Mifepristone safety and efficacy in preinduction of labor: an observational study

Background: When the continuation of pregnancy adversely affecting the mother and fetus, termination of pregnancy is planned. Mifepristone as a method of pre-inducing agent in late pregnancy by increasing sensitivity of the uterus to the actions of prostaglandins and increasing uterine contractility. Objective of this study is to know the efficacy of mifepristone as a preinduction cervical ripening and induction of labor.Methods: In this prospective randomized study, 130 pregnant women are included and divided into two groups i.e. study group(n=65), has received tab mifepristone 200 mg and control group (n=65) has not received any drug.  After the end of 24 hours, Bishops score in both the groups are assessed and those not in labor or with unfavourable cervix are administered with intracervical dinoprostone gel every 6 hourlies for maximum of 3 doses or until pregnant woman entered into active labor. Statistical analysis regarding improvement in Bishops score, induction active phase interval, induction delivery interval is observed.Results: After 24 hours, observation in the mean Bishops score has showed significant improvement in the study group (72.33%), when compared to control group (54.58%). % woman has gone into spontaneous labor in study group (61.5%), and in control group (75.4%). Induction to active phase time duration is less in study group with mean (10.53), and in control group (17.4). Induction to delivery time duration is also less in study group with mean (15.100) when compared to control group (22.100). 67.7% of patients has delivered by vaginally in study group, and in control group 41%.Conclusions: Tab. mifepristone 200 mg has a pre inducing agent for cervical ripening, shown better improvement in Bishops score within 24-48 hours and decreases time duration from induction to active phase and induction to delivery

Short term effects of maternal obesity on mother and fetus: a prospective study

Background: Obesity is such a common health care problem of female population that have major impact on pregnancy. The worldwide prevalence of obesity is more than doubled in between 1980 and 2015. The objectives of present study are to observe whether obese women have an increased risk of pregnancy related complications and adverse fetal outcome and also to compare pregnancy outcomes in different classes of BMI in obese group.Methods: A prospective observational study conducted in OBG department JSS Hospital, Mysore from November 2014 to July 2016. All pregnant women attending OPD and inpatients of antenatal wards were screened for pre-pregnancy BMI. Total number of singleton births were 5727 in our institution. Out of which 314 obese pregnant women were included in the study group, remaining 5413 non-obese pregnant mothers were taken as control group respectively. They are closely monitored in every antenatal visit for development of complications such as pre-eclampsia, gestational diabetes mellitus, increased rate of caesarean section and presence of macrosomia (B.wt >3.5kg).Results: In comparison to normal BMI pregnant women, obese mothers had an increased risk of gestational hypertension (16.9% versus 2.0%, OR-2.3) gestational diabetes mellitus (35.7% versus 3.1%, OR-2.84), preeclampsia (23.9% versus 5%,0R-1.64) cesarean sections (75.2% versus 65.4%), macrosomia (45.9% versus 22%, OR-1.64), it was also found that as BMI increases the incidence of these complications increase as seen in different classes of obese population.Conclusions: Pregnancy associated with obesity is considered as a high-risk pregnancy and obesity being a modifiable risk factor, educating women in early pregnancy and preconceptional counseling regarding harmful effects of obesity and information regarding appropriate gestational weight gain is essential.

Proffering Ranks to the Smart Cities based on the Data Received from IoT Devices using Visualization Techniques

Innovative lifestyle in cities upgraded the smart infrastructure and sustainable significance in the countries worldwide. A new approach is proposed to analyze the smart-city indexing across the world based on the key features to proffer the city ranking. The key features like smart-mobility refers to the Intelligent movement of citizens, smart environment refers to improvement in the efficiency of inhabitance within the city, smart governance used in applying innovative technological implementation to provide service, smart economy refers to the improvement in various urban aspects and livelihood. Proposed approach focuses on classifying the smart innovative infrastructural implementation in the urban livelihood for city data visualization and proffering cluster ranks by validating the proffering with Convolutional-Neural Network (CNN). To collect the data, we used IoT sensors information by integrating the sensors of six feature metrics in city-hubs. The huge data collected from the sensors are utilized to perform the smart-city visualization. Data are analyzed using statistical procedure by grouping the similar data to applying folium cluster techniques and fuzzy mapping. A detailed description and analysis of smart indexing are grounded by proffering effectively, in addition the subsequent research analysis is recommended for the researchers

A Framework for Web Services Retrieval Using Bio Inspired Clustering

Efficiently discovering relevant Web services with respect to a specific user query has become a growing challenge owing to the incredible growth in the field of web technologies. In previous works, different clustering models have been used to address these issues. But, most of the traditional clustering techniques are computationally intensive and fail to address all the problems involved. Also, the current standards fail to incorporate the semantic relatedness of Web services during clustering and retrieval resulting in decreased performance. In this paper, we propose a framework for web services retrieval that uses a bottom-up, decentralized and self organising approach to cluster available services. It also provides online, dynamic computation of clusters thus overcoming the drawbacks of traditional clustering methods. We also use the semantic similarity between Web services for the clustering process to enhance the precision and lower the recall

Numerical Analysis of Friction Stir Welding on an Alumunium Butt Joint

In this paper, we present a three-dimensional numerical analysis of friction stir welding on an alumunium butt joint. A thin sheet of aluminum marking material was embedded into the 6061-aluminum alloy panel and its rear weld path. The positions after friction stir welding were investigated by metallographic techniques. Looking at the visualized material flow pattern, a three-dimensional model was developed to numerically simulate the temperature profile and plastic effects. The calculated velocity profile for plastic flow in the immediate vicinity of the tool generally agrees with the visualized results. Increasing the tool speed while maintaining a constant tool feed rate increases the material flow near the pin. The shape and size of the predicted weld zone match the experimentally measured ones

Online monitoring the isomerization of an azobenzene-based dendritic bolaamphiphile using ion mobility-mass spectrometry

Ion mobility-mass spectrometry was used to obtain detailed information about the kinetics of the light-induced cis/trans isomerization process of a new supramolecular azobenzene-based bolaamphiphile. Further experiments revealed that the investigated light-induced structural transition dramatically influences the aggregation behaviour of the molecule

Insulin resistance and endometrial cancer risk: A systematic review and meta-analysis

Abstract Aim: It has been suggested that chronic hyperinsulinemia from insulin resistance is involved in the etiology of endometrial cancer (EC). We performed a systematic review and meta-analysis to assess whether insulin resistance is associated with the risk of EC. Methods: We searched PubMed-Medline, Embase, Scopus, and Web of Science for articles published from database inception through 30th September 2014. We included all observational studies evaluating components defining insulin resistance in women with and without EC. Quality of the included studies was assessed by NewcastleeOttawa scale. Randomeffects models and inverse variance method were used to meta-analyze the association between insulin resistance components and EC. Results: Twenty-five studies satisfied our inclusion criteria. Fasting insulin levels (13 studies, n Z 4088) were higher in women with EC (mean difference [MD] 33.94 pmol/L, 95% confi- dence interval [CI] 15.04e52.85, p Z 0.0004). No differences were seen in postmenopausal versus pre- and postmenopausal subgroup analysis. Similarly, non-fasting/fasting C-peptide levels (five studies, n Z 1938) were also higher in women with EC (MD 0.14 nmol/L, 95% CI 0.08e0.21, p < 0.00001). Homeostatic model assessment - insulin resistance (HOMA-IR) values (six studies, n Z 1859) in EC patients were significantly higher than in women without EC (MD 1.13, 95% CI 0.20e2.06, p Z 0.02). There was moderate-to-high heterogeneity among the included studies. Conclusion: Currently available epidemiologic evidence is suggestive of significantly higher risk of EC in women with high fasting insulin, non-fasting/fasting C-peptide and HOMAIR values.Revisión por pare

Labor-associated gene expression in the human uterine fundus, lower segment, and cervix

Background Preterm labor, failure to progress, and postpartum hemorrhage are the common causes of maternal and neonatal mortality or morbidity. All result from defects in the complex mechanisms controlling labor, which coordinate changes in the uterine fundus, lower segment, and cervix. We aimed to assess labor-associated gene expression profiles in these functionally distinct areas of the human uterus by using microarrays. Methods and Findings Samples of uterine fundus, lower segment, and cervix were obtained from patients at term (mean +/- 6 SD = 39.1 +/- 0.5 wk) prior to the onset of labor (n = 6), or in active phase of labor with spontaneous onset (n = 7). Expression of 12,626 genes was evaluated using microarrays ( Human Genome U95A; Affymetrix) and compared between labor and non-labor samples. Genes with the largest labor-associated change and the lowest variability in expression are likely to be fundamental for parturition, so gene expression was ranked accordingly. From 500 genes with the highest rank we identified genes with similar expression profiles using two independent clustering techniques. Sets of genes with a probability of chance grouping by both techniques less than 0.01 represented 71.2%, 81.8%, and 79.8% of the 500 genes in the fundus, lower segment, and cervix, respectively. We identified 14, 14, and 12 those sets of genes in the fundus, lower segment, and cervix, respectively. This enabled networks of coregulated and co-expressed genes to be discovered. Many genes within the same cluster shared similar functions or had functions pertinent to the process of labor. Conclusions Our results provide support for many of the established processes of parturition and also describe novel-to-labor genes not previously associated with this process. The elucidation of these mechanisms likely to be fundamental for controlling labor is an important prerequisite to the development of effective treatments for major obstetric problems - including prematurity, with its long-term consequences to the health of mother and offspring

Grand Challenges: Improving HIV Treatment Outcomes by Integrating Interventions for Co-Morbid Mental Illness.

In the fourth article of a five-part series providing a global perspective on integrating mental health, Sylvia Kaaya and colleagues discuss the importance of integrating mental health interventions into HIV prevention and treatment platforms. Please see later in the article for the Editors' Summary