Maternal morbidity due to unsafe medical abortion in rural practice is just the tip of the iceberg: is it really preventable?

Background: In India around 6.4 million abortions are performed annually, of which 3.6 million (56%) were unsafe abortions, account for 8-20% of all maternal deaths. Medical methods of abortion have been proven to be effective and safe option to save women’s lives when practiced under medical supervision. This study was carried out to determine the frequency of unsafe medical abortion, demographic profile of patients, reasons for seeking abortion, abortion providers, evaluation of significant adverse outcome and management.Methods: A 5 year retrospective observational study included 400 patients with history of unsafe medical abortion who were admitted with complications between June 2009 and May 2014, in the department of obstetrics and gynecology, government medical college (Chhattisgarh institute of medical sciences) and tertiary care hospital Bilaspur Chhattisgarh.Results: Unintended pregnancy was the main reason for the unsafe medical abortion in 378 (94.5%) women. Most frequent complains observed for admission were heavy bleeding and retained products (incomplete abortion). Major complications seen in 177 (44.25%) cases only, of which moderate to severe anaemia in 141 (35.25%), shock in 23 (5.75%), septicaemia in 11 (2.75%) and acute renal failure in 2 (0.5%) cases. Majority 206 (51.50%) required surgical intervention. However 5 (1.25%) patients could not survive despite of all resuscitative measures. Post-abortion family planning adopted by 27 (6.75%) cases only.Conclusions: Mostly unsafe abortions take place behind the scene, always remain unnoticed and never listed in government data. In Chhattisgarh state where majority of rural population are tribal, illiterate, living in difficult to reach areas, unaware of safe abortion and abortion rights and dependent on herbs, quacks or paramedics, due to unavailability of clinicians or lady medical officers in government facilities. Thus the best way remain to prevent unsafe abortion is the prevention of unwanted pregnancy

Brain MRI: a useful tool for screening of hypertensive patients for silent cerebro-vascular damage

Background: Worldwide hypertension is an important public-health challenge because of its high frequency and concomitant risks of cardiovascular, renal, cerebrovascular disease and death. Current guidelines for the management of hypertension mainly recommend the search for preclinical damage to the heart and kidneys. However, extending this search to other organs, for instance the brain, might improve risk stratification, might optimize antihypertensive therapy and might, in the end help to further reduce the burden of disease attributable to hypertension.Methods: 84 consecutive hypertensive patients with no target organ damage were enrolled in study to find out silent brain damage over a period of one year.Results: Mean body mass index (BMI) of the study population was 28.4±2.5 kg/m2 (range 23.2 to 35.3kg/m2). 33 (39.3%) subjects had white matter lesions. 13 (15.47%) study subjects were found to have vascular changes which included micro angiopathic changes, infarcts and reduced/slow blood flow. 33 (39.3%) subjects were found to have normal brain MRI in the study. Early brain MRI was found to be beneficial in patients who had uncontrolled blood pressure either due to lack of treatment or irregular use of anti-hypertensive treatment. This was true for every age group in general and particularly in subjects above the age of 50 years.Conclusions: The screening of hypertensive patients for silent cerebrovascular damage with brain MRI may be useful in stratifying the risk of future cerebrovascular disease

Based on mother and child protection card, awareness and practices among Mitanins and auxiliary nurse midwife workers about obstetric care: will repeated drilling be the game changer?

Background: More than 70,000 women community health volunteers called the ‘Mitanins’ and auxiliary nurse midwife (ANM) are working for the improvement of the health care system in the state. The study was undertaken to assess the knowledge and practices among Mitanins and ANMs regarding antenatal care including risk identification , purely based on MCP card to help health professionals to make necessary changes in the MCP card, and revise maternal health policies and practices. Methods: It was a cross-sectional questionnaire-based study, conducted from November 2020 to October 2021 in the department of obstetrics and gynecology at government medical college, Rajnandgaon. This was the only government tertiary care hospital in southwest Chhattisgarh of that time. A total of 22 ANMs and 166 Mitanins were included and assessed. Based on the MCP card predesigned, pretested questionnaires were made and used. ASPSS 21.0 version software was used to analyze the data. Results: Total 166 Mitanins and 22 ANMs were participated in the study. Overall knowledge of participants about antenatal, intra-natal and postnatal care services was poor. None of them were aware of what low-risk or high-risk pregnancy is. Mitanins were not familiar with any of the medical terms or obstetric complications mentioned on the MCP card while ANMs were quite aware of it, however the percentage was negligible (<10%). Moreover, knowledge about obstetrics examination and per vaginum examination was very poor (13.6%) among ANMs. Knowledge about danger signs related to obstetric emergencies which are not mentioned on the MCP card for example, ectopic pregnancy, vesicular mole, obstructed labor, impending scar rupture, and uterine rupture was also very low (<15%) among Mitanins and ANMs. Conclusions: The language and understandability of the MCP card need to be addressed. The gap between knowledge and practice can be bridged by proper ‘training’

A 54 Mb 11qter duplication and 0.9 Mb 1q44 deletion in a child with laryngomalacia and agenesis of corpus callosum

<p>Abstract</p> <p>Background</p> <p>Partial Trisomy 11q syndrome (or Duplication 11q) has defined clinical features and is documented as a rare syndrome by National Organization of Rare Disorders (NORD). Deletion 1q44 (or Monosomy 1q44) is a well-defined syndrome, but there is controversy about the genes lying in 1q44 region, responsible for agenesis of the corpus callosum. We report a female child with the rare Partial Trisomy 11q syndrome and Deletion 1q44 syndrome. The genomic imbalance in the proband was used for molecular characterization of the critical genes in 1q44 region for agenesis of corpus callosum. Some genes in 11q14q25 may be responsible for laryngomalacia.</p> <p>Results</p> <p>We report a female child with dysmorphic features, microcephaly, growth retardation, seizures, acyanotic heart disease, and hand and foot deformities. She had agenesis of corpus callosum, laryngomalacia, anterior ectopic anus, esophageal reflux and respiratory distress. Chromosome analysis revealed a derivative chromosome 1. Her karyotype was 46,XX,der(1)t(1;11)(q44;q14)pat. The mother had a normal karyotype and the karyotype of the father was 46,XY,t(1;11)(q44;q14). SNP array analysis showed that the proband had a 54 Mb duplication of 11q14q25 and a 0.9 Mb deletion of the submicroscopic subtelomeric 1q44 region. Fluorescence Insitu Hybridisation confirmed the duplication of 11qter and deletion of 1qter.</p> <p>Conclusion</p> <p>Laryngomalacia or obstruction of the upper airway is the outcome of increased dosage of some genes due to Partial Trisomy 11q Syndrome. In association with other phenotypic features, agenesis of corpus callosum appears to be a landmark phenotype for Deletion 1q44 syndrome, the critical genes lying proximal to <it>SMYD3 </it>in 1q44 region.</p

Desert locust and its management in Nepal: a review

Locusts are among the most dangerous agricultural pests. They are a group of short horned grasshoppers belonging to Acrididae family and are hemimetabolous insects. This group of grasshoppers have a unique character of changing habits and behaviors when they aggregate in a group and this habit is catalyzed by different environmental factors. In the adult stage, gregarious locusts migrate from one place to another in a swarm. Desert Locust, Schistocerca gregaria (Forksal), is one of those locusts which cause damage to different types of crop which fly in the direction of wind up to a distance of 150 km. Because of polyphagous feeding habits and swarming in a plague (large group of adults), this pest is considered as the hazardous migratory pest. These pests entered Nepal for the first time in 1962 and then in 1996. In 2020 the pest entered the country from India on three different dates 27th June and continued till 29th (5 districts), 12th July (1 district), and 16th July (2 districts). The swarms migrated to 53 districts and caused the considerable loss in agricultural and field crop in 1118 hectare. These pests are monitored on the basis of environmental factors and many tools and practices such as eLocust3, SMELLS (Soil Moisture for Desert Locust Early Survey), P-locust and SUPARCO Disaster Watch Desert Locust Situation Alert are being used. Their control is critical to food security. Many tools and techniques are integrated for prevention and management of these pests to minimize damage in the existing crops where they migrate. These are physical methods, cultural methods, use of botanicals, green muscle, PAN (phenylacetonitrile) and chemicals. Effective preventive management strategy relies on an improved knowledge of the pest biology, more efficient monitoring and control techniques

Effect of elevated CO2 and temperature on growth parameters of pea (Pisum sativum L.) crop

Global warming is predicted to have negative effect on plant growth due to the damaging effect of high temperature on plant development. The field experiment was conducted during 2014-15 to study effect of elevated CO2 and temperature on growth parameters of pea (Pisum sativum L.) crop in order to check the effect of climatechange on vegetable crops. Effect was studied under four conditions i.e. Open Top Chambers, T1: OTC - elevated CO2550±10 ppm; T2: OTC -elevated CO2 550±10 ppm and temperature 1°C; T3: OTC - ambient CO2 and temperature (reference) and T4: natural condition. Maximum plant height at 50 % flowering was recorded in T1 (84.29cm) at elevated CO2 which differed significantly with T2 (79.47cm) at elevated CO2 and temperature, T3 (73.60cm) at ambient CO2 and temperature and natural condition (70.73cm). Minimum days to 50 per cent flowering were recorded in plants growing under T2 (68.56 days). Maximum pollen viability was recorded in T1 (77.42%) followed by T3 (76.36%), T4 (74.65%) and T2 (69.97%). Internode length of plants grown under T1 was maximum (7.01cm) followed by T2 (6.68cm), T3 (6.00cm) and T4 (5.05cm). Elevated temperature and CO2 had significant effects on growth and development in vegetables. Overall, growth parameters of pea crop were affected positively by elevated CO2 whereas under interaction effect of elevated CO2 and temperature these positive effects of CO2 were offset by elevated temperature effect and hampered the growth of pea crop which interns can affect the yield and quality of crop under changing climate scenario

Plasma hormones and milk production performances in early lactation buffaloes supplemented with a mixture of prilled fat, sweetener and toxin binder

The effect of combined feed supplements (prilled fat, sweetener and toxin binder) was studied on 24 apparently healthy early lactating rural and urban maintained Murrah buffaloes. The feeding of combined feed supplement was carried out for a period of 90 days. DMI, BCS, body weight were recorded at fortnightly intervals and milk composition was analyzed at weekly intervals. Blood samples were analyzed for hormones, plasma metabolites and lipid profile. The supplementation increased (p0.05) between the groups. Body weight increased in rural buffaloes in comparison to urban buffaloes. Plasma GH was higher (p0.05) during supplementation period. Mean leptin levels decreased (p<0.05) while plasma estradiol and IgG level increased during the supplementation period. Plasma progesterone and ghrelin level varied non-significantly before and during supplementation. Plasma IGF-1 and glucose levels was more and NEFA level was lower (p<0.05) during the experiment. Mean HDL, triglyceride and cholesterol concentration increased (P<0.05) during supplementation than before supplementation. Blood urea nitrogen and plasma urea level was lower before feeding and increased during the experiment. The conception rate was more and service period was less (P<0.05) in urban buffaloes as compared to rural buffaloes. The complete feed supplementation was highly economical and generated an additional income of Rs. 114.45/day/buffalo with cost benefit ratio of 1:5. It was concluded that complete feed comprising of prilled fat, sweetener and toxin binder augment overall productive performance of rural and urban buffaloes

A minimal binding footprint on CD1d-glycolipid is a basis for selection of the unique human NKT TCR

Although it has been established how CD1 binds a variety of lipid antigens (Ag), data are only now emerging that show how αβ T cell receptors (TCRs) interact with CD1-Ag. Using the structure of the human semiinvariant NKT TCR–CD1d–α-galactosylceramide (α-GalCer) complex as a guide, we undertook an alanine scanning mutagenesis approach to define the energetic basis of this interaction between the NKT TCR and CD1d. Moreover, we explored how analogues of α-GalCer affected this interaction. The data revealed that an identical energetic footprint underpinned the human and mouse NKT TCR–CD1d–α-GalCer cross-reactivity. Some, but not all, of the contact residues within the Jα18-encoded invariant CDR3α loop and Vβ11-encoded CDR2β loop were critical for recognizing CD1d. The residues within the Vα24-encoded CDR1α and CDR3α loops that contacted the glycolipid Ag played a smaller energetic role compared with the NKT TCR residues that contacted CD1d. Collectively, our data reveal that the region distant to the protruding Ag and directly above the F′ pocket of CD1d was the principal factor in the interaction with the NKT TCR. Accordingly, although the structural footprint at the NKT TCR–CD1d–α-GalCer is small, the energetic footprint is smaller still, and reveals the minimal requirements for CD1d restriction

Observation of multiple doubly degenerate bands in ¹⁹⁵Tl

The High-spin states in 195 Tl, populated through the 185,187 Re( 13 C, xn) fusion evaporation reaction at the beam energy of 75 MeV, were studied using the Indian National Gamma Array (INGA). More than 50 new γ transitions have been placed in the proposed level scheme which is extended up to the excitation energy of ≈ 5.6 MeV and spin =22.5ħ . Two pairs of degenerate bands based on two different quasi-particle configurations have been identified in this nucleus indicating the first observation of such bands in an odd- A nucleus in A∼190 region and signify the first evidence of multiple chiral bands in a nucleus in this region. The total Routhian surface calculations predict triaxial shapes for both the configurations and thereby, support the experimental observation. The importance of multiple neutron holes in the i13/2 orbital and the stability of shapes for these two configurations have been discussed.Financial support of Department of Science & Technology, Govt. of India for clover detectors of INGA (Grant No. IR/S2/PF-03/2003-II) is greatfully acknowledged. One of the authors (S. Bhattacharya) acknowledges with thanks the financial support received as Raja Ramanna Fellowship from the Department of Atomic Energy, Govt. of India. T.R and Md. A.A acknowledge with thanks the financial support received as research fellows from the Department of Atomic Energy (DAE), Govt. of India