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Small RNA sequencing (sRNA-seq) and degradome analysis were used for the identification of miRNAs and their target host genes in a pair of near-isogenic lines (NILs), which differed for the presence of leaf rust resistance gene Lr28. The study led to identification of (i) 506 known and 346 novel miRNAs; and (ii) 5054 target genes including 4557 in silico predicted and 497 degradome-based genes using 105 differentially expressed (DE) miRNAs. A subset of 128 targets (67 in silico + 61 degradome-based) was differentially expressed in RNA-seq data that was generated by us earlier using the same pair of NILs; among these 128 targets, 58 target genes exhibited an inverse relationship with the DE miRNAs (expression of miRNAs and activation/suppression of target genes). Eight miRNAs which belonged to the conserved miRNA families and were known to be induced in response to fungal diseases in plants included the following: miR156, miR158, miR159, miR168, miR169, miR172, miR319, miR396. The target genes belonged to the following classes of genes known to be involved in downstream disease resistance pathways; peroxidases, sugar transporters, auxin response signaling, oxidation-reduction, etc. It was also noticed that although a majority of miRNAs and target genes followed the above classical inverse relationship, there were also examples, where no such relationship was observed. Among the target genes, there were also 51 genes that were not only regulated by miRNAs, but were also differentially methylated at sequences including the following segments: promotors, introns, TSS, exons. The results of the present study suggest a complex interplay among miRNA genes, target genes, and various epigenetic controls, which regulate the expression of genes involved in downstream pathways for disease resistance.

Identification of markers associated with major physiological and yield component traits under moisture deficit stress conditions in preferred donor lines paves the way for marker-assisted selection (MAS). In the present study, a set of 183 backcross inbred lines (BILs) derived from the cross HD2733/2*C306 were genotyped using 35K Axiom genotyping array and SSR markers. The multi-trait, multi-location field phenotyping of BILs was done at three locations covering two major wheat growing zones of India, north-western plains zone (NWPZ) and central zone (CZ) under varying moisture regimes. A linkage map was constructed using 705 SNPs and 86 SSR polymorphic markers. A total of 43 genomic regions and QTL × QTL epistatic interactions were identified for 14 physiological and yield component traits, including NDVI, chlorophyll content, CT, CL, PH, GWPS, TGW and GY. Chromosomes 2A, 5D, 5A and 4B harbors greater number of QTLs for these traits. Seven Stable QTLs were identified across environment for DH (QDh.iari_6D), GWPS (QGWPS.iari_5B), PH (QPh.iari_4B-2, QPh.iari_4B-3) and NDVI (QNdvi1.iari_5D, QNdvi3.iari_5A). Nine genomic regions identified carrying major QTLs for CL, NDVI, RWC, FLA, PH, TGW and biomass explaining 10.32–28.35% of the phenotypic variance. The co-segregation of QTLs of physiological traits with yield component traits indicate the pleiotropic effects and their usefulness in the breeding programme. Our findings will be useful in dissecting genetic nature and marker-assisted selection for moisture deficit stress tolerance in wheat.

Heat stress (HS) is detrimental to wheat production and productivity globally. To combat HS, several genetic, molecular, and genomic approaches have been employed in the past. Analyzing the physiochemical mechanisms and the important regulatory genes involved is the key to develop HS tolerant plants. In the present work, a total of 243 novel simple sequence repeat (SSR) markers developed from stress-associated genes identified through RNA-seq were used for understanding marker–trait associations. 37 SSRs were found to be clearly polymorphic and among these, 28 SSR loci were significantly associated with component traits of HS tolerance. The polymorphic SSRs were validated for diversity analysis on a subset of 85 genotypes. The genotypes were grouped into four clusters representing diverse and similar alleles imparting HS tolerance in Indian and exotic genotypes. Additionally, 28 genes selected for the expression analysis confirmed that 15 genes were induced under HS in the thermotolerant WH1021 and Raj3765 and repressed in thermosusceptible HD2009 cultivar. Hence, the information on traits associated with candidate genes and the SSR markers overlying on the gene will enhance our understanding of thermotolerance mechanism operating in wheat and will help the breeders in the precise development of heat-tolerant genotypes through marker-assisted selection (MAS).

Background: Adolescents make up roughly 21% of India's population.In 2006, the Government of India (GOI) created the adolescent reproductive and sexual health (ARSH) initiative in response to the unique needs of teenagers. In 2012, the first "Yuva clinic" in Bihar was created at Patna Medical College to provide services in accordance with ARSH protocols. The purpose of this study was to examine the biosocial and awareness profiles of adolescent clients in relation to the ARSH strategy and the utilisation of clinic services. Methods: Using a semi-structured questionnaire, a cross-sectional study was conducted. Results: A total of 1180 adolescents were studied (950 males and 230 females). Sixty-six percent of males and 74.8 percent of females lived in cities, and over 90 percent were unmarried. The vast majority came from the upper middle class.Females did not use alcohol or tobacco, but 66.6 percent and 86.7 percent of males did. More over 90% of those in attendance said they exercised regularly, with 36.8% of men and 58 percent of women having abnormal BMIs. Seventy-six percent were aware about nutrition, 24.06 percent were knowledgeable about reproductive and sexual health (RSH), and 64.74 percent were knowledgeable about ARSH services. Adolescents' awareness of nutrition, RSH, and available services was significantly linked to their location and socioeconomic status. Females knew a lot more about RSH than males did. Sixty-seven percent availed counseling services and 1.35% was referred, 50.6% came for clinical services out of which 69.8% remained unmet. Conclusions: It is obvious from the encouraging numbers and widely heterogeneous profile of clients coming to the Yuva clinic that the ARSH clinic is a successful initiative. However, there are service gaps when it comes to ARSH methods. If these issues are addressed, the clinic is likely to attract more adolescents and fulfil its goals of improving their health and capacity to better deal with their various challenges.

Genetic diversity and structure analysis using molecular markers is necessary for efficient utilization and sustainable management of gladiolus germplasm. Genetic analysis of gladiolus germplasm using SSR markers is largely missing due to scarce genomic information. In the present investigation, we report 66.66% cross transferability of Gladiolus palustris SSRs whereas 48% of Iris EST-SSRs were cross transferable across the gladiolus genotypes used in the study. A total of 17 highly polymorphic SSRs revealed a total 58 polymorphic loci ranging from two to six in each locus with an average of 3.41 alleles per marker. PIC values ranged from 0.11 to 0.71 with an average value of 0.48. Four SSRs were selectively neutral based on Ewens-Watterson test. Analysis of genetic structure of 84 gladiolus genotypes divided whole germplasm into two subpopulations. 35 genotypes were assigned to subpopulation 1 whereas 37 to subpopulation 2 and rest of the genotypes recorded as admixture. Analysis of molecular variance indicated maximum variance (53.59%) among individuals within subpopulations whereas 36.55% of variation observed among individuals within total population. Least variation (9.86%) was noticed between two subpopulations. Moderate (FST = 0.10) genetic differentiation of two subpopulations was observed. Grouping pattern of population structure was consistent with UPGMA dendrogram based on simple matching dissimilarity coefficient (ranged from 01.6 to 0.89) and PCoA. Genetic relationships assessed among the genotypes of respective clusters assist the breeders in selecting desirable parents for crossing. SSR markers from present study can be utilized for cultivar identification, conservation and sustainable utilization of gladiolus genotypes for crop improvement.

Differential DNA methylation due to APR gene Lr48 for leaf rust resistance in wheat cv. CSP44 was examined at pre-adult plant (P-AP) susceptible stage and adult plant (AP) resistant stage. As many as 52,872 differentially methylated regions (DMRs) carrying 897 differentially methylated genes (DMGs) and many intergenic regions were identified. DMGs included exons/introns, promoters and UTRs. Little less than half of DMGs, were also compared with transcriptome data based on RNA-sEq. Susceptibility (at P-AP) was found to be governed by activation (due to hypomethylation) of relatively more genes, whereas resistance (at AP) involved silencing of relatively large number of genes. Using GO terms, DMGs were found to belong to a variety of biological processes including transcription regulation, protein synthesis, signal transduction, defense, photosynthesis, lipid and carbohydrate metabolism. The results of the present study improved our understanding of the epigenetic control of leaf rust APR in wheat.

Heat stress is one of the most limiting factors for the production of wheat. Global warming and consequent changes in climate adversely affect wheat plant growth and yield. To elucidate genetic basis and map heat tolerance traits, a set of 134 backcross inbred lines (BILs) derived from the cross between WH730/*2 HD2733 was used. The population was evaluated under late sown (LS) and very late sown (VLS) conditions, by exposing to heat stress during rabi season. Positive association of normalized difference vegetation index (NDVI), thousand grain weight (TGW), grain weight per spike (GWS), biomass and grain yield (GY) under both production conditions was observed. However, canopy temperature (CT) and days to heading (DH) showed negative correlation with GY under heat stress. A total of 9 Quantitative trait loci (QTL) were discovered on 7 chromosomes, which includes 4 QTLs in LS and 5 QTLs under VLS condition. Combining the results of these QTLs revealed a major stable QTL for DH (qDH_iari_5A) on chromosome 5A with 23% and 26% explaining phenotypic variance under both sowing conditions. QTL for NDVI was detected on chromosome 1B while QTL for SL and GY on chromosome 2A. The identified QTLs in the genomic regions could be targeted for genetic improvement and marker assisted selection for heat tolerance in wheat.

Abiotic stresses are major constraints to wheat productivity in many parts of the world. Tolerance to abiotic stresses can be achieved indirectly by selection for morpho-physiological traits. Physiological trait based breeding has been associated with improved performance under stress; and hence can combat and adapt wheat to drought and heat stress. Therefore, in the present study, phenotyping was carried out for agro-physiological traits in 52 diverse wheat germplasm lines under timely sown, rainfed and late sown environments for two years. Mean yield of the genotypes over the six environments were positively correlated with NDVI, days to maturity and negatively correlated with canopy temperature. The phenotypic data validated marker-trait associations of a number of meta-QTLs identified earlier for different physiological and agronomic traits. Six and seven meta-QTL genomic regions were found to be consistent in their expression for two years under rainfed/restricted irrigation and late sown environments, respectively. Expression analysis of the underlying candidate gene AK248593.1 in meta-QTL26 region revealed two folds higher expression in the NILs carrying the co-localized SSR markers. The linked markers of the thirteen meta-QTL regions associated with different traits can be used for effective transfer of the QTLs through marker assisted selection in wheat breeding programmes.

Differential DNA methylation due to APR gene Lr48 for leaf rust resistance in wheat cv. CSP44 was examined at pre-adult plant (P-AP) susceptible stage and adult plant (AP) resistant stage. As many as 52,872 differentially methylated regions (DMRs) carrying 897 differentially methylated genes (DMGs) and many intergenic regions were identified. A proportion of individual DMGs involved in methylation included exons/introns, promoters and UTRs. DMGs were also compared with transcriptome data based on RNA-seq. Susceptibility (at P-AP) was found to be governed by activation (due to hypomethylation) of relatively more genes, whereas resistance (at AP) involved silencing of relatively large number of genes. Using GO terms, DMGs were assigned to a variety of functions belonging to biological processes including transcription regulation, protein synthesis, signal transduction, defense, photosynthesis, lipid and carbohydrate metabolism. The results of the present study improved our understanding of the epigenetic control of APR to leaf rust in wheat.

Background:Iodine deficiency disorders (IDDs) are important public health problem which can be prevented by consumption of iodized salt. For sustainable elimination of IDDs, the goal of universal salt iodization (USI) is to cover more than 90% of household to consume adequately iodized salt. This study was conducted with objectives to assess knowledge and practices regarding salt consumption and to find the factors associated with consumption of adequately iodized salt in selected districts of traditional goitre belt of Bihar. Materials and Methods: The study was a community based cross-sectional study conducted in three districts of Bihar by using cluster sampling technique from January 2018 to March 2018. Results: Only 1.7% children and 33% adults were able to identify the condition of goitre. Among adults who identified the case as goitre, around 52% respondents had correct knowledge about cause of goitre. Around 30% caregivers knew the brand name of salt that was used in their household and only 19% of adults had heard about iodized salt.In around 13% households; salt was added at the end of cooking during food preparation. Adequately iodized salt was consumed in 73.5% households. The salt stored in air tight container had significantly higher iodine content in comparison to salt stored in open container (p=0.041). Conclusion: The knowledge among people regarding IDDs and iodized salt was very poor which need to be focused in our national programme. The goal of USI regarding iodized salt consumption is yet to be achieved in these districts.

Drought stress is the major environmental constraint contributing to grain yield instability of wheat. In the present study, the recombinant inbred line population derived from DBW43/HI1500 cross was characterized for various morpho-physiological traits as well as grain yield stability analysis under moisture stress. The population was evaluated for grain yield under three different moisture stress environments viz., restricted irrigation, rainfed and late sown rainfed during the cropping season of year 2013–2014. Based on principal component analysis, the first five components explained over 60.40% of genetic variation. Grain yield per plot showed significant correlation with biomass and physiological traits viz., NDVI3, NDVI4, NDVI5, CT1, CT2 and CT3. The combined analysis of variance on grain yield data showed that mean squares of environments, genotypes and GEI were highly significant (p

Wheat (Triticum aestivum L.) is a major crop, which is widely grown, occupying globally an area of ~225 million hectares. The crop suffers major losses due to leaf rust caused by fungal pathogen, Puccinia triticina Eriks. and E. Henn. When wheat plants are attacked by this fungus, hundreds of downstream genes involved in signal transduction pathways experience regulated expression. This regulation partly depends on non-coding RNAs (ncRNAs) including microRNAs (miRNAs) and long non-coding RNAs (lncRNAs). In the present study, miRNAs and lncRNAs associated with wheat-leaf rust pathosystem were identified using RNA-seq data for a pair of near-isogenic lines (NILs), which differed for the gene Lr28 in the background of wheat cultivar HD2329. The study is a continuation of our earlier transcriptome study involving the same pathosystem. A total of 50 miRNAs and 1178 lncRNAs were identified through in silico analysis of RNA-seq data; of these, 16 miRNAs and 22 lncRNAs were differentially expressed (DE). Expression of as many as 8 miRNAs was induced in resistant NIL; these DE miRNAs targeted several important genes, which include disease responsive genes. As many as 49 lncRNAs were found to be the targets for miRNAs; among these, one lncRNA functioned as a precursor of two mature miRNAs, and three lncRNAs acted as target mimics (TMs, which mimic and therefore compete with the mRNA targets for miRNA) thus regulating the expression of target genes. The results were also validated using qRT-PCR analyses. Taken together, the leaf rust responsive miRNAs, their targets along with putative TMs, and the lncRNAs, identified in the present study, should improve our understanding about the role of non-coding RNAs during response to leaf rust in wheat.

Genome-wide transcriptome analysis was undertaken in a leaf-rust resistant bread wheat line CSP44 (selected from Australian cv. Condor) carrying the adult plant resistance (APR) gene Lr48. Two pre-adult plant (P-AP) susceptible stages (S48 and S96) and two adult plant (AP) resistant stages (R48 and R96) were used for RNA-seq. At the susceptible P-AP stage (during S48 to S96), expression increased in 2062 genes, and declined in 130 genes; 1775 of 2062 differentially expressed genes (DEGs) also exhibited high expression during early incompatible stage R48. Comparison of S96 with R96 showed that the expression of 80 genes was enhanced and that of 208 genes declined at the AP stage. At the resistant AP stage (during R48 to R96), expression of mere 25 genes increased and that of 126 genes declined. Apparently, the resistance during late adult stage (R96) is caused by regulation of the expression of relatively fewer genes, although at pre-adult stage (S48 to S96), expression of large number of genes increased; expression of majority of these genes kept on increasing during adult stage at R48 also. These and other results of the present study suggest that APR may mimic some kind of systemic acquired resistance (SAR). The host-specific DEGs belonged to 10 different classes including genes involved in defence, transport, epigenetics, photosynthesis, genes encoding some transcription factors etc. The pathogen (Puccinia triticina) specific DEGs (including three genes encoding known biotrophic effectors) seem to help the pathogen in infection/growth through large-scale stage-specific enhanced expression of host’s genes. A putative candidate gene for Lr48 containing protein kinase domain (its ortholog in rice encoding OsWAK8) was also identified.

Background: Adolescents constitute about 21% of India’s population. Realizing the special needs of adolescents, GOI launched the adolescent reproductive and sexual health (ARSH) program in 2006. ‘Yuva’ clinic was established for the first time in Bihar in 2012 at Patna Medical College for providing services as per ARSH protocols. This study aimed at analyzing the biosocial and awareness profile of the adolescent clients vis a vis ARSH strategy, and the utilization of services at the clinic.Methods: Cross-sectional study using semi-structured questionnaire.Results: Total of 1180 adolescents (950 males, 230 females) was studied. Sixty-six percent males, 74.8% females were urban; about 90% were unmarried. Majority were from upper middle class. No females but 66.6% and 86.7% of males were taking alcohol and tobacco respectively. More than 90% of attendees reported regular physical exercise; 36.8% males and 58% females had abnormal BMIs. Seventy-six percent were nutritionally aware, 24.06% aware about reproductive and sexual health (RSH), and 64.74% about ARSH services. Rural and SES were significantly associated with the adolescents’ awareness of nutrition, RSH, and services available. Females had significantly more knowledge regarding RSH. Sixty-seven percent availed counseling services and 1.35% was referred, 50.6% came for clinical services out of which 69.8% remained unmet.Conclusions: ARSH clinic is a useful initiative. However there are gaps in services vis-a-vis ARSH strategies. If addressed, clinic is likely to attract more adolescents and achieve the objectives of improving their health and capacity to deal with their myriad problems in a better way.

Background: Vitamin A deficiency (VAD) is a major preventable public health problem. Prevalence of VAD in preschool children was 5.7% (India), and 4.5% (Bihar). India is implementing biannual Vitamin A Supplementation (VAS) since 2007 along with 80 other countries. VAS was originally proposed as a short term measure, followed by dietary improvement. Since vulnerability to VAD is more in high priority districts (HPDs), it was deemed worthwhile to study the extent to which VAS programme is utilized in the 10 HPDs of Bihar with respect to the processes involved and the ultimate outcome of empowering the community with knowledge and capacity to combat VAD on their own.Methods: Cross sectional observational study conducted in 6 randomly selected blocks and 5 session sites per block of the 10 HPDs. 300 sites sampled for processes and 893 caregivers interviewed for their knowledge.Results: Out of 300 sites, 269 sites found functional, 30.85% sites had due lists and 30.11% had MCP cards; 20.44% had adequate VA. IEC displayed at 52.78% and 71.3% sessions conducted in shade. In 79.55% sites efforts made to determine age of child before administration. Correct use of recommended spoon known to 80.66%, benefits of VA to 76.57% and diseases due to VAD to 81.7% of FLWs. Knowledge regarding VA good in 33.4% of caregivers, average in 35.5%, and poor in 30.9%.Conclusions: Crucial gaps found in necessary inputs and conduct of VAS. Community knowledge found lacking for sustainable programme withdrawal. Better programme management will improve utilization.

The decision of the actress, Angelina Jolie (AJ), to undergo preventive risk-reducing bilateral mastectomy has elicited extreme responses, in support and against. We will discuss whether her decision was justified and if there are other options available to women. AJ, who is 38 years old, inherited the BRCA 1 gene. Because of the lack of randomised trials, there is controversy about the overall benefit that various risk-reduction strategies offer carriers of the BRCA 1, but some of the strategies offer a clear benefit. The decision to opt for mastectomy must be driven by the patient's choice, evidence on the balance of the risks and benefits, the quality of life after surgery and issues relating to body image.

Unlike conglomerates in the U.S., where investment flows may be distorted due to power struggles (Rajan, Servaes, and Zingales (2000)), we find that diversified business groups in India, on average, invest efficiently. Our analysis controls for the possibility of tunneling (Bertrand, Mehta, and Mullainathan (2002)) and examines firm level as well as group level investment flows. At the firm level, we find that investment flows are consistent with the Efficient Internal Capital Markets Hypothesis and incentives for investment distortion due to power struggles do not exist. We also find that investment flow (in the “right direction”) increases with diversity in resource-weighted opportunities among those group-firms that have high resources attached to them, suggesting that the allocation of resources is consistent with the Efficient Internal Capital Markets Hypothesis where it matters more.At the firm level, we also find that investments flow from group-firms where the controlling family holds low cash flow rights to firms where the controlling family holds high cash flow rights suggesting tunneling. However, we find that it is only in the group-firms with low growth opportunities that investment flows are related to diversity in cash flow rights, as predicted by the Tunneling Hypothesis. Again, where it matters more (group-firms with high growth opportunities), investment decision making in business groups is consistent with the Efficient Internal Capital Markets Hypothesis. We also find that the presence of relational contracts in business groups mitigates the adverse effects of tunneling incentives, consistent with the internal governance argument in Acharya, Myers, and Rajan (2011).Overall at the group level, our results suggest that investment distortions due to power struggles and tunneling are swamped by efficiency considerations, and investment decisions in diversified business groups are largely consistent with Efficient Internal Capital Markets Hypothesis.

Background: Limited data is available about the toxicity of herbal remedies used for self-medication. Since a popular medicinal plant Ecliptaalba contains various bioactive molecules, the present study aimed to observe the biochemical and histological changes in liver associated with acute oral toxicity (LD50) of aqueous extract of E. alba (L.) Hassk. in female Swiss albino mice. Materials and Methods: For the acute oral toxicity study, the animals were divided into six groups of 6 mice each. Group– I was normal control and the treatment groups were administered aqueous leaf extract of E. alba orally at different doses of 500 mg (group – I),1750 mg (group–III), 2000 mg (group- IV), 2500 mg (group- V) and 3000 mg/ kg/b.wt.(group- VI) for seven consecutive days. The mice were sacrificed on the eighth day and blood was collected for the analysis of ALP (alkaline phosphatase), SGPT (serum glutamic pyruvic transferase), total protein and albumin. The liver was dissected, weighed, and processed for histopathological analysis. Results: The LD50 was found to be 2316.626 mg/kg /body weight in female mice. Serum SGPT, total protein and albumin increased in treated group- IV (P < 0.05), V (P < 0.01), and VI (P < 0.01) as compared to the control (group- I). ALP level significantly decreased in the treated group- IV (P < 0.05), V (P < 0.01) and VI (P < 0.01). Histopathological changes were observed at dose of 2000 mg (group- IV), 2500 mg (group- V) and 3000 mg (group- VI). Conclusion: It was concluded that oral administration of aqueous leaf extract of E. alba had detrimental effects on biochemical parameters and induced histopathological alterations in liver of female Swiss albino mice at doses higher than 2000 mg/kg/day indicating that its indiscriminate use should be avoided.

We conducted a randomised controlled trial to study the effects of metoprolol and diltiazem on the total ischaemic burden--sum of symptomatic and silent myocardial ischaemia, in 146 patients with stable angina pectoris. One-hundred thirty-four completed the study protocol. Sixty-eight patients received metoprolol (100 mg twice daily, n = 52, 50 mg twice daily, n = 16) while 66 received diltiazem (90 mg three times daily, n = 50, 60 mg three times daily, n = 16). The drugs were given for 4 weeks. The primary outcome variables were frequency and duration of total ischaemic burden, silent and symptomatic myocardial ischaemia. These were measured on 48 h of Holter monitoring. The reductions in duration and frequency of total ischaemic burden by metoprolol, 76% and 40%, respectively, were significantly higher than by diltiazem, 43% and 24%, respectively (P0.01 and P0.02). The frequency and duration of silent myocardial ischaemia, which constituted more than 80% of the total ischaemic burden in the two groups showed similar results. However, the reduction in frequency of symptomatic myocardial ischaemia only was significantly greater by metoprolol (63% than diltiazem (24%) as the difference in reduction of duration of symptomatic ischaemia was insignificant (85% vs. 75%; P0.05). Whether a greater reduction of total ischaemic burden by metoprolol as compared to diltiazem has any implications for prognosis in patients with chronic stable angina remains to be established.

Novel molecular breeding selection strategies were implemented in breeding programs in India for wheat improvement under drought and heat stress. Elite Indian varieties HD2733 and GW322 were targeted for improvement to abiotic stresses through marker assisted backcross breeding approach. Backcross populations were advanced to BC1/BC2 F2 after tracking QTLs for foreground selection covering traits such as canopy temperature (CT), chlorophyll content, normalized difference vegetation index (NDVI), grain filling duration (GFD), thousand kernel weight, grain yield and a range of polymorphic microsatellite markers covering entire genome (4–5 SSR markers per chromosome) being used for tracking the recurrent parent genome. Marker assisted recurrent selection (MARS) involved estimation of marker effects for several small effect/major QTLs followed by two recombination cycles. Designed intermating among selected F5 families were carried out after conducting ANOVA and AMMI analysis on multi-location yield trials and polymorphic markers among the parents in two biparental base populations (F5). Inter-family intermating among the best identified families carried out in different combinations to accumulate and recombine 4–8 QTLs per intermated progeny and confirmed in selfed homozygous lines.

Sir, In India, women of child-bearing age constitute approximately 19% of the population.(1) Major portions of these women posses factors that are conducive to increased maternal mortality. Bihar along with UP, MP, Rajasthan, and Punjab have a maternal mortality rate (MMR) over 450 per 100,000 live births.(2) This study was undertaken to find out the root causes of such deaths. During the study period of 2 years from August 2003 to July 2005 in three settings of a Medical College Hospital, all the women who died due to complications of pregnancy and childbirth within 42 days of delivery were selected. The relevant facts and history were noted from case records, attendants, and missing information was collected later by home visits. Data on a total of 329 maternal deaths were recorded. The total number of live births was 8422 during the study period. In the first and second years of the study, maternal deaths were 180 and 149, respectively. The MMR was 4159.93 and 3638.58 per 100,000 live births, respectively making the overall MMR 3906.44/100,000 live births. Among 329 total maternal deaths, the maximum were in the age group of 21 to 30 years old (56.54%) followed by 31 to 40 years old (22.49%). The death rate for mothers from rural areas was higher (67.17%). Maternal deaths were observed more among illiterate women (57.75%). The highest number of maternal deaths occurred among those who were second or third gravida (48.94%) followed by fourth gravida and above (26.14%) [Table 1]. A total of 85.11% of maternal deaths happened among those who had not received adequate antenatal care services. Toxemia of pregnancy (24.01%) was observed as the major cause of maternal death followed by sepsis (17.93%) [Table 2]. Anemia accounted for 15.81% of maternal deaths. In the majority of cases (58.36%), the women went to the hospital more than 24 hours to less than 1 week after the onset of complications and 12.16% of the women went to the hospital more than 1 week after the onset of complications. Table 1 Gravida, utilization of maternal care services, and maternal mortality Table 2 Causes of maternal deaths This study has shown a higher maternal mortality rate (3906.44/100,000 live births) and may be due to being a tertiary care hospital based study, where more complicated cases are admitted. The majority of deaths were in the age group of 21 to 30 years old (56.54%). Baul, et al.(3) had a similar observation of 51.8%. Women from rural areas contributed to a major share of maternal mortality (67.17%). Chi, et al.(4) also reported higher maternal mortality among women of rural areas. The highest rate of deaths was among illiterate women. This is in conformity with Rajaraman, et al.(5) The majority of deaths were among 2nd and 3rd gravida (48.94%) and among those who had not received adequate antenatal care services (84.11%). Baul, et al.(3) and Rajaraman, et al.(5) had similar observations. The direct obstetric causes accounted for 66.56% of maternal deaths; toxemia (24.01%), sepsis (17.93%), and hemorrhage (16.11%) were the major causes. Anemia accounted for another 15.81% of deaths. These findings are in conformity with the findings of Rajaraman, et al.(5) and Ramteke, et al.(6) This study has found the root causes of very high maternal mortality rate to be illiteracy, inadequate antenatal care services, and a delay in the initiation of treatment.