Obstetric and new born outcome in HIV infected pregnant women: a prospective cohort study in Bangalore Medical College Hospitals, India

Background: The effect of HIV on obstetric complications is known to vary across regions of world. The variation may be due to HIV infection per se or it may be due to complex interaction of related medical and social conditions that affect pregnancy. Incidence of these obstetric complications in HIV infected pregnant women is not well reported in India. So, this prospective cohort study was carried to observe the demographics and incidence of obstetrics complications like abortions, still birth, premature rupture of membranes, preterm delivery, opportunistic infections in HIV infected pregnant women.Methods: All pregnant women who were screened positive for HIV test, irrespective of their gestational age were included in the study. Apart from routine obstetric care, CD4 cell count was carried out. The patients were followed up till term, delivery and up to 6-week postpartum period. Obstetric outcomes like incidence of abortion, intrauterine death, preterm delivery and premature rupture of membrane were noted. Baby`s birth weight and the incidence of maternal opportunistic infection were noted and correlated with maternal CD4 cell count.Results: Maternal HIV infection is associated pre-term labour in 34.5%, PROM in 30%, low birth weight in 52.3%. Increased incidences of these adverse outcomes have an inverse relationship with CD4 count.Conclusions: Maternal HIV infection is associated with increased incidence of adverse obstetric outcome and opportunistic infection, and their incidences increase with lower CD4 count

EFFICACY OF SUPPLEMENTATION OF PROBIOTICS ALONG WITH ANTIMICROBIAL AGENTS IN VULVOVAGINAL INFECTIONS IN A TERTIARY CARE HOSPITAL

Objectives: The objectives of the study were to ascertain the efficacy of probiotics along with antimicrobials in the treatment of vulvovaginitis and to evaluate the rate of recurrence. Methods: The study was done on 60 patients who were randomly selected and divided into two groups of 30 each. Prior permission from the Institutional Ethics Committee and higher authorities was obtained before conducting the study. One group received standard treatment including antibacterial, antiviral, and antifungal as per the gynecologist discretion and in other group along with standard treatment, probiotic capsules containing combination of Saccharomyces boulardii, Lactobacillus sporogenes (50 million), Streptococcus faecalis (30 million), Clostridium butyricum (2 million), and Bacillus mesentericus (1 million) given orally twice daily and followed up for a period of 3 months. The drugs were started on the 5th day after menstruation taking starting of the bleeding as day 1. Results: The parameters compared were symptoms and signs (significantly reduced – p-value), clue cells (significantly reduced in number), and recurrence rates (significantly reduced), in 80% of patients smears which were not consistent with BV. Maximum number of patients showed negative KOH mount (71.5%), saline wet mount was negative in 80% of patients in antimicrobial agents + probiotics group. Conclusion: From the present interventional study, probiotics along with antimicrobial agents showed better improvement than antimicrobial agents alone. Hence, supplementation of probiotics along with antimicrobial agents provides better efficacy than antimicrobial agents alone in treating vulvovaginal infections

Clinical outcomes after joint surgery in patients on turoctocog alfa pegol (N8-GP) prophylaxis: a post hoc analysis

Introduction Joint damage in haemophilia often requires surgical correction. However, the surgery effect on bleeding rates and other clinical joint outcomes can be unclear. Aim To investigate the effects of joint surgery on joint annualized bleeding rates (JABRs) and physical health outcomes in patients with haemophilia A undergoing N8-GP prophylaxis. Methods Patients in the pathfinder 2 trial received N8-GP prophylaxis, enrolling in the pathfinder 3 trial for indicated surgery. Patients returned to pathfinder two post-surgery, continuing N8-GP prophylaxis until end-of-trial. JABRs were calculated from bleeding across all joints for pre-surgery (immediately before surgery) and post-surgery (to pathfinder 2 study end) periods. Joint-health-related outcomes were derived from patient records. Results Data (41 joint surgeries; n = 30) were analysed statistically using datamining and descriptively. Pre-surgery mean JABR was higher in patients who later were operated than in 146 non-operated patients (p = .004). In operated patients, mean JABR decreased from 1.33 pre-surgery to .37 post-surgery (p = .011). In all but three patients, JABR improved or remained the same post-surgery. In the three patients whose JABR remained at one (all with multiple joint arthropathy), post-surgery bleeds were mostly at non-operated sites. Two of the three patients whose JABR increased post-surgery had undergone surgery for reasons unlikely to improve JABR. Mobility parameters often improved in patients whose JABR remained at zero. Conclusion Patients with haemophilia treated with N8-GP prophylaxis benefit from surgeries. However, this analysis could not differentiate the relative contributions of surgical interventions and prophylactic treatment to the improvement of JABR

Burden of Neurological Disorders across the US from 1990-2017: A Global Burden of Disease Study

Importance: Accurate and up-to-date estimates on incidence, prevalence, mortality, and disability-adjusted life-years (burden) of neurological disorders are the backbone of evidence-based health care planning and resource allocation for these disorders. It appears that no such estimates have been reported at the state level for the US. Objective: To present burden estimates of major neurological disorders in the US states by age and sex from 1990 to 2017. Design, Setting, and Participants: This is a systematic analysis of the Global Burden of Disease (GBD) 2017 study. Data on incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of major neurological disorders were derived from the GBD 2017 study of the 48 contiguous US states, Alaska, and Hawaii. Fourteen major neurological disorders were analyzed: stroke, Alzheimer disease and other dementias, Parkinson disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, traumatic brain injury, spinal cord injuries, brain and other nervous system cancers, meningitis, encephalitis, and tetanus. Exposures: Any of the 14 listed neurological diseases. Main Outcome and Measure: Absolute numbers in detail by age and sex and age-standardized rates (with 95 uncertainty intervals) were calculated. Results: The 3 most burdensome neurological disorders in the US in terms of absolute number of DALYs were stroke (3.58 95% uncertainty interval UI], 3.25-3.92] million DALYs), Alzheimer disease and other dementias (2.55 95% UI, 2.43-2.68 million DALYs), and migraine (2.40 95% UI, 1.53-3.44 million DALYs). The burden of almost all neurological disorders (in terms of absolute number of incident, prevalent, and fatal cases, as well as DALYs) increased from 1990 to 2017, largely because of the aging of the population. Exceptions for this trend included traumatic brain injury incidence (-29.1% 95% UI, -32.4% to -25.8%); spinal cord injury prevalence (-38.5% 95% UI, -43.1% to -34.0%); meningitis prevalence (-44.8% 95% UI, -47.3% to -42.3%), deaths (-64.4% 95% UI, -67.7% to -50.3%), and DALYs (-66.9% 95% UI, -70.1% to -55.9%); and encephalitis DALYs (-25.8% 95% UI, -30.7% to -5.8%). The different metrics of age-standardized rates varied between the US states from a 1.2-fold difference for tension-type headache to 7.5-fold for tetanus; southeastern states and Arkansas had a relatively higher burden for stroke, while northern states had a relatively higher burden of multiple sclerosis and eastern states had higher rates of Parkinson disease, idiopathic epilepsy, migraine and tension-type headache, and meningitis, encephalitis, and tetanus. Conclusions and Relevance: There is a large and increasing burden of noncommunicable neurological disorders in the US, with up to a 5-fold variation in the burden of and trends in particular neurological disorders across the US states. The information reported in this article can be used by health care professionals and policy makers at the national and state levels to advance their health care planning and resource allocation to prevent and reduce the burden of neurological disorders.. © 2021 American Medical Association. All rights reserved

Segmentation of mango region from mango tree image

In this paper we propose a novel framework for segmentation of mango regions from its tree image. The proposed framework consists of mango localization followed by mapping of boundary information to the located region for segmentation. Initially thresholding is applied to each individual color band R,G and B by adaptive thresholding and later they are combined back. Application of smoothing and binarization to the combined image gives the location of mangoes along with noise. The texture features are extracted from each location then matched with template stored in the database to eliminate the noisy regions. Finally, locations of the mangoes are obtained and edge information is superimposed on to those locations for segmentation. An experiment is performed on our own dataset and efficiency is evaluated by computing the precision, recall and F-measure with respect to the human segmented images considering as a ground truth

Tribology and Mechanical Properties of Carbon Fabric/MWCNT/Epoxy Composites

Cryogenic treated multilayered carbon fabric/oxidized multiwall carbon nanotube/epoxy (CCF/O-MWCNT/E) composite and untreated carbon fabric/epoxy (CF/E) composite were prepared by hot compression molding technique. The density and mechanical properties such as tensile properties, flexural properties, interlaminar shear strength, and microhardness of the composites were investigated as per ASTM standards. The wear and coefficient of friction behavior were investigated using computer interfaced pin-on-disc test rig at room temperature for varied load and sliding speed. The morphology of worn surfaces of the wear test composite specimens were studied by scanning electron microscope. It is found that the synergetic effect of addition of O-MWCNT to epoxy matrix and cryogenic treatment of carbon fabric improved the wear resistance and mechanical properties. Also, a thin lubricating film developed by the oxidized multiwall carbon nanotube/epoxy wear debris reduces the coefficient of sliding friction and wear rate

Sliding wear, mechanical, flammability, and water intake properties of banana short fiber/Al(OH)3/epoxy composites

Banana short fiber/Al(OH)3/epoxy composite laminates were prepared by dispersing short banana fiber and Al(OH)3 particulates in an epoxy matrix and investigated for their specific wear rate, water intake, flammability and mechanical properties. The sliding wear results showed that due to the synergistic effect of both fiber and filler in epoxy matrix enhanced the wear resistant in the composites. Similarly, the tensile stress and hardness improved significantly due to the addition of banana fiber in the composite material. Also, it is found that the composite becomes more fire resistant due to the addition of Al(OH)3. However, the higher percentage of fiber and filler increases the water absorption rate due to voids in the composite. The results of this study provide the insights of solid–solid interface leading to different bulk properties

Analgesic activity of new synthetic thiazolidine-4-ones derivatives

812-815Ten new synthetic thiazolidine-4-ones derivatives (5 chlorothiazolidine-4-ones, 3 methoxythiazolidine-4-ones and 2 hydoxythiazolidine-4-ones) having different substituents at R1, R2 and R3 were evaluated for their analgesic activity using different animal models and their structure activity relationship was also elucidated. Chlorothiazolidine-4-ones and methoxythiazolidine-4-ones exhibited analgesic activity in tail flick test, tail immersion test and acetic acid writhing test. C-III (chloride substituents at R1 and R2) produced higher latencies than any other compounds in tail flick test and C-I (no substituents at R1 and R2) was not effective in acetic acid writhing test. Hydroxythiazolidine-4-ones did not show analgesic activity in any of the animal models used. In conclusion, the character of substituents at R3 of thiazolidine moiety position may have an effect on the analgesic activity of thiazolidine-4-ones and either chloride or methoxy substitution may be necessary to produce analgesic activity. Two chloride substituents in a compound may increase the central analgesic activity of the compound