A study of various neonatal outcomes and complications in live-born infants among IVF pregnancies

Background: In-vitro fertilization or Assisted reproductive techniques (ART) is the most advanced technique of infertility treatment. In-vitro fertilization (IVF) has helped couples all over the world. However, the use of IVF has raised significant concern about the outcome of resulting pregnancies and the health of the newborns. There is a range of possible factors associated with the treatment that may contribute to potential adverse outcomes. Thus, the study was conducted to analyze the neonatal outcomes of children born by ART in the Indian context.Methods: The neonatal characteristics and complications of the live-born infants through IVF at Army Hospital R and R were analyzed in this study between March 2019 to February 2020.Results: Total 231 babies were born to the study group cases. 126 (54.54%) were singletons, 102 (44.16%) were of twin pregnancies and 1.3% were triplets. There were 65.36% term and 34.63% preterm. Of the 231 IVF neonates, 58 needed neonatal intensive care. There were 219 (94.8%) survivors, while 12 (5.2%) did not survive a week. The 16 (6.92%) survivors needed readmissions mainly due to hyperbilirubinemia. There were 106 (45.8%) babies whose weight was less than 2 kg.Conclusions: Infertility cases are usually older, and this is one reason for increased pregnancy and newborn infant complications. Neonates born through IVF appeared to be at higher risk of multiple births, prematurity, low birth weight, and other disabilities

Trends of ectopic pregnancies in Andaman and Nicobar Islands

Background: Ectopic Pregnancy is a common life threatening emergency in the first trimester of pregnancy. Increase in incidence and impairment in fertility are the major concerns. The present study was undertaken to determine the incidence, clinical presentation, risk factors, diagnosis, management, maternal morbidity and mortality due to ectopic pregnancy in a tertiary care hospital.Methods: This cross-sectional, descriptive study was done over a period from January 2014 to October 2016. A total of 73 cases were admitted with the diagnosis of ectopic pregnancy. The following parameters: age, parity, risk factors, gestational age, clinical presentation, investigations, findings at surgery, morbidity and mortality associated with ectopic pregnancy was noted.Results: The incidence of ectopic pregnancy was 0.89%. The peak age of incidence was 25 to 34 years. Multiparous women were the most sufferers. Amenorrhea (93.15%), abdominal pain (87.67%) and vaginal bleeding (64.38%) were the frequent presenting complaints. Pelvic inflammatory disease (32.87%), history of previous caesarean section (26.02%) and history of abortion (13.69%) were the important risk factors. There were 90.41% patients with hemoglobin level less than 10 gm/dl, 8.21% of patients admitted with feature of shock. Majority (90.41%) of the cases were diagnosed through history and clinical examination. The commonest site of ectopic pregnancy was the ampulla (52.94%). Surgery by open method in the form of salpingectomy (72.05%) was the mainstay of treatment. Medical management was possible only in five cases. Morbidity included anemia (97.05%), urinary tract infections (11.76%) and wound infection (4.41%). No maternal mortality noted.Conclusions: Early presentation, high index of suspicion, early referral and timely intervention in the form of conservative or surgical treatment is the key to successful management of ectopic pregnancy

Foetomaternal Outcome in Pregnancy with Burn Injury: A Prospective Cohort Study

Introduction: Pregnancy is a state of an altered physiological process, and a burn injury during pregnancy, serves as an additive factor to this stressful state, such that it can directly or indirectly affect the feto-maternal outcome. Aim: To find out the effects of burn injury in pregnant females, in terms of maternal and foetal outcomes. Materials and Methods: This was a prospective cohort study, done in collaboration with the Department of Surgery at Rajashri Dashrath Autonomous State Medical College, Ayodhya, Uttar Pradesh, India, from September 2019 to November 2021, on 22 pregnant patients. All 22 confirmed cases of pregnancy with burn injury were included. Cases were evaluated in terms of age-wise distribution, parity, gestational age/ trimester of pregnancy, cause of burn injury, Total Body Surface Area (TBSA) distribution, the relation of TBSA distribution with foetal and maternal mortality, and events associated with the burn injury. Data was analysed using trial version of Statistical Package for Social Sciences (SPSS) version 22.0. Results: Mean age of pregnant patients with burns was 25.22±2.3 years. Thirteen (59.09%) patients with burn injuries were married for one to three years, incidence was more in primigravidae 14 (63.63%). Domestic violence and suicide attempts accounted for 12 (54.54%) cases. Kerosene and gas explosions were a major cause of burn injury, that is 16 (72.72%)and 5 (22.72%) respectively. Sixteen (72.72%) patients had burns with TBSA between 31-50%. Foetal mortality was 15 (68.18%) and maternal mortality was 14 (63.63%). Conclusion: Feto-maternal outcome was directly related to TBSA involved in burns. Illiteracy, and cultural practices like the use of earthen lamps, wood, and charcoal used for cooking, were some of the important causes of burn injury

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

A Survey of Different Contract Signing Protocols

Abstract-- Today in the field of security there are various protocols and authentication techniques that make an application in the network more secure and free from various attacks in the network. There are various applications which require exchange of data between parties. A fair exchange is required since the chances of attacks have been greatly increased. Hence a new protocol has been implemented for the fair exchange of data between parties called contract signing protocol. Here in this paper a survey of the entire contract signing protocols that are implemented are given. I

Airway management in a patient of ankylosing spondylitis with traumatic cervical spine injury

Traumatic cervical lesions compressing the spinal cord pose a significant risk of exacerbating the existing neurological condition during tracheal intubation and subsequent positioning. Preexisting ankylosing spondylitis with spinal column involvement renders the spinal column more rigid and introduces difficulty in airway management of the patient with traumatic cervical spinal cord. To improve ease and success, and reduce cervical spine movement, awake fibreoptic intubation (FOI) is considered the gold standard technique for airway management in such cases. Attaining appropriate position for intubation was challenge in this case due to rigid curvature of the ankylosed spinal column. To prevent neurological injury to the spinal cord and preserve spinal cord function, minimizing movement during intubation and attaining appropriate position was of prime concern. Optimal sedation with self-positioning by the patient in a comfortable posture is quite imperative and assures both airway as well as neurological protection in such expected difficult situations. We report the use of dexmedetomidine for self-positioning and awake FOI in a patient with ankylosing spondylitis having traumatic cervical spine who was otherwise neither able to co-operative nor able to give appropriate position for FOI

Causatum in Adults up till 6 months after COVID-19 Infection: A longitudinal study

Background: According to Centers for Disease Control and Prevention (CDC), almost 10% of patients with COVID-19 infection experience symptoms beyond 3 to 4 weeks. This has been termed as “Long Covid”. Post-COVID conditions are a wide range of new, returning, or ongoing health problems people can experience more than four weeks after first being infected with the virus that causes COVID-19. Even people who did not have symptoms when they were infected can have post-COVID conditions. These conditions can have different types and combinations of health problems for different lengths of time. Material and Methods: A longitudinal prospective cohort study was conducted in adults between 18-70 years of age with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who presented at the dedicated COVID hospital associated with RajarshiDashrath Autonomous State Medical College, Ayodhya, Uttar Pradesh. COVID-19 symptom data were obtained at the time the patients presented at the hospital with symptoms or contact history. A total of 400 participants with experience of COVID-19 infection were contacted between August and November 2020 to complete a single follow-up questionnaire. Results: A total of 400 participants between 18- 70 years of age (mean age 46.0 years) with COVID-19 infection completed the survey. Out of these, 120 were females (30%) and remaining 280 (70%) were males. Overall, 43 (10.75%) were asymptomatic, 291 (72.75%) had mild and 66 (16.5%) had moderate or severe symptoms requiring hospitalization. The most common comorbidities (n=180) observed were Diabetes (n= 120, 66.67%), Hypertension (n=60, 33%), Chronic Obstructive Pulmonary Disease (COPD) (n=23, 13.0%), Asthma (n= 13, 7.0%), and Chronic Kidney Disease (n= 4, 2.0%). The follow up survey was completed at a median range of 169 (31-300) days after onset of symptoms in participants with COVID-19. The most common persistent symptoms reported were Fatigue (n=178, 44.5%), Dizziness on standing (n=22, 5.5%), Headache (n= 46, 11.5%), palpitations (n=49, 12.25%), cough (n=112, 28%), chest tightness (n= 59, 14.75%), difficulty in breathing (n= 77, 19.25%), myalgia (n=125, 31.25%), low grade fever (n= 100, 25.0%), loss of smell or taste (68, 17%) and diarrhoea (n=42,10.5%).Conclusion: This study aims at illustrating varied, unmanageable and unsure nature of long Covid shared by the recovered COVID-19 patients so that further work can be done to develop services to address these problems

Not Available

Not AvailableThe present study was undertaken to study the influence of sowing methods and mulching on soil salt dynamics and performance of fodder sorghum. Results showed that the application of saline water (4 irrigations with 6.0 dS/m EC), gradually increased the soil salinity in soil profile depth of 0-60 cm. The mean soil salinity in 0-60 cm soil increased by 127.2 per cent over normal irrigation water. Among the sowing methods, ridge and furrow sowing with alternate furrow irrigation recorded lowest salinity development in upper soil layers. The salinity was 36.4 and 49.1 per cent higher under two row raise beds as compared to ridge and furrow in upper 0-15 and 15-30 cm soil layers, respectively. Mulching with crop residue maintained lower levels of salinity over bare soil. Mulched soil had 24.8 per cent higher moisture content in 0-60 cm soil profile then un-mulched treatment. Irrigation with saline water significantly reduced the fodder yield of sorghum by 10.6 per cent as compared to irrigation with normal water. Sowing of fodder sorghum on two row raised beds recorded significantly highest fodder yield over flat bed and ridge and furrow sowing which was 8.2 per cent higher over flat bed sowing.Not Availabl