Maternal risk factors and perinatal outcome in meconium stained amniotic fluid: a cross sectional study

Background: Meconium staining of amniotic fluid has long been regarded as a sign of fetal distress and fetal asphyxia. Although exact cause is unknown, meconium is thought to be passed from fetal gastro-intestinal tract as a response to hypoxia, mesenteric vasoconstriction induced gut hyper peristalsis, vagal stimulation and normal physiologic function of a mature fetus. Overall frequency has ranged from 5 to 24.6%. Present study is undertaken to detect incidence, mode of delivery, fetal heart rate variability and neonatal outcome in neonates born through MSAF. The objective of the study was to maternal risk factors, mode of delivery and perinatal outcome in labors complicated with meconium stained amniotic fluid.Methods: This is a cross sectional study done at Government Medical College, Thrissur on term, singleton pregnancies complicated with meconium stained amniotic fluid satisfying the inclusion criteria. Patients detailed history, gestational age, per abdominal examination, per speculum and per vaginal examination, admission tests including intrapartum cardiotocography (CTG) was recorded in a predesigned proforma.Results: The age of the patients varied between above 19 and 30 years. Majority of the study population were 69.3% Primi gravidas. Out of 130 cases, 56.2% were grade 2 meconium stained liquor, 30.7% were grade 3 meconium stained and 13.1% were grade 1 meconium stained. Association between neonatal complications in relation to grades of meconium was found to be statistically significant (p = 0.001). NICU admission was 24.7% in grade 2 meconium group. Hypoxic Ischemic encephalopathy was high in grade 3 meconium group, 45%. Majority of babies born through grade 1 meconium were asymptomatic and 10% of babies in grade 3 meconium groups were asymptomatic. Meconium aspiration syndrome, Respiratory distress were more in babies born through deliveries complicated with grade 3 meconium.Conclusions: The study indicated meconium stained amniotic fluid during labour increases the prevalence of abnormal intrapartum CTG, Caesarean section, lower Apgar score, increased duration of NICU and hospital stay, poor perinatal outcome and non-significant difference in incidence of lower birth weight in babies

AYURVEDIC MANAGEMENT IN THREATENED ABORTION AND FOETAL ANOMALY – A CASE REPORT

Congenital anomalies amount to 50% of causative factor to first trimester abortions. Ayurvedic Ante Natal Care is highly effective in maintaining a healthy pregnancy and delivering a healthy progeny. A 28 year old female with bleeding per vaginum which started at 5 weeks of pregnancy, was advised for Medical Termination of Pregnancy. But she wanted to try Ayurvedic management and was treated with Ayurvedic medicines. The bleeding stopped in 11 days and fetal pole was visualized. She had occasional spotting in between and was detected with long bone growth lower than the normal limit in her anomaly scan at 20 weeks of gestation. She was advised termination owing to the risk of fetal anomalies but she was unwilling and wanted to continue Ayurvedic treatment. She was explained regarding all the possible consequences of continuing the pregnancy and with the consent of the patient and her family Ayurvedic treatment was continued. She delivered a healthy male baby of birth weight 2.57kg through Lower Segment Caesarean Section at term with an APGAR score of 9 at 1 minute. The baby had no gross or obvious anomalies at birth. The present case demonstrates the effectiveness of Ayurvedic Ante Natal Care in positive prognosis of threatened abortion

Paralympic movement in Malaysia: The achievement of high-performance para sports

The article elaborates on the achievement of the Malaysian athletes with disabilities locally and also in international scenes. Malaysian athletes start to participate in international competition since 1962, and local games had been organized back in 1982 with the introduction of the Paralympic Games. The article also illustrates the medal achievement where Malaysian contingent achieved a total of 1700 medals at the ASEAN Para Games from 2001-2017. In FESPIC and Asian Para Games, a total of 582 medals was won from the year 1982-2018. At the FESPIC and Asian Youth Para Games, a total of 189 medals won from the year 2003-2017. The highest achievement came from the Paralympic games as Malaysian won 11 medals in total from the year 1962-2016. More need to be done to establish para sports in Malaysia with the support of every parties including the government and the media

A low carbon footprint approach to the reconstitution of plastics into 3D-printer filament for enhanced waste reduction

In this study we aim to investigate recycling of waste plastics products into filaments for use in a typical FDM 3D printing system. We investigate the parameters relating to control of the filament thickness to a variety of different plastic types, which include HDPE and ABS. Following filament generation, parameters were investigated to optimise the print parameters to produce a variety of demonstration models, which test the print resolution. Results suggest that the proposed supply chain can allow for highly repeatable ABS and HDPE filament generation with a diameter of 1.74 ± 0.1mm and 1.65 ± 0.1mm respectively. Ultimately, the production of usable filaments can provide a viable means of consuming waste plastics and reducing the burden of increased landfill.

Contemporary incidence and risk factors of post transplant Erythrocytosis in deceased donor kidney transplantation.

BACKGROUND: Post-Transplant erythrocytosis (PTE) has not been studied in large recent cohorts. In this study, we evaluated the incidence, risk factors, and outcome of PTE with current transplant practices using the present World Health Organization criteria to define erythrocytosis. We also tested the hypothesis that the risk of PTE is greater with higher-quality kidneys. METHODS: We utilized the Deceased Donor Study which is an ongoing, multicenter, observational study of deceased donors and their kidney recipients that were transplanted between 2010 and 2013 across 13 centers. Eryrthocytosis is defined by hemoglobin\u3e 16.5 g/dL in men and\u3e 16 g/dL in women. Kidney quality is measured by Kidney Donor Profile Index (KDPI). RESULTS: Of the 1123 recipients qualified to be in this study, PTE was observed at a median of 18 months in 75 (6.6%) recipients. Compared to recipients without PTE, those with PTE were younger [mean 48±11 vs 54±13 years, p \u3c 0.001], more likely to have polycystic kidney disease [17% vs 6%, p \u3c 0.001], have received kidneys from younger donors [36 ±13 vs 41±15 years], and be on RAAS inhibitors [35% vs 22%, p \u3c 0.001]. Recipients with PTE were less likely to have received kidneys from donors with hypertension [16% vs 32%, p = 0.004], diabetes [1% vs 11%, p = 0.008], and cerebrovascular event (24% vs 36%, p = 0.036). Higher KDPI was associated with decreased PTE risk [HR 0.98 (95% CI: 0.97-0.99)]. Over 60 months of follow-up, only 17 (36%) recipients had sustained PTE. There was no association between PTE and graft failure or mortality. CONCLUSIONS: The incidence of PTE was low in our study and PTE resolved in majority of patients. Lower KDPI increases risk of PTE. The underutilization of RAAS inhibitors in PTE patients raises the possibility of under-recognition of this phenomenon and should be explored in future studies

Clinically adjudicated deceased donor acute kidney injury and graft outcomes

Background: Acute kidney injury (AKI) in deceased donors is not associated with graft failure (GF). We hypothesize that hemodynamic AKI (hAKI) comprises the majority of donor AKI and may explain this lack of association. Methods: In this ancillary analysis of the Deceased Donor Study, 428 donors with available charts were selected to identify those with and without AKI. AKI cases were classified as hAKI, intrinsic (iAKI), or mixed (mAKI) based on majority adjudication by three nephrologists. We evaluated the associations between AKI phenotypes and delayed graft function (DGF), 1-year eGFR and GF. We also evaluated differences in urine biomarkers among AKI phenotypes. Results: Of the 291 (68%) donors with AKI, 106 (36%) were adjudicated as hAKI, 84 (29%) as iAKI and 101 (35%) as mAKI. Of the 856 potential kidneys, 669 were transplanted with 32% developing DGF and 5% experiencing GF. Median 1-year eGFR was 53 (IQR: 41-70) ml/min/1.73m2. Compared to non-AKI, donors with iAKI had higher odds DGF [aOR (95%CI); 4.83 (2.29, 10.22)] and had lower 1-year eGFR [adjusted B coefficient (95% CI): -11 (-19, -3) mL/min/1.73 m2]. hAKI and mAKI were not associated with DGF or 1-year eGFR. Rates of GF were not different among AKI phenotypes and non-AKI. Urine biomarkers such as NGAL, LFABP, MCP-1, YKL-40, cystatin-C and albumin were higher in iAKI. Conclusion: iAKI was associated with higher DGF and lower 1-year eGFR but not with GF. Clinically phenotyped donor AKI is biologically different based on biomarkers and may help inform decisions regarding organ utilization

Connections in higher strength Grade C450 cold formed rectangular hollow sections

CIDECT guidelines for hollow steel joints were mainly based on research of ductile steel with yield strength up to 355 MPa. On higher strength, lower ductility steels (C450 and above) emerging, CIDECT in 2009, extended the design guidelines to C450 RHS connections also, with certain restrictions on material, geometry and class of RHS. An overall reduction factor of 0.9 in design strength and a cap on σy at 0.8 σu were also stipulated. Experimental studies were conducted at the University of Sydney to verify the need and justification for the CIDECT restrictions in C450 RHS connections. This thesis complements the experimental studies using numerical methods and some novel techniques including use of an adapted Lemaitre damage model to track fracture, tracking necking in coupon tests by using recorded engineering stress-strain data and filling in gaps in data by methods such as use of FEA and/or crosshead data, grouping variations in material test results suitably and adopting a weighted average method to depict true stress strain that would reflect plastic deformation and damage. The FE models with these features were initially benchmarked against coupon test results, then validated against RHS jointless tests and finally against 12 K gap joint tests. More than 80 parametric variations that might influence the strength and behaviour of these joints were analysed using FEA. The study led to proposals for modifications to chord plastification, punching shear, chord side wall design equations to better predict ultimate loads and fracture modes. Reduced ductility in the steel was dealt with through a modifier function that is not based on yield stress but instead recognises the reduced ultimate strains, damage parameter for fracture and the ultimate stress of the material. Another research achievement is the perfection of a methodology to numerically predict the fracture / failure behavior of RHS joints and to formulate or test, design criteria if required

Nanobubble dynamics studied with transmission electron microscopy

The study of nanoscale phenomena using in-situ transmission electron microscopy (TEM) has received increasing attention due to its ability to image at both high spatial and temporal resolution. In this study, nanobubbles forming within graphene liquid cells are characterised in TEM. It was observed that nanobubbles shrink quickly under illumination by an electron beam, but are stable for an hour or more in its absence. By observing the merger of nanobubbles, it was deduced that the apparent viscosity of the confined water in the graphene liquid cell is much larger than bulk water, and this reduces the diffusion constant to an extent that supports the long lifetime of the bubble. Apart from these observations, we also characterize instances of bubbles rupturing, oscillating, merging and non-coalescence events. Key Words: Nanobubble, Transmission Electron Microscope, nanobubble stability, bubble merger, bubble shrinkage, bubble rupture, bubble oscillations, diffusion, non-coalescence.DOCTOR OF PHILOSOPHY (SPMS

Investigation of the influence of dielectric charges on passivation efficiency in SiC devices

Silicon Carbide (SiC) is a wide bandgap semiconductor that is currently of major interest for power electronics applications. SiC-based semiconductor devices and circuits are presently being developed for use in high-temperature, high-power, and/or high-radiation conditions under which conventional semiconductors lose their efficiency. However, the blocking capabilities of SiC power rectifiers and transistors are yet to approach their impressive theoretical limit due to so called edge effects at the device periphery. Surface passivation, which addresses many issues related to surface electric fields, is an extremely important fabrication step for high performance semiconductor electronic devices. Surface passivation can influence the surface recombination velocity, surface charge, interface trap density, and other surface characteristics. In this work, two-dimensional device simulations are used to establish the trends and the extent of the influence of charges, present in surface passivation dielectrics, on the reverse bias characteristics of SiC devices. Actual charges and charge instability are experimentally evaluated in a few common types of passivation dielectrics used in SiC device technologies. Device simulations are used to predict the corresponding improvement (or degradation) of the breakdown conditions at the device periphery, associated with the experimentally measured dielectric charges

Synthesis of luminescent copper complexes

La présente thèse décrit la préparation de complexes de Cu(I) stables grâce à l’ingénierie moléculaire de ligands permettant d’éviter la formation de plusieurs espèces en équilibre. Dans le cas de ligands P-N, la stratégie proposée repose sur l’utilisation d’un ligand ayant des substituants permettant de masquer un centre métallique et ainsi d’empêcher les réactions avec des nucléophiles permettant la dissociation du ligand. Dans le cas des dérivés [Cu(NN)(PP)]+, l’approche synthétique développée repose sur l’utilisation de ligands phénanthrolines macrocycliques empêchant la formation des complexes homoleptiques [Cu(NN)2]+ correspondant. Des complexes stables et luminescents ont ainsi été préparés, les rendements quantiques d’émission allant jusqu’à 46% à l’état solide pour les meilleurs luminophores.The present PhD thesis descibes the preparation of stable Cu(I) complexes through appropriate ligand design to prevent the formation of several species in equilibrium. In the case of dinucleating P,N-ligands, the proposed strategy is based on the use of a ligand with additional substituents to shield the metal centers and thus to prevent nucleophilic attacks leading to ligand dissociation. In the case of the [Cu(NN)(PP)]+ derivatives, the proposed synthetic strategy relies on the use of macrocyclic phenanthroline ligands preventing the formation of the corresponding homoleptic complexes [Cu(NN)2]+. Stable luminescent complexes have been thus prepared, the emission quantum yields being as high as 46% in the solid state for the best emitters