Maternal and fetal outcome in primigravida with unengaged head at term in labour

Background: Unengaged head in a primigravida at term gestation at the onset of labor is considered as an obstetric risk factor for dysfunctional labor. Careful monitoring of the progress of labor and timely medical intervention reduced the risk of dysfunctional labor and Cesarean delivery. This study was to assess the effect of unengaged head on course of labor, duration of labor, its maternal and fetal outcome in primigravida at term in labor. Methods: This prospective cross-sectional study was conducted in 100 primigravida with term gestation, unengaged head with spontaneous onset of labor meeting the inclusion criteria admitted to labor ward, Department of Obstetrics & Gynecology, ESIC-MC & PGIMSR Hospital, Bengaluru during January 2019 to June 2020. After detailed clinical evaluation, labor monitored partographically and CTG for fetal surveillance and when necessary, interventions like augmentation of labor and operative vaginal or cesarean delivery performed. Results: Among 100 primigravidae, 19% had floating head, 53% at -3 and 28% at -2 station at the time of onset of labor. The mean duration of 1st, 2nd stage and total duration of labor       was higher in freely floating head compared to -3 and -2 station. The need for augmentation of labor was 100% with freely floating head than with -3 and -2 station. 77% delivered vaginally and 23% by LSCS, arrest disorders being the main indication. There was no significant difference in maternal morbidity or APGAR score at 5 min. 88% of the babies delivered with good APGAR and 12% required NICU admission Conclusions: Our study demonstrates that higher the fetal head station at the onset of labor, greater the duration of labor and the need for augmentation. Unengaged head per se is not an indication for LSCS as 77% of them delivered vaginally with partographically monitored labor

Fuzzy Knowledge Based System for Suitability of Soils in Airfield Applications

Proper design of roads and airfield pavements requires an in-depth soil properties evaluation to determine suitability of soil. Soft computing is used to model soil classification system's dynamic behaviour and its properties. Soft computing is based on methods of machine learning, fuzzy logic and artificial neural networks, expert systems, genetic algorithms. Fuzzy system is a strong method for mimicking human thought and solves question of confusion. This paper proposes a new decision-making approach for soil suitability in airfield applications without a need to perform any manual works like use of tables or chart. A fuzzy knowledge - based approach is built to rate soil suitability in qualitative terms for airfield application. The proposed model describes a new technique by defining fuzzy descriptors using triangular functions considering the index properties of soils as input parameters and fuzzy rules are generated using fuzzy operators to classify soil and rate its suitability for airfield applications. The data obtained from the results of the laboratory test are validated with the results of the fuzzy knowledge-based system indicating the applicability of the Fuzzy model created. The approach developed in this work is more skilled to other prevailing optimization models. Due to its system’s flexibility, it can be suitably customized and applied to laboratory test data available, thus delivering a wide range for any geotechnical engineer. Doi: 10.28991/cej-2021-03091643 Full Text: PD

Orbital order-disorder transition in La(1-x)Nd(x)MnO(3) (x = 0.0-1.0) and La(1-x-y)Nd(yx)Sr(y)MnO(3) (x = 0.1; y = 0.05,0.1)

The nature of orbital order-disorder transition has been studied in the La(1-x)Nd(x)MnO(3) (x = 0.0-1.0) series which covers the entire range between two end points - LaMnO(3) and NdMnO(3) - as well as in La(0.85)Nd(0.1)Sr(0.05)MnO(3) and La(0.8)Nd(0.1)Sr(0.1)MnO(3). It has been observed that the first-order nature of the transition gives way to higher order with the increase in "x" in the case of pure manganites. The latent heat (L) associated with the transition, first, drops with a steeper slope within x = 0.0-0.3 and, then, gradually over a range 0.3<x<0.9. This drop could, possibly, be due to evolution of finer orbital domain structure with "x". In the case of Sr-doped samples, the transition appears to be of higher-order nature even for a doping level 5 at%. In both cases, of course, the transition temperature T(JT) rises systematically with the drop in average A-site radius or rise in average Mn-O-Mn bond bending angle while no apparent correlation could be observed with doping induced disorder sigma^2. The cooperative nature of the orbital order, therefore, appears to be robust.Comment: 15 pages including 4 figures; pdf onl

Efficacy and safety of topical BAK-free travoprost 0.004% versus BAK-preserved travoprost 0.004% in the treatment of primary open angle glaucoma: a comparative study at a tertiary care hospital

Background: Prostaglandin analogues (PGAs) reduce intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG); however, these medications may affect the ocular surface and elicit ocular discomfort when preserved with benzalkonium chloride (BAK). Hence the above study was taken to evaluate the benefit of BAK-free formulations of travoprost. The objectives of the study were to compare the efficacy, safety of topical BAK-free travoprost 0.004% versus BAK-preserved travoprost 0.004% in patients with primary open angle glaucoma.Methods: 40 patients with POAG who fulfilled the inclusion /exclusion criteria were randomised into two groups of 20 each to receive BAK-free travoprost 0.004% or BAK-preserved travoprost once daily in the evening. Efficacy was measured in terms of reduction in IOP monitored at 4, 8 and 12 weeks from baseline. Ocular surface disease index (OSDI) questionnaire was used to assess the ocular surface symptoms. Safety was assessed by monitoring treatment emergent adverse drug reactions (ADRs).Results: Both the study medications were effective in reducing IOP when compared to baseline. Mean IOP reduction from baseline to week 12 was 11±3mmHg (p <0.001), 10.78±3.01mmHg, (p<0.001) in BAK-free travoprost and BAK-preserved travoprost groups respectively. Both produced equivalent reductions in IOP at the end of 4 (7.89±1.82 vs 7.63±2.83, p=0.72), 8 (9.94±2.75 vs10.05±2.75, p=0.90), and 12 weeks (11±3 vs10.78±3.01, p=0.82). BAK-free travoprost demonstrated significantly lower OSDI scores (15.10±3.60) compared to BAK- preserved travoprost (23.47±7.10) at 12 weeks (p <0.0001). There was no significant difference in occurrence of conjunctival hyperaemia between the study drugs (c2 = 0, df = 1, p = 1) and BAK-free travoprost was well tolerated.Conclusions: BAK-free and BAK-preserved travoprost significantly reduced IOP at 12 weeks. But, BAK- free travoprost produced significantly less ocular surface symptoms as compared to BAK- preserved travoprost. Hence it could be a favourable option in POAG patients with ocular surface disease symptoms

Interaction of Ihh and BMP/Noggin Signaling during Cartilage Differentiation

AbstractBone morphogenetic proteins (BMPs) have been implicated in regulating multiple stages of bone development. Recently it has been shown that constitutive activation of theBMP receptor-IAblocks chondrocyte differentiation in a similar manner as misexpression ofIndian hedgehog.In this paper we analyze the role of BMPs as possible mediators of Indian hedgehog signaling and useNogginmisexpression to gain insight into additional roles of BMPs during cartilage differentiation. We show by comparative analysis ofBMPandIhhexpression domains that the borders ofIndian hedgehogexpression in the chondrocytes are reflected in changes of the expression level of severalBMPgenes in the adjacent perichondrium. We further demonstrate that misexpression ofIndian hedgehogappears to directly upregulateBMP2andBMP4expression, independent of the differentiation state of the flanking chondrocytes. In contrast, changes inBMP5andBMP7expression in the perichondrium correspond to altered differentiation states of the flanking chondrocytes. In addition,NogginandChordin,which are both expressed in the developing cartilage elements, also change their expression pattern afterIhhmisexpression. Finally, we use retroviral misexpression ofNoggin,a potent antagonist of BMP signaling, to gain insight into additional roles of BMP signaling during cartilage differentiation. We find that BMP signaling is necessary for the growth and differentiation of the cartilage elements. In addition, this analysis revealed that the members of the BMP/Noggin signaling pathway are linked in a complex autoregulatory network

Survey paper comparing ECC with RSA, AES and Blowfish Algorithms

Data Security is primary concern for every communication system. There exist many frauds in real time through online in each and every aspect, in order to overcome those frauds which means to keep one?s images and personal information secure, there should be some security algorithms which helps in reducing the frauds. In general, there are many encryption algorithms that can be used to reduce the real time frauds. These encryption algorithms can be classified into two types. One is symmetric encryption and the other one is asymmetric encryption. Symmetric encryption algorithms are used earlier for the purpose of providing security such as AES and Blowfish algorithms. In AES algorithm, the processing time is more and requires more rounds of communication when compared to the remaining algorithms and it is not highly secured. In case of blow fish algorithm, uses a lot of memory and has a relatively long key setup time and it was only designed for software. In order to provide more security the asymmetric algorithms are used such as RSA algorithm and Elliptic Curve Cryptography (ECC) algorithm. When compared to ECC, RSA algorithms is little slow and uses larger key or message in size. So, now the most efficient ECC algorithm came into the picture in order to provide high security over the existing credit frauds. This proves the efficiency and the less memory usage after the implementation of elliptic curve cryptography

Incidence and Potential Co-Morbidities in Facial Pigmentary Demarcation Lines in Indian Populations

Background: The most noticeable part of human body is face. The obvious boundaries on the skin known as Pigmentary Demarcation Lines (PDL) found over face and have clear borders of abrupt transition between more hyper-pigmented skin and areas of normal skin pigmentation due to differences in melanocyte distribution that may be influenced by multiple factors. Facial pigmentary demarcation lines (PDL) directly reflect on patient’s physical appearance and self-image as they may contribute to dysmorphism and even central to depressive illness in susceptible individuals posing cosmetic concern for the patient and a challenge for dermatologist. Therefore, it is important for early identification and management of facial skin disorders. Until now, nine different types of PDLs have been described which are designated as Type A to I of which Type F to H PDLs are most common on the face. Etiology involving the whole spectrum of PDL continues to be an enigma and needs further research among Indian population. Materials and Methods: Total 304 patients between 15 to 75 years of age range were included in study lead between May 2018 to May 2020 after thorough examination for inclusion and exclusion criteria, informed consent and Ethics committee approval. Statistical analysis was done using descriptive and inferential statistical approach using Chi-square test and Fisher’s exact test and p value was calculated and considered to be significant if \u3c0.05. Results: Out of 304 study subjects the frequency of facial PDL type H (50.65%) was most common than type G (29.60%) and type F (19.73%) with male predisposition (79.60%) with agricultural occupations (59.86%) than females and with significant family history from father (41.44%). Most of the present study subjects were of Fitzpatrick skin type IV (50.01%) with hyper-pigmented macules (12.5%) and shown unilateral PDL symmetry (58.22%) with sharp PDL line margins (81.25%). The most common aggravating factor was prolonged exposure to sun light (56.90%) and most of (25.98%) the subjects experienced periorbital melanosis at different times. Diabetes (38.15%) and hypertension (29.60%) were the most common co morbidities observed in study subjects. Using Fishers exact test, p value was calculated and it was found to be highly significant (p=0.003). Conclusion: Present study pronounces the incidence of facial PDL (types F-H) are sharply common especially amongst the males who are in agricultural occupations with prolonged sun exposure and with other co morbidities like diabetes, hypertension and tuberculosis. In females the prevalent type was Type H PDL during and after pregnancy. The agricultural occupations with prolonged sun exposure, diabetes, hypertension, tuberculosis and positive paternal family history were shown strong correlation with facial PDL among Indian population irrespective of gender and it was found to be highly significant (p=0.003)