Effect of mifepristone in cervical ripening for induction of labour

Background: Mifepristone is potentially a method of inducing labour in late pregnancy by increasing uterine contractility and by increasing the sensitivity of the uterus to the actions of prostaglandins. Present study was done to portrait the beneficial of mifepristone induction of labour. The objective was to study the effect of mifepristone in induction of labour with the outcome of induction of labour (IOL).Methods: 100 patients (term) were included, after their informed consent. Patients were categorized by BISHOP SCORE at the beginning of induction for comparison of BS, mode of delivery, induction delivery interval (IDI). Women undergoing induction with RU486 (200mg PO) were grouped in one and those with placebo control group into another. Statistical analysis of categorical variables was done.Results: Rate of successful IOL or vaginal delivery was 76% in study group and only 36% in control group. After induction with mifepristone for cervical ripening in study group 76% patient who had cervical score 8 within 24 hours, whereas in control group 2% female’s cervical score was>8. Among the babies, 44% in the control group required baby unit admission as compared to 36% in the study group.Conclusions: In the present study, the women who were induced with mifepristone 200 mg per orally showed drastic improvement in cervical score within 24-48 hours and decreased the cesarean rate in the study group and amount of dose requirement of augmentation of labour with Misoprostol or Oxytocin, lesser NICU admission and maternal complication

Comparative Study of the Effect of Early Versus Late Initiation of Epidural Analgesia on Labour

Background: Epidural analgesia also known as regional analgesia has been established as a safe and an effective method of pain relief during labor. It was thought that epidurals may possibly interfere with labor and consequently increase the rate of cesarean deliveries or instrumental deliveries or other adverse effect. . A more recent review concluded that epidural analgesia is not associated with such a risk. But, the timing of placement of epidural analgesia has been a controversial issue and how early laboring women can benefit from epidural analgesia is still debated. Hence this comparative study determines the effect of early versus late initiation of epidural analgesia on labor.Objective: To compare the effect of early versus late initiation of epidural analgesia on the duration of labour and the mode of delivery.Methodology: A randomized trial in which 100 term women in early labor at less than3 cm of cervical dilatation were assigned to either immediate initiation of epidural analgesia at first request (50 women) or delay of epidural until the cervix was dilated to at least 4 cm (50 women).Results: At initiation of the epidural, the mean cervical dilatation was 3.1 cm in the early epidural group and 4.4 cm in the late group (P value 0.0000). The mean duration from initiation to full dilatation was significantly shorter in the early compared to the late epidural group: 5.57 hours and 6.3hours respectively amongst primigravida (P = 0.0001) and 3.04 hours and 4.07 hours respectively amongst multigravida. The rates of cesarean section were not significantly different between the groups i.e. 6% and 6% in both early and late groups (P = 0.82) which was not significant. When questioned after delivery regarding their next labor, the women indicated a preference for early epidural.Conclusion: Epidural analgesia in the early labour, following the first request for epidural at cervical dilation of 2-3 cm does not prolong the progression of labor and does not increase the rate of Cesarean deliveries , instrumental vaginal deliveries , and other adverse effects in laboring women compared with the delayed analgesia at the cervical dilation of 4.0 cm or more. Furthermore, it was associated with shorter duration of the first stage of labor and was clearly preferred by the women

Status of Maternal Serum Vitamin D Levels in Rural India

Background: The role of Vitamin D during pregnancy and its effect on maternal and fetal health is just beginning to be understood. What is clear, however, is that Vitamin D deficiency during pregnancy is rampant throughout the world. Vitamin D deficiency is prevalent in India, a finding that is unexpected in a tropical country with abundant sunshine. Various studies have shown an intrinsic relation between various parameters of maternal and fetal wellbeing with maternal Vitamin D status during pregnancy.Aim: To determine the status of Vitamin D levels in pregnancy among rural mothers.Methods: A total of 60 pregnant females, aged 20-35 years were studied during the third trimester of pregnancy. Serum Vitamin D was measured by chemiluminescent immunoassay.Results: 65% subjects were found to have Vitamin D deficiency and 26.67% were found to have Vitamin D insufficiency whereas 8.33% had normal Vitamin D levels. Mean maternal serum Vitamin D level was 15.97±9.216 ng/mL.Conclusions: We observed a high prevalence of physiologically significant hypovitaminosis D among pregnant women attending rural hospital. As mentioned in literature, Vitamin D deficiency is associated with adverse fetomaternal outcome, the magnitude of hypovitaminosis D in antenatal period warrants public health intervention

Loss of p53 results in protracted electrographic seizures and development of an aggravated epileptic phenotype following status epilepticus

The p53 tumor suppressor is a multifunctional protein, which regulates cell cycle, differentiation, DNA repair and apoptosis. Experimental seizures up-regulate p53 in the brain, and acute seizure-induced neuronal death can be reduced by genetic deletion or pharmacologic inhibition of p53. However, few long-term functional consequences of p53 deficiency have been explored. Here, we investigated the development of epilepsy triggered by status epilepticus in wild-type and p53-deficient mice. Analysis of electroencephalogram (EEG) recordings during status epilepticus induced by intra-amygdala kainic acid (KA) showed that seizures lasted significantly longer in p53-deficient mice compared with wild-type animals. Nevertheless, neuronal death in the hippocampal CA3 subfield and the neocortex was significantly reduced at 72 h in p53-deficient mice. Long-term continuous EEG telemetry recordings after status epilepticus determined that the sum duration of spontaneous seizures was significantly longer in p53-deficient compared with wild-type mice. Hippocampal damage and neuropeptide Y distribution at the end of chronic recordings was found to be similar between p53-deficient and wild-type mice. The present study identifies protracted KA-induced electrographic status as a novel outcome of p53 deficiency and shows that the absence of p53 leads to an exacerbated epileptic phenotype. Accordingly, targeting p53 to protect against status epilepticus or related neurologic insults may be offset by deleterious consequences of reduced p53 function during epileptogenesis or in chronic epilepsy

Investigating the metabolic capabilities of Mycobacterium tuberculosis H37Rv using the in silico strain iNJ661 and proposing alternative drug targets

<p>Abstract</p> <p>Background:</p> <p><it>Mycobacterium tuberculosis </it>continues to be a major pathogen in the third world, killing almost 2 million people a year by the most recent estimates. Even in industrialized countries, the emergence of multi-drug resistant (MDR) strains of tuberculosis hails the need to develop additional medications for treatment. Many of the drugs used for treatment of tuberculosis target metabolic enzymes. Genome-scale models can be used for analysis, discovery, and as hypothesis generating tools, which will hopefully assist the rational drug development process. These models need to be able to assimilate data from large datasets and analyze them.</p> <p>Results:</p> <p>We completed a bottom up reconstruction of the metabolic network of <it>Mycobacterium tuberculosis </it>H37Rv. This functional <it>in silico </it>bacterium, <it>iNJ</it>661, contains 661 genes and 939 reactions and can produce many of the complex compounds characteristic to tuberculosis, such as mycolic acids and mycocerosates. We grew this bacterium <it>in silico </it>on various media, analyzed the model in the context of multiple high-throughput data sets, and finally we analyzed the network in an 'unbiased' manner by calculating the Hard Coupled Reaction (HCR) sets, groups of reactions that are forced to operate in unison due to mass conservation and connectivity constraints.</p> <p>Conclusion:</p> <p>Although we observed growth rates comparable to experimental observations (doubling times ranging from about 12 to 24 hours) in different media, comparisons of gene essentiality with experimental data were less encouraging (generally about 55%). The reasons for the often conflicting results were multi-fold, including gene expression variability under different conditions and lack of complete biological knowledge. Some of the inconsistencies between <it>in vitro </it>and <it>in silico </it>or <it>in vivo </it>and <it>in silico </it>results highlight specific loci that are worth further experimental investigations. Finally, by considering the HCR sets in the context of known drug targets for tuberculosis treatment we proposed new alternative, but equivalent drug targets.</p

CMS physics technical design report : Addendum on high density QCD with heavy ions

Peer reviewe

CMS physics technical design report, volume II: Physics performance

CMS is a general purpose experiment, designed to study the physics of pp collisions at 14 TeV at the Large Hadron Collider ( LHC). It currently involves more than 2000 physicists from more than 150 institutes and 37 countries. The LHC will provide extraordinary opportunities for particle physics based on its unprecedented collision energy and luminosity when it begins operation in 2007. The principal aim of this report is to present the strategy of CMS to explore the rich physics programme offered by the LHC. This volume demonstrates the physics capability of the CMS experiment. The prime goals of CMS are to explore physics at the TeV scale and to study the mechanism of electroweak symmetry breaking - through the discovery of the Higgs particle or otherwise. To carry out this task, CMS must be prepared to search for new particles, such as the Higgs boson or supersymmetric partners of the Standard Model particles, from the start- up of the LHC since new physics at the TeV scale may manifest itself with modest data samples of the order of a few fb(-1) or less. The analysis tools that have been developed are applied to study in great detail and with all the methodology of performing an analysis on CMS data specific benchmark processes upon which to gauge the performance of CMS. These processes cover several Higgs boson decay channels, the production and decay of new particles such as Z' and supersymmetric particles, B(s) production and processes in heavy ion collisions. The simulation of these benchmark processes includes subtle effects such as possible detector miscalibration and misalignment. Besides these benchmark processes, the physics reach of CMS is studied for a large number of signatures arising in the Standard Model and also in theories beyond the Standard Model for integrated luminosities ranging from 1 fb(-1) to 30 fb(-1). The Standard Model processes include QCD, B-physics, diffraction, detailed studies of the top quark properties, and electroweak physics topics such as the W and Z(0) boson properties. The production and decay of the Higgs particle is studied for many observable decays, and the precision with which the Higgs boson properties can be derived is determined. About ten different supersymmetry benchmark points are analysed using full simulation. The CMS discovery reach is evaluated in the SUSY parameter space covering a large variety of decay signatures. Furthermore, the discovery reach for a plethora of alternative models for new physics is explored, notably extra dimensions, new vector boson high mass states, little Higgs models, technicolour and others. Methods to discriminate between models have been investigated. This report is organized as follows. Chapter 1, the Introduction, describes the context of this document. Chapters 2-6 describe examples of full analyses, with photons, electrons, muons, jets, missing E(T), B-mesons and tau's, and for quarkonia in heavy ion collisions. Chapters 7-15 describe the physics reach for Standard Model processes, Higgs discovery and searches for new physics beyond the Standard Model

CMS physics technical design report, volume II: Physics performance

CMS is a general purpose experiment, designed to study the physics of pp collisions at 14 TeV at the Large Hadron Collider ( LHC). It currently involves more than 2000 physicists from more than 150 institutes and 37 countries. The LHC will provide extraordinary opportunities for particle physics based on its unprecedented collision energy and luminosity when it begins operation in 2007. The principal aim of this report is to present the strategy of CMS to explore the rich physics programme offered by the LHC. This volume demonstrates the physics capability of the CMS experiment. The prime goals of CMS are to explore physics at the TeV scale and to study the mechanism of electroweak symmetry breaking - through the discovery of the Higgs particle or otherwise. To carry out this task, CMS must be prepared to search for new particles, such as the Higgs boson or supersymmetric partners of the Standard Model particles, from the start- up of the LHC since new physics at the TeV scale may manifest itself with modest data samples of the order of a few fb(-1) or less. The analysis tools that have been developed are applied to study in great detail and with all the methodology of performing an analysis on CMS data specific benchmark processes upon which to gauge the performance of CMS. These processes cover several Higgs boson decay channels, the production and decay of new particles such as Z\u27 and supersymmetric particles, B-s production and processes in heavy ion collisions. The simulation of these benchmark processes includes subtle effects such as possible detector miscalibration and misalignment. Besides these benchmark processes, the physics reach of CMS is studied for a large number of signatures arising in the Standard Model and also in theories beyond the Standard Model for integrated luminosities ranging from 1 fb(-1) to 30 fb(-1). The Standard Model processes include QCD, B-physics, diffraction, detailed studies of the top quark properties, and electroweak physics topics such as the W and Z(0) boson properties. The production and decay of the Higgs particle is studied for many observable decays, and the precision with which the Higgs boson properties can be derived is determined. About ten different supersymmetry benchmark points are analysed using full simulation. The CMS discovery reach is evaluated in the SUSY parameter space covering a large variety of decay signatures. Furthermore, the discovery reach for a plethora of alternative models for new physics is explored, notably extra dimensions, new vector boson high mass states, little Higgs models, technicolour and others. Methods to discriminate between models have been investigated. This report is organized as follows. Chapter 1, the Introduction, describes the context of this document. Chapters 2-6 describe examples of full analyses, with photons, electrons, muons, jets, missing E-T, B-mesons and tau\u27s, and for quarkonia in heavy ion collisions. Chapters 7-15 describe the physics reach for Standard Model processes, Higgs discovery and searches for new physics beyond the Standard Model