Maternal near miss events, an obstetrician's nightmare

Background: Near-miss obstetric cases are those who have survived childbirth after a life-threatening complication of pregnancy. The aim of this study is to assess the prevalence of maternal near miss events, fetomaternal outcome and alongside analyze the importance of high dependency unit care for near miss patients in reducing maternal morbidity and mortality.Methods: This hospital based cross-sectional study was conducted in the obstetrics and gynaecology department of Southern railway hospital during June 2019 July 2021. In this study, pregnant or postnatal women with life threatening complications are admitted to the HDU using SAMM composite score and maternal & perinatal outcome are documented. Data entry was done in Microsoft Excel and data were analyzed using Epi Info software (7.1.0.6). Results: Many indicators of maternal near miss are calculated. The incidence of near-miss events was 11.5/1,000 live births. The ratio of near-miss to maternal mortality was 7:1. Hypertensive disorders complicating pregnancy and Obstetric haemorrhage were the most common direct and cardiac diseases complicating pregnancies were the most common indirect causes of admission into HDU care.Conclusions: Evaluation of maternal near miss events provides a good sense about our deficiencies in referral system, treatment protocols and any delay in admission to intervention time. Good maternal outcome after HDU care in MNM patients and also cost-effective benefits

Maternal COVID-19 infection, clinical characteristics, pregnancy and neonatal outcome: a prospective cohort study at a tertiary care center in Central India

Background: COVID-19 caused by severe acute respiratory syndrome coronavirus-2 is a global public health emergency as declared by WHO. Currently how it affects pregnancy very little is known. To identify maternal and neonatal risks associated with COVID-19 in pregnancy and to describe outcome a prospective cohort study was done. Associations were evaluated for all COVID-19 patients and for disease classified as mild versus moderate/severe disease.Methods: In this study COVID RT-PCR positive women who were admitted from 1 May to 31 August were included. Cases were classified according to their severity, investigations done and treated according to MOHFW (ministry of health and family welfare), India guidelines. Data was collected, analysed in terms of maternal and neonatal outcome.Results: Total 221 COVID-19 cases were admitted and 181 delivered during study period. There were 215 (97.28%) mild, 5 (2.71%) moderate and 1 (0.45%) severe cases. 210 (95.02%) were diagnosed in third trimester. Mean gestational age was 36.79±5.24 weeks and 3 out of 4 in moderate/severe category delivered preterm. 132 (59.73%) were asymptomatic. There was 1 ICU admission and 1 maternal death. Mean birth weight was 2.7±0.59 kg. There were 7 stillbirths, 14 NICU admission and 1 neonatal death.Conclusions: Majority of the covid infected women are asymptomatic are in mild category and there is no adverse maternal and neonatal outcome due to disease. Adversity of maternal and neonatal outcome depends on severity of disease and severity of disease is dependent on presence of co-morbidities

Neonatal outcome in randomized controlled trial of low dose oral misoprostol in comparison with intracervical Dinoprostone gel for labour induction

Background: Induction of labour is a therapeutic option when the benefits of delivery outweigh risks of continuing pregnancy. There are several agents for induction of labour to achieve better outcome of labour. Acceptable methods for induction are oxytocin infusion, dinoprostone gel, misoprostol and mechanical cervical dilators. Prostaglandins are the preferred choice in unripened cervix. To study the neonatal outcome in induction of labour with low dose oral misoprostol compared with intracervical dinoprostone gel and also to assess occurrence of meconium staining liquor.Methods: One hundred women with single live fetus, term gestation, cephalic presentation, reactive fetal heart pattern and Bishops score <6 were included in the study. They were randomized to receive either 6 doses of 25ug oral misoprostol every 3rd hourly or 0.5ug intracervical dinoprostone every 6th hourly for a maximum of 3 doses. Oxytocin was administered. Fetal outcome was assessed in terms of APGAR score, meconium staining and need for NICU.Results: Meconium stained amniotic fluid was high in misoprostol group (16%) compared to dinoprostone group (8%). NICU admissions were seen in 7 neonates in both groups.Conclusions: Low dose oral misoprostol is a safe method of labour induction. APGAR and NICU admission rates were comparable in both groups. Meconium staining was more in misoprostol group compared to dinoprostone group

Randomized control trial of low dose oral misoprostol compared with intracervical dinoprostone gel for cervical ripening

Background: Induction of labour is a therapeutic option when the benefits of delivery outweigh risks of continuing pregnancy. There are several agents for induction of labour to achieve better outcome of labour. Acceptable methods for induction are oxytocin infusion, dinoprostone gel, misoprostol and mechanical cervical dilators. Prostaglandins are the preferred choice in unripened cervix. Objective of this study was to compare efficacy, safety of low dose oral misoprostol compared with intracervical dinoprostone gel for cervical ripening.Methods: One hundred women with single live fetus, term gestation, cephalic presentation, reactive fetal heart pattern and Bishops score &lt;6 were included in the study. They were randomized to receive either 6 doses of 25ug oral misoprostol every 3rd hourly or 0.5ug intracervical dinoprostone every 6th hourly for a maximum of 3 doses.Results: Bishops score improvement after 6,12,18 hours in both the groups was statistically insignificant. Induction delivery interval was11.96±5.88 for misoprostol and 10.95±4.58 in dinoprostone group with P value 0.341 which was statistically insignificant. Need for oxytocin augmentation was less (18%) in misoprostol group as compared to dinoprostone group (44%). Caesarean section rate was slightly higher in misoprostol group (26% vs 24%). Meconium stained amniotic fluid was high in misoprostol group (16%) compared to dinoprostone group (8%). Maternal complications were minimal and neonatal outcome was good in both the groups.Conclusions: Compared to dinoprostone; misoprostol is easy to store, cost effective, stable at room temperature, can be easily administered and had better patient compliance and acceptability. It was found to be a better cervical ripening agent with similar maternal and fetal safety profile

SYNTHESIS, CHARACTERIZATION AND ANTI-INFLAMMATORY ACTIVITY OF NOVEL PYRAZOLE DERIVATIVES

Objectives: To synthesize novel pyrazole derivatives and their evaluation for anti-inflammatory activity. Methods: The synthesis of chalcone (1) was carried out by using Claisen-Schmidt condensation. which on further cyclization with thiosemicarbazidegives the substituted 3, 5-diphenyl-4, 5-dihydro-pyrazole-1-carbothoic acid amide (2), further reaction with different aldehydes yield title compounds(3). Using this scheme 8 compounds were synthesized which further have been evaluated for anti-inflammatory activity by egg-albumin induced pawedema.Results: All the synthesized compounds have been supported by spectral analysis. The anti-inflammatory activity of synthesized compounds wascompared with standard anti-inflammatory agent Diclofenac sodium.Conclusion: Compound-8, compound-2 and compound-3 showed greater anti-inflammatory activity due to the presence of alkene and electronwithdrawing groups (Cl and NO2). Keywords: Chalcone, Thiosemicarbazide, Pyrazole derivatives, Anti-inflammatory activity

Dielectric properties characterization of La- and Dy-doped BiFeO3 thin films

The dielectric response of La- and Dy- doped BiFeO3 thin films at microwave frequencies (up to 12 GHz) has been monitored as a function of frequency, direct current (dc) electric field, and magnetic field in a temperature range from 25 to 300 °C. Both the real and imaginary parts of the response have been found to be non-monotonic (oscillating) functions of measuring frequency. These oscillations are not particularly sensitive to a dc electric field; however, they are substantially dampened by a magnetic field. The same effect has been observed when the volume of the characterized sample is increased. This phenomenon is attributed to the presence of a limited number of structural features with a resonance type response. The exact origin of these features is unknown at present. Leakage current investigations were performed on the whole set of films. The films were highly resistive with low leakage current, thereby giving us confidence in the microwave measurements. These typically revealed ‘N'-type I-V characteristic

Genetic Variability for Yield, Physiological and Quality Traits in Novel Super-Early Pigeonpea (Cajanus cajan (L.) Millsp.)

Super-early pigeonpea are novel genotypes that are reported to be photoperiod insensitive making it possible to grow it in non-traditional regions. Estimation of genetic parameters would be useful in developing appropriate selection and breeding strategies. A study was conducted to evaluate 37 super-early pigeonpea genotypes to access the magnitude of variability and to study heritable component of variation present in the yield, physiological and quality traits. The results revealed that traits leaf area duration between 60 DAS & maturity followed by leaf area & leaf area index at maturity, net assimilation between 60 DAS & maturity, leaf area index & leaf area at 60 DAS, leaf area duration between 60 DAS & maturity and plant height had high had higher PCV and GCV values. In general, phenotypic coefficients of variation (PCV) estimates were higher than genotypic coefficients of variation (GCV) estimates for all the characters under study, but the difference was relatively small indicating that these characters were less influenced by the environment and selection to improve those traits might be effective. High heritability combined with high genetic advance as a percent of mean was noted for all the traits except protein content conveying the governance of additive gene on trait expression. Anticipating these traits as selection index reaps competent improvement in yield, physiological and quality traits in early maturing pigeonpea

Genetic Divergence for Yield, Physiological and Quality Traits in Super-Early Pigeon pea (Cajanus cajan. (l.) Millsp.)

The present investigation aimed to study genetic divergence and clustering pattern of 37super-early pigeon pea genotypes. Analysis of variance and hierarchical cluster analysis of tocher’s method revealed significant differences among the genotypes for all the traits under study. Based on genetic distance (D2 value), the 37 genotypes were grouped into 9 distinctive clusters, of which cluster I and II formed the largest clusters with 10 genotypes in each. Among all the characters understudy, leaf area index(LAI) at 60 DAS contributed more to the divergence followed by leaf area (17.02) and leaf area index (12.71) at maturity. Based on the average inter-cluster distance, the cluster III and IX (66.93) tailed by cluster III and VIII (64.86) and cluster VI and VIII (64.06) showed higher inter-cluster distance depicting the wider divergence. Trait-wise selection of diverse parents from the above clusters aids in exploitation of heterosis in superearly pigeon pea

Interactions between Neuropsychiatric Symptoms and Alzheimer’s Disease Neuroimaging Biomarkers in Predicting Longitudinal Cognitive Decline

OBJECTIVE: To examine interactions between Neuropsychiatric symptoms (NPS) with Pittsburgh Compound B (PiB) and fluorodeoxyglucose positron emission tomography (FDG-PET) in predicting cognitive trajectories. METHODS: We conducted a longitudinal study in the setting of the population-based Mayo Clinic Study of Aging in Olmsted County, MN, involving 1581 cognitively unimpaired (CU) persons aged ≥50 years (median age 71.83 years, 54.0% males, 27.5% APOE ɛ4 carriers). NPS at baseline were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Brain glucose hypometabolism was defined as a SUVR ≤ 1.47 (measured by FDG-PET) in regions typically affected in Alzheimer\u27s disease. Abnormal cortical amyloid deposition was measured using PiB-PET (SUVR ≥ 1.48). Neuropsychological testing was done approximately every 15 months, and we calculated global and domain-specific (memory, language, attention, and visuospatial skills) cognitive z-scores. We ran linear mixed-effect models to examine the associations and interactions between NPS at baseline and z-scored PiB- and FDG-PET SUVRs in predicting cognitive z-scores adjusted for age, sex, education, and previous cognitive testing. RESULTS: Individuals at the average PiB and without NPS at baseline declined over time on cognitive z-scores. Those with increased PiB at baseline declined faster (two-way interaction), and those with increased PiB and NPS declined even faster (three-way interaction). We observed interactions between time, increased PiB and anxiety or irritability indicating accelerated decline on global z-scores, and between time, increased PiB and several NPS (e.g., agitation) showing faster domain-specific decline, especially on the attention domain. CONCLUSIONS: NPS and increased brain amyloid deposition synergistically interact in accelerating global and domain-specific cognitive decline among CU persons at baseline