Comparative study of feto-maternal outcome in clinical and subclinical hypothyroidism

Background: Thyroid diseases are the one of commonest endocrine disorders affecting women of reproductive age group, and hence constitute the commonest endocrine disorder complicating pregnancy. Maternal thyroid function changes during pregnancy and inadequate adaptation to these changes results in thyroid dysfunction. The objective of this study was to determine the prevalence of clinical and subclinical hypothyroidism and to study the fetal and maternal complications associated with hypothyroidism.Methods: A prospective and observational study undertaken over a period of 2 years from 1st October 2009 onwards. Pregnant women were screened for thyroid dysfunction irrespective of gestational age. Patients were divided into two group; Group I (subclinical hypothyroidism)- all pregnant patients with serum TSH ≥ 3 mu/l up to 6 mu/l and normal free T4 levels. Group II (clinical hypothyroidism)- all pregnant patients with serum TSH level ≥ 6 mu/l OR on thyroxine pre-pregnancy.Results: In the present study, prevalence of thyroid disorder was 6.22%, subclinical hypothyroidism and clinical hypothyroidism being 3.77% and 2.45% respectively. In subclinical group and clinical group, we found, preeclampsia, preterm labour, first trimester abortions and oligohydramnios in 13.75% versus 19.23%, 13.75% versus 36.54%, 11.25% versus 11.53%, and 16.25% versus 23.02% respectively. Subclinical hypothyroidism was more prevalent and hidden leading to the poor obstetrical outcome and fetal complications like low birth weight, prematurity and intrauterine growth restriction. There was higher incidence of caesarean deliveries in both groups more in clinical hypothyroid cases.Conclusions: Due to the adverse effect of maternal thyroid disorder on maternal and fetal outcome, timely diagnosis and initiation of treatment of hypothyroid disorders is essential

A hospital-based cross-sectional study on congenital anomalies in newborn babies of Uttarakhand

Background: Congenital anomalies make an important contribution to infant mortality. They remain a leading cause of death in many countries of the world. The prevalence and pattern of presentation vary from place to place. Objective: The aims and objectives of this study were to determine the prevalence of congenital abnormalities among babies (inborn and outborn) admitted at the Himalayan Hospital, Dehradun, Uttarakhand, India. Materials and Methods: A cross-sectional retrospective study was conducted in a Medical College Hospital in Uttarakhand. The case files of these babies were retrieved from the hospital records department and examined individually by the investigators. Data collection was done with structured forms designed for the study. Result: Among total 2242 neonates included in the study, the prevalence of congenital malformations was 8.3%. Central nervous system and cardiovascular, musculoskeletal, and genitourinary systems were found to be most commonly involved. Conclusion: The present study provides us an idea regarding prevalence of cases of congenital malformations and factors affecting it. In Indian environment, this study helps us to know the pattern of congenital malformation in this part of the country

A study to determine the knowledge and level of awareness of medical undergraduates about herbal medicines and herb-drug interactions

Background: The increasing usage of herbal medicines worldwide has increased the probability of co-administration of herbal and allopathic medicines. This may lead to serious safety concerns, including herb-drug interactions (HDIs). Many HDIs may be overlooked due to poor doctor-patient communication about herbal drug usage probably because of lack of knowledge of herbal medicines and HDIs among physicians. The study was thus planned to identify the knowledge and awareness of medical students regarding the use of herbal medicines and about HDIs, to help improve the teaching skills and curriculum development for medical students.Methods: 286 medical students of 2nd, 3rd and 4th year MBBS course completed the study. All the participants were asked to fill a self-administered questionnaire consisting of 15 questions which included both open-ended and close-ended questions related to age, sex, knowledge, awareness and usage of herbal medicines and about herb-drug interactions. Data was analyzed and expressed as counts and percentages.Results: Majority (95.45%) of the students were aware of the fact that herbs can be used as medicines. They were most familiar with the herbs tulsi, neem, turmeric, aloe, ashwagandha and ginger. 46.85% consider herbal medicines to be risk free, and majority (55.6%) were not aware of the fact that herbs can cause herb-drug interactions. Media and elderly family members were their most common sources of information regarding herbal medicines. Majority (75.17%) would prefer allopathic medicines over herbal medicines. Only 23.07% always informed the physician about their usage of herbal medicines, although most (84.96%) felt that history regarding use of herbal medicines should be taken. Majority were not aware of the regulatory status of herbal medicines.Conclusions: Lack of knowledge and awareness of medical students about herbal medicines and herb-drug interactions was seen in the study. There is a need to inform the students of allopathic system of medicine about the adverse outcomes of herbal medicines and the knowledge about herb-drug interactions should be a part of the medical curriculum

Cord bilirubin levels as a predictive marker for neonatal hyperbilirubinemia: A prospective study

Background: Hyperbilirubinemia is the most common medical problem in newborn infants. Early discharge is recommended but hospital readmission is a cause of concern among clinicians. This in turn carries a risk of delayed recognition of significant hyperbilirubinemia. Objective: A cross-sectional analytical study was done to evaluate the predictive value of cord bilirubin level for identifying term and near-term neonates for subsequent hyperbilirubinemia. Materials and Methods: Cord bilirubin levels at birth and subsequently serum bilirubin levels at 72 h were assessed in 100 neonates. The cutoff value was estimated beyond which there was significant hyperbilirubinemia. Results: The cutoff value of cord bilirubin >2.02 mg/dl had sensitivity and specificity of 87.5-70.8%, respectively, with positive predictive value of 0.39 and negative predictive value of 0.965 for subsequent hyperbilirubinemia. Conclusion: The cutoff value of cord bilirubin level estimated is 2.02 mg/dl can be used to predict significant neonatal hyperbilirubinemia

Characterisation of mononuclear phagocytes in sheep

The mononuclear phagocyte (MP) system is a heterogenous group of cell populations present in most tissues even in the absence of inflammation. Monocytes and M0 are the major differentiated cells of MP system, have a prominent role in defence against many infectious agents and tumour cells, and are involved in the regulation and induction of immune responses. In addition they secrete a large number of substances which have a role in various physiological and pathological processes.ion they secrete a large number of substances which have a role in various physiological and pathological processes. It is necessary to know the normal distribution and localisation of cell with a particular phenotype in order to understand their involvement in various disease processes. The advent of hybridoma technology has facilitated the dissection of the phenotypic and functional heterogeneity of various cells by producing monoclonal antibodies (mAb) specific to cell surface molecules. Sheep is an important experimental animal model, for the study of the pathogenesis of infectious diseases and little is known about the cell surface determinants of MP in this species.about the cell surface determinants of MP in this species. In this thesis I have characterised MP by devolping novel anti-M0 mAb and further characterising anti-cattle mAb which cross react with sheep (12 integrins.Three mAb (VPM65 , 66 and 67) immunoprecipitated cell surface glycoproteins of the same Mr = 55,000, having approximately 3,000 Da N-linked glycosylation. The antigen is primarily expressed in blood monocytes in addition to its moderate expression in AM and granulocytes but weak expression in afferent dendritic cells (ADC). They also labelled resident M0 in many different tissues but were non reactive with lymphocytes. The molecule is anchored to the cell surface via glycosylphosphatidyl inositol linkage. These mAb recognise the same or overlapping epitopes of the antigen. VPM65/66/67 recognise a homologue of sheep CD14 as determined by antigen preclearing studies and two-colour FACS analysis using human anti-CD14 mAb (TUK4). These mAb also reacted with monocytes and M0 in cattle.VPM63 recognised a dimer of Mj. = 40,000 and 42,000 having approximately 2,000 Da N-linked carbohydrates. VPM63 reacted with resident M0 in most tissues but was absent from blood monocytes, ADC and any lymphocyte populations. The expression of the antigen is lost within two days in cultured AM and did not appear on in vitro monocyte derived macrophages. Immunoblotting of affinity purified VPM63 antigen with polyclonal rabbit anti-bovine FcyRI synthetic peptide of 15 amino acids (150-168) from the second extra cellular domain, suggests the possibility that VPM63 recognises a M0 specific isoform of sheep FcyRII. However VPM63 failed to block uptake of soluble Ag-Ab complexes by AM. VPM64 immunoprecipitated a heterodispersed antigen of Mf = 65,000 to 80,000 from surface labelled AM. In addition to AM the antigen is expressed on granulocytes and has low level of expression on monocytes. VPM64 also stained a small population of CDllb+, non-T, non-B and non-monocyte (CD14") peripheral blood mononuclear cells, possibly to be 'natural killer' cells. VPM64 labelled resident M0 in spleen, gut and lungs. On the basis of its molecular weight and cellular distribution the possibility of VPM64 recognising an antigen equivalent to the mouse FcyRIII is discussed.A panel of mAb specific for (32 integrins on MP of sheep was characterised by immunoprecipitation, flow cytometry and immunohistochemistry using mAb submitted to the 2nd International Workshop on Ruminant Leukocyte differentiation Antigens. Immunoprecipitation, immunohistochemical and flow cytometric analysis differentiated these mAb into four distinct groups (Gp). The relationship between these antibodies is shown by sequential immunoprecipitation which showed that the reactivities of antibodies in Gp 1, 2 and 3 were mutually exclusive but that Gp 4 antibodies shared a common specificity with the other three groups. By analogy with the human, mouse and cattle (52 integrin families Gp 1 mAb seem to be specific for CDlla/CD18 (LFA-1); Gp 2 are CD1 lb/CD18 (CR3 or Mac-1); Gp 3 are CDllc/CD18 (CR4 or pl50/95) and Gp 4 are CD18. The differences in the tissue distribution and cellular localisation for the different (32 integrins are described and discussed.In addition to myeloid cells CDllb and CDllc are also present on a sub-population (30-50%) of resting peripheral blood B cells, which are exclusive to blood and spleen and do not appear to recirculate through peripheral lymph node and do not express L-selectin (Dul.29), a lymph node homing and memory cell marker. In peripheral blood the non-recirculating B-cell population was mutually exclusive to the recirculating B-cell population (Du2.74+). Cells resembling non-recirculating B-cells are confined only to marginal zone in the spleen whereas recirculating B-cells are present in the follicles in spleen and ileal Peyer's patches. These preliminary observations indicate that CDllb+ B cells may represent a population of naive B cells and have distinct recirculatory pathways

To Assess the Quality of Life in Patients Suffering from Allergic Rhinitis

Background: Allergic Rhinitis (AR) associated with impairments in patients day-to-day functioning at home and work is a global health problem. It’s associated with sleep disorders, emotional problems, impairment in activities, and social functioning. However, it’s not known to what extent quality of life (QOL) scores, work impairment, or sleep is altered in Indian setup hence, this study was designed to assess the quality of life of patients suffering from allergic rhinitis.Methodology: This prospective, observational, cross sectional study was conducted on patients suffering from allergic rhinitis visiting the out patients | department. The patients who gave written informed consent were divided into two groups based on gender, Group 1 was males and Group 2 was females. A detailed history was taken and participants underwent thorough medical examination, followed by assessment on Rhino conjunctivitis Quality of Life Questionnaire (RQLQ) and WHOQOL – Bref scores.Results: A total of 87 patients were screened of which 40 patients were enrolled in study. The average age of patients in the study was 28.08±10.01, a total of 26 males and 14 females completed the study. There were significantly worse non nose/eyes symptoms scores, practical problems, and emotional scores in patients in Group 2 as compared to Group 1. Group 1 had better aspect of sleep, nasal symptoms, and eyes symptoms as compared to Group 2. Whereas, Group2 had better aspect of activities score as compared to Group 1.Conclusion: To conclude both groups had compromised quality of life, with females being more affected as compared to male

To Assess the Quality of Life in Patients Suffering from Allergic Rhinitis

Background: Allergic Rhinitis (AR) associated with impairments in patients day-to-day functioning at home and work is a global health problem. It’s associated with sleep disorders, emotional problems, impairment in activities, and social functioning. However, it’s not known to what extent quality of life (QOL) scores, work impairment, or sleep is altered in Indian setup hence, this study was designed to assess the quality of life of patients suffering from allergic rhinitis.Methodology: This prospective, observational, cross sectional study was conducted on patients suffering from allergic rhinitis visiting the out patients | department. The patients who gave written informed consent were divided into two groups based on gender, Group 1 was males and Group 2 was females. A detailed history was taken and participants underwent thorough medical examination, followed by assessment on Rhino conjunctivitis Quality of Life Questionnaire (RQLQ) and WHOQOL – Bref scores.Results: A total of 87 patients were screened of which 40 patients were enrolled in study. The average age of patients in the study was 28.08±10.01, a total of 26 males and 14 females completed the study. There were significantly worse non nose/eyes symptoms scores, practical problems, and emotional scores in patients in Group 2 as compared to Group 1. Group 1 had better aspect of sleep, nasal symptoms, and eyes symptoms as compared to Group 2. Whereas, Group2 had better aspect of activities score as compared to Group 1.Conclusion: To conclude both groups had compromised quality of life, with females being more affected as compared to male

Design and performance analysis of an L-shaped radiator and defected ground antenna for enhancing wireless connectivity in brain implants

Brain implantable wireless microsystems has potential to treat neurological diseases and maintain the quality of life. Highly efficient miniaturized antenna is the fundamental part of BID (brain implantable device) for reliable signaling of data through dissipative intracranial material. In this paper, a patch antenna with L-shaped defected ground is demonstrated. L-shaped radiator contributed to achieve the resonance at 2.45 GHz industrial scientific and medical (ISM) band. Antenna size is reduced to 10 × 10 × 0.25 mm3. The proposed L-shaped ground plane geometry is contributing in improving the radiation performance. |S11| value shifts from 15 dB to 30 dB after modifying the ground plane. Proposed structure attained the gain of −14 dBi when located between the Dura and CSF layers at the depth of 12 mm in human brain model. Full wave simulated antenna prototype is fabricated and measured for performance verification. Impedance bandwidth of 270 MHz and broadside radiation pattern (for transferring maximum electromagnetic energy away from tissue) are maintained by the proposed antenna. Brain tissue safety is ensured by specific absorption rate which is 0.709 W/kg and in compliance with the safety limits of 1.6 W/kg for 1-g averaged tissue. Proposed antenna structure is the promising candidate for medical implant technology