Study of spectrum of cardiac disease complicating pregnancy and the maternal and foetal outcome

Background: Heart diseases are the most important non obstetrical causes of maternal deaths during pregnancy, accounting for almost 10% of maternal deaths. They complicate 1-3% of all pregnancies.Methods: The study was conducted at Cheluvamba Hospital from January 2015 till July 2016. All pregnant women with cardiac disease were included in the study. Pregnant women with cardiac disease were followed up during antenatal period, evaluated and maternal and foetal outcome was studied.Results: Total number of deliveries in the one and half year study period was 18,803 cases and the total number of women with cardiac disease was 90. Most of the subjects belonged to NYHA grade I and II (95.5%), whereas NYHA grade III and IV constituted only 4.4% of cases. Rheumatic heart disease was the principal cardiac lesion (62.22%) among the pregnancies, while congenital heart disease (33.33%) was the second most common cause. 16.7% had cardiac complications and there were 2(2.22%) maternal mortality. 91.86% were live births with 5.88% IUDs and 2.35% neonatal deaths. 15.29% of the babies were Preterm, 8.14% were IUGR babies and 2.35% had congenital anomalies. It was noted NYHA grade III/IV cases had more preterm babies compared to NYHA grade I/II. NICU admissions were also more with NYHA grade III/IV.Conclusions: The results suggest the need for pre-pregnancy counselling, early diagnosis, correction of cardiac lesions where indicated, close surveillance during pregnancy and a team approach comprising of obstetricians, cardiologists, neonatologists and nursing personnel for a successful pregnancy outcome

Study of the indications for caesarean sections between 20 and 28 weeks of gestation

Background: Major change in the practice of obstetrics over the past century is progressive increase in the frequency of caesarean delivery and recent scientific information show improved survival or decreased morbidity for the neonate when caesarean delivery is performed for extreme prematurity. This study was done to determine the caesarean section rate for sections done between 20 and 28 weeks of gestation and to analyze the indications for such sections.Methods: Institutional based retrospective observational study done in the Obstetrics and Gynaecology Department, Cheluvamba Hospital, MMC&RI, Mysore, Karnataka, India. Caesarean sections done over 5 years from January 1st 2010 till December 31st 2014 are considered for the study. The total number of Caesarean sections done for gestational age between 20 and 28 weeks are noted. The data obtained is analyzed for the indications at the respective gestational ages.Results: Frequency of caesarean section at gestational age between 20 and 28 weeks is seen to be <1%. Out of total 15,906 LSCS cases, 97 (0.6%) patients under went caesarean section between 20 and 28 weeks of gestation. Of the 97 cases, 54 cases (55.67%) were operated at 28 weeks, 17 cases (17.52%) at 26 weeks, 20 cases (20.61%) at 24 weeks, 4 cases (4.12%) at 22 weeks and 2 cases (2.06%) at 20 weeks of gestation. APH in 33 (34.0%), pre-ecclampsia and ecclampsia in 30 (30.9%) cases are found to be the indications for delivery in 61 cases (64.9%). The indications for caesarean sections in 44 (45.3%) cases were previous caesarean section associated with or without pre-ecclampsia and APH as contributory factors.Conclusions: Caesarean section rate for gestational age between 20 and 28 weeks’ gestational age is <1% and there is decreasing trend. Previous caesarean section, APH, ecclampsia and pre-ecclampsia with their complications are the common indications for such sections. The decision to perform first caesarean section and the indication for it is of prime importance

Targeted therapies in the management of locally advanced and metastatic pancreatic cancer: a systematic review

Pancreatic cancer has a dismal prognosis particularly in patients presenting with unresectable tumors. We performed a bibliometric analysis of clinical trials for pancreatic cancer conducted between 2014-2016 focusing on patients that presented with unresectable (locally advanced or metastatic) tumors. We discuss a range of studies that employed FOLFIRINOX, the gemcitabine + nab-paclitaxel combination and studies that used molecularly-targeted therapy. Major areas of focus have been dual targeting of EGFR and VEGFR, immunotherapy or a multimodal approach – combining chemotherapy with radiotherapy. We also point out the need for molecular selection for low prevalence subtypes. Key insights sourced from these pivotal trials should improve clinical outcomes for this devastating cancer

Eco-friendly Sustainable Multiphase Polymer Systems for Advanced Functions

When Eric Fawcett and Reginald Gibson discovered polyethylene accidentally, they never realized how useful their discovery will be for mankind, similar to how Charles Goodyear’s idea of adding sulphur to polyisoprene would revolutionize the tire and other rubber industries. Although those discoveries centuries ago have never realized their current impact, however, the fact is undeniable on how polymer science has conquered the world, gaining an irreplaceable position from a utilitarian perspective

Clean coal technology—a technical response to the environmental challenges

Coal occurs in 70 countries of the world. Total proved reserve of coal in the world is about 909 billion tonnes. India contributes about 105 billion tonnes of proven coal reserves and ranks fourth in the world after USA, Russia and China. India is also the third largest producer of coal in the world, producing about 400 million tonnes annually. Jharkhand has 39480 million tonnes of proved coal reserve and ranks first in the country. Coal produces 40% of the world’s electricity and around 70% of the world’s steel. Coal is used in cement, paper, chemical, pharmaceutical industries and also used as liquid fuel in transportation and electricity. Coal is mined in over 50 countries and 7 million people are employed in coal mining sector. In developing countries the coal industry is export oriented and is a major source of foreign currency. Thus, coal makes a significant contribution to global economic development. Beside above facts mining of coal and its uses in different industries have a number of adverse environmental impacts. Use of coal causes emissions of oxides of nitrogen and sulphur, ash, trace elements and carbon dioxide. Ash from coal combustion can effect people’s respiratory systems and it also impacts local visibility. This ash also causes environmental pollution. Emissions of trace elements like selenium and arsenic can be harmful to human health and the environment. During the combustion process NO2 and SO2 gas formed and it can increase ground level ozone, acid rain, green house effect, smog and acidic aerosols. Similarly, coal mining, particularly surface mining, also raises a number of environmental challenges like soil erosion, dust, noise and water pollution etc. which has an impact on local biodiversity

A comparative study of intra-cervical foley’s catheter and PGE2 gel for induction of labour at term

Background: In cervical ripening, before induction of labour, is needed to increase the success of labour induction, to reduce complications and to diminish the rate of caesarean section and duration of labour. Pharmacological preparations are in widespread use for cervical ripening but are not free from side-effects and complications. Mechanical methods, i.e. the use of Foley’s catheter balloon, though effective have not gained much popularity because of the fear of infection. Therefore, the study has been conducted to prove the efficacy and safety of extra amniotic Foley catheter balloon and to compare it with intra-cervical prostaglandin E2 (PGE2) gel. The objective of the study was to the success of induction of labor depends on the cervical status at the time of induction. For effective cervical ripening both Foley's catheter and PGE2 gel are used. The aim of this study was to compare the efficacy of intra cervical Foley's catheter and intra cervical PGE2 gel in cervical ripening for the successful induction of labor.Methods: A randomized, comparative study was conducted in the department of obstetrics and gynaecology, Civil hospital, B.J. Medical College Ahmedabad, during a period of 8 month from September 2018 to April 2019. 100 patients at term with a Bishop's score ≤5 with various indications for induction were randomly allocated to group F (intra-cervical Foley’s catheter) and group P (PGE2 gel) with 50 women included in each group.Results: The groups were comparable with respect to maternal age, gestation age, indication of induction and initial Bishop's score. Both the groups showed significant change in the Bishop's score, 5.10±1.55 and 5.14±1.60 for Foley's catheter and PGE2 gel, respectively, p <0.001. However there was no significant difference between the two groups. There was no significant difference in the side effects and caesarean section rate in both groups. The induction to delivery interval was 16.01±5.50 hours in group F and 16.85 ± 3.81 hours in group P (p=0.073). Apgar scores, birth weights and NICU admissions showed no significant difference between the two groups.Conclusions: The study shows that both Foley's catheter and PGE2 gel are equally effective in pre induction cervical ripening

Momentum space properties from coordinate space electron density

Electron density and electron momentum density, while independently tractable experimentally, bear no direct connection without going through the many-electron wave function. However, invoking a variant of the constrained-search formulation of density functional theory, we develop a general scheme (valid for arbitrary external potentials) yielding decent momentum space properties, starting exclusively from the coordinate space electron density. Numerical illustration of the scheme is provided for the closed-shell atomic systems He, Be and Ne and for $1s^1~2s^1$ singlet electronic excited state for Helium by calculating the Compton profiles and the $$ expectation values derived from given coordinate space electron densities.Comment: 4 pages, 1 figur