Emergency peripartum hysterectomy at a tertiary care hospital: analysis of epidemiology, clinical profile, indications and outcome

Background: Peripartum hysterectomy is a life-saving obstetric procedure that is performed at the time of a caesarean section or postpartum following either vaginal delivery or caesarean section. The purpose of the present study was to determine the incidence, risk factors ,indications ,maternal and neonatal morbidity, mortality and complications  of emergency peripartum  hysterectomy performed at a tertiary teaching hospital in South India and to compare the results with other reports in literature.Methods: During the period of study between January 2015-December 2016, there were 50 cases of emergency peripartum hysterectomy at Tirunelveli medical college hospital, Tirunelveli, Tamil Nadu, South India. Medical, pathology and operation theatre records were analyzed retrospectively. Details of maternal age, parity, booking status, underlying risk factors, past obstetric history, gestational age at delivery ,mode of delivery ,indications for emergency peripartum hysterectomy, type of operation, intraoperative and post-operative complications, blood components transfusion ,maternal and neonatal  outcomes were noted and analyzed.Results: During the 2-year study period there were 50 emergency peripartum hysterectomy out of 14,363 deliveries, a rate of 1 per 294 deliveries (3.4/1000 deliveries). 80% of hysterectomies were performed after caesarean delivery and 20%  after vaginal delivery. The two major indications were abnormal placentation (40%) and uterine atony (28%). There were 6 maternal deaths among patients who underwent emergency peripartum hysterectomy during the period of study.Conclusions: Improved antenatal care, correction of anaemia, identification of risk factors for peripartum hysterectomy, timely referral, expedite management, timely decision, availability and liberal use of blood components and appropriate management of post-operative complications by experienced clinical team are the main stay for saving maternal lives. With increasing rate of caesarean section there is rise in the incidence of abnormal placentation

Asymptomatic bacteriuria in early pregnancy: an analysis

Background: Asymptomatic bacteriuria is defined as greater than 100,000 organisms in the urine of a person who lacks symptoms. The objective of present study was to find out the prevalence of asymptomatic bacteriuria (ASB) in women attending the antenatal OPD in a tertiary care centre and to study the effect of screening and treatment on maternal and fetal outcome.Methods: The study was conducted at OG Department, Tirunelveli Medical College Hospital over a period of ten months from March 2014 to Dec. 2014. Antenatal women at 12-16 weeks were screened by collecting clean catch midstream urine samples and doing routine urine analysis, culture/sensitivity and colony count. Treatment was given to all bacteriaurics with oral cephalexin and for persistent cases with Inj. gentamycin. Repeat culture was done at second and third trimesters.Results: In this study, the incidence of ASB was found to be 10.8%. It was more common among primi gravida (13.98%) and the incidence was found to be high in low socio economic groups (12.4%). In present study E. coli was 88.88%, Klebsiella 7.4% and Staphylococcus aureus 3.7%. Anemia was found in 37.04% of bacteriurics, preeclampsia in 7.4%, preterm delivery in 14.82% and low birth weight in 18.5% of bacteriurics.Conclusions: Treatment of ASB during pregnancy at the first antenatal visit decreases the incidence of preeclampsia, premature delivery, low-birth weight and perinatal mortality

PREVALENCE OF HEPATITIS B VIRUS AND ASSOCIATED RISK FACTORS IN IRULA TRIBAL POPULATION

 Objective: The study is to analyze the prevalence of infections caused by hepatitis B virus (HBV), and to analyze of risk factors for hepatitis B surface antigen (HBsAg) transmission among the Irula tribes of Tamil Nadu.Methods: Serum samples were collected from 350 participants of Irula tribes from 15 different locations of Tamil Nadu. All serum samples were tested for serological markers of HBV (HBsAg) by 3rd generation enzyme-linked immunosorbent assay kit, and the data were subjected to analyze using SPSS (version 17.0) and Chi-square test to determine the risk factors of HBV among Irula tribes.Results: In the study, HBsAg positivity was observed in a higher percentage in males 10 (8.47%) than females 9 (3.54%) and their all age groups indicate the high prevalence of HBV infection in Irula tribes. Analysis of risk factors showed that jaundice in family (JF), tattooing, series of injection, sexual promiscuity, and surgery with blood transfusion plays a major role in transmission in spread of HBV.Conclusion: Hepatitis B is a major health problem in Irula tribes and needs to design intervention strategies among Irula tribal population

The impact of maternal obesity on maternal and fetal outcome

Background: Obesity continues to be a global health concern. Although the increasing obesity rates in developed countries has slowed down in the past 10 years, obesity rates in developing countries continue to increase, as much as three times in some developing countries over the past 30 years. The aim of the study was to determine the adverse effects of obesity in pregnancy and maternal and fetal outcome.Methods: In all patients, a detailed history was taken and examinations and investigations were carried out.  Based on BMI (body mass index), patients were divided into 2 groups. Group 1 = patients with BMI >30 kg/m2 and Group 2 = patients with BMI 30 kg/m2 and normal BMI, authors found that the prevalence of maternal and fetal complications was higher in the obese group. Prevalence of antenatal complications like gestational hypertension, preeclampsia, imminent eclampsia and gestational diabetes mellitus requiring control with insulin was higher in obese women.Conclusions: Obesity is associated with increased adverse effects on pregnancy and its outcome

FisHook -- An Optimized Approach to Marine Specie Classification using MobileNetV2

Marine ecosystems are vital for the planet's health, but human activities such as climate change, pollution, and overfishing pose a constant threat to marine species. Accurate classification and monitoring of these species can aid in understanding their distribution, population dynamics, and the impact of human activities on them. However, classifying marine species can be challenging due to their vast diversity and the complex underwater environment. With advancements in computer performance and GPU-based computing, deep-learning algorithms can now efficiently classify marine species, making it easier to monitor and manage marine ecosystems. In this paper, we propose an optimization to the MobileNetV2 model to achieve a 99.83% average validation accuracy by highlighting specific guidelines for creating a dataset and augmenting marine species images. This transfer learning algorithm can be deployed successfully on a mobile application for on-site classification at fisheries

Production and characterization of antimicrobials from isolate Pantoea agglomerans of Medicago sativa plant rhizosphere soil

Due to rise in drug resistance among pathogens, there is always an urge to look for new drug alternatives. So in this study we aimed to identify the unexplored rhizosphere microflora of alfalfa plant for new antimicrobials. With initial screening for isolates from rhizosphere region for antibacterial activity against selected bacterial pathogens, the isolate AL10 had better activity selected for this study. The isolate mass was cultured and secondary metabolites were extracted using ethyl acetate and subjected to FTIR and GC-MS analysis. Based on functional diversity analysis, the isolate subjected to anti-bacterial activity revealed significant activity against Streptococcus pneumonia, Klebsiella, S. aureus with zone of inhibition in the range of18-20 mm. Based on GC-MS analysis report ten compounds were identified and 1-Octadecane and 1-nonadecanol were found to be responsible for bio-activity. FT-IR results showed that N-H stretching functional group was dominantly present in the extract. Molecular identification of the isolate by 16S rRNA sequencing showed the isolate as Pantoea agglomerans. The results showed that the isolate P.agglomerans, gram negative bacteria had wide antibacterial activity due to 1-Octadecane and 1-nonadecanol. Though Alfalfa plant has been described for various biological activities, this is a first report on rhizosphere region of plant reporting for antibacterial potential microbes

FASTRA – SAFE AND SECURE

The innovative congestion control algorithm named FASTRA (Fast Active Stability TCP) is aimed for high-speed long-latency networks. Four major difficulties in FASTRA are highlighted at both packet and flow levels. The architecture and characterization of equilibrium and stability properties of FASTRA are robust. Experimental results of FASTRA outsmart TCP Reno, HSTCP, and STCP in terms of throughput, fairness, stability, and responsiveness. FASTRA aims to rapidly stabilize high-speed long-latency networks into steady, efficient and fair operating points, in dynamic sharing environments, and the preliminary results are produced as output of our project. The Proposed architecture is explained with the help of an existing real-time example as to explain why FASTRA download is chosen rather than FTP download. The Paper is concluded with the results of the new congestion control algorithm aided with the graphs obtained during its simulation in NS2. On proper implementation, many safe, FASTRA downloads and data transfers can be carried over a high speed internet network

GC-MS analysis of yellow pigmented Macrococcus equipercicus isolated from alfalfa rhizosphere soil fields of Coimbatore

The rhizosphere of plant possesses important microflora, which secretes wide chemical compounds including secondary metabolites necessary for plant growth and development. The microbial flora of alfalfa plant rhizosphere soil region was explored for functional activity and we found upto ten different pigmented colonies. Due to good functional diversity, this yellow pigmented colony was taken for further studies. Thus, the culture was molecularly characterized and identified for potent bioactive components responsible for antimicrobial activity. The selected culture mass was cultured and secondary metabolites were produced and extracted using ethyl acetate and subjected to GC-MS analysis. The antimicrobial study revealed selective activity against Streptococcus pneumonia, and Proteus sp with zone of inhibition to be 18 and 20 mm respectively.  Molecular identification of the isolate by 16S rRNA sequencing showed the isolate as Macrococcus equipercicus with 100 % similarity. Based on GC-MS analysis report 25bioactive compounds were identified and 13-docosenamide, hexadecanoic acid esters and quercetin were found in ethyl acetate extract. Conclusion: Thus the yellow pigmented gram positive cocci M.equipercicus isolated from Medicago sativa possessed wide antibacterial activity due to presence of quercetin. Through the studies, we were able to identify potent antibacterial compound producing bacteria from M. sativa plant rhizosphere soil

Diagnostic efficiency of single source dual energy CT in differentiating adrenal adenoma from adrenal metastasis

Background: The distinction between incidental adrenal lesions is still difficult in diagnostic imaging whereas Dual energy CT has not been thoroughly tested for its ability to diagnose adrenal lesions. This study utilizes dual energy CT to identify between the two most prevalent adrenal neoplasms, adrenal metastasis and adrenal adenomas.Objective:To evaluate the efficacy of non-enhanced single-source dualenergy computed tomography (ssDECT) in differentiating metastases from adenomas in adrenal glands Materials and methods :This is a retrospective study conducted in the department of radio diagnosis of Mysore medical college and research institute after receiving the approval from our institutional ethical committee.A total of fifty six patients (32 men,24 women) with 31 adrenal metastases (AMs) and 32 adrenal adenomas (AAs) underwent a plain dual-energy CT imaging from March 2021 to October 2022 were included. The CT number from the virtual monochromatic spectral (VMS) image sets were measured for the AMs and AAs. The difference of CT numbers between AMs and AAs was statistically compared by P value and the box plot curve. Results: The CT number (medium, range) of metastases (50.47, 29.93 HU at 40 keV and 29.00, 9.36 HU at 140 keV) was significantly higher than that of adenomas (0.76, 33.04 to 13.73, 18.96 HU) at each energy level from 40 to 140 keV (P <.05).Conclusion: Using CT numbers obtained from virtual monochromatic images of single source dual energy CT can be used to differentiate adenomas from adrenal metastasis. The Median CT number of metastases was higher than that of adenomas at 40 Kev and 140 Kev. The median CT number of metastases decreased with increase in incident photon energy in Kev and median CT number of adenomas increased with increase in incident photon energy in Kev