Descriptive audit of maternal sepsis in a tertiary care centre of North India

Background: Maternal sepsis is one of the leading causes of maternal mortality around the world. The aim of this study was to study the prevalence, clinical profile and fetomaternal outcome of maternal sepsis at a dedicated Obstetric critical care unit of a tertiary care centre of North India. It was retrospective study conducted in tertiary care centre in North IndiaMethods: Women diagnosed as sepsis or septic shock at any point in pregnancy and up to 6 weeks postpartum (irrespective of the source of infection) were included in the study. Demographic, clinical, microbiological and outcome data were recorded from the case sheets of all patients admitted in obstetrical critical care unit between January to December 2016. Outcome measures: Prevalence, bacterial organism, source of infection, mode of delivery, period of gestation, maternal and fetal outcome.Results: The prevalence of maternal sepsis was 16.5/10,000 live births. The number of maternal deaths attributable to sepsis were 35, making the maternal mortality ratio due to sepsis 128/100,000 live births. 87% of the cases were unbooked. 22% presented antenatally while 58% were postpartum and 20% were postabortal. Genital tract infection was most common source of infection. E. coli was the predominant organism in 28% followed by Methicillin resistant staphylococcus aureus in 12%. The mortality from sepsis was very high (78%). 54% of cases required mechanical ventilation and around 7% had to be shifted to intensive care unit for advanced life support and care. Sepsis was associated with preterm delivery and a high perinatal mortality rate.Conclusions: Early recognition of the severity of infection and prompt management by a multidisciplinary team of intensivists, anesthetists, neonatologists, obstetrician, midwives are the key to success. Vigilant infection control measures must be strictly practiced during all pregnancy events

Thoracopagus conjoined twin: an unusual presentation

Conjoined twins are among rare clinical conditions observed by obstetricians. Due to rare incidence of this condition there is general lack of knowledge among obstetricians, especially at primary care level which leads to missed diagnosis during antenatal period. The management of this condition is complex especially in cases where the diagnosis is not known before onset of labour. A 30 - year old Hindu lady was referred to us from other hospital with diagnosis of twin pregnancy and prolonged second stage of labour. Clinical examination revealed findings of ruptured uterus and foetal head of one baby and feet of second baby were outside the introitus. Emergency laparotomy was done which revealed conjoined twins. This article report clinical course of a thoracopagus conjoined twin. The relevant literature is also reviewed.

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Descriptive audit of maternal sepsis in a tertiary care centre of North India

Background: Maternal sepsis is one of the leading causes of maternal mortality around the world. The aim of this study was to study the prevalence, clinical profile and fetomaternal outcome of maternal sepsis at a dedicated Obstetric critical care unit of a tertiary care centre of North India. It was retrospective study conducted in tertiary care centre in North IndiaMethods: Women diagnosed as sepsis or septic shock at any point in pregnancy and up to 6 weeks postpartum (irrespective of the source of infection) were included in the study. Demographic, clinical, microbiological and outcome data were recorded from the case sheets of all patients admitted in obstetrical critical care unit between January to December 2016. Outcome measures: Prevalence, bacterial organism, source of infection, mode of delivery, period of gestation, maternal and fetal outcome.Results: The prevalence of maternal sepsis was 16.5/10,000 live births. The number of maternal deaths attributable to sepsis were 35, making the maternal mortality ratio due to sepsis 128/100,000 live births. 87% of the cases were unbooked. 22% presented antenatally while 58% were postpartum and 20% were postabortal. Genital tract infection was most common source of infection. E. coli was the predominant organism in 28% followed by Methicillin resistant staphylococcus aureus in 12%. The mortality from sepsis was very high (78%). 54% of cases required mechanical ventilation and around 7% had to be shifted to intensive care unit for advanced life support and care. Sepsis was associated with preterm delivery and a high perinatal mortality rate.Conclusions: Early recognition of the severity of infection and prompt management by a multidisciplinary team of intensivists, anesthetists, neonatologists, obstetrician, midwives are the key to success. Vigilant infection control measures must be strictly practiced during all pregnancy events

A study on evaluation of different urinary constituents and their ratios in patients with urolithiasis

BackgroundThe lifetime prevalence of kidney stone disease is estimated 1% to 15 % with the probability of varying according to age, gender, race and geographic location. Adult men are 3 times more affected than adult women. Calcium oxalate stones are common in south east. Uric acid stones are common in the east. In India prevalence is more than 11%.Stone disease peaks at 4th to 6th decade. Higher prevalence of stone disease is found in hot, arid or dry climates. Metabolic defects are less likely to occur in the first time stone formers than in patients with recurrent disease. Hypocitraturia and hyperoxaluria are common abnormalities found in stone formers. Stone formers have significantly higher calcium, oxalate and uric acid levels. Citrate/calcium ratios are found to be low in stone formers.Objectives:1.Estimation of urinary parameters such as calcium, magnesium, uric acid, creatinine, oxalate, phosphate and citrate in 24 hour urine. 2.Estimation of calcium/creatinine, citrate/creatinine, uric acid/creatinine, calcium/citrate ratios in 24 hour urine and specifically to screen a patient with renal stone and in turn it will help in the treatment and prevention of stone formation in recurrent stone formers.Materials &Methods:The study included 100 subjects comprising of 50 healthy controls and 50 urolithiasis cases. 24 hour urine was collected and toluene was added as preservative. Urine calcium was estimated by Arsezano’s method. Urine magnesium was estimated by Xylidyl blue method. Urine phosphorus was estimated by end point method. Urine uric acid was measured by uricase method. Urine creatinine was estimated by modified Jaffe’s method. Citrate and oxalate was estimated by enzymatic method.Results:The urinary calcium, phosphorus, uric acid, oxalate was increased in cases when compared to controls. Urine magnesium and citrate was reduced when compared to controls. Urine creatinine was normal or decreased in cases than controls.Conclusion:This study is being undertaken to estimate different ratios so as to get specific ratio as an index in stone formers whereas high calcium/creatinine ratio can be used as a screening procedure to detect increase calcium in urine

Extraction of V2O5 from Bayers Sludge - An Overview

Vanadium is a precious rare metal with very scarce resources available on earths crust. Due to scarcity of deposits of vanadium and generation of large quantities of tailings produced by mining and metallurgical activities, there is a need to find an economical way to recover vanadium from secondary resources. This article brings out a comprehensive data collection of efforts placed worldwide on extraction of vanadium from secondary sources like titaniferrous magnetite (TMO), vanadium sludge of aluminium industry, other resources like effluents, spent catalysts, LD slag, fly ash, oil sludge, spent vanadium catalysts, etc. Special emphasis is laid to the Bayers sludge or vanadium sludge. The processes developed or in vogue for extraction of vanadium are described in some detail, along with recent initiatives

Extraction of vanadium and synthesis of vanadium pentaoxide from Bayer's sludge

Wastes generated from the Bayer's process serve as valuable resources for aluminum, vanadium, gallium, etc. This work aims to develop a environmentally acceptable and low-cost chemical leaching-cumpurification method for the recovery of vanadium sludge of Indian alumina plant (10-12% V2O5) and synthesize vanadium pentaoxide. The efficiency of leaching was evaluated by various lixiviants like acidified water, H2SO4, soda and NaOH against variation in pulp density and temperature. Maximum extraction (96%) vanadium was achieved using acidified water leaching at above ambient temperature in 1 h with 200 g/L pulp density following diffusion control model. Finally, the vanadium rich leach liquor was purified by steps of adsorption/precipitation etc., to remove with iron and silica to get vanadium pentaoxide. A high purity product of 99% V2O5 was obtained by allowing the adsorption at acidic pH followed by desorption and precipitation at 90A degrees C

A study on Serum Ferritin, HbA1c, Nitric oxide, Uric Acid levels in type 2 Diabetes Mellitus

Background: Diabetes mellitus (DM) is a commonest metabolic disorder affecting the people all over the world. There is growing evidence that increased iron stores in the body leads to developmentof glucose intolerance, type 2 DM and insulin resistance syndrome. Several studies have shown that development of endothelial dysfunction is the major cause for vascular complications in type 2 DM subjects and altered bioavailability of serum nitric oxide is found be the underlying cause for endothelial dysfunction in diabetic subjects. Objectives: To estimate fasting plasma glucose, serum ferritin, serum nitric oxide, HbA1cand uric acid levels in type 2 DM subjects and compare the values with healthy controls and to do the correlation analysis between these biochemical parameters in type 2 DM subjects. Materials and methods: A case control study is conducted in a total of 56 diagnosed type 2 DM subjects and 31 healthy controls. Fasting plasma glucose, serum ferritin,serum nitric oxide, HbA1c, and serum uric acid are estimated in all cases and control group. Results: Intergroup comparison of biochemical parameters was done by unpaired “t” testand correlation between parameters by Pearson coefficient analysis. In DM subjects, mean values of serum ferritin, serum nitric oxide, HbA1c, and serum uric acid were found to be significantly increased (p<0.001) when compared to controls. Moreover, Serum ferritin has shown significant positive correlation with HbA1cand serum nitric oxide in type 2 DM patients with „p‟ value of <0.05. Conclusion: The present study suggests that oxidative stress is one of the major factors in the pathogenesis of type 2 DM. There is a need to prevent iron over load in type 2 DM subjects which may occur through many ways. Decreasing iron stores may reduce the oxidative stress, improve the vascularendothelial dysfunction andalso improves insulin sensitivity in type 2 DM subjects

Chebulic Myrobalan for controlling bacterial disease in Muga Silkworm <i>Antheraea assama</i> – A preliminary report

347-348India produces four varieties of silk obtained from four types of moths. These are known as Mulberry, Tussar, Eri and Muga. Muga silkworm, Antheraea assama Ww. producing golden yellow silk, reared in outdoors is found only in Brahmaputra valley of Assam. Now-a-days muga silkworm is very much susceptible to bacterial infection called ‘flacherie’ caused by Pseudomonas aeruginosa and developed certain symptoms such as poor appetite, retarded growth, black body fluid and hanging upside down. Terminalia chebula Retz. (Chebulic myrobalan; Assam —Hilika; Hindi — Harar), a moderate sized or large deciduous tree found in North East India and other parts of the country was evaluated for antibacterial property against P. aeruginosa strain AC-3 causing ‘flacherie’ in muga silkworm. A comparative study on the antimicrobial properties of extracts prepared by different methods was performed in order to choose the most efficient antimicrobial compounds for in vitro as well as in vivo control of bacteria