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Many underutilized edible fruit species (UEFS) are found in the Indo-Gangetic Plains (IGP), which support food security (FS) for both indigenous people and other dependent communities. Unfortunately, there is little study and fragmented information available about these naturally edible products. The UEFS of the IGP was the subject of a systematic review utilizing the PRISMA protocol, which produced implications for FS and land degradation neutrality (LDN). This review aims to survey, summarize, and annotate the published information about the angiosperms native and naturalized UEFS of IGP to identify and make use of this species, particularly for the sustainable development of this region. A systematic review confirmed that 371 species of UEFS, of which 62 species were threatened and near threatened (TNT)-UEFS. Among the TNT-UEFS, 41 species were threatened, while 21 species were NT. The threatened species were further categorized as per the International Union for Conservation of Nature (IUCN) Red List in the IGP as vulnerable (21 species), endangered (16 species), and critically endangered (four species). This systematic review suggests integration of the native and naturalized UEFS in afforestation and reforestation programs to aid in various ecosystem services. Calamus inermis, Corypha taliera, Licuala peltata, and Saurauia punduana are examples of multipurpose species that require immediate sustainable conservation and cultivation initiatives to save them from extinction in the near future. Multipurpose species such as Aegle marmelos, Buchanania lanzan, Manilkara hexandra, Syzygium cuminii, Tamarindus indica are immensely constructive and climate-smart by surviving in harsh agroclimatic conditions and have great potential for establishment on marginal and wastelands throughout the IGP region. These resilient fruit species enhance biodiversity, ecosystems, and landscapes in addition to providing food for humans. It progressively advances India’s commitment to LDN, combating climate change, and achieving the UN-SDGs, which call for reducing hunger and raising FS by 2030. As a result, the study will offer baseline data for the next investigations and be helpful to policymakers in creating sustainable and scientific policies for the IGP. [ABSTRACT FROM AUTHOR]

Introduction Primary aldosteronism (PA), once considered rare, is now recognized as the most common cause of secondary hypertension, accounting for almost a quarter of resistant hypertension (RH) cases. Despite this, PA remains underdiagnosed, with an extremely low percentage of RH patients undergoing screening. Methods In a specialty diabetes-endocrinology clinic, the aldosterone:renin ratio (ARR) was assessed in 115 consecutive RH patients (ages 21-93 years; 47% male; 87% with type 2 diabetes). Fasting blood samples were drawn in a standing position after 30 minutes of walking. Adrenal imaging (CT/MRI) was performed for those with an ARR >20. Results ARR values ranged from 0.4 to 227 (ARR <10 (35%); 11-20 (19%), 21-40 (25%), and >40 (21%)), with corresponding stepwise decreasing plasma renin activity (PRA) (P= 1E-6) and increasing serum aldosterone (SA) (P= 8E-7). Increasing ARR tended to be associated with an increase in serum creatinine (R= 0.23; P= 0.03) and a decrease in estimated glomerular filtration rate (eGFR) (R= -0.24; P= 0.02) and an increase in urine albumin: creatinine ratio. The ARR> 40 group displayed the highest serum creatinine, lowest eGFR, higher urine albumin: creatinine ratio, highest serum sodium, lowest serum potassium, and highest (44%) abnormal adrenal imaging (bilateral hyperplasia diffuse/nodular; solitary adenoma), reflecting a later stage of the pathological spectrum. PA treatment with mineralocorticoid receptor antagonists (MRAs) had a salutary effect. Conclusions Our observations further reinforce that PA is not a binary condition, but exists as a spectrum disorder responsive to MRAs, even in patients with mildly elevated or normal aldosterone levels. Early disease detection/recognition ("renin-independent aldosterone production") can be facilitated by marking "pre-primary" aldosteronism (ARR 11-20), followed by monitoring progression (periodic rescreening) and optimizing treatment, with hopeful mitigation of end-organ damage in RH., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Science for Health issued approval reference number 2022-10-06-01, dated October 22, 2022. Written informed consent was deemed as not necessary as the study involved retrospective data analysis – medical record review only. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Garg et al.)