A study to know clinical characteristics and outcome of obstetrics patients requiring ICU admission

Background: Pregnancy poses unique consideration for critical care and it is imperative that obstetrician and other members of health care team have a working knowledge of these factors because these are women are usually young and in good health, their prognosis should be better than that of many other patients admitted to an intensive care.Methods: The present study was conducted in the Department of Obstetrics and Gynaecology, Gaja Raja Medical College and associate Kamla raja Hospital, Gwalior in the ICU from Oct. 14 to Oct. 15.Results: 678 obstetric women were admitted into the ICU of Kamla Raja Hospital, over a period of 1 year study period. Maximum number of patients belong to age group 21-25 years (54.8%), 398 (58.7%) patients were uneducated, 343 (50.59%) came directly to Kamla Raja Hospital. 362 (53.39%) belongs to urban area. The mean length of stay in ICU was 3 days. Maximum number of patients were postpartum 580 (85.55%). According to mode of delivery maximum number of patients 348 (51.33%) underwent LSCS. Most common obstetric indication for admission in ICU was hypertensive disorder of pregnancy 472 (69.61%). Most common medical indication was severe anaemia 128 (18.87%). Various type intervention like pulse oxymetry, O2 inhalation, BT, nebulisation and ventilation were done in ICU according to patients need. 43 maternal death happened during the study period with most common cause was cardiorespiratory arrest 9 (1.32%) and pulmonary edema 8 (1.17%).Conclusions: Establishment of a dedicated obstetric ICU at tertiary care centre with knowledge familiarity, experience and expertise of an obstetrician and a special team would be best place to monitor and treat the critically ill obstetric patients which will reduce the maternal morbidity and mortality

A randomized study to compare the efficacy and side effects of misoprostol given either orally or vaginally for first trimester medical termination of pregnancy

Background: Medical abortion represents an alternative to first trimester aspiration abortion and has been used by millions of women throughout the world. A numerous study has demonstrated that combination of mifepristone and misporostol is highly efficacious with success rate of approximately 97%.Methods: In the present randomized study 100 women who were requesting for first trimester medical abortion were included in the study. This randomized study was conducted for a period of one year in a tertiary health care centre. All these women were randomly assigned to receive either oral misoprostol (n=52) (group 1) or vaginal misoprostol (n=48) (group 2). We found that after the administration of mifepristone, vaginal misoprostol for the induction of abortion upto 49 days was more effective than oral misoprostol.Results: In present study maximum number of patients were in the age group of 26-30 years. Multiparous women comprised of maximum number of patients in both 70% in group 1 and 83% in group 2. The gestational age at the time of inclusion in study was maximum upto 7 weeks or 49 days gestation in both groups. Acceptability of medical abortion is more in urban locality i.e. 73% in group 1 and 81% in group 2. 73% in group 1 and 79% in group 2 chose to have misoprostol at home. 92% patients in group 1 and 95% patients in group 2 initiated bleeding per vaginum within 4 hours. Side effects like nausea, vomiting and diarrhea were compared. 92.4% patients in group 1 and 97% patients in group 2 who had expulsion of conception without need of surgical intervention was comparable. Only 2 patients in group 1 had incomplete abortion and needed surgical aspiration.Conclusions: This study showed UA-S/D ratio and UA-RI>2SD are significant predictors of perinatal deaths and immediate neonatal resuscitation in preeclampsia. Acute fetal distress in labour or neonatal nursery admission could not be predicted

Hindi language text search: a literature review

The literature review focuses on the major problems of Hindi text searching over the web. The review reveals the availability of a number of techniques and search engines that have been developed to facilitate Hindi text searching. Among many problems, a dominant one is when a text formed by combinatorial characters or words is searched

Isolation of multipotent astroglia form the adult stem cell niche and the injured brain

Adult neural stem cells, as the source of life-long neurogenesis, reside in the subependymal zone (SEZ) in the lateral wall of the lateral ventricles and in the dentate gyrus of the hippocampus. In both neurogenic regions, subsets of glial fibrillary acidic protein (GFAP) expressing astrocytes are found, that have been shown to act as neural stem cells. So far, it is not known how to distinguish these stem cell astrocytes from other astrocyte populations within the SEZ. Towards this end we decided to isolate a subpopulation of adult SEZ astrocytes that expresses the CD133 by FACS. GFP-positive cells in the SEZ from hGFAP/eGFP mice that were also CD133+ve comprised all neurosphere-initiating cells that were self-renewing and multipotent from the SEZ. Moreover, single cell neurosphere analysis showed 70% efficiency in neurosphere formation. Further more Cre-mediated fate mapping of this double-positive population showed their contribution to adult neurogenesis. Transcriptional profiling of the GFP/CD133-double-positive cells allowed us to a) determine their similarity at the transcriptome level to both ependymal cells AND astrocytes and b) to identify their unique molecular neural stem cell signature. We also discovered that astrocytes outside this neurogenic niche could go some way towards dedifferentiation into neural stem cells. We have previously described (Buffo et al., PNAS 2008) a population of astrocytes in the adult cerebral cortex after stab wound injury that dedifferentiates as far to form multipotent and self-renewing neurospheres. Now we succeeded to establish the factor responsible for this dedifferentiation and sufficient to elicit the dedifferentiation response even in cells that were not exposed to injury. These data will be presented. Taken together, our work allows for the first time, the identification and characterization of the astrocyte sub-types acting as neural stem cells

RESPIRATORY FUNCTIONS IN TEXTILE MILL WORKERS: ROLE OF PEAK EXPIRATORY FLOW RATE

Background: Textile industries play a significant role in economical growth of the country. Health concern of these textile mill workers is the biggest challenge. Respiratory alterations were found in these workers with long term exposure of cotton dust. Effect of cotton dust on peak expiratory flow rate is not very well documented in the past.Aim/objective: The main objective of this study was the assessment of respiratory functions in textile mill workers along with the effect on peak expiratory flow rate in these workers.Material & Methods: 130 male textile mill workers were recruited for this study from the different sections of a textile mill. In which, 80 workers were present from exposed and remaining 50 were from non exposed area of a textile mill. 30 to 40 year of age workers with the working history of not more than 5 years, were included for the part of the study. Their Body mass index and respiratory functions were evaluated. Body mass index was calculated by using weight and height of an individual. Respiratory functions including Forced vital capacity and forced expiratory volume in 1 second was estimated by using spirometer and peak expiratory flow rate was measured by means of Wright's peak flow meter.Results: the mean values of FVC, FEV1 and PEFR were found to be significantly (<0.01) lower in exposed group of textile mill when compared non exposed groups. When these values were compared on the basis of BMI, workers with BMI>25kg/m2 were found with lower mean values of FVC, FEV1 and PEFR when compared with workers with BMI<25kg/m2. Also there was significant (<0.05) negative correlation between BMI and PEFR in both exposed group and non exposed group of a textile mill.Conclusion: Workers in textile mill, with short term exposure of cotton dust may also present with respiratory alterations which may increase with long term exposure. Safety controls such as ventilation, etc and routine health check are very much required in textile industries.Keywords: Peak expiratory flow rate, Body mass index, Textile mill.  Â

Comparison of biochemical and anthropometric parameters in complicated and uncomplicated severe acute malnutrition among children aged 6 to 59 months: a cross-sectional study

Aim: The frequency of severe acute malnutrition (SAM) is the highest in India. Although it should receive more attention, severe anemia is one of the comorbidities that increases mortality in children who are severely undernourished. In SAM children, the liver function test (LFT), kidney function test (KFT), and complete blood count (CBC) are deranged, but their correlation with the prognosis is not well defined. The aim was to describe the anthropometric assessment and biochemical profile of children with SAM. Methods: This cross-sectional cohort study was performed at the Departments of Paediatrics and Biochemistry at G.S.V.M. Medical College, Kanpur, and at the Department of Biotechnology at Amity University Rajasthan, Jaipur. One hundred and six patients with SAM were enrolled; 53 were grouped as complicated SAM (Group 1) (dehydration and severe dehydration) and 53 were diagnosed as non-complicated SAM (Group 2). Results: Group II had significantly higher mean values for height, weight, mid-upper arm circumference (MUAC), head circumference, and body mass index (BMI) for age percentile compared to Group I, with P-values of 0.001. Group I had a significantly lower level of hemoglobin (8.86 g/dL ± 2.21 g/dL) compared to Group II (10.0 g/dL ± 1.83 g/dL) with a P-value of 0.003. The difference in the frequency of anemia between the groups was statistically significant, with a P-value of 0.026. Anemia significantly increased the risk of complicated SAM with an odds ratio of 2.60 [95% confidence interval (CI), 1.07–6.31, P = 0.001]. Conclusions: This study suggests that there may be a significant relationship between anemia and the development of complications in high-risk children with SAM

Reactive Glia in the Injured Brain Acquire Stem Cell Properties in Response to Sonic Hedgehog

SummaryAs a result of brain injury, astrocytes become activated and start to proliferate in the vicinity of the injury site. Recently, we had demonstrated that these reactive astrocytes, or glia, can form self-renewing and multipotent neurospheres in vitro. In the present study, we demonstrate that it is only invasive injury, such as stab wounding or cerebral ischemia, and not noninvasive injury conditions, such as chronic amyloidosis or induced neuronal death, that can elicit this increase in plasticity. Furthermore, we find that Sonic hedgehog (SHH) is the signal that acts directly on the astrocytes and is necessary and sufficient to elicit the stem cell response both in vitro and in vivo. These findings provide a molecular basis for how cells with neural stem cell lineage emerge at sites of brain injury and imply that the high levels of SHH known to enter the brain from extraneural sources after invasive injury can trigger this response

Directing Astroglia from the Cerebral Cortex into Subtype Specific Functional Neurons

Forced expression of single defined transcription factors can selectively and stably convert cultured astroglia into synapse-forming excitatory and inhibitory neurons