A comparative study between placental alpha microglobulin-1 rapid immunoassay and standard diagnostic methods for detection of rupture of membranes

Background: To determine the efficacy of an immunoassay to measure levels of placental alpha-microglobulin-1 in cervico-vaginal secretions.Methods: 100 ANC cases admitted in Dr D. Y. Patil Hospital with symptoms of rupture of membranes during study period. Inclusion criteria-Pregnant women who presented with symptoms of ROM either in labour or not in labour, gestational age from 28 weeks onwards and who have given consent.Results: In 9 cases, the immunoassay test was negative, in 91 cases, it was positive and in one case, the liquor had a lot of meconium, the woman had to undergo an emergency cesarean section. This patient was deemed to have a false negative result by the test. Pooling was positive in 87 cases, nitrazine test in 86 cases and ferning in 88 cases. Hence, in comparison to immunoassay test which had 100% specificity and 98.91% sensitivity due to incomplete evaluation, nitrazine test had 95.58% sensitivity and 100% specificity, Pooling has 97.79% sensitivity and 100% specificity, whereas ferning has 98.34% sensitivity and 100% specificity.Conclusions: The PAMG1 is a non-invasive, rapid, one step test with very high sensitivity, specificity and accuracy as compared to the conventional methods together and also individually. Preforming this test instead of conventional methods can aid the early detection of rupture of membranes and largely affect the outcome of maternal and fetal health as timely decision can be taken once diagnosis is confirmed

Assessment of the level of serum uric acid in patients of pre-eclampsia and their comparison with levels in normotensive pregnancy

Background: Pre-eclampsia is one of the major causes of maternal and perinatal morbidity and mortality. There are various parameters to evaluate pre-eclampsia. S.uric acid levels is one of the important biochemical markers in pre-eclampsia. The objective of current study is to compare the levels of S.uric acid in pre-eclamptic patients and normotensive patients.Methods: A total of 256 antenatal patients, consisting of two groups, 128 patients in each group diagnosed with pre-eclampsia (either earlier or during examination) and 128 control antenatal patients in their third trimester were considered. Both the groups were compared in relation to age, parity, socio economic status and geographical variations. Blood sample (venous blood) of about 5ml was drawn from the ante cubital vein of the patient under all aseptic precautions to estimate S.uric acid levels.Results: The observation of present study shows that the level of serum uric acid is significantly higher in the cases of pre-eclampsia. The value of S.uric acid increases with the severity of pre-eclampsia.Conclusions: It is concluded from this study that high levels of uric acid are found in the serum of pre-eclamptic cases as compared to normotensive cases of the study population. The levels of uric acid are higher in severe cases as compared to the levels in mild and moderate cases

USE OF GRAPH DATABASES TO DETECT ILLEGITIMATE MONEY TRANSFERS

The present disclosure includes a method that comprises of determining an entity identifier and a geographic location identifier. The method further includes forming an article identifier using the entity identifier and the geographic location identifier. The articles pertaining to the entity identifier and the geographic location identifier can be grouped. The articles can then be stored in an article database that is indexed to the entity identifier and the geographic location identifier. A suspicious entity in a graph database can be identified. Entities associated with the suspicious entity can be identified using the graph database. The method can then include retrieving articles from the article database associated with the suspicious entity and the determined entities to determine if the suspicious entity is engaged in fraudulent activity

Study of management of postpartum hemorrhage and its complications

Background: Postpartum hemorrhage (PPH) is globally one of the most common causes of maternal death, especially in developing country like India. Pregnancy and childbirth involve significant health risks, even to women with no preexisting health problem. The objective of this study was to analyze the role of various interventions in the management of PPH and its complications.Methods: This prospective observational study was conducted in the department of obstetrics and gynecology of Department of Obstetrics and Gynecology, Dr. D Y Patil Medical college, Pimpri, Pune, Maharashtra, India. A total number of 80 cases of postpartum hemorrhage that fulfilled the selection criteria were included. Data collected and analyzed in PPH patients with medical and surgical management.Results: In present study, most of cases were multigravida (60%) and more than 50 percent of patients required blood and blood products. In present study, most of the postpartum bleeding or postpartum hemorrhage (PPH) cases managed by medical methods. Uterotonic drugs (42.5%) This was possible due to early identification and timely intervention.Conclusions: Active management of third stage of labour is recommended in all cases. Seventy percent cases were  managed by medical methods while rest of the cases required surgical management. Among the medical management uterotonic drugs and bimanual uterine compression was used while among the surgical methods repair of cervical and vaginal laceration was mostly required

Proteomics-Based Approach for Detailing the Allergenic Profile of Cannabis Chemotypes

Allergic sensitization to cannabis is an emerging public health concern and is difficult to clinically establish owing to lack of standardized diagnostic approaches. Attempts to develop diagnostic tools were largely hampered by the Schedule I restrictions on cannabis, which limited accessibility for research. Recently, however, hemp was removed from the classified list, and increased accessibility to hemp allows for the evaluation of its practical clinical value for allergy diagnosis. We hypothesized that the proteomic profile is preserved across different cannabis chemotypes and that hemp would be an ideal source of plant material for clinical testing. Using a proteomics-based approach, we examined whether distinct varieties of cannabis plant contain relevant allergens of cannabis. Cannabis extracts were generated from high tetrahydrocannabinol variety (Mx), high cannabidiol variety (V1-19) and mixed profile variety (B5) using a Plant Total Protein Extraction Kit. Hemp extracts were generated using other standardized methods. Protein samples were subjected to nanoscale tandem mass spectrometry. Acquired peptides sequences were examined against the Cannabis sativa database to establish protein identity. Non-specific lipid transfer protein (Can s 3) level was measured using a recently developed ELISA 2.0 assay. Proteomic analysis identified 49 distinct potential allergens in protein extracts from all chemotypes. Most importantly, clinically relevant and validated allergens, such as profilin (Can s 2), Can s 3 and Bet v 1-domain-containing protein 10 (Can s 5), were identified in all chemotypes at label-free quantification (LFP) intensities \u3e 106. However, the oxygen evolving enhancer protein 2 (Can s 4) was not detected in any of the protein samples. Similarly, Can s 2, Can s 3 and Can s 5 peptides were also detected in hemp protein extracts. The validation of these findings using the ELISA 2.0 assay indicated that hemp extract contains 30-37 ng of Can s 3 allergen per µg of total protein. Our proteomic studies indicate that relevant cannabis allergens are consistently expressed across distinct cannabis chemotypes. Further, hemp may serve as an ideal practical substitute for clinical testing, since it expresses most allergens relevant to cannabis sensitization, including the validated major allergen Can s 3

3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial

Background: Liraglutide 3·0 mg was shown to reduce bodyweight and improve glucose metabolism after the 56-week period of this trial, one of four trials in the SCALE programme. In the 3-year assessment of the SCALE Obesity and Prediabetes trial we aimed to evaluate the proportion of individuals with prediabetes who were diagnosed with type 2 diabetes. Methods: In this randomised, double-blind, placebo-controlled trial, adults with prediabetes and a body-mass index of at least 30 kg/m2, or at least 27 kg/m2 with comorbidities, were randomised 2:1, using a telephone or web-based system, to once-daily subcutaneous liraglutide 3·0 mg or matched placebo, as an adjunct to a reduced-calorie diet and increased physical activity. Time to diabetes onset by 160 weeks was the primary outcome, evaluated in all randomised treated individuals with at least one post-baseline assessment. The trial was conducted at 191 clinical research sites in 27 countries and is registered with ClinicalTrials.gov, number NCT01272219. Findings: The study ran between June 1, 2011, and March 2, 2015. We randomly assigned 2254 patients to receive liraglutide (n=1505) or placebo (n=749). 1128 (50%) participants completed the study up to week 160, after withdrawal of 714 (47%) participants in the liraglutide group and 412 (55%) participants in the placebo group. By week 160, 26 (2%) of 1472 individuals in the liraglutide group versus 46 (6%) of 738 in the placebo group were diagnosed with diabetes while on treatment. The mean time from randomisation to diagnosis was 99 (SD 47) weeks for the 26 individuals in the liraglutide group versus 87 (47) weeks for the 46 individuals in the placebo group. Taking the different diagnosis frequencies between the treatment groups into account, the time to onset of diabetes over 160 weeks among all randomised individuals was 2·7 times longer with liraglutide than with placebo (95% CI 1·9 to 3·9, p<0·0001), corresponding with a hazard ratio of 0·21 (95% CI 0·13–0·34). Liraglutide induced greater weight loss than placebo at week 160 (–6·1 [SD 7·3] vs −1·9% [6·3]; estimated treatment difference −4·3%, 95% CI −4·9 to −3·7, p<0·0001). Serious adverse events were reported by 227 (15%) of 1501 randomised treated individuals in the liraglutide group versus 96 (13%) of 747 individuals in the placebo group. Interpretation: In this trial, we provide results for 3 years of treatment, with the limitation that withdrawn individuals were not followed up after discontinuation. Liraglutide 3·0 mg might provide health benefits in terms of reduced risk of diabetes in individuals with obesity and prediabetes. Funding: Novo Nordisk, Denmark

Role of tranexamic acid in reducing blood loss during and after caesarean section

Introduction: Association between caesarean section and intra operative and post operative bleeding is known. Post-partum hemorrhage is still a leading cause for maternal morbidity and mortality. This study will evaluate the efficacy and safety of tranexamic acid in reducing the blood loss after placental delivery following lower segment caesarean section (LSCS) and note any adverse effects. Materials and Methods: A total of 100 women, who underwent elective or emergency primary caesarean section at term between 37 and 41 weeks have been studied prospectively. They were divided into two groups. In the study group of 50, tranexamic acid 1 gm IV was given 20 minutes before making incision for caesarean section and the control group of 50 did not receive tranexamic acid. Statistical Analysis: For quantitative outcomes, the t-test was used to test for difference in the two groups. For categorical outcomes, chi square and odds ratio with 95% confidence interval were used as applicable. Results: The patient characteristics, namely age, height, weight, gestational age and gravidity in two groups were similar which was statistically insignificant. Hemoglobin decreased slightly after birth in both groups but no statistical difference between two groups was noticed. There was no episode of thrombosis in the study. Tranexamic acid significantly reduced the quantity of the blood loss from time of placental delivery to 2 hours postpartum (P < 0.001) and from end of LSCS to 2 hours postpartum (P < 0.001). However, there was no statistical difference in quantity of blood loss from time of placental delivery to end of LSCS in both groups (P < 0.001). Conclusion: A safe dose of tranexamic acid has an effective role in reducing blood loss during LSCS without causing adverse reaction. Thus, drug can be used effectively in reducing maternal morbidity and mortality during LSCS

Research Journal of Pharmaceutical, Biological and Chemical Sciences Case Report: A Rare Case of Primary Ovarian Pregnancy

ABSTRACT Primary ovarian pregnancy occurs very rarely, its incidence being almost 1 to 3% of all ectopic gestations. We present a rare case of a second gravida diagnosed with a ruptured ectopic pregnancy but who had intra operative and histopathological diagnosis of a primary ovarian pregnancy