A study on fetomaternal outcome in eclampsia in a tertiary care institute

Background: Eclampsia is a life threatening emergency that continues to be a major cause of maternal and perinatal mortality. The present study was undertaken to analyse the maternal and fetal outcome in patients of eclampsia and to evaluate various factors influencing this outcome. Methods: A retrospective observational epidemiological study was undertaken in the Department of Obstetrics and Gynecology, Mysore Medical College and Research Institute, Mysore, for a period of three years from January 2020 to December 2022. All women who presented as eclampsia or developed eclampsia during hospital stay were included in the study. Data analysed included various maternal parameters, fetal parameters, and the outcome of pregnancy. Results: The incidence of eclampsia was 7.14% which is relatively high, attributing to the fact that being tertiary care centre many cases are referred. Higher incidence seen in primigravida (72.4%) and low maternal age (48%). Caesarean section was indicated in 50% deliveries indicating immediate action was necessary for better fetomaternal outcome. 58.6% had an uneventful maternal outcome.There was 7.65% maternal mortality most common cause of death was intracranial hemorrhage. 53% were preterm deliveries and 29.4% stillbirths, respiratory distress in the newborn was seen as the major complication (41.9%). Conclusions: In our study, maternal complications were recorded in 41.3% of the patients with a case fatality rate of 7.65%. Respiratory distress, prematurity, growth restriction and low birth weight are the neonatal complications to be anticipated. We infer from our study that better antenatal care, early recognition of disease, timely referral, early initiation of treatment and termination of pregnancy in eclamptic women could improve maternal and fetal outcome

Impact of low birth weight and breastfeeding practices on the nutritional status of children aged 2 to 5 years in the slums

Malnutrition among children in developing countries is a major public health problem, especially in India. Inappropriate feeding practices, in combination with other causes such as infection and food shortage, may be responsible for 1/3rd of malnutrition. Moreover, the risk of mortality is inversely related to children's height-for-age and weight-for-height. The aim: To assess the nutritional status of children aged 2 to 5 years in the urban field practice area of SVIMS-Sri Padmavathi Medical College for Women, Tirupati and to determine the impact of low birth weight, breastfeeding practices and other related factors on the nutritional status of the above study population. Materials and methods: This is a community-based observational cross-sectional study conducted among 282 children aged 2 to 5 years in the urban field practice area of SVIMS-Sri Padmavathi Medical College for Women, Tirupati. Socio-demographic data, Birth history, breastfeeding practices and anthropometric measurements were noted in the study questionnaire. Nutritional status was determined using HAZ, WHZ and WAZ scores of WHO child growth standards. Data was entered and analyzed using IBM SPSS Statistics 26 version to test for association between categorical variables, and a p-value < 0.05 was considered statistically significant. Results: A total of 282 school children with mean age of 39.9 (+10.4) months participated in the study, of which 132 (46.8 %) were boys and 150 (53.2 %) were girls. This study observed exclusive breastfeeding in 193 (68.4 %) children. Prevalence of stunting, wasting and being underweight were 22 %, 12.4 % and 23.8 %, respectively. A statistically significant association was found between stunting (p=0.006) and underweight (p=0.001) with low birth weight children. Conclusions: The present study revealed a high prevalence of malnutrition, especially stunting, a common outcome of long-term malnutrition among young children. Low birth weight and inappropriate breastfeeding practices result in long-term adverse consequences on the nutrition of preschool children, which should be prevented through appropriate strategies

GOLM1 depletion modifies cellular sphingolipid metabolism and adversely affects cell growth

Golgi membrane protein 1 (GOLM1) is a Golgi-resident type 2 transmembrane protein known to be overexpressed in several cancers, including he-patocellular carcinoma (HCC), as well as in viral in-fections. However, the role of GOLM1 in lipid metabolism remains enigmatic. In this study, we employed siRNA-mediated GOLM1 depletion in Huh -7 HCC cells to study the role of GOLM1 in lipid metabolism. Mass spectrometric lipidomic analysis in GOLM1 knockdown cells showed an aberrant accu-mulation of sphingolipids, such as ceramides, hex-osylceramides, dihexosylceramides, sphinganine, sphingosine, and ceramide phosphate, along with cholesteryl esters. Furthermore, we observed a reduction in phosphatidylethanolamines and lyso-phosphatidylethanolamines. In addition, Seahorse extracellular flux analysis indicated a reduction in mitochondrial oxygen consumption rate upon GOLM1 depletion. Finally, alterations in Golgi struc-ture and distribution were observed both by electron microscopy imaging and immunofluorescence mi-croscopy analysis. Importantly, we found that GOLM1 depletion also affected cell proliferation and cell cycle progression in Huh-7 HCC cells. The Golgi structural defects induced by GOLM1 reduction might potentially affect the trafficking of proteins and lipids leading to distorted intracellular lipid ho-meostasis, which may result in organelle dysfunction and altered cell growth. In conclusion, we demon-strate that GOLM1 depletion affects sphingolipid metabolism, mitochondrial function, Golgi structure, and proliferation of HCC cells.Peer reviewe

Insulin-inducible THRSP maintains mitochondrial function and regulates sphingolipid metabolism in human adipocytes

Background Thyroid hormone responsive protein (THRSP) is a lipogenic nuclear protein that is highly expressed in murine adipose tissue, but its role in humans remains unknown. Methods We characterized the insulin regulation of THRSP in vivo in human adipose tissue biopsies and in vitro in Simpson-Golabi-Behmel syndrome (SGBS) adipocytes. To this end, we measured whole-body insulin sensitivity using the euglycemic insulin clamp technique in 36 subjects [age 40 +/- 9 years, body mass index (BMI) 27.3 +/- 5.0 kg/m(2)]. Adipose tissue biopsies were obtained at baseline and after 180 and 360 min of euglycemic hyperinsulinemia for measurement of THRSP mRNA concentrations. To identify functions affected by THRSP, we performed a transcriptomic analysis of THRSP-silenced SGBS adipocytes. Mitochondrial function was assessed by measuring mitochondrial respiration as well as oxidation and uptake of radiolabeled oleate and glucose. Lipid composition in THRSP silencing was studied by lipidomic analysis. Results We found insulin to increase THRSP mRNA expression 5- and 8-fold after 180 and 360 min of in vivo euglycemic hyperinsulinemia. This induction was impaired in insulin-resistant subjects, and THRSP expression was closely correlated with whole-body insulin sensitivity. In vitro, insulin increased both THRSP mRNA and protein concentrations in SGBS adipocytes in a phosphoinositide 3-kinase (PI3K)-dependent manner. A transcriptomic analysis of THRSP-silenced adipocytes showed alterations in mitochondrial functions and pathways of lipid metabolism, which were corroborated by significantly impaired mitochondrial respiration and fatty acid oxidation. A lipidomic analysis revealed decreased hexosylceramide concentrations, supported by the transcript concentrations of enzymes regulating sphingolipid metabolism. Conclusions THRSP is regulated by insulin both in vivo in human adipose tissue and in vitro in adipocytes, and its expression is downregulated by insulin resistance. As THRSP silencing decreases mitochondrial respiration and fatty acid oxidation, its downregulation in human adipose tissue could contribute to mitochondrial dysfunction. Furthermore, disturbed sphingolipid metabolism could add to metabolic dysfunction in obese adipose tissue.Peer reviewe

LEARN: A multi-centre, cross-sectional evaluation of Urology teaching in UK medical schools

OBJECTIVE: To evaluate the status of UK undergraduate urology teaching against the British Association of Urological Surgeons (BAUS) Undergraduate Syllabus for Urology. Secondary objectives included evaluating the type and quantity of teaching provided, the reported performance rate of General Medical Council (GMC)-mandated urological procedures, and the proportion of undergraduates considering urology as a career. MATERIALS AND METHODS: LEARN was a national multicentre cross-sectional study. Year 2 to Year 5 medical students and FY1 doctors were invited to complete a survey between 3rd October and 20th December 2020, retrospectively assessing the urology teaching received to date. Results are reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). RESULTS: 7,063/8,346 (84.6%) responses from all 39 UK medical schools were included; 1,127/7,063 (16.0%) were from Foundation Year (FY) 1 doctors, who reported that the most frequently taught topics in undergraduate training were on urinary tract infection (96.5%), acute kidney injury (95.9%) and haematuria (94.4%). The most infrequently taught topics were male urinary incontinence (59.4%), male infertility (52.4%) and erectile dysfunction (43.8%). Male and female catheterisation on patients as undergraduates was performed by 92.1% and 73.0% of FY1 doctors respectively, and 16.9% had considered a career in urology. Theory based teaching was mainly prevalent in the early years of medical school, with clinical skills teaching, and clinical placements in the later years of medical school. 20.1% of FY1 doctors reported no undergraduate clinical attachment in urology. CONCLUSION: LEARN is the largest ever evaluation of undergraduate urology teaching. In the UK, teaching seemed satisfactory as evaluated by the BAUS undergraduate syllabus. However, many students report having no clinical attachments in Urology and some newly qualified doctors report never having inserted a catheter, which is a GMC mandated requirement. We recommend a greater emphasis on undergraduate clinical exposure to urology and stricter adherence to GMC mandated procedures

Spatial multivariate selection of climate indices for precipitation over India

Large-scale interdependent teleconnections influence precipitation at various spatio-temporal scales. Selecting the relevant climate indices based on geographical location is important. Therefore, this study focuses on the spatial multivariate selection of climate indices influencing precipitation variability over India, using the partial least square regression and variable importance of projection technique. 17 climate indices and gridded precipitation dataset (0.25 × 0.25°) from the Indian Meteorological Department for 1951–2020 at a monthly scale are considered. Results show that among all the indices, Nino 4, Nino 1 + 2, Trans Nino Index, Atlantic Multidecadal Oscillation (AMO), quasi-biennial oscillation (QBO), Arctic oscillation (AO), and North Atlantic Oscillation (NAO) have a significant influence on precipitation over India. Further, within homogenous regions, it is found that the Southern Oscillation Index and Nino 3.4 are selected majorly in the South Peninsular compared to other regions. The NAO/AO show a similar pattern and was found to be relevant in the Northeast region (>89%). AMO is selected mainly in Northwest, and West Central (>80%), AMO and QBO at about 70% of grid locations over Central Northeast India. It is to be noted that the number of climate indices identified varies spatially across the study region. Overall, the study highlights identifying the relevant climate indices would aid in developing improved predictive and parsimonious models for agriculture planning and water resources managemen

Impression Cytology in the Evaluation of Ocular Surface Squamous Neoplasia- A Retrospective Cohort Study National

Introduction: Ocular Surface Squamous Neoplasia (OSSN) are a diverse group of lesions varying from Conjunctival Intraepithelial Neoplasia (CIN) to invasive Squamous Cell Carcinomas (SCC). Histopathological examination is the gold standard technique in diagnosing them. However, it is invasive and may not be suitable in recurrent cases. Numerous minimally invasive techniques are available to diagnose OSSN cytologically. This study employs Impression Cytology (IC) to diagnose ocular squamous neoplastic lesions and compare it with the histological diagnosis. Aim: To utilise IC in the diagnosis of OSSN and to compare its findings with histopathological diagnosis. Materials and Methods: This was a retrospective cohort study, conducted in a Tertiary Eye care Hospital, Hubli, Karnataka, India during January 2023. The data included was over a period of three years (from July 2016 to June 2019). A total of 44 eyes (34 patients), in which both biopsy and IC done, were included. The patients’ age, sex and ocular examination findings were recorded. The cytological and histopathological slides were retrieved from the archives and examined morphologically. The cytological findings were compared with histopathological diagnosis and the sensitivity and specificity of the IC technique were calculated. The data was analysed using Microsoft excel sheets. Results: A total of 34 patients were studied ranging from 19 to 85 years. The mean age was 49 years, 21 (61.76%) of them were males and 13 (38.24%) were females. In 24 patients, single eye was affected and in 10 patients bilateral eye involvement was seen. Histology revealed that there were 18 (40.90%) CIN I cases, 4 (9.09%) CIN II, 5 (11.36%) CIN III and 17 (38.65%) SCC. On cytology, 3 (6.82 %) were normal conjunctival epithelium, 30 (68.18 %) were dysplasia and 11 (25.00 %) were SCC. On cyto-histomorphological analysis, 35 (79.55 %) were concordant, out of 44 diagnosis. IC has a sensitivity of 88.89% and specificity of 64.71% to detect dysplasia. To diagnose SCC, it has sensitivity of 64.71% and 100% specificity. Conclusion: According to the present study observations, IC is an excellent preliminary tool to investigate suspected neoplastic lesions of ocular surface. It has a very good concordance with histopathological diagnosis. IC is highly sensitive to detect dysplasia (CIN) and is very specific to diagnose SCC