Post caesarean section complication and its management in Dhaka medical college hospital

Background: The increase in the rate of caesarian sections globally is intimately related to the development of the women access to this procedure when required. But it is still related to the indiscriminate use without medical indication. This has fulminated in the recent efforts to reduce these rates while incorporating the obstetric preferences of women. Objective of the current study was to find out the predisposing factors for caesarian complications and to observe its management pattern. Methods: This was a cross sectional observational and descriptive study performed in the department of obstetrics and gynecology, Dhaka medical college hospital, Dhaka from January2019 to June 2019. All mothers admitted for elective and emergency cesarean section were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 100 patients were finalized. A pre-tested, observation based, peer-reviewed data collection sheet was prepared before study. Data regarding clinical, biochemical and surgical profile were recorded. Results: The mean age of the respondents was 25.96±4.43 (age range: 17-39) years. Among 100 mothers, 59% underwent elective and 41% underwent emergency cesarean section. 67% had uneventful outcome after LSCS. Rest 33% had post cesarean section complications. Among them 33% mother who had complications, 19 (57.57%), 12 (36.36%), 10 (30.30%) and 8(24.24%) had wound gap, UTI, GIT complications and haemorrhage respectively. 3 (9.09%) each suffered from thromboembolic complications and septic thrombophlebitis. Only one (3.03%) experienced DIC. Out of 33 complicated cases; 27 (81.81%) required treatment with injection oxytocin, blood transfusion, condom catheterization and 10 (30.30%) required secondary closure. Among them 4 (12.12%) underwent mass closure and received antithrombotic drug. One (3.03%) each underwent excision sinus tract and re-laparotomy. Conclusions: Caesarean section complications can result in death or morbidity. Despite advances in technology and expertise, wound infection or wound gap remains the most common post-c-section complication. It is critical to successfully manage complications after cesarean section in order to reduce morbidity and mortality among mothers

Clinical study on the relationship of scar tenderness with scar integrity at repeat caesarean section

Background: Caesarean section is an operative process whereby the fetuses after the end of 28th weeks are delivered through an incision on the abdominal and uterine wall. This excludes delivery through an abdominal incision where the fetus lying free in the abdominal cavity following uterine rupture or in secondary abdominal pregnancy. The first operation carried out on a patient is referred to as an primary caesarean section. When the operation is carried out in subsequent pregnancies, it is referred to as repeat caesarean section. Caesarean section is used in cases where vaginal delivery is not either feasible or would impose undue risks on mother or baby. The aim of the study to assess the Relationship of Scar Tenderness with Scar Integrity at repeat caesarean section. Methods: This is an observational study. The study used to be carried out in the admitted patient’s Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh. The duration of the period from April 2017 to October 2017. Results: This study shows that the according to age of 50 Patients aged 20 to 35 years. Here out of 50 mothers the highest 23(46%) mothers belonged to 21-25 years age group. Subsequently, 15(30%), 9(18%), 2(4%) and 1(2%) belonged to 26-30 years, ≤20 years, 31-35 years and >35 years respectively. The mean age of the respondents was 23.16±5.79 (age range: 17-38) years. Conclusions: The scar complications are highly associated with the intensity of scar tenderness. Henceforth, it can be concluded here that scar tenderness is a vital factor responsible for scar complications.

Risk factors and complications in pregnancies associated with placenta previa among admitted cases in FMCH

Background: Placenta previa is a leading cause of antepartum haemorrhage. Placenta previa present a significant clinical problem and patients are at risk for significant haemorrhage, needing blood transfusion. The risks are increased in women with previous placenta previa, endometrial damage caused by DE and C, caesarean delivery, myomectomy, multiparity, alcohol cocaine use during pregnancy, smoking during pregnancy. Methods: Admitted patients were selected with convenience sampling type of non-probability sampling type of non-probability sampling technique. The primary end point was to determine the risk factors of placenta previa and its complications. The secondary end point was to determine maternal morbidity and mortality of placenta previa. Results: Incidence of placenta previa was 2.03% out of 2459 patients, 70% were associated with risk factors. Among them 42% had history of caesarean section, 14% had history of abortion, 10% had history of manual removal, 48% patients were more than 25% years old, 36% were more than 30 years. Placenta previa occurred in gravida 3rd or more. Forty two percent patients belonged to lower socioeconomics group. Only 12% patients had regular antenatal checkup. Malpresentations were present in 24% cases. In this study 50% patients were associated with central placenta previa. Eighty percent patients were in shock, only 2% patients were asymptomatic. Regarding management 76.34% patients were managed actively, 12% patients had expectant management. Only 2% patients delivered vaginally, 82% patients delivered by caesarean section. Maternal mortality rate was 02%. Regarding fetal outcome, 76% babies were alive and there were 20% perinatal deaths. Conclusions: Although etiology of placenta previa largely remain obscure and speculative. There is a strong association between advanced maternal age, multiparity, history of caesarean section and abortion with subsequent development of placenta previa. Women aged >30 years, grand multipara, previa and must be monitored carefully. Hence the study advocates proper antenatal care early referral to hospital and prompt management of patients after proper selection can reduce maternal morbidity and mortality

Hepatorenal protective action of Spirulina platensis against beryllium induced hepatorenal dysfunction and histopathological alterations in rats

23-32Beryllium (Be) is highly toxic to human, induces oxidative stress and leads to Chronic Beryllium Disease (CBD) or berylliosis, apoptosis and cancer. In this study, we have investigated the antioxidative and hepatorenal protective potential of Spirulina platensis (SP) against beryllium (Be) induced alterations in hepatorenal biochemical parameters, oxidative stress and histopathological alterations in rats. Different doses of SP (50, 100, 200 and 400 mg/kg, p.o.) were administered (once a day daily for 7 days) against Be(NO3)2 (1 mg/kg, i.p. once a day daily, for 28 days) induced toxic menifestations in female Wistar rats. Be decreased GSH, SOD, CAT, G-6-Pase, ALP and ATPase activities and increased TBARS and ACP activity in liver and kidney. Be enhanced ALT, AST, bilirubin, uric acid, creatinine, total cholesterol and decreased haemoglobin, total protein, sugar in blood. Be deposited in vital organs of rats and altered the histoarchitecture of liver and kidney. Different doses of SP showed dose dependent recovery. SP @400 mg/kg showed significant recovery against Be induced oxidative stress, maintained hepatorenal function towards normal and reduced beryllium body burden. Results of the study. well supported by histopathological observations, conclude that SP possesses hepatorenal protective potential against Be induced toxicity in rats

Altered expression and editing of miRNA-100 regulates iTreg differentiation

RNA editing ofmiRNAs, especially in the seed region, adds another layer to miRNA mediated gene regulation which can modify its targets, altering cellular signaling involved in important processes such as differentiation. In this study, we have explored the role of miRNA editing in CD4+ T cell differentiation. CD4+ T cells are an integral component of the adaptive immune system. Na¨ıve CD4+ T cells, on encountering an antigen, get differentiated either into inflammatory subtypes like Th1, Th2 or Th17, or into immunosuppressive subtype Treg, depending on the cytokine milieu. We found C-to-U editing at fifth position of mature miR-100, specifically in Treg. The C-to-U editing of miR-100 is functionally associated with at least one biologically relevant target change, from MTOR to SMAD2. Treg cell polarization by TGFβ1 was reduced by both edited and unedited miR-100 mimics, but percentage of Treg in PBMCs was only reduced by edited miR-100 mimics, suggesting a model in which de-repression of MTOR due to loss of unedited mir-100, promotes tolerogenic signaling, while gain of edited miR-100 represses SMAD2, thereby limiting the Treg. Such delicately counterbalanced systems are a hallmark of immune plasticity and we propose that miR-100 editing is a novel mechanism toward this end

Inferring gene coexpression networks for low dose ionizing radiation using graph theoretical algorithms and systems genetics

Background Biological data generated through large scale -omics technologies have resulted in a new paradigm in the study of biological systems. Instead of focusing on individual genes or proteins these technologies enable us to extract biological networks using powerful computing and statistical algorithms that are scalable to very large datasets. Materials and methods We have developed a tool chain using novel graph algorithms to extract gene coexpression networks from microarray data. We highlight implementation of our tool chain to investigate the effects of in vivo low dose ionizing radiation treatments on mice. We are using systems genetics approach to investigate the biological effects of low dose (10 cGy) ionizing radiation. We measured the base line gene expression profile from spleen tissue of BXD recombinant inbred mice using Illumina microarrays. The data was filtered using coefficient of variance after robust spline normalization and variance stabilizing transformation. A graph was then derived from this data, with probes as vertices and edges between them representing correlations. The graph was analyzed using our toolkit to find the size and number of maximal cliques. We deployed another tool called paraclique that relaxes clique’s requirement that every edge be present between all vertices. Paraclique enables us to account for inherent noise in the microarray data and stochastic nature of biological processes. Using immunophenotype data from the baseline BXD mice, we employed biclique analysis to determine interactions between genotypes and immunophenotypes (%CD4, %CD3, LN T:B, %CD8, and LN CD4:CD8). We also extracted eQTLs from BXD data using QTL-Reaper from base line gene expression profiles. 1881 transcripts were associated with 686 loci. The eQTLs were classified as cis or trans according to their genomic positions. Besides population level studies we also investigated the differential effect of low dose and high dose (1Gy) of ionizing radiations on spleen gene expression in inbred parental strains (C57BL/6J and DBA/2J) of BXD recombinant inbred mice as well as BALB/c mice, a known radiation-sensitive strain

Maternal consumption of fish oil programs reduced adiposity in broiler chicks

Maternal intake of eicosapentaenoic acid (EPA; 20:5 n-3) and docosahexaenoic acid (22:6 n-3) has been associated with reduced adiposity in children, suggesting the possibility to program adipose development through dietary fatty acids before birth. This study determined if enriching the maternal diet in fish oil, the primary source of EPA and DHA, affected adipose development in offspring. Broiler chickens were used because they are obesity-prone, and because fatty acids provided to the embryo can be manipulated through the hen diet. Hens were fed diets supplemented (2.8% wt:wt) with corn oil (CO; n-6) or fish oil (FO; n-3) for 28 d. Chicks from both maternal diet groups were fed the same diet after hatch. Maternal FO consumption enriched chick adipose tissue in EPA and DHA and reduced adiposity by promoting more, but smaller, adipocytes. This adipocyte profile was paralleled by upregulated expression of the adipogenic regulator PPARGand its co-activator PPARGC1B, and reduced expression of LPL. Proteomics identified 95 differentially abundant proteins between FO and CO adipose tissue, including components of glucose metabolism, lipid droplet trafficking, and cytoskeletal organization. These results demonstrate that the maternal dietary fatty acid profile programs offspring adipose development

One of the first blooms

https://trace.tennessee.edu/utiaphoto_2015/1036/thumbnail.jp

Genetic characterization and evolutionary inference of TNF-α through computational analysis

TNF-α is an important human cytokine that imparts dualism in malaria pathogenicity. At high dosages, TNF-α is believed to provoke pathogenicity in cerebral malaria; while at lower dosages TNF-α is protective against severe human malaria. In order to understand the human TNF-α gene and to ascertain evolutionary aspects of its dualistic nature for malaria pathogenicity, we characterized this gene in detail in six different mammalian taxa. The avian taxon, Gallus gallus was included in our study, as TNF-α is not present in birds; therefore, a tandemly placed duplicate of TNF-α (LT-α or TNF-β) was included. A comparative study was made of nucleotide length variations, intron and exon sizes and number variations, differential compositions of coding to non-coding bases, etc., to look for similarities/dissimilarities in the TNF-α gene across all seven taxa. A phylogenetic analysis revealed the pattern found in other genes, as humans, chimpanzees and rhesus monkeys were placed in a single clade, and rats and mice in another; the chicken was in a clearly separate branch. We further focused on these three taxa and aligned the amino acid sequences; there were small differences between humans and chimpanzees; both were more different from the rhesus monkey. Further, comparison of coding and non-coding nucleotide length variations and coding to non-coding nucleotide ratio between TNF-α and TNF-β among these three mammalian taxa provided a first-hand indication of the role of the TNF-α gene, but not of TNF-β in the dualistic nature of TNF-α in malaria pathogenicity