Uterotonic effect of rectal misoprostol as preoperative medication for assessment of intraoperative and postoperative blood loss in cesarean delivery

Background: Postpartum hemorrhage is the leading cause of maternal mortality and it's prevention has been identified as key component of safe motherhood. Misoprostol is an effective uterotonic for prophylaxis and control of PPH. Aim of our study was to evaluate the effect of preoperative rectal misoprostol (400μg) on blood loss during and after cesarean delivery.Methods: It was a randomised controlled trial done on 200 women scheduled for elective cesarean delivery. Eligible participants were randomized into two groups. In the study group 100 women received a preoperative 400 μg per rectal misoprostol tablet just after spinal anaesthesia while 100 women assigned to the control group did not receive misoprostol tablet.Results: The mean intra operative and postoperative blood loss was lower in study group than the control group 345.98±79.57 ml and 114±19.97 ml versus 408.6±63.68 ml and 136.38±24.81 ml, respectively. The difference between the preoperative and postoperative hematocrit values was also significantly lower in the study group than the control group (33.43±1.93 and 33.64±1.82)Conclusions: In our study it was concluded that preoperative 400 μg rectal misoprostol is effective in reducing intraoperative and postoperative blood loss, thus preventing postpartum hemorrhage and reducing incidence of overall maternal morbidity and mortality

Incidence of anemia in pregnancy and its maternal-fetal outcome in admitted ANC patients in tertiary care center, Bhilai, Chhattisgarh, India

Background: Anemia in pregnancy is an important public health problem in developing countries like India. Anemia results in poor pregnancy outcome and also affects fetal outcome. The present study was conducted to asses maternal and fetal outcome in relation anemia. Aim and objectives of the study was to determine incidence, risk factors and maternal-fetal outcome of anemia in the admitted pregnant women attending obstetrics and gyanecology department, shanakarcharya institute of medical sciences, Bhilai.Methods: This is retrospective observational study conducted among pregnant women admitted in labor room over a period of one year after getting approval from the institutional ethical committee.Results: Out of total 1503 delivery during study period 675 patients were found to be anaemic which gives incidence of 44.5%. Most the pregnant women were moderately anaemic i.e. 50.96% followed by mild (45.04%) and severe (4%) repectively. Among the pregnant women most common type of anaemia is Iron deficiency anaemia (69.65%) followed by Sickle cell anaemia (15.4%). In the present study,90.4% of subject received oral iron, 26.9% received parenteral iron and 19.4% received blood transfusion. Common maternal outcome related to anemia found to be low birth weight (25.2%) followed by premature delivery (22.96%) and fetal outcome in anemic mother in the form of preterm (22.9%) followed by NICU admission (14.37%) and FGR (8.6%).Conclusions: Anemia being one of the most important cause of poor feto maternal outcome should be treated preconceptionaly. There is a need of health education programmes and adequate intake of iron rich diet during pregnancy, to be strengthened for safe maternal and foetal outcomes

Water Stress in Crop Plants Challenges and its Management A Review

In 21st century, shrinkage of land resources, heavy population pressure and degradation of soil has declined the fertility and productivity of soil. Water stress is the main factor that decreases growth, development and photosynthesis of plants because water is the central molecule for transporting metabolites and nutrients, forms biomass of 80-90% in plants. Water stress disturbs organization of proteins with lipids, transportation, activities of enzymes and also decreases biosynthesis of mRNAs, proteins and overall yield up to 80%. During stress conditions, abscisic acid, diacylglycerol (DAG), inositol triphosphate and inositol hexaphosphate acts as signal molecules and controls gene expression. Therefore, plant has developed defensive mechanisms at morphological, physiological, molecular and biochemical level such as: lower CO2 concentration, impairment in carbon and nitrogen metabolism, decrease in stomatal conductance, CO2 assimilation, etc. Moreover, there are two component of antioxidant defence system in cell of plants: non-enzymatic and enzymatic). The various components of enzymatic system are as follows; glutathione reductase, superoxide dismutase, ascorbate peroxidise, catalase and peroxidise. The components of non-enzymatic systems are ascorbic acid, cysteine and reduced glutathione. The other enzymes are glutathione reductase, monodehydroascorbate reductase, ascorbate peroxidise and dehydro-ascorbate reductase. The antioxidative defence system is considered as the important adaptive mechanism The most critical hormone is ABA which helps in conducting resistance to abiotic and biotic stress. The catabolism and synthesis of many PGRs such as gibberellins, auxins, cytokinins, jasmonic acid, ethylene, brassinosteroids, etc. are the main consequent of osmotic damage of plants. But it can be improved by exogenous application of substances, fertilizers, bio fertilizers, plant growth regulators, hydrogels, genomic editing and agronomic approaches, etc. Apart from these, resistant varieties can be used for better yields and returns

A study to assess the knowledge and awareness regarding safe disposal of pharmaceutical wastes among 2nd year medical and para-medical students in a tertiary care teaching hospital in North India

Background: The use of pharmaceutical products in our day to day life is escalating and one cannot deny their presence in every household. Unfortunately not all the medicines that reach our homes get consumed. Unused, unwanted and expired drugs get accumulated over time and are generally disposed along with other household trash thus contributing to environmental pollution. This turns our attention towards the significance of eco-pharmacovigilance. Assessing the level of knowledge and awareness of students under training  as health care professionals  regarding safe disposal of pharmaceutical wastes can help us to partly assess the magnitude of the problem of inappropriate disposal methods and help us to plan and initiate steps to prevent the hazards caused by improper disposal of these items.Methods: A questionnaire based cross-sectional study was conducted among medical and paramedical students of a tertiary care teaching hospital using a pre-validated questionnaire from previous studies.Results: Majority of the participants were not aware of the possible hazards of improper disposal of pharmaceutical wastes. They expressed the need for awareness programs regarding the subject.Conclusions: The study revealed the practice of drug accumulation at home. The disposal methods opted by the participants were not the recommended methods. There is a need to address this issue through awareness programs at various levels

Magnesium Sulfate and Fentanyl for Facilitating Awake Fiberoptic Nasotracheal Intubation: A Randomized Study

Background: Various drugs have been used to facilitate awake fiberoptic intubation (AFOI). Although fentanyl is probably used most frequently, magnesium sulfate can provide muscle relaxation without respiratory depression and attenuate hemodynamic responses. Methods: We randomly allocated 20 patients of both sexes, aged 18 - 60 years, and ASA status I-II to receive fentanyl 2 g/kg (group F) ormagnesiumsulfate 45mg/kg (groupM) before AFOI. The intubating conditionswere evaluated by Ramsay sedation score (RSS), cough score, post-intubation score, additional topicalization requirement, and hemodynamic response. Oxygen desaturation, airway morbidity, recall of procedure, and the patient’s willingness to return for the same kind of anesthesia, if required, were also studied. Statistical analyses were done using SPSS V. 17.0 software. Numerical data were analyzed using independent and paired t-tests and categorical data using the chi-square test. P values of < 0.05 were considered significant. Results: RSS, cough score, post-intubation score, lignocaine dose, airway-related morbidity, and willingness to undergo the same kindof anesthesia for a secondtimewere comparablebetweenthe twogroups. Bothdrugshadcomparable effectsonhemodynamic response to intubation. However, the incidence of recall of the procedure was significantly lower in group F (P = 0.003). Conclusions: The degree of coughing during fiberoptic bronchoscopy, tolerance of the endotracheal tube after intubation, and the hemodynamic response to intubationwere similar after the administration of either fentanyl 2 g/kg ormagnesiumsulfate 45 mg/kg

Youth Savings in Developing Countries: Trends in Practice, Gaps in Knowledge

Youth Savings in Developing Countries: Trends in Practice, Gaps in Knowledg

An ANN Solution for Generalized Sierpinski Fractal Antenna

A neural network (NN) based analysis model is developed for locating the operating frequencies of generalized Sierpinski fractal antenna. The developed model can locate the operating frequencies of standard as well as perturbed antennas. The performance of the neural model is validated with simulations as well as with results reported in literature

An ANN Solution for Generalized Sierpinski Fractal Antenna

A neural network (NN) based analysis model is developed for locating the operating frequencies of generalized Sierpinski fractal antenna. The developed model can locate the operating frequencies of standard as well as perturbed antennas. The performance of the neural model is validated with simulations as well as with results reported in literature

On the Effectiveness of Using Elitist Genetic Algorithm in Mutation Testing

Manual test case generation is an exhaustive and time-consuming process. However, automated test data generation may reduce the efforts and assist in creating an adequate test suite embracing predefined goals. The quality of a test suite depends on its fault-finding behavior. Mutants have been widely accepted for simulating the artificial faults that behave similarly to realistic ones for test data generation. In prior studies, the use of search-based techniques has been extensively reported to enhance the quality of test suites. Symmetry, however, can have a detrimental impact on the dynamics of a search-based algorithm, whose performance strongly depends on breaking the “symmetry” of search space by the evolving population. This study implements an elitist Genetic Algorithm (GA) with an improved fitness function to expose maximum faults while also minimizing the cost of testing by generating less complex and asymmetric test cases. It uses the selective mutation strategy to create low-cost artificial faults that result in a lesser number of redundant and equivalent mutants. For evolution, reproduction operator selection is repeatedly guided by the traces of test execution and mutant detection that decides whether to diversify or intensify the previous population of test cases. An iterative elimination of redundant test cases further minimizes the size of the test suite. This study uses 14 Java programs of significant sizes to validate the efficacy of the proposed approach in comparison to Initial Random tests and a widely used evolutionary framework in academia, namely Evosuite. Empirically, our approach is found to be more stable with significant improvement in the test case efficiency of the optimized test suite