A comparative study of neonatal and maternal outcome between forceps delivery and vacuum extraction

Background: Aims and objectives of the study were to compare maternal and neonatal outcomes of forceps versus vacuum application in assisted vaginal delivery. Methods: This prospective study was conducted in a tertiary care hospital of West Bengal over one year. Women in labor with vertex presentation were delivered by vacuum and forceps. A total of 100 cases were included of which 50 patients selected for forceps delivery and 50 patients for vacuum extraction. The instruments were either silastic cup vacuum extractor or Wrigley`s outlet forceps. Maternal morbidity was studied in terms of cervical tears, vaginal lacerations, episiotomy extension, perineal tears, PPH, and retention of urine. Neonatal morbidity was studied in terms of Apgar score, instrumental injuries, cephalhematoma, NICU admission and the outcome was compared. Chi square test was used to analyze the data. Results: Observations maternal morbidity viz. episiotomy extension, traumatic PPH were significant in the forceps group (p=0.01). With regards to neonatal morbidity, SNCU admission were significantly higher in forceps delivery (p=0.02) and incidence of cephalohematomas were more in ventouse delivery (p=0.02). Conclusions: Vacuum and forceps should remain appropriate tools in the armamentarium of the modern obstetrician. However, ventouse may be chosen first (if there is no fetal distress) as it is significantly less likely to injure the mother.

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Regulation of Actin and Its mRNA by Thyroid Hormones in Cultures of Fetal Human Brain During Second Trimester of Gestation

The effect of thyroid hormones (TH5) on the expression of actin gene during fetal human brain development and the period of sensitivity to the hormones have been investigated. Developmental profile of actin in the cytoskeletal (CSK) and noncytoskeletal (non-CSK) fractions in the fetal cerebra showed a pronounced rise in the level of CSK actin at weeks 17—19. Northern blot analysis also revealed a sharp rise in the level of actin mRNA at weeks 16—18, temporally coinciding with the period of rise of THs and peak expression of TH receptors in the fetal brain. In organ cultures of weeks 13—23 fetal cerebra, THs elicited a general stimulation of CSK proteins at all ages studied with a preferential effect on actin at weeks 17—19. During this period, TH5 also stimulated the rate of synthesis of actin. Kinetics of induction of actin by TH in the non-CSK and CSKfractions in organ cultures of week 17 fetal cerebra showed an increased level of actin in both fractions within 1 h. Subsequently (at 5 and 18 h), induction was evident only in the insoluble CSK fraction, suggesting an effect of the hormone on the intracellular distribution of actin between the soluble non-CSK fraction and the insoluble CSKfraction. Correspondingly, in cultures of week 17 fetal cerebra, THs elicited an increase in actin mRNA level within 30 mm of hormonal exposure. The overall results suggest that THs regulate the expression of actin gene by stimulating the rate of synthesis as well as intracellular distribution of actin during the mid phase of the second trimester of gestation. Key Words: Thyroid hormone—Actin—Human fetal brain—Gene expression. and hearing or speech disabilities (Glorieux et al., 1983) apart from other mild to significant neurological abnormalities (Birrell et al., 1983; Rovet et al., 1984). However, little is known concerning the molecular events associated with the effect of THs in human brain development, because most of the experimental studies have been performed with prenatal or postnatal animals (Dussault and Ruel, 1987). Although the sequence of neurodevelopmental events is identical in rats and humans, the time spans of these events are quite different and much more prolonged in humans. High-affinity nuclear TH receptors as well as triiodothyronine (T3) appear in human fetal brain as early as week 11 of gestation, but their concentration undergoes a dramatic increase at midgestation during weeks 16—18 (Bernal and Pekonen, 1984; Karmarkar et al., 1990). Other evidence indicates that the critical event of neurite outgrowth and elongation, which leads to synaptogenesis in human brain, is also initiated during the second trimester of gestation (Delong, 1989; Stein et al., 1989; Ulfig, 1992). Earlier investigations with rat brain led to the identification of several target proteins such as actin (De et al., 1991), tubulin (Chaudhury et al., 1985), epidermal growth factor

Hemodynamic effects of propranolol with spironolactone in patients with variceal bleeds: A randomized controlled trial

AIM: To study the hemodynamic effects of spironolactone with propranolol vs propranolol alone in the secondary prophylaxis of variceal bleeding

Transport and magnetic properties of La(1-x)Ba(x)CoO(3)

We have systematically investigated transport, magnetic, and structural properties of La(1-x)Ba(x)CoO(3) in the range of doping 0<xless than or equal to0.55. In this system, the metal-insulator transition is observed to be coincident with the onset of ferromagnetic (FM) ordering at x=0.20. Well below Curie temperature T(C), rho exhibits T(2) behavior whereas over a temperature interval just below T(C), it shows T(4) dependence due to the scattering of charge carriers by magnetic fluctuations. For x<0.20, the low temperature magnetic property is dominated by a spin-glass- or cluster-glasslike phase. The role of ionic size mismatch on the above mentioned physical properties has also been investigated by partially substituting La with Nd and Ba with Sr for a fixed doping. A phase diagram, the dependence of transition temperatures on doping (x), has been constructed for La(1-x)Ba(x)CoO(3) from this study

Electro‐capillary filling in a microchannel under the influence of magnetic and electric fields

We numerically investigate the dynamics of two immiscible conductive fluids in a narrow fluidic channel under the combined influence of electric and magnetic fields using a diffuse interface based phase-field model. The numerical solver is validated from two different perspectives, viz., with the reported results of microscale multiphase transport as well as the available experimental results in the paradigm of electrically actuated transport. The magnetic field induces the Lorentz force due to its interaction with the electrical forcing, which in turn leads to complex interfacial dynamics and development of a finger-like interface front of the advancing fluid into the receding fluid. Under certain conditions studied in the present work, the trend reverses, and a finger of receding fluid is formed into the advancing fluid. The effect of contrast in fluid properties is studied and the interface breaking phenomenon is observed beyond a threshold viscosity contrast. It is found that for a given viscosity contrast between the fluids, an increase in the strength of the applied magnetic field prevents wetting failure

Protein kinase A linked phosphorylation mediates triiodothyronine induced actin gene expression in developing brain

In the developing rat cerebra, triiodothyronine (T<SUB>3</SUB>) stimulates actin mRNA by acting predominantly at the level of transcription whereas tubulin mRNA is enhanced primarily by post-transcriptional regulation. We report here that in primary cultures of rat cerebra, the T<SUB>3</SUB>-induced actin gene expression is mediated by phosphorylation events. Inhibition of protein kinase A (PKA), but not of protein kinase C (PKC) or tyrosine kinase, totally blocked the induction of actin mRNA by T<SUB>3</SUB>. Under identical conditions, induction of tubulin mRNA by T<SUB>3</SUB> was virtually unaffected by all the inhibitors. Activators of PKA, but not of PKC, potentiated the T<SUB>3</SUB>-induced actin gene expression, both at mRNA and protein level, by about 2-fold. In the absence of T<SUB>3</SUB>, neither the inhibitor nor the activator of PKA had any significant effect on this induction. The involvement of PKA in mediating the induction of actin mRNA by T<SUB>3</SUB> was confirmed by transfecting primary cultures of rat cerebra with an expression vector encoding the protein kinase A inhibitor which totally abolished the induction. T<SUB>3</SUB> is shown to enhance the phosphorylation of the thyroid hormone receptor, TRα , by about 2-fold but the level of phosphorylation of TRβ remained virtually unaffected

Electro‐capillary filling in a microchannel under the influence of magnetic and electric fields

We numerically investigate the dynamics of two immiscible conductive fluids in a narrow fluidic channel under the combined influence of electric and magnetic fields using a diffuse interface based phase-field model. The numerical solver is validated from two different perspectives, viz., with the reported results of microscale multiphase transport as well as the available experimental results in the paradigm of electrically actuated transport. The magnetic field induces the Lorentz force due to its interaction with the electrical forcing, which in turn leads to complex interfacial dynamics and development of a finger-like interface front of the advancing fluid into the receding fluid. Under certain conditions studied in the present work, the trend reverses, and a finger of receding fluid is formed into the advancing fluid. The effect of contrast in fluid properties is studied and the interface breaking phenomenon is observed beyond a threshold viscosity contrast. It is found that for a given viscosity contrast between the fluids, an increase in the strength of the applied magnetic field prevents wetting failure