Prelabour rupture of membranes at term prospective study of expectant management versus induction of labour

Background: Premature rupture of membranes (PROM) complicates 5-10 % of pregnancies. Approximately 60-70 % of term PROM cases are followed by the onset of labor within 24 hours. Diagnosis and proper management is very important. In spite of many studies available in the literature, the clinical management is surprisingly controversial.Methods: Study conducted was prospective randomised controlled trial. Total 150 women were selected fulfilling the inclusion criteria, randomly allotted to the 3 groups. In group A, patients were observed for 24 hours. If labor didn’t supervene in 24 hours since admission, induction of labor was done depending on the bishop’s score. In the group B, labour was induced by vaginal misoprostol 25 micrograms given 4 hourly for 4 doses and in group C, labor was induced by instillation of 0.5mg PGE2 gel in the posterior fornix. The women were observed for onset and progress of labour. Failure of induction was considered if patient was not in established labour within 24 hours of instillation of first dose of cerviprime/misoprostol. Labour was monitored and managed as per hospital protocol. The analysis verified the following variables: duration of latent phase and active phase of labour, mode of delivery (spontaneous/vaccum/forceps/LSCS), third stage complications (PPH/fever/retained placenta), neonatal outcome.Results: Thirty percent women had onset of spontaneous labor during expectant management in group A. The durations of latent phase and active phase of labour were lower in group B and C than group A (9 and 10.4 versus 15 hours; p<0.001) and (4 and 6 versus10 hours; p<0.001), respectively. Immediate induction in group B and C resulted in significantly lower rate of caesarean section (17% and 19% versus 28.5%, P= 0.049) and operative vaginal delivery (5% and 3% versus 13%, P=0.007). Only a few maternal-neonatal infections occurred and no significant difference was noted (2.7% and 3% versus 3.5%, P= 0.71).Conclusions: Immediate induction with prostaglandin shortens the delivery interval and lowers the caesarean section rate as compared to expectant management; however the neonatal outcome is similar in the three groups

Tulexia: Tutor for Dyslexics

This paper introduces a software for dyslexic patients. Dyslexia is a brain condition in which people face problems in detecting words, reading sentences. They cannot read words aloud and they get confused in similar alphabets and numbers. This problem can be cured but it requires proper attention and training to dyslexic people. Training is given like word detecting practices, character visualization, practicing similar alphabets, teaching phonics. This software is based on artificial intelligence and virtual reality. It will try to help dyslexic people and will improve their condition. This software will also contain some animations to reduce the frustration level of dyslexics

Knowledge towards post-mortem examination and reasons for not specialising in morbid anatomy: study among medical undergraduate students

Background: The use of autopsy in medical education has been declining just as autopsy rate has been falling worldwide. This is further worsened by the prevention of medical students from attending autopsy sections in some areas. Aim of the study was to ascertain the knowledge of medical students towards autopsy and post-mortem examination. An additional objective was to assess reasons for not specialising in morbid anatomy.  Methods: The present cross sectional study was carried out among students of a medical college in Uttar Pradesh in the month of February 2016 using pretested self-administered questionnaire. The study population consisted of undergraduate medical students who were currently studying the forensic medicine and toxicology. A detailed proforma containing 20 questions was framed for the purpose of capturing socio-demographic information of the study participants, questions concerning knowledge about the post-mortem and reasons for not specializing in morbid anatomy.Results: 82.2% were aware that post-mortems are conducted to know the cause and manner of death. Three students (3.3%) opined that the post-mortem is to harass the relatives of the deceased. Almost all the students were having a fair knowledge about the gross procedure involved in the post-mortem examination. Majority of male students would not wish to specialize in morbid anatomy because it deals with death, while most of female students said either they had made up their mind to specialize in some other fields or they do not want to touch and dissect dead bodies.Conclusions: Students possess a reasonable knowledge about post-mortem but knowledge alone may not be enough for increasing the post-mortem/autopsy rate, unless they acquire the skills required for the procedure as currently they are not provided with any training during their medical curriculum.

Transcriptional network involving ERG and AR orchestrates Distal-less homeobox-1 mediated prostate cancer progression

Distal-less homeobox-1 (DLX1) is a well-established non-invasive biomarker for prostate cancer (PCa) diagnosis, however, its mechanistic underpinnings in disease pathobiology are not known. Here, we reveal the oncogenic role of DLX1 and show that abrogating its function leads to reduced tumorigenesis and metastases. We observed that ~60% of advanced-stage and metastatic patients display higher DLX1 levels. Moreover, ~96% of TMPRSS2-ERG fusion-positive and ~70% of androgen receptor (AR)-positive patients show elevated DLX1, associated with aggressive disease and poor survival. Mechanistically, ERG coordinates with enhancer-bound AR and FOXA1 to drive transcriptional upregulation of DLX1 in ERG-positive background. However, in ERG-negative context, AR/AR-V7 and FOXA1 suffice to upregulate DLX1. Notably, inhibiting ERG/AR-mediated DLX1 transcription using BET inhibitor (BETi) or/and anti-androgen drugs reduce its expression and downstream oncogenic effects. Conclusively, this study establishes DLX1 as a direct-target of ERG/AR with an oncogenic role and demonstrates the clinical significance of BETi and anti-androgens for DLX1-positive patients

SECURING WMN USING HYBRID HONEYPOT SYSTEM

ABSTRACT Wireless Mesh Network (WMN) has been a field of active research in the recent years. Lot of research has focused various routing mechanism but very little effort has been made towards attack detection or intrusion detection. In this paper, we propose an attack detection approach for wireless mesh network using Honeypot technique. A Honeypot is a security resource whose value lies in being probed, attacked or compromised. A honeypot is designed to interact with attackers to collect their attack techniques and behaviors. A collection of such Honeypots laid to effectively trap the attacker is called a Honeynet. In our paper, we propose a honeynet, that is able to trap the attackers by analyzing their attacking techniques and thereby sending the logs to a centralized repository to analyze those logs so as to better understand the technique used for attacking

Insights into <i>Mycobacterium leprae</i> Proteomics and Biomarkers—An Overview

Although leprosy is curable, the identification of biomarkers for the early diagnosis of leprosy would play a pivotal role in reducing transmission and the overall prevalence of the disease. Leprosy-specific biomarkers for diagnosis, particularly for the paucibacillary disease, are not well defined. Therefore, the identification of new biomarkers for leprosy is one of the prime themes of leprosy research. Studying Mycobacterium leprae, the causative agent of leprosy, at the proteomic level may facilitate the identification, quantification, and characterization of proteins that could be potential diagnostics or targets for drugs and can help in better understanding the pathogenesis. This review aims to shed light on the knowledge gained to understand leprosy or its pathogen employing proteomics and its role in diagnosis

Targeting NF-kappa B Signaling by Artesunate Restores Sensitivity of Castrate-Resistant Prostate Cancer Cells to Antiandrogens

Androgen deprivation therapy (ADT) is the most preferred treatment for men with metastatic prostate cancer (PCa). However, the disease eventually progresses and develops resistance to ADT in majority of the patients, leading to the emergence of metastatic castration-resistant prostate cancer (mCRPC). Here, we assessed artesunate (AS), an artemisinin derivative, for its anticancer properties and ability to alleviate resistance to androgen receptor (AR) antagonists. We have shown AS in combination with bicalutamide (Bic) attenuates the oncogenic properties of the castrate-resistant (PC3, 22RV1) and androgen-responsive (LNCaP) PCa cells. Mechanistically, AS and Bic combination inhibits nuclear factor (NF)-κB signaling and decreases AR and/or AR-variant 7 expression via ubiquitin-mediated proteasomal degradation. The combination induces oxidative stress and apoptosis via survivin downregulation and caspase-3 activation, resulting in poly-ADP-ribose polymerase (PARP) cleavage. Moreover, preclinical castrate-resistant PC3 xenograft studies in NOD/SCID mice (n =28, seven per group) show remarkable tumor regression and significant reduction in lungs and bone metastases upon administering AS (50 mg/kg per day in two divided doses) and Bic (50 mg/kg per day) via oral gavage. Taken together, we for the first time provide a compelling preclinical rationale that AS could disrupt AR antagonist–mediated resistance observed in mCRPC. The current study also indicates that the therapeutic combination of Food and Drug Administration–approved AS or NF-κB inhibitors and AR antagonists may enhance the clinical efficacy in the treatment of mCRPC patients

Epigenetic Silencing of miRNA-338-5p and miRNA-421 Drives SPINK1-Positive Prostate Cancer.

PURPOSE: Serine peptidase inhibitor, Kazal type-1 (SPINK1) overexpression defines the second most recurrent and aggressive prostate cancer subtype. However, the underlying molecular mechanism and pathobiology of SPINK1 in prostate cancer remains largely unknown. EXPERIMENTAL DESIGN: miRNA prediction tools were employed to examine the SPINK1-3\u27UTR for miRNA binding. Luciferase reporter assays were performed to confirm the SPINK1-3\u27UTR binding of shortlisted miR-338-5p/miR-421. Furthermore, miR-338-5p/-421-overexpressing cancer cells (SPINK1-positive) were evaluated for oncogenic properties using cell-based functional assays and a mouse xenograft model. Global gene expression profiling was performed to unravel the biological pathways altered by miR-338-5p/-421. IHC and RNA in situ hybridization were carried out on prostate cancer patients\u27 tissue microarray for SPINK1 and EZH2 expression, respectively. Chromatin immunoprecipitation assay was performed to examine EZH2 occupancy on the miR-338-5p/-421-regulatory regions. Bisulfite sequencing and methylated DNA immunoprecipitation were performed on prostate cancer cell lines and patients\u27 specimens. RESULTS: We established a critical role of miRNA-338-5p/-421 in posttranscriptional regulation of SPINK1. Ectopic expression of miRNA-338-5p/-421 in SPINK1-positive cells abrogates oncogenic properties including cell-cycle progression, stemness, and drug resistance, and shows reduced tumor burden and distant metastases in a mouse model. Importantly, we show that patients with SPINK1-positive prostate cancer exhibit increased EZH2 expression, suggesting its role in epigenetic silencing of miRNA-338-5p/-421. Furthermore, presence of CpG dinucleotide DNA methylation marks on the regulatory regions of miR-338-5p/-421 in SPINK1-positive prostate cancer cells and patients\u27 specimens confirms epigenetic silencing. CONCLUSIONS: Our findings revealed that miRNA-338-5p/-421 are epigenetically silenced in SPINK1-positive prostate cancer, although restoring the expression of these miRNAs using epigenetic drugs or synthetic mimics could abrogate SPINK1-mediated oncogenesis. See related commentary by Bjartell, p. 2679