Changing trends of prevalence and presentation of ectopic pregnancy cases admitted in DMCH

Background: An ectopic pregnancy occurs outside the uterus and is a relatively common condition among women of childbearing age. Most ectopic pregnancies occur in the Fallopian tube (so-called tubal pregnancies), but implantation can also occur in the cervix, ovaries, and abdomen. An ectopic pregnancy is a potential medical emergency, and, if not treated properly, can lead to death. The aim of the study was to evaluate the changing trends of prevalence and presentation of ectopic pregnancy cases admitted in DMCH. Methods: This study was undertaken among the patients admitted in the Department of Obstetrics and Gynecology, Dhaka Medical College Hospital during the period from October 2012 to March 2013. Clinical evaluation of cases of ectopic pregnancy in terms of sociodemographic factors, presentations, risk factors, examination findings, per operative findings and management offered to the patients. The period from Data was entered in MS Excel and Statistical analysis was done using SPSS-24. Results: Most of the patients were 20-30 years age group and mean age was 28.08±4.24 years. The frequency of ectopic pregnancy was 7.60%.  High incidence was found among 0-1 parity (48%) and from a lower socioeconomic status. Commonest presentation was lower abdominal pain (94%), amenorrhoea (100%), P/V bleeding (38%) and syncopal attack (48%). Most of the cases was without contraceptic coverage (60%). Previous history of abortion/MR (50%), history of pelvic infection (30%) and history of D&C (16%) constitute the main bulk of risk factors. Most of the patients managed by laparotomy followed by salpingectomy which is still the standard treatment in many cases. Conclusions: Study has found that previous abortions are major etiological factor for ectopic pregnancy than previous pelvic infection. Most of the patients were managed by laparotomy. The general public should be made aware the sign and symptoms of ectopic pregnancy. Proper and modern diagnostic tools and training program for these should be made available in all tertiary level hospital

Physical, Chemical, and Electrochemical Properties of Redox-Responsive Polybenzopyrrole as Electrode Material for Faradaic Energy Storage

Polybenzopyrrole (Pbp) is an emerging candidate for electrochemical energy conversion and storage. There is a need to develop synthesis strategies for this class of polymers that can help improve its overall properties and make it as suitable for energy storage applications as other well-studied polymers in this substance class, such as polyaniline and polypyrrole. In this study, by synthesizing Pbp in surfactant-supported acidic medium, we were able to show that the physicochemical and electrochemical properties of Pbp-based electrodes are strongly influenced by the respective polymerization conditions. Through appropriate optimization of various reaction parameters, a significant enhancement of the thermal stability (up to 549.9 °C) and the electrochemical properties could be achieved. A maximum specific capacitance of 166.0 ± 2.0 F g−1 with an excellent cycle stability of 87% after 5000 cycles at a current density of 1 A g−1 was achieved. In addition, a particularly high-power density of 2.75 kW kg−1 was obtained for this polybenzopyrrole, having a gravimetric energy density of 17 Wh kg−1. The results show that polybenzopyrroles are suitable candidates to compete with other conducting polymers as electrode materials for next-generation Faradaic supercapacitors. In addition, the results of the current study can also be easily applied to other systems and used for adaptations or new syntheses of advanced hybrid/composite Pbp-based electrode materials

Synthesis, Characterization and Electrochemical Performance of a Redox-Responsive Polybenzopyrrole@Nickel Oxide Nanocomposite for Robust and Efficient Faraday Energy Storage

A polybenzopyrrole@nickel oxide (Pbp@NiO) nanocomposite was synthesized by an oxidative chemical one-pot method and tested as an active material for hybrid electrodes in an electrochemical supercapattery device. The as-prepared composite material exhibits a desirable 3D cross-linked nanostructured morphology and a synergistic effect between the polymer and metal oxide, which improved both physical properties and electrochemical performance. The unprocessed material was characterized by X-ray diffraction, FTIR and UV–Vis spectroscopy, scanning electron microscopy/energy disperse X-ray analysis, and thermogravimetry. The nanocomposite material was deposited without a binder on gold current collectors and investigated for electrochemical behavior and performance in a symmetrical two- and three-electrode cell setup. A high specific capacity of up to 105 C g$^{-1}$ was obtained for the Pbp@NiO-based electrodes with a gravimetric energy density of 17.5 Wh kg$^{-1}$, a power density of 1,925 W kg$^{-1}$, and excellent stability over 10,000 cycles

Polyindole Embedded Nickel/Zinc Oxide Nanocomposites for High-Performance Energy Storage Applications

Conducting polymers integrated with metal oxides create opportunities for hybrid capacitive electrodes. In this work, we report a one-pot oxidative polymerization for the synthesis of integrated conductive polyindole/nickel oxide (PIn/NiO), polyindole/zinc oxide (PIn/ZnO), and polyindole/nickel oxide/zinc oxide (PNZ). The polymers were analyzed thoroughly for their composition and physical as well as chemical properties by X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), ultraviolet–visible spectroscopy (UV–Vis), and thermogravimetric analysis (TGA). The PIn and its composites were processed into electrodes, and their use in symmetrical supercapacitors in two- and three-electrode setups was evaluated by cyclic voltammetry (CV), galvanostatic discharge (GCD), and electrochemical impedance spectroscopy (EIS). The best electrochemical charge storage capability was found for the ternary PNZ composite. The high performance directly correlates with its uniformly shaped nanofibrous structure and high crystallinity. For instance, the symmetrical supercapacitor fabricated with PNZ hybrid electrodes shows a high specific capacitance of 310.9 F g$^{−1}$ at 0.5 A g$^{−1}$ with an energy density of 42.1 Wh kg$^{−1}$, a power density of 13.2 kW kg$^{−1}$, and a good cycling stability of 78.5% after 5000 cycles. This report presents new electrode materials for advanced supercapacitor technology based on these results

Emerging Horizons in Cancer Therapy: Illuminating the Potential of Photodynamic Therapy (PDT) For Enhanced Treatment Strategies

Photodynamic therapy (PDT) involves light activation, in presence of molecular oxygen, and certain dyes that are taken up by the target tissue. The therapy includes giving a photosensitizing drug to the target tissue, which accumulates and then exposing the tissue to a precise wavelength of light. The medicine is activated by the light and release reactive oxygen species that kill the target tissue. PDT is a medical treatment that treats specific illnesses by using light-sensitive medicines and particular light sources. The dyes used in the therapy are termed as photo sensitizers. The mechanism of interaction of the photo sensitizers and light along with the effects produced in the target tissue. Current status of clinical PDT is discussed along with the new photo sensitizers being used and their role in therapy. Despite the promising results of PDT, significant additional work is needed to bring this new modality of treatment into modern clinical practice. Improvements in the area of light source delivery, light dosimetry and computation of models of treatment are necessary to proper treatment delivery. The present work encompasses new insights on PDT to combat various types of cancer cells as a novel technique with its specific limitation and future aspects

Efficacy of 5-(2-aroyl)aryloxy methyl-2-phenyl-1,3,4-oxadiazoles as antibacterial and antifungal agents

Research and development of potent and effective antimicrobial agents represent one of the most important advances in therapeutics; the main aim of these efforts is not only control the serious infections, but also prevention and treatment of some infectious complications of other therapeutic modalities. A series of 5-(2-aroyl)aryloxy methyl-2-phenyl-1,3,4-oxadiazoles were screened for their antibacterial and antifungal activities. Anti-bacterial activity against B. cereus, S. aureus, B. subtilis, S. aureus (MRSA), E. aerogenes, M. luteus, K. pneumonia, P. aeruginosa, S. typhimurium, E. coli, paratyphi-B, P. vulgaris bacterial strains and anti-fungal activity against C. albicans, A.niger, F.solani, A.flavus, B.cinerea, C.krusei, M. pachydermatis, C.parapsilosis, F.moniliforme, C.gloeosporioides fungal strains were carried out. The bioassays indicated that most of the synthesized compounds showed potential antibacterial and anti-fungal activity

Zinc supplementation in male infertility

Background: Inferile males have been shown to have lower levels of seminal plasma zinc which have been associated with reduced levels of zinc in their blood. Supplementation improve semen parameters by improving zinc level in blood.  Objective: To fnd out whether zinc supplementation is effective in improving semen parameters in oligo­asthenozoospermic patients. Method: The study was carried out in the Infertility unit of the Dept of Obs & Gynae, BSMMU during the period of March 2011 to February 2012. Seventy five oligo-asthenozoospermic patients having no history of medical treatment were recruited for the study. The patients were divided into two groups by odd and even numbers. Odd numbers received tablet zinc 20 mg twice daily (Group A) and even numbers received placebo (Group B).Serum zinc level and seminal zinc level estimation were done by Graphite Furnace Atomic Absorption Spectropho­tometry and semen analysis was done according to WHO guidelines (1999). Data analysis was done using software SPSS (version 16) by applying ANOVA (PostHock) and Paired Student's 't' test. Results: Serum zinc level was low in oligo­zoospermic patients which showed significant improvement with zinc supplementation (A+ 197.83 mmol/1, P<0.01). Mean (±SD) seminal plasma zinc level showed significant improvement in group A following zinc supplementation (+942.39 mmol/L, P<0.001). The mean increase in sperm count, sperm motility, sperm rapid linear motility, sperm morphology in group A following zinc supplementation for 12 weeks was 14.83 million/ml (P<0.01), 16.30% (P<0.01), 11.96% (P<0.01), 4.26% (P<0.001) respectively, which was statistically significant. Conclusion: The study shows zinc deficiency affects sperm count, sperm motility, rapid linear motility and sperm morphology and with zinc supplementa­tion there can be significant improvement in semen parameters

Discovery of a highly active anticancer analogue of cardamonin that acts as an inducer of caspase-dependent apoptosis and modulator of the mTOR pathway

Nineteen analogues of cardamonin were semi-synthesized and tested against A549 and HK1 cell lines. The analogues were fully characterized via IR and NMR analyses, while compound 19 (a Cu (II) complex of cardamonin) was further characterized via HRMS, ELEMENTAL ANALYSIS, TGA and UV-VIS spectroscopy. Results of the MTS cell viability assay showed that several derivatives possessed cytotoxic activities that were several-fold more potent than cardamonin. Compound 19 was the most potent analogue possessing IC50 values of 13.2 µM and 0.7 µM against A549 and HK1 cells, corresponding to a 5- and 32-fold increase in activity, respectively. Furthermore, the active analogues, especially 19, have generally demonstrated lower toxicity towards normal MRC5 cells. SAR analysis showed the importance of the ketone and alkene groups for bioactivity, while substituting cardamonin’s phenolic groups with more polar moieties resulted in activity enhancement. As part of the SAR study and further exploration of chemical space, the effect of metal coordination on cytotoxicity was also investigated, but it was only possible to successfully obtain the Cu (II) complex of cardamonin (19), and results showed that the metal ion enhanced activity. 19 was also able to significantly inhibit the migration of A549 and HK1 cells. Further studies have shown that the most active analogue, 19, induced DNA damage resulting in G2/M-phase cell-cycle arrest in both cell lines. These events further led to the induction of apoptosis by 19 via caspase-3/7 and caspase-9 activation, PARP cleavage and downregulation of Mcl-1 expression. Finally, 19 inhibited the expression levels of p-mTOR and p-4EBP1. These data indicated that 19 exerted its anticancer activity, at least in part, via inhibition of the mTOR signalling pathway

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication