A prospective clinical trial to evaluate the prevalence of thyroid disorder among pregnant women and obstetrical and fetal outcome in a tertiary health centre located in central India

Background: A prospective clinical trial to evaluate the prevalence of thyroid disorder among pregnant women and obstetrical and fetal outcome was done in a tertiary health centre (RKDF Medical College and Research Centre, Bhopal) located in central India.Methods: This prospective study was carried out in antenatal women in their first trimester attending antenatal OPD in RKDF Medical College and Research Centre, Bhopal, Madhya Pradesh to know the prevalence of thyroid disorder and its association with pregnancy outcome.Results: In this study prevalence of thyroid disorder was 12.4%, subclinical hypothyroidism 7.2%, overt hypothyroidism 3.4%, subclinical hyperthyroidism 1.4%, overt hyperthyroidism 0.4%. Thyroid disorder is responsible for several obstetrical and fetal complication like pre-eclampsia, preterm delivery, abortion, IUGR and low birth weight.Conclusions: Thyroid disorder associated with poor obstetrical outcome and fetal complication. so timely diagnosis and treatment is required. Universal screening should be preferred over high-risk screening because of high prevalence of the disease in India

A study to compare the efficacy, acceptability and side effect of combined contraceptive vaginal ring with the combined oral contraceptive pills in a tertiary health centre located in central India

Background: A study to compare the efficacy, acceptability and side effect of combined contraceptive vaginal ring with the combined oral contraceptive pills in a tertiary health centre (RKDF Medical College and Research Centre, Bhopal) located in central India.Methods: This prospective randomized comparative trial enrolled hundred women aged between 20 to 40 years seeking for contraception with no contraindication to hormonal contraception. After proper counseling and informed consent, women divided into two groups, study group (50) includes women using contraceptive vaginal ring and control group (50) include women using combined oral contraceptives. The contraceptive efficacy, acceptability, tolerability and adverse events were recorded at each follow-up visit at RKDF Medical College and Research Centre, Bhopal.Results: Vaginal ring and combined oral contraceptives were found to have comparable contraceptive efficacy. In study group no pregnancy reported during study period while one pregnancy reported in control group, which was statistically insignificant. Satisfaction, continuation and recommendation to others were more with vaginal ring which were not significant statistically. Cycle control is superior with vaginal ring. Incidence of adverse effects was same in both groups.Conclusions: Combined contraceptive vaginal ring is an effective and reliable contraception with excellent cycle control, well-tolerated and highly acceptable to most women

Evaluation of methods to estimate foliage density in the understorey of a tropical evergreen forest

Foliage density and leaf area index are important vegetation structure variables. They can be measured by several methods but few have been tested in tropical forests which have high structural heterogeneity.In this study, foliage density estimates by two indirect methods, the point quadrat and photographic methods,were compared with those obtained by direct leaf counts in the understorey of a wet evergreen forest in southern India. The point quadrat method has a tendency to overestimate, whereas the photographic method consistently and significantly underestimates foliage density. There was stratification within the understorey, with areas close to the ground having higher foliage densities

Vacancy-ordered Double Perovskites A2_2BX6_6 (A = Cs, B = Pt, Pd, Te, Sn, X = I): An Emerging Class of Thermoelectric Materials

Vacancy-ordered double perovskites (A$_2$BX$_6$), being one of the environmentally friendly and stable alternatives to lead halide perovskites, have garnered considerable research attention in the scientific community. However, their thermal transport has not been explored much despite their potential applications. Here, we explore A$_2$BX$_6$ (A = Cs, B = Pt, Pd, Te, Sn, X = I) as potential thermoelectric materials using the state-of-the-art first-principles based methodologies, viz., density functional theory (DFT) combined with many-body perturbation theory (G$_0$W$_0$) and spin-orbit coupling (SOC). The phonon dispersion plots and Poisson's and Pugh's ratios show the dynamical and mechanical stability of this class of perovskites. The absence of polyhedral connectivity in vacancy-ordered perovskites gives rise to additional degrees of freedom leading to lattice anharmonicity. The presence of anharmonic lattice dynamics leads to strong electron-phonon coupling, which is well captured by Fr\"{o}hlich mesoscopic model to investigate the interaction of longitudinal optical phonon modes with the carriers that strongly influence the carrier mobility. The lattice anharmonicity is further studied using $ab$ $initio$ molecular dynamics simulations and electron localization function. The maximum anharmonicity is observed in Cs$_2$PtI$_6$, followed by Cs$_2$PdI$_6$, Cs$_2$TeI$_6$ and Cs$_2$SnI$_6$. Also, the computed average thermoelectric figure of merit ($zT$) for Cs$_2$PtI$_6$, Cs$_2$PdI$_6$, Cs$_2$TeI$_6$ and Cs$_2$SnI$_6$ are 0.88, 0.85, 0.95 and 0.78, respectively, which reveals their promising renewable energy applications.Comment: 33 pages, 9 figure

Engineering of Extracellular Vesicles as Nano Therapy for Breast Cancer

Extracellular vesicles are membrane-derived nanoparticles that represent a novel mechanism of cell-to-cell communication. It is well reported that EVs play a central role in the tumor microenvironment by mediating intercellular signaling among cancer cells. This has resulted in the development of therapeutic strategies targeting various EV signaling pathways in cancer. However, because of their small size and endogenous origin, they have been extensively explored for cancer drug delivery. Hence, owing to their natural ability to mediate intercellular communication, high stability, and low immunogenicity, they have emerged as an attractive platform for cancer treatment. However, limited production and insufficient loading with therapeutic moieties are some of the issues constraining their clinical translation. In this chapter, recent research studies performed in an attempt to develop EVs as cancer biomarkers or drug delivery systems will be discussed. Further, it will also discuss various strategies such as direct and indirect cell surface modification, which can be employed to make EVs successful as cancer therapeutics. Furthermore, it will highlight the current and completed clinical trials using naturally derived EVs as cancer therapeutics

Indirect Evidences of Wildlife Activities in Shoals of Western Ghats, a Biodiversity Hotspots

The presence of wildlife fauna and its activities were ascertained with the density of the scat, dung and other markings or droppings of the wildlife abode therein. Attempt was made to find out spatial differences in the activities of the wildlife populations and to comment on the abundance of different preys and predators within shola forests of Western Ghat hill forests, a Biodiversity hotspot in India. An indirect sampling method, Transect Count Method, was employed to count dung/pellet group/scat and other markings in that area. Pachyderms were found to be mostly dominant in Varagaliar and Punnumala shola patches while scats of all the three important predators, viz., tiger (Panthera tigris tigris), Indian wild dog (Cuon alpinus) and leopard (Panthera pardus) were encountered only in Varagaliar shola. Greater abundance was recorded from Indira Gandhi Wildlife Sanctuary than Silent Valley National Park may be because of the restriction of animal movements in the former due to topographical barriers and its existence as isolated shola patches that led to a greater concentration of wild fauna in a relatively segregated forest coverПрисутствие организмов в природной среде и их жизнедеятельность были установлены по плотности распределения экскрементов и других меток животных в исследованных местах. Были сделаны попытки найти отличия в жизнедеятельности популяций диких животных, и прокомментировать многообразие хищников и их жертв в лесах шола, местах наибольшего биоразнообразия в Индии. Метод косвенных образцов и метод трансектного подсчета были использованы для подсчета экскрементов/погадок и других меток в исследуемом регионе. Установлено, что на небольших участках земли в шола Варагалиар и Пуннумала доминируют толстокожие, тогда как экскременты хищников – тигра (Panthera tigris tigris), красного волка (Cuon alpinus) и леопарда (Panthera pardus) – были случайно обнаружены только в шола Варагалиар. Значительно большее количество было зарегистрировано в Заповеднике дикой природы им. Индиры Ганди по сравнению с Национальным парком «Тихая Долина», возможно, из-за ограничения миграций животных топографическими барьерами в прошлом, что привело к большей концентрации дикой фауны в относительно обособленном лесу

Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.publishedVersio

Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12.2 million (95% UI 11.0-13.6) incident cases of stroke, 101 million (93.2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6.55 million (6.00-7.02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11.6% 10.8-12.2] of total deaths) and the third-leading cause of death and disability combined (5.7% 5.1-6.2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70.0% (67.0-73.0), prevalent strokes increased by 85.0% (83.0-88.0), deaths from stroke increased by 43.0% (31.0-55.0), and DALYs due to stroke increased by 32.0% (22.0-42.0). During the same period, age-standardised rates of stroke incidence decreased by 17.0% (15.0-18.0), mortality decreased by 36.0% (31.0-42.0), prevalence decreased by 6.0% (5.0-7.0), and DALYs decreased by 36.0% (31.0-42.0). However, among people younger than 70 years, prevalence rates increased by 22.0% (21.0-24.0) and incidence rates increased by 15.0% (12.0-18.0). In 2019, the age-standardised stroke-related mortality rate was 3.6 (3.5-3.8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3.7 (3.5-3.9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62.4% of all incident strokes in 2019 (7.63 million 6.57-8.96]), while intracerebral haemorrhage constituted 27.9% (3.41 million 2.97-3.91]) and subarachnoid haemorrhage constituted 9.7% (1.18 million 1.01-1.39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79.6 million 67.7-90.8] DALYs or 55.5% 48.2-62.0] of total stroke DALYs), high body-mass index (34.9 million 22.3-48.6] DALYs or 24.3% 15.7-33.2]), high fasting plasma glucose (28.9 million 19.8-41.5] DALYs or 20.2% 13.8-29.1]), ambient particulate matter pollution (28.7 million 23.4-33.4] DALYs or 20.1% 16.6-23.0]), and smoking (25.3 million 22.6-28.2] DALYs or 17.6% 16.4-19.0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries