Study of congenital anomalies of fetus and its outcome in a tertiary care centre

Background: According to WHO Congenital anomalies are defined as structural or functional anomalies, including metabolic disorders which are present at the time of birth. Congenital anomalies are a major health problem accounting for 8% to 15% of perinatal deaths and 13% to 16% of neonatal deaths in India. This study was done to know the frequency, pattern of congenital anomalies and various presentations, which may help to develop strategies for patient counseling and management. The objective of study was to present the spectrum of various congenital anomalies, epidemiological features of pregnant women with anomalous fetus.Methods: Retrospective, analytical hospital based study of 45 patients who delivered or aborted congenital anomalous baby from a period of 1st Jan 2012 to 31st August 2015. Relevant information regarding maternal age, parity, gestational age, birth weight, sex, and consanguinity antenatal ultrasound was documented.Results: During the study period 45 congenital anomalies were seen in delivered babies and aborted fetus, 32 (71%) patients were in the age group of 20-29 years. 35 (77%) patients were from rural area and 29 (65%)were unbooked patients. The incidence of congenital malformations was higher among abortions and preterm deliveries. Incidence of congenital anomalies was higher in stillborn. 31 (68%) patients had anomalies diagnosed on antenatal ultrasound. Central nervous system was the most common system involved followed by musculoskeletal system. Anencephaly was the common malformation seen in 12 (27%) patients.Conclusions: Our study concluded that number of congenital anomalies were more in rural patients and were higher in stillborn. Central nervous system was commonly involved. Early diagnosis, antenatal ultrasonography, proper counseling for this pregnancy and subsequent pregnancy in needed for proper management of the problem

Internal iliac artery ligation to combat post partum haemorrhage: an institutional review of case series

Background: Internal iliac artery supplies the pelvic viscera. IIAL is a valuable surgical procedure to control intractable pelvic haemorrhage with the mainstay aim of uterus preservation. There is a reduction of 85% in pulse pressure and 48% in the blood flow in the arteries distal after internal iliac artery ligation. Thus, the expertise to perform IIAL should be present in armamentarium of every obstetrician and gynaecologist.Methods: Retrospective review of 22 cases who have undergone IIAL or Peripartum hysterectomy for management of Post- Partum haemorrhage in the study period of January 2012 till December 2015 in the Department of Obstetrics and Gynaecology of People’s College of Medical Science and Research Centre, Bhopal.Results: Internal iliac artery ligation was performed in 53% out of which 31.8%% was for placenta previa, 4.54% for adherent placenta, 9.1% IIAL for Atonic PPH. Whereas peripartum hysterectomy was performed in 38% cases out of which 13.6% had perforation of uterus. 9% underwent hysterectomy as well as IIAL. Blood loss more than two 2 liters within period of 60-90mins was effectively and dramatically controlled with IIAL. Thus, maternal mortality reduced while preserving fertility. Control of Pelvic hemorrhage was achieved in 100% of cases.Conclusions: Bilateral ligation of the internal iliac arteries is a safe, rapid and very effective method of controlling bleeding from UTERUS and genital tract. It plays a major role in safe guarding the patient from undergoing life threatening consequences due to pelvic haemorrhage

Formulation and Characterization of Novel Transfersomes Gel for Enhance TDDS of Losartan Potassium

A transferosome is the first generation of an elastic liposome prepared from phospholipids and edge activators. An edge activator is often a single-chain surfactant with a high radius of curvature that destabilizes the lipid bilayers of vesicles and increases the deformability of the bilayers, thereby making the vehicle ultra-deformable. Losartan potassium is an orally active angiotensin-II receptor antagonist used in the treatment of hypertension due to mainly blockade of AT1 receptor. It is freely soluble in water, slightly soluble in acetonitrile, and soluble in isopropyl alcohol. The aim of the present study was to investigate the potential of transfersomal gel formulations for transdermal delivery of losartan potassium by reverse phase evaporation method. Characterization of transfersomes gel performed by vesicle size, pH measurements,  drug content, entrapment efficiency, in vitro drug diffusion study, spreadability and stability study. In the formulations pH is found to be around 6.8 to 6.9, pH is found in the range of 6 which is compatible with skin. In the formulations spreadability is found to be around 6.75 to 10.11 g m cm/sec. The prepared gel containing losartan potassium-loaded transfersomal formulation was optimized and can be use for topical preparation. The results were obtained which showed that transfersomal gel was a promising candidate for transdermal delivery with targeted and prolonged release of a drug. It also enhances skin permeation of many drugs. Keywords: Transferosome gel, Losartan potassium, Antihypertensives, Reverse phase evaporation metho

Automated Multi-Peak Tracking Kymography (AMTraK): A Tool to Quantify Sub-Cellular Dynamics with Sub-Pixel Accuracy

<div><p>Kymographs or space-time plots are widely used in cell biology to reduce the dimensions of a time-series in microscopy for both qualitative and quantitative insight into spatio-temporal dynamics. While multiple tools for image kymography have been described before, quantification remains largely manual. Here, we describe a novel software tool for automated multi-peak tracking kymography (AMTraK), which uses peak information and distance minimization to track and automatically quantify kymographs, integrated in a GUI. The program takes fluorescence time-series data as an input and tracks contours in the kymographs based on intensity and gradient peaks. By integrating a branch-point detection method, it can be used to identify merging and splitting events of tracks, important in separation and coalescence events. In tests with synthetic images, we demonstrate sub-pixel positional accuracy of the program. We test the program by quantifying sub-cellular dynamics in rod-shaped bacteria, microtubule (MT) transport and vesicle dynamics. A time-series of <i>E</i>. <i>coli</i> cell division with labeled nucleoid DNA is used to identify the time-point and rate at which the nucleoid segregates. The mean velocity of microtubule (MT) gliding motility due to a recombinant kinesin motor is estimated as 0.5 μm/s, in agreement with published values, and comparable to estimates using software for nanometer precision filament-tracking. We proceed to employ AMTraK to analyze previously published time-series microscopy data where kymographs had been manually quantified: clathrin polymerization kinetics during vesicle formation and anterograde and retrograde transport in axons. AMTraK analysis not only reproduces the reported parameters, it also provides an objective and automated method for reproducible analysis of kymographs from <i>in vitro</i> and <i>in vivo</i> fluorescence microscopy time-series of sub-cellular dynamics.</p></div

Nucleoid segregation dynamics of <i>E</i>. <i>coli</i>.

<p>(A) Image time-series of <i>E</i>. <i>coli</i> MG1655 grown on agar pads and imaged in DIC (left) and fluorescence based on HupA-GFP (right) are analyzed using AMTraK. (B) AMTraK generates a maximum intensity projection on the basis of which user-selected lines of interest (red lines) are used by the program to generate kymographs. The kymographs based on (C) LOI 1 (k1) and (D) LOI 2 (k2) were tracked resulting in branched tracks (colored lines). (E) The instantaneous velocities of nucleoids 1 and 2 (n1, n2) from kymographs 1 (k1) and 2 (k2) are plotted as a function of time (colors indicate nucleoids n1, n2 each from the kymographs k1, k2). (F) Mean velocities are estimated using both the arithmetic mean (±s.d.) and v_ex, the mean of the exponential decay (y = e^-1/vex) that was fit (red line) to the frequency distribution of instantaneous velocity (bars). Scale bar 4 μm.</p

Microtubule (MT) gliding motility on kinesin motors.

<p>MTs gliding on kinesin (images acquired every 1 minute for 30 minutes) were analyzed using AMTraK by either detecting <b>(A)</b> the centerline (red) or <b>(B)</b> the two edges the filament, edge 1 (red) and 2 (cyan). Color bar: gray scale image intensity normalized by the maximal value for the bit-depth. <b>(C, D)</b> The velocity estimates from the centroid-based velocity estimates and the two edges and <b>(E)</b> the velocity estimated from each edge are correlated. <b>(F)</b> The frequency distribution of the instantaneous velocity estimates using the centroid (blue) is compared to edge-based estimates. r²: goodness of fit, y/x: slope of the linear fit. Number of filaments analyzed, n = 10.</p

Estimating positional accuracy.

<p>(A) A single frame of a 2D image time-series of static spheres (with a peak intensity of 1) with Gaussian noise (mean = 0, s.d. = 40) is analyzed using AMTraK (B) resulting in a kymograph. (C) The frequency distribution of the error in position detection (Δx) by AMTraK (bars) is fit by an exponential decay (red). The mean error obtained is 0.75 pixels (goodness of fit R² = 0.95) for a representative time-series with noise s.d. = 40. (D) The mean error of detection (y-axis) from the exponential fit <Δx> = 1/b (black) is compared to the arithmetic mean (blue) in pixel units, plotted as a function of increasing noise s.d. (x-axis). The noise generates random intensities drawn from a Gaussian distribution with mean 0 and the specified s.d. being added to the image (based on the “Specified Noise” function in ImageJ).</p

Analysis of synaptic vesicle transport.

<p><b>(A)</b> GFP-Rab3 tagged vesicles from posterior touch cell neurons in <i>C</i>. <i>elegans</i> (experimental data from taken from supporting movie <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0167620#pone.0167620.s010" target="_blank">S1 Movie</a> from [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0167620#pone.0167620.ref028" target="_blank">28</a>]) were analyzed using AMTraK. Colored lines with index numbers indicate tracks. <b>(B)</b> The frequency distribution of instantaneous velocities of the vesicles (n = 1592) is plotted using AMTraK (mean: 0.49 μm/s, s.d. 0.88). <b>(C, D)</b> The frequency distribution of non-zero velocities are fit with an exponential decay function y = A*e^-x/m (red line), where A: scaling factor and <i>m</i>: mean. <b>(C)</b> The mean anterograde velocity from the fit is 0.625 μm/s with arithmetic mean 0.77±0.53 μm/s (n = 425) and <b>(D)</b> the mean retrograde velocity from the fit is 0.714 μm/s with arithmetic mean 0.854±0.67 μm/s (n = 540). Arithmetic means are reported ± standard deviation (s.d.). R² indicates the goodness of the fit.</p