A comparative study of maternal outcome between vacuum extraction and outlet forceps delivery

Background: Instrumental delivery is an art that is fading and may disappear in the near future as more and more obstetricians are resorting to caesarean sections. Instrumental vaginal deliveries comprise the use of vacuum assisted devices and /or forceps to assist in delivering a fetus, offering the alternative to accomplish vaginal delivery in properly selected cases thereby reducing maternal morbidity in terms of blood loss and increase hospital stay which is a consequence of cesarean sections. The objective of the present study is to compare the maternal morbidity with vacuum and outlet forceps delivery.Methods: A prospective comparative study was conducted in women delivering at department of obstetrics and gynaecology, in SDUMC, R L Jalappa Hospital, Kolar from March 2016 - March 2017 for a period of one year. A minimum of 180 patients were taken up for study. 90 women delivered by outlet forceps delivery and 90 women by vacuum delivery. Cases which require instrumental vaginal delivery and fulfilling the inclusion criteria for forceps or vacuum were taken up for the study, after taking informed consent. Maternal outcomes including episiotomy wound and extension, perineal tear, post-partum hemorrhage, hospital stay was analyzed and compared.Results: Mostly forceps and vacuum were applied for age group of 26-30 years and primigravida, which showed a statistical significance. Extension of episiotomy was more with forceps that is 21.1% and with vacuum being 4.4%. This difference was statistically significant. Postpartum hemorrhage was also more common in forceps group that is 13.3%compared to vacuum 11.1% but the difference was not statistically significant. The need for blood transfusion was seen more in cases of forceps that is 11.1% cases whereas in vacuum i.e. 6.7% cases but was not statistically significant.Conclusions: With the expertise and appropriate decision on the indication and meticulous handling of the instrument whether outlet forceps or vacuum, especially in a tertiary care centre, the maternal outcome is equally good with both the instruments

COFORMER SELECTION: AN IMPORTANT TOOL IN COCRYSTAL FORMATION

Cocrystals are multicomponent system in which one component is Active Pharmaceutical Ingredient (API) and another is called coformer. So coformer selection is one of the main challenge in cocrystal development which is compatible with API. A general approach to coformer selection is by tactless†cocrystal screening, whereby a predetermined library of pharmaceutically acceptable/approved compounds is used to attempt cocrystallization. In cocrystal development one of the approach of coformer selection is based on trial and error. Other approaches are supramolecular synthon approach which utilizes Cambridge Structural Database (CSD) to effectively prioritize coformers for crystal form screening, Hansen solubility parameter and knowledge of hydrogen bonding between coformer and API. In this review, all the parameters are explain and correlate with each other and with cocrystal formatio

Septate uterus: incidental finding in multiparous woman with breech with bad obstetric history who had an emergency caesarean

The most common anomalies of reproductive tract are Mullerian duct anomalies, among which septate uterus is the commonest with highest reproductive failure rate. As there are some pitfalls in diagnosis therefore the incidence is difficult to be mentioned as many remain asymptomatic. A 20 year old G5P1L0A3 with 36+4 weeks of gestation with breech presentation in active labour came to our hospital. Patient had previous history of intrauterine death at 8 months of amenorrhea and previous abortions at 5, 5 and 4 months of amenorrhoea in the year 2011, 2013, and 2014 respectively. She underwent emergency caesarean section due to breech at 36+4 weeks in active labour with the delivery of a live late preterm female baby extracted by complete breech of weight 2.28kgs with bilateral CTEV of the baby. Intraoperative findings- of septate uterus–septum extending from fundus to external os, fundal dimpling present. Though rare but uterine anomalies should be suspected in patients with recurrent pregnancy loss, preterm birth and malpresentation

WSU Liverpool City Campus Crèche Evaluation Report: Untold Stories of Student Parents

In Australia, being a working and/or studying parent can be isolating, stressful and challenging, especially for those student parents with limited or no access to family and formal childcare support. This report presents findings from an evaluation of the pilot creche care model implemented at the Western Sydney University (WSU) Liverpool city campus. The model presents as an alternative form of childcare support for student parents and faculty at WSU. The report demonstrates that the creche care model does not only improve student parents' overall university experience and study outcomes, but it also has the potential of mitigating isolation through the creation of a community of student parents with similar lived experiences

Patient perceptions of oral health care following stroke : a qualitative study

Background: Stroke is a serious cerebrovascular disease and is one of the world’s leading causes of disability. Maintaining good oral health is a challenge among those hospitalised after stroke. A multidisciplinary approach to oral care involving non-dental professionals can be beneficial in improving oral health outcomes for patients. The aim of this study was to understand the perceptions of stroke survivors regarding oral healthcare across acute and rehabilitation settings. Methods: A descriptive qualitative approach was used. Face-to-face semi-structured interviews were conducted. A framework analysis was employed to analyse the data. Patients who had recently experienced a stroke were purposively recruited across both acute and rehabilitation settings, at two metropolitan hospitals in Sydney, Australia. In total, 11 patients were interviewed. Results: Although participants recognised the importance of oral health, few understood the link between oral and general health. Regular oral hygiene practices varied since having stroke, with a few receiving oral care assistance from nurses. Time, cost and lack of information were some barriers to accessing dental services, while supportive measures such as coordination of oral care, financial subsidy and nurse assistance were strategies proposed to support oral care practices amongst stroke survivors. Conclusions: There is scope to improve current models of oral care in stroke. While stroke survivors understand the importance of oral care, an integrated oral health model with a multidisciplinary approach could improve health outcomes

Diabetes reversal by inhibition of the low-molecular-weight tyrosine phosphatase.

Obesity-associated insulin resistance plays a central role in type 2 diabetes. As such, tyrosine phosphatases that dephosphorylate the insulin receptor (IR) are potential therapeutic targets. The low-molecular-weight protein tyrosine phosphatase (LMPTP) is a proposed IR phosphatase, yet its role in insulin signaling in vivo has not been defined. Here we show that global and liver-specific LMPTP deletion protects mice from high-fat diet-induced diabetes without affecting body weight. To examine the role of the catalytic activity of LMPTP, we developed a small-molecule inhibitor with a novel uncompetitive mechanism, a unique binding site at the opening of the catalytic pocket, and an exquisite selectivity over other phosphatases. This inhibitor is orally bioavailable, and it increases liver IR phosphorylation in vivo and reverses high-fat diet-induced diabetes. Our findings suggest that LMPTP is a key promoter of insulin resistance and that LMPTP inhibitors would be beneficial for treating type 2 diabetes

RNAi phenotype profiling of kinases identifies potential therapeutic targets in Ewing's sarcoma

<p>Abstract</p> <p>Background</p> <p>Ewing's sarcomas are aggressive musculoskeletal tumors occurring most frequently in the long and flat bones as a solitary lesion mostly during the teen-age years of life. With current treatments, significant number of patients relapse and survival is poor for those with metastatic disease. As part of novel target discovery in Ewing's sarcoma, we applied RNAi mediated phenotypic profiling to identify kinase targets involved in growth and survival of Ewing's sarcoma cells.</p> <p>Results</p> <p>Four Ewing's sarcoma cell lines TC-32, TC-71, SK-ES-1 and RD-ES were tested in high throughput-RNAi screens using a siRNA library targeting 572 kinases. Knockdown of 25 siRNAs reduced the growth of all four Ewing's sarcoma cell lines in replicate screens. Of these, 16 siRNA were specific and reduced proliferation of Ewing's sarcoma cells as compared to normal fibroblasts. Secondary validation and preliminary mechanistic studies highlighted the kinases STK10 and TNK2 as having important roles in growth and survival of Ewing's sarcoma cells. Furthermore, knockdown of STK10 and TNK2 by siRNA showed increased apoptosis.</p> <p>Conclusion</p> <p>In summary, RNAi-based phenotypic profiling proved to be a powerful gene target discovery strategy, leading to successful identification and validation of STK10 and TNK2 as two novel potential therapeutic targets for Ewing's sarcoma.</p