Late quaternary palaeoclimates of western India : A geoarchaeological approach

Western India comprises parts of the states of Rajasthan, Gujarat and Maharashtra. This region has varied climate and landscape. Northwestern Rajasthan is an area of internal drainage, with dunes, playas and rocky pediments. The Luni, Sabarmati and Mahi basins to the south of this zone show the influence of both aeolian and fluvial processes. Aeolian landforms are absent in the Nrmada, Tapi, Godavari and Bhima basins and fluvial aggradation has alternated with erosion in response to climatic change. Dominance of semi-arid to arid climate throughtout the Quaternary in the entire region has ment that Quaternary geological processes have been weak, preserving many features of the Tertiary in the present landscape. The variation in the geomorphic processes shaping the landscape and the complex links between geomorphic proceses and climate mean that our understanding of palaeoclimates in western India in far from complete. This paper gives an overview of the Late Quaternary palaeoclimate of western India, based primarily on recent work by the authors in Rajasthan and Maharashtra. Some issues in the palaeoclimatic interpretation of the geological record are discussed. Signatures of Late Pleistocene aridity, fluctuating climate during the Pleistocene Holocene transitional period, early Holocene humid climate and increased aridity from the middle Holocene onwards are reflected in different ways in the different landscape settings.

P-P09 Salvage transgastric necrosectomy as a part of a step-up approach to managing acute necrotising pancreatitis

Background The use of EUS (endoscopic ultrasound) guided drainage with endoscopic LAMS (lumen apposing metal stent) necrosectomy is an emerging treatment option for walled-off pancreatic necrosis (WOPN) secondary to acute severe pancreatitis. It can delay or remove the need for surgical necrosectomy, which can be associated with high morbidity and mortality. However, the endoscopic approach is not always successful due to a multitude of factors and salvage transgastric necrosectomy can be performed using the tract created by the LAMS to achieve internal drainage and remove necrotic pancreas. Methods We describe our unit’s experience in managing WOPN in two patients. We suggest a treatment pathway of WOPN which includes a step-up approach including salvage transgastric necrosectomy in patients where multiple endoscopic necrosectomies and washouts have failed. Results Two patients, aged 67 and 69, were admitted as intensive care transfers for gallstone and alcohol pancreatitis respectively. They underwent a step-up approach to treat their infected WOPN, starting with the deployment of LAMS and endoscopic necrosectomy. They both showed brief clinical improvement after repeated endoscopic necrosectomy but further imaging showed ongoing large collections that could not be treated endoscopically. Both patients underwent successful transgastric open necrosectomy where necrotic pancreatic tissue was accessed surgically through the already created cyst-gastrostomy. This had the advantage of internal drainage of the collection into the stomach without the need for external surgical drains. Conclusions The emphasis in the treatment of WOPN has shifted to minimally invasive percutaneous or endoscopic drainage modalities. Endoscopically inserted LAMS may not always achieve definitive drainage of the WOPN but should be employed in the first instance as they are associated with reduced morbidity and mortality compared to surgery. Ultimately, open necrosectomy with washout remains the definitive management strategy in the step-up approach. We believe that the trans-gastric open necrosectomy approach can be used successfully in patients where the minimally invasive approach has failed.

Method of internal drainage of seroma after hernioplasty

A method for allohernioplasty of indirect inguinal hernia has been developed, in which an additional layer consisting of the peritoneum of the hernial sac is formed between the spermatic cord and the mesh. The peritoneal flap prevents direct contact between the mesh and the spermatic cord and ensures rapid absorption of inflammatory serous fluid. The manifestations of implant-associate inflammation of the spermatic cord and persistent seromas decrease in the tissues. The method was applied in 25 patients in the period from 2017 to 2021.

Evaluation of Suitable Lands for Elaeis guineensis Jacq. Using Geographic Information Systems in the Sierra Region, Tabasco, Mexico

Objective: The objective of this study was to evaluate the edaphic suitability of Elaeis guineensis at a semi-detailed scale (1:50000), in the Plains and Terraces of Tabasco, Mexico (PTT). Design/Methodology/Approach: The edaphic requirements consisted of a semi-detailed soil map. The evaluation of the edaphic suitability was based on the agroecological zoning methodology proposed by FAO and the final 1:50000 scale map was developed using the algebra mapping tool with the ArcGis® Geographic Information System. Results: The Gleysols, Fluvisols, Luvisols, and Lixisols groups dominate the PTT, with 65.1, 16.2, 6.3, and 4%, respectively. Most of the soils (79.95%) have zero suitability for oil palm. Study Limitations/Implications: Oil palm is the eighth most important perennial crop (over cocoa) for the economy of southeastern Mexico. In this scenario, the expansion of plantations in the country is a possibility; therefore, complying with internal regulations and carry is important. Findings/Conclusions: The internal drainage of Gleysols soils limits the establishment of E. guineensis plantations in the plains and terraces of Tabasco, Mexico.

Vacuum Therapy and Internal Drainage as the First-Line Endoscopic Treatment for Post-Bariatric Leaks: A Systematic Review and Meta-Analysis

<b><i>Introduction:</i></b> Several endoscopic methods can be employed to manage post-bariatric leaks. However, endoluminal vacuum therapy (EVT) and endoscopic internal drainage (EID) are relatively new methods, and studies regarding these methods are scarce. We performed a systematic review of the literature and a meta-analysis to evaluate the efficacy of EVT and EID. <b><i>Methods:</i></b> Databases were searched for eligible studies. The clinical success of leak closure was the primary outcome of interest. A proportional meta-analysis was performed for pooling the primary outcome using a fixed-effects model. A meta-analysis or descriptive analysis of other outcomes was performed based on the data availability. <b><i>Results:</i></b> Data from 3 EVT and 10 EID studies (<i>n</i> = 279) were used for evidence synthesis. The leak closure rates (95% confidence interval [CI]) of EVT and EID were 85.2% (75.1%–95.4%) and 91.6% (88.1%–95.2%), respectively. The corresponding mean treatment durations (95% CI) were 28 (2.4–53.6) and 78.4 (50.1–106.7) days, respectively. However, data about other outcomes were extremely limited; thus, a pooled analysis could not be performed. <b><i>Conclusions:</i></b> Both EVT and EID were effective when used as the first-line treatment for post-bariatric leaks. However, larger studies must be conducted to compare the efficacy of the 2 interventions.