Urticarial rash of pregnancy turning into a rare and scary dermatosis of pregnancy: a case report and review of literature

Dermatosis of pregnancy encompasses a group of skin conditions that occurs due to interaction of multiple factors in the body during pregnancy or during post-partum period. We presented a case of 25-year-old G4P1L1A2 with initial symptom of urticarial rash which later progressed to a rare and a scary dermatosis of pregnancy which became a challenge both to the obstetrician and the dermatologist

Study of inflammatory markers for COVID-19 in control population and in pregnant women: a systematic review

COVID-19 infection is an inflammatory state and has varied presentation ranging from mild to severe condition. The second wave of COVID-19 resulted in greater mortality and morbidity as compared to first wave both in general as well as in pregnant patient. As the progression of disease is rapid and fatal hence there is a need of reviewing relevant inflammatory markers for predicting the disease course and severity. The inflammatory markers considered are Interleukins, CRP, LDH, serum Ferritin, Neutrophil/ lymphocyte ratio and in some cases serum Procalcitonin. These markers are raised in other inflammatory conditions also and therefore the maximum predictability of various markers differs in different conditions. COVID-19 in pregnancy in itself is challenging as it alters the immunity and hemodynamic and therefore the value of these markers in pregnancy can affect the sensitivity and specificity in predicting the severity of the disease. This review will evaluate the role of inflammatory markers in general population as well as pregnancy with regards to their prognostication in assessing the disease severity

Study of the cases of severe acute maternal morbidity at a tertiary care centre

Background: Reduction in the maternal morbidity has been the key strategy towards achievement of Millennium Development Goal. Despite exhaustive measures at all levels, the decline has been slow. WHO in 2007 established a technical working group to identify cases of severe acute maternal morbidity. It served dual goals to identify the causes and pointing out delays leading to SAMM. SAMM is now an established superior indicator of surviving women’s health and allows uniform comparisons. The present study was conducted with an aim to identify cases of SAMM at our centre. The objective is to determine the frequency of maternal near miss and conduct an epidemiological survey.Methods: This retrospective study was conducted in the department of Obstetrics and Gynecology and ICU of School of Medical Sciences and Research, Greater Noida, from November 2014 to October 2017. All the cases identified as SAMM, as per WHO 2009 criteria (modified according to the local protocol), were included in the study.  Results: During the study period there were a total of 2252 delivery, out of which 2051 were live births. There were 123 SAMM cases and 47 were excluded out of study. So, study was done on 76 cases of SAMM, and on 11 maternal deaths in the study period. Calculated MNM incidence ratio was 37.05 per 1000 live births. A mortality index of 12.64% was calculated. MNM to maternal death ratio was 6.9:1. Major identifiable cause for SAMM was hypertension (35.5%)), followed by haemorrhage (18.4%). Haematologic system was the commonest organ system involved. 67.8% of the admissions were done in critical condition.Conclusions: Maternal mortality and SAMM cases shared characteristics, and study of SAMM cases can provide an insight into the causative etiology and give time for early intervention

6-Shogaol reduced chronic inflammatory response in the knees of rats treated with complete Freund's adjuvant

BACKGROUND: 6-Shogaol is one of the major compounds in the ginger rhizome that may contribute to its anti-inflammatory properties. Confirmation of this contribution was sought in this study in Sprague- Dawley rats (200–250 g) treated with a single injection (0.5 ml of 1 mg/ml) of a commercial preparation of complete Freund's Adjuvant (CFA) to induce monoarthritis in the right knee over a period of 28 days. During this development of arthritis, each rat received a daily oral dose of either peanut oil (0.2 ml-control) or 6-shogaol (6.2 mg/Kg in 0.2 ml peanut oil). RESULTS: Within 2 days of CFA injection, the control group produced maximum edematous swelling of the knee that was sustained up to the end of the investigation period. But, in the 6-shogaol treated group, significantly lower magnitudes of unsustained swelling of the knees (from 5.1 ± 0.2 mm to 1.0 ± 0.2 mm, p < 0.002, n = 6) were produced during the investigation period. Unsustained swelling of the knees (from 3.2 ± 0.6 mm to 0.8 ± 1.1 mm, p < 0.00008, n = 6) was also produced after 3 days of treatment with indomethacin (2 mg/Kg/day) as a standard anti-inflammatory drug, but during the first 2 days of drug treatment swelling of the knees was significantly larger (11.6 ± 2.0 mm, p < 0.0002, n = 6) than either the controls or the 6-shogaol treated group of rats. This exaggerated effect in the early stage of indomethacin treatment was inhibited by montelukast, a cysteinyl leukotriene receptor antagonist. Also, 6-shogaol and indomethacin were most effective in reducing swelling of the knees on day 28 when the controls still had maximum swelling. The effect of 6-shogaol compared to the controls was associated with significantly lower concentration of soluble vascular cell adhesion molecule-1 (VCAM-1) in the blood and infiltration of leukocytes, including lymphocytes and monocytes/macrophages, into the synovial cavity of the knee. There was also preservation of the morphological integrity of the cartilage lining the femur compared to damage to this tissue in the peanut oil treated control group of rats. CONCLUSION: From these results, it is concluded that 6-shogaol reduced the inflammatory response and protected the femoral cartilage from damage produced in a CFA monoarthritic model of the knee joint of rats

INFLUENCE OF MICROFLUIDIC GEOMETRY ON MICRO-DROPLET FORMATION

Micro-droplet technologies are a novel platform for performing chemical or biological analyses. These suspended micro-droplets (water-in-oil) that encapsulate reagents for chemical and biological reactions are generated by utilizing flow instabilities in microfluidic channel structures and are formed with controllable compositions and drop size, stably for long operating times. The nature of the device fabrication process however can introduce differences in identical microfluidic designs from device to device. These deviations in the droplet formation region, though seemingly minor, influence the drop formation process and droplet characteristics

INFLUENCE OF MICROFLUIDIC GEOMETRY ON MICRO-DROPLET FORMATION

Micro-droplet technologies are a novel platform for performing chemical or biological analyses. These suspended micro-droplets (water-in-oil) that encapsulate reagents for chemical and biological reactions are generated by utilizing flow instabilities in microfluidic channel structures and are formed with controllable compositions and drop size, stably for long operating times. The nature of the device fabrication process however can introduce differences in identical microfluidic designs from device to device. These deviations in the droplet formation region, though seemingly minor, influence the drop formation process and droplet characteristics

INFLUENCE OF MICROFLUIDIC GEOMETRY ON MICRO-DROPLET FORMATION

Micro-droplet technologies are a novel platform for performing chemical or biological analyses. These suspended micro-droplets (water-in-oil) that encapsulate reagents for chemical and biological reactions are generated by utilizing flow instabilities in microfluidic channel structures and are formed with controllable compositions and drop size, stably for long operating times. The nature of the device fabrication process however can introduce differences in identical microfluidic designs from device to device. These deviations in the droplet formation region, though seemingly minor, influence the drop formation process and droplet characteristics

Comparative analysis of concurrent and sequential chemoradiation in locally advanced lung cancer: a single institution experience

Background: Outcome of various treatment regimen are dismal in non-small cell lung cancer. This analysis is done to find possible care in authors institutional set up and to see how these protocols have effect in Indian patients in term of toxicity.Methods: Medical records and data on patients who had been diagnosed with non-small cell lung cancer histologically or cytologically, and who had been treated with sequential chemoradiation and concurrent chemoradiation at the hospital from January 2007 to March 2015 was retrospectively reviewed and analyzed. Two groups of sequential chemoradiotherapy and concurrent chemoradiotherapy were formed and compared for outcomes.Results: Of the 114 evaluable patients in sequential chemoradiotherapy group, the median survival time was 16.0 months and the 1, 3- and 5-years overall survival were 57.0, 26.9 and 21.2%, respectively. Median progression free survival (PFS was 13.0 months and the 1, 3 and 5 years PFS were 52.6, 14.6 and 7.8%, respectively. In concurrent chemoradiotherapy group (105 patients), the overall median survival time was 15 months and the 1, 3- and 5-year overall survival were 56.2, 20.6 and 14.7%, respectively. Median PFS was 13 months and the 1, 3 and 5-year PFS were 48.8, 19.7 and 10.3%, respectively. Grade 3 and 4 toxicity in both regimen groups are same and statistically not significant.Conclusions: Analysis confirm dismal outcome with standard treatment and signifies to search for care beyond conventional chemoradiotherapy