Extraperitoneal versus transperitoneal cesarean section: a retrospective analysis

Background: Cesarean section is becoming a more common delivery type worldwide. The objective of this study was to compare surgical morbidity in extraperitoneal versus transperitoneal techniques of cesarean section.Methods: A total of 60 patients was included in this study out of which 30 underwent extraperitoneal cesarean section(ECS) and 30 patients underwent transperitoneal cesarean section (TCS) and compared both the techniques with respect to nausea or vomiting intra-operatively, pain score (as measured by visual analogue scale) post operatively, return of bowel function and blood loss.Results: Intra-operative nausea and vomiting was noted in 33.34% of patients in TCS group while none of the patients in ECS group had any such complaints. No difference was noted in average blood loss between the 2 groups. Post-operative pain in ECS was 4.13 as compared to 6.86 in TCS. Return of bowel sounds in ECS group was much earlier (5.46 hours) as compared to TCS group (11.33 hours).Conclusions: We conclude that extraperitoneal technique is advantageous over transperitoneal approach. Decreased nausea and vomiting, early return of bowel function in the post-operative period, decreased post-operative pain allowing early feeding and mobilization are definite benefits of this technique. This further helps in making a relatively smoother post-operative recovery

Application of Radiation Technology: A Novel Vaccine Approach to Induce Protective Immunity against Malaria Infection

Among the numerous infectious diseases, malaria remains a major health challenge. Despite the various approaches adopted for the vector control and availability of antimalarial drugs, the success of malaria eradication is dampened by the spread of drug and insecticide resistance, unavailability of proper diagnostic treatment and successful vaccine. Among the various approaches, vaccination with the aim of developing protective immunity is the most suited, safe and reliable approach for the entire mankind. Numerous approaches are in use for vaccine development; however, they suffer from the drawbacks that immunity developed is short lived and are both species- and stage-specific. Of late, radiation sterilization has drawn the attention in the vaccine development due to its advantages over the conventional methods, and successful clinical trials of irradiated vaccines against the pathogens and tumor. Recently, a novel approach of genetically attenuated sporozoites (PfRAS, PfSPZ, PFSPZ-GA1 sporozoites vaccines) has shown promising results by generating protective immunity against the homologous and heterogenous infection in the clinical trials. Radiation techniques have also been beneficial in controlling the insects by sterility technique. In this chapter, we have recapitulated the role of radiation biology in the malaria vaccine development with its current status and future challenges associated with the development of radiation attenuated parasite vaccine

Medium optimization for the production of lipstatin by Streptomyces toxytricini using full factorial design of experiment

Abstract: Full factorial design of experiment for medium optimization was employed for lipstatin production by Streptomyces toxytricini in shake flask study. The full factorial DOE was very much effective in screening of nutritional parameters within the stipulated time frame in a limited number of experiments. A maximum lipstatin production was achieved 3.290 g/l with the following optimized factors: soya flour 35g/l and soya oil 25g/l. Validation experiments were also carried out to verify the adequacy and the accuracy of the model. The results also give a scope for large scale fermentation of lipstatin production. [Luthra, U., Kumar, H., Kulshreshtha, N., Tripathi, A., Trivedi, A., Khadpekar, S., Chaturvedi, A. and Dubey, R.C. Medium optimization for the production of lipstatin by Streptomyces toxytricini using full factorial design of experiment. Nat Sci 2013;1

Bronchiectasis in India:results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry

BACKGROUND: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India. METHODS: The Indian bronchiectasis registry is a multicentre, prospective, observational cohort study. Adult patients ( 6518 years) with CT-confirmed bronchiectasis were enrolled from 31 centres across India. Patients with bronchiectasis due to cystic fibrosis or traction bronchiectasis associated with another respiratory disorder were excluded. Data were collected at baseline (recruitment) with follow-up visits taking place once per year. Comprehensive clinical data were collected through the European Multicentre Bronchiectasis Audit and Research Collaboration registry platform. Underlying aetiology of bronchiectasis, as well as treatment and risk factors for bronchiectasis were analysed in the Indian bronchiectasis registry. Comparisons of demographics were made with published European and US registries, and quality of care was benchmarked against the 2017 European Respiratory Society guidelines. FINDINGS: From June 1, 2015, to Sept 1, 2017, 2195 patients were enrolled. Marked differences were observed between India, Europe, and the USA. Patients in India were younger (median age 56 years [IQR 41-66] vs the European and US registries; p<0\ub70001]) and more likely to be men (1249 [56\ub79%] of 2195). Previous tuberculosis (780 [35\ub75%] of 2195) was the most frequent underlying cause of bronchiectasis and Pseudomonas aeruginosa was the most common organism in sputum culture (301 [13\ub77%]) in India. Risk factors for exacerbations included being of the male sex (adjusted incidence rate ratio 1\ub717, 95% CI 1\ub703-1\ub732; p=0\ub7015), P aeruginosa infection (1\ub729, 1\ub710-1\ub750; p=0\ub7001), a history of pulmonary tuberculosis (1\ub720, 1\ub707-1\ub734; p=0\ub7002), modified Medical Research Council Dyspnoea score (1\ub732, 1\ub725-1\ub739; p<0\ub70001), daily sputum production (1\ub716, 1\ub703-1\ub730; p=0\ub7013), and radiological severity of disease (1\ub703, 1\ub701-1\ub704; p<0\ub70001). Low adherence to guideline-recommended care was observed; only 388 patients were tested for allergic bronchopulmonary aspergillosis and 82 patients had been tested for immunoglobulins. INTERPRETATION: Patients with bronchiectasis in India have more severe disease and have distinct characteristics from those reported in other countries. This study provides a benchmark to improve quality of care for patients with bronchiectasis in India. FUNDING: EU/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis Consortium, European Respiratory Society, and the British Lung Foundation

Effect of pH, Salinity, Dye, and Biomass Concentration on Decolourization of Azo Dye Methyl Orange in Denitrifying Conditions

A recent study by the current authors found simultaneous decolourization and mineralization of high concentrations of methyl orange (500 mg/L) in an anoxic up-flow reactor in denitrifying conditions. To supplement this work, various batch reactor studies were carried out to study the effect of (i) pH (4 to 9), (ii) salinity (1 g/L NaCl to 10 g/L NaCl), (iii) dye concentration (100 mg/L to 1000 mg/L), (iv) biomass concentration (0.3 g/L to 0.21 g/L); on the process, and (iv) kinetics of decolourization in denitrifying conditions. The adapted mixed microbial consortium, originally sourced from the activated sludge process, was capable to simultaneously remove colour, COD, and NO3−-N under denitrifying conditions, even at high methyl orange (MO) concentrations of 1000 mg/L at 84 h. Although the decolourization was possible for wide ranges of pH, better performance was obtained at alkaline pH levels. The decolourization performance increased when biomass concentration increased and was not affected by salinity up to 10 g/L NaCl. This may have been due to enhanced lyses of biomass at high salt concentrations. Batch kinetic studies showed that the MO decolourization followed first-order kinetics, with a rate constant of 0.0612 h−1. Results of this study may help in the future application of textile effluent treatments, using a high biomass retention reactor in denitrifying conditions with minimum sludge disposal costs

Malnutrition from anorexia nervosa triggers severe complications of hereditary spherocytosis in an adolescent girl: A case report.

Hemolytic crises and aplastic crises in hereditary spherocytosis (HS) are most commonly triggered by viral infections. We present the case of an adolescent girl with HS who developed unexpected and life-threatening complications of her inherited hemolytic anemia as a consequence of anorexia nervosa and severe malnutrition

Hyponatremia in Patients With Multisystem Inflammatory Syndrome in Children

We report 2 patients with multisystem inflammatory syndrome in children with evidence of hyponatremia on admission. Despite fluid resuscitation and resolution of dehydration, the hyponatremia worsened. Serum and urine studies were evaluated and demonstrated evidence of syndrome of inappropriate antidiuretic hormone. Fluid restriction and anti-inflammatory therapy were initiated with resolution of hyponatremia