Comparison between laparoscopy and laparotomy in the management of ectopic pregnancy: a retrospective study

Background: Ectopic pregnancy is one of the most important causes of maternal mortality and morbidity in the first trimester of pregnancy. Objective of this study was to compare the safety, feasibility and advantage of laparoscopic approach with that of laparotomy in management of ectopic pregnancy.Methods: A retrospective study was conducted at two tertiary hospitals over a period of two years i.e.; from Aug 2015 to July 2017. Seventy-five patients who had histopathology confirmed tubal ectopic pregnancy were divided into two groups; laparoscopy (Group I, no-39) and laparotomy (Group II no-36). The main outcome measures were operative time, blood loss, and requirement of blood transfusion, requirement of analgesia and duration of hospital stay.Results: Seventy-five patients of ectopic pregnancy who were managed surgically were studied. There were 39 cases in laparoscopy group and 36 cases in laparotomy group. The incidence of ectopic pregnancy was 1.56% (out of all deliveries over 2 years). Ampullary region was the commonest site of ectopic pregnancy (74.6%). No difference was found in the two groups regarding age, site of tubal pregnancy, pre op Hb status and haemoperitoneum. Mean operating time was significantly shorter in the laparoscopy group 39 min (range 30 - 52 min) versus 50 min (range 40-60 min) in the laparotomy group. There was no difference between the groups regarding the treatment with blood products and perioperative complications. Hospital stay was significantly longer in the laparotomy group (3.5 days) as compared to 2 days in laparoscopy group. The duration of post op analgesia requirement was also longer in laparotomy group (4 days) as compared to 2 days in laparoscopy group.Conclusions: Laparoscopic management of ectopic pregnancy is a safe, effective and beneficial option in the hands of an experienced laparoscopic surgeon even in cases of massive haemoperitoneum. It definitely offers the advantage of shorter duration of surgery, faster post op recovery, shorter duration of hospital stays and lesser requirement of post op analgesia

EFFECT OF GIBBERELLIC ACID PRE-TREATMENTS ON GROWTH PARAMETERS OF WALNUT (Juglans regia L.)

Present investigation was carried out during the winter season at Horticulture Research block, Department of Horticulture, Shri Guru Ram Rai University, Dehradun, Uttarakhand. To investigate the effect of GA3 treatment on growth attributes and days taken for germination initiation of walnut. The experiment was laid out in randomized block design with three replications and twelve treatments. The treatments comprised following levels of GA3 concentrations viz. 500ppm, 1000ppm, 15000ppm and control in three different replications of Horticultural Research Block. Various observations regarding growth parameters such as leaf length, leaf width, shoot length, shoot width and numbers of days taken for germination initiation of walnut were recorded. The result revealed that treatment of GA3 1500ppm of nursery polybag application found to be beneficial for vegetative characters viz, found to be the most effective treatment for increasing leaf length, shoot length and shoot diameter. In another point of view, 1500ppm GA3 treatment in polyhouse was found to be profitable as compared to rest of treatments in terms of number of days taken for germination. Apart from this leaf width of 1000ppm in nursery polybag was found best. View Article DOI: 10.47856/ijaast.2021.v08i3.00

Maternal and fetal factors associated with non detection of fetal growth restriction at term: a retrospective study

Background: Fetal growth restriction (FGR) is one of the major factors of perinatal morbidity and mortality. Aim was to study the maternal and fetal risk factors associated with non- detection of fetal growth restriction.Methods: A retrospective analysis was done at a tertiary care hospital. 280 term newborn cases weighing <2.5 kg were selected and they were divided into two groups, Group I- FGR detected cases by ultrasound, and group II- FGR non detected cases. Data was collected from the labour room registers.Results: Incidence of FGR found to be 6.8%.The maternal biological factors found to be significantly associated with fetal growth restriction were gestational hypertension, chronic hypertension and anemia. Fewer ANC visits was associated with non-detection of FGR cases. Detection of FGR cases were more if the birth weight found to be <2 kg when compared to non detection of FGR cases.Conclusions: Anaemia and fewer ante natal visits were associated with non detection of FGR at term when compared with antenatally detected FGR patients

Effect of Organic Manures on the Growth and Yield Attributes of Spinach Beet (Beta vulgaris var bengalensis) at Low Hills of Uttarakhand

A field experiment was planned and conducted during 2020-21 at Horticulture Research Block, Department of Horticulture, School of Agricultural Sciences, SGRR University, Dehradun, Uttarakhand to investigate the “Effect of different organic manures on the growth and yield attributes of spinach beet at lower hills of Uttarakhand”. The experiment was laid out in randomized block design with three replications and nine treatments including various organic manures at different concentrations. Observations on various growth and yield attributes were recorded at regular intervals. Studies on vegetative and yield attributes were recorded using standard method of measurements. Among all the organic treatments, soil application with Farmyard manure (5kg) + Vermicompost (2.5kg) + foliar spray of Vermiwash (25%) was sown the significant improvement in plant height (cm), number of leaves per plants, length of leaves (cm), width of leaves (cm), petiole length (cm), root length (cm) and yield than other treatments. View Article DOI: 10.47856/ijaast.2021.v08i11.00

Assessing Safety Against Floods for an Ashpond Garlanded by Two Natural Streams

Source: ICHE Conference Archive - https://mdi-de.baw.de/icheArchiv

Invasive Mechanical Ventilation of COVID-19 ARDS Patients

The purpose of this review article is to analyse evidence on the use of ventilatory strategies and associated cointerventions in adult patients with COVID-19 induced acute respiratory distress syndrome (ARDS) and to provide treatment recommendations based on these interventions. For each recommendation mentioned, it is important to consider the quality of the evidence reviews thoroughly before applying these recommendations to specific clinical situations or policy decisions. No guideline or recommendations can consider all the compelling clinical features of individual patients, as they are unique. Thus, it is imperative that clinicians, patients, policy makers, and other stakeholders should not regard these recommendations as mandatory. However, this review article, impartially discusses the nuances of treatment available and management protocols followed in many centres around the world for the consumption of all treating physicians.El propósito de este artículo de revisión es analizar la evidencia sobre el uso de estrategias ventilatorias y cointervenciones asociadas en pacientes adultos con síndrome de dificultad respiratoria aguda (SDRA) inducido por COVID-19 y brindar recomendaciones de tratamiento basadas en estas intervenciones. Para cada recomendación mencionada, es importante considerar la calidad de las revisiones de la evidencia a fondo antes de aplicar estas recomendaciones a situaciones clínicas específicas o decisiones políticas. Ninguna guía o recomendación puede considerar todas las características clínicas convincentes de los pacientes individuales, ya que son únicas. Por lo tanto, es imperativo que los médicos, los pacientes, los responsables políticos y otras partes interesadas no consideren estas recomendaciones como obligatorias. Sin embargo, este artículo de revisión analiza de manera imparcial los matices del tratamiento disponible y los protocolos de manejo seguidos en muchos centros alrededor del mundo para el consumo de todos los médicos tratantes

External review : Governance, Equity and Health Program, IDRC, 2006-2011

Overall, the implementation of the Governance, Equity and Health (GEH) program has closely followed the program of work described in the Prospectus of April 2006 – March 2011. The program initiative places a unique focus on intensive knowledge translation within communities, civil societies and local and national governments. Achievements have been made in: convergence of research projects around primary health care; better integration and linkages with social justice to redress health inequities; wider geographical and increasing global reach of projects; and increased understanding of governance and health systems equity among GEH recipients

Brucella melitensis Lurking Threat in Eastern Part of Odisha - A Case Report

Brucellosis is a rising veterinary and human health problem in India. It may manifest with a varied multisystem clinical presentation. In our case patient was of 72 years male with a complaint of abdominal pain for 2 months following COVID-19 infection. He was a known case of CAD (coronary artery disease) post PTCA status, on regular follow up & treatment. Patient had post COVID pulmonary fibrosis. When the patient admitted in our hospital with above mentioned complaints, necessary investigations along with blood culture by automated method was sent and patient was started on empirical doxycycline along with other symptomatic treatment. As the patient was not very sick and was reluctant to stay in hospital during the COVID-19 situation, he was discharged on request with a treatment and follow up plan. Blood culture was found to be positive for Brucella melitensis. When we got the blood culture report the patient was contacted telephonically and started Rifampicin along with Doxycycline for 6 weeks

Centrosomal kinase Nek2 Cooperates with Oncogenic Pathways to Promote Metastasis

Centrosomal kinase Nek2 is overexpressed in different cancers, yet how it contributes toward tumorigenesis remains poorly understood. dNek2 overexpression in a Drosophila melanogaster model led to upregulation of Drosophila Wnt ortholog wingless (Wg), and alteration of cell migration markers—Rho1, Rac1 and E-cadherin (Ecad)—resulting in changes in cell shape and tissue morphogenesis. dNek2 overexpression cooperated with receptor tyrosine kinase and mitogen-activated protein kinase signaling to upregulate activated Akt, Diap1, Mmp1 and Wg protein to promote local invasion, distant seeding and metastasis. In tumor cell injection assays, dNek2 cooperated with Ras and Src signaling to promote aggressive colonization of tumors into different adult fly tissues. Inhibition of the PI3K pathway suppressed the cooperation of dNek2 with other growth pathways. Consistent with our fly studies, overexpression of human Nek2 in A549 lung adenocarcinoma and HEK293T cells led to activation of the Akt pathway and increase in b-catenin protein levels. Our computational approach identified a class of Nek2-inhibitory compounds and a novel drug-like pharmacophore that reversed the Nek2 overexpression phenotypes in flies and human cells. Our finding posits a novel role for Nek2 in promoting metastasis in addition to its currently defined role in promoting chromosomal instability. It provides a rationale for the selective advantage of centrosome amplification in cancer