Role of modified biophysical profile and cerebroplacental ratio in fetal outcome in low risk and high risk pregnancies

Background: The timely detection of morbid changes in the fetal status followed by adequate interventions to avoid death or disability is one of the most important objectives of prenatal care. Objective of present study was to Comparing the role of modified biophysical profile and the cerebroplacental ratio in fetal outcome in low risk and high risk pregnancies.Methods: Two hundred and seventy three singleton pregnant women were included in this study. Following routine examination, amniotic fluid index, pulsatility index of middle cerebral artery and pulsatility index of umbilical artery, uterine artery mean pulsatility index were evaluated. Non stress test (NST) was done. Modified biophysical profile (MBPP) and Cerebroplacental ratio (CPR in percentile) was generated. Caeserean section because of Fetal distress, birth weight 24hours were used in evaluating the perinatal outcome.Results: Out of 273 cases, 107 cases had poor perinatal outcome. Out of 107 cases, 35.5% cases were IUGR, 39.2% cases underwent caesarean section in view of fetal distress, 39.2% babies had 5min APGAR 24hrs. In high risk cases, poor perinatal outcome was seen in 45.5% pregnancies and 36.7% in low risk pregnancies. Sixty seven percent of these cases had abnormal modified biophysical profile and only 7.4% cases had cerebroplacental ratio <1.Conclusions: Modified biophysical profile was proved to be more significant than cerebroplacental ratio in prediction of perinatal outcome.

Lipid Profile levels on the second day of Acute Myocardial Infarction; is it the right time for estimation?

The main objective of this study is to note the changes that occur in the lipid profile levels following an acute myocardial ischemic attack and also correlate the changes in the lipid profile levels to the ischemic markers (Cardiac troponin-I and AST). The study included two groups; the first group consisted of 50 patients who were admitted to the hospital with Acute Myocardial Infarction (AMI). The second group patients were normal healthy controls. Serum levels of Cardiac troponin-I (cTnI) and AST were assessed immediately and 12hrs fasting blood drawn for assessing the lipid profile levels. The patients with AMI had shown significant rise in cTnI and AST and the lipid parameters like High density lipoprotein (HDL) had shown significant decrease and the Very Low Density Lipoprotein (VLDL) and triglycerides (TG) had shown significant increase in cases compared to normal healthy individuals. Total Cholesterol (TC) and Low Density Lipoprotein (LDL) in cases had shown decrease compare to controls but not significant statistically. The cTnI showed a significant negative correlation with decrease in the TC and HDL and LDL. The AST showed significant negative correlation with TC and LDL only. So routine diagnosis of lipid parameter for assessing the clinical risk should be reliably assessed within 24 hours and the lipid parameters assessed after 24 hours are invalid for risk assessment for patients with AMI

The Path to Innovation: An Amalgamation of Patent Law and the Dynamic Competition Regime

The purpose of this paper is to identify a method to create a balance between competition laws and the patent protection regime so as to promote innovation. The relationship between competition law and the law relating to intellectual property has long been recognized to be a turbulent one. The traditional perspective adopted towards the relationship between the subjects is that one is opposed to the other; where intellectual property laws encourage and protect monopoly, competition laws seek to curb and control it. This research focuses on the possibility of change from the conventional view relating to competition law and intellectual property law by making the approach to these two subjects more innovation centric. The paper examines these apparently paradoxical disciplines from the perspective of innovation and finds that both intellectual property laws and competition laws have a common objective, which is to increase innovation. This paper undertakes conceptual research in order to develop new concepts and to re-interpret the existing ones. It analyses various economic theories of development and the existing conceptual framework pertaining to competition and patent laws. Finally, the paper suggests amendments in the existing law and proposes a new legal and policy framework that reconciles both the fields so as to promote effective innovation crucial for economic development and trade in India

Comparative Antioxidant, Antimicrobial and Phytochemical Assesments of Leaves of Desmostachya bipinnata L. Stapf, Hordeum vulgare L. and Drepanostachyum falcatum (Nees) Keng f.

&nbsp;Nepal is rich in varieties of religious plants. The locally used religious plants also carry medicinal importance. Desmostachya bipinnata L. Stapf, Hordeum vulgare L. and Drepanostachyum falcatum (Nees) Keng f. are three plants belonging to the family Poaceae having religious significance in different practices of Hinduism. They were also used as traditional medicines by our ancestors but nowadays they are underutilized. In this research, our core objective was to validate the traditional assumption of use of these plants in medicinal purposes by carrying out the assessments like antimicrobial assessment, antioxidative assessment and phytochemical assessment. Methanolic extracts produced from leaves of all three plants were examined for antimicrobial activities through agar well diffusion method. The same extracts were also assessed for determining their antioxidative potentials with the use of DPPH (1, 1-diphenyl-2-picryl hydrazyl) free radical scavenging assay followed by qualitative phytochemical analysis and GCMS (Gas Chromatography Mass Spectroscopy). Most promising antimicrobial activity was shown by Desmostachya bipinnata L. against Salmonella typhimurium and Staphylococcus aureus, Drepanostachyum falcatum (Nees) Keng f. against Salmonella typhimurium and Klebsiella pneumoniae and Hordeum vulgare L. against Salmonella typhmurium and Staphylococcus aureus. The antioxidant activity of the plant extracts were observed in descending order of Hordeum vulgare L.&gt;Desmotachya bipinnata L. &gt; Drepanostachyum falcatum (Nees) keng f. and phytochemical assessment of the extracts indicated the presence of alkaloids, glycosides, sterols, Triterpenes, Saponins, Flavonoids, Coumarins, Phlobatanin and reducing sugars. Through this project, we can clarify that the above mentioned plants have bioactive compounds which contributed for the presence of antimicrobial and antioxidative property in the plants

Efficacy of fungicides in management of Downy mildew disease of Cucumber (Cucumis sativus L.) under open field conditions, in Dhading district of Nepal

Downy mildew (Pseudoperonospora cubensis) is one of the most important disease of cucumber under open field conditions. Hence, the experiment was conducted to study the efficacy of fungicides in management of downy mildew disease of cucumber (Cucumis sativus L.) under open field in Chauradi-7 Dhading during spring season, 2019. Bhaktapur local variety of cucumber was used for the study. The experiment was laid out in single factor randomized complete block design with four replications. Three different bio-fungicides; Trichoderma viride + Trichoderma harzianum, Bacillus subtilis, Verticillium lecanii and one chemical fungicide; Krilaxyl (metalaxyl 8% + mancozeb 64%) were used as treatments. Normal water spray served as control. It was observed that bio-fungicides had insignificant effect in controlling the downy mildew. Pathological observation such as disease incidence percentage, severity percentage and AUDPC in bio-fungicides treated plots were not significantly different from water-sprayed control plots. Similarly, biometric attributes such as number of fruit, length and diameter of fruit, weight of fruit were also non-significant. Krilaxyl resulted significant effect in controlling downy mildew, providing maximum disease reduction (37.48%-50.72%) with lowest disease incidence (1.25-61.25%) and lowest value of AUDPC (138.7). Krilaxyl treated plots had higher number of fruit (6), longer length of fruit (17.15-18.95), higher diameter of fruit (4.16- 4.45 cm) and higher weight of fruit (677 - 759 g). Hence, chemical fungicide Krilaxyl was found better for the management of downy mildew disease in open field cucumber cultivation. Further, researches on bio-fungicides, especially of native strains are required for best result

Effect of heat treatment parameters on the mechanical properties and microstructure of aluminium bronze

Aluminium bronzes are used for their combination of high strength, excellent corrosion and wear resistance. This paper presents the research of heat treatment parameters of two different chemical compositions of aluminium bronze (Cu-Al-Fe- Ni alloy) on microstructure and mechanical properties. The heat treatment employed in this research were solutionizing and tempering. The solution treatment was carried out at a temperature of 950 °C and the duration in the range of two hours. Similarly, tempering was carried out at 300 °C and 400 °C, wherein the duration was maintained at two hours. The heat treated samples were subjected to the cold water quenching in order to bring them to an ambient temperature. Metallographic studies were performed on samples in order to determine the changes in the microstructure of the hardened bronze, on the metallographic microscope OLYMPUS GX51 with a digital image analysis and the scanning electron microscope TESCAN VEGA 5136MM with EDX along with the digital recording on the computer. Moreover, the Glow Discharge Spectroscopy-GDS was done to determine the chemical composition of the samples. The results of the chemical composition for the aluminium bronze AK2 were: Cu- 78,37%; Al- 10,52%; Fe- 4,44%; Ni- 5,16% and for AK3 alloy: Cu- 78,95%, Al- 10,97%; Fe- 4,16%; Ni- 4,8%. The behavior of the alloy has been assessed in terms of the influence of the temperature and duration of the heat treatment on the microstructural and mechanical properties of the samples. The hardness of samples was measured by using a Vickers hardness tester at an applied load of one kg. The samples were polished metallographically prior to their hardness measurement and an average of three observations has been considered. The hardness of the AK2 alloy increased from 320 HV1 to 425 HV1 after quenching and to 500 HV1 after tempering on 300 °C or 540 on 400 °C. The hardness of the AK3 alloy increased from 300 HV1 to 400 HV1 after quenching and to 475 HV1 after tempering on 300 °C or 470 on 400 °C

Combined novice, near-peer, e-mentoring palliative medicine program: A mixed method study in Singapore

INTRODUCTION:An acute shortage of senior mentors saw the Palliative Medicine Initiative (PMI) combine its novice mentoring program with electronic and peer mentoring to overcome insufficient mentoring support of medical students and junior doctors by senior clinicians. A three-phased evaluation was carried out to evaluate mentees' experiences within the new CNEP mentoring program. METHODS:Phase 1 saw use of a Delphi process to create a content-valid questionnaire from data drawn from 9 systematic reviews of key aspects of novice mentoring. In Phase 2 Cognitive Interviews were used to evaluate the tool. The tool was then piloted amongst mentees in the CNEP program. Phase 3 compared mentee's experiences in the CNEP program with those from the PMI's novice mentoring program. RESULTS:Thematic analysis of open-ended responses revealed three themes-the CNEP mentoring process, its benefits and challenges that expound on the descriptive statistical analysis of specific close-ended and Likert scale responses of the survey. The results show mentee experiences in the PMI's novice mentoring program and the CNEP program to be similar and that the addition of near peer and e-mentoring processes enhance communications and support of mentees. CONCLUSION:CNEP mentoring is an evolved form of novice mentoring built on a consistent mentoring approach supported by an effective host organization. The host organization marshals assessment, support and oversight of the program and allows flexibility within the approach to meet the particular needs of mentees, mentors and senior mentors. Whilst near-peer mentors and e-mentoring can make up for the lack of senior mentor availability, their effectiveness hinges upon a common mentoring approach. To better support the CNEP program deeper understanding of the mentoring dynamics, policing and mentor and mentee training processes are required. The CNEP mentoring tool too needs to be validated

Melioidosis presenting with mediastinal lymphadenopathy masquerading as malignancy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Melioidosis, endemic in Thailand and in the Northern Territory of Australia is an emerging infectious disease in India which can present with varied forms. A case of melioidosis, presenting as a rare anterior mediastinal mass which can masquerade as malignancy or tuberculosis, is described here. With treatment, our patient initially showed an increase in the size of mediastinal node and development of new submandibular node.. To the best of our knowledge, this phenomenon has not been documented in the literature and the same is highlighted in this case report. </p> <p>Case Presentation</p> <p>A 43-year-old Asian man with diabetes presented with fever, loss of appetite, weight loss for one month and painful swelling below his left mandible for five days. An examination revealed an enlarged left submandibular lymph node and bilateral axillary lymph nodes. A chest X-ray showed mediastinal widening. Computed tomography of his thorax showed a lobulated heterogeneously enhancing anterior mediastinal mass encasing the superior vena cava suggestive of malignancy. An excision biopsy of the lymph node showed granulomas suggestive of tuberculosis but bone marrow culture and lymph node aspirate culture grew <it>Burkholderia pseudomallei</it>. He was treated with parenteral ceftazidime and amoxicillin-clavulanic acid. During the course of treatment, he developed an enlargement of the submandibular lymph node on the opposite side. It gradually subsided with the continuation of therapy orally with a combination of cotrimoxazole and doxycycline for six months. A repeat computed tomography chest scan showed resolution of the mediastinal mass.</p> <p>Conclusion</p> <p>Melioidosis can present as a mediastinal mass that mimics tuberculosis or malignancy. During the initial phase of treatment of melioidosis, the appearance of new lymph nodes or an increase in the size of the existing lymph nodes does not mean treatment failure. Inexperienced clinicians may consider this as treatment failure and may switch treatment. To the best of our knowledge, this is the first report documenting this phenomenon in melioidosis cases.</p

Green Synthesis of Silver Nanoparticles using Litsea glutinosa L. Leaves and Stem Extracts and their Antibacterial Efficacy

The present study explores the green approach for the preparation of silver nanoparticles (AgNPs) through the reduction of silver nitrate by the cell-free stem and leaf aqueous extracts of Litsea glutinosa (L.glutinosa) and its potential antibacterial activity. The analytical instruments include scanning electron microscopy, Fourier transforms infrared spectroscopy, UV-visible spectroscopy, and X-ray diffraction spectroscopy confirmed the synthesis of smaller, uniformly spherical AgNPs (10-40 nm). The average crystalline size of prepared AgNPs produced by L. glutinosa leaf extract was found to be 19 mm. From UV-visible spectral analysis, the maximum absorbance peak appeared at 444 nm for leaf extract AgNPs different from stem extract AgNPs (422 nm), which are found to be specific for AgNPs. The L.glutinosa stem extract-assisted AgNPs have shown significant antibacterial activity against Bacillus subtilis (Gram-positive) and Escherichia coli (Gram-negative) in comparison to Gentamycin. Hence, the AgNPs obtained by green synthesis can be therapeutically explored against bacterial infections

Safe practices for legitimate medical use of opioids: a study of trends in opioids prescription over a decade

Background: An unwavering availability of opioids is crucial for effective pain and palliative care and for managing opioid dependence. This study aims to study the pattern of morphine consumption and the use of safety protocols for prescribing opioids in a tertiary cancer hospital in India. Patients and methods: We studied the medical and pharmacy records retrospectively, to investigate the pattern of oral Morphine consumption and distribution from 2008 to 2020. Results: The number of new cancer patients visiting the hospital, the number of re-visits of these patients, and inpatient admissions to palliative care service increased unswervingly from 2008 to 2019 with a sharp fall in 2020 owing to the COVID pandemic. Annual oral morphine consumption showed a steady increase from 4.89 kgs in 2008 to 11.53 kgs in 2019 with a fall to 5.68 kgs in 2020. However, the trend for oral morphine dispensed per patient per visit showed a mild increase from 1.1 gram in 2008 to 2.06 grams in 2012, followed by a gradual decline to 0.89 grams in 2020. Opioid diversion incidence was found to be zero. Conclusions: Comprehensive interventions alongside safety protocols for prescriptions of opioids and effective integration of palliative care can help prevent opioid use disorders