Analysis of maternal mortality at tertiary care centre

Background: The aim of the study was to analyse the causes of maternal mortality at a tertiary care centre and find measures to reduce it.Methods: A retrospective study of maternal deaths from January 2018 to December 2020 that occurred at Government Vellore Medical College and Hospital, a tertiary care hospital in Tamil Nadu. Data collected from case records and death reviews.Results: There was total of 71 deaths at the tertiary care hospital during the period January 2018 to December 2020 out of 31407 live births giving Maternal mortality rate of 226/1,00,000 live births. The MMR is high as it is a tertiary hospital catering referral from six districts. Most of the cases were due to late referrals. The majority of the deaths occurred in primigravida (50.7%), in the age group of 21 to 25 years (35.2%) and around term gestational age (49.3%). The most common cause of death in our study was hypertensive disorders of pregnancy (29.5%) followed by PPH (14.08%).Conclusions: From our study we concluded that the most common causes of maternal death were due to direct obstetric causes like severe pre-eclampsia, eclampsia and post-partum haemorrhage. Early identification of high-risk cases, early identification of GHT, anaemia and its correction, early referral of high-risk cases to tertiary centre can prevent most of the deaths.

Comparative study of the cytologic diagnosis, specimen adequacy, sensitivity, and cost effectiveness of liquid-based cytology with that of conventional PAP tests

Background: Cervical cancer is the most common cancer among women in many developing countries constituting 20-30% of female cancers. In the developed western countries, it accounts for only 4-6% of female cancers. This difference largely reflects the impact of mass screening using cervical cytologic methods.Methods: Prospective observational study.300 patients were selected from the gynaecology OPD of Government RSRM lying In Hospital. A detailed history was taken and they were informed about the screening procedures and counselling given regarding the necessity for their participation in screening program. Both conventional pap and liquid-based cytology were performed in the same patient and results were analyzed.Results: Out of 300 patients screened for cancer cervix with conventional Pap and liquid-based cytology in the same patient, LBC detection rate of cervical abnormalities and HSIL was higher than that of CP. False -ve rate of LBC was only 2%. Sensitivity is 97% and false positive rate is 44%. The sensitivity is equal to that of the gold standard method. Infection detection rate increased with LBC. Specimen adequacy improved with LBC substantially. The collection sample device brush was found superior to the wooden Ayre’s spatula in both not injuring tissues and specimen collection. The adverse impact on a woman's quality of life caused by unnecessary repeat smears and possible investigations would reduce the cost with LBC. The economic evidence suggests that LBC screening every 3 years or longer may be cost-effective. LBC reduced the pressure on a skilled workforce.Conclusions: As stated in WHO press release, dated 11 October 2001 it can be concluded through the current study that we should aim to divert our resources to screening and treating the high-risk groups of women. The effort once or twice in their lifetime will reduce the incidence of cervical cancer by 50%

Paratuberculosis in different breeds of sheep: A retrospective study of cases

AbstractSpontaneous ovine paratuberculosis in an organized farm was diagnosed based on histopathological lesions, demonstration of acid-fast bacilli in different visceral organs, and detection of antibody levels against Mycobacterium paratuberculosis by agar gel immunodiffusion test (AGID). Out of 190 morbid specimens examined histopathologically, 77% of specimens had pathological lesions, which included predominant epithelioid cell formation, infiltration of lymphocytes, monocytes and macrophages. In acid-fast staining of tissue sections, 74% of intestinal specimens and 53% of mesenteric lymph nodes were positive for the presence of acid-fast bacilli. Hematologically, the animals were showing leucopenia, macrocytic and normochromic anemia. Out of 49 animals tested, 28.5% of animals were positive for antibodies against M. paratuberculosis. Local breeds, namely Nilagiri and Sandyno sheep, were found to be more susceptible than exotic breeds, namely Dorset. Females were more susceptible than males. Mortality was noticed in the age group of 4months to 10years

Chemical Properties of Water Hyancinth Plant Ash

In ponds, water hyacinth expands rapidly and doubles in size in just two weeks. The significance of integrated and adaptable management strategies that take into account the ecological, economic, and social aspects of water hyacinth reduction is emphasized in this abstract. To successfully handle the water hyacinth issue and encourage the sustainable use of this problematic plant, cooperation among governments, communities, researchers, and environmental groups is essential. We can improve the quality of life for individuals impacted by the existence of water hyacinth by putting these measures into practice and working to restore the health of aquatic ecosystems. The dense mats of water hyacinth on the water's surface can block sunlight, reduce oxygen levels, and obstruct natural water movement, which can have a negative impact on native aquatic species and ecological balance. Additionally, its presence in water bodies can hinder fishing, transportation, and irrigation, which can result in losses for people who depend on these resources economically

OPTIMIZATION STUDY ON EXTRACTION & PURIFICATION OF PHYCOERYTHRIN FROM RED ALGAE KAPPAPHYCUS ALVAREZII

Objective: The current study focuses on R-Phycoerythrin pigment production from Seaweed using different chemical and physical conditions. Methods: In the present study Seaweed was collected from Rameshwaram and identified by CS-MCRI Institute, Mandapam. The collected seaweed was then washed using distilled water for further processing. Using a sterile knife the seaweed was cut into small pieces. The chopped seaweeds were then weighed and subjected to different optimization procedures for pigment production. These equally weighed seaweeds were treated with three varying Buffers at different pH, the buffer showing better O.D value was subjected to different Cell disruption techniques and finally freeze thawed at different temperature stress.Results: The seaweeds were subjected to different chemical and physical stress conditions for R-phycoerythrin production. On optimizing the different buffer solutions for pigment production Sodium phosphate buffer showed maximum O.D of 0.215 when compared to other buffers whereas on providing different pH conditions the O.D value obtained was high at pH 7.2. Different cell disruption techniques were followed for pigment production using the sodium phosphate buffer at pH 7.2 and freeze thaw method was found suitable for the highest pigment production with O.D value of 0.441. Hence after optimization of different extraction procedures, cell disruption followed by freeze & thaw method (−20°C and 25°C) showed maximum R-phycoerythrin content. Conclusion: From the findings, it was also observed that the primary metabolites produced by these organisms may serve as potential bioactive compounds of interest in the Food industries as natural colourant and in cosmetic industries.Keywords: Seaweeds, Extraction, Phycoerythrin, Optimization, Cell disruption, Sonication

ZIPRASIDONE HYDROCHLORIDE LOADED NANOSTRUCTURED LIPID CARRIERS (NLCS) FOR INTRANASAL DELIVERY: OPTIMIZATION AND IN VIVO STUDIES

Objective: The present study was an attempt to systemically deliver the most desirable schizophrenia drug, ziprasidone hydrochloride (ZRS) via the intranasal route using nanostructured lipid carrier (NLC) approach. Methods: The desired ZRS loaded NLCs were developed using central composite statistical design and the developed formulation was monitored for improving ZRS bioavailability and their brain targeting efficacy. Results: Pharmacokinetic studies revealed a 10 fold increase (ZRS blood-brain ratio) for NLCs administered through nasal route (in comparison to intravenous route). Similarly, the concentration of ZRS (in the brain) delivered via nasal route exhibits 4 fold increment at all-time points. Conclusion: Therefore, the obtained results suggest a potential nose to brain transport of loaded ZRS by effective bypassing of the Blood-Brain Barrier (BBB)

A prospective observational study on prescribing patterns of drugs used in alcoholic liver disease patients at tertiary care teaching hospital

Background: Rational drug prescribing can be defined as appropriate drugs prescribed in the right dose, at correct time intervals and for a sufficient duration. Alcoholic Liver Disease (ALD) and its complications are the principle cause for morbidity and mortality rate and accounts for elevated social and economic costs. The drug use will be a challenge for the physicians as there was no specific treatment for ALD, and decisions regarding treatment are critically depends on the symptoms and complications.Methods: A uni-centric prospective (observational) study was conducted for a period of 6months, to evaluate the current prescribing patterns used in treating ALD. All the patients admitted with diagnosis of ALD in General medicine department, both male and female medical wards were included in the study. General medicine outpatient department, special population such as pregnancy and psychiatry, patients below 18years and those who are not willing to sign in informed consent form was excluded from the study.Results: Number of males (98.02%) between age group 31-40years (29.6%) was more prone when compared to females (1.77%). Portal hypertension (30.35%) followed by jaundice (11.30%) and Ascites (10.71%) were frequently observed complications associated co-morbidities with ALD. WHO prescribing indicators showed deviation from there standard reference values. Diuretics (15.73%), antibiotics (13.14%), vitamin supplements (11.11%) and antacids (10.13%) categories were the most commonly prescribed for patients. The drugs prescribed from NLEM-2015 (82.11%) shows deviation from standard values.Conclusions: Futhermore, multi-centered studies should be conducted to draw best results on prescribing patterns of ALD in India

Malignant phyllodes tumors display mesenchymal stem cell features and aldehyde dehydrogenase/disialoganglioside identify their tumor stem cells

INTRODUCTION: Although breast phyllodes tumors are rare, there is no effective therapy other than surgery. Little is known about their tumor biology. A malignant phyllodes tumor contains heterologous stromal elements, and can transform into rhabdomyosarcoma, liposarcoma and osteosarcoma. These versatile properties prompted us to explore their possible relationship to mesenchymal stem cells (MSCs) and to search for the presence of cancer stem cells (CSCs) in phyllodes tumors. METHODS: Paraffin sections of malignant phyllodes tumors were examined for various markers by immunohistochemical staining. Xenografts of human primary phyllodes tumors were established by injecting freshly isolated tumor cells into the mammary fat pad of non-obese diabetic-severe combined immunodeficient (NOD-SCID) mice. To search for CSCs, xenografted tumor cells were sorted into various subpopulations by flow cytometry and examined for their in vitro mammosphere forming capacity, in vivo tumorigenicity in NOD-SCID mice and their ability to undergo differentiation. RESULTS: Immunohistochemical analysis revealed the expression of the following 10 markers: CD44, CD29, CD106, CD166, CD105, CD90, disialoganglioside (GD2), CD117, Aldehyde dehydrogenase 1 (ALDH), and Oct-4, and 7 clinically relevant markers (CD10, CD34, p53, p63, Ki-67, Bcl-2, vimentin, and Globo H) in all 51 malignant phyllodes tumors examined, albeit to different extents. Four xenografts were successfully established from human primary phyllodes tumors. In vitro, ALDH(+) cells sorted from xenografts displayed approximately 10-fold greater mammosphere-forming capacity than ALDH(-) cells. GD2(+) cells showed a 3.9-fold greater capacity than GD2(-) cells. ALDH(+)/GD2(+)cells displayed 12.8-fold greater mammosphere forming ability than ALDH(-)/GD2(-) cells. In vivo, the tumor-initiating frequency of ALDH(+)/GD2(+) cells were up to 33-fold higher than that of ALDH(+) cells, with as few as 50 ALDH(+)/GD2(+) cells being sufficient for engraftment. Moreover, we provided the first evidence for the induction of ALDH(+)/GD2(+) cells to differentiate into neural cells of various lineages, along with the observation of neural differentiation in clinical specimens and xenografts of malignant phyllodes tumors. ALDH(+) or ALDH(+)/GD2(+) cells could also be induced to differentiate into adipocytes, osteocytes or chondrocytes. CONCLUSIONS: Our findings revealed that malignant phyllodes tumors possessed many characteristics of MSC, and their CSCs were enriched in ALDH(+) and ALDH(+)/GD2(+) subpopulations