Ovarian tumours associated with pregnancy: a five year retrospective study in a tertiary care hospital

Background: Pregnancy with ovarian tumors was reviewed over a 5 year period to determine the types of ovarian tumors associated with pregnancy in patients undergoing surgery and also the maternal and fetal outcome.Methods: This retrospective study of 17 cases of ovarian tumors treated surgically during pregnancy and puerperium was carried out at a tertiary hospital between June 2009 and June 2014 to determine the incidence, clinico pathological features and outcome.Results: The overall incidence of ovarian tumor in pregnant woman undergoing surgery was 1 in 1693 (0.025%) deliveries. 52.87%   tumors were diagnosed in the first and second trimesters of pregnancy.  Ten (58.82%) presented as an emergency at different periods of gestation with torsion being the most common cause of surgery. Serous cyst adenoma (23.52%) and dermoid tumor (17.64%) were the most common types of ovarian tumors found in the study. The incidence of malignant tumors was one (5.88%).Maternal outcome was uneventful in all patients. Abortion rate was 100% in first trimester. Outcome in second trimester is inconclusive as few patients were lost to follow-up. Patients diagnosed in third trimester had an uneventful fetal outcome.Conclusions: Ovarian tumors are encountered with greater frequency, most being benign and self-resolving with malignancy occurring in a small minority of cases. Removal of persisting or enlarging ovarian masses as soon as possible is important to obtain a final histologic diagnosis and rule out malignancy

Helicobacter pylori infection and hyperemesis gravidarum: a prospective pilot study in India

Background: About 80% of all pregnant women experience some form of nausea and vomiting during their pregnancy. Hyperemesis gravidarum, the commonest indication for admission to hospital in the first half of pregnancy affects approximately 0.3%-2.0% of pregnancies. Helicobacter pylori infection has been implicated in the cause of nausea and occasional vomiting in early pregnancy. The objectives of this study are to determine the proportion of H. pylori seropositivity among women with hyperemesis gravidarum (HG) and determine its relation with socio-economic status.Methods: This was a prospective study conducted in a tertiary hospital in Bangalore among 60 pregnant women with HG for a period of 12 months. Venous blood samples were obtained and serum IgG for H. pylori was measured using enzyme-linked immunosorbant assay (ELISA). Details regarding socioeconomic status, recurrence of symptoms and severity were noted.Results: The proportion of H. pylori seropositivity among pregnant women with hyperemesis in our study was 70%.There was a significant increase in severity and recurrence of vomiting among seropositive cases. Women belonging to rural areas had 1.17 times the risk of infection compared to women with urban area. We also found women belonging to the lower socioeconomic status had 0.52 times more risk to develop Helicobacter pylori infection.Conclusions: This study suggests that H. pylori is an independent risk factor for vomiting in pregnancy. Effective treatment and eradication of H pylori infection may help reduce severity and recurrence of vomiting among positive cases thus reducing its adverse consequences

Study of maternal and perinatal outcome among twin pregnancies with one twin demise

Background: To study the incidence, management and to determine maternal and perinatal outcome in cases of twin pregnancy with one twin demise in the second half of the pregnancy.Methods: This retrospective study was carried out at Cheluvamba Hospital, a tertiary care hospital attached to Mysore medical college and research institute between September 2009 and 2014. 19 twin pregnancies complicated by single intrauterine fetal demise (IUFD) after 20 weeks of gestation were identified from the hospital records. Data collected included maternal age, parity, antenatal complications, cause of IUFD, gestational age at diagnosis, time interval between diagnosis of IUFD and delivery, mode of delivery, birth details, type of placentation and neonatal complications.Results: The incidence of twin with one twin demise was 2.056%. Mean gestational age at presentation was 33.86 weeks. Most common cause of death was growth discordance in 7 cases followed by placental insufficiency in 4 cases. 57.89% of cases had monochorionic placentation. Neonatal course was most commonly complicated by prematurity. Maternal course was uneventful in majority (63.15%) of cases with two maternal deaths due to intravascular coagulopathy sequelae.Conclusions: Single fetal death occurs more often in monochorionic twins. The main problem for the surviving twin is prematurity. It is very important to identify the chorionicity by ultrasound examination in early pregnancy and implement specific surveillance of monochorial pregnancies

EFFECT OF PUNARNAVADI KASHAYAM AND ASWAGANDHA CHOORNA IN PREMENSTRUAL SYNDROME

Premenstrual syndrome (PMS) is a common disorder of young and middle-aged women characterized by cyclic occurrence in the luteal phase of the menstrual cycle of a combination of distressing physical, psychological and behavioral changes of sufficient severity to result in deterioration of inter- personal relationships; which remit upon onset or immediately after menstruation. PMS is due to doshic imbalance and impairment of satwa. Objective of study is to find out the effect of Punarnavadi kashayam and Aswagandha choornam in Premenstrual syndrome. Study design was interventional, pre and posttest with a sample size of 20. Females of age group 20-35 years with PMS fulfilling the American College of Obstetrics and Gynecology criteria of PMS was selected. Punarnavadi Kashayam in the dose of 48 ml bid, 30 minutes before food and Aswagandha choorna in the dose of 3 gm. bid along with kashaya. Administration of drug started 14 days before menstruation and was continued till fourth day of menstruation for three consecutive cycles. Follow up was done for next two consecutive cycles. Patient was assessed on fifth day of menstruation during study period and follow up period. The research drug had shown effectiveness in the treatment of depressive effect, anxiety, fatigue, irritation, depressive thoughts, pain, appetite changes, sleep changes, bloating assessed by premenstrual scale. Both drugs showed effectiveness in normalizing serum sodium and serum potassium levels. Associated premenstrual complaints also subsided. Study concluded that Punarnavadi kashaya and Aswagandha choorna is very much effective in treating Premenstrual syndrome

Presence of rd8 mutation does not alter the ocular phenotype of late-onset retinal degeneration mouse model.

PurposeA spontaneous frameshift mutation, c.3481delC, in the Crb1 gene is the underlying cause of dysplasia and retinal degeneration in rd8 mice. The rd8 mutation is found in C57BL/6N but not in C57BL/6J mouse sub-strains. The development of ocular pathology in single knockout Ccl2-/-, Cx3cr1-/- and in double knockout Ccl2-/-, Cx3cr1-/- mice raised on a C57BL/6 background has been reported to depend on the presence of a rd8 mutation. In this study, we investigated the influence of the rd8 mutation on the retinal pathology that we previously described in the late-onset retinal degeneration (L-ORD) mouse model with a heterozygous S163R mutation in the C1q-tumor necrosis factor-related protein-5Ctrp5+/- gene that was generated on a C57BL/6J background.MethodsMouse lines carrying the Ctrp5 S163R and rd8 mutations (Ctrp5+/-;rd8/rd8), corresponding controls without the rd8 mutation (Ctrp5+/-;wt/wt), and wild-type mice with and without the rd8 mutation (Wtrd8/rd8 and Wtwt/wt, respectively) were generated by systematic breeding of mice in our L-ORD mouse colony. Genotyping the mice for the rd8 (del C at nt3481 in Crb1) and Ctrp5 S163R mutations was performed with allelic PCR or sequencing. Retinal morphology was studied with fundus imaging, histology, light microscopy, electron microscopy, and immunohistochemistry.ResultsGenotype analysis of the mice in L-ORD mouse colony detected the rd8 mutation in the homozygous and heterozygous state. Fundus imaging of wild-type mice without the rd8 mutation (Wtwt/wt) revealed no autofluorescence (AF) spots up to 6-8 months and few AF spots at 21 months. However, the accumulation of AF lesions accelerated with age in the Ctrp5+/- mice that lack the rd8 mutation (Ctrp5+/-;wt/wt). The number of AF lesions was significantly increased (p<0.001), and they were small and uniformly distributed throughout the retina in the 21-month-old Ctrp5+/-;wt/wt mice when compared to the age-matched controls. Wild-type and Ctrp5+/- mice with the rd8 mutation (Wtrd8/rd8 and Ctrp5+/-;rd8/rd8, respectively) revealed an integrated retinal architecture with well-defined outer segments/inner segments (OS/IS), outer nuclear layer (ONL), outer plexiform layer (OPL), and inner nuclear layer (INL). The presence of pseudorosette structures reported in the rd8 mice between the ONL and the INL in the ventral quadrant of the retina was not observed in all genotypes studied. Further, the external limiting membrane was continuous in the Ctrp5+/-;rd8/rd8 and Wtrd8/rd8 mice. Evaluation of the retinal phenotype revealed that the Ctrp5+/-;wt/wt mice developed characteristic L-ORD pathology including age-dependent accumulation of AF spots, development of sub-retinal, sub-RPE, and basal laminar deposits, and Bruch's membrane abnormalities at older age, while these changes were not observed in the age-matched littermate WTwt/wt mice.ConclusionsThe Wtrd8/rd8 and Ctrp5+/-;rd8/rd8 mice raised on C57BL/6J did not develop early onset retinal changes that are characteristic of the rd8 phenotype, supporting the hypothesis that manifestation of rd8-associated pathology depends on the genetic background. The retinal pathology observed in mice with the Ctrp5+/-;wt/wt genotype is consistent with the L-ORD phenotype observed in patients and with the phenotype we described previously. The lack of rd8-associated retinal pathology in the Ctrp5+/-;wt/wt mouse model raised on the C57BL/6J background and the development of the L-ORD phenotype in these mice in the presence and absence of the rd8 mutation suggests that the pathology observed in the Ctrp5+/-;wt/wt mice is primarily associated with the S163R mutation in the Ctrp5 gene

The effect of antenatal corticosteroids on maternal glycemic control, in a tertiary care centre in North Kerala - India

Background: Antenatal glucocorticoid therapy (ACT) can be life-saving in preterm babies and risk of PTL is increasing in. The prevalence of GDM also increasing. Virtually, all women will experience deterioration in their glycaemic control following ACT. The NICE guideline recommends additional insulin and the national Indian guidelines recommend a 20% increase. Objective of this study was to evaluate the changes in maternal serum glucose following corticosteroids in antenatal women.Methods: Prospective controlled trial of 206 patients, divided into 2 groups. Group 1:105 patients with no GDM and Group 2: 101 patients with GDM. Ethical committee approved. FBS and PPBS measured for following 5 days of D1. BMI and starting dose of insulin and dose of insulin hike were recorded. FBS >90 mg/dL and PPBS >120 mg/dL were taken as abnormal. Data were analyzed using SPSSV22.Results: There were a total of 206 of which 105 were in group 1(51%) and 101(49%) were in Group 2. FBS >90 mg/dL in over 65% of all women on D2 10 new cases on D3 and PPBS >120 mg/dL in over 66% of all women on D2 and 13 new cases on D3. Insulin was started in a total of 66 patients of 105 (62.9%) in Group 1 and 33 out of 40 (82.5%) in GDM on MNT. Of the 66 patients who started on insulin in Group 1, 17 (16.2%) patients had to continue insulin and out of 33. In MNT subgroup 10 (25%) had to continue. BMI was high in the patients, who was given and continued insulin.Conclusions: The findings support the concept of increasing the dose of insulin even before the hyperglycemia documented. In the Group 1 66 of 105 patients were started on insulin due to hyperglycemia and 17 had to continue insulin 25.7%), and 33 of 40 patients in GDM on MNT were started on insulin and 10 (30.33%) had to continue. We suggest testing all patients for hyperglycemia and to start  insulin especially in the those with high BMI (>25 as per the Asian Indian)

The comparison of USG measured cervical length in pregnant women with previous induced abortion versus those who have not had an induced abortion

Background: The majority of women who undergo induced abortion are young and of low parity. Hence, it is desirable to look for any association effects of induced abortion with future reproductive outcomes. In this study, we aim to compare ultrasound measured cervical length in pregnant women with previous induced abortion versus those who have not had an induced abortion.Methods: This was a prospective observational study performed at tertiary care hospital. Total of 400 patients were recruited, divided into two groups. Patients with an induced abortion in previous pregnancy were included as cases and those with no history were taken as controls. Cervical length was measured by transvaginal ultrasound in all participants at 11-14, 18-22 and 28-32 weeks. Pregnancies were followed up to note incidence of spontaneous preterm delivery, preterm pre labour rupture of membranes (PPROM), threatened preterm, and second trimester miscarriage.Results: Authors have found that there was no significant difference in the cervical length of pregnant patients with or without a history of prior induced abortions.  In our study authors found that mean cervical length at 11-14weeks, 18-22 weeks, and 28-32 weeks was 3.47±0.126cm and 3.48±0.195cm; 3.44±0.296cm and 3.49±0.182cm; 3.36±0.477cm and 3.42±0.310cm respectively among cases and controls. However, there was a demonstrably increased risk of spontaneous preterm delivery, PPROM and threatened preterm in patients with a history of prior induced abortion.Conclusions: Authors conclude that previous induced abortion increases the risk of threatened preterm, PPROM, spontaneous preterm delivery in the subsequent pregnancy. But, this risk is not predictable by measuring cervical length as the mean cervical length remained the same in both the groups

¿Es capaz el mindfulness de reducir la intensidad de juicio y el efecto de falso consenso?

Treball Final de Grau en Psicologia. Codi: PS1048. Curs acadèmic: 2016/2017El mindfulness es, por definición, la acción de prestar atención completa a la experiencia presente de una forma particular, con un propósito y sin hacer juicios o evaluaciones de los eventos privados experimentados y de los estímulos externos relacionados con estos eventos privados. Este ejercicio es una técnica de relajación que, en numerosos estudios, ha demostrado ser capaz de producir efectos positivos en el ámbito laboral, educativo y sanitario. Sin embargo, es escasa la literatura que explica los mecanismos cognitivos a los que afecta esta técnica y que explicarían estos efectos. Algunos de los estudios que pretenden dar una explicación a tales efectos han demostrado que el mindfulness es capaz de mejorar las capacidades cognitivas y los procesos atencionales. En lo referido a procesos atributivos, se ha demostrado que algunos de los sesgos atributivos elementales, como el sesgo de correspondencia, se reducen de forma significativa con la práctica de esta técnica dada la capacidad para otorgar a sus practicantes la habilidad de realizar observaciones centradas en el momento presente e impedir en gran medida la actuación de mecanismos automáticos de prejuicio y estereotipación. El presente estudio pretende conocer en qué medida es capaz el mindfulness de modificar la intensidad con la que las personas emiten juicios morales, así como a cometer errores atributivos, en concreto el efecto de falso consenso. Para este cometido se ha contado con una muestra de 440 participantes y se han utilizado herramientas como el cuestionario MINDSENS, la Escala de Necesidad de Cognición y cuestionarios de elaboración propia donde los participantes debían emitir juicios, considerar el consenso social existente y situar estas respuestas en una dimensión de intensidad. Los resultados obtenidos reflejan una reducción significativa del efecto de falso consenso en los participantes meditadores. Sin embargo, no se aprecian diferencias en la intensidad de los juicios emitidos entre meditadores y no meditadores.Mindfulness is, by definition, the action of paying attention to the actual experience in a particular way, with a purpose and without making judgments or evaluations of the experienced private events and the external stimuli related to these private events. This exercise is a relaxation technique that, in many studies, has shown to be able to produce positive effects in the labor, educational and health field. However, there are not many literature explaining the cognitive mechanisms that affect this technique and explain these effects. Some of the studies that attempt to explain the stories have shown that mindfulness is capable of improving cognitive abilities and attentional processes. With regard to attributive processes, it has been shown that some of the biases of elemental attributions, such as correspondence bias, are significantly reduced with the practice of this technique given the ability to give its practitioners the ability to perform observations centered on the present moment and greatly impede the performance of automatic mechanisms of prejudice and stereotyping. The present study intends to know to what extent the mindfulness is able to modify the intensity with which people emit moral judgments, as well as to commit attributive errors, in particular the effect of false consensus. For this purpose, a sample of 440 participants has used tools such as the MINDSENS questionnaire, the Cognition Need Scale and the self-elaboration questionnaires where participants should make judgments, consider the existing social consensus and find these answers in An intensity dimension The results obtained reflect a significant reduction of the effect of false consensus on the meditator participants. However, there are no differences in the intensity of the judgments emitted between meditators and non-meditators

EVALUATION OF CARDIOPROTECTIVE ACTIVITY OF ALLIUM CEPA AERIAL LEAVES

Objective: The present work deals with the study of the ethanolic extract of fruits of Allium cepa aerial leaves for cardioprotective activity.Methods: Cardioprotective activity of the ethanolic extract of aerial leaves of Allium cepa was determined by the administration of isoproterenol (60 mg/kg, s. c) for two days.Results: Pretreatment with ethanolic extract of Allium cepa aerial leaves (200 mg/kg, p. o and 100 mg/kg, p. o) for 28 d in significantly (p<0.01) reduce the levels of serum transaminases, alkaline phosphates, lactate dehydrogenase, creatinine kinase, total cholesterol, triglycerides, LDL-cholesterol, VLDL-cholesterol and increase the levels of HDL-cholesterol. Histopathological studies of the hearts of isoproterenol treated rats have showed infiltration of inflammatory cells and lacking of continuity in muscle fiber was suggesting an irreversible cell injury.Conclusion: Animals treated with ethanolic extract of Allium cepa aerial leaves showed less degenerative changes compared to isoproterenol-treated animals

Plant disease prediction using convolutional neural network

Every year India losses the significant amount of annual crop yield due to unidentified plant diseases. The traditional method of disease detection is manual examination by either farmers or experts, which may be time-consuming and inaccurate. It is proving infeasible for many small and medium-sized farms around the world. To mitigate this issue, computer aided disease recognition model is proposed. It uses leaf image classification with the help of deep convolutional networks. In this paper, VGG16 and Resnet34 CNN was proposed to detect the plant disease. It has three processing steps namely feature extraction, downsizing image and classification. In CNN, the convolutional layer extracts the feature from plant image. The pooling layer downsizing the image. The disease classification was done in dense layer. The proposed model can recognize 38 differing types of plant diseases out of 14 different plants with the power to differentiate plant leaves from their surroundings. The performance of VGG16 and Resnet34 was compared.  The accuracy, sensitivity and specificity was taken as performance Metrix. It helps to give personalized recommendations to the farmers based on soil features, temperature and humidit