Bystanders or Not? Microglia and Lymphocytes in Aging and Stroke

As the average age of the world population increases, more people will face debilitating aging-associated conditions, including dementia and stroke. Not only does the incidence of these conditions increase with age, but the recovery afterward is often worse in older patients. Researchers and health professionals must unveil and understand the factors behind age-associated diseases to develop a therapy for older patients. Aging causes profound changes in the immune system including the activation of microglia in the brain. Activated microglia promote T lymphocyte transmigration leading to an increase in neuroinflammation, white matter damage, and cognitive impairment in both older humans and rodents. The presence of T and B lymphocytes is observed in the aged brain and correlates with worse stroke outcomes. Preclinical strategies in stroke target either microglia or the lymphocytes or the communications between them to promote functional recovery in aged subjects. In this review, we examine the role of the microglia and T and B lymphocytes in aging and how they contribute to cognitive impairment. Additionally, we provide an important update on the contribution of these cells and their interactions in preclinical aged stroke

Bystanders or Not? Microglia and Lymphocytes in Aging and Stroke

As the average age of the world population increases, more people will face debilitating aging-associated conditions, including dementia and stroke. Not only does the incidence of these conditions increase with age, but the recovery afterward is often worse in older patients. Researchers and health professionals must unveil and understand the factors behind age-associated diseases to develop a therapy for older patients. Aging causes profound changes in the immune system including the activation of microglia in the brain. Activated microglia promote T lymphocyte transmigration leading to an increase in neuroinflammation, white matter damage, and cognitive impairment in both older humans and rodents. The presence of T and B lymphocytes is observed in the aged brain and correlates with worse stroke outcomes. Preclinical strategies in stroke target either microglia or the lymphocytes or the communications between them to promote functional recovery in aged subjects. In this review, we examine the role of the microglia and T and B lymphocytes in aging and how they contribute to cognitive impairment. Additionally, we provide an important update on the contribution of these cells and their interactions in preclinical aged stroke

To study the feto-maternal outcome in cases with previous surgical intervention for first trimester abortion on subsequent pregnancy and to compare with cases without history of previous abortion

Background: To study the Feto-maternal outcome in cases with previous surgical intervention for first trimester abortion on subsequent pregnancy and to compare with cases without history of previous abortion.Methods: A cross sectional observational study was conducted over a period of two years. Study included 80 consenting females at 28 weeks POG. Females with history of prior surgical abortion just before the present pregnancy were included as cases (n=40) and rest as controls (n=40). Detailed obstetric history was taken, subjects were then followed till delivery and feto-maternal outcomes such as period of gestation, mode of delivery birth weight, Apgar score, increased NICU stay at the time of delivery were recorded and analyzed.Results: We observed that the women with history of induced surgical abortion were at increased risk of Pre term birth (52.5%, p value0.006), Cesarean section (40%, p value 0.012), Low birth weight (47.5%, p value <0.001), increased NICU stay (32.5%, p value 0.027) compared to primi-gravida controls.Conclusions: We concluded that women with previous history of induced surgical abortions were at increased risk of preterm birth, very preterm birth and low birth weight babies, NICU stay in the subsequent pregnancies. The risk of caesarean was found to be increased in women with previous induced abortions exposing the women to the morbidity associated with the C-section. Hence patient with prior history of surgical first trimester abortion needs more vigilant monitoring during antenatal period in subsequent pregnancy

Comparative evaluation of artificial rupture of membranes and spontaneous rupture of membranes on course of labour and feto-maternal outcomes

Background: Present study was undertaken to do a comparative evaluation of artificial rupture of membrane (ARM) and spontaneous rupture of membrane (SRM) on the course of labour and feto-maternal outcome.Methods: It was prospective interventional randomized comparative study including 120 primigravidae (60 in ARM and SRM group each) with cervical dilatation ≥3 cm and intact membranes. Amniotomy was performed in ARM group after enrolment while no intervention in SRM group. Outcomes noted were duration of labor, mode of delivery, APGAR score, NICU stay.Results: Significant reduction seen in duration of labour in ARM group (p=0.0001). Mean duration of labor was 5.24 hours in ARM group while 6.94 hours in SRM group. No significant difference noted in mode of delivery (p=0.082). No significant adverse feto-maternal outcomes were seen with amniotomy. APGAR score and NICU admission had no significant difference among the two groups.Conclusions: ARM can be opted as an intervention with shorter duration of labour without adversely affecting the feto-maternal outcomes. It is safe, reliable and cost effective modality when employed in primigravida and may be considered as a low-cost accessible intervention to reduce prolonged labour and its associated complications.

NEED FOR ANTI-LITTERING LEGISLATION IN INDIA

Littering is one of the most pervasive social issues and yet subconsciously one of the accepted habits. The disappointment emerging from continuous failure in maintaining spick and span public spaces led to the writing of this paper. Further, the amount of litter only seems to rise despite all the furor about sustainability and preservation of the environment. The paper takes into account the various provisions adopted in certain parts of India and other countries, with regard to environmental conservation and ensuring cleanliness. It offers the solution to the issue of omnipresent litter in the form of an Anti-Littering Law. This paper seeks to elaborate on the dire need to have an anti-littering law and the chain of positive change that it will set in motion. Suggestions are being made in the paper by furnishing provisions of Anti-Littering Legislation. It aims to offer practical and tangible solutions to the litter problem

Lactate dehydrogenase levels in preeclampsia and its correlation with maternal and perinatal outcome

Background: Hypertensive disorder of pregnancy occurs in approximately 6-8% of all pregnancies. The most serious consequences for the mother and the baby are the result of preeclampsia and eclampsia. Lactate Dehydrogenase (LDH) is an intracellular enzyme. Recently LDH has been suggested as potential marker to predict severity of pre-eclampsia. The objective of the present study was to compare the serum lactate dehydrogenase levels in women with preeclampsia and normal pregnant women and to correlate lactate dehydrogenase levels with maternal and perinatal outcome in preeclampsia.Methods: An observational prospective study was conducted on 200 antenatal women attending the labour room emergency. Women with singleton pregnancy and cephalic presentation, from 28 weeks onwards were enrolled in the study. Out of 200, 100 were normal pregnant women and 100 were preeclamptic women. Serum LDH levels were measured in all women and maternal and perinatal outcome was assessed in terms of LDH levels.Results: Higher levels of LDH was observed in pregnant women with preeclampsia (627.38±230.04 IU/l) as compared to normal pregnant women (224.43±116.61 IU/l). The maternal complications were found to be maximum in women with LDH > 800 IU/l.  Abruption was the most common complication. The perinatal mortality and neonatal deaths were found to have significant correlation with high LDH levels.Conclusions: Maternal and perinatal complications were associated with higher LDH levels in preeclampsia patients. Serum LDH levels can be offered to all patients of preeclampsia and can be used to predict the prognosis of preeclampsia

Early induction versus expectant management in prelabour rupture of membranes

Background: Prelabour rupture of membrane defined as spontaneous rupture of membrane prior to the onset of regular uterine contractions. The incidence of PROM varies from 6-18%. Management of term PROM is not having specific guidelines leading to management dilemma.Methods: This prospective study was conducted on 100 women with singleton pregnancy, cephalic presentation with spontaneous PROM at term. The aim to compare maternal and perinatal outcome of early induction with expectant management in women with PROM. The patients were divided into two group expectant group and early induction group. Induction of labour was done by PGE2 gel and expectant group patient were observed for 24 hours for spontaneous labour since leaking. Augmentation of labour was done with Oxytocin if required. Outcomes were measured as PROM to delivery interval, induction to delivery interval, mode of delivery, maternal and neonatal morbidity.Results: Eighty percent of women of expectant group went into active labour within 24 hours, and all patient of induction group went into active labour in 18 hours (p<0.001). ROM to active labour interval and ROM to delivery interval were significantly less in early induction group, (9.87 and 17.212 hour) compared to expectant group (19.118 and 23.34-hour, p<0.001). Fetal distress and LSCS were comparatively higher in induction group (16%vs 2% p=0.038). Neonatal Sepsis was seen more in expectant group but statistically insignificant (22% versus 16%, p=0.26).Conclusions: Women with term PROM can be given informed choice of expectant management and early induction explaining the merits and demerits of both options

Clinical study of ectopic pregnancy at tertiary care center in Haryana, India

Background: Ectopic pregnancy is a life threatening condition in the first trimester of pregnancy. Diagnosis can be done by clinical examination, serum β-HCG and ultrasonography. This retrospective study was done to know the incidence, risk factors, and management of ectopic pregnancy.Methods: It was a retrospective study conducted on 75 patients of ectopic pregnancy admitted at tertiary care hospital in Haryana from February-2017 to January-2019. Data collected from record room and analysis done.Results: Total deliveries were conducted were 5064. The incidence of ectopic pregnancy was 1.48%, majority of the women were in the age group of 21-30 (68%), multi-parous (77.32%). The most common risk factor was abortion 33.33%, f/b tubal ligation was 13.13%, medical management of ectopic pregnancy done in 30.66%, 8% were managed by laproscopically and 58.66% by laparotomy.Conclusions: Safe sexual practices can reduce pelvic infections and ectopic pregnancy incidences. Early diagnosis before tubal rupture can reduce morbidity and mortality in ectopic pregnancy

Wood-based construction project supplier selection under uncertain starting date

There is a growing interest in supply management systems in today's competitive business environment. Importance of implementing supply management systems especially in home construction industry is due to the fact that several risks arising from different sources can adversely affect the project financially or its timely completion. Some risks of construction projects are out of managers' control while other risks such as supply related ones can usually be controlled and directed by effective managerial tactics. In this paper, we address the supplier selection problem (SSP) in wood-based construction industry (housing projects) in the presence of project commencement uncertainties. Based on the suppliers' (vendors') reaction towards these uncertainties in the delivery time, we explore two cases: (a) supplier selection with buyer penalty for a delay (SSPD) where the price of product increases with the delay; (b) supplier selection with quantity reduction for a buyer delay (SSQRD). Three heuristic-based supplier selection approaches are proposed and tested on randomly generated data sets. The proposed approaches show promising result