Classification of Caesarean Section According to Robson Criteria: An Approach to Optimize Caesarean Section Rates at Tertiary Care Hospital in Western India

Introduction: Caesarean section (CS) rates have been increasing worldwide. For proper assessment of CS rate, the ten group Robson classification is recommended by WHO. We are analyzing the CS rates by classifying the caesarean sections using Robson‘s ten group classification. The aim of this study is to perform an analysis based on Robson‘s ten group classification system and to identify strategies to optimize CS rate in our institution. Materials and Methods: This was a retrospective observational study conducted in the department of obstetrics and gynaecology between July 2022 to December 2022 at SardarVallabhbhai Patel Institute of Medical Sciences and Research (SVPIMSR) in Ahmedabad, western India. Results: Total number of deliveries during the study period was 3121. The total numbers of CS were 1078 (34.55%) and total vaginal deliveries were 2043 (65.45%). The main contributors to overall caesarean section rate were group 5 (previous CS) (14.03%) and group 2 (nullipara, singleton cephalic,>=37 weeks) (11.40%). Women with one previous LSCS contributed majorly to the CS rate. Conclusions: Robson‘s classification is easily implementable and an effective tool for surveillance. The results can be compared between Institutions, states and countries. By using Robson classification, groups identified which contributed the most to the overall CS rate and approach to reduce the same has to be our prime objective. Any reduction in CS in nullipara group affect the CS rate in the total group of nulliparous women with a potential for vaginal birth and would also reduce number of women in group 5 (previous CS)

Trajectories of suicidality in the course of major depression

The Differential Activation Theory of suicide suggests that once suicidality has occurred during one episode of depression it is highly likely to recur, when depression recurs. However, paradoxically, although depression recurs, for some people their suicidality may stop. Few studies have addressed the psychological factors associated with resolution or persistence of suicidality within recurrent depression but some research has shown pre-adult onset of depression and suicidality can have particularly toxic consequences. For this thesis, baseline data was obtained from the assessments of a large randomised clinical trial in major depression, in particular a novel method of using timeline data was used to explore 153 previously depressed adults’s life history. This data was examined for the presence of sub-groups within those who have been previously depressed based on their history of suicidality. The overall aims of this thesis were to investigate whether distinct suicidal groups, characterised by different patterns of recurrence of suicidality, could be identified within a sample of participants who all had recurrent major depression. If these specific groups existed within our sample, then a further aim was to compare the socio-demographic and clinical characteristics of each group to those who had never been suicidal. The trajectories of onset of depression and suicidality in adolescence were also explored. Results showed that although it was possible to identify resolved and unresolved groups, differences between the groups were limited. The unresolved group reported experiencing more intrusive suicidal thoughts and found suicidal thoughts more comforting. In regards to age of onset, more than half of the sample had an onset of depression during their adolescence. Those with an onset of suicidality in adolescence experienced a greater number of subsequent suicidal episodes. The presence of suicidality within the first episode of depression rendered individuals more vulnerable to experiencing further suicidal episodes in the future. Intervention, prevention and assessment of suicidality should take into consideration onset of depression and suicidality as well as whether suicidality was present in initial depressive episodes, levels of comfort obtained from suicidal thoughts and how intrusive suicidal thought are

Trajectories of suicidality in the course of major depression

The Differential Activation Theory of suicide suggests that once suicidality has occurred during one episode of depression it is highly likely to recur, when depression recurs. However, paradoxically, although depression recurs, for some people their suicidality may stop. Few studies have addressed the psychological factors associated with resolution or persistence of suicidality within recurrent depression but some research has shown pre-adult onset of depression and suicidality can have particularly toxic consequences. For this thesis, baseline data was obtained from the assessments of a large randomised clinical trial in major depression, in particular a novel method of using timeline data was used to explore 153 previously depressed adults’s life history. This data was examined for the presence of sub-groups within those who have been previously depressed based on their history of suicidality. The overall aims of this thesis were to investigate whether distinct suicidal groups, characterised by different patterns of recurrence of suicidality, could be identified within a sample of participants who all had recurrent major depression. If these specific groups existed within our sample, then a further aim was to compare the socio-demographic and clinical characteristics of each group to those who had never been suicidal. The trajectories of onset of depression and suicidality in adolescence were also explored. Results showed that although it was possible to identify resolved and unresolved groups, differences between the groups were limited. The unresolved group reported experiencing more intrusive suicidal thoughts and found suicidal thoughts more comforting. In regards to age of onset, more than half of the sample had an onset of depression during their adolescence. Those with an onset of suicidality in adolescence experienced a greater number of subsequent suicidal episodes. The presence of suicidality within the first episode of depression rendered individuals more vulnerable to experiencing further suicidal episodes in the future. Intervention, prevention and assessment of suicidality should take into consideration onset of depression and suicidality as well as whether suicidality was present in initial depressive episodes, levels of comfort obtained from suicidal thoughts and how intrusive suicidal thought are.</p

Effect of Action Observation Therapy on Pain, Kinesiophobia, Function, and Quality of Life in Adhesive Capsulitis Patients

Background: Adhesive capsulitis is a common musculoskeletal health problem. Cortical changes along with maladaptive pain behavior has been reported in literature. There is a need to implement biopsychosocial rehabilitation approaches to achieve successful outcomes. Hence, this study aims to evaluate the effect of action observation therapy (AOT) on pain, kinesiophobia, function and quality of life in adhesive capsulitis patients. Methods: This single-center, prospective study was conducted in a group of 30 persons diagnosed with adhesive capsulitis patients (19 males, 11 females). Patients were randomly assigned into two groups. Patients in one group were given AOT along with conventional exercises, while the patients in the other group received only conventional exercises. The patients were evaluated before and after 4 weeks of intervention using numerical pain rating scale (NRS), pain catastrophizing scale (PCS), Tampa scale of kinesiophobia (TSK), Shoulder pain and disability index (SPADI) and 36-Item Short Form Survey (SF-36). Results: There was a statistically significant difference seen in pre and post intervention scores of the NRS, PCS, TSK, SPADI, SF-36 PCS and SF36 MCS (p0.05). Conclusion: The present study supports the addition of AOT to conventional exercises in rehabilitation of patients with adhesive capsulitis. AOT promotes a top-down approach leading to cortical reorganization and helps to reduce kinesiophobia and improve quality of life in adhesive capsulitis patients as compared to conventional exercises alone

Trajectories of Suicidality in the Course of Major Depression

The Differential Activation Theory of suicide suggests that once suicidality has occurred during one episode of depression it is highly likely to recur, when depression recurs. However, paradoxically, although depression recurs, for some people their suicidality may stop. Few studies have addressed the psychological factors associated with resolution or persistence of suicidality within recurrent depression but some research has shown pre-adult onset of depression and suicidality can have particularly toxic consequences. For this thesis, baseline data was obtained from the assessments of a large randomised clinical trial in major depression, in particular a novel method of using timeline data was used to explore 153 previously depressed adults’s life history. This data was examined for the presence of sub-groups within those who have been previously depressed based on their history of suicidality. The overall aims of this thesis were to investigate whether distinct suicidal groups, characterised by different patterns of recurrence of suicidality, could be identified within a sample of participants who all had recurrent major depression. If these specific groups existed within our sample, then a further aim was to compare the socio-demographic and clinical characteristics of each group to those who had never been suicidal. The trajectories of onset of depression and suicidality in adolescence were also explored. Results showed that although it was possible to identify resolved and unresolved groups, differences between the groups were limited. The unresolved group reported experiencing more intrusive suicidal thoughts and found suicidal thoughts more comforting. In regards to age of onset, more than half of the sample had an onset of depression during their adolescence. Those with an onset of suicidality in adolescence experienced a greater number of subsequent suicidal episodes. The presence of suicidality within the first episode of depression rendered individuals more vulnerable to experiencing further suicidal episodes in the future. Intervention, prevention and assessment of suicidality should take into consideration onset of depression and suicidality as well as whether suicidality was present in initial depressive episodes, levels of comfort obtained from suicidal thoughts and how intrusive suicidal thought are.This thesis is not currently available on ORA

A review on Effectivity of Plant based vaccines in the treatment of viral diseases

Plant engineering technology has been working effectively since last 30 years. Commercialization of different product using plant engineering is encouraging us to develop effective treatment and this progress takes too much effort and time, but still many candidate vaccines for use in humans are in clinical trials. Virus-like particles (VLPs) are basically self-constructed structures departed from viral antigens which copy the organization of similar viruses but without viral genome. This technology offers several pros in terms of safety, immunogenicity and stability in production over vaccines derived from pathogen formulation. Now, many pharmaceutical companies are working in this technology to develop effective treatment against various diseases. This review discusses how plant engineering technology works for diseases and regulations relevant to the development of plant-based vaccines in the treatment of viruses like Hepatitis B, Ebola, Papilloma, Norwalk, Influenza, HIV and Covid-19. Keywords: Plant engineering technology, Virus-like Particles, Pathogens, Antibodies

A Study on the Online Shopping - Pre and Post Pandemic

Prior to the pandemic, online shopping was infrequent. However, when the COVID-19 situation worsened, people were unable to purchase the products they needed since stores were closed and there was only one way to get them: online shopping. As a result, they started buying online, but they soon realized that they had a lot of possibilities, so they progressively went toward it. People continued to shop online and in-store as the situation stabilized. People preferred both online and in-store purchasing, but it was discovered that online shopping surged after the pandemic

Determination of neuroprotective effects of medium chain fatty acids and their derivatives on mutant huntingtin aggregates, oxidative stress and ATP levels in HD150Q cell line model of Huntington’s disease

741-749Huntington's disease (HD) is a rare autosomal dominant genetic disorder resulting from expansion of polymorphic CAG repeats in the exon 1 of huntingtin gene that translates into elongated polyglutamine (ployQ) tract in huntingtin protein (HTT).PolyQ expansion alters HTT structure resulting in abnormal protein-protein interactions, aggregation, mitochondrial dysfunction, oxidative and endoplasmic reticulum stress, inflammation and altered gene expression leading to neuronal cell death.HD symptoms involves chorea, dementia, behavioural and psychological problems and currently there is no cure highlighting the need for novel therapeutic interventions. Several fatty acids have been reported to have protective effects in neurological disorders including Alzheimer’s disease, Parkinson’s disease and epilepsy. However, their effects in HD is largely unexplored. Neurodegenerative diseases share several common pathways and thus it is likely that a combination of selected fatty acids show neuroprotective effects in HD. This study utilized a cell line model of HD expressing inducible mutant huntingtin fragment with 150 polyQ repeats (HD150Q) to investigate neuroprotective effects of two medium chain fatty acids and one triglyceride. Significant reduction in mutant HTT aggregates and mitochondrial oxidative stress and restoration of ATP levels was observed upon treatment with Decanoic acid, 2-butyloctanoic acid, and Glyceryl triacetate. Encouraging results in the cell line model opens avenues for investigating the underlying molecular mechanisms and validation in the animal models

A Hierarchical Approach for the Diagnosis of Sleep Disorders Using Convolutional Recurrent Neural Network

Sleep is an essential criterion for health. However, sleep disorders degrade the sleep quality. Hence, to diagnose sleep disorders, sleep monitoring is crucial. The cyclic alternating patterns (CAP) phases describe the sleep quality. However, CAP detection is a time-consuming, hectic, and uncertain process. Therefore, an automatic detection of CAP phases is necessary. This study proposes a hierarchical approach to identify sleep disorders and classify CAP phases. Single-channel EEG recording provided by the CAP sleep database has been utilized in this study. The proposed approach classifies CAP sequence into healthy or unhealthy. Further, it identifies sleep disorder of unhealthy sequence among periodic leg movement (PLM), rapid eye movement behaviour disorder (RBD), nocturnal frontal lobe epilepsy (NFLE), narcolepsy (NARCO), and insomnia (INS). Further using our prior work, the CAP phase of the sequence can be identified. The best model was obtained by long short-term memory (LSTM) along with convolutional neural network (CNN) for healthy-unhealthy, and disease classification with an accuracy of 91.45&#x0025; and 90.55&#x0025;, respectively. The same models gave an accuracy of 92.79&#x0025; for healthy-unhealthy and 93.31&#x0025; for disease classification when evaluated using dataset of only phase B, highlighting the importance of phase B for identifying sleep disorders

Single Amino Acid Based Self-Assemblies of Cysteine and Methionine

We report for the very first time self-assembly of Cysteine and Methionine to discrenible strucutres under neutral condition. The nature of interactions which lead to such self-assemblies was purported by coincubating assemblies in urea and mercaptoethanol. Further interaction of aggregates with short amyloidogenic dipeptide diphenylalanine (FF) was assessed. While cysteine aggregates completely disrupted FF fibres, methionine albeit triggered fibrillation. . The results presented in the manuscript are striking, since to the best of our knowledge,this is the first report which demonstrates that even non-aromatic amino acids (cysteine and methionine) can undergo spontaneous self-assembly to form ordered aggregates