Exploring caesarean delivery in the second stage of labour at a tertiary care hospital: a retrospective study

Background: Caesarean section (CS) performed in the second stage of labour has many implications for maternal and neonatal morbidity as well as for subsequent pregnancies. The objectives of this study were to determine the rates of CS at full dilatation, their indications, associated maternal and neonatal complications.Methods: This retrospective study assessed all the women with a singleton fetus in cephalic presentation at term (≥37 weeks) who underwent CS in the second stage of labor between 1 August 2019 and 31 March 2020 at a tertiary care hospital. Maternal demographics, labour and delivery details as well as neonatal outcomes were collected.Results: During the study period, 2124 (36%) babies were born by CS. Of these, 49 (2.3%) were performed in the second stage of labour at ≥37 weeks of gestation. The most common indication of CS was non-descent of head in 38 (77.55%) of cases. The majority of women 38 (77.55%) delivered by CS in the second stage of labor were primiparous. The 27 (55.10%) women were in the age group of 20-25 years. Most common intraoperative complication was blood-stained urine in 20 (40.81%) women. Overall transfusion rate was 18.36%. Maximum number of babies born 44 (89.79%) were having birth weight between 2.5-3.5 kg. Out of 65 babies born, 17 (34.69%) were admitted to neonatal intensive care unit.Conclusions: Formulation of an institutional protocol and training and supervision of trainees to improve the skill of operative vaginal delivery and second stage cesarean is needed

Pattern of adverse drug reaction in geriatric inpatients of medicine in a tertiary care center: a prospective observational study

Background: Adverse drug reactions (ADRs) represent a major public health problem in older age. In order to better evaluate this problem, this study was designed to assess the prevalence and spectrum of ADRs in terms of frequency, type, severity and preventability in geriatric patients in medicine ward of Guru-Gobind Sing hospital, Jamnagar during 12 months study period.Methods: All ADR related patient’s necessary data was obtained and recorded on a pre- designed case record form (CRF). The data record includes general details e.g., name, age, sex, past and present history, general and systemic examination, laboratory investigation, diagnosis and treatment. Details regarding suspected medications, treatment given, and the outcome were documented with prior permission of institutional ethics committee.Results: Demographic analysis of prospective study revealed that out of 84 patients, 45 male and 39 were female. The patients had developed ADR within the age ranges of 31 (65-69) followed by 23 (75-79). The majority of ADR was vomiting and diarrhea 15 followed by chills 08 and cough 04. It is evident that antimicrobials 31 agents were mainly suspected followed by NSAIDs 18. According to WHO-UMC scale, the possible cases had a higher incidence 63, followed by probable 19 and certain 2. After estimating the severity by Hartwigs scale 79.8% were mild to moderate while 20.23% were severe in nature.Conclusions: Age is not an independent risk factor of ADRs and suitable monitoring and regular medication review can reduce the incidence of ADRs in geriatric people

Solitary colonic metastasis from renal cell carcinoma presenting as a surgical emergency nine years post-nephrectomy

Late colonic metastasis following curative surgery for renal cell carcinoma has rarely been described. We present the first reported case of solitary colonic renal cell carcinoma metastasis presenting as an intra-abdominal bleed, nine years post-nephrectomy

न्यू फेरी वार्फ, मुंबई में कोष संपाशों द्वारा एलिपेस जेड्डाबा (फोर्सकल) और मेगालास्पिस कोर्डिला (लिन्नेयस) का असाधारण अवतरण

कृपया पूरा लेखा पढ

Mechanism of Hydrogen-Bonded Complex Formation between Ibuprofen and Nanocrystalline Hydroxyapatite.

Nanocrystalline hydroxyapatite (nanoHA) is the main hard component of bone and has the potential to be used to promote osseointegration of implants and to treat bone defects. Here, using active pharmaceutical ingredients (APIs) such as ibuprofen, we report on the prospects of combining nanoHA with biologically active compounds to improve the clinical performance of these treatments. In this study, we designed and investigated the possibility of API attachment to the surface of nanoHA crystals via the formation of a hydrogen-bonded complex. The mechanistic studies of an ibuprofen/nanoHA complex formation have been performed using a holistic approach encompassing spectroscopic (Fourier transform infrared (FTIR) and Raman) and X-ray diffraction techniques, as well as quantum chemistry calculations, while comparing the behavior of the ibuprofen/nanoHA complex with that of a physical mixture of the two components. Whereas ibuprofen exists in dimeric form both in solid and liquid state, our study showed that the formation of the ibuprofen/nanoHA complex most likely occurs via the dissociation of the ibuprofen dimer into monomeric species promoted by ethanol, with subsequent attachment of a monomer to the HA surface. An adsorption mode for this process is proposed; this includes hydrogen bonding of the hydroxyl group of ibuprofen to the hydroxyl group of the apatite, together with the interaction of the ibuprofen carbonyl group to an HA Ca center. Overall, this mechanistic study provides new insights into the molecular interactions between APIs and the surfaces of bioactive inorganic solids and sheds light on the relationship between the noncovalent bonding and drug release properties

Effect of spacing and nitrogen levels on performance of hybrid napier in semiarid ecosystem of Gujarat

The present study was undertaken during 2011-12 at Krishi Vigyan Kendra, Panchmahal to find out the effect of spacing and nitrogen levels on performance of hybrid napier in semi-arid ecosystem of Gujarat. The results revealed that the different spacing could not exert significant effect on the plant height, whereas nitrogen levels significantly influenced the plant height. The application of higher dose of nitrogen (200 kg/hr) significantly exhibited higher plant (132.25 cm) followed by 175 and 150 kg/ha N. Tillers/clump and leaf stem ratio was influenced significantly owing to different spacing and levels of nitrogen. The highest leaf stem ratio and more number of leaves/stem were recorded with the spacing of 75 cm × 60 cm and application of 200 kg/ha. The green fodder yield was increased significantly with increasing the spacing and levels of nitrogen. Interaction effect of adoption of spacing and levels of nitrogen indicate that the treatment combination having spacing 75 cm × 60 cm and nitrogen level 200 kg/ha recorded significantly highest green fodder yield. Higher gross returns, net return with maximum benefit cost ratio were recorded when the clumps were planted at the spacing 75 cm × 60 cm with of 200 kg/ha N

Effect of sowing time on productivity and economics of okra (Abelmoschus esculentus) under semi-arid conditions

An investigation to study the effect date of sowing on productivity of okra (Abelmoschus esculentus L. Moench) cv. Gujarat Okra 2 was carried out at the five farmer's field at Panchmahals district of central Gujarat under on farm trial during 2011-12 and 2012-13. The maximum plant height (97.15 cm) at the time of first flowering, number of branches (4.10), pod length (11.55 cm), pod diameter (14.20 cm), number of pods/plant (9.25), pod weight (32.40g) and fruit yield (10.41 tonnes/ha) were recorded in T2. The minimum time (60.50 days) for flowering was recorded in T1. The maximum gross return (Rupees 116 265) and net return (Rupees 86 980) was recorded in T1 followed by T3 (Rupees 87 590, 58 390) and (Rupees 75 895, 45 778) in T2. The maximum B: C ratio (3.97) was recorded in T1 followed by T3 and T2. The B: C ratio is one of most important aspect for selection of particular crop and season by the farmers to maximize the productivity and net return. The farmers of adjoining area have realized the effect of sowing time on productivity and net return and have adopted this technology

Study of molecular structure, chemical reactivity and H-bonding interactions in the cocrystal of nitrofurantoin with urea

YesThe cocrystal of nitrofurantoin with urea (C8H6N4O5)·(CH4N2O), a non-ionic supramolecular complex, has been studied. Nitrofurantoin (NF) is a widely used antibacterial drug for the oral treatment of infections of the urinary tract. Characterization of the cocrystal of nitrofurantoin with urea (NF–urea) was performed spectroscopically by employing FT-IR, FT- and dispersive-Raman, and CP-MAS solid-state 13C NMR techniques, along with quantum chemical calculations. With the purpose of having a better understanding of H-bonding (inter- and intra-molecular), two different models (monomer and monomer + 3urea) of the NF–urea cocrystal were prepared. The fundamental vibrational modes were characterized depending on their potential energy distribution (PED). A combined experimental and theoretical wavenumber study proved the existence of the cocrystal. The presence and nature of H-bonds present in the molecules were ascertained using quantum theory of atoms in molecules (QTAIM) and natural bond orbital (NBO) analysis. As the HOMO–LUMO gap defines the reactivity of a molecule, and this gap is more for the API than the cocrystal, this implies that the cocrystal is more reactive. Global descriptors were calculated to understand the chemical reactivity of the cocrystal and NF. Local reactivity descriptors such as Fukui functions, local softness and electrophilicity indices were analysed to determine the reactive sites within the molecule. The comparison between NF–urea (monomer) and NF showed that the cocrystal has improved overall reactivity, which is affected by the increased intermolecular hydrogen bond strength. The docking studies revealed that the active sites (C[double bond, length as m-dash]O, N–H, NO2, N–N) of NF showed best binding energies of −4.89 kcal mol−1 and −5.56 kcal mol−1 for MUL and 1EGO toxin, respectively, which are bacterial proteins of Escherichia coli. This cocrystal could potentially work as an exemplar system to understand H-bond interactions in biomolecules

Subclinical candiduria in patients with gastrointestinal malignancies : a preliminary study on the protective effect of a natural phitocompound

Amyloid-\u3b2 (A\u3b2) peptide aggregation forms such as soluble oligomers (O) have a causal role in neuronal dysfunction and death associated with Alzheimer's Disease (AD). The main efforts for the development of neuroprotective drugs are therefore focused on preventing A\u3b2 production, aggregation or downstream neurotoxic events. We therefore investigated the effect of guanosine (GUO), a guanine based purine, that exerts neurotrophic and neuroprotective effects. The GUO showed the ability to reduce neuronal death in terms of apoptosis, but not necrosis, elicited by A\u3b21-42O in human neuroblastoma SH-SY5Y cells. The neuroprotective effect was recorded only when the GUO was added simultaneously to treatment of the SH-SY5Y cells with A\u3b21-42O. By contrast, the GUO treatment of SH-SY5Y cells before and after the appearance of \u3b21-42O toxicity had no neuroprotective effects. The employment of specific inhibitors showed the involvement of neuronal survival pathways, such as PI3K-Akt and MAPK-ERK for the GUO anti-apoptotic effects observed. In parallel, the SH-SY5Y cells treated with GUO, in experimental conditions similar to those adopted to evaluate neuronal death, showed a marked decrease of the early reactive oxygen species formation induced by A\u3b21-42O and pro-oxidant H2O 2. In the same neuronal model, GUO was also shown to inhibit the extra- and intra-cellular A\u3b21-42 release as well as the \u3b2-secretase activity evoked by H2O2 pro-oxidant action. Based on these findings, GUO and other guanine based purines appear to be a promising class of compounds with neuroprotective properties that may play an important role in the therapy of AD. Copyrigh

High spin band structures in doubly-odd 194^{194}Tl

The high-spin states in odd-odd $^{194}$Tl nucleus have been studied by populating them using the $^{185,187}$Re($^{13}$C, xn) reactions at 75 MeV of beam energy. $\gamma-\gamma$ coincidence measurement has been performed using the INGA array with a digital data acquisition system to record the time stamped data. Definite spin-parity assignment of the levels was made from the DCO ratio and the IPDCO ratio measurements. The level scheme of $^{194}$Tl has been extended up to 4.1 MeV in excitation energy including 19 new gamma ray transitions. The $\pi h_{9/2} \otimes \nu i_{13/2}$ band, in the neighboring odd-odd Tl isotopes show very similar properties in both experimental observables and calculated shapes. Two new band structures, with 6-quasiparticle configuration, have been observed for the first time in $^{194}$Tl. One of these bands has the characteristics of a magnetic rotational band. The cranked shell model calculations, using a deformed Woods-Saxon potential, have been performed to obtain the total Routhian surfaces in order to study the shapes of the bands and the band crossing in $^{194}$Tl. The semiclassical formalism has been used to describe the magnetic rotational band.Comment: Accepted for publication in Physical Review