32 research outputs found

    Identification of in Situ Progenitor Cell Features Contributing to Cartilage Repair and Strategies for Cartilage Repair Augmentation

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    Le cartilage articulaire hyalin recouvre l’extrĂ©mitĂ© des os longs. Sa capacitĂ© de guĂ©rison intrinsĂšque est faible puisqu’il n’est pas vascularisĂ©. Suite Ă  une blessure, la guĂ©rison n’a gĂ©nĂ©ralement pas lieu, ou demeure de faible amplitude. Une dĂ©gĂ©nĂ©rescence des lĂ©sions peut Ă©galement survenir suite au relargage de cytokines et autres facteurs inflammatoires. Un dĂ©sĂ©quilibre entre les activitĂ©s anaboliques et cataboliques peut Ă©ventuellement induire l’érosion du cartilage, l’exposition de l’os sous-jacent et l’ostĂ©oarthrite. Les techniques de stimulation de la moelle osseuse sont une façon de stimuler la guĂ©rison du cartilage en perçant l’os situĂ© sous les lĂ©sions du cartilage. Les canaux percĂ©s permettent aux cellules progĂ©nitrices qui se trouvent dans la moelle osseuse (bone marrow progenitor cells en anglais) de migrer vers les lĂ©sions. Ces cellules progĂ©nitrices se diffĂ©rencient et synthĂ©tisent un tissue de granulation qui sera remodelĂ© en tissue de guĂ©rison. Les techniques de stimulation de la moelle osseuse sont beaucoup utilisĂ©es en clinique puisqu’elles sont simples et peu coĂ»teuses Ă  effectuer, que les patients se rĂ©tablissent rapidement aprĂšs la chirurgie et qu’elles sont efficaces pour diminuer la douleur. Cependant, les bienfaits ressentis ne sont pas durables puisque le tissu de guĂ©rison est un tissue fibrocartilagineux qui ne possĂšde pas les propriĂ©tĂ©s biologiques et mĂ©caniques du cartilage hyalin. Les inconvĂ©nients les plus communs observĂ©s au cours d’études prĂ©-cliniques et cliniques portant sur les techniques de stimulation de la moelle osseuse sont une guĂ©rison incomplĂšte, une grande variabilitĂ© inter-individu, et des rĂ©sultats insatisfaisants, surtout chez les individus plus ĂągĂ©s. Il a dĂ©jĂ  Ă©tĂ© dĂ©montrĂ© dans des Ă©tudes prĂ©-cliniques que l’emplacement de la lĂ©sion ainsi que l’ñge de l’animal sont deux paramĂštres qui affectent grandement la guĂ©rison. Plus spĂ©cifiquement, chez le lapin, les lĂ©sions situĂ©es sur la trochlĂ©e guĂ©rissent mieux que les lĂ©sions situĂ©es sur le condyle fĂ©moral mĂ©dial, ce qui suggĂšre que les cellules progĂ©nitrices de la moelle osseuse prĂ©sentes aux deux emplacements ne possĂšderaient pas les mĂȘmes propriĂ©tĂ©s biologiques intrinsĂšques. L’objectif de la premiĂšre Ă©tude de cette thĂšse Ă©tait de dĂ©terminer l’effet de l’emplacement et de l’ñge de l’animal sur les propriĂ©tĂ©s biologiques intrinsĂšques des cellules progĂ©nitrices de la moelle osseuse. Pour ce faire, les propriĂ©tĂ©s biologiques des cellules isolĂ©es Ă  partir de la trochlĂ©e et des condyles chez des lapins jeunes et ĂągĂ©s ont Ă©tĂ© caractĂ©risĂ©es. Ensuite, puisque de prĂ©cĂ©dentes Ă©tudes chez le lapin ont dĂ©montrĂ© qu’un perçage profond Ă  6 mm favorise la guĂ©rison du cartilage dans la trochlĂ©e en comparaison Ă  un perçage peu profond, les propriĂ©tĂ©s biologiques de cellules progĂ©nitrices isolĂ©es Ă  partir de la moelle mĂ©taphysaire (rĂ©gion profonde) et de la moelle Ă©piphysaire (rĂ©gion peu profondes) ont Ă©tĂ© caractĂ©risĂ©es. Deux mĂ©thodes d’isolation des cellules progĂ©nitrices ont Ă©tĂ© utilisĂ©es, soit la digestion enzymatique Ă  la collagĂ©nase et la culture d’explants osseux. Pour chaque population de cellules progĂ©nitrices, le rendement cellulaire, le potentiel clonogĂ©nique et l’expression de diffĂ©rents marqueurs ont Ă©tĂ© dĂ©terminĂ©s in vitro. Le potentiel chondrogĂ©nique a, quant Ă  lui, Ă©tĂ© dĂ©terminĂ© en stimulant les cellules progĂ©nitrices avec un milieu de culture chondrogĂ©nique contenant de l’ascorbate, ITS et TGF-III. Enfin, le potentiel ostĂ©ogĂ©nique a Ă©tĂ© dĂ©terminĂ© en stimulant les cellules progĂ©nitrices avec un milieu de culture ostĂ©ogĂ©nique contenant du dexamethasone, de la ÎČ-glycerophosphate et de l’ascorbate. Une comparaison entre les propriĂ©tĂ©s biologiques obtenues pour les cellules progĂ©nitrices provenant des condyles, de la trochlĂ©e profonde, ou de la trochlĂ©e peu profonde, pour les lapins jeune ou ĂągĂ©s et pour les cellules isolĂ©es par digestion enzymatique ou par culture d’explants a ensuite Ă©tĂ© effectuĂ©e. Selon les critĂšres Ă©tablis par l’International Society for Cell Therapy, les cellules progĂ©nitrices isolĂ©es lors de l’étude pouvaient ĂȘtre dĂ©crites comme une population de cellules souches mĂ©senchymateuses. Les condyles avaient un faible rendement cellulaire en comparaison Ă  la trochlĂ©e et les cellules progĂ©nitrices isolĂ©es Ă  partir des condyles avaient Ă©galement de faibles potentiels clonogĂ©nique et chondrogĂ©nique. En revanche, les cellules progĂ©nitrices isolĂ©es Ă  partir de la trochlĂ©e possĂ©daient un haut rendement cellulaire, des potentiels clonogĂ©nique et chondrogĂ©nique Ă©levĂ©s et exprimaient beaucoup de glycosaminoglycanes et de collagĂšne type II, deux molĂ©cules prĂ©sentes dans le cartilage articulaire hyalin. Le site d’isolation ou l’emplacement Ă©tait donc un facteur dĂ©terminant pour les propriĂ©tĂ©s biologiques des cellules progĂ©nitrices, ce qui suggĂšre que le potentiel de guĂ©rison Ă©levĂ© observĂ© dans la trochlĂ©e du lapin serait dĂ» Ă  la prĂ©sence d’une population nombreuse de cellules progĂ©nitrices ayant un fort potentiel chondrogĂ©nique. L’ñge des lapins s’est aussi avĂ©rĂ© ĂȘtre un facteur important puisque le rendement cellulaire, l’expression de marqueurs pour cellules souches et la diffĂ©renciation chondrogĂ©nique et ostĂ©ogĂ©nique Ă©taient meilleurs chez les lapins jeunes que chez les lapins ĂągĂ©s. Enfin, il n’y avait pas de diffĂ©rence entre les cellules isolĂ©es par digestion enzymatique ou par culture d’explants. L’objectif de la deuxiĂšme Ă©tude de cette thĂšse Ă©tait de dĂ©terminer s’il existe une corrĂ©lation entre les propriĂ©tĂ©s biologiques intrinsĂšques des cellules progĂ©nitrices de la moelle osseuse et la capacitĂ© de guĂ©rison du cartilage sus-jacent. Pour ce faire, un modĂšle bilatĂ©ral a Ă©tĂ© effectuĂ© chez 8 lapins. Pour chaque lapin, des lĂ©sions cartilagineuses ont Ă©tĂ© crĂ©Ă©es sur un genou Ă  deux emplacements (la trochlĂ©e et le condyle fĂ©moral mĂ©dial) puis traitĂ©es par microperçage, tandis que l’autre genou demeurait intact. AprĂšs 3 semaines de guĂ©rison, les lapins ont Ă©tĂ© sacrifiĂ©s et des sections histologiques ont Ă©tĂ© rĂ©coltĂ©es du genou traitĂ© par microperçage afin d’évaluer la guĂ©rison. ParallĂšlement, les cellules progĂ©nitrices du genou intact ont Ă©tĂ© rĂ©coltĂ©es et leurs propriĂ©tĂ©s biologiques caractĂ©risĂ©es tel que dĂ©crit ci-haut. Chez tous les lapins, la guĂ©rison induite par stimulation de la moelle osseuse Ă©tait compromise dans le condyle fĂ©moral mĂ©dial, oĂč trĂšs peu de tissu de guĂ©rison Ă©tait prĂ©sent aprĂšs 3 semaines. En revanche, une guĂ©rison modĂ©rĂ©e Ă  excellente Ă©tait apparente dans la trochlĂ©e de 6 lapins sur 8, alors que 2 lapins ont Ă©tĂ© classifiĂ©s comme faisant partie d’un groupe ayant un plus faible potentiel de guĂ©rison. Tout comme pour la premiĂšre Ă©tude, les cellules progĂ©nitrices de la trochlĂ©e avaient un meilleur rendement cellulaire et de forts potentiels clonogĂ©nique et chondrogĂ©nique que les cellules des condyles. Une variabilitĂ© inter-individu Ă©tait Ă©galement prĂ©sente dans le cas des propriĂ©tĂ©s biologiques des cellules progĂ©nitrices. Les tissus de guĂ©rison de la trochlĂ©e ainsi que la matrice extracellulaire synthĂ©tisĂ©e par les cellules progĂ©nitrices isolĂ©es Ă  partir de la trochlĂ©e contenaient une grande quantitĂ© de glycosaminoglycanes et de collagĂšne type II. Des analyses statistiques ont permis de dĂ©terminer qu’il existait de fortes corrĂ©lations positives entre les propriĂ©tĂ©s intrinsĂšques des cellules progĂ©nitrices de la moelle osseuse et la capacitĂ© de guĂ©rison du cartilage sus-jacent. Les propriĂ©tĂ©s biologiques ayant le plus d’impact sur la guĂ©rison ont Ă©tĂ© identifiĂ©es. L’objectif de la troisiĂšme Ă©tude de cette thĂšse Ă©tait de dĂ©velopper un modĂšle animal reprĂ©sentatif de la situation clinique, et d’y tester une nouvelle mĂ©thode de guĂ©rison. En clinique, les lĂ©sions du cartilage sont rarement dĂ©tectĂ©es rapidement, ce qui complique le traitement. Une grande variabilitĂ© de la rĂ©ponse et une guĂ©rison compromise sont Ă©galement observĂ©es chez les patients plus ĂągĂ©s souffrant de lĂ©sions dĂ©gĂ©nĂ©ratives chroniques. La rĂ©traction du caillot sanguin qui remplit les lĂ©sions cartilagineuses suite au microperçage et sa perte subsĂ©quente sont une raison qui pourrait expliquer les rĂ©sultats insatisfaisants observĂ©s en clinique. Il a Ă©tĂ© dĂ©montrĂ© que le chitosane permet d’inhiber la rĂ©traction du caillot sanguin et, par le fait mĂȘme, qu’il promeut la guĂ©rison du cartilage en ayant des effets sur le recrutement cellulaire, la vascularisation and le remodelage osseux. Le plasma riche en plaquettes (PRP) contient une concentration Ă©levĂ©e de facteurs de croissance capables de stimuler le recrutement cellulaire et la diffĂ©renciation chondrogĂ©nique. Il a Ă©tĂ© dĂ©montrĂ© que le chitosane favorise la stabilitĂ© du PRP et le relargage de facteurs de croissance. Un modĂšle de lĂ©sions cartilagineuses chroniques a d’abord Ă©tĂ© dĂ©veloppĂ© chez le lapin. Deux chirurgies Ă©tait nĂ©cessaires pour effectuer ce modĂšle. Au cours de la premiĂšre chirurgie, des lĂ©sions cartilagineuses bilatĂ©rales ont Ă©tĂ© induites dans la trochlĂ©e de 8 lapins et laissĂ©es sans traitement pendant 4 semaines afin qu’elles dĂ©gĂ©nĂšrent Ă  un stade chronique. Au cours de la deuxiĂšme chirurgie, ces lĂ©sions cartilagineuses ont Ă©tĂ© traitĂ©es par microperçage et par l’implantation de chitosane lyophilisĂ© solubilisĂ© dans du PRP autologue, ou par injection de PRP seul, comme contrĂŽle. Le tissu de guĂ©rison a Ă©tĂ© rĂ©coltĂ© aprĂšs 2 mois et des sections histologiques ont permis d’évaluer la quantitĂ© et la qualitĂ© du tissu de guĂ©rison. La guĂ©rison osseuse ainsi que le remodelage osseux ont Ă©galement Ă©tĂ© caractĂ©risĂ©es par analyse micro-CT. Les implants chitosane-PRP favorisaient la guĂ©rison des lĂ©sions cartilagineuses chroniques comparĂ©es au PRP seul. La composition biochimique de la matrice cartilagineuse ressemblait plus Ă  du cartilage hyalin en prĂ©sence des implants chitosane-PRP. Finalement, l’analyse micro-CT dĂ©montrait que les implants chitosane-PRP favorisent le remodelage osseux mais que le phĂ©nomĂšne est toujours en cours aprĂšs 2 mois de guĂ©rison. En rĂ©sumĂ©, le contenu de cette thĂšse nous a permis d’identifier certaines variables liĂ©es Ă  l’emplacement, au donneur et Ă  l’ñge qui expliqueraient partiellement la variabilitĂ© inter-individu et les rĂ©sultats dĂ©cevants parfois obtenus suite Ă  une stimulation de la moelle osseuse. Le modĂšle de lĂ©sions chroniques dĂ©crit dans cette thĂšse contribuera grandement au dĂ©veloppement de nouvelles techniques et de nouveaux produits pour favoriser la guĂ©rison du cartilage articulaire. Enfin, les implants chitosane-PRP Ă©tudiĂ©s au cours de cette thĂšse constituent une approche prometteuse qui pourrait Ă©ventuellement servir Ă  soulager des patients souffrant de lĂ©sions chroniques ou dĂ©gĂ©nĂ©ratives.----------ABSTRACT Articular cartilage is a thin layer of hyaline cartilaginous tissue covering the ends of long bones. Due to its avascular nature, it possesses very limited regeneration potential. In the event of an injury, the repair is either very limited or not initiated at all. As a result, cartilage lesions degenerate extensively under the influence of damaging cytokines and proinflammatory factors released. An imbalance in anabolic and catabolic activities continues to erode the cartilaginous surface exposing subchondral bone leading to osteoarthritis. Bone marrow stimulation (BMS) initiates repair by fracturing or drilling into subchondral bone. The channels created provide access to the underlying subchondral progenitor cells that are recruited into the defect. Granulation tissue thus formed undergoes a complex cascade of events to generate a repair tissue. BMS is considered a gold standard of cartilage repair strategies since it is easy, relatively less invasive with swift recovery, more economical and appreciable short-mid term relief. However, long term outcome is generally discouraging due to poor durability of repair tissue. The quality of repair tissue is generally fibrocartilagenous with inferior mechanical and biological characteristics compared to hyaline cartilage. The most common drawbacks of the procedure include incomplete regeneration, high inter-individual variability and poor repair outcome especially in older individuals in preclinical as well as clinical studies. Earlier studies have shown that defect location and animal age affect the cartilage repair outcome observed in vivo, suggesting a strong influence of biological characteristics of progenitor cells (Bone Marrow stem cells; BMSCs or mesenchymal stem cells; MSCs) present in subchondral bone. Specifically, rabbit trochlea showed a superior repair and chondrogenic potential compared to the medial femoral condyle. Inspired by these observations, we carried out a study for comprehensive analysis of progenitor cells present in the subchondral bone of condyle and trochlea in young and old rabbits in order to determine the influence of location and age on the properties of progenitor cells. Earlier we had found that drilling to 6 mm improves the repair outcome in rabbit trochlea possibly by providing access to metaphyseal marrow and thus higher progenitor cell population. As a result, MSCs were isolated from epiphyseal (trochlea upper) and metaphyseal (trochlea lower) regions of the trochlea. Collagenase-derived MSCs originated from collagenase digest of bone chips while the digested explants were subsequently cultured to obtain explant-derived MSCs via cell outgrowth. In vitro characterization assays were used to determine the cell yield, clonogenic potential and surface marker expression profile. Chondrogenic differentiation was stimulated using pellets of condylar and trochlear MSCs in the presence of chondrogenic media, rich in chondrogenic stimulating factors such as ascorbate, insulin-transferrin-selenium (ITS) and TGF-ÎČIII. Finally, MSCs were differentiated into osteogenic lineage in presence of osteogenic media containing osteogenic stimulants such as dexamethasone, ÎČ-glycerophosphate and ascorbate. The aforementioned MSC characteristics were compared for trochlea vs. condyle, old vs. young and collagenase- vs. explant-derived cultures. MSCs isolated from distal femur epiphyseal bone had stem cell characteristics and fulfilled the stem cell criteria outlined by International Society for Cell Therapy. Location was an important factor influencing the properties of MSCs indicated by low cell yield, clonogenic potential and inferior chondrogenic potential of condylar cells. Results showed that rabbit trochlear vs. condylar subchondral bone yielded a greater number of progenitors with superior cartilaginous matrix expression under chondrogenic conditions suggesting higher intrinsic capacity for cartilage repair compared to condylar subchondral bone. Trochlear MSCs displayed superior chondrogenic differentiation evidenced by higher glycosaminoglycan (GAG) and collagen type II deposition. Age of the donor was an additional factor with significant bearing on the inherent properties of MSCs since growth rate, cell yield, expression of stem cell markers and osteogenic differentiation were found to be significantly superior in younger animals. As expected, no significant difference was observed between collagenase- and explant-derived cultures. Continuing our exploration of the mechanisms underlying variability in BMS procedure, we carried out the next study to verify if the cartilage repair outcome in condyle and trochlea correlated with the pre-existing properties of progenitor cells present in these two sites. A bilateral rabbit model was used to test this hypothesis. For each rabbit, full thickness acute defects were created in one knee and treated by BMS by microdrilling, while the second knee was left intact. Animals were sacrificed 3 weeks later and transverse sections of repair tissue from the treated knee were used to analyze the quality and quantity of repair macroscopically and by safranin- O (Saf-O) and immunostaining. At the time of animal sacrifice, distal femurs were separated and MSCs were isolated from condylar and trochlear regions of the intact contralateral knee for biological characterization of cell yield, clonogenic potential, cell surface marker profile and differentiation potency. BMS induced inferior cartilage repair in condyles of all donors studied further underlining the implication of location in influencing repair outcome. Macroscopic examination revealed extremely poor fill in condylar defects. In contrast, moderate to excellent fill was observed in six out of eight trochlear defects. This led us to identify a donor-dependent variability in repair outcome and the donors were classified as good trochlear responders and poor trochlear responders. In another observation, trochlear MSCs were characterized by increased cell yield, higher clonogenic potential and superior chondrogenic potential. Histopathological analysis indicated better matrix composition, rich in GAG and collagen type II in trochlea both in vivo and in vitro. Donor related variability in repair outcome was also observed in vitro through biological characterization of MSCs. Statistical analysis provided substantial evidence to identify strong, positive location- and donor-dependent correlations between inherent properties of MSCs and cartilage repair outcome in condyle and trochlea and factors with maximum influence on the repair outcome were identified. By this stage, it became imperative to seek after a clinically relevant application of our understanding based on current and past findings. Cartilage lesions are rarely detected in early stages, unfortunately reducing the efficacy of BMS procedure. Unpredictable, highly variable repair of poor quality is observed in degenerative defects, especially in older patients. Platelet-mediated retraction of the blood clot that fills cartilage lesions following BMS is believed to be one underlying cause of inferior quality and durability of repair tissue. Chitosan inhibits this blood clot shrinkage and leads to the formation of a voluminous, adherent and stable clot and thereby enhances cartilage repair by promoting cell recruitment, transient vascularization and subchondral bone remodeling. Platelet-rich-plasma (PRP) contains a 2-10 fold concentration of growth factors and cytokines and has been shown to improve recruitment and chondrogenic potential of subchondral MSCs. Chitosan increases the stability of PRP and promotes the release of platelet-derived growth factors in a more sustained manner. Using a more clinically relevant chronic defect model, we tested the efficacy of implants composed of freeze-dried chitosan solubilized in PRP in improving marrow stimulated cartilage repair outcome compared to BMS augmented with just PRP. Two surgeries were performed in skeletally mature rabbits to create a bilateral trochlear defect model. Defects created in the first surgery were allowed to degenerate over 4 weeks and repaired in a second surgery by BMS. Treatments included BMS augmented with chitosan/PRP implants in one knee and BMS with PRP in the other knee. Repair tissue was harvested 2 months later and transverse sections were used to characterize the quality and quantity of repair by assessing the GAG and coll-II deposition. Subchondral bone repair was analysed by micro-CT. Augmentation of BMS with freeze-dried chitosan/PRP implants in chronic defects improved cartilage repair compared to PRP by increasing quantity and quality of repair tissue and promoting subchondral bone repair. Matrix composition was improved in presence of chitosan/PRP indicated by increased GAG and collagen deposition. MicroCT analysis showed further evidence of increased, albeit incomplete, subchondral bone remodeling induced by chitosan/PRP. In summary, these studies led us to recognize significant donor-, age- and location-dependent variability which might help in understanding the mechanism underneath the unpredictability and inter-individual variability observed with BMS. Needless to say, these observations would be extremely valuable in improving the consistency, durability and quality of BMS repair procedure. Moreover, the innovative chronic model studied here is expected to make significant contributions in progress of cartilage repair field. Finally, chitosan/PRP implants investigated in this research are a promising approach to treat chronic cartilage lesions and could eventually provide relief to osteoarthritic patients with challenging, degenerative defects

    Neonatal outcome in early term and late term pregnancy

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    Background: Full-term neonates born between 37- and 41-weeks’ gestational age have been considered a homogeneous, low-risk group. However, recent evidence from studies has pointed toward increased NICU admissions and morbidity associated with births (37-38 weeks) compared with term neonates (39-41 weeks). The objective of this study was to compare the short-term morbidity of early-term vs term neonates in a county-based birth cohort using the primary objective of admission to a neonatal intensive care unit (NICU) or neonatology service. Methods: Retrospective observational population-based 2 year birth cohort study at Department of Obstetrics and Gynecology GSVM Medical College, Kanpur. All full-term live births comprised the birth cohort; this information was obtained from the hospitals’ perinatal databases, and data pertaining to NICU, or neonatology service admissions were extracted from individual medical records.  Gestational age of early term (37 0/7-38 6/7 weeks) verses term (39 0/7-4 10/7 weeks). Admission to the NICU or neonatology service. Results: There were 17,132 live births during the 2 year period, of which 13679 had a gestational age between 37 and 41 weeks. Of all live births, 6204 (45.3%) were early term. Compared with term infants, early-term neonates had significantly higher risks for the following: hypoglycaemia (29.9% verses 14.7%), NICU or neonatology service admission (20.9% vs12.05 %), need for respiratory support (36.8% verses 29.9%), treatment with intravenous antibiotics [39.4% verses 25. Delivery by caesarean section was common among early-term births (45.9%)]. Conclusions: Early-term births are associated with high neonatal morbidity and with NICU or neonatology service admission. Evaluation of local prevalence data will assist in implementation of specific preventive measures and plans, as well as prioritize limited health care resources

    Study of association of socio-demographic characteristics with the knowledge about sex determination and preconception and prenatal diagnostic technique act among pregnant women

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    Background: Preconception and prenatal diagnostic technique Act was amended in year 2003 which provides for prohibition of sex selection before and after conception and for regulation of prenatal diagnostic technique.Methods: A cross sectional study was carried out in antenatal ward of GSVM Medical College Kanpur during the period of January to December 2019. A total of 2500 pregnant women were included and predesigned and pretested questionnaire was used to get information regarding socio-demographic details of pregnant women. They were asked regarding the knowledge and attitude towards the PC-PNDT Act. Data were collected and analyzed using Microsoft excel and SPSS-12. Results: In the present study, out of 2500 women, 2125 (85%) knew about sex determination while 125 (5%) knew about PNDT Act. There was significant association of occupation, education and annual income with knowledge. Majority of women know about PC-PNDT act from health staff and ultrasonography was the main technique they know to detect sex determination. Conclusions: The falling ratio of girl child is a matter of grave concern. Effective implementation of the PNDT Act in addition to spreading awareness about this act among people is the need of the hour. Educating the community will prevent the decline in sex ratio and female feticide through PC-PNDT Act

    Effect of anaemia on maternal and fetal outcome: an observational study

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    Background: Anaemia in pregnancy is a globally health-related issue that affects both mothers and their new-born. Hence an observational study to see the effect of anaemia on maternal and foetal outcome was conducted. Methods: 15024 mothers coming in OPD or IPD in past 4 years were recruited and their haemoglobin measured. Descriptive statistics was used for baseline characteristics. This observational study was conducted in department of obs and gynae, GSVM Medical College Kanpur from August 2018 to August 2022. All the data gathered was processed by SPSS version 25. Results: The main outcomes included 4 maternal outcomes (postpartum haemorrhage, shock, ICU admission, and maternal mortality) and 4 neonatal outcomes (foetal growth restriction, birth weight, NICU admission, stillbirth). 60.03% of the mothers were anaemic in our study. Maternal and foetal complications were more in anaemic than non-anaemic mothers with incidence of PPH, shock, ICU admission, and maternal mortality being 14.07%, 11.33% ,4.30 and 1.31% respectively than non-anaemic mothers with incidence of 11.22%, 7.26%, 1.76%, and 7.28% respectively. Foetal outcome was also poorer in anaemic mothers with incidence of FGR, LBW, NICU admission, Still birth being 3.15%, 8.85%, 12.96%, and 1.09% higher than non-anaemic group with incidence being 1.80%, 3.43%, 9.75%, and 0.30 % respectively. Conclusions: This observational study provides valuable insights into the effect of anaemia on both maternal and foetal outcomes. It emphasizes the importance of early detection and management of anaemia to mitigate the risks associated with this condition

    Salivary uric acid as a non-invasive marker of early onset preeclampsia

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    Background: Preeclampsia is one of the most common complications in pregnancy and is a major cause of maternal and perinatal morbidity and mortality. Early prediction of preeclampsia is crucial in proactive management of the patient. Uric acid is a biomarker of hypertension. Methods: A prospective study was done on 200 pregnant females in their first or early second trimester of pregnancy and were followed till one week of delivery or termination of pregnancy. After taking socio-demographic details, detailed medical and obstetric history was taken. Blood pressure of the patients was routinely measured and mean arterial pressure was calculated. Blood and saliva samples were taken and were analysed following standard protocol for serum and salivary uric acid levels respectively. Participants were classified into normotensive and preeclampsia groups depending on the criteria met. Results: Preeclampsia group participants had significantly more adverse and feto-maternal outcomes. Salivary uric acid is a promising diagnostic predictor of preeclampsia in pregnant women by the virtue of being a non-invasive investigation with cut off value 4.86 mg/dl having a sensitivity of 70.8%, specificity of 45.7% and a PPV of 81.3%. Salivary uric acid level and mean arterial pressure were found to be better predictors of preeclampsia as compared to salivary uric acid level. Conclusions: Salivary uric acid is a reliable predictor of preeclampsia in pregnant females in first and early second trimester of pregnancy. Further largescale studies are warranted to establish an accurate cut off value with good diagnostic properties for Indian population

    New emerging rare-earth free yellow emitting 2D BCNO nanophosphor for white light emitting diodes

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    We have demonstrated a new emerging rare-earth free highly-efficient two dimensional (2D) boron carbon oxynitride (BCNO) yellow emitting nanophosphor with high quantum efficiency for white light emitting diode (WLED) devices. This BCNO nanophosphor exhibits 2D layered structures analogous to hexagonal BN phase. Further, the EELS and XPS results confirm the nanophosphor consisted of B, C, N and O elements. The BCNO nanophosphor shows a broad highly intense yellow emission band centered at 580 nm corresponding to 470 nm excitation wavelength with a quantum efficiency approaching 89%. This novel nanophosphor with strong emission has subsequently been integrated to chip on board (CoB) based blue LEDs in order to fabricate WLEDs devices with a color rendering index of 92. Low color temperature (4899) and better CIE color coordinates (x = 0.3496, y = 0.3679) of a fabricated WLEDs device supports a 2D BCNO nanophosphor that could be an exceptional choice for CoB based WLEDs. Hence, our method provides a facile synthesis of rare-earth free 2D lightweight BCNO nanophosphor and its integration with CoB based blue LEDs for next generation advanced solid state white light applications

    Probing on green long persistent Eu2+/Dy3+ doped Sr3SiAl4O11 emerging phosphor for security applications

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    Herein, a novel green emitting long-persistent Sr(3)SiAl(4)O(1)1:Eu2+/Dy3+ phosphor was synthesized in a single phase form using facile solid state reaction method under the reducing atmosphere of 10% H-2 and 90% N-2. The resulting phosphor exhibits hyper-sensitive strong broad green emission, peaking at 510 nm upon 340 nm excitation wavelength, which is attributed to the 4f(6)5d(1)-4f(7) transitions of emission center of europium (Eu2+) ions. Moreover, the incorporation of dysprosium (Dy3+) ions, which act as effective hole trap centers with appropriate depth, largely enhances the photoluminescence characteristics and greatly improves the persistent intense luminescence behavior of Sr3SiAl4O11:Eu2+/Dy3+ phosphor under ultraviolet (UV) excitation. In addition, with the optimum doping concentration and sufficient UV excitation time period, the as-synthesized phosphor can be persisted afterglow for time duration similar to 4 h with maximum luminescence intensity. Thus, these results suggest that this phosphor could be expected as an ultimate choice for next generation advanced luminescent materials in security applications such as latent finger-marks detection, photo-masking induced phosphorescent images, and security code detection

    A protective role for nitric oxide and salicylic acid for arsenite phytotoxicity in rice (Oryza sativa L.)

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    The authors are thankful to Director, CSIR-National Botanical Research Institute (CSIR-NBRI), Lucknow for the facilities and for the financial support from the network projects (CSIR-INDEPTH), New Delhi, India. APS is thankful to CSIR New Delhi, India respectively, for the award of Research Associateship. RDT is gratefully thankful to Award of Emeritus Scientist (CSIR). GD is thankful to SERB-DST, New Delhi for award of NPDF. AK is thankful to UGC for award of DSKPDF. Award of Fast Track Scientist to SM from DST is gratefully acknowledged. We are also thankful to Mr. Dilip Chakraborty for technical assistance.Peer reviewedPostprin

    Utilization of RHA in development of green composite material using RSM

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    In the present investigation, rice husk waste from rice mill was utilized in the development of aluminum based green metal matrix composite. Response surface methodology (RSM) was employed to develop green metal matrix composite by considering tensile strength as a response. Rice husk ash (RHA) was used as primary reinforcement material and B4C was used as a secondary reinforcement material in the development of composite. Microstructure results showed a uniform distribution of RHA and B4C in aluminum based matrix material. The optimum combination of reinforcement parameters was found to be RHA weight percentage of 7.8%, RHA preheats temperature of 231.12∘C, B4C preheats temperature of 435.24∘C and B4C wt.% of 6.67% respectively to achieve a tensile strength of 249.867 MPa

    The association of breast feeding and nutritional status of children 13-36 months of age /

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    Previous studies failed to report benefits of prolonged breast feeding on nutritional status. A nationally representative sample of 1411 children from Sri Lanka (1987) was used to compare breast feeders versus non breast feeders, as well as duration of breast feeding, through multivariate analyses for height-for-age, weight-for-age and weight-for-height z-scores. Analyses of interaction showed prolonged breast feeding to be advantageous among children of working mothers, and children from households using an unimproved water supply. For example, children 35 months of age, breast fed for 24 versus 8 months were 0.9 centimetres (95% confidence interval; +0.0, 1.8) taller if mothers worked and 420 grams (140, 690) heavier if households used an unimproved water supply. Among uneducated mothers breast fed children were 1.3 cm (2.2, 3.3) shorter than non breast fed children. Prolonged breast feeding should be encouraged as it is advantageous for the nutritional status of certain subgroups of children older than 12 months of age
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