Study of medical disorders in pregnancy among in patients at a tertiary care hospital in Haryana, India

Background: Pregnancy is a physiological condition in which various changes occur in pregnant women just to accommodate growing fetus. Pregnancy is a stress test for woman and may unmask certain underlying chronic diseases like, DM, hypertension which were silent or asymptomatic prior to pregnancy. This study was done to know the incidence, type and demographic profile of medical disorders in pregnancy among in patient at a tertiary care hospital.Methods: It was a retrospective study conducted on 578 patients of medical disorders in pregnancy admitted in a tertiary care hospital from January 2017 to December 2017. Data collected from record room and analysis done.Results: Total antenatal admissions were 4721. Incidence of medical disorders was 12.24%. Majority of women were in age group 20-30 years (65.5%). Low-parity (P0, P1). Hypertensive disorders in pregnancy was commonest reported disorder (42.3%), followed by hematological disorder (38.7%), liver disorder 5%, endocrine disorder 4.8%, epilepsy 3.8% and HIV 2.6% in present study.Conclusions: Hypertensive disorders were commonest medical disorder followed by hematological, liver, endocrine and epilepsy. All medical disorders in pregnancy to be managed by team approach

Effects of glenohumeral corticosteroid injection on stiffness following arthroscopic rotator cuff repair: a prospective, multicentric, case-control study with 18-month follow-up

Background This study aimed to analyze the efficacy of single-dose corticosteroid injection (CSI) administered at 6 weeks postoperative to treat stiffness following arthroscopic rotator cuff repair (ARCR). Methods In this prospective, multicentric, case-control study, post-ARCR stiffness at 6 weeks was treated with either a single dose of intra-articular CSI (CSI group) or physical therapy with oral analgesics (non-CSI group). Pain intensity according to visual analog scale (VAS), functional outcome using the Constant Murley Shoulder Score, time to return to activities of daily living (ADLs), and retear rate were recorded at 6 weeks, 9 weeks, 12 weeks, 6 months, 12 months, and 18 months postoperatively in both groups. Results A total of 149 patients (54.5%) in the CSI group and 124 patients (45.5%) in the non-CSI group were included in this study. Pain and function were significantly better in the CSI group at 9-week, 12-week, and 6-month (P<0.001) follow-up, whereas they were not significantly different when the groups were compared at 12- and 18-month follow-up. The mean duration to return to ADLs was significantly shorter (P<0.001) in the CSI group. The incidence of retears was not significantly different (P=0.36) between groups at the end of 18 months of follow-up. Conclusions Single-dose intra-articular CSI administered at 6 weeks postoperative to treat post-ARCR stiffness significantly improved pain, function, and duration of return to ADLs without increasing the risk of retears compared to patients who did not receive intra-articular CSI. Level of evidence III

Genome-Wide Analyses of Nkx2-1 Binding to Transcriptional Target Genes Uncover Novel Regulatory Patterns Conserved in Lung Development and Tumors

The homeodomain transcription factor Nkx2-1 is essential for normal lung development and homeostasis. In lung tumors, it is considered a lineage survival oncogene and prognostic factor depending on its expression levels. The target genes directly bound by Nkx2-1, that could be the primary effectors of its functions in the different cellular contexts where it is expressed, are mostly unknown. In embryonic day 11.5 (E11.5) mouse lung, epithelial cells expressing Nkx2-1 are predominantly expanding, and in E19.5 prenatal lungs, Nkx2-1-expressing cells are predominantly differentiating in preparation for birth. To evaluate Nkx2-1 regulated networks in these two cell contexts, we analyzed genome-wide binding of Nkx2-1 to DNA regulatory regions by chromatin immunoprecipitation followed by tiling array analysis, and intersected these data to expression data sets. We further determined expression patterns of Nkx2-1 developmental target genes in human lung tumors and correlated their expression levels to that of endogenous NKX2-1. In these studies we uncovered differential Nkx2-1 regulated networks in early and late lung development, and a direct function of Nkx2-1 in regulation of the cell cycle by controlling the expression of proliferation-related genes. New targets, validated in Nkx2-1 shRNA transduced cell lines, include E2f3, Cyclin B1, Cyclin B2, and c-Met. Expression levels of Nkx2-1 direct target genes identified in mouse development significantly correlate or anti-correlate to the levels of endogenous NKX2-1 in a dosage-dependent manner in multiple human lung tumor expression data sets, supporting alternative roles for Nkx2-1 as a transcriptional activator or repressor, and direct regulator of cell cycle progression in development and tumors

On a fractional integral operator containing ψ-generalized Mittag Leffler function in its kernel and properties

This paper is devoted to the study of ψ-generalized Mittag-Leffler function associated with ψ-generalized beta function. We also obtain integral representations and other useful properties of it for example, Mellin transforms, recurrence relations etc. Further we develop derivative formulas and some fractional differ-integral properties for this ψ-generalized Mittag-Leffler function. Other than this we also establish fractional integral operator containing ψ-generalized Mittag-Leffler function as its kernel and obtain some associated properties.Publisher's Versio

Automatic Bottle Filling System Using Programmable Logic Controller

Till now there is a consistent problem of increasing crowd density at water filling areas at small places such as railway stations, bus stands etc. the use of large conveyer belts at local areas will obviously be largely expensive and also not practicable. The cleanliness of such areas becomes a huge issue. The wastage of water is an alarming challenge keeping along with the today’s water crisis. So the need of the hour is automation. With the introduction of most feasible and durable device like Programmable Logical Controller (PLCs), a disciplined and time bounded bottle filling system can be installed at numerous places. This real life problem has usually been neglected due to the unawareness of latest technologies. This system can be used with numerous modifications for the betterment of the general utilities

Social and Behavioral Determinants for Early Childhood Caries among Preschool Children in India

Background and aims. Early Childhood Caries (ECC) is a public health problem with biological, social and behavioural determinants and the notion that the principal etiology is inappropriate feeding modalities is no longer tenable. Hence this study was undertaken to assess the relationship between ECC and socio-demographic factors, dietary habits, oral hygiene habits and parental characteristics. Materials and methods. The study involved a dental examination of 1400 children aged 0‒71 months, recording caries using Gruebbel’s deft index and a structured questionnaire to interview parents or caretakers. The tabulated data was statis-tically analyzed using t-test and ANOVA at 5% level of significance. Results. The variables significantly associated with ECC were age (P<0.001), geographical location (P<0.05), duration of breast/bottle feeding (P<0.001), use of sweetened pacifiers (P<0.001), frequency of snacking (P<0.05), frequency of tooth brushing (P<0.001), the person responsible for child’s oral health care (P<0.05) and education level of parents (P<0.05). However, other variables like child’s gender, number of siblings, types of snack the child preferred and age at which tooth brushing was instituted did not have statistically significant relationship with ECC (P>0.05). Conclusion. ECC is preventable and manageable with proper information and skills. It is important for healthcare profes-sionals, family physicians and parents to be cognizant of the involved risk factors as their preventive efforts represent the first line of defense

Automatic outer and inner breast tissue segmentation using multi-parametric MRI images of breast tumor patients

<div><p>The objectives of the study were to develop a framework for automatic outer and inner breast tissue segmentation using multi-parametric MRI images of the breast tumor patients; and to perform breast density and tumor tissue analysis. MRI of the breast was performed on 30 patients at 3T-MRI. T₁, T₂ and PD-weighted(W) images, with and without fat saturation(WWFS), and dynamic-contrast-enhanced(DCE)-MRI data were acquired. The proposed automatic segmentation approach was performed in two steps. In step-1, outer segmentation of breast tissue from rest of body parts was performed on structural images (T₂-W/T₁-W/PD-W without fat saturation images) using automatic landmarks detection technique based on operations like profile screening, Otsu thresholding, morphological operations and empirical observation. In step-2, inner segmentation of breast tissue into fibro-glandular(FG), fatty and tumor tissue was performed. For validation of breast tissue segmentation, manual segmentation was carried out by two radiologists and similarity coefficients(Dice and Jaccard) were computed for outer as well as inner tissues. FG density and tumor volume were also computed and analyzed. The proposed outer and inner segmentation approach worked well for all the subjects and was validated by two radiologists. The average Dice and Jaccard coefficients value for outer segmentation using T₂-W images, obtained by two radiologists, were 0.977 and 0.951 respectively. These coefficient values for FG tissue were 0.915 and 0.875 respectively whereas for tumor tissue, values were 0.968 and 0.95 respectively. The volume of segmented tumor ranged over 2.1 cm3–7.08 cm³. The proposed approach provided automatic outer and inner breast tissue segmentation, which enables automatic calculations of breast tissue density and tumor volume. This is a complete framework for outer and inner breast segmentation method for all structural images.</p></div

General overview of the process for outer and inner segmentation in breast MR images.

<p>(A) Original T₂-W MRI Image. (B) Image shows points P1, P2 and P3. (C) Image after fractional Otsu thresholding. (D) Image after the morphological operation. (E) Image shows points P3 and P3’(new P3 point). (F) Image shows points P1, P2, P3, P3’, P4, P5 and fat thickness t, indicated by red arrow. (G) Image shows an overlay of the fitted B-spline curve (yellow) through P4, P3’ and P5. (H) Outer segmented mask image. (I) Outer segmented breast tissue overlaid on the original T₂-W image using the proposed method. (I) and (J) show Non-Fat-Sat T₂-W and Fat-Sat T₂-W images after outer segmentation respectively. (K) Difference image. (L) Inner segmentation image in which FG indicated by green color, fatty tissue by orange and tumor by red color.</p

Manual segmentation.

<p>(A and B) show Extreme Slices (C) ROI was drawn on T₂-W without fat saturation images for separating out the breast tissue. (D) ROI was drawn on tumor tissue. Dark green color shows the ROI contour on both images.</p

Bar graph of breast density vs age.

<p>The figure shows bar graph plot of breast density in different age groups. Error bars represent SD of breast density within each group.</p