Comparison of incidences and indications of multi primary caesarean with primi caesarean mothers in a tertiary care teaching hospital

Background: The incidences and indications of caesarean sections between the primary caesarean multies and caesarean primies were comparable in respect of their demographical and clinical variables of mothers and their foetal outcomes. Aim and objective of the study was to analyze the incidences and indications of primary caesarean multies and caesarean primies. To compare the incidences and indications of mothers between the primary caesarean multies and caesarean primies. To compare the demographic and clinical profiles of the mothers and babies.Methods: During January to June 2016 total of 3583 deliveries were conducted in Tiruneleli Medical College Hospital, Tamil Nadu, India. Among them 89 and 1168 were primary caesarean multies and caesarean primies respectively. They had been compared according to the objectives.Results: The caesarean incidences were 62.5% among the primies and 4.8% among the multies as Primary. The primary caesarean incidences among the multies were statistically significantly lesser in the 15-24 ages than the primi (P0.05). After 30 years of age, the incidences were statistically significantly increased among the multies (P0.05). The indications of Foetal distress, Severe Oligo hydration and others did not show any statistically significantly difference between the groups (P>0.05). Mal presentation and Ante Partum hemorrhage were significantly more among the multies than primies (p<0.05) and Failed indication and CPD were the significantly lesser indication than the primies (P<0.05).Conclusions: Without reducing the caesarean section rate in primi we cannot bring down the overall caesarean rate of delivery

Fetomaternal outcome among elderly gravida and normal age group mothers

Background: Advanced maternal age is defined as 35 years or more at estimated date of delivery is considered to have higher incidence of obstetric complications and adverse pregnancy outcome than younger women. Maternal age plays a vital role in pregnancy outcome. This study is instituted with the idea of identifying the association of advanced maternal age and adverse pregnancy outcome. Objective was to compare demographic characteristics and maternal outcome in elderly pregnancy in comparison with normal age group pregnancy. To compare perinatal outcome of elderly pregnancy with normal age group pregnancy. Methods: This was comparative case control study conducted at department of obstetrics and gynecology, Tirunelveli medical college hospital in 100 patients, about 50 in each of the 2 groups with maternal age &gt; 35years and &lt; 35 years. A group 1 (study group) was pregnant women of age &gt;35 years and group 2 was pregnant women of age &gt;18 years and&lt;35 years. Pregnant women of age&lt; 18 years and pregnant women having major medical disorders before pregnancy were excluded from study. Results: Among the study group incidence of artificial conception; spontaneous abortion; overt diabetes; chronic hypertension; preeclampsia; gestational hypertension ; fetal complications like FGR; shoulder dystocia were statistically significant. Conclusions: This study concludes that there is raised maternal morbidity and operative interventions needed with increasing age. Close monitoring for any complications is vital as early diagnosis and intervention will bring an excellent maternal and fetal outcome

Unveiling the Essence of the American Dream: A Modern Perspective via Philip Roth's The Human Stain

The concept of The American Dream has captivated the attention of scores of people, within and outside of the U.S., generation after generation, for this American Dream is a reality that provides the comfort of a self-sufficient and self-reliant life amongst the highly educated, cultured and like-minded class of people, in one of the highly civilized parts of the world. This ideal and mesmerizing lifestyle has not only encouraged the major white population in the U.S. to strive towards it, but has also earned the attention of the non-white, immigrant communities, many of whom migrate to the U.S. with the hope of making lives better for themselves. The novel The Human Stain by Jewish American author Philip Roth depicts the lives of some such non-white and immigrant characters. While some of them are successful in navigating through a maze of hurdles to experience and relish the reality of the American Dream, there are some who either subject themselves to or are subjected to struggles, challenges and humiliations in the face of their attempt in realizing this dream, with a white supremacist and oft-changing American political scene in the background. This paper attempts to explore and expose the reality of the feasibilities and difficulties behind realizing the American Dream, through the lens of Roth’s The Human Stain

Modulational instability in PT\cal{PT}-symmetric Bragg grating structures with saturable nonlinearity

We investigate the nontrivial characteristics of modulational instability (MI) in a system of Bragg gratings with saturable nonlinearity. We also introduce an equal amount of gain and loss into the existing system which gives rise to an additional degree of freedom, thanks to the concept of $\cal PT$- symmetry. We obtain the nonlinear dispersion relation of the saturable model and discover that such dispersion relations for both the conventional and $\cal PT$- symmetric cases contradict with the conventional Kerr and saturable systems by not displaying the typical signature of loop formation in either the upper branch or lower branch of the curve drawn against the wavenumber and detuning parameter. We then employ a standard linear stability analysis in order to study the MI dynamics of the continuous waves perturbed by an infinitesimal perturbation. The main objective of this paper is twofold. We first investigate the dynamics of the MI gain spectrum at the top and bottom of the photonic bandgap followed by a comprehensive analysis carried out in the anomalous and normal dispersion regimes. As a result, this perturbed system driven by the saturable nonlinearity and gain/loss yields a variety of instability spectra, which include the conventional side bands, monotonically increasing gain, the emergence of a single spectrum in either of the Stokes wavenumber region, and so on. In particular, we observe a remarkably peculiar spectrum, which is caused predominantly by the system parameter though the perturbation wavenumber boosts the former. We also address the impact of all the physical parameters considered in the proposed model which include coupling coefficient, dispersion parameter, and saturable nonlinearity on the phenomenon of MI for different $\cal PT$- symmetric regimes ranging from unbroken to broken one in greater detail.Comment: To appear in Phys. Rev.

Determinants of dysphagia following stroke

Background: Swallowing is affected following stroke. Many studies focus on various aspects of swallowing difficulties (dysphagia) following stroke. However, there are not many studies on the determinants of dysphagia following stroke. The aim of the present study is to establish the association between various factors with the severity of dysphagia.Methods: After screening for Mann Assessment of Swallowing Ability (MASA),110 patients, post-stroke were selected using consecutive sampling to assess the common risk factors, namely the presence of diabetes mellitus, dyslipidemia, hypertension, alcohol usage and smoking habits. Additionally, other variables such as age, gender, type of lesion, side of lesion, tobacco chewing, speech disorders, arterial dysfunction, lobe involvement and Brunnstrom’s stages, were also evaluated using a structured interview method. c2 (chi-squared) analysis was carried out to find out the association between the selected determinants and severity of dysphagia following stroke.Results: It was found that age and Brunnstrom’s stages are the determinants of dysphagia, as analysis showed a strong association with a p value &lt; 0.001. A marginal association between post-stroke dysphagia and type of lesion with a p value of 0.056 was also observed.Conclusions: Among 15 factors evaluated, age, type of lesion and Brunnstrom’s stages showed a significant association with the severity of dysphagia following stroke. This study advocates early dysphagia management for elderly patients with high Brunnstrom’s grading, for those who are not expected to spontaneously recover following stroke, and for earlier and better community rehabilitation. [Ethiop.J. Health Dev. 2019; 33(3):147-152]Key words: Post-stroke dysphagia, Brunnstrom’s stages, dysphagia risk factors

1,5-Dicyano­anthraquinone

The complete mol­ecule of the title compound, C16H6N2O2, which is generated by a crystallographic inversion centre, is almost planar (r.m.s. deviation = 0.04 Å). In the crystal, adjacent mol­ecules are stacked along the a axis, with a shortest centroid–centroid separation of 3.826 (2) Å

Sub-clinical diabetic cardiomyopathy - assessment by systolic time intervals

Left ventricular performance in diabetics wit he at hypertension, ischemic Tie art disease, or clinical evidence of other heart diseases was assessed by systolic time intervals and echo-cardiography. The PEP/ LVET ratio was 3.48% higher in diabetics than in controls. There was good correlation of abnormality of PEP/LVET ratio with duration of diabetes. There was no correlation with age of patient or severity of diabetes. There was good correlation between abnormal PEP/LVET and incidence of retinopathy and nephropathy. This suggests the possibility of the presence of subclinical diabetic cardiomyopathy in these individuals

13C-assisted metabolic flux analysis to investigate heterotrophic and mixotrophic metabolism in Cupriavidus necator H16

Introduction. Cupriavidus necator H16 is a gram-negative bacterium, capable of lithoautotrophic growth by utilizing hydrogen as an energy source and fixing carbon dioxide (CO2) through Calvin-Benson-Bassham (CBB) cycle. The potential to utilize synthesis gas (Syngas) and the prospects of rerouting carbon from polyhydroxybutyrate synthesis to value-added compounds makes C. necator an excellent chassis for industrial application. Objectives. In the context of lack of sufficient quantitative information of the metabolic pathways and to advance in rational metabolic engineering for optimized product synthesis in C. necator H16, we carried out a metabolic flux analysis based on steady-state 13C-labelling. Methods. In this study, steady-state carbon labelling experiments, using either D-[1-13C]fructose or [1,2-13C]glycerol, were undertaken to investigate the carbon flux through the central carbon metabolism in C. necator H16 under heterotrophic and mixotrophic growth conditions, respectively. Results. We found that the CBB cycle is active even under heterotrophic condition, and growth is indeed mixotrophic. While Entner-Doudoroff (ED) pathway is shown to be the major route for sugar degradation, tricarboxylic acid (TCA) cycle is highly active in mixotrophic condition. Enhanced flux is observed in reductive pentose phosphate pathway (redPPP) under the mixotrophic condition to supplement the precursor requirement for CBB cycle. The flux distribution was compared to the mRNA abundance of genes encoding enzymes involved in key enzymatic reactions of the central carbon metabolism. Conclusion. This study leads the way to establishing 13C-based quantitative fluxomics for rational pathway engineering in C. necator H16

RNA Sequencing of Pancreatic Circulating Tumour Cells Implicates WNT Signaling in Metastasis

Circulating tumour cells (CTCs) shed into blood from primary cancers include putative precursors that initiate distal metastases. While these cells are extraordinarily rare, they may identify cellular pathways contributing to the blood-borne dissemination of cancer. Here, we adapted a microfluidic device for efficient capture of CTCs from an endogenous mouse pancreatic cancer model and subjected CTCs to single molecule RNA sequencing, identifying Wnt2 as a candidate gene enriched in CTCs. Expression of Wnt2 in pancreatic cancer cells suppresses anoikis, enhances anchorage-independent sphere formation, and increases metastatic propensity in vivo. This effect is correlated with fibronectin upregulation and suppressed by inhibition of Map3k7 (Tak1) kinase. In humans, formation of non-adherent tumour spheres by pancreatic cancer cells is associated with upregulation of multiple Wnt genes, and pancreatic CTCs revealed enrichment for Wnt signaling in 5 of 11 cases. Thus, molecular analysis of CTCs may identify candidate therapeutic targets to prevent the distal spread of cancer

Community evaluation of glycoproteomics informatics solutions reveals high-performance search strategies for serum glycopeptide analysis

Glycoproteomics is a powerful yet analytically challenging research tool. Software packages aiding the interpretation of complex glycopeptide tandem mass spectra have appeared, but their relative performance remains untested. Conducted through the HUPO Human Glycoproteomics Initiative, this community study, comprising both developers and users of glycoproteomics software, evaluates solutions for system-wide glycopeptide analysis. The same mass spectrometrybased glycoproteomics datasets from human serum were shared with participants and the relative team performance for N- and O-glycopeptide data analysis was comprehensively established by orthogonal performance tests. Although the results were variable, several high-performance glycoproteomics informatics strategies were identified. Deep analysis of the data revealed key performance-associated search parameters and led to recommendations for improved 'high-coverage' and 'high-accuracy' glycoproteomics search solutions. This study concludes that diverse software packages for comprehensive glycopeptide data analysis exist, points to several high-performance search strategies and specifies key variables that will guide future software developments and assist informatics decision-making in glycoproteomics