Maternal sepsis- an audit in a tertiary care center in South India

Background: Objective of this study was to audit the cases of maternal sepsis and analyze their maternal and fetal outcomes.Methods: A retrospective analysis of cases of maternal sepsis was undertaken for one year. Cases were taken as infection with fever, tachycardia, tachypnea, low oxygen saturation, high or low white blood counts and clinical or laboratory evidence of organ dysfunction and were analyzed. Demographic profile, gestational age at the time of diagnosis, organisms & their sources of infection was noted. Maternal outcomes of abortion, preterm delivery, need for intensive care unit (ICU) / high dependency unit (HDU) stay, blood and blood products, surgical interventions for the control of infection, culture-positive rate, source of organism, antibiotic usage and maternal mortality were analyzed. Fetal outcomes of early fetal demise, preterm birth, intrauterine death, stillbirth and term birth were studied.  Results: There were a total of 2327 deliveries, with 2333 live births during the study period. Twenty-two cases were diagnosed with sepsis, of which 17 survived, and five died. The incidence of maternal sepsis was 9.4/1000 live births & maternal deaths were 22.7%. Ninety percent were in the age group of 21-39 years, 68% were referred, 59% were post-delivery. Fifty nine percent of women who survived, and none of the women who died had medical co-morbidities. Respiratory tract followed by genitourinary tract were the most common source of infection, though culture was negative in 54.5% of the cases. The organisms grown were varied, with Escherichia coli (3/10) contributing to 30% of the culture positive cases. Spontaneous abortion and preterm delivery were 18% each, 36% required surgical intervention, 81% required ICU and 64.7% HDU stay. Seventy-seven had live birth.Conclusions: Maternal sepsis is an evolving preventable health burden. Early recognition requires a high index of clinical suspicion, even in the absence of risk factors. Mortality to morbidity ratio is very high in maternal sepsis. The timing of sepsis determines the fetal outcomes

A stochastic model for prediction of Erosion-oxidation interaction on boiler grade steel Surfaces

Fly ash particles entrained in the flue gas from boiler furnaces in coal-fired power stations can cause serious erosive wear on steel surfaces along the flow path. Such erosion can reduce significantly the operational life of the boiler components. A fundamentally-derived mathematical model embodying the mechanisms of erosion involving cutting wear, plastic deformation wear and effect of temperature on erosion behaviour, has been developed to predict erosion rates on the coal fired boiler components such as boiler tubes, economizer and airpreheater assemblies at room and elevated temperature. Various grades of steels, commonly used in the fabrication of boiler components and published data pertaining boiler fly ash has been used for modelling the process. The model incorporates the tensile properties of the target metal surface at room and elevated temperatures, as well as the characteristics of the ash particle dynamics in the form of impingement angle, impingement velocity and composition of the ash particle in terms of the silica content. The mathematical model has been implemented in an userinteractive in-house computer code, (EROSIM–1 ) to predict the erosion rates at room and elevated temperature for various grades of steel normally used in boiler components. The model predictions have been found to be in good agreement with the published data. The model will be calibrated in future with the plant and experimental data generated from a high temperature air-jet erosion testing facility. It is hoped that the calibrated model will be useful to the power plant industry for erosion analysis of boiler components

Mathematical modelling of ductile erosion behaviour of impacted fly ash particles on steel components of a coal fired boiler

In coal-fired power stations about 20% of tie ash produced in the boilers is deposited on the boiler walls, economisers, air-heaters and super-heater tubes. An abin-itio, first principle based mathematical model embodying the mechanisms of erosion involving cutting, wear, plastic deformation wear and effect of temperature on erosion behaviour has been developed to predict erosion rates on the coal fired boiler components such as boiler tubes, economiser and air-preheater assemblies at room and elevated temperature

Mathematical Modelling of ductile erosion behaviour of impacted fly ash particles on steel components of coal fired boiler

In coal-fired power stations about 20% of the ash prod-uced in the boilers is deposited on the boiler walls, economisers, air-heaters and super-heater tubes. An abinitio, first principle based mathematical model emb-odying the mechanisms of erosion involving cutting, wear, plastic deformation wear and effect of temperature on erosion behaviour has been developed to predict erosion rates on the coal fired boiler components such as boiler tubes, economiser and air-preheater assembles at room & elevated temperature

Protein kinases orchestrate cell cycle regulators in differentiating BeWo choriocarcinoma cells

Abstract Choriocarcinoma, a trophoblastic neoplasia, occurs in women as an incidence of abnormal pregnancy. BeWo choriocarcinoma cells derived from the abnormal placentation are a suitable model system to study the factors associated with differentiation, invasion and other cellular events as an alternative to clinical samples. Many protein kinases orchestrate the complex events of cell cycle and in case of malignancy such regulators are found to be mutated. In the present study, BeWo cells treated with forskolin (Fo) and phorbol 12-myristate 13-acetate (PMA) were used to study the role of PKA (protein kinase A) and PKC (protein kinase C), respectively, on the expression pattern of differentiation-related genes, membrane markers, PKC isoforms and cell cycle regulators. The effect of Fo and PMA on the cell proliferation was assessed. Progressive induction of alkaline phosphatase level and formation of multinucleated differentiated cells were observed in the cells treated with Fo. Exposure of cells to Fo and PMA induced the mRNA transcripts of α-hCG, β-hCG and endoglin and down-regulates E-cadherin at mRNA and protein levels. Synergistic levels of both up- and down-regulated genes/proteins were observed when cells were treated with the combination of Fo and PMA. The mRNA levels of cyclin D1, cyclin E1, p21, Rb, p53, caspase-3 and caspase-8 decreased gradually during differentiation. Fo significantly inhibited the protein levels of PCNA, Rb, PKC-α and PMA stimulated mRNA expression of PKC-ε and PKC-δ. Further, failure in the activation of essential components of the cell cycle machinery caused G2/M phase arrest in differentiating BeWo cells

Molar-incisor hypomineralization: Prevalence, severity and clinical characteristics in 8- to 13-year-old children of Udaipur, India

Background: The last couple of decades has seen an increasing interest in molar-incisor hypomineralization (MIH). Although the reported prevalence of MIH ranges from 2.4% to 40.2% worldwide, very little data is available from India. Objective: To assess the prevalence, clinical characteristics, distribution, severity and association with caries of MIH defects in children aged 8-13 years of Udaipur, Rajasthan. Study design: This cross-sectional descriptive study consisted of 1173 children aged 8-13 years selected by random sampling procedure. The European Academy of Pediatric Dentistry criteria were followed for MIH diagnosis. The presence of dental caries and treatment need for MIH-affected teeth were recorded as per the WHO criteria. Results: The prevalence of MIH in the children examined was 9.46%. Severity of the defects increased with the age of the children. Involvement of incisors increased when more First permanent molars (FPMs) were affected. An average of 3.65 teeth was involved per MIH-affected individual. Significantly larger numbers of mandibular FPMs and maxillary central incisors were diagnosed with MIH. The association of dental caries was significantly higher with MIH-affected FPMs. Primary molars and permanent canines and premolars were also showed MIH like lesions in some of the MIH-affected children. Conclusion: MIH was observed in about 10% of the children examined. MIH-affected FPMs appear to be more vulnerable to early caries and subsequent pulp involvement with need for extensive dental treatment

Complications of untreated molar-incisor hypomineralization in a 12-year-old boy

Complications arising because of untreated molar-incisor hypomineralization (MIH) have received little mention in the dental literature. However, this can be an area of concern, with severe consequences in rare cases. Hence, early recognition and prompt management of MIH is essential for long-term oral health of affected individuals. This paper describes an untreated case of severe MIH that resulted in infection of facial spaces

Indigenous tooth powders = Covert lead poisoning?

Aim: The present study aimed to measure the concentration of lead in various indigenous preparations of tooth powders available and used locally in and around Udaipur, Rajasthan, India. Materials and Methods: Seven different brands of tooth powders manufactured and/or marketed locally were obtained from stores all over Udaipur city. Some home-made powders commonly used for cleaning teeth were also collected. The tooth powders were analyzed for lead content by atomic absorption spectrophotometry. Results: All tooth powders tested were found to contain high levels of lead ranging from 21 ppm to 82 ppm, above the maximum permissible level of 20 ppm prescribed by the Bureau of Indian Standards. Conclusion: Indigenous tooth powders contain high levels of lead and thus may be a source of lead poisoning that is often overlooked

“Bulls Eye For Bulls Teeth”- Endodontic Management of Taurodontism Using CBCT as A Diagnostic Tool- 2 Rare Case Reports

Taurodontism is a rare dental anomaly presented with an aberration of teeth that lacks the constriction at the level of the cemento-enamel junction (CEJ). It is characterized by elongated pulp chambers and apical displacement of bifurcation or trifurcation of the roots, forming a rectangular shape. Whilst, it appears most frequently as an isolated anomaly, its association with several syndromes and abnormalities has also been reported in the literature. Although permanent molars are most commonly affected, this anomaly could also be seen in deciduous dentition, unilaterally or bilaterally, and in any combination of teeth or quadrants. These morphological anomalies pose various challenges to the dentist during their endodontic treatment. Modern diagnostic tools such as Cone beam computed tomography (CBCT), loupes and Dental operating microscopes (DOM) help in achieving better treatment outcome in such cases. The presented article elaborates diagnosis and successful management of 2 rare cases of taurodontism in permanent molars