Miscarriage and early first trimester growth restriction by ultrasound

Background: Concern about the possibility of spontaneous miscarriage is one of the most common reasons women seek evaluation in the emergency department during their first trimester. According to the obstetrics and gynecology literature, it is estimated that 20% to 25% of all clinically recognized pregnancies result in spontaneous miscarriage. The objective of the study is to examine with whether viable early pregnancies that subsequently end in miscarriage exhibit evidence of first-trimester growth restriction. The prospective cohort study design used for this purpose with setting of Antenatal clinic of a teaching hospital. Women attending the clinic between 5 and 10 weeks of gestation took part in the study.Methods: Women with spontaneously conceived intrauterine, viable singleton pregnancies with certain last menstrual period and regular cycles were included. The deviation between the observed and expected crown-rump length (CRL) for gestation was calculated and expressed as a z-score. Pregnancies were followed up until 11-14 weeks, and the deviation between those that remained viable and miscarried subsequently was calculated. Viability at 11-14 weeks was measured.Results: Over 12 months, 320 women met the inclusion criteria. Twenty women were excluded. Of the remaining 300, the pregnancy remained viable in 248 (82.6%) and 52 (17.4%) suffered a miscarriage. At the first transvaginal ultrasound, the z score of the mean measured CRL for pregnancies that remained viable was -0.69 while in pregnancies that subsequently miscarried the z-score was -2.95 and the CRL was significantly smaller (P < 0.048). In the latter group, the initial CRL was below the expected mean for gestational age in all women.Conclusions: CRL was significantly smaller in pregnancies that subsequently ended in miscarriage. This suggests that early first trimester growth restriction is associated with subsequent intrauterine death

W+W−W^+W^- production in Large extra dimension model at next-to-leading order in QCD at the LHC

We present next-to-leading order QCD corrections to production of two $W$ bosons in hadronic collisions in the extra dimension ADD model. Various kinematical distributions are obtained to order $\alpha_s$ in QCD by taking into account all the parton level subprocesses. We estimate the impact of the QCD corrections on various observables and find that they are significant. We also show the reduction in factorization scale uncertainty when ${\cal O}(\alpha_s)$ effects are included.Comment: Journal versio

Intravenous versus oral iron therapy in treatment of postpartum anaemia

Background: Postpartum iron deficiency anaemia (IDA) is common in women. Most women are treated with either oral iron supplementation or blood transfusion. Hence, the aim of our study was to compare the effect of treatment with either oral ferrous sulphate or intravenous ferrous sucrose on postpartum IDA.Methods: 100 postpartum women with proven iron deficiency anaemia with hemoglobin <9gm/dl and serum ferritin <15 µgm/l were included in the study. They were randomized to receive either oral ferrous sulphate 200 mg twice daily for 6 weeks (group 1) or intravenous ferrous sucrose 200 mg, two to three doses given on alternate days (group 2). Total iron deficit was calculated using a standard formula. Target hemoglobin was 11 gm/dl. Results were analysed by the students t-test and chi-square test. Hemoglobin, hematocrit, red cell indices and ferritin were measured on day 2-3, 1-2 weeks and 6 weeks postpartumResults: By 1-2 weeks, hemoglobin level in women treated with intravenous iron had risen from 7.81±0.849 to 9.88±0.760 gm/dl which was more than those treated with oral iron (p<0.01); although by 6 weeks, there was no significant difference between the two groups. Ferritin levels rose rapidly in those treated with intravenous iron and remained significantly higher than in those treated with oral iron (p<0.01).Conclusions: Intravenous iron sucrose increases the hemoglobin level more rapidly than oral ferrous sulphate in women with postpartum IDA. It also replenishes iron stores more rapidly.

Building blocks of Cwebs in multiparton scattering amplitudes

The correlators of Wilson-line operators in non-abelian gauge theories are known to exponentiate, and their logarithms can be organised in terms of the collections of Feynman diagrams called Cwebs. The colour factors that appear in the logarithm correspond to completely connected diagrams and are determined by the web mixing matrices. In this article we introduce several new concepts: (a) Normal ordering of the diagrams of a Cweb, (b) Fused-Webs (c) Basis and Family of Cwebs. We use these ideas together with a Uniqueness theorem that we prove to arrive at an understanding of the diagonal blocks, and several null matrices that appear in the mixing matrices. We demonstrate using our formalism that, once the basis Cwebs present upto order αsn are determined, the number of exponentiated colour factors for several classes of Cwebs starting at order αsn+1 can be predicted. We further provide complete results for the mixing matrices, to all orders in perturbation theory, for two special classes of Cwebs using our framework. © 2022, The Author(s)

Identification of factors determining the initiation of breastfeeding in postnatal women in a tertiary care centre: an observational study

Background: The WHO recommends that mothers worldwide to initiate breastfeeding within an hour of delivery to achieve optimal growth, development and health but the breastfeeding rates remain far below the recommended standards. The aim of this study was to find the prevalence of delay in initiation of breast feeding, to identify various factors which determine the initiation of breastfeeding and to correlate their association with delayed onset of breast feeding.Methods: Hundred and thirty six postnatal women, who delivered in Santosh Medical College and Hospital, Ghaziabad, were recruited in the study. They were interviewed after their informed consent using a pretested structured questionnaire. Socio-demographic and obstetric factors were compared between subjects who initiated breast feeding in less than and more than 1 hours. Frequencies were calculated for different variables. Data was statistically analyzed and p value of <0.05 was taken significant.Results: The prevalence of delay in initiation of breast feeding in our study was found to be 74.2% (n=101).The mean time of initiation of breast feeding was 18.43 hours. Significant association (p <0.05) was found in various sociodemographic, obstetrical and social factors.Conclusions: Identifying mothers at risk of delayed breastfeeding initiation should be the target for breastfeeding promotion during prenatal, antenatal as well as postnatal period. Public health officials and health care providers should consider interventions to promote and support early initiation of breast feeding

Genexpert test and endometrial histological findings in infertile women

Background: Infertility is a worldwide health problem with very definite physiological, psychological and social implications. According to studies, about 30% of infertility cases are due to the male factors, 40 to 50% have the origin of female factors and 20 to 30% of cases are caused by both male and female factors. Genital tuberculosis is among the main causes of female infertility. Due to its high prevalence, especially in developing countries, work-up of an infertile couple should include evaluation for tuberculosis irrespective of history or exposure. The objective of the present study is to find out the prevalence of genital tuberculosis in all females presenting with infertility in a tertiary care hospital over a given period of time, and diagnostic comparison of endometrial tuberculosis by GeneXpert and Histopathological examination (HPE).Methods: The prospective observational study was conducted from January 2016-June 2017.A total of 81 endometrial tissue samples were collected from the women, satisfying the inclusion and exclusion criteria.Results: GeneXpert scored negative in our study. On HPE, out of 81 patients, proliferative endometrium (anovulatory) was found in 34 cases (41.9%), non-specific endometritis in 1 case (1.23%) and 1 case (1.23%) was found positive for tubercular endometritis. Secretory endometrium was found in 45 cases (55.55%).Conclusions: Endometrial biopsy shows not only the tuberculous endometritis, but also gives additional information about hormone response of endometrium, local factors of endometrium concerning non-specific and specific infections and anovulatory cycles. Gene Expert if positive on endometrial biopsy is a reliable test for FGTB and treatment can be started on its basis

Resummed transverse momentum distribution of pseudo-scalar Higgs boson at NNLOA_A+NNLL

In this article we have studied the transverse momentum distribution of the pseudo-scalar Higgs boson at the Large Hadron Collider (LHC). The small \pt region which provides the bulk of the cross section is not accessible to fixed order perturbation theory due to the presence of large logarithms in the series. Using the universal infrared behaviour of the QCD we resum these large logarithms up to next-to-next-to-leading logarithmic (NNLL) accuracy. We observe a significant reduction in theoretical uncertainties due to the unphysical scales at NNLL level compared to the previous order. We present the $p_T$ distribution matched to NNLO$_A$+NNLL, valid for the whole $p_T$ region and provide a detailed phenomenological study in the context of both 14 TeV and 13 TeV LHC using different choices of masses, scales and parton distribution functions which will be useful for the search of such particle at the LHC in near future.Comment: 20 pages, 8 figures, 2 table

Antenatal counselling as a tool to increase acceptability of postpartum intrauterine contraceptive device insertion in a tertiary care hospital

Background: Acceptance of postpartum intrauterine device (IUD) insertions in women in Uttar Pradesh is low. In response to the concept that a good postpartum programme should begin prenatally, this study was designed to determine whether the provision of expert contraceptive counselling during the antenatal period would have an impact on its uptake as compared to women who were counselled in post partum period.Methods: Expert contraceptive counselling was given to 264 and154 women during their antenatal visits and postpartum hospitalization, respectively. Acceptors received IUCDs within 48 h of delivery in the case of vaginal delivery or transcesarean insertion in case of abdominal delivery. The acceptance rate of PPIUCD and the percentage of actual insertions were recorded. The causes of refusal were also recorded.Results: Among the 264 couples counselled in antenatal period 116 (43.9%) had PPIUCD insertion. Among the 154 unbooked women who were counselled postpartum only PPIUCD was inserted in 36 (23.4%) women. PPIUCD insertion was significantly high in women receiving expert counselling during antenatal period as compared to the women who were counselled in postnatal period (p< 0.001). Family refusal, No knowledge of PPIUCD and preference for another contraceptive methods were the most common reasons for refusing the use of PPIUCD.Conclusion: Acceptability of PPIUCD insertion was high in women counselled in antenatal period. Hence, it is suggested that counselling for PPIUCD should start in antenatal period

Cwebs beyond three loops in multiparton amplitudes

Correlators of Wilson-line operators in non-abelian gauge theories are known to exponentiate, and their logarithms can be organised in terms of collections of Feynman diagrams called webs. In [1] we introduced the concept of Cweb, or correlator web, which is a set of skeleton diagrams built with connected gluon correlators, and we computed the mixing matrices for all Cwebs connecting four or five Wilson lines at four loops. Here we complete the evaluation of four-loop mixing matrices, presenting the results for all Cwebs connecting two and three Wilson lines. We observe that the conjuctured column sum rule is obeyed by all the mixing matrices that appear at four-loops. We also show how low-dimensional mixing matrices can be uniquely determined from their known combinatorial properties, and provide some all-order results for selected classes of mixing matrices. Our results complete the required colour building blocks for the calculation of the soft anomalous dimension matrix at four-loop order.Comment: 51 pages, 37 figures, Published version, published in JHE

Role of cytology, colposcopy and colposcopic directed biopsy in the evaluation of unhealthy cervix

Background: The objective was to find out the magnitude of precancerous lesions and evaluate the performance of colposcopy in estimating the presence and grade of cervical disease vs conventional Pap smear testing of women with unhealthy cervix.Methods: This was a prospective observational study. All the women were subjected to Pap smear and colposcopy, whereas histopathology was done in patients having abnormal findings on colposcopy. Biopsies were taken from the abnormal areas.Results: Out of 110 women who completed the study 60 (54.5%) had changes in their cervical epithelium on colposcopy. These 60 women with unhealthy cervix underwent cervical biopsy, and 20 (33.3%) had histologically proven chronic cervicitis, 6 (10%) had chronic cervicitis with condylomatous change followed by 17 (28.3%) with CIN 1 lesion, 8 (13.3%) with CIN 2, 4 (6.7%) with CIN 3 lesion and only one (1.7%) had histologically proven malignancy. Cytology alone identified the population at risk with a high sensitivity [70.00% (95% CI: 50.60 % to 85.24 %)] but low specificity [60.00% (95% CI: 40.61 % to 77.32 %)] rate. Colposcopy showed a high sensitivity rate [93.33 % (95% CI: 77.19 % to 98.99 %)] but a limited specificity [70.00% (95% CI: 50.60% to 85.24%)].Conclusions: It is very important to diagnose the CIN lesions with accuracy once a woman comes to a tertiary care hospital with symptoms or is referred for a suspicious looking cervix. All these women must be screened by colposcopy and directed biopsy must be taken if indicated in the same sitting