Clinical outcomes of ectopic pregnancy

Background: Ectopic pregnancy (EP) is a life threatening gynaecological emergency, and a significant cause of maternal mortality and morbidity worldwide. Aim of this study was to determine and evaluate the incidence, clinical presentation, risk factors, management strategies and outcome of the patients with EP.Methods: This was a prospective study of all cases of ectopic pregnancies admitted and managed at PGIMS Rohtak over a period of 1 year. All patients admitted through accident and emergency unit as well as the gynaecology clinic that were managed in gynaecological ward were included in the study. The diagnosis of EP was made by history, clinical examination, urinary pregnancy test and ultrasound examination. Patients were managed as per hospital protocol and relevant data on age, parity, clinical presentation, risk factors, management and findings at laparotomy, and the outcome of treatment were collected.Results: The incidence of ectopic pregnancy in this study was 1.056%. The mean age of the patients was 27±3 years. Of the 102 ectopic pregnancies, 86 (84.31%) were ruptured ectopic pregnancies, while 16 (15.68%) were unruptured ectopic pregnancies. The commonest clinical complaint was abdominal pain (97 of 102, 95.09%) History of previous abortion (induced or spontaneous) was the commonest risk factor (92 of 102, 90.19%) followed by past history of pelvic inflammatory disease (56 of 102, 54.90%). History of tubal surgery was present in 27 of 102 patients (26.47%). commonest surgical procedure done was emergency laparotomy followed by salpingectomy (67 of 102, 65.68%).Conclusions: EP is an important cause of maternal morbidity and mortality in early pregnancy and has remained a reproductive health challenge. Early diagnosis and treatment can improve reproductive outcomes.

A comparative study of intraocular pressure changes in postmenopausal normotensive and hypertensive women

Background: Elevated intraocular pressure is a major modifiable risk factor for preventing glaucoma. Changes in intraocular pressure are directly and significantly associated with changes in blood pressure. Menopausal women with hypertension are at an increased risk of developing elevated intraocular pressure. Aim of current study was to compare the intraocular pressure changes in postmenopausal normotensive and hypertensive women.Methods: 35 normotensive and 35 hypertensive (based on JNC7 classification) postmenopausal women in the age group of 45-55 years participated in the study. Blood pressure was recorded in the sitting position with a mercury sphygmomanometer. Intraocular pressure was measured using Goldmann applanation tonometer.Results: Mean Intraocular Pressure in postmenopausal normotensive women was 13.01 ± 2.61 mmHg while that of postmenopausal hypertensive women was 15.15 ± 2.16 mmHg which was statistically significant. A statistically significant correlation was observed between IOP and systolic blood pressure and positive correlation was obtained between IOP and diastolic blood pressure in postmenopausal hypertensive women.Conclusion: Menopausal women are at an increased risk of developing hypertension due to age, hormonal changes and obesity which may lead to increased IOP. IOP is also directly and significantly related to systemic blood pressure hence postmenopausal women with systemic hypertension need periodic ophthalmologic examination. Detecting early IOP changes will help them in identifying the risk groups and formulating strategies for screening glaucoma.

PHARMACOLOGICAL INVESTIGATION ON METHANOLIC EXTRACT OF LEAVES OF Diospyros peregrina GURKE ON ALLOXAN INDUCED HYPERGLYCEMIA IN RATS

Diospyros peregrina, commonly known as Kalatendu, is widely used in different parts of India for the treatment of diabetes mellitus. The present study was designed to evaluate the antihyperglycemic effect of a methanolic extract of Diospyros peregrina leaves (DPLE) in alloxan diabetic rats. Hyperglycemia was induced by single intravenous injection of alloxan (70mg/kg body weight). The extract was administered orally at a dose of 100, 200 and 400 mg/kg body weight, to normal and alloxan diabetic rats. No effect of the extract was observed in normal rats. Significant effect of the extract was observed in alloxan diabetic rats. Metformin was the reference drug used in the experiments. Glucose tolerance test was also performed. The studies indicate that the crude extract exhibited statistically significant antihyperglycemic activities in glucose tolerance test and alloxan induced diabetic rats

Performance evaluation of a low-cost, novel vanadium nitride xerogel (VNXG) as a platinum-free electrocatalyst for dye-sensitized solar cells

A vanadium nitride xerogel (VNXG) was synthesised by a simple and effective method of ammonialising a vanadium pentoxide xerogel at a higher temperature. Xerogel-structured materials possess salient features such as high surface area, tunable porosity and pore size that result in enhancing the catalytic activity by a fast electron-transport pathway and increase electrolyte diffusion channels. Metal nitrides are reported as promising alternate low-cost counter electrodes to replace the conventional and expensive platinum (Pt) counter electrode. Though few studies are reported on aerogel-based CEs for DSSCs, the present work is the first attempt to synthesize and evaluate the performance of xerogel-structured metal nitrides as counter electrode materials for dye-sensitized solar cells. The synthesized material was well characterized for its structural and morphological characteristics and chemical constituents by photoelectron spectroscopy. Finally, the VNXG was tested for its electrocatalytic performance as a choice of counter electrodes for dye-sensitized solar cells (DSSCs). The photo-current studies were performed under standard 1 SUN, class AAA-simulated illumination with AM1.5G. The consolidated results revealed that the vanadium nitride xerogel exhibited good photocatalytic activity and low charge transfer resistance. This identified it as a promising low-cost counter electrode (CE) material for dye-sensitized solar cells. The photo-current conversion efficiency of the vanadium nitride xerogel CE-based DSSC reached 5.94% comparable to that of the conventional thermal decomposed Pt CE-based DSSC, 7.38% with the same iodide/triiodide electrolyte system. Moreover, the 28 days stability study of VNXG CE DSSCs provided an appreciably stable performance with 37% decrement in the PCE under the same test condition

Dopants for enhanced performance of tin-based perovskite solar cells—a short review

Lead-based perovskite solar cells had reached a bottleneck and demonstrated significant power conversion efficiency (PCE) growth matching the performance of traditional polycrystalline silicon solar cells. Lead-containing perovskite solar cell technology is on the verge of commercialization and has huge potential to replace silicon solar cells, but despite the very promising future of these perovskite solar cells, the presence of water-soluble toxic lead content is a growing concern in the scientific community and a major bottleneck for their commercialization. The less toxic, tin-based perovskite solar cells are promising alternatives for lead-free perovskite solar cells. Like lead-based perovskite, the general chemical formula composition of tin-based perovskite is ASnX3, where A is a cation and X is an anion (halogen). It is evident that tin-based perovskites, being less-toxic with excellent photoelectric properties, show respectable performance. Recently, numerous studies reported on the fabrication of Sn-based perovskite solar cells. However, the stability of this novel lead-free alternative material remains a big concern. One of the many ways to stabilize these solar cells includes addition of dopants. In this context, this article summarizes the most important fabrication routes employing dopants that have shown excellent stability for tin-based perovskite photovoltaics and elaborates the prospects of lead-free, tin based stable perovskite photovoltaics

The impact of multimorbidity on adult physical and mental health in low- and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal?

BACKGROUND: Chronic diseases contribute a large share of disease burden in low- and middle-income countries (LMICs). Chronic diseases have a tendency to occur simultaneously and where there are two or more such conditions, this is termed as 'multimorbidity'. Multimorbidity is associated with adverse health outcomes, but limited research has been undertaken in LMICs. Therefore, this study examines the prevalence and correlates of multimorbidity as well as the associations between multimorbidity and self-rated health, activities of daily living (ADLs), quality of life, and depression across six LMICs. METHODS: Data was obtained from the WHO's Study on global AGEing and adult health (SAGE) Wave-1 (2007/10). This was a cross-sectional population based survey performed in LMICs, namely China, Ghana, India, Mexico, Russia, and South Africa, including 42,236 adults aged 18 years and older. Multimorbidity was measured as the simultaneous presence of two or more of eight chronic conditions including angina pectoris, arthritis, asthma, chronic lung disease, diabetes mellitus, hypertension, stroke, and vision impairment. Associations with four health outcomes were examined, namely ADL limitation, self-rated health, depression, and a quality of life index. Random-intercept multilevel regression models were used on pooled data from the six countries. RESULTS: The prevalence of morbidity and multimorbidity was 54.2 % and 21.9 %, respectively, in the pooled sample of six countries. Russia had the highest prevalence of multimorbidity (34.7 %) whereas China had the lowest (20.3 %). The likelihood of multimorbidity was higher in older age groups and was lower in those with higher socioeconomic status. In the pooled sample, the prevalence of 1+ ADL limitation was 14 %, depression 5.7 %, self-rated poor health 11.6 %, and mean quality of life score was 54.4. Substantial cross-country variations were seen in the four health outcome measures. The prevalence of 1+ ADL limitation, poor self-rated health, and depression increased whereas quality of life declined markedly with an increase in number of diseases. CONCLUSIONS: Findings highlight the challenge of multimorbidity in LMICs, particularly among the lower socioeconomic groups, and the pressing need for reorientation of health care resources considering the distribution of multimorbidity and its adverse effect on health outcomes

The use of plants in the traditional management of diabetes in Nigeria: Pharmacological and toxicological considerations

Ethnopharmacological relevance: The prevalence of diabetes is on a steady increase worldwide and it is now identified as one of the main threats to human health in the 21st century. In Nigeria, the use of herbal medicine alone or alongside prescription drugs for its management is quite common. We hereby carry out a review of medicinal plants traditionally used for diabetes management in Nigeria. Based on the available evidence on the species׳ pharmacology and safety, we highlight ways in which their therapeutic potential can be properly harnessed for possible integration into the country׳s healthcare system. Materials and methods: Ethnobotanical information was obtained from a literature search of electronic databases such as Google Scholar, Pubmed and Scopus up to 2013 for publications on medicinal plants used in diabetes management, in which the place of use and/or sample collection was identified as Nigeria. ‘Diabetes’ and ‘Nigeria’ were used as keywords for the primary searches; and then ‘Plant name – accepted or synonyms’, ‘Constituents’, ‘Drug interaction’ and/or ‘Toxicity’ for the secondary searches. Results: The hypoglycemic effect of over a hundred out of the 115 plants reviewed in this paper is backed by preclinical experimental evidence, either in vivo or in vitro. One-third of the plants have been studied for their mechanism of action, while isolation of the bioactive constituent(s) has been accomplished for twenty three plants. Some plants showed specific organ toxicity, mostly nephrotoxic or hepatotoxic, with direct effects on the levels of some liver function enzymes. Twenty eight plants have been identified as in vitro modulators of P-glycoprotein and/or one or more of the cytochrome P450 enzymes, while eleven plants altered the levels of phase 2 metabolic enzymes, chiefly glutathione, with the potential to alter the pharmacokinetics of co-administered drugs. Conclusion: This review, therefore, provides a useful resource to enable a thorough assessment of the profile of plants used in diabetes management so as to ensure a more rational use. By anticipating potential toxicities or possible herb–drug interactions, significant risks which would otherwise represent a burden on the country׳s healthcare system can be avoided

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Not AvailableThe study quantified the generation of surplus crop biomass at district level in three crop growing seasons (kharif, rabi and summer) for all the 662 districts of the country. A total of eleven crops, namely rice, wheat, maize, sugarcane, cotton, pulses (Gram & Tur) and oilseed (groundnut, mustard, soybean and castor) were selected for the study. The crops were selected based on their acreage and total production across the country. The total gross cultivated area of the country is about 195 million hectare. The area under cultivation for the selected eleven selected crops is 137 M ha i.e about 70% of gross cultivated area. The assessment methodology involved four major steps: (1) compilation of area and production statistics of selected crops, (2) estimation of dry biomass generation, (3) development of surplus factors and quantification of surplus biomass generation, and (4) estimation of bioethanol production potential of surplus crop biomass. The crop biomass usage pattern by farmers for their own self as well as the biomass sold to others for industrial or any other usage was compiled to estimate the factors for surplus crop biomass generation. A novelty of this study is that it has developed crop specific season wise and district wise surplus factors and these factors were used to estimate the surplus crop biomass generated by the selected crops in the country. The study also estimated the district wise theoretical bio-ethanol production potential of surplus crop biomass generated by each crop in each season. Of the total gross area under cultivation for the eleven selected crops, 72% area is accounted by rice, wheat, cotton and soybean crops only. These eleven crops generate about 683 million tons (MT) of total dry biomass in the three crop growing seasons. Out of this total annual crop biomass, 59% is generated during kharif season and 39% during rabi season. The remaining about 2% is generated during summer season. After different usages of this crop biomass by farmers, there is still some surplus left which can be utilized in a useful manner. The total annual surplus crop biomass is estimated to be approximately 178 MT which is about 26% of the total dry biomass generated. The season wise surplus biomass is highest in kharif season (72%) and the major crops contributing to surplus biomass are rice sugarcane cotton and soybean. In rabi season wheat, gram, rice and mustard are the crops contributing to the surplus crop biomass. The surplus biomass generated during summer is negligible. In kharif season the States of Punjab, Uttar Pradesh (U.P.), Maharashtra, Tamil Nadu (T.N.), Andhra Pradesh (A.P.), Karnataka, Telangana, Gujarat, Madhya Pradesh (M.P.), and Rajasthan generated high surplus crop biomass. Whereas in rabi season the States of Punjab, U.P., M.P., Maharashtra, Karnataka, Rajasthan, and Haryana generated high surplus crop biomass. The total annual bio-ethanol production potential from this surplus crop biomass generated in the country is 51.35 billion litres from eleven selected crops. The study provides district scale seasons wise crop area, crop dry biomass, surplus biomass and bioethanol maps for each of the eleven crops for use by different stakeholders. It is expected that the outcome of this study shall help in developing an improved policy for 2nd generation biofuel by utilizing surplus crop residues. This will also help India in achieving the goal of bio-ethanol blending with gasoline.Technology Information, Forecasting and Assessment Council (TIFAC