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

Promoting Non-Cooperation Through Ordering

In many real world situations, like minor traffic offenses in big cities, a central authority is tasked with periodic administering punishments to a large number of individuals. Common practice is to give each individual a chance to suffer a smaller fine and be guaranteed to avoid the legal process with probable considerably larger punishment. However, thanks to the large number of offenders and a limited capacity of the central authority, the individual risk is typically small and a rational individual will not choose to pay the fine. Here we show that if the central authority processes the offenders in a publicly known order, it properly incentives the offenders to pay the fine. We show analytically and on realistic experiments that our mechanism promotes non-cooperation and incentives individuals to pay. Moreover, the same holds for an arbitrary coalition. We quantify the expected total payment the central authority receives, and show it increases considerably

Uniformity of point samples in metric spaces using gap ratio

Teramoto et al. defined a new measure called the gap ratio that measures the uniformity of a finite point set sampled from $\cal S$, a bounded subset of $\mathbb{R}^2$. We generalize this definition of measure over all metric spaces by appealing to covering and packing radius. The definition of gap ratio needs only a metric unlike discrepancy, a widely used uniformity measure, that depends on the notion of a range space and its volume. We also show some interesting connections of gap ratio to Delaunay triangulation and discrepancy in the Euclidean plane. The major focus of this work is on solving optimization related questions about selecting uniform point samples from metric spaces; the uniformity being measured using gap ratio. We consider discrete spaces like graph and set of points in the Euclidean space and continuous spaces like the unit square and path connected spaces. We deduce lower bounds, prove hardness and approximation hardness results. We show that a general approximation algorithm framework gives different approximation ratios for different metric spaces based on the lower bound we deduce. Apart from the above, we show existence of coresets for sampling uniform points from the Euclidean space -- for both the static and the streaming case. This leads to a $\left( 1+\epsilon \right)$-approximation algorithm for uniform sampling from the Euclidean space.Comment: 31 pages, 10 figure

ACE Alzheimer’s: The Role of Vitamin A, C and E (ACE) in Oxidative Stress induced Alzheimer’s Disease

Alzheimer's disease (AD), a chronic neurodegenerative disease which is known to progress gradually and has now become a substantial health concern through-out the world. Clinically, cognitive declination and progressive dementia are the main characteristics of AD while pathologically; Aß plaques and tau-neurofibrils are the hallmarks. The present literature search has suggested that oxidative stress is one of the most vital risk factor which can potentially lead to the development of AD. Oxidative stress is known to produce the Reactive Oxygen Species (ROS) which has a potential to increase in the structural and functional abnormalities in the glial cells of the brain and which could further lead to a cognitive decline and subsequently, dementia. Hence, in order to curb this oxidative stress in the glial cells, antioxidants have been proved to be of great help according to the literature search done in PubMed, Google Scholar and Scopus. We included Meta-Analysis, Systemic Reviews and Original studies. Vitamins A, C, and E are an example of antioxidants that can be used as adjuvants in the treatment of AD. This article focuses on the contemporary literature search and presents forward the evidence-based banes of using Vitamin A, C, and E as an adjuvant therapy for preventing and treating AD

Bovine rotavirus pentavalent vaccine development in India

AbstractA bovine rotavirus pentavalent vaccine (BRV-PV) containing rotavirus human-bovine (UK) reassortant strains of serotype G1, G2, G3, G4 and G9 has been developed by the Serum Institute of India Ltd, in collaboration with the National Institute of Allergy and Infectious Diseases (NIAID), USA. The vaccine underwent animal toxicity studies and Phase I and II studies in adults, toddlers and infants. It has been found safe and immunogenic and will undergo a large Phase III study to assess efficacy against severe rotavirus gastroenteritis

Case Report: Unprovoked venous thromboembolism in a young adult male [version 2; peer review: 2 approved]

A 24-year-old male was presented to us with sudden onset of chest pain and dyspnea for the past one hour. There was no history of calf pain, trauma, surgery, prolonged immobilization, long-haul air travel, bleeding diathesis or any other co-morbidity. The patient denied any addiction history. The heart rate was 114 beats/min, and blood pressure was 106/90 mmHg. Electrocardiogram showed tachycardia with S 1Q 3T 3 pattern. The left arterio-venous Doppler study was suggestive of a thrombus in popliteal vein and sapheno-popliteal junction. The CT-Pulmonary Angiogram scan was suggestive of a massive pulmonary thromboembolism. The patient was thrombolysed with Intravenous Alteplase immediately and was put on tab Rivaroxaban for maintenance. He was later discharged after being stable. Unprovoked venous thromboembolism (VTE) is very rare and has the potential to lead to pulmonary embolism which could be disastrous, especially in young adults. We present such a case where unprovoked VTE was diagnosed and treated. This case suggests that high clinical suspicion is the key for the diagnosis of acute pulmonary embolism, especially in the absence of history suggestive of deep vein thrombosis

Two-year safety and efficacy of Indigenous Abluminus Sirolimus Eluting Stent. Does it differ amongst diabetics? – Data from en-ABLe- REGISTRY

Introduction: To evaluate the efficacy/safety profile of the Abluminus DES+ over 2-years follow-up in the "real-world" scenario in diabetics as compared to non-diabetics. Methods: In prospective, all-comers, open-label registry conducted at 31 sites, patients were analyzed for 1 & 2-year outcomes with the primary endpoint defined as 3P-MACE of CV death, target vessel related myocardial infarction (TV-MI), ischemia-driven target lesion revascularization (TLR)/target vessel revascularization (TVR) apart from Stent thrombosis (ST). Results: Of 2500 patients of PCI with 3286 Abluminus-DES+, 1641 (65.64%) were non-diabetics while859 (34.36%) were diabetics. The 3-P MACE for the cohort at 1 & 2 years were 2.9%, and 3.16%; TLR/TVR - 1.4% at both the intervals for 2493 patients at 2 yrs. follow-up. TV-MI & ST were 0.36% and0.56% at 1st and 2nd year respectively. The 3P-MACE was lower in non-diabetics at 1 & 2 years (2.3%vs 4.2%; 2.4% vs 4.7% respectively). For components of MACE, CV mortality (0.9 vs 1.9% at 1 yr ; 1.0vs 2.1% at 2 years) was significant (P < 0.05) while TLR (1.1 vs 1.9% at 1 yr. & 1.1 vs 2.1% at 2 yrs.) and TV-MI (0.9 vs 1.9% at 1 yr. & 1 vs 2.1% at 2 years) were similar for diabetics and non-diabetics so was ST (P > 0.05). Conclusion: Abluminus-DES+ showed excellent 2-year safety and efficacy with low 3-P MACE which was higher in diabetics driven by higher CV death but similar TLR, TV-MI and ST

Clinical characteristics, multiorgan dysfunction and outcomes of patients with COVID-19: a prospective case series

BACKGROUND: Characterizing the multiorgan manifestations and outcomes of patients hospitalized with COVID-19 will inform resource requirements to address the long-term burden of this disease. We conducted a descriptive analysis using prospectively collected data to describe the clinical characteristics and spectrum of organ dysfunction, and in-hospital and longer-term clinical outcomes of patients hospitalized with COVID-19 during the first wave of the pandemic at a Canadian centre. METHODS: We conducted a prospective case series involving adult patients (aged ≥ 18 yr) with COVID-19 admitted to 1 of 2 hospitals in London, Ontario, from Mar. 17 to June 18, 2020, during the first wave of the pandemic. We recorded patients\u27 baseline characteristics, physiologic parameters, measures of organ function and therapies administered during hospitalization among patients in the intensive care unit (ICU) and in non-ICU settings, and compared the characteristics of hospital survivors and nonsurvivors. Finally, we recorded follow-up thoracic computed tomography (CT) and echocardiographic findings after hospital discharge. RESULTS: We enrolled 100 consecutive patients (47 women) hospitalized with COVID-19, including 32 patients who received ICU care and 68 who received treatment in non-ICU settings. Respiratory sequelae were common: 23.0% received high-flow oxygen by nasal cannula, 9.0% received noninvasive ventilation, 24.0% received invasive mechanical ventilation and 2.0% received venovenous extracorporeal membrane oxygenation. Overall, 9.0% of patients had cerebrovascular events (3.0% ischemic stroke, 6.0% intracranial hemorrhage), and 6.0% had pulmonary embolism. After discharge, 11 of 19 patients had persistent abnormalities on CT thorax, and 6 of 15 had persistent cardiac dysfunction on echocardiography. INTERPRETATION: This study provides further evidence that COVID-19 is a multisystem disease involving neurologic, cardiac and thrombotic dysfunction, without evidence of hepatic dysfunction. Patients have persistent organ dysfunction after hospital discharge, underscoring the need for research on long-term outcomes of COVID-19 survivors

"Mother-weights" and lost fathers: parents in South Asian American literature

That parent-child relationships should play a significant role within South Asian American literature is perhaps no surprise, since this is crucial material for any writer. But the particular forms they so often take – a dysfunctional mother-daughter dynamic, leading to the search for maternal surrogates; and the figure of the prematurely deceased father – are more perplexing. Why do families adhere to these patterns in so many South Asian American texts and what does that tell us about this œuvre? More precisely, why are mothers subjected to a harsher critique than fathers and what purpose does this critique serve? How might we interpret the trope of the untimely paternal death? In this article I will seek to answer these questions – arguably key to an understanding of this growing body of writing – by considering works produced between the 1990s and the early twenty-first century by a range of South Asian American writers