Uterine inversion: a shocking aftermath of mismanaged third stage of labour

Background: To study the incidence, causes, clinical presentations, management and maternal morbidity and mortality associated with acute puerperal inversion of uterus.Methods: This retrospective study was conducted in Department of Obstetrics and Gynecology, G.S.V.M. Medical College, Kanpur, from March 2008 to March 2013. All the women who developed acute puerperal inversion of uterus either in or outside our hospital were included in the study.Results: Majority of women presenting with inversion belonged to age group 20-35 years, were multigravida (68.2%), came from rural set-up (81.4%) and were unbooked (81.8%). Majority of deliveries complicated by inversion took place at home (50%), delivered by dais (46%). Mismanaged 3rd stage of labour proved to be an important factor (36.4%) leading to inversion uterus followed by atonicity of uterus. 90% of women suffered due to delay in management at PHC and CHC, 68%women succumbed to delay in diagnosis at the place of delivery by untrained staff, whereas 45% women suffered due to delay in transport facility. 13.63% women suffered from sepsis in post-operative period, 22.72% from renal failure whereas 18.18% died.Conclusion: Proper education and training regarding active management of third stage of labour, diagnosis and management of uterine inversion should be imparted to traditional birth attendants, so that this potentially life-threatening obstetric emergency could be averted

Supporting Collaborative Health Tracking in the Hospital: Patients' Perspectives

The hospital setting creates a high-stakes environment where patients' lives depend on accurate tracking of health data. Despite recent work emphasizing the importance of patients' engagement in their own health care, less is known about how patients track their health and care in the hospital. Through interviews and design probes, we investigated hospitalized patients' tracking activity and analyzed our results using the stage-based personal informatics model. We used this model to understand how to support the tracking needs of hospitalized patients at each stage. In this paper, we discuss hospitalized patients' needs for collaboratively tracking their health with their care team. We suggest future extensions of the stage-based model to accommodate collaborative tracking situations, such as hospitals, where data is collected, analyzed, and acted on by multiple people. Our findings uncover new directions for HCI research and highlight ways to support patients in tracking their care and improving patient safety

Genome-wide identification and expression analysis of the NHX gene family under salt stress in wheat (Triticum aestivum L)

Salt stress affects plant growth and development, resulting in the loss of crop yield across the world, and sodium-proton antiporters (NHXs) are one of the genes known to promote salt tolerance in transgenic plants. In this study, we conducted a comprehensive genome-wide analysis and expression profile of NHX genes in wheat under salinity stress. We identified 30 TaNHX genes in wheat based on the Na+/H+ exchanger domain, with all genes containing an amiloride motif except one, a known for inhibiting Na+ ions in plants. Phylogenetic analysis classified these genes into three classes with subfamilies: 12 were localized in vacuoles, while 18 were in the endoplasmic reticulum and plasma membrane. Promoter analysis revealed stress-related cis-acting elements, indicating their potential role in abiotic stress tolerance. The non-synonymous (Ka)/synonymous (Ks) ratios highlighted that the majority of TaNHX genes experienced robust purifying selection throughout their evolutionary history. Transcriptomis data analysis and qRT-PCR demonstrated distinct expression patterns for TaNHX genes across various tissues when subjected to salt stress. Additionally, we predicted 20 different miRNA candidates targeting the identified TaNHX genes. Protein-protein interaction prediction revealed NHX6’s involvement in the SOS1 pathway, while NHX1 gene exhibit proton antiporter activity. Molecular dynamics (MD) simulations were also conducted to examine the interactions of TaNHX1, TaNHX2, and TaNHX3. These results represent a significant advancement in our understanding of the molecular mechanisms governing Na+ transporters. This may also offer promising avenues for future studies aimed at unraveling the intricate details of their biological roles and applications

The Right To Information Act, 2005 And The Approach Of The Judiciary

On international right to know day an organization name as center for law & democracy issued a ranking for Right to information Act across the world and Indian Right to information Act got 4th position in the list. The very first RTI legislation was passed in Sweden which known as freedom of information Act 1776. In 1948 UN general Assembly passed a resolution and declares that right to information is fundamental human right. At present almost 111 countries have their own Right to information Ac

Prevalence Of Tuberculin Skin Test Positivity In Patients Of Early Rheumatoid Arthritis- Study from a tertiary care centre in North India.

Objective: To assess the prevalence of tuberculin skin test (TST) positivity in early rheumatoid arthritis patients (< 6months disease duration) using Tuberculin sensitivity testing in a TB endemic country. Method: Included in this cross-sectional study were 200 patients of early rheumatoid arthritis divided into three groups- treatment naïve, patients on methotrexate only and methotrexate plus low dose corticosteroids. Results: 200 early RA patients and 60 healthy controls were included in this study. The median age of the study population was 43 years (IQR 33-51) with a mean disease duration of 3.4 ± 2.1 months. 54 patients (27%) with early RA and 22 healthy control (36.7%) had TST positive (p=0.1). Conclusion: Tuberculin positivity is low among patients with early RA as compared to the general population. The use of low dose steroids or methotrexate doesn’t affect the tuberculin anergy

Stroke genetics informs drug discovery and risk prediction across ancestries

Previous genome-wide association studies (GWASs) of stroke — the second leading cause of death worldwide — were conducted predominantly in populations of European ancestry1,2. Here, in cross-ancestry GWAS meta-analyses of 110,182 patients who have had a stroke (five ancestries, 33% non-European) and 1,503,898 control individuals, we identify association signals for stroke and its subtypes at 89 (61 new) independent loci: 60 in primary inverse-variance-weighted analyses and 29 in secondary meta-regression and multitrait analyses. On the basis of internal cross-ancestry validation and an independent follow-up in 89,084 additional cases of stroke (30% non-European) and 1,013,843 control individuals, 87% of the primary stroke risk loci and 60% of the secondary stroke risk loci were replicated (P < 0.05). Effect sizes were highly correlated across ancestries. Cross-ancestry fine-mapping, in silico mutagenesis analysis3, and transcriptome-wide and proteome-wide association analyses revealed putative causal genes (such as SH3PXD2A and FURIN) and variants (such as at GRK5 and NOS3). Using a three-pronged approach4, we provide genetic evidence for putative drug effects, highlighting F11, KLKB1, PROC, GP1BA, LAMC2 and VCAM1 as possible targets, with drugs already under investigation for stroke for F11 and PROC. A polygenic score integrating cross-ancestry and ancestry-specific stroke GWASs with vascular-risk factor GWASs (integrative polygenic scores) strongly predicted ischaemic stroke in populations of European, East Asian and African ancestry5. Stroke genetic risk scores were predictive of ischaemic stroke independent of clinical risk factors in 52,600 clinical-trial participants with cardiometabolic disease. Our results provide insights to inform biology, reveal potential drug targets and derive genetic risk prediction tools across ancestries

A study of MHD fluid with second order slip and thermal flow over a nonlinear stretching sheet

An electrically conducted viscous incompressible nanofluid flow caused by the nonlinear stretching surface with stagnation flow has been investigated numerically. The effect of Brownian motion and thermophoresis on the nanofluid is also incorporated. The governing partial differential equations with nonlinear second order boundary conditions are solved by the fourth order Runge-Kutta technique using MATLAB programming. The effect of the radiation parameter (Rd), stretching parameter (n), Brownian motion parameter (Nb), thermophoresis parameter (Nt) on temperature, velocity and mass transfer are shown graphically. The influence of some of these parameters on the local Nusselt number (−′(0)) and local Sherwood number (−′(0)) are shown by the graphs

Ameliorating Effects of Iron and Zinc on Vigna mungo

Different dilutions, that is, 25, 50, 75, and 100%, of tannery effluent (TE) were chosen for the present study to assess the phytotoxic effects on Vigna mungo L. For amelioration purposes, different levels and combinations of iron and zinc were supplied to the plants along with 50% TE that is chosen on the basis of prior test under Petri dish culture. Cytotoxic and biochemical analysis and plant tolerance index (PTI) of plant were observed. Mitotic index deceased with increase in effluent concentration whereas abnormality % was increased. The pigments (chlorophyll a, total, and carotenoids) were decreased with increasing treatment levels of TE at both growth stages. However, carotenoid content increased significantly at all dilution levels of TE after first growth stage. Chlorophyll b was increased significantly after 35 days of growth but decreased after 70 days. The protein contents were also significantly decreased with increase in all TE treatments and increased significantly in zinc recovery treatments. Activities of catalase and peroxidase enzymes were significantly affected and increased significantly with effluent treatments. PTI showed an enhanced tolerance capacity of plant with treatment of iron and zinc. A negative correlation was found (r=-0.97) between plant height and different dilutions of effluent whereas it was positively correlated (r=0.95) with iron and zinc treatments. The study represents the ameliorative effect of iron and zinc for phytotoxic damage in V. mungo caused by tannery effluent

Genome-wide identification and expression analysis of the GRAS gene family under abiotic stresses in wheat (Triticum aestivum L.)

Abstract The GRAS transcription factors are multifunctional proteins involved in various biological processes, encompassing plant growth, metabolism, and responses to both abiotic and biotic stresses. Wheat is an important cereal crop cultivated worldwide. However, no systematic study of the GRAS gene family and their functions under heat, drought, and salt stress tolerance and molecular dynamics modeling in wheat has been reported. In the present study, we identified the GRAS gene in Triticum aestivum through systematically performing gene structure analysis, chromosomal location, conserved motif, phylogenetic relationship, and expression patterns. A total of 177 GRAS genes were identified within the wheat genome. Based on phylogenetic analysis, these genes were categorically placed into 14 distinct subfamilies. Detailed analysis of the genetic architecture revealed that the majority of TaGRAS genes had no intronic regions. The expansion of the wheat GRAS gene family was proven to be influenced by both segmental and tandem duplication events. The study of collinearity events between TaGRAS and analogous orthologs from other plant species provided valuable insights into the evolution of the GRAS gene family in wheat. It is noteworthy that the promoter regions of TaGRAS genes consistently displayed an array of cis-acting elements that are associated with stress responses and hormone regulation. Additionally, we discovered 14 miRNAs that target key genes involved in three stress-responsive pathways in our study. Moreover, an assessment of RNA-seq data and qRT-PCR results revealed a significant increase in the expression of TaGRAS genes during abiotic stress. These findings highlight the crucial role of TaGRAS genes in mediating responses to different environmental stresses. Our research delved into the molecular dynamics and structural aspects of GRAS domain-DNA interactions, marking the first instance of such information being generated. Overall, the current findings contribute to our understanding of the organization of the GRAS genes in the wheat genome. Furthermore, we identified TaGRAS27 as a candidate gene for functional research, and to improve abiotic stress tolerance in the wheat by molecular breeding

Alopecia as the first manifestation of azathioprine myelosuppression in a genetically predisposed patient

Azathioprine, an analog of mercaptopurine, is used for various inflammatory/autoimmune diseases in diverse fields such as rheumatology, ophthalmology, gastroenterology, and neurology. One of the dreaded side effects of this drug is myelosuppression, which can be either dose related or “idiosyncratic.” The latter group often manifests with sudden cytopenias and is often secondary to a genetic predisposition. Mutations in the genes thiopurine S-methyltransferase (TPMT) and nucleoside diphosphate-linked moiety X-type motif 15 (NUDT15) have been identified to predispose to severe myelosuppression with azathioprine. An important clinical clue that can precede the onset of myelosuppression is alopecia. Here, we describe the case of a young lady treated with azathioprine, who developed alopecia (progressing to alopecia totalis), which was followed by severe cytopenia – both of which recovered on stopping the drug. On genetic analysis, she was found to be homozygous for mutation in NUDT15 (C415T) but was negative for mutation in TPMT. We review various other cases reporting alopecia as a marker of azathioprine-induced myelosuppression and the genetic mutations described