Review of obstetrical emergencies and fetal out come in a tertiary care centre

Background: Obstetric emergencies can occur suddenly and unexpectedly. Obstetrics is unique in that there are two patients to consider and care for, a mother and a baby or fetus. Identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness can reduce the incidence of obstetric emergencies. Present study was carried out to know the incidence, nature and outcome of obstetric emergencies.Methods: Retrospective study of obstetric emergencies admitted to Obstetrics and Gynaecology department of Indira Gandhi Institute of Medical science, Patna from March 2015 to September 2017.Results: The common clinical presentation was Ectopic Pregnancy (19.64%), Heart Disease (16.64%), Abortion (13.69%), Severe Anaemia (16.66%), Purpureal Sepsis (9.52%), Sever pregnancy induced hypertension (3.57%), Eclampsia/ HELLP Syndrome (2.38%), Multiple Pregnancy (1.19%) Malignancy Disorder with Pregnancy (2.97%) and HIV in pregnancy (0.59%). Intervention done include Dilation and evacuation (13.69%), Caesarean section (28.57%), Vaginal delivery (22.62%), Caesarean Hysterectomy (2.38%), Exploratory Laparotomy (20.83%) and conservative management in (11.90%) of patients. Maternal outcome include shock due to rupture ectopic and post-partum (16.68%), Blood Transfusion done in (27.99%), Septicaemia (15.48%), ICU admission (8.92%), HDU (12.5%), Pulmonary oedema (6.54%), DIC (4.16%), CCF (3.57%), Ventilatory Support (1.78%) and Maternal Mortality (2.38%). Fatal outcome includes live birth (58.8%), NICU Admission (27.45%), Ventilatory Support (7.84%) and Neonatal mortality (5.88%).Conclusions: High risk pregnancy identification and proper antenatal, intranatal and postnatal care will reduce the incidence of obstetrical emergencies. Peripheral health care system need to be strengthen and early referral need to be implemented for better maternal and fetal outcome

Unconventional Breathing Currents Far beyond the Quantum Tunneling Distances in Large-Gapped Nanoplasmonic Systems

Localized surface plasmon resonance (LSPR) in plasmonic nanoparticles propels the field of plasmo-electronics, holding promise for transformative optoelectronic devices through efficient light-to-current conversion. Plasmonic excitations strongly influence the charge distribution within nanoparticles, giving rise to electromagnetic fields that can significantly impact the macroscopic charge flows within the nanoparticle housing material. In this study, we present evidence of ultralow, unconventional breathing currents resulting from dynamic irradiance interactions between widely separated nanoparticles, extending far beyond conventional electron (quantum) tunneling distances. We develop an electric analogue model and derive an empirical expression to elucidate the generation of these unconventional breathing currents in cascaded nanoplasmonic systems under irradiance modulation. This technique and theoretical model have significant potential for applications requiring a deeper understanding of current dynamics, particularly on large nanostructured surfaces relevant to photocatalysis, energy harvesting, sensing, imaging, and the development of future photonic devices

Low dose Mifepristone (100 mg) for medical termination of pregnancy

Background: Abortion is the most common entity in the practice of obstetrics and gynaecology. Different methods and modes have been opted for until now to find an effective regimen with the least complications. We have tried the minimal dose (100 mg) of Mifepristone (PO) instead of the presently recommended 200 mg for medical abortion in early first trimester cases. Objectives: The objective of the study was to determine the efficacy of low dose (100 mg) Mifepristone for medical termination of early pregnancy with oral Misoprostol 800 μg, 24 hours later. Design: A prospective analytical study was conducted on a population of 82 early-pregnant patients who have requested medical abortions. Method: Pregnant women of less than 56 days gestation age from their last menstrual period, requesting medical abortion were selected over a period of 14 months from January 2007 to March 2008. They were given 100 mg Mifepristone orally on Day-1, followed by 800 μg Misoprostol orally 24 hours later on Day-2, keeping the patient in the ward for at least 6 hours. Abortion interval, success rate, post-abortion bleeding and side-effects were noted. Success was defined as complete uterine evacuation without the need for surgical intervention. Results: The total success rate of this minimal dose Mifepristone regimen was 96.25%. Pain and nausea were the predominant side-effects noted. In total 72 (90%) women had completely aborted within 5 hours of taking Misoprostol. Three (3.75%) women only required suction aspiration, hence termed as failed medical abortion. The abortion interval increased with the gestation age. All three failures were of the more-than-42-day gestational age group. The overall mean abortion interval was 4.68 ± 5.32 hours. Conclusion: Mifepristone 100 mg, followed 24 hours later by Misoprostol 800 μg orally, is a safe and effective regimen for medical abortion

Review of obstetrical emergencies and fetal out come in a tertiary care centre

Background: Obstetric emergencies can occur suddenly and unexpectedly. Obstetrics is unique in that there are two patients to consider and care for, a mother and a baby or fetus. Identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness can reduce the incidence of obstetric emergencies. Present study was carried out to know the incidence, nature and outcome of obstetric emergencies.Methods: Retrospective study of obstetric emergencies admitted to Obstetrics and Gynaecology department of Indira Gandhi Institute of Medical science, Patna from March 2015 to September 2017.Results: The common clinical presentation was Ectopic Pregnancy (19.64%), Heart Disease (16.64%), Abortion (13.69%), Severe Anaemia (16.66%), Purpureal Sepsis (9.52%), Sever pregnancy induced hypertension (3.57%), Eclampsia/ HELLP Syndrome (2.38%), Multiple Pregnancy (1.19%) Malignancy Disorder with Pregnancy (2.97%) and HIV in pregnancy (0.59%). Intervention done include Dilation and evacuation (13.69%), Caesarean section (28.57%), Vaginal delivery (22.62%), Caesarean Hysterectomy (2.38%), Exploratory Laparotomy (20.83%) and conservative management in (11.90%) of patients. Maternal outcome include shock due to rupture ectopic and post-partum (16.68%), Blood Transfusion done in (27.99%), Septicaemia (15.48%), ICU admission (8.92%), HDU (12.5%), Pulmonary oedema (6.54%), DIC (4.16%), CCF (3.57%), Ventilatory Support (1.78%) and Maternal Mortality (2.38%). Fatal outcome includes live birth (58.8%), NICU Admission (27.45%), Ventilatory Support (7.84%) and Neonatal mortality (5.88%).Conclusions: High risk pregnancy identification and proper antenatal, intranatal and postnatal care will reduce the incidence of obstetrical emergencies. Peripheral health care system need to be strengthen and early referral need to be implemented for better maternal and fetal outcome

Apoptogenic effect of 7,8-diacetoxy-4-methylcoumarin and 7,8-diacetoxy-4-methylthiocoumarin in human lung adenocarcinoma cell line: role of NF-κB, Akt, ROS and MAP kinase pathway

Coumarin (1,2-benzopyrone) is a naturally occurring fragrant compound found in a variety of plants and spices. Coumarins have attracted intense interest in recent years because of their diverse pharmacological activities. This study examines the antioxidant coumarin 7,8-diacetoxy-4-methylcoumarin (DAMC) and its thiocoumarin derivative 7,8-diacetoxy-4-methylthiocoumarin (DAMTC) for their effect on human non-small cell lung cancer A549 cells. Here we show that both DAMC and DAMTC not only inhibited cell proliferation, but also induced apoptosis with an IC50 of 160 μg/ml as confirmed by morphological examination, annexin-V assay and flow cytometric analysis. Interestingly, it was observed that these two coumarin compounds exhibited little cytotoxicity towards peripheral blood mononuclear cells but induced apoptosis in malignant cells. DAMC/DAMTC treatment also resulted in pronounced release of apoptogenic cytochrome c from mitochondria to cytosol, alteration of mitochondrial membrane potential (Δψm), and activation of caspase-9 and caspase-3. Although an increase in the levels of reactive oxygen species (ROS) was observed, pre-treatment with antioxidant showed no protective effect against DAMC/DAMTC-induced apoptosis. Results of present study suggest that downregulation of Bcl-xl, Cox-2 and mitogen activated protein kinase pathway and upregulation of p53, Akt and NF-κB pathway are involved in the underlying molecular mechanism of apoptosis induction by DAMC and DAMTC in A549 cells

PEI-alginate nanocomposites as efficient in vitro gene transfection agents

The positive charge on PEI was partially shielded by forming ionic nanocomposites with a polysaccharide, alginic acid, in aqueous solution, bypassing tedious chemical synthesis. The content of alginic acid was varied systematically to obtain a series of nanocomposites. The nanocomposites were first characterized by assessing the surface charge (zeta potential), size (DLS) and morphology (AFM) followed by evaluation for their DNA interaction ability, cytotoxicity and transfection efficiency on various cell lines. The transfection efficiency of PEI-alginate (6.26%) nanocomposites improved dramatically (2-16-fold over native PEI) in all the cell lines studied. However, a decrease in transfection efficiency was observed on deviating from this optimal concentration of alginic acid in nanocomposites. Cytotoxicity of PEI-alginate/DNA complexes was nearly abolished on increasing the concentration of alginic acid in nanocomposites. PEI-alginate (6.26%) nanocomposites also delivered SiRNAs efficiently into mammalian cells, resulting in 80% suppression of GFP expression. The cellular uptake and endosomal escape of PEI-alginate nanocomposites and PEI were found to follow a similar route when transfection was carried out in presence of chloroquine, bafilomycin A1, cytochalasin B and methyl-β-cyclodextrin. The results demonstrate a versatile vector that can be used for efficient cytoplasmic delivery of a broad range of nucleic acids

Unconventional Breathing Currents Far beyond the Quantum Tunneling Distances in Large-Gapped Nanoplasmonic Systems

Localized surface plasmon resonance (LSPR) in plasmonic nanoparticles propels the field of plasmo-electronics, holding promise for transformative optoelectronic devices through efficient light-to-current conversion. Plasmonic excitations strongly influence the charge distribution within nanoparticles, giving rise to electromagnetic fields that can significantly impact the macroscopic charge flows within the nanoparticle housing material. In this study, we present evidence of ultralow, unconventional breathing currents resulting from dynamic irradiance interactions between widely separated nanoparticles, extending far beyond conventional electron (quantum) tunneling distances. We develop an electric analogue model and derive an empirical expression to elucidate the generation of these unconventional breathing currents in cascaded nanoplasmonic systems under irradiance modulation. This technique and theoretical model have significant potential for applications requiring a deeper understanding of current dynamics, particularly on large nanostructured surfaces relevant to photocatalysis, energy harvesting, sensing, imaging, and the development of future photonic devices