Fetal akinesia deformation sequence: a case report and review of literature

Fetal Akinesia Deformation Sequence (FADS) is a condition characterised by decreased fetal movement (fetal akinesia), multiple joint contractures (arthrogryposis), facial anomalies, intrauterine growth restriction, pulmonary hypoplasia and other developmental abnormalities. These disorders are clinically and genetically heterogenous and its etiology remains unclear. This syndrome is rare and the primary diagnosis is made when lack of mobility is noted in routine ultrasound scanning. The increasing use of ultrasound has enabled earlier detection of these cases. A 20 year old primi in her routine ultrasound at 14weeks of gestation showed features fetal akinesia deformation sequence with increased nuchal translucency and hydrops. Early diagnosis, prenatal evaluation and better understanding of the ultrasound findings will be helpful for genetic counselling and clinical management.

Mapping non-white educators' experiences in changed racial contexts.

Thesis (M.Ed.) - University of KwaZulu-Natal, Durban, 2005.President Mandela, in his inaugural speech of 1994, inscribed the metaphor of

Influence of loading rate on bond shear strength of autoclaved aerated concrete masonry

This study aims to investigate the bond shear strength of autoclaved aerated concrete (AAC) masonry, focusing on the influence of pre-compression and load rates. Experimental results show that the bond shear strength of AAC masonry increases with increasing load rates as well as with increasing pre-compression stress. It is understood from the experimental studies that both loading rate and pre-compression stress significantly affect the failure mode and stress distribution of AAC masonry specimens under shear loading. To provide further insights, the paper aims to develop a nonlinear finite element modelling approach with Abaqus software employing detailed surface-based cohesive contact approaches, which can reliably capture the bond shear behaviour and failure modes of AAC masonry. Higher stress contours are seen at higher displacement rates due to the development of sudden dynamic and irregular loads compared to lower rates. The stress-strain characteristics and the deformed shape of the specimens obtained from the numerical analyses were found to be identical to those from the experimental studies. Instead of expensive and time-consuming experimental tests, the proposed numerical modelling approach can be an effective alternative to studying the bond shear behaviour of AAC masonry

The 'Healthy Passport' intervention with older people in an English urban environment:effects of incentives and peer-group organisers in promoting healthy living

This paper reports the evaluation of the effectiveness of incentives (viz. points and prizes) and of peer-group organisers ('older people's champions') in the outcomes of a health-improvement programme for people aged 50 + years in a multi-ethnic district of the West Midlands, England. Health promotion activities Were provided, and adherence, outcome variables and barriers to adherence were assessed over six months, using a `passport' format. Those aged in the fifties and of Asian origin Were under represented, but people of Afro-Caribbean origin were well represented and proportionately most likely to stay in the project. Those of greater age and With more illness were most likely to drop out. There were significant improvements in exercise, diet and the uptake of influenza vaccines and eyesight tests, but slighter improvements in wellbeing. Positive outcomes related to the incentives and to liking the format. The number of reported barriers was associated with lower involvement and lack of change, as was finding activities too difficult, the level of understanding, and transport and mobility problems, but when these were controlled, age did not predict involvement. Enjoying the scheme was related to positive changes, and this was associated with support from the older people's champions

The COVID-19 Pandemic in UK Care Homes - Revealing the Cracks in the System

open access articleThere are around 420,000 residents living in UK care homes. The majority are over 85, have multiple health conditions, live with frailty and are nearing the end of their lives. Up to 80% of residents live with dementia. Care homes are not part of the National Health Service (NHS). Care home places are funded through a complex mix of self-funding, means-tested support from local authorities, and continuous healthcare funding from the NHS. They are run by independent organisations. A third of providers are large for-profit chains, the remainder comprising not-for-profit third-sector organisations, or small private companies with only a small number of homes. The level of government reimbursement for long-term care homes in the UK is low by international standards, an issue highlighted by multiple public commissions3,4 but which has gone unaddressed by successive UK governments. Medical care to UK care homes is highly variable. In some areas, the NHS Care Home Vanguards have established dedicated General Practitioners with responsibility for each home and direct access to specialist multidisciplinary teams, with evidence that such approaches may minimise unnecessary admission to hospital5. But often, care is based on residents’ individual relationships with family doctors, with the result that access to medical care is variable and uncoordinated6. As the COVID -19 pandemic started, arrangements for medical care in English care homes were in the early stages of being standardised as part of the NHS England Enhanced Health in Care Homes project. There is a social dread surrounding care homes, perceived as places to avoid because of concerns about care quality and resistance to having to pay for social care when health care is free. Most of the coverage of care homes in mainstream media prior to COVID was negative, focussing on isolated scandalous cases of negligence or abuse, and rarely reporting on the exceptional work done by the sector daily. The workforce is not valued. There is no national accreditation for care home staff, opportunities for career progression are limited, staff are poorly paid and positions in care homes are often referred to as unskilled work

Study of maternal serum lipid profile and apolipoprotein a levels and its correlation with fetal growth restriction

Background: This study was aimed to estimate maternal serum lipid profile and apolipoprotein A levels in pregnancies complicated with FGR and to compare the levels with the levels in normal pregnancies.Methods: A prospective observational study was conducted in Lady Hardinge Medical College, New Delhi, in a study group consisting of 30 pregnant women at gestation 32-34 weeks with ultrasound diagnosed FGR and control group consisting of 30 age and gestation matched uncomplicated pregnant women. Maternal serum lipid profile and apolipoprotein A levels were measured and compared between the two groups.Results: Total serum cholesterol, triglyceride, LDL-cholesterol, VLDL-cholesterol and Apolipoprotein A were significantly lower in FGR group compared to normal controls. Mean±SD of total cholesterol was found to be 199.17±49.06 mg/dl in cases and 244.10±53.17 mg/dl in controls. Mean±SD of triglyceride was 200.53±60.25 mg/dl in cases compared to 304.13±69.12 mg/dl in controls. Mean±SD of LDL-Cholesterol was 98.19±37.91 mg/dl in cases and 127.07±47.84 mg/dl in controls. Mean±SD of VLDL-cholesterol was 40.11±12.05 mg/dl in cases and 60.83±13.82 mg/dl in controls. Mean±SD of Apolipoprotein A was 147.71±16.40 mg/dl in cases compared to 163.30±16.07 mg/dl in controls. HDL-cholesterol did not change significantly as its mean±SD was 60.87±15.18 mg/dl in FGR group and 56.20±16.07 mg/dl in control group.Conclusions: The decreased levels of total cholesterol, triglyceride, LDL-cholesterol, VLDL-cholesterol and apolipoprotein A levels may be used as biochemical marker for detection of FGR

The formulation and evaluation of mouth dissolving tablet Levocetirizine by using synthetic Superdisintegrants

Aim of this research work was to develop mouth dissolving tablet that disintegrates rapidly in mouth by using tasteless complex of Levocetirizine and β-CD. Mouth dissolving Tablets also called as Orodispersible tablets. Formulated Levocetirizine β-CD complex was characterized by infrared spectroscopy, thermal analysis and X-ray diffraction pattern. Tablets were developed by direct compression method. Superdisintegrants like Sodium starch glycolate (SSG), Crosscarmellose sodium (CCS) and Crosspovidone (CP) were used for the formulation. Every formulation was subjected to in-vitro tests like wetting time, disintegration test and dissolution test. The in-vitro study showed that increasing the concentration of superdisintegrants lowers the wetting time (WT) and disintegration time (DT) and enhances the drug release percentage of the formulations. The formulation CPX5 was the most effective formulation as it showed wetting time of 12 seconds, disintegration time of 20 seconds and cumulative % drug release of 41 and 99% at 1 and 10 minutes respectively. The study showed that the formulations containing SSG and CP as the superdisintegrants showed better drug release pattern than the formulations with other superdisintegrants. The study also showed that SSG as the superdisintegrant was more effective for the formulation of orodispersible tablets of levocetirizine dihydrochlorid

Canonical steering ellipsoids of pure symmetric multiqubit states with two distinct spinors and volume monogamy of steering

Quantum steering ellipsoid formalism provides a faithful representation of all two-qubit states and helps in obtaining correlation properties of the state through the steering ellipsoid. The steering ellipsoids corresponding to the two-qubit subsystems of permutation symmetric $N$-qubit states is analysed here. The steering ellipsoids of two-qubit states that have undergone local operations on both the qubits so as to bring the state to its canonical form are the so-called canonical steering ellipsoids. We construct and analyze the geometric features of the canonical steering ellipsoids corresponding to pure permutation symmetric $N$-qubit states with two distinct spinors. Depending on the degeneracy of the two spinors in the pure symmetric $N$-qubit state, there arise several families which cannot be converted into one another through Stochastic Local Operations and Classical Communications (SLOCC). The canonical steering ellipsoids of the two-qubit states drawn from the pure symmetric $N$-qubit states with two distinct spinors allow for a geometric visualization of the SLOCC-inequivalent class of states. We show that the states belonging to the W-class correspond to oblate spheroid centered at $(0,0,1/(N-1))$ with fixed semiaxes lengths $1/\sqrt{N-1}$ and $1/(N-1)$. The states belonging to all other SLOCC inequivalent families correspond to ellipsoids centered at the origin of the Bloch sphere. We also explore volume monogamy relations of states belonging to these families, mainly the W-class of states.Comment: 13 pages, 13 figures; Revised version; Comments welcom