Nuchal cord: from dread towards confident management

Background: This study was aimed at observing the outcomes of pregnancies with sonographically detected nuchal cord or cord around the neck at term. Early studies on nuchal cord showed many maternal and neonatal complications. But several recent studies have suggested that maternal and neonatal complications do not increase with nuchal cord at delivery. This ambiguity increases anxiety in treating obstetricians and relatives of pregnant women, thus leading to unnecessary caesarean sections. This study is intended to observe the maternal and neonatal outcomes of 300 pregnant women with sonographically detected nuchal cord at term.Methods: Prospective observational study where 300 term pregnant women with sonographically detected nuchal cord were observed through delivery at Shri Venkata Sai Medical College, Mahabubnagar, Telangana, during October 2016 to April 2018.Results: In this study 80.6% women had normal vaginal delivery, 8.3% had LSCS, 11% had instrumental deliveries. 54% had loose nuchal cord, 46% had tight loop of cord.60% had normal CTG, 8% had variable deceleration, 2% late deceleration. Neonatal morbidity was 9.6% and zero neonatal mortality.Conclusions: The study concluded that the presence of nuchal cord does not adversely affect the mother and the neonate. Presence of nuchal cord per se is not an indication for LSCS. Effect of nuchal cord on neonate is only transient. These women can be allowed for vaginal delivery with routine labour room protocols. Routine sonographycal detection of nuchal cord is not required and if it is reported, it should not dictate obstetric management

A Study on the Contributing Factors of Major Landslides in Malaysia

Landslide is one of the most prominent geo-hazard that accounts for colossal losses every year. The contributing factors of landslides in Malaysia are reasonably different from rest of the world. According to a study, the most dominant factor that catalysis the slope failure in many countries of the world is geological conditions. However, in case of Malaysia; most of the landslides occur as a consequence of flawed design, improper construction and non-maintenance of slopes which correlates with the human errors. The statistics of Malaysia shows that highest number of landslides took place in 1996 with 71 cases which is followed by 68 cases in 1995. According to the findings of Highland Towers (1993) landslide, the main causes of failure were inaccuracies in design, poor supervision during the construction and inadequate drainage system. Similarly, in case of Taman Hillview and Bukit Antarabangsa landslide, it has been revealed that improper design practices and poor drainage system supplemented with prolonged rain were the significant causes of the cataclysm. Therefore, based on the investigations on retrospective landslides, this study proposes to incorporate Human Reliability Assessment technique as a part of working strategy for slopes along with strong adherence to the design guidelines in order to minimize the likelihood of landslides

A Remarkable Case of Acute Motor-Sensory Axonal Polyneuropathy (AMSAN) Variant of Guillain Barré Syndrome, in a Diabetic Patient Infected With COVID-19: A Case Report and Review of the Literature

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease- 2019 (COVID-19), has been a global epidemic in our healthcare system. SARS-CoV-2 primarily affects the respiratory system, but neurological involvement has also been reported, including Guillain–Barré syndrome (GBS) development.Case PresentationA 58-year-old male with known co-morbid hypertension and type 2 diabetes mellitus presented to the emergency room with complaints of worsening shortness of breath, dry cough, and fever for the past 10 days. On day 20 of hospitalization, he developed neurological symptoms after being tested positive for COVID-19. A neuroelectrophysiology study was conducted to evaluate neurological symptoms and suggested that the patient suffers from acute motor-sensory axonal polyneuropathy (AMSAN). CSF analysis showed elevated protein levels that confirmed the diagnosis of GBS. He was subsequently treated with oral prednisolone and IVIG, which improved neurological symptoms.ConclusionEver since the emergence of COVID-19, GBS has surfaced as to its potentially dangerous outcome. Healthcare professionals should be mindful of GBS and should rule it out in anyone having sensory symptoms or weakness during or after a COVID-19 infection. Its early detection and treatment can result in improved clinical outcomes

Study protocol of DIVERGE, the first genetic epidemiological study of major depressive disorder in Pakistan

INTRODUCTION: Globally, 80% of the burdenof major depressive disorder (MDD) pertains to low- and middle-income countries. Research into genetic and environmental risk factors has the potential to uncover disease mechanisms that may contribute to better diagnosis and treatment of mental illness, yet has so far been largely limited to participants with European ancestry from high-income countries. The DIVERGE study was established to help overcome this gap and investigate genetic and environmental risk factors for MDD in Pakistan. METHODS: DIVERGE aims to enrol 9000 cases and 4000 controls in hospitals across the country. Here, we provide the rationale for DIVERGE, describe the study protocol and characterise the sample using data from the first 500cases. Exploratory data analysis is performed to describe demographics, socioeconomic status, environmental risk factors, family history of mental illness and psychopathology. RESULTS AND DISCUSSION: Many participants had severe depression with 74% of patients who experienced multiple depressive episodes. It was a common practice to seek help for mental health struggles from faith healers and religious leaders. Socioeconomic variables reflected the local context with a large proportion of women not having access to any education and the majority of participants reporting no savings. CONCLUSION: DIVERGE is a carefully designed case-control study of MDD in Pakistan that captures diverse risk factors. As the largest genetic study in Pakistan, DIVERGE helps address the severe underrepresentation of people from South Asian countries in genetic as well as psychiatric research

Study protocol of DIVERGE, the first genetic epidemiological study of major depressive disorder in Pakistan.

INTRODUCTION: Globally, 80% of the burdenof major depressive disorder (MDD) pertains to low- and middle-income countries. Research into genetic and environmental risk factors has the potential to uncover disease mechanisms that may contribute to better diagnosis and treatment of mental illness, yet has so far been largely limited to participants with European ancestry from high-income countries. The DIVERGE study was established to help overcome this gap and investigate genetic and environmental risk factors for MDD in Pakistan. METHODS: DIVERGE aims to enrol 9000 cases and 4000 controls in hospitals across the country. Here, we provide the rationale for DIVERGE, describe the study protocol and characterise the sample using data from the first 500 cases. Exploratory data analysis is performed to describe demographics, socioeconomic status, environmental risk factors, family history of mental illness and psychopathology. RESULTS AND DISCUSSION: Many participants had severe depression with 74% of patients who experienced multiple depressive episodes. It was a common practice to seek help for mental health struggles from faith healers and religious leaders. Socioeconomic variables reflected the local context with a large proportion of women not having access to any education and the majority of participants reporting no savings. CONCLUSION: DIVERGE is a carefully designed case-control study of MDD in Pakistan that captures diverse risk factors. As the largest genetic study in Pakistan, DIVERGE helps address the severe underrepresentation of people from South Asian countries in genetic as well as psychiatric research

Telomerecat: A ploidy-agnostic method for estimating telomere length from whole genome sequencing data.

Telomere length is a risk factor in disease and the dynamics of telomere length are crucial to our understanding of cell replication and vitality. The proliferation of whole genome sequencing represents an unprecedented opportunity to glean new insights into telomere biology on a previously unimaginable scale. To this end, a number of approaches for estimating telomere length from whole-genome sequencing data have been proposed. Here we present Telomerecat, a novel approach to the estimation of telomere length. Previous methods have been dependent on the number of telomeres present in a cell being known, which may be problematic when analysing aneuploid cancer data and non-human samples. Telomerecat is designed to be agnostic to the number of telomeres present, making it suited for the purpose of estimating telomere length in cancer studies. Telomerecat also accounts for interstitial telomeric reads and presents a novel approach to dealing with sequencing errors. We show that Telomerecat performs well at telomere length estimation when compared to leading experimental and computational methods. Furthermore, we show that it detects expected patterns in longitudinal data, repeated measurements, and cross-species comparisons. We also apply the method to a cancer cell data, uncovering an interesting relationship with the underlying telomerase genotype

Publisher Correction: Telomerecat: A ploidy-agnostic method for estimating telomere length from whole genome sequencing data.

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“Analysis of the opportunities and challenges of women's entrepreneurship in developing countries : A quantitative study from Pakistan, India, and Bangladesh.

This study investigates the opportunities and constraints of women's entrepreneurship in emerging countries, focusing on quantitative data from Pakistan, India, and Bangladesh. Women entrepreneurs play an important role in socioeconomic growth, but they confront distinct challenges due to social, institutional, and familial constraints. Using a descriptive study approach, data were obtained from 277 female entrepreneurs via a structured questionnaire. The findings reveal substantial hurdles, such as limited resource access, societal norms, and budgetary limits, as well as reasons such as empowerment, financial independence, and flexibility. The study emphasizes the need for specialized interventions, such as financial support, education, and cultural mentorship, to boost women's entrepreneurial success. Policymakers should prioritize integrated measures that include community development, resource allocation, and mentorship to create a conducive environment for women entrepreneurs. Despite its contributions, the study's geographic and methodological limitations indicate areas for future research, notably in broadening the scope to cover varied socio-cultural contexts and delving into qualitative aspects of women's entrepreneurial experiences

“Analysis of the opportunities and challenges of women's entrepreneurship in developing countries : A quantitative study from Pakistan, India, and Bangladesh.

This study investigates the opportunities and constraints of women's entrepreneurship in emerging countries, focusing on quantitative data from Pakistan, India, and Bangladesh. Women entrepreneurs play an important role in socioeconomic growth, but they confront distinct challenges due to social, institutional, and familial constraints. Using a descriptive study approach, data were obtained from 277 female entrepreneurs via a structured questionnaire. The findings reveal substantial hurdles, such as limited resource access, societal norms, and budgetary limits, as well as reasons such as empowerment, financial independence, and flexibility. The study emphasizes the need for specialized interventions, such as financial support, education, and cultural mentorship, to boost women's entrepreneurial success. Policymakers should prioritize integrated measures that include community development, resource allocation, and mentorship to create a conducive environment for women entrepreneurs. Despite its contributions, the study's geographic and methodological limitations indicate areas for future research, notably in broadening the scope to cover varied socio-cultural contexts and delving into qualitative aspects of women's entrepreneurial experiences