Study of fetomaternal outcome in emergency peripartum hysterectomy at pannadhay zanana hospital, Udaipur, India

Background: Peripartum or obstetric hysterectomy is the removal of the corpus uteri alone or with the cervix at the time of a caesarean section or shortly after a vaginal delivery. On one hand, it is the last resort to save a woman's life and on the other hand, her reproductive capability is sacrificed. Many times it is a very difficult decision and requires good clinical judgment. Most of the time the operation is carried out when the condition of patient is too critical to withstand the risks of anesthesia or surgery, but proper timing and meticulous care may reduce or prevent maternal complications. Methods: The study is prospective study and was conducted on cases of peripartum emergency hysterectomy performed at PDZH, Udaipur, during the period from April 2021 to October 2022. Results: Our study depicts following results on the basis of 31498 deliveries during the study period (April 2021 to October 2022), so the overall incidence of peripartum hysterectomy is 1 in 1049 (0.095%). Incidence of hysterectomy following vaginal delivery found to be 0.15%, whereas following caesarean incidence found to be 0.24%. Conclusions: Increase in caesarean section rates may lead to a rise in the number of peripartum hysterectomies required in the future because of increased chances of scar dehiscence and morbidly adherent placenta and Thus, there is a need for institutions to reassess their indication for first caesarean section to decrease the incidence of caesarean sections.

Study of maternal and perinatal outcome in twin pregnancy at a tertiary care hospital

Background: Twin pregnancy refers to the presence of two fetuses in the uterus. The phenomenon of twinning has fascinated mankind throughout its recorded history. The major problems occurring in twin pregnancy are prematurity, Lbw, IUGR, birth trauma, birth asphyxia and congenital anomalies. The most serious risk is preterm delivery, which accounts for most of the increased perinatal mortality, neonatal morbidity, and long-term morbidity of twins. Methods: This prospective observational study included analysis of 250 women with twin pregnancies, over a period from 01st November 2021 to 31st October 2022 with 28 completed weeks of gestation, admitted at PDMC, Udaipur, Rajasthan. Results: In our study 250 twin pregnancies delivered Out of total 15209 deliveries were studied in our institute. incidence of twin pregnancy was 1.64%. The majority of study participants were in the age group 20 to 29 year and delivered between the gestation age 34-37week, multigravida was 51.2% and in primi it was 48.8%. The 4% patients underwent caesarean section and 48% delivered by vaginal delivery. Conclusions: Twin pregnancy is a great challenge to the concerned obstetricians. Complications associated with twin pregnancies cannot be prevented but can be detected early and controlled adequately by proper and prompt management. Timely diagnosis and treatment of nutritional anaemia and pre-eclampsia helps in preventing additional complications. Hence the need for better obstetric care, neonatal care, health services to get a better fruitful outcome

PersonaSAGE: A Multi-Persona Graph Neural Network

Graph Neural Networks (GNNs) have become increasingly important in recent years due to their state-of-the-art performance on many important downstream applications. Existing GNNs have mostly focused on learning a single node representation, despite that a node often exhibits polysemous behavior in different contexts. In this work, we develop a persona-based graph neural network framework called PersonaSAGE that learns multiple persona-based embeddings for each node in the graph. Such disentangled representations are more interpretable and useful than a single embedding. Furthermore, PersonaSAGE learns the appropriate set of persona embeddings for each node in the graph, and every node can have a different number of assigned persona embeddings. The framework is flexible enough and the general design helps in the wide applicability of the learned embeddings to suit the domain. We utilize publicly available benchmark datasets to evaluate our approach and against a variety of baselines. The experiments demonstrate the effectiveness of PersonaSAGE for a variety of important tasks including link prediction where we achieve an average gain of 15% while remaining competitive for node classification. Finally, we also demonstrate the utility of PersonaSAGE with a case study for personalized recommendation of different entity types in a data management platform.Comment: 10 pages, 6 figures, 7 table

A Study to Assess the Knowledge and Practice Regarding Cardiopulmonary Resuscitation Among Nursing Students of Agra, Uttarpradesh

Background: Cardiopulmonary resuscitation (CPR) is a life-saving operation performed in an emergency when the heart stops beating. Immediate CPR following a cardiac arrest can double or triple the odds of survival. The American Heart Association welcomes you to join us in our vision of a future without cardiac arrest. In the United States, 350,000 individuals die from cardiac arrest each year. CPR keeps the blood pumping and the body supplied with oxygen until specialized treatment is available. There is normally enough oxygen left in the blood to support the brain and other organs for a few minutes. Objective: To assess the knowledge and practice regarding cardiopulmonary resuscitation among diploma nursing students. Methods: Descriptive research design was used. This study included 60 students. Knowledge and practice checklist was used to assess the knowledge and practice and chi-square test used to see the association between dependent and independent variables. Result: In this study, level of knowledge regarding cardiopulmonary resuscitation pretest level poor knowledge 23(38.3%), poor knowledge 19(31.7%) and good knowledge 18(30%) . level of skills regarding cardiopulmonary resuscitation pretest level skills 60(100%) poor skills 0(0.0%) good skills. Age, Gender, religion, Course of study, Family history of cardiac disease, Aware about cardio pulmonary resuscitation, source of information regarding cardio pulmonary resuscitation, Classes on cardio pulmonary resuscitation within the last 6 months had shown no statistically significant association with the pretest levels of skills regarding cardio pulmonary resuscitation among students. Conclusion: Despite the fact that more than half of students had good knowledge, so students required proper skill development about cardio pulmonary resuscitation

Financial Management Strategies for Sustainable Farming Practices

This paper delves into the multifaceted realm of sustainable farming, offering a holistic view of its definition, significance, and the manifold benefits it brings to the agricultural landscape. Sustainable farming represents a paradigm shift in agriculture, emphasizing environmental responsibility, societal well-being, and economic viability. The benefits it offers span across the realms of environmental conservation, social equity, and financial sustainability, making it a compelling and pressing approach for modern farmers. The financial fundamentals of sustainable farming are explored, covering crucial aspects such as budgeting, cash flow management, and the integration of sustainable technologies. Sound financial management is pivotal for ensuring that eco-friendly practices align with economic stability and long-term prosperity. Risk management is another cornerstone, with a focus on identifying and mitigating potential threats, as well as the role of insurance and hedging in safeguarding farming operations. Access to capital is addressed from both traditional and alternative sources, highlighting the significance of financial support for the adoption of sustainable practices. Record-keeping and financial analysis are essential tools for farmers, facilitating informed decision-making, performance tracking, and the adaptability of strategies to achieve maximum sustainability benefits. Study underscores the pivotal role of government support, encapsulating policies, incentives, and tax benefits designed to encourage sustainable farming practices and compliance with regulatory standards. By adhering to these guidelines, farmers not only contribute to environmental conservation but also secure their economic future

Spin-state driven ferromagnetic and spin glass states in layered LaSrCoO4_4

Famous for its spin-state puzzle, LaSrCoO$_4$ (Co$^{3+}$) is an intermediate between antiferromagnetic (AFM) La$_2$CoO$_4$ (Co$^{2+}$) and ferromagnetic (FM) Sr$_2$CoO$_4$ (Co$^{4+}$). The appearance of the Co$^{3+}$ valence state (not present in the end compounds) is intriguing because of the spin-state transitions associated with it. In this work, we report two magnetic transitions in LaSrCoO$_4$: (i) a transition at T $=$ T$_c$ $\simeq$ 225 K, from the paramagnetic state to a state with an inhomogeneous long-range ferromagnetic (FM) order wherein finite FM clusters coexist with infinite FM matrix in the percolation sense, and (ii) the transition to the cluster spin glass (CSG) state at T $=$ T$_g$ $\simeq$ 8 K. Finite FM clusters (which at low temperatures give rise to the cluster spin glass state) and infinite FM matrix are formed due to the spin-spin interactions brought about by the inhomogeneously distributed Co$^{3+}$ high spin (HS) and Co$^{3+}$ low spin (LS) ions. A firm support to the presence of an unconventional (inhomogeneous) ferromagnetic order comes from the anomalous values of the critical exponents $\beta$, $\gamma$ and $\delta$ for the spontaneous magnetization, `zero-field' magnetic susceptibility and the critical M - H isotherm, while the coexistence of HS Co$^{3+}$ and LS Co$^{3+}$ ions is confirmed by the results of the extended X-ray absorption fine structure spectroscopy.Comment: 18 pages, 6 figure

Epidemiology and Clinicopathological Profile of Renal Cell Carcinoma: A Review from Tertiary Care Referral Centre

Renal cell carcinoma (RCC) accounts for 3% of all adult cancers and 85% of all kidney tumours. Incidence of RCC is lower in Asian region, particularly in India, probably due to lack of reporting. Most of the data about RCC are from Western countries; and data from India are scarce, especially regarding para-neoplastic syndromes. We sought to determine the epidemiology, clinicopathological profile and management of RCCin a tertiary care centre in Western India. This was a retrospective study that involved data analysis of records of RCC patients who presented to our institution from April 2016 to February 2020. Laboratory investigations, including tests for paraneoplastic syndrome (PNS), and relevant radiologic investigations were performed and treatment was offered according to the stage, patient factors and available modalities. A total 142 RCC patients were included in the study. The median age of presentation was 58 years. Most of the patients (67%) were symptomatic, and 33% of the patients were asymptomatic, and the RCC was diagnosed incidentally. A large number of patients (56.3%) had PNS. The most common histopathologic type of RCC was clear cell carcinoma (68.8%), followed by papillary (20%) and chromophobe (8%) carcinoma. 40% of carcinomas with sarcomatoid differentiation were seen in patients under 50 years of age. Two cases of multicystic RCC were both seen in patients less than 50 years of age. 65.5% of the patients presented at Stage 1 and 2. Most surgeries (71.2%) were done in a minimally invasive manner. A significant number of patients were asymptomatic, in which RCC was detected incidentally. The age of presentation was earlier, yet the patients had a higher tumour stage. More than half of the patients had PNSs. Despite growing trend towards Western data, the significantly higher number of patients with PNSs and early age of presentation suggest inherent differences in tumour biology, possibly related to differences in genetic and environmental factors

Exploring the impact of salinity on citrus (Citrus spp.) rootstock seed germination and seedling biomass

An experiment was conducted at the screen house of the Department of Horticulture, CCS Haryana Agricultural University, Hisar, Haryana during 2018–19 and 2019–20 to assess the impact of 5 different salinity levels [0.07 (control), 2.5, 4.0, 5.5, and 7.0 dS/m] on the seed germination and biomass of 9 citrus (Citrus spp.) rootstock seedlings (Rough lemon, Pectinifera, Cleopatra mandarin, Rangpur lime, Alemow, Volkamer lemon, NRCC-4, NRCC-3 and CRH-12). Experiment consisted of 45 treatment combinations and 3 replications in a completely randomized design (CRD). Under the influence of soil salinity, the number of days taken for seed germination, seed germination percentage, fresh and dry root and shoot biomass were adversely affected across all rootstocks compared to the control treatment (0.07 dS/m). Among the tested rootstocks, Volkamer lemon exhibited the highest seed germination rate (57%), followed by Rangpur lime (53%) and CRH-12 (50%). Conversely, Pectinifera showed the lowest seed germination percentage (37%), followed by Alemow (43%) at 7 dS/m. The minimum reduction at 7 dS/m over control in fresh shoot and root and dry shoot and root biomass was observed in Rangpur lime (37.7, 16.2, 27.8 and 27.3%, respectively), followed by Volkamer lemon (38.0, 16.2, 28.3 and 28.5%, respectively). On the other hand, Pectinifera exhibited the highest reduction in biomass (51.9, 40.5, 47.0 and 43.9%, respectively), followed by Alemow (45.7, 30.9, 46.5 and 39.9%, respectively). Among all the rootstocks, Rangpur lime, Volkamer lemon and Cleopatra mandarin displayed better tolerance to salinity, exhibiting relatively lower reduction in biomass at the highest salinity level (7 dS/m) compared to the control. Cleopatra mandarin, Rough lemon and NRCC-3 showed a moderate response, while Pectinifera, NRCC-4, and Alemow were found to be less tolerant, exhibiting higher reduction in terms of count of seed germination days, seed germination percentage, fresh and dry root biomass, and shoot biomass at 7 dS/m compared to the control treatment

Latent HIV in primary T lymphocytes is unresponsive to histone deacetylase inhibitors

Recently, there is considerable interest in the field of anti-HIV therapy to identify and develop chromatin-modifying histone deacetylase (HDAC) inhibitors that can effectively reactivate latent HIV in patients. The hope is that this would help eliminate cells harboring latent HIV and achieve an eventual cure of the virus. However, how effectively these drugs can stimulate latent HIVs in quiescent primary CD4 T cells, despite their relevant potencies demonstrated in cell line models of HIV latency, is not clear. Here, we show that the HDAC inhibitors valproic acid (VPA) and trichostatin A (TSA) are unable to reactivate HIV in latently infected primary CD4 T cells generated in the H80 co-culture system. This raises a concern that the drugs inhibiting HDAC function alone might not be sufficient for stimulating latent HIV in resting CD4 T cells in patients and not achieve any anticipated reduction in the pool of latent reservoirs