Risk factors in pregnancy with heart disease and their co-relation with adverse feto-maternal outcome

Background: Heart disease complicates 1% to 3% of all pregnancies and is responsible for 10% to 15% of maternal mortality. In India, the predominant heart disease is still RHD (rheumatic heart disease), whereas in the developed countries congenital heart disease is more common.Methods: This prospective observational study conducted in Department of Obstetrics and Gynecology in carried in PGIMER and Dr. RML Hospital, New Delhi from November 2015 to March 2017. 35 patients with heart disease were included in this study eight risk factors, four non-cardiac (age, parity, BMI and time of reporting to hospital) and four cardiac risk factors (etiology of lesion, type of lesion, prosthetic valve on anticoagulation and associated cardiac complication like atrial fibrillation (AF), pulmonary edema, pulmonary artery hypertension (PAH) were co-related with predefined indicators for adverse feto-maternal outcome. NYHA class, CARPREG score, modified WHO class were also co-related with adverse feto-maternal outcome.Results: RHD is still more common than CHD in our population. No association was seen between any non-cardiac risk factor and adverse maternal outcome. Among cardiac risk factors, severe MS, severe PAH, NYHA class IV, AF, CARPREG score ≥2 were significantly associated with adverse maternal and fetal outcome. There was no maternal or fetal death in the present study.Conclusions: Severe MS, severe PAH, AF, NYHA Class IV, CARPREG score ≥2 had positive predictive value for adverse feto maternal outcome in the present study which had no maternal or fetal mortality. Need for Preconceptional counselling which was seen to be totally absent in the present study is emphasized

An evaluation of microleakage of various glass ionomer based restorative materials in deciduous and permanent teeth: An in vitro study

AbstractAimTo evaluate the microleakage of recently available glass ionomer based restorative materials (GC Fuji IX GP, GC Fuji VII, and Dyract) and compare their microleakage with the previously existing glass ionomer restorative materials (GC Fuji II LC) in primary and permanent teeth.MethodOne hundred and fifty (75+75) non-carious deciduous and permanent teeth were restored with glass ionomer based restorative materials after making class I cavities. Samples were subjected to thermocycling after storing in distilled water for 24h. Two coats of nail polish were applied 1mm short of restorative margins and samples sectioned buccolingually after storing in methylene blue dye for 24h. Microleakage was assessed using stereomicroscope.ResultSignificant differences (P<0.05) were found when inter group comparisons were done. Except when GC Fuji VII (Group III) was compared with GC Fuji II LC (Group II) and Dyract (Group IV), non-significant differences (P>0.05) were observed. It was found that there was no statistically significant difference when the means of microleakage of primary teeth were compared with those of permanent teeth.ConclusionsGC Fuji IX GP showed maximum microleakage and GC Fuji VII showed least microleakage

The Acrocallosal Syndrome in A Neonate With Further Widening of Phenotypic Expression

How to Cite This Article: Singhal R, Pandit S, Saini A, Singh P, Dhawan N. The Acrocallosal Syndrome in A Neonate With Further Widening of Phenotypic Expression. Iran J Child Neurol. 2014 Spring;8(2):60-64. The presentation of the typical characteristics of the acrocallosal syndrome (ACLS) are hypoplasia/agenesis of corpus callosum, moderate to severe mental retardation, characteristic craniofacial abnormalities, distinctive digitalmalformation, and growth retardation in a neonate.An Indian neonate presented on day 1 of life (youngest in the literature to be reported) with combination of abnormalities consistent with the acrocallosal syndrome and some additional findings. The baby, born to non-consanguineous, healthy parents, presented with macrocephaly, prominent forehead, hypertelorism, polydactyly of the hands and feet, duplication of hallux, hypotonia, recurrent cyanotic episodes, rib anomalies, dextro-positioning of heart, and delayed fallof umbilical cord.As the mode of inheritance of ACLS is autosomal recessive, the risk of recurrence is 25%. Genetic counselling is of prime importance, Polydactyly, and central nervous system malformations can be detected by ultrasonography in the second trimester, but due to variability of presentation, prenatal diagnosis may not always be possible.References1. Schinzel A. Postaxial polydactyly, hallux duplication, absence of corpus callosum, macencephaly and severemental retardation: a new syndrome? Helv Paediatr Acta 1979:34:141-146.2. Schinzel A. The acrocallosal syndrome: expansion of the phenotypic spectrum. Clin Dysmorphol 1994;3:31-34.3. Schinzel A, Schmid W. Hallux duplication, postaxial Polydactyly, absence of corpus callosum, severe mental retardation and additional anomalies in two unrelated patients: a new syndrome. Am J Med Genet 1980;6:241-249.4. Moeschler JB, Pober BR, Holmes LB, Graham JM Jr. Acrocallosal syndrome: new findings. Am J Med Genet 1989;32:195-199.5. Schinzel A, Kaufmann U. The acrocallosal syndrome in sisters. Clin Genet 1986;30:399-405.6. Koenig R, Bach A, Woelki U, Grzeschik KH, Fusch S. Spectrum of acrocallosal syndrome. Am J Med Genet 2002;108:7-11.7. Schinzel A. The acrocallosal syndrome in first cousins: widening of the spectrum of clinical features and further support for automal inheritance. J Med Genet 1988;25:332-336.8. Hendriks HJE, Brunner HG, Haagen TAM, Hamel BCJ. Acrocallosal syndrome. Am J Med Genet 1990;35:443-446.9. Yuksel M, Caliskan M, Ogur G, Ozmen M, Dolunary G, Apak S. The acrocallosal syndrome in a Turkish Boy. J Med Genet 1990;27:48-49.10. Casamassima AC, Beneck D, Gewitz MH, Horowitz MA, Woolf PK, Pettersen IM, Shapiro LR. Acrocallosal Syndrome: additional manifestation. Am J Med Genet 1989;32:311-317.11. Courtens W, Vamos E, Christophe C, Schinzel A. Acrocallosal syndrome in an Algerian boy born to consanguineous parents: review of the literature and further delineation of the syndrome. Am J Med Genet 1997;69:17-22.12. Bassam R Ali, Jennifer L Silhavy, Nadia A Akawi, Joseph G Gleeson Lihadh Al-Gazali. A mutation in KIF7 is responsible for te autosomal recessive syndrome of macrocephaly, multiple epiphyseal dysplasia and distinctive facial appearance. Orphanet J Rare Dis 2012 May 15;7:27

ANEXdb: An Integrated Animal Annotation and Microarray EXpression Database

All publicly available porcine expressed sequences were assembled to create longer, fuller transcripts for annotation purposes. The longer sequences were then used as queries in sequence alignment and comparison software to transfer functional annotation from their homologues in other species. In addition to transferred annotation, sequence variation was also predicted from the assembly. This information can then be used with expression data from high through-put expression measures, such as microarrays, to more fully understand the underlying mechanisms of biological processes. Both kinds of data, expression and annotation, are housed together and available at www.anexdb.org

Biogenic Preparation, Characterization, and Biomedical Applications of Chitosan Functionalized Iron Oxide Nanocomposite

Chitosan (CS) functionalization over nanomaterials has gained more attention in the biomedical field due to their biocompatibility, biodegradability, and enhanced properties. In the present study, CS functionalized iron (II) oxide nanocomposite (CS/FeO NC) was prepared using Sida acuta leaf extract by a facile and eco-friendly green chemistry route. Phyto-compounds of S. acuta leaf were used as a reductant to prepare CS/FeO NC. The existence of CS and FeO crystalline peaks in CS/FeO NC was confirmed by XRD. FE-SEM analysis revealed that the prepared CS/FeO NC were spherical with a 10&ndash;100 nm average size. FTIR analyzed the existence of CS and metal-oxygen bands in the prepared NC. The CS/FeO NC showed the potential bactericidal activity against E. coli, B. subtilis, and S. aureus pathogens. Further, CS/FeO NC also exhibited the dose-dependent anti-proliferative property against human lung cancer cells (A549). Thus, the obtained outcomes revealed that the prepared CS/FeO NC could be a promising candidate in the biomedical sector to inhibit the growth of bacterial pathogens and lung cancer cells

Cholesterol Induces Specific Spatial and Orientational Order in Cholesterol/Phospholipid Membranes

In lipid bilayers, cholesterol facilitates the formation of the liquid-ordered phase and enables the formation of laterally ordered structures such as lipid rafts. While these domains have an important role in a variety of cellular processes, the precise atomic-level mechanisms responsible for cholesterol's specific ordering and packing capability have remained unresolved

Cholesterol Induces Specific Spatial and Orientational Order in Cholesterol/Phospholipid Membranes

In lipid bilayers, cholesterol facilitates the formation of the liquid-ordered phase and enables the formation of laterally ordered structures such as lipid rafts. While these domains have an important role in a variety of cellular processes, the precise atomic-level mechanisms responsible for cholesterol's specific ordering and packing capability have remained unresolved

Asymptomatic late embolization of Amplatzer septal occluder device

Atrial septal defects of Ostium Secundum type with suitable anatomy and margins are commonly closed with septal occluder devices. With the increasing number of catheterization laboratories and increasing availability of different devices, the device closure procedure is very commonly performed in different institutes. Embolization of the septal occluder is one of the most dreaded complications of this procedure, which usually occurs in the early hours or days after the procedure. We report a case of silent embolization of the Amplatzer septal occluder, detected seven months after its use to close an Ostium Secundum atrial septal defect, which was detected during pre-anaesthetic evaluation and echocardiography for non-cardiac surgery. The patient denied having any symptom in-between. The device was retrieved and the defect was closed surgically

Risk factors in pregnancy with heart disease and their co-relation with adverse feto-maternal outcome

Background: Heart disease complicates 1% to 3% of all pregnancies and is responsible for 10% to 15% of maternal mortality. In India, the predominant heart disease is still RHD (rheumatic heart disease), whereas in the developed countries congenital heart disease is more common.Methods: This prospective observational study conducted in Department of Obstetrics and Gynecology in carried in PGIMER and Dr. RML Hospital, New Delhi from November 2015 to March 2017. 35 patients with heart disease were included in this study eight risk factors, four non-cardiac (age, parity, BMI and time of reporting to hospital) and four cardiac risk factors (etiology of lesion, type of lesion, prosthetic valve on anticoagulation and associated cardiac complication like atrial fibrillation (AF), pulmonary edema, pulmonary artery hypertension (PAH) were co-related with predefined indicators for adverse feto-maternal outcome. NYHA class, CARPREG score, modified WHO class were also co-related with adverse feto-maternal outcome.Results: RHD is still more common than CHD in our population. No association was seen between any non-cardiac risk factor and adverse maternal outcome. Among cardiac risk factors, severe MS, severe PAH, NYHA class IV, AF, CARPREG score ≥2 were significantly associated with adverse maternal and fetal outcome. There was no maternal or fetal death in the present study.Conclusions: Severe MS, severe PAH, AF, NYHA Class IV, CARPREG score ≥2 had positive predictive value for adverse feto maternal outcome in the present study which had no maternal or fetal mortality. Need for Preconceptional counselling which was seen to be totally absent in the present study is emphasized

Pharmaco – Mechanical management of acute massive pulmonary embolism in a postpartum female

Background: The optimal use of pharmaco-mechanical therapy is not clear in the management of the acute massive pulmonary thromboembolism. Methods: A 30-year-old postpartum female presented with acute massive pulmonary embolism and was managed with catheter mediated thrombus aspiration and fragmentation after the standard intravenous thrombolysis had failed. Thrombus was aspirated by 7F Mullins sheath with 50cc aspiration syringe and was fragmented by TYSHAK II PTV balloon. This was followed by catheter directed thrombolysis. Results: Intravenous thrombolysis was only partially successful whereas catheter mediated thrombus aspiration and fragmentation followed by catheter directed thrombolysis resulted in hemodynamic stabilization and early discharge from the hospital. Conclusion: Pharmaco-mechanical therapy is an effective therapy of acute massive pulmonary embolism and may be beneficial over the standard systemic thrombolysis