Changes in blood and urine parameters among pregnant women during third trimester

Background: During pregnancy, the pregnant lady undergoes significant anatomical and physiological changes in order to nurture and accommodate the developing fetus. These changes begin after conception and affect every organ system in the body.Methods: The study was carried out in the United Arab Emirates - Ajman (Thumbay Hospital) during the period of (March - Jun) in the year of 2018 to estimate HbA1c% levels, hematological blood parameters and urine culture in healthy pregnant women during 3rd trimester. The study was conducted on (108) healthy pregnant women during3rd trimester. Urine culture was performed to detect the growth of bacteria after the culture, gram stain was done to differentiate the bacteria followed by biochemical test to detect the type of bacteria.Results: A total 26 (79%) of patients had normal HbA1c% result while 7(21%) had elevated HbA1c% result. The results of HbA1c% in last trimester mean±SD (range) HbA1c% (n=33) were 5.5±0.52% (111.5±14.8 mg/dL). Also, our results showed strong positive correlation between HbA1% with estimated Average blood glucose (r=0.78, P value=0.00), and weak positive correlation between HbA1 with age (years) (r=0.2, P value=0.02). Bacterial culture showed that two positive results of stenotrophomonas maltophilia was isolated, three cases of Staphylococcus aureus was isolated and three cases of staphylococcus saprophyticus. Hematological profile showed a clinically significant (≤ 0.05) in Hb mean 11.47, P value 0.001, HCT mean, 33.9 P value 0.001 and MCV mean 73.7 value 0.001. No clinically significant (≥ 0.05) in RBCs mean 3.93, P value 0.010, MCH mean 27.3 P value 0.061 and MCHC mean 30.9 P value 0.134.Conclusions: Our study conclude that estimation of HbA1c%, hematological blood parameters and urine culture level in last trimester will be helpful in diagnosis, monitoring and predicting fetal distress

Global gene expression profiling data analysis reveals key gene families and biological processes inhibited by Mithramycin in sarcoma cell lines

AbstractThe role of Mithramycin as an anticancer drug has been well studied. Sarcoma is a type of cancer arising from cells of mesenchymal origin. Though incidence of sarcoma is not of significant percentage, it becomes vital to understand the role of Mithramycin in controlling tumor progression of sarcoma. In this article, we have analyzed the global gene expression profile changes induced by Mithramycin in two different sarcoma lines from whole genome gene expression profiling microarray data. We have found that the primary mode of action of Mithramycin is by global repression of key cellular processes and gene families like phosphoproteins, kinases, alternative splicing, regulation of transcription, DNA binding, regulation of histone acetylation, negative regulation of gene expression, chromosome organization or chromatin assembly and cytoskeleton

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Product Failure and Warranty Purchase: Their Effects on Target-Specific Emotions and Attitude Toward the Brand

This paper investigates the consumer affective responses to product failure as a result of making a decision to buy or not buy a warranty at the time of product purchase. Specifically, we present hypotheses about differences in consumers' emotional reactions to products failure, and consequently their attitude toward the brand, depending upon whether they have purchased product warranties. The hypotheses are derived by arguing that different types of counterfactual thinking and attributions are invoked under conditions of product failure or no product failure, and the purchase of a warranty or no warranty purchase by the consumer. Theoretical and managerial implications are briefly discussed

Investigations on the nitrogen inhibition during an anaerobic co-digestion process

Nitrogen Inhibition during an anaerobic co-digestion process was studied in this work.The substrate and inoculum used were obtained from a thermophilic biogas plant Sobacken,situated in Borås, Sweden. The batch experiments have been carried out in triplicate reactorswith different concentrations of ammonia ranging from 2400mg/l to 3400mg/l. The batchexperiment was working well for the all the concentrations of ammonia investigated. Theaverage methane yield was around 0.65 Nm3 CH4/kgVS for all the reactors. The laboratorywork has been further proceeded with a continuous process having two reactors working inparallel. Reactor 1 containing only substrate and the Reactor 2 contain substrate with surplusammonia added to make final concentration of 3400mg/l. The reactors were operated atorganic loading rate (OLR) of 3.3gVS/l/day and hydraulic retention time (HRT) of 20 days.Both reactors worked well for 29 days. During a period of an initial stable operation, theaverage methane production of Reactor 1 was 0.59 Nm3CH4/kgVS/day and for Reactor 2 theproduction rate was 0.56 Nm3CH4/kgVS/day. Then Reactor 1 showed a steady decrease in pHand methane production, while Reactor 2 showed stable operation for a few days longer withdecreasing pH and methane production only from day 36. The composition of substrate wasnot optimal; therefore the inhibition level of ammonium could not be determined

Investigations on the nitrogen inhibition during an anaerobic co-digestion process

Nitrogen Inhibition during an anaerobic co-digestion process was studied in this work.The substrate and inoculum used were obtained from a thermophilic biogas plant Sobacken,situated in Borås, Sweden. The batch experiments have been carried out in triplicate reactorswith different concentrations of ammonia ranging from 2400mg/l to 3400mg/l. The batchexperiment was working well for the all the concentrations of ammonia investigated. Theaverage methane yield was around 0.65 Nm3 CH4/kgVS for all the reactors. The laboratorywork has been further proceeded with a continuous process having two reactors working inparallel. Reactor 1 containing only substrate and the Reactor 2 contain substrate with surplusammonia added to make final concentration of 3400mg/l. The reactors were operated atorganic loading rate (OLR) of 3.3gVS/l/day and hydraulic retention time (HRT) of 20 days.Both reactors worked well for 29 days. During a period of an initial stable operation, theaverage methane production of Reactor 1 was 0.59 Nm3CH4/kgVS/day and for Reactor 2 theproduction rate was 0.56 Nm3CH4/kgVS/day. Then Reactor 1 showed a steady decrease in pHand methane production, while Reactor 2 showed stable operation for a few days longer withdecreasing pH and methane production only from day 36. The composition of substrate wasnot optimal; therefore the inhibition level of ammonium could not be determined

Epidural catheter fixation. A comparison of subcutaneous tunneling versus device fixation technique

Background and Aims: The technique of securing the epidural catheter has a major bearing on the efficacy of epidural analgesia. Specific fixator devices, for e.g., Lockit epidural catheter clamp, which successfully prevents catheter migration, are available. The possibility of catheter snapping and surgical retrieval has been reported with tunneling of catheters. These techniques have not been compared for safety, efficacy and appropriateness of achieving secure epidural catheter fixation in the postoperative period. Material and Methods: A total of 200 patients who required postoperative epidural analgesia were included. They were randomized into two groups: Group I (n = 100) in whom epidural catheters were tunneled vertically in the paravertebral subcutaneous tissue and group II (n = 100) wherein a Lockit device was used to fix the catheter. Likert score was used to quantify patient′s comfort during procedure. The techniques were compared for migration, catheter dislodgement, local trauma, catheter snapping and catheter obstruction. Results: 12% of tunneled catheters had migrated significantly outward. 22% of patients had erythema and 77% had significant procedural discomfort in group I. In group II, 3% catheters had kinked and 14% had erythema from device adhesive. Conclusion: Our results support the use of Lockit device as a safe and comfortable fixation device compared to subcutaneous tunneling of catheters