32 research outputs found

    Correlation of lateral placental location with development of preeclampsia

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    Background: Preeclampsia is a complex clinical syndrome which involves multiple organ systems and remains the principle cause of maternal and perinatal morbidity and mortality. Preeclampsia is a disease of trophoblastic tissue. Placental abnormality is one of the initial events in patients who are destined to develop pregnancy induced hypertension subsequently. Objective of this study was to evaluate the association of laterally located placenta on ultrasound with development of preeclampsia.Methods: This prospective observational study was conducted on 200 antenatal women with singleton pregnancy at 18-24 weeks of gestation who attended antenatal clinic of obstetrics and gynaecology, PGIMS Rohtak from October 2017 to October 2018. Detailed antenatal transabdominal ultrasound along with placental location was done between 18-24 weeks of gestation in women who fitted into inclusion criteria. All the antenatal women belonged to 18-24 weeks of gestation were included in the study except those women with chronic hypertension, diabetes mellitus, renal disease, severe anaemia, thyrotoxicosis, low lying placenta, previous history of preeclampsia or eclampsia.Results: Out of 200 antenatal women, 84 had lateral placenta while 116 had central placenta. Out of these 84 women who had lateral placenta, 55 women (65.5%) developed preeclampsia and out of 116 (58%) women who had central placenta, 28 women (24.1%) developed preeclampsia.Conclusions: From the above study, we concluded that women with laterally located placenta by ultrasound at 18-24 weeks of gestation have greater risk of developing preeclampsia

    A comparative study of feto-maternal outcome in instrumental vaginal delivery at tertiary health level hospital in Uttarakhand state

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    Background: Instrumental vaginal delivery is an age-long obstetric practice used to expedite vaginal delivery or avert recourse to caesarean delivery. Objective of the study is to compare maternal and neonatal outcomes of vacuum and forceps application in instrumental vaginal delivery.Methods: This is a retrospective observational study. Retrospective study of 70 consecutive ventouse and 70 consecutive forceps deliveries was done. Maternal and neonatal morbidity were compared in terms of perineal laceration, episiotomy extension, postpartum hemorrhage, apgar score, neonatal injuries and NICU admissions.Results: Maternal morbidity in terms of periurethral tear, second and third degree perineal tear were significantly more in forceps group (p=0.0332 and p=0.0173 respectively). However neonatal outcomes were found to be similar in both types of instrumental deliveries.Conclusions: Ventouse should be preferred over forceps whenever there is an indication for instrumental delivery (except in fetal distress) as it is associated with less maternal trauma and most of the neonatal morbidities were insignificant in comparison with both instruments

    Cross-Species Analyses Identify the BNIP-2 and Cdc42GAP Homology (BCH) Domain as a Distinct Functional Subclass of the CRAL_TRIO/Sec14 Superfamily

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    The CRAL_TRIO protein domain, which is unique to the Sec14 protein superfamily, binds to a diverse set of small lipophilic ligands. Similar domains are found in a range of different proteins including neurofibromatosis type-1, a Ras GTPase-activating Protein (RasGAP) and Rho guanine nucleotide exchange factors (RhoGEFs). Proteins containing this structural protein domain exhibit a low sequence similarity and ligand specificity while maintaining an overall characteristic three-dimensional structure. We have previously demonstrated that the BNIP-2 and Cdc42GAP Homology (BCH) protein domain, which shares a low sequence homology with the CRAL_TRIO domain, can serve as a regulatory scaffold that binds to Rho, RhoGEFs and RhoGAPs to control various cell signalling processes. In this work, we investigate 175 BCH domain-containing proteins from a wide range of different organisms. A phylogenetic analysis with ∼100 CRAL_TRIO and similar domains from eight representative species indicates a clear distinction of BCH-containing proteins as a novel subclass within the CRAL_TRIO/Sec14 superfamily. BCH-containing proteins contain a hallmark sequence motif R(R/K)h(R/K)(R/K)NL(R/K)xhhhhHPs (‘h’ is large and hydrophobic residue and ‘s’ is small and weekly polar residue) and can be further subdivided into three unique subtypes associated with BNIP-2-N, macro- and RhoGAP-type protein domains. A previously unknown group of genes encoding ‘BCH-only’ domains is also identified in plants and arthropod species. Based on an analysis of their gene-structure and their protein domain context we hypothesize that BCH domain-containing genes evolved through gene duplication, intron insertions and domain swapping events. Furthermore, we explore the point of divergence between BCH and CRAL-TRIO proteins in relation to their ability to bind small GTPases, GAPs and GEFs and lipid ligands. Our study suggests a need for a more extensive analysis of previously uncharacterized BCH, ‘BCH-like’ and CRAL_TRIO-containing proteins and their significance in regulating signaling events involving small GTPases

    A comparative study of feto-maternal outcome in instrumental vaginal delivery at tertiary health level hospital in Uttarakhand state

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    Background: Instrumental vaginal delivery is an age-long obstetric practice used to expedite vaginal delivery or avert recourse to caesarean delivery. Objective of the study is to compare maternal and neonatal outcomes of vacuum and forceps application in instrumental vaginal delivery.Methods: This is a retrospective observational study. Retrospective study of 70 consecutive ventouse and 70 consecutive forceps deliveries was done. Maternal and neonatal morbidity were compared in terms of perineal laceration, episiotomy extension, postpartum hemorrhage, apgar score, neonatal injuries and NICU admissions.Results: Maternal morbidity in terms of periurethral tear, second and third degree perineal tear were significantly more in forceps group (p=0.0332 and p=0.0173 respectively). However neonatal outcomes were found to be similar in both types of instrumental deliveries.Conclusions: Ventouse should be preferred over forceps whenever there is an indication for instrumental delivery (except in fetal distress) as it is associated with less maternal trauma and most of the neonatal morbidities were insignificant in comparison with both instruments

    Sequence logos of CRAL_TRIO and BCH domains.

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    <p>The sequence logos derived from 175 BCH and 78 CRAL_TRIO domain sequences are shown in this figure. The conserved residues are marked with arrows and the numbering is given according to the yeast Sec14p protein (NCBI accession: NP_013796) for CRAL_TRIO domains and the human BNIP-2 protein (NCBI accession: NP_004321) for BCH domains. The approximate positions of α-helices and β-beta strands are indicated at the bottom by blue cylinders and red arrows. In order to avoid any biased data, the ‘BCH-like’ groups (NF1 and RhoGEFs) were excluded from the logo calculation. These logos reveal characteristic differences between BCH and CRAL_TRIO domains. Unique positions within the two groups are marked by arrows. BCH domains have a unique signature motif R(R/K)h(R/K)(R/K)NL(R/K)xhhhhHPs in which ‘h’ refers to any large and hydrophobic residue and ‘s’ is a small and weekly polar residue (A, T, G, S). This motif is missing in CRAL_TRIO domains. The motif contains a patch of positively charged residues referred to as an Arg/Lys patch. Similarly, as exemplified by the aromatic residue in the middle of three α-helices, many of the hydrophobic residues (shown in grey) are conserved at various positions. The conservation of long and hydrophobic residues in the β-strands provides a hydrophobic surface.</p

    Conservation of residues characteristic of (a) CRAL_TRIO and (b) BCH domains of the Sec14 superfamily.

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    <p>The numbering of residues is given according to the positions of residues in yeast Sec14p and Human BNIP-2 proteins in Table columns (a) and (b) respectively. Only values above 50% are given in the table. *Proline residues of CRAL_TRIO and BCH domains are not in single column in multiple sequence alignment, they are conserved at one position apart (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0033863#pone-0033863-g002" target="_blank">Figure 2</a>).</p

    Average sequence identity within and across the groups of Sec14 superfamily.

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    <p>The average sequence identity is given as calculated between all pairs of sequences. The numbers in bracket refers to the number of comparisons made in each group. The values are higher when compared within the group. The domains of NF1 and RhoGEF groups share comparable sequence similarity with BCH and with CRAL_TRIO domains. Thus, the domains of these proteins were referred as ‘<i>BCH-like</i>’.</p
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