) patients were females, with the most common age group between 12 and 18 years (34.24%). 132/146 (90.4%) remembered the aspiration event before coming to the hospital. Cough was the predominant presenting symptom. (71.22%). In all 146 cases, the foreign body was identified on a standard chest X-ray. The left main bronchus was the most common site of aspiration, 67/146 (45.89%), followed by the right main bronchus, 56/146 (38.35%). 14 patients (9.58%) had a history of unsuccessful attempts to remove by rigid bronchoscopy, and flexible bronchoscopy was successful in these 14 (100%) patients who had a prior unsuccessful attempt to remove. The current series is the largest in literature and demonstrated an excellent success rate in the removal of the aspirated scarf pin.

Medical Thoracoscopy (MT) is commonly performed by respiratory physicians for diagnostic as well as therapeutic purposes. The aim of the study was to provide evidence-based information regarding all aspects of MT, both as a diagnostic tool and therapeutic aid for pulmonologists across India. The consensus-based guidelines were formulated based on a multistep process using a set of 31 questions. A systematic search of published randomized controlled clinical trials, open labelled studies, case reports and guidelines from electronic databases, like PubMed, EmBase and Cochrane, was performed. The modified grade system was used (1, 2, 3 or usual practice point) to classify the quality of available evidence. Then, a multitude of factors were taken into account, such as volume of evidence, applicability and practicality for implementation to the target population and then strength of recommendation was finalized. MT helps to improve diagnosis and patient management, with reduced risk of post procedure complications. Trainees should perform at least 20 medical thoracoscopy procedures. The diagnostic yield of both rigid and semirigid techniques is comparable. Sterile-graded talc is the ideal agent for chemical pleurodesis. The consensus statement will help pulmonologists to adopt best evidence-based practices during MT for diagnostic and therapeutic purposes.

Systems for disease vector control should be effective, efficient, and flexible to be able to tackle contemporary challenges and threats in the control and elimination of vector-borne diseases. As a priority activity towards the strengthening of vector control systems, it has been advocated that countries conduct a vector-control needs assessment. A review was carried out of the perceived needs for disease vector control programs among eleven countries and subnational states in South Asia and the Middle East. In each country or state, independent teams conducted vector control needs assessment with engagement of stakeholders. Important weaknesses were described for malaria, dengue and leishmaniases regarding vector surveillance, insecticide susceptibility testing, monitoring and evaluation of operations, entomological capacity and laboratory infrastructure. In addition, community mobilization and intersectoral collaboration showed important gaps. Countries and states expressed concern about insecticide resistance that could reduce the continued effectiveness of interventions, which demands improved monitoring. Moreover, attainment of disease elimination necessitates enhanced vector surveillance. Vector control needs assessment provided a useful planning tool for systematic strengthening of vector control systems. A limitation in conducting the vector control needs assessment was that it is time- and resource-intensive. To increase the feasibility and utility of national assessments, an abridged version of the guidance should focus on operationally relevant topics of the assessment. Similar reviews are needed in other regions with different contextual conditions.

Background: Adequate knowledge among nursing professionals toward hospital infection control measures related to hemodialysis (HD) services is essential to decrease infection among patients. Objective: This study assessed nursing professionals' knowledge about hospital infection control measures related to HD services and the effect of training interventions. Settings and Designs: It was a single group, a pre–post-interventional study conducted on nursing professionals of a single apex medical college of Haryana. Materials and Methods: A pretested questionnaire consisting of two parts was used as a study tool. Statistical Analysis: Various statistical tests such as paired t-test and Pearson's correlation were used. Results: The pre-intervention group had a lower mean knowledge score (mean knowledge = 90.2786, strongly disagree [SD] = 15.52682, standard error [SE] = 1.09518) and then the post-intervention mean knowledge score (mean knowledge = 137.5622, SD = 9.72252, SE = 0.68577). Conclusions: The training program or educational intervention proved very useful for enhancing nursing professional's knowledge about hospital infection control measures related to HD services.

Objective: The aim of the present study is to evaluate the role of urinary transforming growth factor – β1 (uTGF-β1) in congenital unilateral pelvi-ureteric junction obstruction (PUJO) upto the point of developing conventional indications for surgery and after pyeloplasty with the aim to explore the development of targeted therapeutic strategies aimed at modulating its effects and attenuating renal fibrosis. Methods: Sixty two children with unilateral pelvi-ureteric junction obstruction, consisting of 46 boys and 16 girls, with a mean age of 9.4 months forms the study group. Twenty three out of 62 (37.1%) developed indication for surgery after a mean follow-up of 24.2±3.7 months. The uTGF-β1 levels have been measured by ELISA at different points of intervals, i.e., before indications for surgery, at the development of indications for surgery and after surgical intervention and compared with children continued to followon without indications for surgery. Results: In children, who were continued to be followed up without indications for surgery, 39 had a mean baseline uTGF-β1 levels of 698.4mg/pg/Cr. which increased to 753.1mg/pg/Cr. (p valuie

Storage is an important aspect of groundnut, as the in-shell and shelled kernels are prone to infestation by insects, pests, and fungi. Among several storage pests, the groundnut bruchid, Caryedon serratus, causes serious losses. Farmers often resort to different management practices, including hermetic storage, to control it. The moisture content of the commodity plays an important role in insect infestation during storage. Drying to safe moisture levels before storage is known to prevent the activity of various living organisms, such as storage pests. However, drying to low levels of moisture may not be economical for farmers, as they may not have access to devices to accurately check product moisture. In this regard, we wanted to demonstrate the efficacy of triple-layer hermetic storage bags in preventing the damage caused by C. serratus when the groundnuts are stored at intermediate (10%) and high (14%) levels of moisture compared to traditionally used bags such as polypropylene bags and jute bags. Groundnut pods at 10% moisture content and 14% moisture content were separately inoculated with adult bruchids and a toxigenic strain of Aspergillus flavus fungal inoculum before storing them for 6 months. Results from groundnut samples taken at two-month intervals indicated that groundnut pods stored in triple-layer hermetic bags were completely free from infestation by C. serratus by recording a zero number of eggs laid, number of pupae, adult emergence, percentage of loss, and percentage of damage up to 6 months of storage, by creating low oxygen (hypoxia) and high carbon dioxide (hypercarbia) conditions. Results also indicate no loss of pod weight stored in triple-layer bags, but a slight reduction in germination percentage was recorded due to a slight increase in fungal activity, but the reduction was significantly less in triple-layer plastic bags compared to other bag types. Similarly, biochemical constituents such as oil and protein content were slightly reduced in triple-layer plastic bags when pods were stored at a 10% moisture level, but a higher reduction was observed at a 14% moisture level. However, the reduction was very high and significant in other bag types at both 10 and 14% moisture levels.

Macrophomina phaseolina is the most devastating and emerging threat to groundnut production in India. An increase in average temperature and inconsistent rainfalls resulting from changing climatic conditions are strongly believed to aggravate the disease and cause severe yield losses. The present study aims to conduct a holistic survey to assess the prevalence and incidence of dry root rot of groundnut in major groundnut growing regions of Southern India, viz., Andhra Pradesh, Telangana, Karnataka, and Tamil Nadu. Furthermore, the pathogenic variability was determined using different assays such as morphological, cultural, pathogenic, and molecular assays. Results indicate that disease incidence in surveyed locations ranged from 8.06 to 20.61%. Both temperature and rainfall played a major role in increasing the disease incidence. The pathogenic variability of M. phaseolina isolates differed significantly, based on the percent disease incidence induced on cultivars of JL-24 groundnut and K-6 groundnut. Morphological variations in terms of growth pattern, culture color, sclerotia number, and sclerotia size were observed. The molecular characterization of M. phaseolina isolates done by ITS rDNA region using ITS1 and ITS4 primers yielded approximately 600 bp PCR amplicons, sequenced and deposited in GenBank (NCBI). Molecular variability analysis using SSR primers indicated the genetic variation among the isolates collected from different states. The present investigation revealed significant variations in pathogenic variability among isolates of M. phaseolina and these may be considered important in disease management and the development of resistant cultivars against groundnut dry root rot disease.

Background: The inflammatory and immune factors play a key role in the pathogenesis of vitiligo, and there are very few studies that have investigated the levels of major cytokines produced by T helper (Th) 1, Th2, and Th17 cells. This can enable better understanding of the, pathogenesis, and severity of vitiligo. Objectives: To evaluate the serum levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, IL-1β, interferon (IFN)-γ, and IL-10 in patients with vitiligo and to correlate them with the disease severity and activity and to compare them with normal healthy controls. Materials and Methods: A case–control study was conducted with 100 study participants: 50 cases clinically diagnosed as vitiligo and 50 controls. All patients underwent complete evaluation with detailed demographic parameters, history, and physical examination. The severity of the disease was assessed clinically by Vitiligo Area Scoring Index (VASI) and Vitiligo Disease Activity Score (VIDA). Blood investigations performed were IL-6, TNF-α, IL-1β, IFN-γ, and IL-10. Results: We observed significantly higher levels of serum IFN-γ levels in the patient group when compared with those of the normal controls (P = 0.002) and showed a positive correlation with the activity and severity of the disease with a significant VASI (P = 0.05) and VIDA score (P = < 0.001). The mean serum IL-10 (p < 0.001) in patients with vitiligo was significantly lower than that in the control group. There was no significant difference in the serum level of TNF-α level (P = 0.347), IL-6 (P = 0.365), and IL-1β (P = 0.362) between vitiligo and healthy controls. Conclusion: This study proved that high serum level of IFN-γ may be a risk factor for vitiligo progression and significantly low levels of IL-10, which has an anti-inflammatory role, suggesting that they could be used as a marker for assessing vitiligo activity and may open the way for further therapeutic approaches for vitiligo.

A survey was conducted to determine the human tick-borne bacterial infections in the nymphs which were collected from Western Ghats’ fringe forest areas. Tick nymphs were collected using the flagging method from the villages where cases Kyasanur Forest Disease (KFD) were previously reported in the states of Goa, Karnataka and Maharashtra. A total of 200 tick pools consisting of 4587 nymphs were tested by PCR for the detection of bacteria of public health importance, such as Coxiella burnetii and Rickettsia spp. Of these, four pools (4.8%) in Karnataka and three pools (4.4%) in Maharashtra were positive for Coxiella burnetii, while none of the samples from Goa state were positive. Rickettsia spp. were positively obtained from Maharashtra (51.5%), Goa (35.42%) and Karnataka (26.19%). The sequence results of Rickettsia spp. showed similarity to the spotted fever group Candidatus Rickettsia shennongii, Rickettsia conorii subsp. heilongjiangensis and Rickettsia spp. strain koreansis. Individuals are entering into the forest areas for various reasons are more likely to infect with Coxiella burnetii. and Rickettsia spp.

Climate change across the globe has an impact on the occurrence, prevalence, and severity of plant diseases. About 30% of yield losses in major crops are due to plant diseases; emerging diseases are likely to worsen the sustainable production in the coming years. Plant diseases have led to increased hunger and mass migration of human populations in the past, thus a serious threat to global food security. Equipping the modern varieties/hybrids with enhanced genetic resistance is the most economic, sustainable and environmentally friendly solution. Plant geneticists have done tremendous work in identifying stable resistance in primary genepools and many times other than primary genepools to breed resistant varieties in different major crops. Over the last two decades, the availability of crop and pathogen genomes due to advances in next generation sequencing technologies improved our understanding of trait genetics using different approaches. Genome-wide association studies have been effectively used to identify candidate genes and map loci associated with different diseases in crop plants. In this review, we highlight successful examples for the discovery of resistance genes to many important diseases. In addition, major developments in association studies, statistical models and bioinformatic tools that improve the power, resolution and the efficiency of identifying marker-trait associations. Overall this review provides comprehensive insights into the two decades of advances in GWAS studies and discusses the challenges and opportunities this research area provides for breeding resistant varieties.

Hereditary recurrent fever syndromes are rarely diagnosed in India, and the age at diagnosis is usually childhood or early adulthood. We present an adult male patient with recurrent fever since childhood who presented to us at 59 years of age and was subsequently diagnosed to have TNFR1-associated periodic fever syndrome that responded well to colchicine.

Abstract With the speeding up of social activities, rapid changes in lifestyles, and an increase in the pressure in professional fields, people are suffering from several types of sleep‐related disorders. It is a very tedious task for clinicians to monitor the entire sleep durations of the subjects and analyse the sleep staging in traditional and manual laboratory environmental methods. For the purpose of accurate diagnosis of different sleep disorders, we have considered the automated analysis of sleep epochs, which were collected from the subjects during sleep time. The complete process of an automated approach of sleep stages’ classification is majorly executed through four steps: pre‐processing the raw signals, feature extraction, feature selection, and classification. In this study, we have extracted 12 statistical properties from input signals. The proposed models are tested in three different combinations of features sets. In the first experiment, the feature set contained all the 12 features. The second and third experiments were conducted with the nine and five best features. The patient records come from the ISRUC‐Sleep database. The highest classification accuracy was achieved for sleep staging through combinations with the five feature set. From the categories of the subjects, the reported accuracy results were found to exceed above 90%. As per the outcome from the proposed system the random forest classification techniques achieved best accuracy incomparable to that of the other two classifiers.

Primary Biliary Cholangitis (PBC) is a debilitating autoimmune disorder involving intrahepatic biliary ducts. It is characterized by chronic inflammation followed by fibrous obliteration of biliary ducts. This condition is rarely associated with pericardial effusion. The association of pericarditis and PBC is rare and identifies the existence of extensive systemic inflammation. In the literature, only 5 cases of this association are reported. As a specific systemic syndrome, this association should be evaluated and its prognostic consequences should be analyzed in depth. We report a case of life-threatening pericardial effusion progressing to tamponade with pericarditis in a 38-year-old female patient with PBC.

Abstract Objective To review the global impact of the COVID‐19 pandemic on stroke care‐metrics and report data from a health system in Houston. Methods We performed a meta‐analysis of the published literature reporting stroke admissions, intracerebral hemorrhage (ICH) cases, number of thrombolysis (tPA) and thrombectomy (MT) cases, and time metrics (door to needle, DTN; and door to groin time, DTG) during the pandemic compared to prepandemic period. Within our hospital system, between January–June 2019 and January–June 2020, we compared the proportion of stroke admissions and door to tPA and MT times. Results A total of 32,640 stroke admissions from 29 studies were assessed. Compared to prepandemic period, the mean ratio of stroke admissions during the pandemic was 70.78% [95% CI, 65.02%, 76.54%], ICH cases was 83.10% [95% CI, 71.01%, 95.17%], tPA cases was 81.74% [95% CI, 72.33%, 91.16%], and MT cases was 88.63% [95% CI, 74.12%, 103.13%], whereas DTN time was 104.48% [95% CI, 95.52%, 113.44%] and DTG was 104.30% [95% CI, 81.99%, 126.61%]. In Houston, a total of 4808 cases were assessed. There was an initial drop of ~30% in cases at the pandemic onset. Compared to 2019, there was a significant reduction in mild strokes (NIHSS 1‐5) [N (%), 891 (43) vs 635 (40), P = 0.02]. There were similar mean (SD) (mins) DTN [44 (17) vs 42 (17), P = 0.14] but significantly prolonged DTG times [94 (15) vs 85 (20), P = 0.005] in 2020. Interpretation The COVID‐19 pandemic led to a global reduction in stroke admissions and treatment interventions and prolonged treatment time metrics.

Fracture and embolization of peripheral intravenous cannula is very rare. Although endovascular retrieval is the standard of care for most of the embolized intravascular devices, endovascular management of embolized peripheral intravenous cannula is technically difficult due to its radiolucent nature and it is not described previously in the literature. We describe the clinical presentation, imaging findings, and endovascular management in a middle aged male who had fractured peripheral intravenous cannula which was embolized into the pulmonary artery branch. Technical nuances associated with retrieval of this radiolucent little plastic tube have been discussed.

Background: Methaemoglobinemia is a rare disease complicating pregnancy and often diagnosed for the first time in perioperative or peripartum setting. Aim: To analyse the type of methaemoglobinemia, clinical presentation and pregnancy outcomes in our series of pregnant women with methaemoglobinemia. Methods: This is a single centre retrospective study of patients with methaemoglobinemia admitted between 2003 and 2015. Results: We had six pregnant women with methaemoglobinemia during the study period. Three women had congenital methaemoglobinemia and three of them had acquired methaemoglobinemia. Obstetric and foetal outcomes were good. Conclusion: Congenital methaemoglobinemia is reasonably well tolerated in pregnancy. With proper counselling, follow-up, avoidance of drugs associated with methaemoglobinemia and prompt diagnosis and management especially in cases of acquired methaemoglobinemia, we can achieve good pregnancy outcomes.

One of the major causes of reversible left ventricular (LV) systolic dysfunction is takotsubo cardiomyopathy. It is characterized by angina, dyspnea, electrocardiogram changes (ST segment elevation and T wave changes on chest leads of electrocardiogram), echocardiographic changes (LV dysfunction with predominant apical involvement), elevation of troponin and brain natriuretic peptide, usually mimicking acute coronary syndrome. Coronary angiogram in such cases is either normal or shows only insignificant coronary disease. Although LV apical involvement is the commonest manifestation, about one-fifth of cases of takotsubo cardiomyopathy have normal apical contractility but severe systolic dysfunction of the basal segments of the left ventricle. We report a case of reverse takotsubo cardiomyopathy developed in a relatively young patient following hip surgery and how three-dimensional and strain echocardiography clearly demonstrated the abnormality and aided the recovery of the patient.

Foliar fungal diseases (rust and late leaf spot) incur large yield losses, in addition to the deterioration of fodder quality in groundnut worldwide. High oleic acid has emerged as a key market trait in groundnut, as it increases the shelf life of the produce/products in addition to providing health benefits to consumers. Marker-assisted backcrossing (MABC) is the most successful approach to introgressing or pyramiding one or more traits using trait-linked markers. We used MABC to improve three popular Indian cultivars (GJG 9, GG 20, and GJGHPS 1) for foliar disease resistance (FDR) and high oleic acid content. A total of 22 BC3F4 and 30 BC2F4 introgression lines (ILs) for FDR and 46 BC3F4 and 41 BC2F4 ILs for high oleic acid were developed. Recurrent parent genome analysis using the 58 K Axiom_Arachis array identified several lines showing upto 94% of genome recovery among second and third backcross progenies. Phenotyping of these ILs revealed FDR scores comparable to the resistant parent, GPBD 4, and ILs with high (~80%) oleic acid in addition to high genome recovery. These ILs provide further opportunities for pyramiding FDR and high oleic acid in all three genetic backgrounds as well as for conducting multi-location yield trials for further evaluation and release for cultivation in target regions of India. Keywords: Foliar disease resistance, High oleic acid, Late leaf spot, Marker-assisted backcrossing, SNP array, Background genome recovery

Rice, the world’s most extensively cultivated cereal crop, serves as a staple food and energy source for over half of the global population. A variety of abiotic and biotic factors such as weather conditions, soil quality, temperature, insects, pathogens, and viruses can greatly impact the quantity and quality of rice grains. Studies have established that plant infections have a significant impact on rice crops, resulting in substantial financial losses in agriculture. To accurately diagnose and manage the diseases affecting rice plants, plant pathologists are seeking efficient and reliable methods. Traditional disease detection techniques, employed by farmers, involve time-consuming visual inspections and result in inadequate farming practices. With advancements in agricultural technology, the identification of pathogenic organisms in rice plants has become significantly more manageable through techniques such as machine learning and deep learning, which are receiving significant attention in crop disease research. In this paper, we used the transfer learning approach on 15 pre-trained CNN models for the automatic identification of Rice leave diseases. Results showed that the InceptionV3 model is outperforming with an average accuracy of 99.64% with Precision, Recall, F1-Score, and Specificity as 98.23, 98.21, 98.20, and 99.80, and the AlexNet model resulted in poor performance with average accuracy of 97.35% among others.

Abstract Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) is preferred for evaluating malignant lymph nodes and staging of lung cancer. Nevertheless, larger tissue samples are increasingly needed, particularly for molecular analysis. We describe the feasibility, technical details, and complications of EBUS‐guided transbronchial cryo‐node biopsy (TBCNB) in four patients with mediastinal adenopathy. The samples obtained by EBUS‐TBCNB in all cases were adequate for histopathological examination (HPE) and immunohistochemistry (IHC) staining. In case 1, HPE showed non‐caseating epithelioid granuloma with giant cells and fibrosis consistent with sarcoidosis. Case 2 was diagnosed with adenocarcinoma with positivity for ROS1(D4D6). Case 3 showed features of metastatic adenocarcinoma from the breast (positive for Her2, ER, and GATA3). Case 4 was diagnosed with tuberculosis (necrotizing granuloma in histopathology, stain with Ziehl–Neelsen that showed few rod‐shaped bacilli). Only one patient had minimal bleeding at the puncture site controlled with cold saline. There were no adverse events such as major bleeding, pneumomediastinum, or pneumothorax.

BackgroundBetter drug regimens for mass drug administration (MDA) could accelerate the Global Programme to Eliminate Lymphatic Filariasis (LF). This community study was designed to compare the safety and efficacy of MDA with IDA (ivermectin, diethylcarbamazine and albendazole) or DA (diethylcarbamazine and albendazole) in India.Methodology/principal findingsThis two-armed, open-labelled, block randomised, community study was conducted in LF endemic villages in Yadgir district, Karnataka, India. Consenting participants ≥5 years of age were tested for circulating filarial antigenemia (CFA) and microfilaremia (Mf) before treatment with a single oral dose of IDA or DA. Adverse events (AEs) were monitored actively for two days and passively for five more days. Persons with positive CFA or Mf tests at baseline were retested 12-months post-treatment to assess treatment efficacy. Baseline CFA and Mf-rates were 26.4% and 6.9% in IDA and 24.5% and 6.4% in DA villages respectively. 4758 and 4160 participants received IDA and DA. Most AEs were mild after both treatments; fewer than 0.1% of participants experienced AEs with severity > grade 1. No serious AEs were observed. Fever, headache and dizziness were the most common AEs. AE rates were slightly higher after IDA than DA (8.3% vs. 6.4%, PConclusions/significanceIDA had an acceptable safety profile and was more effective for clearing Mf than DA. With adequate compliance and medical support to manage AEs, IDA has the potential to accelerate LF elimination in India.Trial registrationClinical Trial Registry of India (CTRI No/2016/10/007399).

Background Although strokes are rare in trauma patients, they are associated with worse functional and cognitive outcomes and decreased mobility. Blunt cerebrovascular injury (BCVI)–related strokes and mortality have decreased, likely due to refined screening and treatment algorithms in trauma literature; however, there is a paucity of research addressing non-BCVI strokes in trauma. The purpose of this study is to evaluate the incidence, etiology, and risk factors of stroke in our trauma population in order to identify preventive strategies.Methods This study was a retrospective review of all adult trauma patients admitted to a level 1 trauma hospital who suffered a stroke during trauma admission from 2010 to 2017. Data were collected from the prospectively maintained trauma and stroke databases. Stroke etiology was determined by a vascular neurologist.Results Of the 43 674 adult trauma patients admitted during the study period, 99 (0.2%) were diagnosed with a stroke during the index admission. Twenty-one (21%) strokes were due to BCVI. Seventy-eight (79%) strokes were due to non-BCVI etiologies. Patients with non-BCVI strokes were older, less severely injured, and had more medical comorbidities compared with patients with a BCVI stroke. While patients with a BCVI stroke were more likely to suffer multiple traumatic injuries from MVC (76% vs 28%, p

High oleic trait, resistance to rust and late leaf spot (LLS) are important breeding objectives in groundnut. Rust and LLS cause significant economic loss, and high oleic trait is an industry preferred trait that enhances economic returns. This study reports marker-assisted selection to introgress high oleic content, resistance to LLS and rust into Kadiri 6 (K 6), a popular cultivar. The alleles for target traits were selected using linked allele-specific, simple sequence repeats and single nucleotide polymorphic markers. The F1s (384), intercrossed F1s (441), BC1F1s (380), BC1F2s (195), and BC1F3s (343) were genotyped to obtain desired allelic combination. Sixteen plants were identified with homozygous high oleic, LLS and rust resistance alleles in BC1F2, which were advanced to BC1F3 and evaluated for disease resistance, yield governing and nutritional quality traits. Phenotyping with Near-Infrared Reflectance Spectroscopy identified three lines (BC1F3-76, BC1F3-278, and BC1F3-296) with >80% oleic acid. The identified lines exhibit high levels of resistance to LLS and rust diseases (score of 3.0–4.0) with preferred pod and kernel features. The selected lines are under yield testing trials in multi-locations for release and commercialization. The lines reported here demonstrated combining high oleic trait with resistance to LLS and rust diseases.

The present study sought to identify household risk factors associated with aflatoxin contamination within and across diverse Indian food systems and to evaluate their utility in risk modeling. Samples (n = 595) of cereals, pulses, and oil seeds were collected from 160 households across four diverse districts of India and analyzed for aflatoxin B1 using enzyme-linked immunosorbent assay (ELISA). Demographic information, food and cropping systems, food management behaviors, and storage environments were profiled for each household. An aflatoxin detection risk index was developed based on household-level features and validated using a repeated 5-fold cross-validation approach. Across districts, between 30-80% of households yielded at least one contaminated sample. Aflatoxin B1 detection rates and mean contamination levels were highest in groundnut and maize, respectively, and lower in other crops. Landholding had a positive univariate effect on household aflatoxin detection, while storage conditions, product source, and the number of protective behaviors used by households did not show significant effects. Presence of groundnut, post-harvest grain washing, use of sack-based storage systems, and cultivation status (farming or non-farming) were identified as the most contributive variables in stepwise logistic regression and were used to generate a household-level risk index. The index had moderate classification accuracy (68% sensitivity and 62% specificity) and significantly correlated with village-wise aflatoxin detection rates. Spatial analysis revealed utility of the index for identifying at-risk localities and households. This study identified several key features associated with aflatoxin contamination in Indian food systems and demonstrated that household characteristics are substantially predictive of aflatoxin risk.

BACKGROUND:Lymphatic filariasis (LF) is targeted for elimination by the year 2020. As of 2017, 67 of the 72 endemic countries have implemented annual Mass Drug Administration (MDA) for interrupting LF transmission. Transmission Assessment Survey (TAS) is the recommended protocol to evaluate the impact of MDA and to decide when to stop MDA in an Evaluation Unit (EU, population ≤2 million). As the human infection levels go down with repeated MDA rounds, it becomes a challenge to select the appropriate survey methods to assess transmission interruption. This study validates a standard protocol for molecular xenomonitoring of infection in vectors (MX) at an EU as a complementary tool for TAS to stop MDA and its utility for post-MDA or post-validation surveillance. METHODOLOGY:The study was conducted in Cuddalore district, Tamil Nadu, India, which was found eligible for TAS after 15 annual rounds of MDA (4 with DEC alone and 11 with DEC plus albendazole). The district was divided into two EUs as per the TAS protocol and one EU was randomly selected for the study. A two-stage cluster design vector sampling, developed and validated at a sub-district level, was implemented in 30 randomly selected clusters in the EU. Female Culex quinquefasciatus were collected placing gravid traps overnight (1800-0600 hrs) inside the premises of systematically selected households. Pools of 20-25 blood-fed, semi-gravid and gravid Cx. quinquefasciatus were subjected to real-time quantitative PCR (polymerase chain reaction) assay for detecting Wuchereria bancrofti DNA. Pool infection rate (% of pools positive for W. bancrofti DNA), and the estimated prevalence of W. bancrofti DNA in mosquitoes and its 95% confidence interval were calculated. Additionally, in these 30 clusters, microfilaria (Mf) survey among individuals >5 years old was carried out. School-based TAS was conducted using Immunochromatographic Card Test (ICT) in the EU. Prepared itemized cost-menu for different cost components of MX survey and TAS were estimated and compared. RESULTS:MX survey showed that only 11 (3.1%) of the 358 pools (8850 Cx.quinquefasciatus females), collected from 30 clusters, were found positive for W. bancrofti DNA. The estimated vector infection rate was 0.13% (95% CI: 0.07-0.22%), below the provisional threshold (0.25%) for transmission interruption. Of 1578 children tested in the TAS, only four (0.25%) were positive for filarial antigenemia, and it is well below the critical cut-off (18 positives) for stopping MDA. Among 9804 persons tested in the 30 clusters, only four were found positive for Mf (0.04%; 95% CI: 0.01-0.1%). The Mf-prevalence was

In this paper an efficient ISAR image classification method is proposed based on Minimum Enclosed Circle based Shape Matrix (MECSM) representation of the targets. Initially, discordant ISAR images are processed to remove the noise and outliers. Next, an orientation alignment method is used to align the targets vertically to achieve rotation invariance. The Enhanced Minimum Enclosed Circle calculation method (EnMEC) finds the radius and centre of the Minimum Enclosed Circle (MEC) of the shape. Then, the classification of the targets is performed based on shape matrices generated by the MECSM representation method proposed in this paper. The MECSM representation overcomes the limitations of the conventional shape matrix representation such as the dependency of the shape matrix representation on centre of mass (COM) and maximum radius of the shape of the target. The MECSM representation also curtails the extraneous interpolations in representing the insignificant details around the target. Experimental analysis shows that the proposed method is robust against the deformations in the rudimentary silhouettes of the targets emanated from the complications abounded with ISAR image reconstruction and processing mechanisms. Keywords: Inverse Synthetic Aperture Radar (ISAR) imagery, ISAR image classification, Shape matrices, Minimum Enclosed Circle (MEC), Automatic Target Classification (ATC), Automatic Target Recognition (ATR)

Sclerotium rolfsii Sacc. is a destructive soilborne fungal pathogen with a wide host range that includes peanuts. Biological control offers an interesting alternative to fungicides for sustainable management of soilborne diseases. The current investigation is aimed at evaluating one potential biocontrol agent Streptomyces sp. RP1A-12 for growth promotion and the management of peanut stem rot disease caused by S. rolfsii under field conditions. Preliminary studies conducted under in vitro and the greenhouse conditions showed promising results against the stem rot pathogen. Further in vitro and pot experiments conducted to assess Streptomyces sp. RP1A-12 for its growth promoting abilities using whole organisms have shown an increase in seed germination, root and shoot length. Other parameters like nodule number and plant biomass were also significantly increased over control treatments indicating that the test bioagent possesses growth promoting abilities along with disease suppression capabilities. Subsequently field studies were carried out for two consecutive rainy seasons. The bioagent was applied as whole organism and partially purified crude metabolites. Results indicate the bioagent reduced stem rot disease incidence by 64–67% and 22–49% respectively in two field trials conducted with notable increase in yield. Partially purified Streptomyces sp. RP1A-12 metabolites exhibited an even greater effect in reducing the incidence and severity of stem rot compared to the pathogen inoculated control.

Aflatoxin contamination is a global menace that adversely affects food crops and human health. Peanut seed coat is the outer layer protecting the cotyledon both at pre- and post-harvest stages from biotic and abiotic stresses. The aim of the present study is to investigate the role of seed coat against A. flavus infection. In-vitro seed colonization (IVSC) with and without seed coat showed that the seed coat acts as a physical barrier, and the developmental series of peanut seed coat showed the formation of a robust multilayered protective seed coat. Radial growth bioassay revealed that both insoluble and soluble seed coat extracts from 55-437 line (resistant) showed higher A. flavus inhibition compared to TMV-2 line (susceptible). Further analysis of seed coat biochemicals showed that hydroxycinnamic and hydroxybenzoic acid derivatives are the predominant phenolic compounds, and addition of these compounds to the media inhibited A. flavus growth. Gene expression analysis showed that genes involved in lignin monomer, proanthocyanidin, and flavonoid biosynthesis are highly abundant in 55-437 compared to TMV-2 seed coats. Overall, the present study showed that the seed coat acts as a physical and biochemical barrier against A. flavus infection and its potential use in mitigating the aflatoxin contamination.

Background: Anesthetic agents cause a dose-dependent effect on motor-evoked potentials (MEPs). We conducted a study to find whether addition of ketamine to the combination of propofol–fentanyl–dexmedetomidine has an effect on MEP monitoring and hemodynamic parameters in patients undergoing spine surgeries. Materials and Methods: Sixty patients of American Society of Anesthesiologists Grade I–III undergoing spine surgery in general anesthesia were divided into two groups,P and K randomly. Written informed consent was obtained and all the patients were blinded to the interventions. After induction, anesthesia was maintained in Group P using propofol + dexmedetomidine + fentanyl infusion, whereas in Group K, ketamine infusion was added to the above combination. After taking baseline reading of MEP, heart rate (HR), and mean arterial pressure (MAP), mean of all the other readings was calculated and percentage fall in all factors was calculated. More than 80% fall in mean MEP and more than 20% fall in mean HR and MAP were considered significant. Statistical Analysis: Analysis was done by SPSS 20.0 statistical system. Continuous normally distributed data were analyzed using Student's independent t-test. Results: In Group P, percentage fall in MEP on the right side was 46.39 ± 24.19, whereas in Group K, it was 37.98 ± 26.17. Similar results were obtained on the left side. In Group P, percentage fall in HR in Group P was 17.68 ± 7.0, on the other hand, it was 14.02 ± 7.7 in Group K. Finally, percentage fall in MAP was found to be 14.61 ± 6.37 in Group P, whereas in Group K, it was 9.51 ± 5.02. On intergroup comparison of all factors, we found that difference in percentage fall in MEP and HR was insignificant whereas it was significant in case of MAP. Conclusion: It was found that addition of ketamine in Group K led to better hemodynamics in patients undergoing spine surgery without affecting the MEP significantly.

Background and Objective: Modern sulfonylureas like glimepiride offer effective glycemic control with extrapancreatic benefits and good tolerability. The objective of the present study was to evaluate and compare safety and efficacy of glimepiride and sitagliptin in combination with metformin in patients with type 2 diabetes mellitus (T2DM). Methods: In this open-label, randomized, comparative, multicenter study, a total of 305 T2DM patients who were either drug naïve or uncontrolled on metformin were randomized to glimepiride 1 or 2 mg/sustained-release metformin 1000 mg once daily (glimepiride group, n = 202) or sitagliptin 50 mg/metformin 500 mg twice daily (sitagliptin group, n = 103) for 12 weeks. Primary endpoint was change in glycosylated hemoglobin (HbA1c). Secondary endpoints were change in fasting plasma glucose (FPG), postprandial plasma glucose (PPG), body mass index (BMI) and to assess overall safety profile. Results: At 12 weeks, there was a statistically significant difference in the mean HbA1c reduction in glimepiride group (0.42%) as compared to sitagliptin group (0.30%) (P = 0.001). Mean reduction in FPG and PPG was also statistically significant in the glimepiride group as compared to the sitagliptin group (P = 0.008). There was no significant difference in terms of change in BMI (0.07 ± 0.39 kg/m2 vs. 0.08 ± 0.31 kg/m2) in glimepiride and sitagliptin groups, respectively, (P = 0.644) between both the groups. The incidences of hypoglycemic events were also comparable among both the groups. Conclusion: In T2DM patients, glimepiride/metformin combination exhibited significant reduction in glycemic parameters as compared to sitagliptin/metformin combination. Moreover, there was no significant difference between both the groups in terms of change in BMI and incidence of hypoglycemia.

Introduction: Dengue is one of the common diseases presenting as fever with thrombocytopenia, also causing significant morbidity and complications. Objectives: Though the correlation between platelet count, bleeding manifestations and hemorrhagic complications has been extensively studied, less is known about the correlation between platelet count and non hemorrhagic complications. This study was done to see the correlation between platelet count and non hemorrhagic complications, duration of hospital stay and additive effect of leucopenia with thrombocytopenia on complications. Methods: Our study is prospective observational study done on 99 patients who had dengue fever with thrombocytopenia. Correlations were obtained using scatter plot and SPSS software trail version. Results: Transaminitis (12.12%) was the most common complication followed by acute renal injury (2%). In our study we found that, as the platelet count decreased the complication rate increased (P = 0.0006). In our study duration of hospital increased (P is 0.00597) with decreasing platelet count when compared to other study where there was no correlation between the two. There was no correlation between thrombocytopenia with leucopenia and complications (P is 0.292), similar to other study. Conclusion: Platelet count can be used to predict the complication and duration of hospital stay and hence better use of resources.

Background: Juvenile plantar dermatosis (JPD), also known as “wet and dry foot syndrome,” is a skin disorder of the feet that commonly affects children from ages 3–14. JPD is frequently seen in children with eczema, but it is not a requirement for diagnosis. Forefoot eczema (FE) is synonymous with JPD is a condition characterized by dry fissured dermatitis of the plantar surface of the feet. Aims: To study the clinical patterns of FE and its associated risk factors. Methods: Twenty-five patients were recorded in the study during the period from April 2013 to March 2014. Fungal scrapings, patch testing, and biopsy for histopathological examination were done wherever required. Results: In our study, the most common site affected was the plantar surface of the toes in 8 (32%) patients. Hand involvement, with fissuring and soreness of the fingertips and palm, was seen in two patients (8%). Four patients (16%) had a personal history of atopy whereas a family history of atopy was present in 3 (12%). Nine patients (36%) had associated risk factors with reported aggravation of itching with plastic, rubber, or leather footwear, and with prolonged contact with water and detergents. Negative fungal scrapings and culture in all patients ruled out a dermatophyte infection. Patch testing with Indian Standard Series was performed in all patients and was positive in three. Conclusions: This study concluded FE as a distinctive dermatosis of the first and second decade, predominantly in males, with a multifactorial etiology and confirming the concept of FE as a barrier disease beyond eczema.

Introduction: Laryngoscopy and intubation leads to stimulation of the laryngopharyngeal and tracheal structures which leads to reflex sympathetic response and sudden rise of Blood Pressure (BP) and Heart Rate (HR). This sudden rise, particularly in patients with cardiovascular and cerebrovascular diseases, can lead to precipitation of Myocardial ischaemia or heart failure. Drugs like fentanyl, esmolol, lignocaine, clonidine when given before the procedure can blunt this reflex, but their response varies widely. Aim: To compare the efficacy of lignocaine and clonidine in attenuating BP and HR response to intubation. Materials and Methods: The study was a double-blind randomised controlled trial was conducted in Operation Theatre (OT) of Indian Spinal Injuries Centre, New Delhi, India (between March 2009 to April 2011). After taking an informed consent, 105 patients of American Society of Anaesthesiologists (ASA) Grade I and II were randomised into three groups: a) Lignocaine; b) Clonidine and c) control group with Normal Saline (NS) and outcome of 90 patients was noted. The drugs were given by IV route before induction of anaesthesia and vital parameters before and after intubation were noted. An anaesthesiologist who was blinded to the study drugs for each group gave the drugs. Statistical analysis was done using Paired t-test, ANOVA, Duncan’s multiple range test. Significant p-value was considered less than 0.05. Results: The rise in BP and HR from baseline to one minute after intubation, was significantly less in both lignocaine and clonidine groups, as compared to the control. Conclusion: Both lignocaine and clonidine can be used to attenuate the haemodynamic response however, lignocaine seems to be better in maintaining vitals around baseline level and rise and fall of BP and HR is less.

Introduction: Psoriasis is a multi-system chronic inflammatory skin disease targeting 2% to 3% of the general population. It is a prototype of immune dysregulation mediated by TH1 proinflammatory cytokines such as TNF-α, IFN-gamma, IL-6, and IL-12 with far reaching systemic effects. There is growing and emerging evidence that psoriasis patients have a higher prevalence of associated comorbid diseases, with severe skin disease portends a serious risk for development of these comorbidities and are found to have a higher association of extracutaneous disease manifestations. Aim: To look for eye involvement in psoriasis patients and to evaluate the risk and prognostic factors of disease association. Material and Methods: 200 Patients with psoriasis were screened for any eye involvement after few unusual case presentations with eye complications during the period from September 2013 - August 2014. Results: First case was a post cataract sudden loss of vision secondary to development of uveitis in a female patient aged 52 years, with past history of psoriasis with minimal skin lesions and no arthritis. Another 5 cases of psoriasis with eye involvement were detected during the screening employed in a series of 200 psoriasis cases. Conclusion: The present report highlights the importance of psoriasis and eye involvement, need for collaboration between dermatologists and ophthalmologists for thorough examination and evaluation prior to any surgical intervention and also further long term follow-up studies are warranted for confirmation of this causal relationship.

Introduction: Clonidine an alpha 2 adrenoceptor agonist possesses analgesic properties and has been used as an adjuvant in epidural analgesia. The addition of clonidine to other analgesics may result in enhanced analgesia through additive mechanisms or synergistic mechanisms. The enhanced analgesia may lead to a decrease in the dosage of analgesic drugs along with reduction of side effects. Aim: The purpose of this study was to evaluate the effect of adding clonidine to epidural ropivacaine and fentanyl mixture in terms of quality of analgesia and side effects in patients of total knee replacement surgery. Materials and Methods: A prospective randomised double blind study was conducted on 60 patients of ASA physical status I, II and III who underwent unilateral total knee replacement surgery under combined spinal epidural anaesthesia. Patients were divided into two Groups A and B randomly. Postoperatively Group A received continuous epidural infusion of ropivacaine 2 mg.ml -1 and fentanyl 2 μg.ml -1 along with clonidine 2 μg.ml-1 in the range of 3-7 ml.hr-1 while Group B received the ropivacaine and fentanyl epidural solution. The postoperative VAS scores, haemodynamic parameters, motor block, sedation, nausea, vomiting and any other significant side effects were noted. The two groups were compared with student's t-test, Pearson’s Chi square test and t-test using SPSS statistical software. Results: Visual analog scale scores were lower in Group A (3.38) than in Group B (3.72). The average infusion rate was lower in Group A (4.7 ± 0.7 ml.hr -1 ) than in Group B (5.5 ± 0.7 ml.hr-1 ). Patients in Group A required less dosage of rescue pain medication Paracetamol (1g i.v.), diastolic pressure and heart rate were lower in Group A. The groups were comparable in terms of sedation, motor block and nausea vomiting. Conclusion: Clonidine added to a ropivacaine and fentanyl mixture augmented the postoperative epidural analgesia without significant side effects.