Towards safe motherhood to - are we moving in the right direction?: experience from an urban health facility in South India

Background: This study was designed to evaluate the institutional Maternal Mortality Ratio (iMMR) in our institution, a tertiary private medical college hospital and to suggest recommendations and possible interventions to reduce it.Methods: This retrospective descriptive study was conducted by reviewing the hospital records over a period of ten years from January 2009-December 2018. The case records were reviewed for maternal demographic characteristics and complications.Results: The total number of deaths during the study period was 21, giving an iMMR of 85.268 per 100000 live births. Most of the maternal deaths (>80%) occurred postpartum. Obstetric causes contributed to 57% of the deaths with hypertension and hemorrhage topping the list. Other causes were sepsis and non obstetric causes including one case of maternal suicide. 52.38% of the women died more than 48 hours after admission to the hospital, while 28.57% succumbed in less than six hours. Secondary complications noted were ICU admission, extended intubation, massive transfusion, operative intervention and multi organ dysfunction.Conclusions: The classical triad of Hypertension, Hemorrhage and Sepsis continues to be the major determinant of maternal mortality and are potentially preventable by promoting universal access to quality health care, strengthening of health services and ensuring accountability

Synthesis, structure and optical properties of rare-earth benzene carboxylates

Two series of rare-earth isophthalates of the general formula, [M2(H2O)] [{C6H4(COO)2}2{C6H4(COOH)(COO)}2]·H2O, M = La (I), Pr (Ia), and Nd (Ib) and [M2(H2O)2][{C6H4(COO)2}3]·H2O, M = Y (II), Gd (IIa), and Dy (IIb) have been prepared by the reaction of the corresponding trivalent lanthanide salts and isophthalic acid under mild hydrothermal conditions. The La (I), Pr (Ia) and Nd (Ib) have MO9 polyhedra connected to the isophthalate anions forming a two-dimensional structure, whereas Y (II), Gd (IIa) and Dy (IIb) have MO7 and MO8 polyhedral units connected to the isophthalate anions forming a different, but related two-dimensional structure. Both the structures are stabilized by hydrogen bonding and π···π/CH···π interactions. Partial substitution of Eu and Tb (2 and 4%) at the La (I) and Y (II) sites give rise to characteristic red/pink or green luminescence, indicating a ligand-sensitized metal-centered emission. The Nd (Ib) compound shows interesting UV and blue emission through an up-conversion process

A Case Report: Mucinous Tubular and Spindle Cell Carcinoma of Kidney with Spindle Cell Predominance Mimicking Mesenchymal Tumour

Mucinous tubular and spindle cell carcinoma (MTSCC) of kidney is a rare variant of renal cell carcinoma which was first described in the 2004 World Health Organization classification of tumours of the kidney. Morphologically, MTSCC is composed of tubules merging with bland-appearing spindle cells in a myxoid/mucinous stroma. Diverse morphological patterns have been reported in MTSCC; however, a spindle cell predominant morphology mimicking a mesenchymal tumour is rare and only two cases have been reported so far. We report a case of MTSCC with spindle cell predominance in kidney which was a diagnostic challenge. Though MTSCC usually shows an indolent course, there have been cases showing aggressive behaviour even with bland morphology. Hence, a thorough histopathological evaluation with ancillary studies are required to differentiate spindle cell predominant MTSCC from its mimics. Our case was a 40-year-old female who was incidentally found to have a well-defined hypodense lesion measuring around 2 cm in the upper pole of the right kidney. Right partial nephrectomy was performed which showed a 2.7 × 2.5 × 2 cm well-defined grey tan tumour without necrosis or haemorrhage, limited to kidney. Histopathological examination showed sheets of bland-appearing spindle cells mimicking a mesenchymal tumour. The tumour was extensively sampled, revealing small foci of tubule formation and mucinous stroma. Tumour cells were positive for CK7, AMACR, and PAX8. A final diagnosis of MTSCC was made. Hereby, we discuss ways of differentiating MTSCC from other spindle cell tumours of the kidney

The use of hydrothermal methods in the synthesis of novel open-framework materials

The preparation of inorganic compounds, exhibiting open-framework structures, by hydrothermal methods has been presented. To illustrate the efficacy of this approach, few select examples encompassing a wide variety and diversity in the structures have been provided. In all the cases, good quality single crystals were obtained, which were used for the elucidation of the structure. In the first example, simple inorganic network compounds based on phosphite and arsenate are described. In the second example, inorganic-organic hybrid compounds involving phosphite/arsenate along with oxalate units are presented. In the third example, new coordination polymers with interesting structures are given. The examples presented are representative of the type and variety of compounds one can prepare by careful choice of the reaction conditions

A study of menstrual hygiene practices and associated environmental & social factors among adolescent girls in rural Puducherry

Introduction. Adolescent females were prevented from receiving the appropriate knowledge due to social restrictions and traditional beliefs, which in turn led to poor hygiene habits. Material and methods. A community-based descriptive cross-sectional study employing a semi-structured questionnaire was carried out in the rural field practice region of MGMCRI, Puducherry, between the 15th of March 2019 and the 31st of April 2021. The study was done in Puducherry. The comprehensive enumeration yielded a total of 528 countable teenage females. Results. The vast majority of the teenage females (89.2%) reported using sanitary pads, whereas just 6.6% and 4.2%, respectively, reported using fresh or reused towels. 65.3% of the girls changed their wet absorbent between two and five times during the day. The vast majority of the girls, or 60.8% of them, disposed of their spent absorbent by either burying it or burning it. 67.9% of the girls were cleansing their genitalia when they were urinating. 54.4% of people cleaned their hands using soap and water, whereas 1.4% utilized ash soil, muddy dirt, or other types of soil. There was a statistically significant correlation between the style of housing and the availability of sanitary latrines (p<0.005) in relation to menstrual hygiene behaviors. Conclusions. This research also highlighted the absence of sanitary toilet facilities in the majority of residences, which negatively impacted the girls' ability to maintain their privacy and led to bad practices around menstruation hygiene

Sex‑specific differences in systemic immune responses in MIS‑C children

Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare manifestation of Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) infection that can result in increased morbidity and mortality. Mounting evidence describes sex disparities in the clinical outcomes of coronavirus disease 2019 (COVID-19). However, there is a lack of information on sex-specific differences in immune responses in MIS-C. This study is an observational and cross-sectional study and we wanted to examine immune parameters such as cytokines, chemokines, acute phase proteins (APPs), growth factors, microbial translocation markers (MTMs), complement components and matrix metalloproteinases (MMPs) in MIS-C children, based on sex. Male children were associated with heightened levels of pro-inflammatory cytokines—IFNγ, IL-2, TNFα, IL-1α, IL-1β, IL-6, IL-12, G-CSF and GM-CSF, chemokines-CCL2, CCL11, CXCL1, CXCL8 and CXCL10, acute phase proteins-α-2M, CRP,growth factors VEGF and TGFα, microbial translocation markers- iFABP, LBP, EndoCAb, complement components—C1q, MBL and C3 and matrix metalloproteinases MMP-8 and MMP-9 compared to female children with MIS-C. These results indicate that the heightened immune response in males is a characteristic feature of MIS-C. These findings might explain the differential disease pathogenesis in males compared to females with MIS-C and facilitate a deeper understanding of this disease

The malaria circumsporozoite protein has two functional domains, each with distinct roles as sporozoites journey from mosquito to mammalian host

Conformational changes influence functional properties of circumsporozoite protein expressed on the surface of Plasmodium sporozoites

Role of matrix metalloproteinases in multi-system inflammatory syndrome and acute COVID-19 in children

INTRODUCTION: Multisystem Inflammatory Syndrome in children (MIS-C) is a serious inflammatory sequela of SARS-CoV2 infection. The pathogenesis of MIS-C is vague and matrix metalloproteinases (MMPs) may have an important role. Matrix metalloproteinases (MMPs) are known drivers of lung pathology in many diseases. METHODS: To elucidate the role of MMPs in pathogenesis of pediatric COVID-19, we examined their plasma levels in MIS-C and acute COVID-19 children and compared them to convalescent COVID-19 and children with other common tropical diseases (with overlapping clinical manifestations). RESULTS: Children with MIS-C had elevated levels of MMPs (P < 0.005 statistically significant) in comparison to acute COVID-19, other tropical diseases (Dengue fever, typhoid fever, and scrub typhus fever) and convalescent COVID-19 children. PCA and ROC analysis (sensitivity 84–100% and specificity 80–100%) showed that MMP-8, 12, 13 could help distinguish MIS-C from acute COVID-19 and other tropical diseases with high sensitivity and specificity. Among MIS-C children, elevated levels of MMPs were seen in children requiring intensive care unit admission as compared to children not needing intensive care. Similar findings were noted when children with severe/moderate COVID-19 were compared to children with mild COVID-19. Finally, MMP levels exhibited significant correlation with laboratory parameters, including lymphocyte counts, CRP, D-dimer, Ferritin and Sodium levels. DISCUSSION: Our findings suggest that MMPs play a pivotal role in the pathogenesis of MIS-C and COVID-19 in children and may help distinguish MIS-C from other conditions with overlapping clinical presentation

Squamomelanocytic tumor of the plantar aspect of the foot: A collision tumor

Collision tumors are two cancers that coexist in the same anatomical site. The etiopathogenesis of collision tumors remains controversial. Even though collision is uncommon, the association between squamous cell carcinoma and malignant melanoma is very rare compared to basal cell carcinoma and malignant melanoma. Here, we report a case of squamous cell carcinoma with malignant melanoma which was confirmed by histopathological examination and immunohistochemistry. The patient underwent wide local excision and flap cover. This case is reported due to the rarity