Posterior reversible encephalopathy syndrome in preeclampsia

Background: Posterior reversible encephalopathy is a clinico-radiological syndrome marked by headache, altered mental status, seizures, visual disturbances, and extensive white-matter changes, also known as hyper perfusion encephalopathy, brain capillary leak syndrome, and hypertensive encephalopathy. This syndrome was a possible consequence of several medical conditions but especially in pregnancy it is associated with pre-eclampsia and eclampsia. Objective of this study was to know the incidence and analyze the clinical features, biochemical, and radiological abnormalities in posterior reversible encephalopathy syndrome (PRES) as a complication of preeclampsia.Methods: This was a one-year cross-sectional analytical study conducted at NRI general hospital, Chinakakani, Guntur of patients with the diagnosis of PRES. Data was obtained from medical records and analyzed them in terms of mean for continuous variables and percentages for categorical data.Results: Total no of patients diagnosed as PRES were 16 out of 127 patients of preeclampsia. Among them, 14 presented with eclampsia, and two presented with severe preeclampsia and imminent symptoms of eclampsia. Headache was the most common symptom (100%). PRES occurred at a peak SBP of ≥160 mmHg in 75% cases and peak DBP of ≥110 mmHg in 50% cases. Serum lactate dehydrogenase (LDH) level was ≥600 in 56.25% and serum uric acid level ≥6 in 50% of patients of PRES. The drug of choice was magnesium sulfate.Conclusions: Neuroimaging abnormality is a definitive component in the diagnosis of PRES. These cerebral abnormalities are vital components in the pathogenesis of eclampsia. Considerable number of patients of preeclampsia might develop PRES even without eclampsia, with mild elevation in BP, serum LDH, and serum uric acid levels

Pregnancy in Takayasu arteritis - maternal and fetal outcome

Background: Takayasu arteritis is a rare medical disorder of primary vasculitis of unknown etiology. It affects reproductive age women. It is rare disease and associated with serious maternal and fetal complications and long term morbidity.Methods: Retrospective analysis of patients with diagnosed Takayasu arteritis, to know the impact of disease on maternal status and evaluate fetal outcome. The objective of this study was to know the maternal and fetal outcome in pre-diagnosed cases of Takayasu arteritis. The necessity of accurate measurement of pulse and blood pressures in all the limbs in a suspected case of hypertension in antenatal women at any period of gestation and TYPE the disease accordingly. 3. To evaluate the typing of TA on maternal and fetal outcome.Results: All the 4 patients with TA had medical complication like hypertension in the form of chronic hypertension and pre eclampsia that needed good monitoring of BP in all 4 limbs.Conclusions: As the typing of disease increased, more medical and obstetric complications were noticed

The Sponge-associated Bacterium Bacillus licheniformis SAB1: A Source of Antimicrobial Compounds

Several bacterial cultures were isolated from sponge Halichondria sp., collected from the Gujarat coast of the Indo Pacific region. These bacterial cultures were fermented in the laboratory (100 mL) and the culture filtrate was assayed for antibiotic activity against 16 strains of clinical pathogens. Bacillus sp. (SAB1), the most potent of them and antagonistic to several clinically pathogenic Gram-positive, Gram-negative bacteria and the fungus Aspergillus fumigatus was chosen for further investigation. Analysis of the nucleotide sequence of the 16S rDNA gene of Bacillus sp. SAB1 showed a strong similarity (100%) with the 16S rDNA gene of Bacillus licheniformis HNL09. The bioactive compounds produced by Bacillus licheniformis SAB1 (GenBank accession number: DQ071568) were identified as indole (1), 3-phenylpropionic acid (2) and a dimer 4,4′-oxybis[3-phenylpropionic acid] (3) on the basis of their Fourier Transform Infrared (FTIR), Nuclear Magnetic Resonance (NMR) and Electrospray Ionization Mass Spectrometer (ESI-MS) data. There is a single reference on the natural occurrence of compound 3 from the leaves of a terrestrial herb Aptenia cordifolia in the literature, so to the best of our knowledge, this is a first report of its natural occurrence from a marine source. The recovery of bacterial strains with antimicrobial activity suggests that marine-invertebrates remain a rich source for the isolation of culturable isolates capable of producing novel bioactive secondary metabolites

A quadratic boost converter derived multi output converter for electric vehicles application

A novel Solar Photo Voltaic Powered dual output DC to DC converter with the Quadratic Boost Converter as the core element, typically for Electrical Vehicle applications has been proposed and validated in this work. The proposed system harvests the solar power and charges a 12 V battery, supplies power to a 12 V load, using the buck feature of the proposed converter. A second channel of 48 V output is derived using the boost channel and the 48 V output is meant for driving the traction motor as well as any other load that requires a regulated 48 V. The proposed converter can operate in three different modes. For the purpose of voltage regulation at the 48 V and 12 V output channels and for the Maximum Power Point Tracking, applicable to the Solar Photo Voltaic source, individual Sliding Mode Controllers are used. The proposed idea has been validated using simulations in the MATLAB SIMULINK environment and an experimental prototype

Study on HELLP syndrome - maternal and perinatal outcome

Background: HELLP Syndrome is a serious obstetric complication in pregnancy characterised by haemolysis, elevated liver enzymes and low platelet count. Incidence is 0.5-0.9% of all pregnancies and in 10-20% of cases with severe preeclampsia and eclampsia. The aim of the study was to study the incidence, different clinical presentations and diagnosis of HELLP syndrome in Pre eclampsia and Eclampsia and to analyze the severity, complications, maternal and perinatal outcome.Methods: It is a 16 months period retrospective study of 102 cases of preeclampsia and eclampsia admitted in NRIMC and GH in OBGY Department with more than 28 weeks gestation. Of these, 91 cases had preeclampsia and 11 cases had eclampsia. Out of these, 15 cases developed HELLP Syndrome. The available history, clinical data, detailed laboratory investigations were studied and categorized by Mississippi classification for better analysis of complications and outcome in HELLP syndrome.Results: Of 91 cases of Preeclampsia, 12 cases (13.18%) developed HELLP syndrome and out of 11 cases of Eclampsia, 3 cases (27.27%) had HELLP Syndrome. Majority of the cases belonged to 21-25years age group and were mostly from lower Socio economic status. The present study showed 60% maternal morbidity and 6.6% maternal mortality and the perinatal morbidity and mortality was 46.6% each.Conclusions: HELLP Syndrome is a severe variant and a dreadful complication of Preeclampsia and Eclampsia, it needs early diagnosis and timely intervention in the form of termination of pregnancy to arrest further progress of pathophysiology leading to complications

Comparison of RMI 3 and RMI 4 in pre-operative evaluation of ovarian masses

Background: To differentiate ovarian mass as benign or malignant could change clinical approach. Finding a screening and diagnostic method for ovarian cancer is challenging due to high mortality and insidious symptoms. Risk malignancy index (RMI) has the advantage of rapid and exact triage of patients with ovarian mass.Methods: Prospective study carried for 2 years at NRI Medical College and General Hospital, Chinakakani, Mangalagiri, Andhra Pradesh, India. 79 patients with ovarian mass were investigated and risk malignancy index (RMI-3 and RMI-4) calculated. Final confirmation was done based on histopathological report. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for RMI 3 and RMI 4 taking histopathology as control and comparison was done.Results: (n=79); 50 (63.29%) cases were benign and 29 (36.70%) were malignant based on histopathology. RMI 4 is more sensitive (68.96%) than RMI 3 (62.06%), but RMI 3 is more specific (94%) than RMI 4 (92%).The positive predictive value of RMI-3 and RMI-4 were 85.71%  and 83.33% respectively. The negative predictive value for RMI-4 and RMI-3 were 83.63% and 81.03% respectively.Conclusions: With increasing age, chance of malignancy increases. RMI 4 was more sensitive than RMI-3, however less specific than RMI 3 in differentiating benign and malignant tumors. The positive predictive value is slightly more for RMI 3, than RMI 4. Negative predictive value is slightly more for RMI 4, than RMI 3.

Pseudoaneurysm of uterine artery: as a cause of secondary post partum haemorrhage

Background: Secondary PPH is rare and life threatening, if the cause is not properly identified. Cases should be subjected for USG doppler to exclude rare entities such as pseudoaneurysm of uterine artery and AV malformations. Pseudoaneurysm of uterine artery is a rare entity to produce secondary PPH, but once identified can be effectively treated, provided facility of uterine artery embolisation is available.Methods: Here in we report 6 cases of secondary post partum haemorrhage where 5 were treated by uterine artery embolization, for recurrent attacks of bleeding following caesarean section with no identifiable cause and referred to our institution. We subjected them for USG doppler study - diagnosed to have pseudo aneurysm in 6 cases and further managed by angiography, followed by uterine artery embolisation.Results: Out of 6 cases, all cases were diagnosed of having pseudoaneurysm of either Right or Left uterine artery. 5 were subjected to uterine artery embolization. Out of the 5 cases, 4 responded well and in one case following coil embolisation as bleeding through collaterals still observed, hysterectomy had to be done. For 6th case because of haemodynamic unstability hysterectomy had to be done.Conclusions: Uterine artery embolization is an effective and reliable method for control of haemorrhage in pseudoaneurysm. One should have doubt about pseudoaneurysm in cases of secondary PPH where the bleeding is recurrent and cause not acertainable and to be referred in time where the facility of uterine artery embolization is available

Food, Nutrition and Agrobiodiversity Under Global Climate Change

Available evidence and predictions suggest overall negative effects on agricultural production as a result of climate change, especially when more food is required by a growing population. Information on the effects of global warming on pests and pathogens affecting agricultural crops is limited, though crop–pest models could offer means to predict changes in pest dynamics, and help design sound plant health management practices. Host-plant resistance should continue to receive high priority as global warming may favor emergence of new pest epidemics. There is increased risk, due to climate change, to food and feed contaminated by mycotoxin-producing fungi. Mycotoxin biosynthesis gene-specific microarray is being used to identify food-born fungi and associated mycotoxins, and investigate the influence of environmental parameters and their interactions for control of mycotoxin in food crops. Some crop wild relatives are threatened plant species and efforts should be made for their in situ conservation to ensure evolution of new variants, which may contribute to addressing new challenges to agricultural production. There should be more emphasis on germplasm enhancement to develop intermediate products with specific characteristics to support plant breeding. Abiotic stress response is routinely dissected to component physiological traits. Use of transgene(s) has led to the development of transgenic events, which could provide enhanced adaptation to abiotic stresses that are exacerbated by climate change. Global warming is also associated with declining nutritional quality of food crops. Micronutrient-dense cultivars have been released in selected areas of the developing world, while various nutritionally enhanced lines are in the release pipeline. The high-throughput phenomic platforms are allowing researchers to accurately measure plant growth and development, analyze nutritional traits, and assess response to stresses on large sets of individuals. Analogs for tomorrow’s agriculture offer a virtual natural laboratory to innovate and test technological options to develop climate resilience production systems. Increased use of agrobiodiversity is crucial to coping with adverse impacts of global warming on food and feed production and quality. No one solution will suffice to adapt to climate change and its variability. Suits of technological innovations, including climate-resilient crop cultivars, will be needed to feed 9 billion people who will be living in the Earth by the middle of the twenty-first century

Studies on the biomass in the Deep Scattering Layer of the Indian EEZ

The bioacoustic scattering layer of the EEZ of India is found in depths between 200 - 540 m. An additional layer is also recorded at a depth of 20-100 m in some regions. The DSL shows characteristic vertical migration, ascending to surface or epipelagic realm after dusk and descending down to a depth of 2W54Om during day. This study on the biomass of the DSL is based on samples of 364 horizontal hauls by IKMT from the appropriate layers of the DSL during day and night collected by FORV Sagar Sampada in her cruises 1 - 15 covering both the coasts of India. The estimated biomass in the DSL of the surveyed area vary from 0.1 ml to 38.1 m1/100~with the highest abundance recorded from the region 7" - 10°3(YN and 70" -n030'E. Average monthly biomass varies from 2.1 to 21.0 m1/1000 m3 during day and 2.2 to 14.7m1/1000m3at night, with peak values noticed during April and December