SummaryBackgroundPost-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage.MethodsIn this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283.FindingsBetween March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus ...

Approximately 20%–30% of plant and animal species are at risk of extinction by the end of the 21st century owing to climate change. Range shifts and range contractions in plant species will dramatically affect the distribution of animals relying on them for food and shelter. The negative impacts of climate change on forested landscapes of the northern highlands of Pakistan (NHP) could change the species composition and distribution. The Asiatic black bear (Ursus thibetanus), a forest‐dwelling species, primarily depends on plants for foraging, and is assumed to be affected by climate change in NHP. Scat analyses and indigenous knowledge from Machiara National Park revealed the maximum consumption of Quercus species (natural food) and Zea mays (human grown food) by the Asiatic black bear in autumn season. We collected the occurrence data of the Asiatic black bear and its commonly used food (three Quercus spp.) in the NHP. We used the MaxEnt model to simulate current and future (in 2050 and 2070) distribution of the species under RCP4.5 (medium carbon emission scenario) and RCP8.5 (extreme carbon emission scenario). The results predict range reduction and extreme fragmentation in the habitats of all the Quercus spp. Besides, a dramatic decrease in the suitable (SH) and very highly suitable (HSH) habitats was predicted in the future. Range shift and range reduction of Quercus spp. may interrupt the denning chronology of Asiatic black bears, escalate the human‐black bear conflicts and local extirpation of the species. Given the extent and magnitude of climate change, it will likely not be enough to focus solely on the conservation of the Asiatic black bear. We need more dynamic planning aiming at mitigating the effect of climate change in forested landscapes including the Quercus forests.

Photoperiod and shelter have direct or indirect effects on phenotypic traits expression in different fish species. The present study was, therefore, intended to explore whether these light and shelter could influence some phenotypic traits of African catfish larvae under laboratory condition. Newly hatched larvae were stocked in plastic aquaria (10L) at a rate of 5 individuals/L and reared for one month under four treatments such as 24h light (24L), 24 h dark (24D), 12h light and 12h dark with PVC (12DL_PVC), and 12h light and 12h dark without PVC (12DL) conditions. A total of 108 larvae were sampled for phenotypic traits analysis. The results revealed that complete darkness (24D) significantly improved the overall growth parameters (total length, standard length, caudal peduncle length, anal fin length, caudal fin length, total body depth, dorsal fin length, pre dorsal distance, pre anal distance, pre ventral distance, head width, head length, eye diameter, maxillary barbell length, inter orbital length, and specific growth rate) than all other treatments, while no significant variation was found among other treatments. Although shelter did not show any significant role in the overall growth, it significantly reduced the larval mortality than those reared without shelter. The survival rates were also significantly different among various light regimes in which the highest was found in 24D (86%) followed by 12DL_PVC (74%), 24L (71%), and 12DL (60%). The study also revealed that larvae reared in 24D exhibited maximum dark brown body colouration (63%), while in 24L showed maximum light brown colouration (96%). On the other hand, maximum larvae were appeared as medium brown color (76%) in tanks having PVC, whereas many of them were light brown (61%) in non-PVC tanks. Taken together, the study suggests that C. gariepinus larvae should be reared in completely dark condition to enhance their overall production.

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Description of A New Spider Species of The Genus Gnaphosa (Araneae, Gnaphosidae) From Pakistan Gnaphosa pakistanica Ovchinnikov, Ahmad et Inayatullah, sp. n. from Pakistan is described. Comments on the other two species recorded from Pakistan are given.

Parazodarion, a New Genus of the Spider Family Zodariidae (Araneae) from Asia. Ovchinnikov S. V., Ahmad B., Gurko V. O. -Parazodarion Ovchinnikov, gen. n. is described. It is a monotypic genus with the type species Zodarion raddei Simon, 1889 widespread

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