Assessment of the effect of injection magnesium sulphate on fetal heart rate pattern in patients of eclampsia and preeclampsia

Background: To assess the effect of injection magnesium sulphate on fetal heart rate pattern in severe preeclampsia and eclampsia.Methods: This is a hospital-based prospective observational study. It was conducted in the Dept. of Obstetrics and Gynaecology, BRD Medical College, Gorakhpur over period of one year from August 2014 to July 2015.Total 122 patients with diagnosis of severe preeclampsia and eclampsia who received injection MgSO4 were included in the study. Patients who delivered within 1 to 2 hrs of injection MgSO4, had pulmonary edema, respiratory depression, renal insufficiency, patients with recurrent convulsions not controlled by MgSO4 alone, fetus who had abnormal fetal heart rate pattern prior to administration of injection MgSO4, IUD baby, baby of gestetional age <28 weeks were excluded from the study. Fetal heart rate pattern tracings were taken by CTG machine before administration of injection magnesium sulphate. Injection magnesium sulphate was given according to Pritchard Regime. Fetal heart rate pattern after injection MgSO4 were compared with fetal heart rate pattern before injection magnesium sulphate regarding all four parameters fetal heart rate, variability, accelerations and deceleration.Results: Before injection magnesium sulphate mean fetal heart rate was 148.7 bpm+10.78. After 15 minutes mean fetal heart rate was 147.8 bpm+10.32.After 1hour, 2 hour and 4 hour of injection magnesium sulphate mean fetal heart rate was139.1 bpm+9.6,139.2 bpm+9.8 and 137 bpm+9.4 respectively which was statistically significant (p value <0.001). Only patients with good variability were included in the study. After 1 hour of injection magnesium sulphate 16.4%, after 2 hour 23% and after 4 hour 31.1 % developed poor variability i.e. <5. Before injection magnesium sulphate only 4% had no acceleration, after 15 minutes, 1 hour, 2 hour and 4 hour of injection magnesium sulphate 4.9%, 29.5%, 49% and 55% patients had no acceleration respectively. Before injection magnesium sulphate no patient had late deceleration. After 15 min only 2 patients had variable prolonged deceleration. After 1 hour, 2 hour and 4 hour 0%, 4.1% and 6.6% had late deceleration respectively.Conclusions: Maternal exposure to magnesium sulphate in severe preeclampsia and eclampsia is associated with persistent fall in baseline fetal heart rate by approximately 9-11 bpm which appeared at 1 hr of injection MgSO4 but it is within the accepted normal range (110 bpm - 160bpm). Statistically significant patients developed decreased beat to beat variability <5 after 1 hr of injection MgSO4. Statistically significant patients developed absent acceleration. Few patients developed late decelerations but it was not significant

Carbapenem resistance in Escherichia coli and Klebsiella pneumoniae among Indian and international patients in North India

The aim of the study was to find out the carbapenem resistance rate and prevalence of different carbapenemase genes in Klebsiella pneumoniae and Escherichia coli from a North Indian corporate hospital that receives both Indian and international patients. A total of 528 clinical isolates of E. coli and K. pneumoniae were included in the study. All isolates that were found resistant to carbapenems by MIC testing (Vitek II Compact®) were screened for NDM, OXA-48, VIM, and KPC genes by PCR. Sequencing of NDM gene and transmissibility by conjugation assay were checked on 22 randomly selected NDM-positive isolates. One hundred and fifty-six isolates (29.54%) were carbapenem-resistant. The rate of carbapenem resistance was significantly higher in K. pneumoniae as compared to E. coli (53.9% vs. 15.6%; p < 0.05). The NDM gene was found in 34.6% (54/156), OXA-48 in 31.4% (49/156), co-expression of NDM + OXA-48 in 15.3% (24/156) of the carbapenem-resistant isolates. VIM and KPC were absent in all isolates. NDM gene was significantly more prevalent in E. coli than K. pneumoniae (p < 0.05). All the tested isolates formed transconjugants and NDM-5 was the most common variant in both species (15/22). The presence of plasmid-based NDM calls for stricter surveillance measures in our hospital settings

Satellite Image Classification Using a Hybrid Manta Ray Foraging Optimization Neural Network

A semi supervised image classification method for satellite images is proposed in this paper. The satellite images contain enormous data that can be used in various applications. The analysis of the data is a tedious task due to the amount of data and the heterogeneity of the data. Thus, in this paper, a Radial Basis Function Neural Network (RBFNN) trained using Manta Ray Foraging Optimization algorithm (MRFO) is proposed. RBFNN is a three-layer network comprising of input, output, and hidden layers that can process large amounts. The trained network can discover hidden data patterns in unseen data. The learning algorithm and seed selection play a vital role in the performance of the network. The seed selection is done using the spectral indices to further improve the performance of the network. The manta ray foraging optimization algorithm is inspired by the intelligent behaviour of manta rays. It emulates three unique foraging behaviours namelys chain, cyclone, and somersault foraging. The satellite images contain enormous amount of data and thus require exploration in large search space. The spiral movement of the MRFO algorithm enables it to explore large search spaces effectively. The proposed method is applied on pre and post flooding Landsat 8 Operational Land Imager (OLI) images of New Brunswick area. The method was applied to identify and classify the land cover changes in the area induced by flooding. The images are classified using the proposed method and a change map is developed using post classification comparison. The change map shows that a large amount of agricultural area was washed away due to flooding. The measurement of the affected area in square kilometres is also performed for mitigation activities. The results show that post flooding the area covered by water is increased whereas the vegetated area is decreased. The performance of the proposed method is done with existing state-of-the-art methods

Analyzing sub-optimal rural microgrids and methods for improving the system capacity and demand factors : filibaba microgrid case study examined

Solar energy kiosks in developing countries are commonly designed with battery storage as daytime energy production does not coincide with an evening peak consumption. Curtailment of excess solar energy production can occur when current load and battery storage charging is not high enough during peak solar generation hours. Valuation of the options for coping with this phenomena, after a system is already built, is important for kiosk operators to continue to improve technical and economic performance. Furthermore, little real-world data is available to analyze the extent and impact of this issue, much less the available decisions for the manager of such systems when it occurs. This paper analyzes some of these phenomena and the decisions that kiosk operators can make to improve such performance. Furthermore it analyzes data-sets from a 1.8 kW solar-battery energy kiosk in rural Filibaba, Zambia to determine the level of lost energy production/curtailing that occurred in that system. Finally, potential strategies, including demand response strategies are proposed to both increase as well as shift consumption to daytime hours and ultimately increase the capacity factor of the system. Such strategies could potentially help reduce the lost production of almost 1.7MWh that was witnessed in 11 months of system usage. These strategies could also increase the revenue of the system by approx. US$810 annually. Such strategies include pricing incentives, manual demand response, and system re-design options. In the general context of operations of rural solar kiosks, this work advocates for the need to continuously improve operational as well as hardware strategy based on field-evidence

Sistema Solar: Planetas Clássicos

O conhecimento curricular de Astronomia para surdos, não pode ser empobrecido, subtraído, fragmentado, mas sim formulado para corresponder a sua identidade de cognição, sem distanciar-se, porém, do direito inalienável a tudo que devem conhecer. Métodos de ensino não podem ser únicos para todos e, um sistema educacional que não revela estas diferenças está fadado em provocar a exclusão destes educandos por considerá-los inaptos, intelectualmente. Sendo assim, ao organizar o conteúdo que será trabalhado em sala de aula, o professor terá sempre em mente o tema Sistema Solar /Planetas Clássicos. Este tema está diretamente ligado a outros temas, permitindo ao aluno surdo fazer parte desse todo tão complexo que é o Universo em que vivemo

Long-Term Outcomes in Patients With Spontaneous Cerebellar Hemorrhage: An International Cohort Study

International audienceBACKGROUND:Spontaneous intracerebral hemorrhage (ICH) in the cerebellum has a poor short-term prognosis, whereas data on the long-term case fatality and recurrent vascular events are sparse. Herewith, we aimed to assess the long-term case fatality and recurrence rate of vascular events after a first cerebellar ICH.METHODS:In this international cohort study, we included patients from 10 hospitals (the United States and Europe from 1997 to 2017) aged ≥18 years with a first spontaneous cerebellar ICH who were discharged alive. Data on long-term case fatality and recurrence of vascular events (recurrent ICH [supratentoria or infratentorial], ischemic stroke, myocardial infarction, or major vascular surgery) were collected for survival analysis and absolute event rate calculation.RESULTS:We included 405 patients with cerebellar ICH (mean age [SD], 72 [13] years, 49% female). The median survival time was 67 months (interquartile range, 23–100 months), with a cumulative survival rate of 34% at 10-year follow-up (median follow-up time per center ranged: 15–80 months). In the 347 patients with data on vascular events 92 events occurred in 78 patients, after initial cerebellar ICH: 31 (8.9%) patients had a recurrent ICH (absolute event rate, 1.8 per 100 patient-years [95% CI, 1.2–2.6]), 39 (11%) had an ischemic stroke (absolute event rate, 2.3 [95% CI, 1.6–3.2]), 13 (3.7%) had a myocardial infarction (absolute event rate, 0.8 [95% CI, 0.4–1.3]), and 5 (1.4%) underwent major vascular surgery (absolute event rate, 0.3 [95% CI, 0.1–0.7]). The median time to a first vascular event during follow-up was 27 months (interquartile range, 8.7–50 months), with a cumulative hazard of 47% at 10 years.CONCLUSIONS:The long-term prognosis of patients who survive a first spontaneous cerebellar ICH is poor and comparable to that of patients who survive a first supratentorial ICH. Further identification of patients at high risk of vascular events following the initial cerebellar ICH is needed. Including patients with cerebellar ICH in randomized controlled trials on secondary prevention of patients with ICH is warranted

The predictive validity of a Brain Care Score for dementia and stroke: data from the UK Biobank cohort

IntroductionThe 21-point Brain Care Score (BCS) was developed through a modified Delphi process in partnership with practitioners and patients to promote behavior changes and lifestyle choices in order to sustainably reduce the risk of dementia and stroke. We aimed to assess the associations of the BCS with risk of incident dementia and stroke.MethodsThe BCS was derived from the United Kingdom Biobank (UKB) baseline evaluation for participants aged 40–69 years, recruited between 2006–2010. Associations of BCS and risk of subsequent incident dementia and stroke were estimated using Cox proportional hazard regressions, adjusted for sex assigned at birth and stratified by age groups at baseline.ResultsThe BCS (median: 12; IQR:11–14) was derived for 398,990 UKB participants (mean age: 57; females: 54%). There were 5,354 incident cases of dementia and 7,259 incident cases of stroke recorded during a median follow-up of 12.5 years. A five-point higher BCS at baseline was associated with a 59% (95%CI: 40-72%) lower risk of dementia among participants aged &lt;50. Among those aged 50–59, the figure was 32% (95%CI: 20-42%) and 8% (95%CI: 2-14%) for those aged &gt;59 years. A five-point higher BCS was associated with a 48% (95%CI: 39-56%) lower risk of stroke among participants aged &lt;50, 52% (95%CI, 47-56%) among those aged 50–59, and 33% (95%CI, 29-37%) among those aged &gt;59.DiscussionThe BCS has clinically relevant and statistically significant associations with risk of dementia and stroke in approximately 0.4 million UK people. Future research includes investigating the feasibility, adaptability and implementation of the BCS for patients and providers worldwide

Two new triterpenoid glycosides from <i>Centipeda minima</i>

320-323Two new triterpenoid glycosides have been isolated from the whole plant of Centipeda minima. They are characterized as 1β, 2α, 3β, 19α-tetrahydroxy urs-12-ene-28 -oate-3-O-β--xylopyranoside 1 and 1β, 2β , 3β, 19α-tetrahydoxyurs-12-ene-28-oate-3-O-β--xylopyranoside 2 and their structures elucidated by spectral and chemical studies

Transcriptional Analysis and Functional Characterization of a Gene Pair Encoding Iron-Regulated Xenocin and Immunity Proteins of Xenorhabdus nematophila▿ †

We describe a two-gene cluster encoding a bacteriocin, xenocin, and the cognate immunity protein in the insect-pathogenic bacterium Xenorhabdus nematophila, which infects and kills larval stages of the common crop pest Helicoverpa armigera. The two genes, xcinA and ximB, are present in the genome as a single transcriptional unit, which is regulated under SOS conditions. The stress-inducible promoter was activated by mitomycin C, glucose, and Fe3+ depletion and at an elevated temperature when it was tested in Escherichia coli cells. Expression of the xenocin protein alone in E. coli inhibited the growth of this organism. The growth inhibition was abolished when the immunity protein was also present. A recombinant xenocin-immunity protein complex inhibited the growth of E. coli indicator cells when it was added exogenously to a growing culture. Xenocin is an endoribonuclease with an enzymatically active C-terminal domain. Six resident bacterial species (i.e., Bacillus, Enterobacter, Enterococcus, Citrobacter, Serratia, and Stenotrophomonas species) from the H. armigera gut exhibited sensitivity to recombinant xenocin when the organisms were grown under iron-depleted conditions and at a high temperature. Xenocin also inhibited the growth of two Xenorhabdus isolates. This study demonstrates that Fe3+ depletion acts as a common cue for synthesis of xenocin by X. nematophila and sensitization of the target strains to the bacteriocin

OBSERVATIONS ON A NEW XIPHIDIOCERCARIA

Cercaria peterin. sp., a Xiphidiocercaria is described from Lymaea auricularia (L.) at Lucknow. It develops inside mother sporocyst. Experimentally, the cercaria has been ency's ted in mosquito and chironomus larvae. Metacercaria has been briefly described. Feeding experiments have been performed with Rana cyanophlyctis and Anatas testudineous but with negative results