Clinical study of maternal complications associated with eclampsia

Background: Eclampsia is still one of the leading causes of maternal mortality and morbidity in developing countries. Though the incidence in developed nations has drastically reduced, it has remained the same over years in India, mainly due to lack of awareness, poor socio-economic status and inadequate ante natal check-ups. The objective of this study was to determine the presentation, demographic features, risk factors, management, maternal mortality and morbidity, in women presenting with eclampsia.Methods: This study was conducted in Vanivilas hospital from January to December 2014 for 12 months. Total 230 women with eclampsia were studied with respect to their age, parity, socio economic status, gestational age, details of previous antenatal check-ups, clinical features at presentation, nature and number of convulsions, treatment received before admission, management in the institution and maternal morbidity and mortality.Results: The incidence of Eclampsia was 1.4%. 30% were below 20 years of age, 45% were primigravidas, 97% were referred cases with inadequate antenatal checkups. 68% had antepartum eclampsia, 22% had intrapartum eclampsia and 10% had postpartum eclampsia. 24% had instrumental delivery, 24% underwent caesarean delivery. There were 17.4% ICU admissions, 5.7% acute kidney injury cases and 13 maternal deaths.Conclusions: Eclampsia still remains a major cause of maternal morbidity and mortality in india. Information about danger signs of pre-eclampsia/ eclampsia should be made available to antenatal clients. Importance of timely referral to the tertiary center should be emphasised to the peripheral health workers

Instrumental delivery: a comparative study in a tertiary care hospital

Background: To compare maternal and neonatal outcomes of vacuum versus forceps application in assisted vaginal delivery.Methods: Women in labor with vertex presentation were delivered by indicated/propylactic vacuum or forceps. A total of 500 cases were included in this retrospective study. Maternal and neonatal morbidity were compared in terms of perineal lacerations, episiotomy extension, post-partum hemorrhage, Apgar score, neonatal jaundice, perinatal mortality, NICU admissions etc. Chi square test was used to analyze the data.Results: Maternal morbidity was significant in the forceps group. With regards to neonatal morbidity, in NICU admissions, statistically significant difference was noted.Conclusions: Vacuum and forceps should remain appropriate tools in the modern obstetrics. However, ventouse may be chosen first (if there is no fetal distress) as it is significantly less likely to injure the mother and decrease NICU admissions

Mode of delivery and outcome of breech presentation: a prospective observational study in a tertiary centre

Background: Breech presentation is the commonest malpresentation with the incidence of 3-4% at term. This study was done with the objective of studying the mode of delivery in breech presentation and to compare the maternal and fetal outcome in patients delivered vaginally to those delivered by cesarean section.Methods: This prospective observational study was conducted in Vanivilas Hospital, affiliated to Bangalore Medical College and Research Institute, from June 2014 to May 2015. The study group included 509 patients with breech presentation who were studied with respect to their gestational age, birth weight, type of breech, mode of delivery, maternal and perinatal outcome.Results: The incidence of breech presentation was 2.92% (509) among 17454 total deliveries with the incidence of 3.17% in primi and 2.73% in multies. 193 (38%) patients had vaginal breech delivery and 316 (62%) delivered by LSCS. Apgar score of less than 7 at 1 minute was seen with 21.42% of vaginally delivered fetuses and 9.09% of fetuses delivered by cesarean section. The perinatal mortality was 1.6% (8 cases) in vaginal group 0.8% (4 cases) in LSCS group. The short term maternal complications in LSCS group was 7.62% and in vaginal delivery group was 3.09%.Conclusions: The short term maternal morbidity is higher in patients with cesarean section compared to those with vaginal breech delivery. Perinatal outcome is better in babies delivered by cesarean section. Still vaginal breech delivery can be an option for breech babies with proper selection and when conducted by a skilled obstetrician

Extraction and Evaluation of Tamarind Kernel Mucilage powder for Hydrocolloidal Properties

Hydrocolloids are commonly used as dietary fibers, thickeners, gelling agents, emulsifiers, stabilizer, fat replacers, clarifying agents, flocculating agents, clouding agents and whipping agents. The development of applicable hydrocolloids from crops and food disposals allow the recovery, recycling and sustainability of high value-added ingredients in the food chain. Tamarind seeds are subjected to various methods (soaking, drying, parching) for removal of seed coat. Finally parching at 80c for 20min resulted in 72% seed coat removal. The kernels were then milled through 355µm mesh using hammer mill. TKM is isolated from powder by hydrating TKP and dried with spray dryer which yielded 40% of TKMP. Physical and bio chemical parameters are studied for the kernel powder and mucilage powder. Functional properties such as solubility, water holding capacity, oil holding capacity, swelling index, emulsifying ability and foaming capacity were analyzed. Solubility, WHC, OHC increased with increase in temperature, foaming and emulsifying capacity increased with increased weight to volume ratio of mucilage powder. The efficiency of using TKMP as coating agent was studied by dipping potato wedges in different aqueous 0.5% solutions of CMC, xanthan gum and TKMP. The percent coat pick up of TKMP was recorded as 6% which is higher than CMC. The percent frying yield of potato wedges dipped in TKMP solutions recorded 68.4% which is higher than the potato wedge dipped in CMC solution (60.97%). These results show that TKMP can be effectively used as coating material for increasing frying yield of the samples

Identification of QTLs and candidate genes for high grain Fe and Zn concentration in sorghum [Sorghum bicolor (L.)Moench]

Sorghum is a major food crop in the semi-arid tropics of Africa and Asia. Enhancing the grain iron (Fe) and zinc (Zn) concentration in sorghum using genetic approaches would help alleviate micronutrient malnutrition in millions of poor people consuming sorghum as a staple food. To localize genomic regions associated with grain Fe and Zn, a sorghum F6 recombinant inbred line (RIL) population (342 lines derived from cross 296B PVK 801) was phenotyped in six environments, and genotyped with simple sequence repeat (SSR), DArT (Diversity Array Technology) and DArTSeq (Diversity Array Technology) markers. Highly significant genotype environment interactions were observed for both micronutrients. Grain Fe showed greater variation than Zn. A sorghum genetic map was constructed with 2088 markers (1148 DArTs, 927 DArTSeqs and 13 SSRs) covering 1355.52 cM with an average marker interval of 0.6 cM. Eleven QTLs (individual) and 3 QTLs (across) environments for Fe and Zn were identified. We identified putative candidate genes from the QTL interval of qfe7.1, qzn7.1, and qzn7.2 (across environments) located on SBI-07 involved in Fe and Zn metabolism. These were CYP71B34, and ZFP 8 (ZINC FINGER PROTEIN 8). After validation, the linked markers identified in this study can help in developing high grain Fe and Zn sorghum cultivars in sorghum improvement programs globally

Topoisomerase II\u3b2 mediates the resistance of glioblastoma stem cells to replication stress-inducing drugs

The mesenchymal state in cancer is usually associated with poor prognosis due to the metastatic predisposition and the hyper-activated metabolism. Exploiting cell glucose metabolism we propose a new method to detect mesenchymal-like cancer cells. We demonstrate that the uptake of glucose-coated magnetic nanoparticles (MNPs) by mesenchymal-like cells remains constant when the glucose in the medium is increased from low (5.5 mM) to high (25 mM) concentration, while the MNPs uptake by epithelial-like cells is significantly reduced. These findings reveal that the glucose-shell of MNPs plays a major role in recognition of cells with high-metabolic activity. By selectively blocking the glucose transporter 1 channels we showed its involvement in the internalization process of glucose-coated MNPs. Our results suggest that glucose-coated MNPs can be used for metabolic-based assays aimed at detecting cancer cells and that can be used to selectively target cancer cells taking advantage, for instance, of the magnetic-thermotherapy

The Beijing genotype and drug resistant tuberculosis in the Aral Sea region of Central Asia

BACKGROUND: After the collapse of the Soviet Union, dramatically increasing rates of tuberculosis and multidrug-resistant tuberculosis (MDR-TB) have been reported from several countries. This development has been mainly attributed to the widespread breakdown of TB control systems and declining socio-economic status. However, recent studies have raised concern that the Beijing genotype of Mycobacterium tuberculosis might be contributing to the epidemic through its widespread presence and potentially enhanced ability to acquire resistance. METHODS: A total of 397 M. tuberculosis strains from a cross sectional survey performed in the Aral Sea region in Uzbekistan and Turkmenistan have been analysed by drug susceptibility testing, IS6110 fingerprinting, and spoligotyping. RESULTS: Fifteen isolates showed mixed banding patterns indicating simultaneous infection with 2 strains. Among the remaining 382 strains, 152 (40%) were grouped in 42 clusters with identical fingerprint and spoligotype patterns. Overall, 50% of all isolates were Beijing genotype, with 55% of these strains appearing in clusters compared to 25% of non-Beijing strains. The percentage of Beijing strains increased with increasing drug resistance among both new and previously treated patients; 38% of fully-susceptible isolates were Beijing genotype, while 75% of MDR-TB strains were of the Beijing type. CONCLUSION: The Beijing genotype is a major cause of tuberculosis in this region, it is strongly associated with drug resistance, independent of previous tuberculosis treatment and may be strongly contributing to the transmission of MDR-TB. Further investigation around the consequences of Beijing genotype infection for both tuberculosis transmission and outcomes of standard short course chemotherapy are urgently needed

The oxysterol 27-hydroxycholesterol increases β-amyloid and oxidative stress in retinal pigment epithelial cells

<p>Abstract</p> <p>Background</p> <p>Alzheimer's disease (AD) and age-related macular degeneration (AMD) share several pathological features including β-amyloid (Aβ) peptide accumulation, oxidative damage, and cell death. The causes of AD and AMD are not known but several studies suggest disturbances in cholesterol metabolism as a culprit of these diseases. We have recently shown that the cholesterol oxidation metabolite 27-hydroxycholesterol (27-OHC) causes AD-like pathology in human neuroblastoma SH-SY5Y cells and in organotypic hippocampal slices. However, the extent to which and the mechanisms by which 27-OHC may also cause pathological hallmarks related to AMD are ill-defined. In this study, the effects of 27-OHC on AMD-related pathology were determined in ARPE-19 cells. These cells have structural and functional properties relevant to retinal pigmented epithelial cells, a target in the course of AMD.</p> <p>Methods</p> <p>ARPE-19 cells were treated with 0, 10 or 25 μM 27-OHC for 24 hours. Levels of Aβ peptide, mitochondrial and endoplasmic reticulum (ER) stress markers, Ca²⁺homeostasis, glutathione depletion, reactive oxygen species (ROS) generation, inflammation and cell death were assessed using ELISA, Western blot, immunocytochemistry, and specific assays.</p> <p>Results</p> <p>27-OHC dose-dependently increased Aβ peptide production, increased levels of ER stress specific markers caspase 12 and gadd153 (also called CHOP), reduced mitochondrial membrane potential, triggered Ca²⁺dyshomeostasis, increased levels of the nuclear factor κB (NFκB) and heme-oxygenase 1 (HO-1), two proteins activated by oxidative stress. Additionally, 27-OHC caused glutathione depletion, ROS generation, inflammation and apoptotic-mediated cell death.</p> <p>Conclusions</p> <p>The cholesterol metabolite 27-OHC is toxic to RPE cells. The deleterious effects of this oxysterol ranged from Aβ accumulation to oxidative cell damage. Our results suggest that high levels of 27-OHC may represent a common pathogenic factor for both AMD and AD.</p

A first assessment of the genetic diversity of Mycobacterium tuberculosis complex in Cambodia

<p>Abstract</p> <p>Background</p> <p>Cambodia is among the 22 high-burden TB countries, and has one of the highest rates of TB in South-East Asia. This study aimed to describe the genetic diversity among clinical <it>Mycobacterium tuberculosis </it>complex (MTC) isolates collected in Cambodia and to relate these findings to genetic diversity data from neighboring countries.</p> <p>Methods</p> <p>We characterized by 24 VNTR loci genotyping and spoligotyping 105 <it>Mycobacterium tuberculosis </it>clinical isolates collected between 2007 and 2008 in the region of Phnom-Penh, Cambodia, enriched in multidrug-resistant (MDR) isolates (n = 33).</p> <p>Results</p> <p>Classical spoligotyping confirmed that the East-African Indian (EAI) lineage is highly prevalent in this area (60%-68% respectively in whole sample and among non-MDR isolates). Beijing lineage is also largely represented (30% in whole sample, 21% among non-MDR isolates, OR = 4.51, CI_95%[1.77, 11.51]) whereas CAS lineage was absent. The 24 loci MIRU-VNTR typing scheme distinguished 90 patterns with only 13 multi-isolates clusters covering 28 isolates. The clustering of EAI strains could be achieved with only 8 VNTR combined with spoligotyping, which could serve as a performing, easy and cheap genotyping standard for this family. Extended spoligotyping suggested relatedness of some unclassified "T1 ancestors" or "Manu" isolates with modern strains and provided finer resolution.</p> <p>Conclusions</p> <p>The genetic diversity of MTC in Cambodia is driven by the EAI and the Beijing families. We validate the usefulness of the extended spoligotyping format in combination with 8 VNTR for EAI isolates in this region.</p