Overview of liver disorders during pregnancy at a tertiary care centre: Uttarakhand scenario

Background: Liver disorders in pregnancy encompass a spectrum of diseases encountered during antenatal and postnatal period resulting in abnormal liver function tests and hepatobiliary dysfunction or both. This study is aimed at determining the causes of liver disorders during pregnancy and associated maternal and fetal outcomes over a period of 3 years at a tertiary care centre of Dehradun.Methods: All case records of patients with liver disorders during pregnancy from May 2013 to May 2016 were retrieved from medical record department of SGRRIMHS, Dehradun and analyzed for various causes of liver disorders and associated maternal and fetal outcomes.Results: During the three-year study period, 146 pregnant patients were found to have liver disorders. The study found that viral hepatitis was the most common cause of liver disorders followed by Intrahepatic cholestasis of pregnancy IHCP. There were 6 mortalities among the study group out of which hepatitis E was the culprit for maternal mortality in two patients. The serum bilirubin levels were directly proportional to the maternal deaths.Conclusions: Liver disorders during pregnancy are rare but an important cause of maternal and fetal morbidity and mortality. Early recognition, timely referral and aggressive management may lead to better maternal and fetal outcome

Analysis of maternal deaths over a period of three years at a tertiary care centre of Uttarakhand, India

Background: Globally, about 800 women die every day of preventable causes related to pregnancy and childbirth; 20 per cent of these women are from India. The study is aimed at evaluating maternal deaths over a period of three years at a tertiary care centre of Dehradun, India.Methods: This was a retrospective study conducted in the Department of Obstetrics and Gynecology at SGRRIMHS, Dehradun. The case record files of all maternal deaths from January 2015 to December 2017 was obtained from medical record section of the hospital. Maternal age, parity, educational status, antenatal registration, mode of delivery, admission death interval and causes of each maternal death was noted and analysed statistically.Results: There were 48 maternal deaths from January 2015 to December 2017.Maximum deaths were in the age group of 21-25 years. The maternal mortality ratio over a period of three years was 671 per one lac live births. Most of the maternal deaths were due to direct causes like hemorrhage , eclampsia followed by sepsis.Conclusions: Most of the maternal deaths are preventable. High risk cases should be identified at root level and early referral should be the moto. All women need access to antenatal care in pregnancy, skilled care during childbirth, and care and support in the weeks after childbirth. To avoid maternal deaths, unwanted and too-early pregnancies should be avoided. All women, including adolescents, should have access to contraception, safe abortion services to the full extent of the law, and quality post-abortion care. It is particularly important that all births are attended by skilled health professionals, as timely management and treatment can make the difference between life and death for both the mother and the baby

Hybrid Dynamic CML with Modified Current Source (H-MDyCML): A Low-Power Dynamic MCML Style

With the growing demands of portable devices, it is necessary to pay attention to low-power digital integrated designs. This paper proposes a low-power MOS Current Mode Logic (MCML) design, termed as Hybrid Dynamic Current Mode Logic with modified current source (H-MDyCML). In H-MDyCML circuits, the functions are realized using complementary pass transistor logic which helps to overcome the problem of stacking of transistors in multiple levels. The dynamic current source has also been modified from an NMOS transistor to a PMOS transistor-driven current source which leads to the elimination of the use of CMOS inverter. H-MDyCML circuits are compared with other existing designing styles: Dynamic CML (DyCML), Hybrid DyCML (H-DyCML), and DyCML with modified current source (Dy-CML-NP). The proposed design (H-MDyCML) shows an overall improvement (in terms of Power Delay Product (PDP)) up to 94.77% compared to DyCML, 52.17% compared to Dy-CML-NP, and 91.40% compared to H-DyCML, for single stage circuits. Keyword

A COMPARATIVE STUDY OF SCREEN TIME AND ITS EFFECTS IN PRE-COVID AND COVID-ERA IN CHILDREN OF 5 TO 15 YEARS

Objective: The objective of this study was to compare the screen time (ST) in pre-COVID and COVID era in children aged 5–15 years and to analyse the ST effect in pre-COVID and COVID era in the children. Methods: The study was done at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow. Two hundred and seventy-six children aged between 5 and 15 years, attending outpatient department or inpatient department were enrolled in the study. Results: It was observed that the ST was significantly increased in post-COVID as compared to pre-COVID time and the difference was statistically significant (p<0.0001*). It was also observed that the screening time was significantly increased in post-COVID as compared to pre-COVID time and the difference was statistically significant (p<0.0001*). Conclusion: The present study found that when screening duration was analysed, the screening time during COVID-19 was significantly longer than the screening time before COVID-19 which may be associated with the various health problems reported among children during COVID-19 pandemic

Analysis of maternal deaths over a period of three years at a tertiary care centre of Uttarakhand, India

Background: Globally, about 800 women die every day of preventable causes related to pregnancy and childbirth; 20 per cent of these women are from India. The study is aimed at evaluating maternal deaths over a period of three years at a tertiary care centre of Dehradun, India.Methods: This was a retrospective study conducted in the Department of Obstetrics and Gynecology at SGRRIMHS, Dehradun. The case record files of all maternal deaths from January 2015 to December 2017 was obtained from medical record section of the hospital. Maternal age, parity, educational status, antenatal registration, mode of delivery, admission death interval and causes of each maternal death was noted and analysed statistically.Results: There were 48 maternal deaths from January 2015 to December 2017.Maximum deaths were in the age group of 21-25 years. The maternal mortality ratio over a period of three years was 671 per one lac live births. Most of the maternal deaths were due to direct causes like hemorrhage , eclampsia followed by sepsis.Conclusions: Most of the maternal deaths are preventable. High risk cases should be identified at root level and early referral should be the moto. All women need access to antenatal care in pregnancy, skilled care during childbirth, and care and support in the weeks after childbirth. To avoid maternal deaths, unwanted and too-early pregnancies should be avoided. All women, including adolescents, should have access to contraception, safe abortion services to the full extent of the law, and quality post-abortion care. It is particularly important that all births are attended by skilled health professionals, as timely management and treatment can make the difference between life and death for both the mother and the baby

Overexpression of wbkF gene in Brucella abortus RB51WboA leads to increased O-polysaccharide expression and enhanced vaccine efficacy against B. abortus 2308, B. melitensis 16M, and B. suis 1330 in a murine brucellosis model.

Brucella abortus RB51 is an attenuated, stable, spontaneous rough mutant derived in the laboratory from the virulent strain B. abortus 2308. Previous studies discovered that the wboA gene, which encodes a glycosyltransferase required for synthesis of the O-polysaccharide, is disrupted in strain RB51 by an IS711 element. However, complementation of strain RB51 with a functional wboA gene (strain RB51WboA) does not confer it a smooth phenotype but results in low levels of cytoplasmic O-polysaccharide synthesis. In this study, we asked if increasing the potential availability of bactoprenol priming precursors in strain RB51WboA would increase the levels of O-polysaccharide synthesis and enhance the protective efficacy against virulent Brucella challenge. To achieve this, we overexpressed the wbkF gene, which encodes a putative undecaprenyl-glycosyltransferase involved in bactoprenol priming for O-polysaccharide polymerization, in strain RB51WboA to generate strain RB51WboAKF. In comparison to strain RB51WboA, strain RB51WboAKF expressed higher levels of O-polysaccharide, but was still attenuated and remained phenotypically rough. Mice immunized with strain RB51WboAKF developed increased levels of smooth LPS-specific serum antibodies, primarily of IgG2a and IgG3 isotype. Splenocytes from mice vaccinated with strain RB51WboAKF secreted higher levels of antigen-specific IFN-γ and TNF-α and contained more numbers of antigen-specific IFN-γ secreting CD4+ and CD8+ T lymphocytes when compared to those of the RB51 or RB51WboA vaccinated groups. Immunization with strain RB51WboAKF conferred enhanced protection against virulent B. abortus 2308, B. melitensis 16M and B. suis 1330 challenge when compared to the currently used vaccine strains. Our results suggest that strain RB51WboAKF has the potential to be a more efficacious vaccine than its parent strain in natural hosts

Bibliometric Review of Blended Finance and Partial Risk Guarantee: Establishing Needs and Advantages

A partial risk guarantee (PRG) is one of the critical instruments in the blended finance approach that provides partial assurance to the risk investor to lend leveraged capital to the borrower. Under the PRG scheme, philanthropic capital is employed as a risk guarantee to create financial and economic additionality through the multiplier effect. This study examines the current trends in PRG and blended finance ecosystem research. This study also aims to identify future research areas to work upon. The bibliometric analysis highlights the need and advantages of blended finance and PRG. The study highlights themes, such as climate finance, SDGs, impact investments, and blended finance/PRGs, from the literature on blended finance. This study illustrates the impact for researchers and managers regarding the future direction to undertake and the domains where PRG can work wonders. The research allows for a comprehensive view of the leading trends, such as utilising blended finance tools such as PRG in funding the work in climate financing, SDGs, water, sanitation, and impact investment. This is perhaps the first study to conduct a bibliometric analysis of the developing area of blended finance partial risk guarantee literature to highlight its importance and advantages

Correction: Assessment of lung function in successfully treated tuberculosis reveals high burden of ventilatory defects and COPD.

[This corrects the article DOI: 10.1371/journal.pone.0217289.]