A pregnancy with GDM, hypothyroidism, polyhydrramnios with history of treatment for subfertility

Gestational diabetes (GDM) is defined as carbohydrate intolerance that begins or is first recognized during pregnancy. Although it is a well-known cause of pregnancy complications, its epidemiology has not been studied systematically. There are several identifiable predisposing factors for GDM, and in the absence of risk factors, the incidence of GDM is low. Low thyroid hormone levels in early pregnancy are a risk factor for GDM incidence. Although gestational hyperthyroidism is uncommon (0.2%), hypothyroidism (autoimmune disease or suboptimal iodine intake) occurs in 2.5% of women and is predictive of reduced neonatal and child neuropsychological development and maternal obstetric complications.  It is well documented that thyroid disorders are associated with maternal and fetal complications during gestation and sequelea after delivery. The case-finding strategy does not solve the serious problem of leaving undiagnosed and untreated patients without risk factors. In the absence of strong evidence that support universal thyroid screening in pregnancy, current guidelines suggest a case-finding approach targeting thyroid function testing in high-risk groups. A couple have history of sub-fertility. Patient conceived following treatment. During pregnancy, GDM developed and later half of pregnancy was complicated by polyhydramnios. Baby was delivered by LSCS due to PPROM

Comparative study of some routinely measured Serum biochemical parameters between acute exacerbation of Chronic Obstructive Pulmonary Disease and stable Chronic Obstructive Pulmonary Disease patients in a tertiary care hospital of Kolkata: an attempt to make simple prognostic indicators

Background: Patients with COPD often have exacerbations which frequently require hospitalization, resulting in higher mortality rates and costs than patients managed at OPD. Some easily available blood parameters in both stable COPD and AECOPD patients are measured that can be done in every patient even in poor resource settings. Finally, Results were analysed statistically to find out if there is any presence of significant difference of biochemical profile in stable COPD patients and AECOPD patients with or without any prognostic significance.Methods: In institution based observational case control study, authors measured 1.  FBS and PPBS 2. Serum Urea and Creatinine 3. Serum Electrolytes- Na+, K+, Cl- 4. LFT  5. Uric acid in both stable COPD(n=50) and AECOPD (n=50) patients. Finally, Results were analysed statistically to find out if there is any presence of significant difference of biochemical profile in stable COPD patients and AECOPD patients.Results: AECOPD patients had statistically significant higher urea, uric acid levels and higher fasting hyperglycemia than stable COPD patients. Hypernatremia, hyponatremia and hyperkalemia, hypokalemia - all were significantly higher in AECOPD group. Low level of serum bilirubin and higher level of AST and ALP were common in AECOPD patients. AECOPD patients with high urea value (>50 mg/dl) (but not high creatinine) was associated with poor patient outcome in respect to ICU transfer, death and prolonged hospital stay. Low bilirubin, high ALP and AST level in AECOPD patients was associated with higher ICU transfer and mortality but only high ALP level was associated with prolonged hospital stay. High uric acid level (>6 mg/dl) was a major determinant of ICU transfer, mortality and prolonged hospital stay.Conclusions: Predicting exacerbation by these parameters early in the course of disease can decrease morbidity and mortality as well as health care cost to great extent. By measuring the changes in it can also be predicted early who will need ICU support in future and who can be treated at ward

Evaluation the results of surgical management of traumatic paraplegia in traumatic thoracolumbar fractures

Background: Thoracolumbar spine fractures are common injuries that can result in significant disability, deformity and neurological deficit. Aim of this study was to evaluate the results of surgical management of traumatic paraplegia, complete or incomplete as classified by Frankel scoring.Methods: A prospective study was conducted in patients attending outdoor and emergency department of Orthopedics of a tertiary care teaching institute in Kolkata, West Bengal with traumatic paraplegia involving the dorsolumbar spine. The important objectives are the time for recovery of various functions like sensory, motor and bowel and bladder function, comparison between early and late decompression, results of posterolateral fusion and time taken for solid bony fusion after operation. Total 46 cases were selected within a minimum of 6-month post-operative follow-up of which 4 cases lost in follow-up. Data collected from patient records included age, sex, time from injury to hospitalization, initial neurological status as per Frankel Score, MRI findings, surgery performed, postoperative course and neurological status at the time of discharge and latest follow up. Patients lost to follow up were not studied for outcome analysis.Results: When decompression done within 1st week in incomplete paraplegia, 80% of the patients showed return of grade 3 power. In complete paraplegia cases, 11% of the patients had return of power up to grade 3 when decompression done within 1 week, where no cases showed return of grade 3 power when decompression done after 2nd or 3rd week.Conclusions: After recovery from spinal shock, the earlier the surgical compression done, the better the neurological and bowel/bladder function recovery both in complete and incomplete paraplegic cases. Reduction is better and easy and less time consuming in early decompression than in late. Motor recovery can continue for over 6 months after decompression

Effects of optical and magnetic fields on the electrical characteristics of colloidal graphene quantum dots

The effects of optical and magnetic fields have a pronounced influence on the electrical performance of graphene quantum dots (GQDs). Nonlinear current-voltage hysteresis during a voltage sweep is revealed due to the charge traps by adsorbates present on the quantum dot (QD) surface. Hence, a polarization dependent variation in QDs even in the presence of the surrounding medium presented an interesting variation in the electrical conductivity. Furthermore, a study of capacitance with frequency revealed that the microwave heating time (MHT) during the preparation of GQDs greatly affected the capacitance value of the colloidal QDs owing to size variation where larger QDs arising from a greater MHT showed lower capacitance and vice versa

EFFECT OF ELECTRON-PHONON INTERACTION ON ELECTRON SPIN POLARIZATION IN A QUANTUM DOT LIGHT EMITTING DIODE

This paper presents a theoretical model for the effect of electron-phonon interaction, temperature and magnetic field on degree of electron spin polarization in GaAs/InAs quantum dot LED. To describe the dynamics, quantum Langevin equation for photon number and carrier number is used. Simulation results show that degree of electron spin polarization in quantum dot decreases with increase of electron phonon interaction parameter at constant temperature and constant magnetic field which agrees with experimental results in literatures

Zinc oxide quantum dots decorated carbon nanotubes for improved opto-electro-mechanical response

Hybrid nanostructures play a major role towards outstanding performance of nano-devices by coupling different functionalities. In this study, we report in-situ decoration of zinc oxide quantum dots (QDs) on the outer walls of multi-walled carbon nanotubes (MWCNT). The coupling of MWCNT and QDs not only provides excellent radiation sensitivity but also a high mechanical actuation induced by electrical polarization. A flexible thin paper-based device demonstrated combined opto-electro-mechanical performance under constant electric field with similar to 122% enhancement in the response current for optoelectrical and similar to 345% enhancement in actuation for electromechanical properties of the hybrid paper device as compared to the response from the pristine sample. (C) 2017 Elsevier B.V. All rights reserved

Influence of flame on graphene based flexible nanocomposite

The study aims to develop a novel composite, with a combined contribution of reduced graphene oxide, poly(dimethyl-siloxane), and sodium bentonite (organoclay), for flame protection. Thermo-gravimetric analysis revealed an outstanding thermal stability of the composite as compared to its constituents. The superior composite is demonstrated to efficiently protect a polymer layer that burns instantly upon exposure to flame. The char residue of the composite indicated the formation of a spherical structure that acted as barrier layer to the underlying material to avoid any structural damage caused due to the exposure of the flame

Ischiopagus tetrapus conjoined twins: 22 years after separation

There is no record of both separated ischiopagus tetrapus conjoined twins leading normal lives 22 years after separation. We separated a pair of such twins in 1986 and have followed them up till date. Details regarding the technique of separation and the procedures required to ensure normal defecation and micturition and normal musculoskeletal function have been described by us in earlier communications. In this paper we describe their present status and ability to face the world as independent adult females. The outcome reflects the responsibilities and dedication of pediatric surgeons for infant patients with congenital problems after they have become adults, taking a pivotal role to involve surgeons of other disciplines as and when necessary

Layered Assembly of Reduced Graphene Oxide and Vanadium Oxide Heterostructure Supercapacitor Electrodes with Larger Surface Area for Efficient Energy-Storage Performance

The architecture of a supercapacitor (SC) electrode plays a crucial role in defining the overall energy-storage performance of the SC. Layer-by-layer assembly of a reduced graphene oxide (rGO) and vanadium oxide (V₂O₅) (rGO/V₂O₅)-based heterostructure is patterned in interdigitated electrodes (IDEs) deposited directly on a flexible conducting current collector for the SC. The IDE pattern offers efficient accessibility to the electrolyte ions and a synergistic contribution for energy storage. An as-fabricated solid-state flexible sandwich-type SC with IDEs displays a more efficient energy-storage performance than a conventional solid-state flexible sandwich-type SC composed of rGO/V₂O₅ electrodes. Moreover, a solid-state flexible in-plane microsupercapacitor (MSC) is fabricated, which offers much higher capacitance (24 mF/cm² and 34.28 F/cm³) and energy density (3.3 μWh/cm² and 4.7 mWh/cm³). The as-fabricated flexible in-plane MSC displays a negligible capacitance loss of about 6.3% after 10 000 charge–discharge cycles and a superior stability of energy-storage performance towards mechanical deformation