A comparison of visual analog scale and Wong Baker facial pain scale for pain measurement in post lower caesarean section case

Background: There is various pain measurement tools commonly used to measure pain intensity. However, no single standard exists for quantifying pain in post caesarean section. In our study, we have divided two groups according to use of pain scales and found one scale is more useful than the other in the post caesarean cases.Methods: The study has been conducted in upper India Sugar Exchange Maternity Hospital department of obstetrics and gynaecology, GSVM Medical College, Kanpur for the duration of 18 months starting from February 2014 to August 2015 on 100 women who were operated for lower caesarean section (LSCS) under spinal anesthesia. Women were divided into two groups according to pain scales visual analog scale (VAS) and Wong Baker facial pain scale (WBFPS). All these selected women were studied in details with regards to clinical history, general examination and local examination. Women from respective group were asked to rate their pain intensity on these pain scales. SPSS was used to analyze the data statistically.Results: Using analysis of variance, we found that there is significant relationship within the groups having different parameters at different time interval at different probability level. There is a mutual relationship between the groups at different probability level.Conclusions: The study shows that VAS is the most sensitive and reliable tool to measure post LSCS pain as compared to WBFPS and minimum consumption of rescue analgesia in VAS group to maintain minimum pain score to keep the patient pain free

Endometrial stromal sarcoma together with leiomyosarcoma in a single patient: a rare case report

Uterine sarcomas are relatively rare tumors of mesodermal origin. The three most common histological variants of uterine sarcoma are Leiomyosarcomas, Endometrial stromal sarcomas, and Carcinosarcomas. It is extremely uncommon to find the 2 variants in a single patient. Given the rarity of these tumors there are limited reports in the literature referring to the clinical management and final outcome of these cases. Our patient was a 60 year old post-menopausal women presented in the opd with post-menopausal bleeding. Ultrasound report showed a fibroid of around 8 by 8 cm fundal fibroid. Endometrial biopsy report showed low grade endometrial sarcoma while the CECT report showed leiomyosarcoma creating a dilemma in the diagnosis. Patient was then taken up for surgical exploration. The biopsy report confirmed the existence of both the types of tumor, a very rare finding

Remote preconditioning by aortic constriction: affords cardioprotection as classical or other remote ischemic preconditioning? Role of iNOS

Dose remote preconditioning by aortic constriction (RPAC) affords cardioprotection similar to classical or other remote ischemic preconditioning stimulus? Moreover study was also designed to investigate role of inducible nitric oxide synthase in remote preconditioning by aortic constriction. There are sufficient evidences that "ischemic preconditioning" has surgical applications and afford clinically relevant cardioprotection. Transient occlusion of circumflex artery, renal artery, limb artery or mesenteric artery preconditions the myocardium against ischemia reperfusion injury in case of ischemic heart disease leading to myocardial infraction. Here abdominal aorta was selected to produce RPAC. Four episodes of Ischemia-reperfusion of 5 min each to abdominal aorta produced RPAC by assessment of infract size, LDH and CK. These studies suggest RPAC produced acute (FWOP) and delayed (SWOP) cardioprotective effect. RPAC demonstrated a significant decrease in Ischemia-reperfusion induced release of LDH, CK and extent of myocardial infract size. L-NAME (10 mg/Kg i.v.), Aminoguanidine (150 mg/Kg s.c.), Aminoguanidine (300 mg/Kg s.c.), S-methyl isothiourea (3 mg/Kg i.v.), 1400W (1 mg/Kg i.v.) administered 10 min. before global ischemia reperfusion produced no marked effect. Aminoguanidine (150 mg/Kg s.c.), Aminoguanidine (300 mg/Kg s.c.), S-methyl isothiourea (3 mg/Kg i.v.), 1400W (1 mg/Kg i.v.) pretreatment after RPAC produced no significant effect on acute RPAC induced decrease in LDH, CK and infract size, whereas L-NAME (10 mg/Kg i.v.) increased RPAC induced decrease in LDH, CK and infract size. Most interesting observation is in delayed RPAC, where all NOS inhibitors pretreatment attenuate RPAC induced decrease in LDH, CK and infract size. In conclusions, "Remote preconditioning by aortic constriction" (RPAC) affords cardioprotection similar to classical or other remote ischemic preconditioning stimulus. Moreover, late or delayed phase of RPAC has been mediated by inducible nitric oxide synthase (iNOS) whereas it has not involved in acute RPAC

Ondansetron exposure during pregnancy is not associated with risk of congenital malformations: evidence from a meta-analysis

Ondansetron is widely used drug for treatment of morning sickness and hyperemesis gravidarum. However, whether exposure to ondansetron during pregnancy is associated with risk of congenital malformations or not remains debatable. The present meta-analysis was performed for published cohort/registry-based studies which evaluated the association between ondansetron exposure and risk of congenital malformations. Major congenital malformations were considered as the primary outcome measure. Specific abnormalities like cardiac malformation, septal defect, cleft lip/palate, hypospadias, and genitourinary abnormalities were considered as secondary outcome measures along with spontaneous abortion/miscarriage, stillbirth, preterm delivery, and low birth weight babies. Pooled analysis was done using the Mantle-Hanzle method, random effect model and were expressed as odds ratio (OR) with 95% CI. Fourteen studies were included in systematic review. There was no significant difference for major congenital malformations [n=12; OR: 1.12 (95% CI: 0.93-1.36), I2=96], septal defect [n=5; OR: 1.39 (95% CI: 1.01-1.91), I2=48%], cleft lip/palate [n=3; OR: 1.11 (95% CI: 0.80-1.53), I2=41%] between ondansetron exposed and control arms. However, a greater number of events were found in control arm than intervention arm for cardiac defect [n=7; OR: 1.26 (95% CI: 1.09-1.45), I2=71%; p=0.002]. We also observed a greater number of events for stillbirth and pre-term labour in control arm than in intervention arm with OR: 1.57 (95% CI: 1.24-1.97); p=0.0001 and OR: 1.33 (95% CI: 1.05-1.69); p=0.02, respectively. This meta-analysis concludes that ondansetron exposure during pregnancy is not associated with any increased risk of major congenital malformations, septal /cardiac defect, cleft lip/palate, spontaneous abortion/miscarriage, stillbirth, pre-term labour and low birth weight babies

MADS-box gene family in rice: genome-wide identification, organization and expression profiling during reproductive development and stress

<p>Abstract</p> <p>Background</p> <p>MADS-box transcription factors, besides being involved in floral organ specification, have also been implicated in several aspects of plant growth and development. In recent years, there have been reports on genomic localization, protein motif structure, phylogenetic relationships, gene structure and expression of the entire MADS-box family in the model plant system, <it>Arabidopsis</it>. Though there have been some studies in rice as well, an analysis of the complete MADS-box family along with a comprehensive expression profiling was still awaited after the completion of rice genome sequencing. Furthermore, owing to the role of MADS-box family in flower development, an analysis involving structure, expression and functional aspects of MADS-box genes in rice and <it>Arabidopsis </it>was required to understand the role of this gene family in reproductive development.</p> <p>Results</p> <p>A genome-wide molecular characterization and microarray-based expression profiling of the genes encoding MADS-box transcription factor family in rice is presented. Using a thorough annotation exercise, 75 MADS-box genes have been identified in rice and categorized into MIKC^c, MIKC*, Mα, Mβ and Mγ groups based on phylogeny. Chromosomal localization of these genes reveals that 16 MADS-box genes, mostly MIKC^c-type, are located within the duplicated segments of the rice genome, whereas most of the M-type genes, 20 in all, seem to have resulted from tandem duplications. Nine members belonging to the Mβ group, which was considered absent in monocots, have also been identified. The expression profiles of all the MADS-box genes have been analyzed under 11 temporal stages of panicle and seed development, three abiotic stress conditions, along with three stages of vegetative development. Transcripts for 31 genes accumulate preferentially in the reproductive phase, of which, 12 genes are specifically expressed in seeds, and six genes show expression specific to panicle development. Differential expression of seven genes under stress conditions is also evident. An attempt has been made to gain insight into plausible functions of rice MADS-box genes by collating the expression data of functionally validated genes in rice and <it>Arabidopsis</it>.</p> <p>Conclusion</p> <p>Only a limited number of MADS genes have been functionally validated in rice. A comprehensive annotation and transcriptome profiling undertaken in this investigation adds to our understanding of the involvement of MADS-box family genes during reproductive development and stress in rice and also provides the basis for selection of candidate genes for functional validation studies.</p

Females with paired occurrence of cancers in the UADT and genital region have a higher frequency of either Glutathione S-transferase M1/T1 null genotype

Upper Aero digestive Tract (UADT) is the commonest site for the development of second cancer in females after primary cervical cancer. Glutathione S-transferase (GSTM1 and / or T1) null genotype modulates the risk of developing UADT cancer (primary as well as second cancer). The aim of this study was to evaluate the difference in GST null genotype frequencies in females with paired cancers in the UADT and genital region as compared to females with paired cancers in the UADT and non-genital region. Forty-nine females with a cancer in the UADT and another cancer (at all sites-genital and non-genital) were identified from a database of patients with multiple primary neoplasms and were analyzed for the GSTM1 and T1 genotype in addition to known factors such as age, tobacco habits, alcohol habits and family history of cancer. Frequencies of GSTM1 null, GSTT1 null, and either GSTM1/T1 null were higher in females with paired occurrence of cancer in the UADT and genital site (54%, 33% and 75% respectively) in comparison to females with paired occurrence of cancer in the UADT and non-genital sites (22%, 6% and 24% respectively). The significantly higher inherited frequency of either GSTM1/T1 null genotype in females with a paired occurrence of cancers in UADT and genital region (p = 0.01), suggests that these females are more susceptible to damage by carcinogens as compared to females who have UADT cancers in association with cancers at non-genital sites

Revealing intrinsic domains and fluctuations of moir\'e magnetism by a wide-field quantum microscope

Moir\'e magnetism featured by stacking engineered atomic registry and lattice interactions has recently emerged as an appealing quantum state of matter at the forefront condensed matter physics research. Nanoscale imaging of moir\'e magnets is highly desirable and serves as a prerequisite to investigate a broad range of intriguing physics underlying the interplay between topology, electronic correlations, and unconventional nanomagnetism. Here we report spin defect-based wide-field imaging of magnetic domains and spin fluctuations in twisted double trilayer (tDT) chromium triiodide CrI3. We explicitly show that intrinsic moir\'e domains of opposite magnetizations appear over arrays of moir\'e supercells in low-twist-angle tDT CrI3. In contrast, spin fluctuations measured in tDT CrI3 manifest little spatial variations on the same mesoscopic length scale due to the dominant driving force of intralayer exchange interaction. Our results enrich the current understanding of exotic magnetic phases sustained by moir\'e magnetism and highlight the opportunities provided by quantum spin sensors in probing microscopic spin related phenomena on two-dimensional flatland

Renal control of disease tolerance to malaria

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