Effectiveness of evidence based regimen for medical abortion over conventional methods

Background: Medical abortion is a means of medical termination of pregnancy by drugs alone. This can be done upto 63 days using mifepristone and misoprostol tablets. For the conventional method, patient has to come to the hospital 3 times. In our study we reduced the interval between the drugs there by reducing the number of hospital visits. The objectives were to study the reduction of induction abortion interval following administration of evidence based regimen and to compare the proportion of patients developing complications in both the groups.Methods: It was a comparative study conducted at Department of Obstetrics and Gynecology, Govermnent MedicalCollege Kottayam, Kerala, India from May 2015 to November 2015.Results: The mean induction abortion interval in experimental group was 14.3 hours and in control group, it was 60.4 hours which was found to be statistically significant. Only 3 patients (7%) of experimental group had side effects whereas 12 patients. (17.4%) had side effects in the control group. Major side effects encountered were severe abdominal pain and severe bleeding per vaginum. Evidence based  regimen consist of administration of mifepristone 200mg and vaginal misoprostol 600µg 6 hours later for termination of pregnancy up to 63 days could reduce the induction abortion interval by 46 hours and had less side effects.Conclusions: As it reduces the induction abortion Interval and complications we feel that the evidence based regimen for Medical Termination of Pregnancy is superior to the FDA approved regimen

Maternal and neonatal outcome in primigravida with mobile head at ≥39 weeks of gestation

Background: Primigravida with mobile head at ≥39 weeks of gestation are prone to the probability of caesarean section. With this study we aimed to identify the maternal and neonatal outcome of primigravida with mobile head at ≥39 weeks of gestation under the watchful expectancy and good conduct of labour.Methods: A cross sectional study was conducted among primigravida with mobile head at ≥39 weeks admitted for delivery in the department of obstetrics and gynaecology, govt. medical college, Kottayam, Kerala, from February 2021 to September 2021. A sample size of 247 was identified considering 28% proportion of presentation with deflexed head, 95% confidence interval and 2% margin of error. A detailed history, physical examination and ultrasonography was performed.Results: Of the 250 participants, the mean age of the study subjects was 24.97±3.93 and mean body mass index (BMI) was 23.72±4.78 kg/m2. The most common cause for mobile head was a deflexed head (35.2%). A lower segment caesarean section (LSCS) was conducted in 28.8% participants while vacuum assistance ad forceps assistance was required for 9.6% and 4.4% participants respectively. The most common indication for LSCSC being moderate to thick meconium-stained amniotic fluid (MSAF) 23% followed by 1st degree CPD failed trial in 17% cases. A significant association with maternal morbidity was observed in undiagnosed placenta previa (p=0.039) and vacuum-assisted deliveries (p=0.001). We observed that 3.6% of babies have meconium aspiration syndrome, and 8% of new born were admitted in intensive care for foetal distress.Conclusions: Primigravida with mobile head at term during labour requires intense monitoring. Although the duration of labour appeared to be prolonged in a small proportion of patients with watchful expectancy and good conduct of labour and timely intervention, vaginal delivery is possible with minimal maternal and neonatal morbidity.

A deep investigation into the structure of carbon dots

Since their discovery, carbon dots (CDs) have been a promising nanomaterial in a variety of fields including nanomedicine. Despite their potential in this area, there are many obstacles to overcome for CDs to be approved for biomedical use. One major hindrance to CDs’ approval is related to their poorly defined structure. Herein a structural study of CDs is presented in order to rectify this shortcoming. The properties of three CDs which have significant promise in biomedical applications, black CDs (B-CDs), carbon nitride dots (CNDs), and yellow CDs (Y-CDs), are compared in order to develop a coherent structural model for each nanosystem. Absorption coefficients were measured for each system and this data gave insight on the level of disorder in each system. Furthermore, extensive structural characterization has been performed in order to derive structural information for each system. This data showed that B-CDs and CNDs are functionalized to a greater degree and are also more disordered and amorphous than Y-CDs. These techniques were used to develop a structural model consistent with the obtained data and what is known for carbonic nanostructures. These models can be used to analyze CD emission properties and to better understand the structure-property relationship in CDs

Healthcare-associated infections including neonatal blood stream infections in a leading tertiary hospital in Botswana

Background: Healthcare-associated infections (HAIs) increase morbidity, mortality, length of hospital stay and costs, and should be prevented where possible. In addition, up to 71% of neonates are prone to bloodstream infections (BSI) during intensive care due to a variety of factors. Consequently, the objectives of this study were to estimate the burden of HAIs and possible risk factors in a tertiary hospital in Botswana as well as describe current trends in bacterial isolates from neonatal blood specimen and their antibiotic resistance patterns.Methods: Point Prevalence Survey (PPS) in all hospital wards and a retrospective cross-sectional review of neonatal blood culture and sensitivity test results, with data abstracted from the hospital laboratory database.Results: 13.54% (n = 47) of patients had HAIs, with 48.9% (n = 23) of them lab-confirmed. The highest prevalence of HAIs was in the adult intensive care unit (100% - n = 5), the nephrology unit (50% - n = 4), and the neonatal intensive care unit (41.9% - n = 13). One-fourth of HAIs were site unspecific, 19.1% (n = 9) had surgical site infections (SSIs), 17% (n = 8) ventilator-associated pneumonia/complications, and 10.6% (n = 5) were decubitus ulcer infections. There were concerns with overcrowding in some wards and the lack of aseptic practices and hygiene. These issues are now being addressed through a number of initiatives. Coagulase Negative Staphylococci (CoNS) was the commonest organism (31.97%) isolated followed by Enterococci spp. (18.03%) among neonates. Prescribing of third-generation cephalosporins is being monitored to reduce Enterococci, Pseudomonas and Acinetobacter spp. infections.Conclusions: There were concerns with the rate of HAIs and BSIs. A number of initiatives are now in place in the hospital to reduce these including promoting improved infection prevention and control (IPC) practices and use of antibiotics via focal persons of the multidisciplinary IPC committee. These will be followed up and reported on

Production of Magnetized Electron Beam from a DC High Voltage Photogun

Bunched-beam electron cooling is a key feature of all proposed designs of the future electron-ion collider, and a requirement for achieving the highest promised collision luminosity. At the Jefferson Lab Electron Ion Collider (JLEIC), fast cooling of ion beams will be accomplished via so-called \u27magnetized cooling\u27 implemented using a recirculator ring that employs an energy recovery linac. In this contribution, we describe the production of magnetized electron beam using a compact 300 kV DC high voltage photogun with an inverted insulator geometry, and using alkali-antimonide photocathodes. Beam magnetization was assessed using a modest diagnostic beamline that includes YAG view screens used to measure the rotation of the electron beamlet passing through a narrow upstream aperture. Magnetization results are presented for different gun bias voltages and for different laser spot sizes at the photocathode, using 532 nm lasers with DC and RF time structure. Photocathode lifetime was measured at currents up to 4.5 mA, with and without beam magnetization

Cultivating capacities in community-based researchers in low-resource settings: Lessons from a participatory study on violence and mental health in Sri Lanka

Participatory methods, which rely heavily on community-based data collectors, are growing in popularity to deliver much-needed evidence on violence and mental health in low- and middle-income countries. These settings, along with local researchers, encounter the highest burden of violence and mental ill-health, with the fewest resources to respond. Despite increased focus on wellbeing for research participants and, to a lesser degree, professional researchers in such studies, the role-specific needs of community-based researchers receive scant attention. This co-produced paper draws insights from one group’s experience to identify rewards, challenges, and recommendations for supporting wellbeing and development of community-based researchers in sensitive participatory projects in low-resource settings. Twenty-one community-based researchers supporting a mixed-methods study on youth, violence and mental health in Sri Lanka submitted 63 reflexive structured journal entries across three rounds of data collection. We applied Attride-Stirling’s method for thematic analysis to explore peer researchers’ learning about research, violence and mental health; personal-professional boundaries; challenges in sensitive research; and experiences of support from the core team. Sri Lanka’s first study capturing experiences of diverse community-based researchers aims to inform the growing number of global health and development actors relying on such talent to deliver sensitive and emotionally difficult work in resource-limited and potentially volatile settings. Viewing participatory research as an opportunity for mutual learning among both community-based and professional researchers, we identify practice gaps and opportunities to foster respectful team dynamics and create generative and safe co-production projects for all parties. Intentional choices around communication, training, human and consumable resources, project design, and navigating instable research conditions can strengthen numerous personal and professional capacities across teams. Such individual and collective growth holds potential to benefit short- and long-term quality of evidence and inform action on critical issues, including violence and mental health, facing high-burden, low-resource contexts

Stem cell function and stress response are controlled by protein synthesis.

Whether protein synthesis and cellular stress response pathways interact to control stem cell function is currently unknown. Here we show that mouse skin stem cells synthesize less protein than their immediate progenitors in vivo, even when forced to proliferate. Our analyses reveal that activation of stress response pathways drives both a global reduction of protein synthesis and altered translational programmes that together promote stem cell functions and tumorigenesis. Mechanistically, we show that inhibition of post-transcriptional cytosine-5 methylation locks tumour-initiating cells in this distinct translational inhibition programme. Paradoxically, this inhibition renders stem cells hypersensitive to cytotoxic stress, as tumour regeneration after treatment with 5-fluorouracil is blocked. Thus, stem cells must revoke translation inhibition pathways to regenerate a tissue or tumour.This work was funded by Cancer Research UK (CR-UK), Worldwide Cancer Research, the Medical Research Council (MRC), the European Research Council (ERC), and EMBO. Research in Michaela Frye's laboratory is supported by a core support grant from the Wellcome Trust and MRC to the Wellcome Trust-Medical Research Cambridge Stem Cell Institute.This is the author accepted manuscript. The final version is available from Nature Publishing Group via http://dx.doi.org/10.1038/nature1828

Fertility decline in India: a futuristic perspective

Fertility projections based on log linear analysis suggest that India will attain replacement level fertility by 2019, given the past trends during 1981-94 continue. About 56 percent reduction in the current fertility levels is required to take India to replacement level fertility. The proximate determinants play an important role in the continuing decline in fertility in both the low and high fertility states. The implications of such an observed fertility decline in terms of population momentum are further discussed