Clinical characteristics and outcomes of pregnant patients with COVID-19 at BPKIHS, a prospective study

Background: Coronavirus disease (COVID-19) can vary in presentation, women present with a spectrum of clinical manifestations that range from mild symptoms and signs to severe illness, may require immediate advanced critical care support. Therefore, a hospital-based study was conducted to evaluate the effect of COVID-19 on maternal and perinatal outcomes of COVID-19 infected pregnant women. Methods: This was prospective descriptive study conducted at B. P. Koirala institute of health science. Total duration of study was one year from September 2020 to August 2021. This study was done in 70 pregnant ladies with confirmed SARS CoV2 infection. Different clinical presentation, mode of delivery, treatment given, need of oxygen, need of ICU admission, maternal outcomes, neonatal outcomes were observed. Result: The most common symptom was fever in 38 (54.2%) patients, followed by cough in 22 (31.5%) patients. Eighteen (25.71%) had mild degree of pneumonia with fall in oxygen saturation below 95% and required oxygen via face mask. Three patients (4.28%) develop sever pneumonia and required mechanical ventilation two (2.85%) had maternal mortality due to covid pneumonia. Most common mode of delivery was LSCS 21 (61.76%). Seven (10%) patients had preterm delivery. Conclusions: Most of the COVID-19 positive pregnant women remained asymptomatic or had mild infections. COVID-19 infections in late pregnancy might lead to an increased incidence of caesarean deliveries as observed in the present study. Adverse perinatal outcomes are mostly due to delayed presentation of patient to the hospital during COVID pandemic. High maternal mortality rate has been seen in present study. So proper intensive care is must for the management of such patient during pandemics. Also, efforts to limit exposure to COVID-19 of pregnant women should be strengthened for saving mother and child

Is Cerebrospinal Fluid C-reactive Protein a Better Tool than Blood C-reactive Protein in Laboratory Diagnosis of Meningitis in Children?

Objectives: This study aimed to test whether C-reactive protein (CRP) measurement could differentiate between different types of meningitis and become a routine test. Methods: A prospective study included 140 children admitted to Manipal Teaching Hospital, Pokhara, Nepal, between July 2009 and June 2011. The subjects had a blood test and detailed cerebrospinal fluid (CSF) analysis, including blood and CSF CRP levels. Results: Of those admitted, 31.1% had pyogenic meningitis (PM), 26.2% partially treated meningitis (PPM), 33% viral meningitis (VM), and 9.7% tubercular meningitis (TBM), with 26.4% controls. Organisms were isolated in 12.5% of the cases by blood culture and 25% of cases through CSF culture. Blood CRP was positive in all groups, with the highest values in PM (53.12 ± 28.88 mg/dl) and PPM (47.55 ± 34.34 mg/dl); this was not statistically significant (P = 0.08). The CSF CRP levels were significantly higher (P <0.001) in PM (45.75 ± 28.50 mg/dl) and PPM (23.11 ± 23.98 mg/dl). The sensitivity and specificity of blood CRP was 90.62%, 88.88%, 64.7%, 70% and 32.4%, 30.97%, 24.52%, 26.12% and that of CSF CRP was 96.87%, 66.66%, 20.58%, 10% and 74.73%, 63.71%, 50.94%, 55.35% for PM, PPM, VM and TBM, respectively. Conclusion: Because of its high sensitivity, both CSF CRP and blood CRP can be used to screen for bacterial meningitis (both PM and PPM). CSF CRP screening yielded results with a higher specificity than blood CRP; hence, it can be a supportive test along with CSF cytology, biochemistry, and microbiology for diagnosing meningitis

Efficacy and Toxicity of Different Forms of Asparaginases Against Acute Lymphoblastic Leukemia: A Review

Acute lymphoblastic leukemia (ALL) is a form of blood cancer that affects white blood cells and is among the most common forms of leukemia with children and adolescents showing the highest number of cases. Most treatment protocols include chemotherapy using asparaginase. Asparaginase converts asparagine to aspartic acid and ammonia. Unlike normal, healthy cells, cancerous cells depend on asparagine for their growth. When these cells are deprived of asparagine by the action of the enzyme, the cancer cells selectively die. As of date, several forms of asparaginases are commercially available and are administered in ALL therapy. But due to limited study, it will be early and inaccurate to predict which forms of the enzymes are better. In this review, we aim to compare the efficacy and toxicity of four different asparaginases—native Escherichia coli asparaginase, PEG Escherichia coli asparaginase, Erwinia chrysanthemi asparaginase and a recombinant Escherichia coli asparaginase—used in ALL therapy in children and adolescents using available clinical trial data. PubMed and Clinical trial.org databases were used to select studies. Asparaginase activity, toxicity, anti-asparaginase antibody level and event-free, overall survival was compared for different asparaginases. Seventeen randomized and non-randomized controlled trials were included. Evidence was insufficient to ascertain which asparaginase is the best. PEG Escherichia coli asparaginase seems to be better with a high activity among the treated patients but there remains high toxicity for all available asparaginases. This study highlights a need to discover alternative sources of asparaginase from the organisms, which are evolutionarily distant from Escherichia coli and Erwinia chrysanthemi with high higher enzyme activity and reduced toxicity

Line tension and structure of smectic liquid crystal multilayers at the air-water interface

At the air/water interface, 4,-8-alkyl[1,1,-biphenyl]-4-carbonitrile (8CB) domains with different thicknesses coexist in the same Langmuir film, as multiple bilayers on a monolayer. The edge dislocation at the domain boundary leads to line tension, which determines the domain shape and dynamics. By observing the domain relaxation process starting from small distortions, we find that the line tension is linearly dependent on the thickness difference between the coexisting phases in the film. Comparisons with theoretical treatments in the literature suggest that the edge dislocation at the boundary locates near the center of the film, which means that the 8CB multilayers are almost symmetric with respect to the air/water interface.Comment: 21 pages, 6 figure

Development and Validation of an Information Booklet Aimed at Promoting Mental Health for Pregnant Women with a History of Abuse.

BACKGROUND:Mental health needs of victims of domestic and family violence are often overlooked. A booklet was designed to help women update their knowledge and skills in effective coping with domestic and family violence and support them in developing effective stress reduction and problem management techniques. In addition, this booklet is believed to serve as a reference for further use. This paper describes the development process and validation of the information booklet. This booklet was used during an intervention trial conducted in Nepal to educate abused pregnant women. METHODS:This methodological study involved three stages: bibliographical survey, development of the booklet, and validation by specialists in the relevant fields and representatives of the target audiences. A total of eight experts, currently working in the field of domestic violence and/or midwifery, and 15 representatives of the target participants were involved in the validation process. A minimum Content Validity Index of 0.78 was considered for content validation, and minimum agreement of 75% for face validation. RESULTS:The booklet presented a global Content Validity Index of 0.92. The overall level of agreement within the target participants was 86.3%, which was higher than the minimum recommended level. Both subject experts and participants positively evaluated the adequacy, coverage and readability of contents of the booklet. CONCLUSIONS:The booklet was validated using content and face validity. This validated booklet is expected to be an effective tool for communication that would help pregnant women cope better with domestic and family violence and adopt strategies to remain emotionally healthy