Rare case of ruptured uterus in previously normal delivered patient due to hydatid cystic disease in pregnant uterus

Hydatid cystic disease is parasitic disease caused by Echinococcus granulosus. Dogs and carnivors like fox are definitive hosts harbouring warms in intestine. Eggs passed in stools eaten by intermediate hosts and larvae encyst in liver, lungs and other organs. Humans are accidental hosts. Incidence of hydatid cystic disease in genital organs is low around 0.5%. Hydatid cyst most often found in liver - 60%, lungs - 30% accounting approximately 90% of the disease. Incidence of hydatid disease in pregnancy is very rare ranging from 1/20000 to 1/30000. 22 years old G2P1L1 with 39weeks gestation age (GA) with intrauterine fetal death (IUFD) with query ruptured uterus, extra uterine pregnancy, transverse lie with severe anaemia referred from Jalgaon civil hospital for further management

Assessment of maternal and perinatal outcome in cases of prolonged pregnancy in a tertiary healthcare institute: a cross sectional observational study

Background: Prolonged pregnancy has always been regarded as a high‑risk condition because perinatal morbidity and mortality is known to rise. The interest in postdatism (just beyond expected date of delivery) has been recent and the management is controversial, more so with the advent of sonography providing information about placental aging and amount of amniotic fluid.  The aim of the present retrospective study was to analyze the outcome of pregnancies which crossed the expected date of delivery.Methods: The present study was a cross sectional observational study, conducted between April 2018 to September 2018, among 90 cases presented with post dated pregnancy under the department of obstetrics and gynecology, in a tertiary medical teaching institute in Maharashtra.Results: Maximum number of cases, i.e., 22.22% indications were meconium stained liquor with fetal distress, in 18.51% cases indications were failure of induction, in 22.22% indications were nonreactive NST, in 17.61% cases indications were CPD.Conclusions: It was concluded that prolonged pregnancy was associated with significant risk of perinatal complications such as fetal distress, meconium aspiration syndrome and IUGR

COST OF THERAPY INCURRED FOR TUBERCULOSIS PATIENTS RECEIVING DIRECTLY OBSERVED THERAPY (DOT)

Objective: To estimate the cost of therapy of tuberculosis patients registered under DOTS program in the treatment of tuberculosis.Methods: A prospective observational study was conducted over a period of nine months in the Pulmonary Department of Bharati hospital and Research centre, Pune. 97 patients registered under RNTCP between August 2014 and April 2015, were interviewed at two time points: one at the time of first hospital visit and second on the completion of treatment. During the interview, information relating to various costs such as direct (out of pocket) and indirect cost was collected.Results: The mean total cost for Pulmonary tuberculosis treatment was found to be/5474.7 ($85.4), Extra pulmonary was/10574.8 ($164.9) and Pulmonary and Extra pulmonary was/14638.5 ($228.3) respectively. Out of total cost the cost incurred by the patients for the hospital stay and diagnosis (i.e. tuberculosis detection) has the maximum expenditure cost which was 90.4 % for pulmonary tuberculosis, 77.2% extra pulmonary and 72.5% pulmonary and extra pulmonary. About 39.2 % of patients and their care takers lost work days. 52.0% pulmonary patients, 68.4% extra-pulmonary and 66.7 % pulmonary and extra-pulmonary patients had decreased earning ability due to illness. Conclusion: The maximum cost is incurred for diagnosis and hospital stay in tuberculosis patients. Though DOTS strategy can help to reduce cost, achieve effective cure and save life of TB patients, still patients need to spend for other investigations and other drugs.Â

Cell population structure prior to bifurcation predicts efficiency of directed differentiation in human induced pluripotent cells.

Steering the differentiation of induced pluripotent stem cells (iPSCs) toward specific cell types is crucial for patient-specific disease modeling and drug testing. This effort requires the capacity to predict and control when and how multipotent progenitor cells commit to the desired cell fate. Cell fate commitment represents a critical state transition or tipping point at which complex systems undergo a sudden qualitative shift. To characterize such transitions during iPSC to cardiomyocyte differentiation, we analyzed the gene expression patterns of 96 developmental genes at single-cell resolution. We identified a bifurcation event early in the trajectory when a primitive streak-like cell population segregated into the mesodermal and endodermal lineages. Before this branching point, we could detect the signature of an imminent critical transition: increase in cell heterogeneity and coordination of gene expression. Correlation analysis of gene expression profiles at the tipping point indicates transcription factors that drive the state transition toward each alternative cell fate and their relationships with specific phenotypic readouts. The latter helps us to facilitate small molecule screening for differentiation efficiency. To this end, we set up an analysis of cell population structure at the tipping point after systematic variation of the protocol to bias the differentiation toward mesodermal or endodermal cell lineage. We were able to predict the proportion of cardiomyocytes many days before cells manifest the differentiated phenotype. The analysis of cell populations undergoing a critical state transition thus affords a tool to forecast cell fate outcomes and can be used to optimize differentiation protocols to obtain desired cell populations

Routinely collected data for randomized trials: promises, barriers, and implications

This work was supported by Stiftung Institut für klinische Epidemiologie. The Meta-Research Innovation Center at Stanford University is funded by a grant from the Laura and John Arnold Foundation. The funders had no role in design and conduct of the study; the collection, management, analysis, or interpretation of the data; or the preparation, review, or approval of the manuscript or its submission for publication.Peer reviewedPublisher PD

Computational Prediction of Intronic microRNA Targets using Host Gene Expression Reveals Novel Regulatory Mechanisms

Approximately half of known human miRNAs are located in the introns of protein coding genes. Some of these intronic miRNAs are only expressed when their host gene is and, as such, their steady state expression levels are highly correlated with those of the host gene's mRNA. Recently host gene expression levels have been used to predict the targets of intronic miRNAs by identifying other mRNAs that they have consistent negative correlation with. This is a potentially powerful approach because it allows a large number of expression profiling studies to be used but needs refinement because mRNAs can be targeted by multiple miRNAs and not all intronic miRNAs are co-expressed with their host genes

Good documentation practice in clinical research

One of the most common inspection findings in investigator site inspections is lack of reliable, accurate and adequate source documentation. This also happens to be the most common pitfall identified during sponsor audits. The importance of good documentation practice needs to be emphasized to investigator sites to ensure that the study results are built on the foundation of credible and valid data. This article focuses on the key principles of good documentation practice and offers suggestions for improvement

Wind Turbines on Amtrak Trains and on Sides of Expressways

Our SLX pitch aims to generate clean energy from the wind produced by vehicles traveling at high-speeds. While vehicles are traveling, they create apparent wind which can be converted into clean,and sustainable energy by utilizing miniature wind turbines attached to the sides of expressways. A different version of our wind turbines could be attached to Amtrak trains, allowing them to also harness green energy. This energy could be used to power the cabin, or to charge a battery. Trains consume a lot of energy and vehicles omit a large amount of pollution. Our mission is to offset this consumption of energy and carbon emissions in an attempt to make transportation more sustainable. With the addition of our product, we can take a step forward to a greener future and community