A prospective study of efficacy and safety of mifepristone and vaginal misoprostol in termination of pregnancy up to 63 days of gestation

Background: Illegal abortion is still one of the important causes of maternal mortality in India accounting for approximately 13%. Medical Management of abortion is a non-surgical termination which does not require special facilities like operation theatre, hospital stay and thereby reduces complications associated with the same.Methods: It is a prospective study done in a Tertiary care Government Hospital over a span from Jan 2015 to April 2016. After patient selection as per inclusion criteria and written informed consent after evaluating patients were enrolled in the study. In first visit Tab. mifepristone 200 mg. orally was given and advised to take Tab. misoprostol 800 mcg. Vaginally after 48 hours at home. They were counselled for side effects and asked to report in case of excess bleeding, pain, fever or no bleed for 24 hours of misoprostol. After 7 days follow up was done to ensure completion of abortion. Any additional drugs required were noted. Contraceptive advice is also given during these visits.Results: In our study 60 cases were taken. Majority of women are between 20-29 years of age which is peak reproductive age. 61.1% women are of second parity. The success rate of medical methods is 96.6%, two cases out of 60 underwent surgical evacuation and one was lost to follow up. Most common adverse effect noted is abdominal cramps. No patient required hospitalization. Additional Misoprostol was required in 4 cases. This method is highly acceptable 95% cases as it is non invasive and preferred to adopt the same in future if needed.Conclusions: Patient participation, motivation, compliance, regular follow up visits, ability to record and report complications are the pillars on which the success of medical methods depends. Hence overall, it came out to be safe and effective method

The Grass Is Indeed Greener in India and China for Returnee Entrepreneurs

Presents survey findings on why Indian and Chinese entrepreneurs left the United States to found companies back home, how they view their home countries' business climates and their advantages and disadvantages, and whether they maintain ties to the U.S

Miss Julie: A Psychoanalytic Study

Sigmund Freud theorized that ‘the hero of the tragedy must suffer…to bear the burden of tragic guilt…(that) lay in rebellion against some divine or human authority.’ August Strindberg, the Swedish poet, playwright, author and visual artist, like Shakespeare before him, portrayed insanity as the ultimate of tragic conflict. In this paper I seek to explore and reiterate the dynamics of human relationships that are as relevant today as they were in Strindberg’s time. I propose to examine Strindberg’s Miss Julie, a play set in nineteenth century Sweden, through a psychoanalytic lens. The play deals with bold themes of class and sexual identity politics. Notwithstanding the progress made in breaking down gender barriers, the inequalities inherent in a patriarchal system persist in modern society. Miss Julie highlights these imbalances. My analysis of the play deals with issues of culture and psyche, and draws on Freud, Melanie Klein, Lacan, Luce Irigaray and other contemporary feminists. Miss Julie is a discourse on hysteria, which is still pivotal to psychoanalysis. Prominent philosophers like Hegel and the psychoanalyst Jacques Lacan have written about the dialectic of the master and the slave – a relationship that is characterized by dependence, demand and cruelty. The history of human civilization shows beyond any doubt that there is an intimate connection between cruelty and the sexual instinct. An analysis of the text is carried out using the sado-masochistic dynamic as well the slave-master discourse. I argue that Miss Julie subverts the slave-master relationship. The struggle for dominance and power is closely linked with the theme of sexuality in the unconscious. To quote the English actor and director Alan Rickman, ‘Watching or working on the plays of Strindberg is like seeing the skin, flesh and bones of life separated from each other. Challenging and timeless.

EFFECT OF PREVIOUS SCORPION BITE ON THE EFFICACY OF INTRATHECALLY ADMINISTERED LEVOBUPIVACAINE IN SUBARACHNOID BLOCK

Objectives: Local anesthetics administered by spinal anesthesia acts through sodium channels. Mutations of sodium channels may be responsible for resistance to local anesthetic agents. The scorpion venom contains neurotoxins that block the sodium channels. In view of the high prevalence of scorpion stings in our region and observation of failure of spinal anesthesia in patients with a history of scorpion stings in routine practice, the present study is planned. Methods: Forty patients of the American Society of Anesthesiologists Grade I or II who were undergoing infraumbilical surgery were divided into two groups as S (patients with h/o scorpion bite) and C (patients with no such history). The subarachnoid block was given with 3.2 ml of injection Levobupivacaine 0.5% heavy using 26 gauzes Quincke spinal needle. A blind observer recorded a sensory block using a needle prick and a motor block using the Bromage scale. Onset of sensory and motorized block, time to peak of sensory, and motor block and its relation to number of scorpion bites were observed in both the groups. Results: The onset of sensory (2.61±1.68 mins) and motor blockade (2.91±1.80 mins) was significantly delayed in Group S (p=0.010 and 0.004, respectively). Time to peak of sensory and motor blockade was also prolonged in Group S (6.45±2.83 mins and 7.8±3.95 mins) compared to Group C (3.60±0.84 mins and 4.56±1.30 mins) which was statistically significant (p<0.05). Patients who had previous scorpion bites (Group S) had a significant failure rate of spinal anesthesia compared to the control group. Conclusion: In this study, it was observed that the patients with scorpion bites had a significant failure rate of spinal anesthesia, suggesting probable resistance to the local anesthetic agents

A Real Time System for Hand Gesture Recognition

In this paper we explore the various aspects of hand gesture recognition in real time using neural networks. Hand gesture can be a vital way for the user to interact with any system. In this system we capture a hand gesture from the user and then perform the action related to it. This provides us with an alternative to mouse and keyboard to control a system. Hand gesture recognition can be helpful in various fields and areas where interacting with the system without touch is important. Hand gesture recognition is incorporated along with image processing and to add additional accuracy we are using neural network. This combination of image processing and neural network in real time forms a really powerful tool, forming the base of our project

Interscalene Block in the Modern Era: When Stuck, Go Back to the Roots!

The traditional interscalene block has evolved over time to lower, lateral and posterior approaches, coinciding with the advent of Peripheral Nerve Stimulator and Ultrasonography. In limited infrastructure settings, such technology remains elusive and the classical paresthesia technique comes to the rescue. This approach is however very difficult to elicit in pediatric patients. It is here that the grassroot approach of a fascial “click” or “pop” emerges as the savior to administer a satisfactory block. We describe a case of a young boy with successful conduct of anaesthesia for K wire fixation of supracondylar fracture of humerus under lower interscalene block with loss of resistance technique. In light of recent research showing about 40-50% variation in the brachial plexus anatomy around the subclavian artery, use of technology in anaesthesia is the future. However, till such technology is made universally affordable, it is pertinent to remember the roots of interscalene block

Mechanisms of Action of Human Mesenchymal Stem Cells in Tissue Repair Regeneration and their Implications

Cell replacement therapy holds a promising future in the treatment of degenerative diseases related to neuronal, cardiac and bone tissues. In such kind of diseases, there is a progressive loss of specific types of cells. Currently the most upcoming and trusted cell candidate is Mesenchymal Stem Cells (MSCs) as these cells are easy to isolate from the tissue, easy to maintain and expand and no ethical concerns are linked. MSCs can be obtained from a number of sources like bone marrow, umbilical cord blood, umbilical cord, dental pulp, adipose tissues, etc. MSCs help in tissue repair and regeneration by various mechanisms of action like cell differentiation, immunomodulation, paracrine effect, etc. The future of regenerative medicine lies in tissue engineering and exploiting various properties to yield maximum output. In the current review article, we have targeted the repair and regeneration mechanisms of MSCs in neurodegenerative diseases, cardiac diseases and those related to bones. Yet there is a lot to understand, discover and then understand again about the molecular mechanisms of MSCs and then applying this knowledge in developing the therapy to get maximum repair and regeneration of concerned tissue and in turn the recovery of the patient

SILYMARIN PROTECTS AGAINST COPPER-ASCORBATE INDUCED INJURY TO GOAT CARDIAC MITOCHONDRIA IN VITRO: INVOLVEMENT OF ANTIOXIDANT MECHANISM(S)

Silymarin, 'one of the component of the Milk thistle seeds Silybum marianum (L.) is used in traditional food and medicine in India. In the present study, we investigated the antioxidant activities of Silymarin against copper-ascorbate induced toxic injury to mitochondria obtained from goat heart, in vitro. Incubation of isolated cardiac mitochondria with copper-ascorbate resulted in elevated levels of lipid peroxidation and protein carbonylation of the mitochondrial membrane, a reduced level of mitochondrial GSH and altered status of antioxidant enzymes as well as decreased activities of pyruvate dehydrogenase and the Kreb's cycle enzymes, altered mitochondrial morphology, mitochondrial swelling and di-tyrosine level. All these changes were found to be ameliorated when the cardiac mitochondria were co-incubated with copper-ascorbate and Silymarin, in vitro. Silymarin, in our in vitro experiments, was found to scavenge hydrogen peroxide, superoxide anion free radicals, hydroxyl radicals and DPPH radical, in a chemically defined system, indicating that this compound may provide protection to cardiac mitochondria against copper-ascorbate induced toxic injury through its antioxidant activities. The results of this study suggest that Silymarin may be considered as a future therapeutic antioxidant and may be used singly or as a co-therapeutic in the treatment of diseases associated with mitochondrial oxidative stress

Mitochondrial dysfunction and its association with age-related disorders

Aging is a complex process that features a functional decline in many organelles. Various factors influence the aging process, such as chromosomal abnormalities, epigenetic changes, telomere shortening, oxidative stress, and mitochondrial dysfunction. Mitochondrial dysfunction significantly impacts aging because mitochondria regulate cellular energy, oxidative balance, and calcium levels. Mitochondrial integrity is maintained by mitophagy, which helps maintain cellular homeostasis, prevents ROS production, and protects against mtDNA damage. However, increased calcium uptake and oxidative stress can disrupt mitochondrial membrane potential and permeability, leading to the apoptotic cascade. This disruption causes increased production of free radicals, leading to oxidative modification and accumulation of mitochondrial DNA mutations, which contribute to cellular dysfunction and aging. Mitochondrial dysfunction, resulting from structural and functional changes, is linked to age-related degenerative diseases. This review focuses on mitochondrial dysfunction, its implications in aging and age-related disorders, and potential anti-aging strategies through targeting mitochondrial dysfunction