Assessment of maternal and fetal outcome in eclampsia patients getting admitted in Bundelkhand Medical College, Sagar, India on basis of general condition of patient at time of admission and induction delivery interval

Background: Eclampsia is the convulsive and most severe manifestation of the hypertensive disorders of pregnancy. Eclampsia is defined by new-onset tonic-clonic, focal, or multifocal seizures in the absence of other causative conditions. Methods: It is a prospective observational study conducted in BMC Sagar, Madhya Pradesh, India of duration one year, according to inclusion and exclusion criteria with 72 eclampsia patients. Results: Most patients had vaginal deliveries 62.5%. There were 4.2% maternal deaths. 65.4% patients’ babies were shifted to mother’s side. Lesser no. of SNCU referrals were seen in cases of LSCS as compared to vaginal deliveries, in cases where patients had GCS more than 8 at time of admission, where admission delivery interval was less than 12 hrs. Conclusions: The results of the current study indicated that better the general condition of patient at time of admission, lesser the induction/admission delivery interval-better is the fetal maternal outcome. Eclampsia could have been prevented in patients by regular antenatal visits and early detection in pre-eclampsia/gestational hypertension stage

Bidirectional LAO* Algorithm (A Faster Approach to Solve Goal-directed MDPs)

Uncertainty is a feature of many AI applications. While there are polynomial-time algorithms for planning in stochastic systems, planning is still slow, in part because most algorithms plan for all eventualities. Algorithms such as LAO* are able to find good or optimal policies more quickly when the starting state of the system is known. In this thesis we present an extension to LAO*, called BLAO*. BLAO* is an extension of the LAO* algorithm to a bidirectional search. We show that BLAO* finds optimal or E-optimal solutions for goal-directed MDPs without necessarily evaluating the entire state space. BLAO* converges much faster than LAO* or RTDP on our benchmarks

EXTENDED CULTIVATION TIME BEYOND 7 DAYS ENHANCES PROPIONIBACTERIUM ACNES ISOLATION IN SUSPECTED BONE AND JOINT INFECTIONS: A RETROSPECTIVE STUDY.

Background  Diagnosing bone and joint infections caused by Propionibacterium acnes is challenging due to the lengthy cultivation period, which can extend to 14 days. This study explored the potential of a 7-day cultivation period for precise diagnosis while maintaining sensitivity. Methods A one-year retrospective analysis included individuals with at least one positive Propionibacterium acnes sample. Patients were categorized as "infection" or "no infection" based on predefined criteria. The study assessed clinical and microbiological data, including time to positive results using different cultivation techniques. Results Among 70 confirmed P. acnes cases, the median time to positivity was 6 days, compared to 9 days in 47 contaminant cases. Tissue samples from 15 infected cases (21.4%) remained positive after day 7. Beyond day 10, blind thioglycolate broth subcultures detected infection in 6 patients (8.6%). Thioglycolate broth showed the highest sensitivity at 66.3%, while anaerobic agar plates had a notable positive predictive value of 96.5%. P. acnes growth occurred promptly upon transfer to the microbiological laboratory. Conclusion Reducing the cultivation period to 7 days may increase false-negative results by 21.4%. To achieve precise identification of P. acnes, it is recommended to implement a 10-day biopsy specimen culturing method for bone and joint infections, including a blind subculture. Recommendations Based on this study, it is advisable to conduct biopsy specimen culturing for 10 days, including a blind subculture after day 7, to accurately diagnose Propionibacterium acnes-related bone and joint infections. This approach enhances sensitivity and reduces the risk of false negatives. Further research and validation of this cultivation protocol may improve clinical diagnosis accuracy

Pregnancy with uncorrected tetralogy of Fallot: a case report

Tetralogy of Fallot (TOF) is the commonest form of cyanotic congenital heart disease, with overall incidence accounting for 10% of all congenital heart disease. Natural survival into the fourth decade is extremely rare (only about 3%). After corrective surgery, the life expectancy has increased, so increasing number of women with cyanotic congenital heart disease with pregnancy are coming to hospitals, thereby imposing a great challenge to obstetricians. We have discussed below a rare case of pregnancy with uncorrected TOF in a 24 year old woman.

Correlation of endothelial cell proliferation with vascular endothelial growth factor in endometrium of women with menorrhagia

Background: Approximately 30% of women of reproductive age experience excessive blood loss during menstruation. In 50% of cases, menorrhagia has no underlying pathology. However, until recently, the only permanent cure for menorrhagia was hysterectomy. In this study we aim to determine the correlation of vascular endothelial growth factor (VEGF) expression with markers of endometrial endothelial cell proliferation like proliferating cell nuclear antigen (PCNA) and Cluster Determination (CD34).Methods: A total of 100 patients with history of menorrhagia were selected for study. Double Immunohistochemistry was performed on these endometrial biopsy sections. Proliferating endothelial cells were identified by an immunohistochemical double staining technique with PCNA and CD34. VEGF expression was also seen in endometrial biopsy.Results: In general, expression of both VEGF and PCNA was more in functional layer than basal layer in both menorrhagic patients as well as non menorrhagic patients.  When glandular cytoplasmic VEGF expression was compared with PCNA the association was statistically significant whereas completely opposite findings was seen with glandular luminal surface VEGF positivity but the association was statistically significant. In secretory phase (p-value<0.001) there was highly statistically significant association in PCNA grading with glandular luminal surface VEGF positivity whereas when we correlated PCNA with  cytoplasmic  glandular VEGF in secretory phase it was statistically significant (p-value<0.001).Conclusions: The endothelial proliferation was significantly higher in menorrhagia patients during late secretory phase of cycle than controls. We were able to demonstrate increased endothelial proliferation in patients in the premenstrual part of cycle

Estimation of various associated factors in multiparous females undergoing primary caesarean sections at a tertiary care health centre in rural Western Maharashtra, India

Background: Caesarean section is one of the commonly performed operation in women due to safety reason and modern techniques. Primary caesarean section in the multipara means first caesarean section done in the patients who had previously delivered vaginally once or more. Aims and objectives of this study were to know association of various parameters like Age, Parity, Haemoglobin, Blood Pressure, Baby weight, Perinatal and Maternal Mortality with primary caesarean section among multipara.Methods: This was a prospective study of primary caesarean section in multipara women admitted at tertiary care hospital in western rural Maharashtra during the period of 6 months from January 2018 to June 2018. Multipara with pregnancy of >28 weeks gestation (gravida 2 and above), each of whom has had a previous vaginal delivery of >20 weeks gestation were included. Women with previous abortions and previous section were excluded.Results: Total 1705 sections were performed during the same period out of total 4648 deliveries. Out of these sections 194 sections were performed in multipara for the first time. Maximum numbers of patients (58%) were in the age group of 15-24 years and Parity 2 (68%). Almost 70% women among multipara have Hb <11 Mgm/dl. Most of the patients (84.53%) have normal Blood pressure readings. Most of the babies’ i.e.70 (36.08%) have birth weight in the range of 2.5-3 kg. Out of 194 deliveries, there were only 3 neonatal deaths (1.54%) and 1 maternal death (0.51%).Conclusions: Proper antenatal and intrapartum care and early referral can reduce the maternal and perinatal morbidity and mortality in multipara.

Indications of primary caesarean section in multiparous women in patients of rural area of Western Maharashtra, India

Background: Caesarean section is commonly performed operation in women in last few decades and can be life saving for the child, the mother or both in certain cases. Primary caesarean section in the multipara means first caesarean section done in the patients who had previously delivered vaginally once or more. Aims and objectives of this study were to know the incidence and various indications of primary caesarean section in multipara.Methods: This was a prospective study of primary caesarean section in multipara women admitted at tertiary care hospital in western rural Maharashtra during the period of 6 months from January 2018 to June 2018. Multipara with pregnancy of >28 weeks gestation (gravida 2 and above), each of whom has had a previous vaginal delivery of >20 weeks gestation were included. Women with previous abortions and previous section were excluded.Results: Total no. of deliveries during this period were 4648.Total 1705 sections were performed during the same period. Thus, the incidence caesarean sections are 36.68%. Out of these sections 194 sections were performed in multipara for the first time, thus giving the incidence of 0.42% of total deliveries and 11.38% of total caesarean sections. Most common indication for caesarean section in multipara was malpresentation (19.6%) followed by foetal distress (16.49%) and severe pre-eclampsia (13.4%).Conclusions: Present study concludes that proper antenatal care should always be given to multipara even though there was history of previous vaginal deliveries.

Visual Performance under Varying Illumination Conditions while using an Indigenously Developed Wrist Wearable Computer

Ambient illumination conditions have significant impact on users’ visual performance while carrying out onscreen reading tasks on visual display units, especially smaller screen sizes. Present study assessed the visual performance responses of different ambient illumination levels during onscreen reading on Wrist Wearable Computer (WWC) developed for the command-control-communication between the control room and the soldiers operating in remote locations. Ten (10) Indian Infantry soldiers performed two different types of loud reading tasks on the display of WWC under three different ambient illumination (mean ±SEM) conditions namely, Indoor controlled (450.00±10.00 lx), Outdoor daylight (11818.7±582.91 lx) and Indoor dark (0.12±0.03 lx) environments. While reading, participants wore an eye tracking glass which recorded the eye movement responses. Visualisation techniques were used to predict the association of illumination levelof surrounding with visual performance of the user. Subjective legibility rating was also applied to understand participants’ preferences towards physical attributes of the onscreen information and illumination level. Results indicated that illumination had a significant effect on eye movement parameters like fixation frequency, fixation duration and scanpath length while completing the tasks. Overall, participants performed better under indoor controlled illumination conditions in terms of fixation profile and scanpath length, apart from improved subjective legibility ratings as compared to other two illumination conditions. Future research attempts need to be directed towards the optimum performance of the display across wide range of ambient illumination conditions and to establish how the display of indigenously developed wearable computer performs in comparison to other such displays available across the globe

Role of maternal serum Chlamydia trachomatis IgG antibodies and serum C-reactive protein in preterm labour

Background: The objective was to find the role of maternal serum C- reactive protein and Chlamydia trachomatis IgG antibodies as predictors of preterm delivery.Methods: This prospective study was conducted in UISEMH, Department of Obstetrics and Gynecology, GSVM Medical College, Kanpur from September 2011 to September 2013. The present study comprised of a total of 100 cases, out of which 50 were in study group and 50 in control group. Cases were compared with respect to presence of Chlamydia trachomatis antibodies and maternal C- reactive protein levels.Results: CRP levels were higher and C. trachomatis immunoglobulin G levels were more often present in the women with preterm deliveries. A total of 20 cases (40%) were found to be seropositive for IgG antibodies to C. trachomatis. The seropositive women were significantly more likely to have a preterm birth (75% [15/20] v. 40% [12/30]; p = 0.0182, odds ratio 4.50, 95% CI 1.29 to 15.67). In study group 21 cases were CRP positive (42%). The CRP positive women were significantly more likely to have a preterm birth (76.2% [16/21] v. 37.93 % [11/29]; p = 0.009, odds ratio 5.24, 95% CI 1.49 to 18.34). Thus risk of preterm delivery was greater in seropositive women and in CRP positive women.Conclusion: The detection of maternal serum C- reactive protein and antichlamydial antibodies are valuable, non-invasive diagnostic procedure for prediction of preterm delivery and can be used as predictors of preterm delivery

An integrative approach towards prevention & management of psychological illnesses during COVID 19 crisis

Widespread outbreaks of infectious disease, such as COVID-19, are associated with psychological distress and symptoms of mental illness. To date (June 29th, 2020), over 10,021,401 confirmed cases and 499,913 deaths attributable to this disease have been reported. Ayurveda though being an ancient life science clearly mentions about such disease conditions. A detailed chapter on Janapadodhwansa in Charaka Samhita explains epidemic disease and its etiological factors. Adharma as the root cause of Janapadodhwansa. The current article is a narrative review of the existing literature on mental health symptoms and interventions relevant to the COVID-19 pandemic. Psychiatric and psychological problems that were present before the pandemic and the Patho-plastic effects of the pandemic on these problems; the responses to social isolation and lockdown; the psychological response to the diagnosis public responses to those with symptoms suggestive of COVID-19 infection, as well as the aftermath ofthe infection. Timely identification of high-risk groups especially those with prior mental health issues, are essential to prevent extreme events such as suicide and other impulsive behaviors. Acharya Charaka has described Chikitsa Siddhant to be followed during Janapadoudhwamsa; Karma Panchavidham, Rasayananamupyoga. Langhan, Langhan-Pachana and Doshavasechan. Harsha Prinananam - Cheerful mind best in bringing delightfulness. Charaka has also stated that the disease of a patient having Pravara-Sattva recovers quickly as compared to patients of Avara-Sattva. Also, body and mind follow and influences each other i.e. any kind of change in mental status results in both physiological as well as psychological variation from normalcy