Effect of epidural analgesia on the duration of labour and pains: a comparative study

Background: Epidural analgesia is regional anaesthesia that blocks pain in a particular region of the body. The use of Epidural Analgesia (EA) in labor is widespread in modern labor ward practice, and its benefits in terms of pain relief are well-recognized. Objective of this study was to study the effect of epidural analgesia on the duration of labour and pains.Methods: The present study was conducted on 60 women in the department of obstetrics and gynecology at Topiwala National Medical College, Mumbai during a period from October 2014 to January 2017. The women requesting EA were assigned as the study group (Group A - 30 cases) and women not receiving EA were included in the control group (Group B - 30 cases).Results: The duration of active phase of first and second stage of labour was found to be prolonged in patients who received EA as compared to control group. An increase in number of caesarean sections and requirement of oxytocin augmentation was found to be more in Group A as compared to Group B. There was no statistically significant difference in Apgar score of newborns at 1 min and 5 min in both the groups. The patients demanding epidural drug had better pain relief during labour. In Group A, 17% of patients and in Group B, 7% of patients had nausea and vomiting. Other side effects were minimal.Conclusions: Epidural analgesia is not a totally free of disadvantages, it is the most effective mode of pain relief available compared with other techniques. The addition of patient-controlled epidural analgesia and innovations using new technologies enhance patient satisfaction

A study of visual inspection of cervix under acetic acid and visual inspection of cervix under Lugol's iodine for screening of carcinoma cervix

Background: Carcinoma cervix is the most common cancer among women in developing countries. The objectives of the study were to study the sensitivity and specificity of visual inspection of  the cervix with acetic acid (VIA) and Lugol's iodine (VILI) for cervical cancer screening. To study the correlation of demographic data like age, socioeconomic status, education residential area, parity, age at marriage in premalignant lesion of  the cervix.Methods: The present study was conducted in the department of Obstetrics and Gynecology  at a Tertiary Medical Care Center over a period of two years. Five hundred fifty women between 20-65 years of age who fulfilled the selection criteria were enrolled in our study. Positive tests for VIA was opaque aceto white lesion on applying 5% acetic acid or detection of definite yellow iodine non uptake areas with Lugol's iodine in the transformation zone or close to touching the squamocolumnar junction. Positive cases were scheduled for cervical biopsy. Ethical approval of the study protocol was obtained from the ethics committee of the institute.Results: On down staging 7.2% (40/550) of cases  had an unhealthy cervix and 0.36% (2/550) with a suspicious cervix. VIA positive in 4.55% (25/550), VILI positive in 2.73% (15/550). Biopsy was taken from positive with VIA and VILI. On histology 2.9% (16) were chronic cervicitis, CIN I had (1), 0.2%, CIN II (2) 0.4%, CIN III (4) 0.7% and squamous cell carcinoma (2) 0.4% VIA sensitivity 72.22%, specificity 97.74%. VILI sensitivity 100%, specificity 98.89%.Conclusions: VIA and VILI are simple, inexpensive, low resources technique. Both have high sensitivity and specificity

Coupled Phonons, Magnetic Excitations and Ferroelectricity in AlFeO3: Raman and First-principles Studies

We determine the nature of coupled phonons and magnetic excitations in AlFeO3 using inelastic light scattering from 5 K to 315 K covering a spectral range from 100-2200 cm-1 and complementary first-principles density functional theory-based calculations. A strong spin-phonon coupling and magnetic ordering induced phonon renormalization are evident in (a) anomalous temperature dependence of many modes with frequencies below 850 cm-1, particularly near the magnetic transition temperature Tc ~ 250 K, (b) distinct changes in band positions of high frequency Raman bands between 1100-1800 cm-1, in particular a broad mode near 1250 cm-1 appears only below Tc attributed to the two-magnon Raman scattering. We also observe weak anomalies in the mode frequencies at ~ 100 K, due to a magnetically driven ferroelectric phase transition. Understanding of these experimental observations has been possible on the basis of first-principles calculations of phonons spectrum and their coupling with spins

Stroke genetics: prospects for personalized medicine.

Epidemiologic evidence supports a genetic predisposition to stroke. Recent advances, primarily using the genome-wide association study approach, are transforming what we know about the genetics of multifactorial stroke, and are identifying novel stroke genes. The current findings are consistent with different stroke subtypes having different genetic architecture. These discoveries may identify novel pathways involved in stroke pathogenesis, and suggest new treatment approaches. However, the already identified genetic variants explain only a small proportion of overall stroke risk, and therefore are not currently useful in predicting risk for the individual patient. Such risk prediction may become a reality as identification of a greater number of stroke risk variants that explain the majority of genetic risk proceeds, and perhaps when information on rare variants, identified by whole-genome sequencing, is also incorporated into risk algorithms. Pharmacogenomics may offer the potential for earlier implementation of 'personalized genetic' medicine. Genetic variants affecting clopidogrel and warfarin metabolism may identify non-responders and reduce side-effects, but these approaches have not yet been widely adopted in clinical practice

Peak effect in a superconducting DyBa2Cu3O7-y film at microwave frequencies

We report the observation of a peak in the microwave (9.55 GHz) surface resistance in an epitaxial DyBa2Cu3O7-y superconducting film in magnetic fields (parallel to the c axis) ranging between 0.2 to 0.9 Tesla. Such a peak is absent in the measurements done in zero-field. The temperature and field dependence of the peak suggests that this peak could be associated with the peak effect phenomenon reflecting the order-disorder transformation in the flux-line lattice. A strong dependence of this peak effect at frequencies close to the depinning frequency of the flux line lattice is observed.Comment: 1 text, 4 figures (all postscript) to be published in Phys. Rev.

Modeling of synthesis and flow properties of propylene-diene copolymers

Copolymerization with nonconjugated dienes offers an attractive route for introducing long-chain branching in polypropylene. From a simplified set of rate equations for such copolymerization with a metallocene catalyst, we derive the probabilities of branch formation at different stages of the reaction in a semibatch reactor. Using these probabilities, we generate an ensemble of molecules via a Monte Carlo sampling. The knowledge of the branching topology and segment lengths allows us to compute the flow properties of the resins from computational rheology. We compare our model predictions with existing experimental data, namely the molar mass distribution and small amplitude oscillatory shear response, for a set of resins with varying diene content. The rheology data suggest that the entanglement time Ï.,e depends sensitively and in a well-defined fashion on the diene content

Design considerations of high RAP-content asphalt produced at reduced temperatures

In many countries recycling of reclaimed asphalt pavement (RAP) for road surface layers is limited to a maximum of 10–30%. This is due to technical limitation of common asphalt plant but also to specifications that are still restrictive when it comes to increasing RAP in surface courses. The mistrust in this practice is mainly related to uncertainty in performance of these mixes as well as to existing fundamental issues with the mix design, especially when production temperatures are lowered. This paper analyses some of the factors affecting the design of warm asphalt mixtures for surface course layers containing 50% RAP, and suggests a framework to justify the common assumption of full blending by optimising production conditions. A control hot mix asphalt which was manufactured with 49 dmm penetration binder and asphalt mixtures containing 50% RAP produced at temperatures between 95 and 135 °C and at different mixing times were investigated in terms of volumetric properties, indirect tensile stiffness modulus, and indirect tensile strength. The high-content RAP mixtures were produced within the warm mix region by using only a very soft binder as a rejuvenator, which reduces production costs. Statistical analysis was deployed, and different models were developed to estimate degree of blending between RAP binder and rejuvenator binder, and to predict the equivalent penetration of the blend without binder extraction and recovery. The analysis results showed that the selected performance indicators correlate significantly with mixing time and temperature, and provide evidence that only in certain circumstances and if the production conditions are accurately controlled, the practical full blending approach is acceptable

Mechanisms and treatment of ischaemic stroke: insights from genetic associations

The precise pathophysiology of ischaemic stroke is unclear, and a greater understanding of the different mechanisms that underlie large-artery, cardioembolic and lacunar ischaemic stroke subtypes would enable the development of more-effective, subtype-specific therapies. Genome-wide association studies (GWASs) are identifying novel genetic variants that associate with the risk of stroke. These associations provide insight into the pathophysiological mechanisms, and present opportunities for novel therapeutic approaches. In this Review, we summarize the genetic variants that have been linked to ischaemic stroke in GWASs to date and discuss the implications of these associations for both our understanding and treatment of ischaemic stroke. The majority of genetic variants identified are associated with specific subtypes of ischaemic stroke, implying that these subtypes have distinct genetic architectures and pathophysiological mechanisms. The findings from the GWASs highlight the need to consider whether therapies should be subtype-specific. Further GWASs that include large cohorts are likely to provide further insights, and emerging technologies will complement and build on the GWAS findings

Institutional distance and foreign subsidiary performance in emerging markets: moderating effects of ownership strategy and host-country experience

Institutional distance has been known to be an important driver of Multinational Enterprises’ strategies and performance in host countries. Based on a large panel dataset of 10562 firms operating in 17 emerging markets and spanning 80 home countries, we re-examine the relationship described by Gaur and Lu (2007) between regulatory institutional distance and subsidiary performance. We extend this research by (1) examining this relationship in the context of emerging markets, (2) examining the moderating effects of ownership strategy and host-country experience within the context of emerging markets and (3) accounting for a greater variety of institutions by including a large number of home and host countries. We find that institutional distance negatively affects subsidiary performance in emerging markets. Our findings also show that the negative effects of institutional distance on subsidiary performance are lesser for subsidiaries with partial ownership (than for subsidiaries with full ownership) and for subsidiaries with greater host-country experience. We discuss our findings with respect to Gaur and Lu’s model, which explores the relationships between these variables in a general context