Emerging Considerations for Diversity Education of South Asian American Students

Educatio

Analysis of risk factors associated with caesarean section surgical site infections: a case control study

Background: Surgical site infection (SSI) is defined as infection occurring within 30 days after a surgical procedure and affecting either the incision or deep tissues at the operation site. SSIs are the most common nosocomial infections, accounting for 38% of hospital-acquired infections. Despite the advances in SSI control practices, SSIs remain common causes of morbidity and mortality among hospitalized patients. This study was undertaken with an objective to determine and analyze the risk factors associated with cesarean section SSIs.Methods: The study was carried out at Medical College and SSG Hospital, Baroda. After obtaining informed consent to be a part of the study, 140 subjects having cesarean section SSI as per the definition, were included as cases in the study. The controls (140) were also selected from the hospital subjects. The primary post-operative care was similar for the cases as well as controls. For patients who had SSI, samples of discharge from the cesarean section wound were collected and transported for culture. Antibiotics were given accordingly. Details about patient characteristics and outcomes were collected in the proforma for cases and controls and data analyzed.Results: The cesarean section SSI rate was 4.78%. Of the parameters studied, maternal age, parity, gestational age, HIV status, meconium stained amniotic fluid, amount of blood loss, previous surgery, duration of surgery were not associated with cesarean section SSI.Conclusions: Number of antenatal care (ANC) visits, haemoglobin, total white blood cells (WBC) count, pre eclampsia, premature rupture of membranes (PROM), non-progression in 2nd stage and subcutaneous tissue thickness were the independent significant risk factors associated with post-cesarean SSI

A comparison of sublingual with vaginal administration of misoprostol for induction of labor at term

Background: To compare the efficacy and safety of sublingual route of misoprostol with vaginal route of administration.Methods: This study was conducted at Department of Obstetrics and Gynecology, Medical College, Baroda, Gujarat, India. 50 cases each with a singleton term pregnancy and a live fetus requiring induction of labor were allocated to sublingual and vaginal administration of misoprostol. Outcome measures related to labor and maternal and fetal side effects were compared between the 2 groups and evaluated using Chi square test and relative risk (RR) with 95% confidence intervals (CI).Results: The sublingual route of misoprostol was associated with a reduced risk of failed induction, reduced time from initiation to induction, reduced induction to delivery interval and a higher incidence of maternal and fetal side effects. However, the differences were not statistically significant.Conclusions: The sublingual route of administration of misoprostol is comparable in efficacy and safety to the vaginal route for induction

Fetal heart rate patterns in patients with thick meconium staining of amniotic fluid and its association with perinatal outcome

Background: This study assesses the role of abnormal fetal heart rate tracing patterns in patients with thick meconium staining of the amniotic fluid and its association with perinatal outcomes.Methods: Prospective unmatched case-control study on 2 groups of 136 subjects each- cases had thick MSAF and controls had clear liquor with abnormal fetal heart rate tracings on cardiotocography.Results: Gestational age (GA) >40 weeks, was found to have a significant association with MSAF (p value 0.01556 CI 95%). Premature Rupture of membranes at term (PROM) showed a significant association with MSAF with an OR of 2.25 (95% CI 1.37, 3.7); Post datism had significantly higher odds for being a risk factor for MSAF with an OR (3.194) (CI 95% 1.003-10.165). MSAF was not found to be significantly associated with abnormal trace on CTG. Neonatal morbidity (MAS, birth asphyxia, sepsis, HIE) had statistically higher odds in cases 1.669 (0.884-3.150) as compared to controls.Conclusions: No particular cardio-tocograph pattern can be considered to have a poor prognostic value in the presence of thick MSAF and the decision to deliver and the mode of delivery should be based on the overall assessment and the stage and progress of labor. While management should be individualized, a higher Caesarean section rate in thick MSAF can be justified to ensure a better outcome for the neonate even in the presence of a normal CTG trace

Screening for retinopathy of prematurity in neonates

Background: Retinopathy of prematurity (ROP) is a vaso-proliferative disorder of the retina among preterm infants. Neonates born at less than 32 weeks of gestation are at risk of developing ROP. However preterm infants born at 32 weeks or later can also develop severe ROP if they had turbulent NICU course or required prolonged oxygen therapy. Aims of the study were to determine incidence, risk factors of ROP in neonates and to determine the association of birth weight, gestational age and incidence of ROP.Methods: Prospective analytic study done in indoor patients in neonatal intensive care unit at a tertiary care center from June 2015 to May 2016.Results: Overall incidence of retinopathy of prematurity in preterm neonates is 18.4%. Incidence increases with decreasing gestational age. In preterm <28 weeks of gestational age, incidence of ROP is 35%. Incidence also increases with decreasing birth weight. Incidence of ROP in neonates with birth weight less than 1.25kg is 50%. Risk factors include prematurity, oxygen therapy, septicemia, intraventricular hemorrhage, anemia needing blood transfusion. Most patients of ROP have stage-1 disease (76%). The twenty one cases having ROP underwent laser ablative therapy. Earlier detection by screening leads to early intervention and prevention of blindness.Conclusions: The timely retinal screening of high-risk preterm infants is important to prevent the development of advanced ROP. Since ROP may produce serious sequel up to complete blindness, all efforts must be made to prevent the development of advanced ROP through elimination of preterm births, changes in the neonatal care and improvement in detection of threatening ROP markers

Charaterization of a crosslink between Xyloglucan and Rhamnogalacturonan from cotton cell walls

Pectin is the most complex and major component of primary plant cell walls. For better understanding of its structural complexity and heterogeneity, it is crucial to know about the structure and linkages within the pectic regions as well as to other polysaccharides present in primary cell walls. Our main aim is to characterize the cross-linkage between the XG and RG. Preliminary results show nearly half of the XG is covalently linked to RG. EPG digestion of cell walls followed by strong alkali extraction (24 % KOH & 0.1 % NaBH4) solubilizes most of the XG-RG complex along with other pectic polysaccharides and unlinked hemicelluloses. The XG-RG complex can then separated from the neutral and slightly acidic sugars using ion exchange chromatography. Treatment with arabinosidase removes the arabinose from the arabinan in the XG-RG complex. Free arabinose can be separated using an ion exchange column. Further treatment of the complex with arabinanase, cleaves the arabinan linkages essentially dissociating most of the XG from RG. These finding were supported with sugar composition, CZE electropherograms, MALDI-TOF MS spectra, and NMR spectroscopy. Our experimental results significantly suggest arabinan being the crosslink present between the XG and RG complex as proposed in an earlier plant cell wall model by Keegstra et al.Department of Biochemistry and Molecular Biolog

Supporting Vermont Families in Packing Healthy Lunches for Children in Childcare

Introduction. Partnering with Hunger Free Vermont, an organization that works to end hunger and malnutrition across the state, we investigated the nutritional value of the packed meals parents provide for their children in early childcare. The USDA\u27s My Plate resource was used as a measure to assess variety, dividing foods into five groups: grains, dairy, vegetables, fruits, and protein. The results will help Hunger Free Vermont design nutrition education materials for childcare centers to provide to the families they serve. Methods. Online surveys were distributed, asking parents to report the foods they recently provided for their children in packed lunches, to rate how \u27healthy\u27 they thought those lunches were, and to note any barriers they experience to packing healthy foods. Results. Survey results showed that the average number of sweets packed by parents who had low confidence in their ability to pack healthy meals was significantly higher than the average number packed by parents with high confidence (p \u3c 0.05). Additionally, the total number of cited barriers was significantly higher in parents who had low confidence in their ability to pack healthy meals (p \u3c 0.01). Conclusions. Many parents cited time constraints and ‘picky’ children as barriers to providing healthy meals, with concerns about the expense of healthy items and lack of childcare for shopping or food-prep time following close behind. In the future, education materials that address children’s unhealthy food preferences or further investigations into barriers to providing healthy lunches may facilitate development of resources for Vermont families.https://scholarworks.uvm.edu/comphp_gallery/1259/thumbnail.jp

\u27A lot better than medicine\u27: Self-organised ocean swimming groups as facilitators for healthy ageing

Exercise, spending time in nature and feeling part of a supportive community all contribute to better physical and mental health and to healthy ageing. This focused ethnography investigates how participation in self-organised ocean swimming groups contributes to healthy ageing amongst older men and women in the Australian coastal city of Perth. It explores the ways marine life, personal experiences and social connectedness mediate their group use of public blue space, and highlights that group membership promotes participants\u27 enhanced health and wellbeing, and supports development of self-efficacy and resilience. These findings suggest that more inclusive access to ocean swimming and other forms of active or adventure-based leisure activities should be advocated from a public health perspective