A study of feto-maternal outcome in case of premature rupture of membrane at a tertiary care center

Background: Premature rupture of membranes is the rupture of the fetal membranes in the absence of uterine contraction or before the onset of labor. When this occurs before 37 weeks of gestation, it is termed as preterm premature rupture of membranes. Management depends upon gestational age and the presence of complicating factors. An accurate assessment of gestational age and knowledge of the maternal, fetal and neonatal risks are essential to appropriate evaluation, counselling, and care of patients with PROM. The purpose of the study is timely diagnosis and appropriate management of the cases of PROM and PPROM to improve maternal and neonatal outcomes. Methods: A Prospective study was performed at the department of obstetrics and gynecology, at a tertiary care center from August 2020 to December 2021. A clinical data sheet was made for recording all information about the pregnant women after taking their consent. And their maternal and neonatal outcomes were recorded. Results: a total of 150 cases of PROM and PPROM were taken during our study out of which 53.33% belong to the younger age group, 43.33% were primi gravida, 66.66% belonged to the lower socioeconomic class, 25.33% had a previous history of abortion followed by dilatation and evacuation, rate of cesarean delivery was 34.66% and rate of NICU admission of neonates was 15.78% and 57.87% babies had low birth weight and rate of stillbirth was 1.97%. whereas 34.66% of cases had various complications related to PROM. Conclusions: Individualized management of PROM cases depending on the gestational age and risk of complications and antibiotic coverage is the best way to achieve a good fetomaternal outcome

Effect of supplemental Ca2+ on NaCl-stressed castor plants (Ricinus communis L.)

Greenhouse experiments were conducted to assess the effects of supplemental Ca2+ in salinised soil on germination and plant growth response of castor plant (Ricinus communis L. Var. Avani-31, Euphorbiaceae). NaCl amounting to 390 g was thoroughly mixed with soil of seven lots, of 100 kg each, to give electrical conductivity of 4.1 dS m–1. Further, Ca(NO3)2 × 4H20 to the quantity of 97.5, 195, 292.5, 390, 487.5, and 585 g was separately mixed with soil of six lots to give 1:0.25, 1:0.50, 1:0.75, 1:1, 1:1.25, and 1:1.50 Na+/Ca2+ ratios, respectively. The soil of the seventh lot contained only NaCl and its Na+/Ca2+ ratio was 1:0. Soil without addition of NaCl and Ca (NO3)2 × 4H20 served as control, with a 0:0 Na+/Ca2+ ratio. Salinity significantly retarded seed germination and plant growth, but the deleterious effects of NaCl on seed germination were ameliorated and plant growth was restored with Ca2+ supply at the critical level (1:0.25 Na+/Ca2+ ratio) to salinised soil. Supply of Ca2+ above the critical level further retarded seed germination and plant growth due to the increased soil salinity. Salt stress reduced N, P, K+ and Ca2+ content in plant tissues, but these nutrients were restored by addition of Ca2+ at the critical level to saline soil. In contrast, Na+ content in plant tissues significantly increased in response to salinity, but significantly decreased with increasing Ca2+ supply to saline soil. The results are discussed in terms of the beneficial effects of Ca2+ supply on the plant growth of Ricinus communis grown under saline conditions

Systematic review: Effects, design choices, and context of pay-for-performance in health care

<p>Abstract</p> <p>Background</p> <p>Pay-for-performance (P4P) is one of the primary tools used to support healthcare delivery reform. Substantial heterogeneity exists in the development and implementation of P4P in health care and its effects. This paper summarizes evidence, obtained from studies published between January 1990 and July 2009, concerning P4P effects, as well as evidence on the impact of design choices and contextual mediators on these effects. Effect domains include clinical effectiveness, access and equity, coordination and continuity, patient-centeredness, and cost-effectiveness.</p> <p>Methods</p> <p>The systematic review made use of electronic database searching, reference screening, forward citation tracking and expert consultation. The following databases were searched: Cochrane Library, EconLit, Embase, Medline, PsychINFO, and Web of Science. Studies that evaluate P4P effects in primary care or acute hospital care medicine were included. Papers concerning other target groups or settings, having no empirical evaluation design or not complying with the P4P definition were excluded. According to study design nine validated quality appraisal tools and reporting statements were applied. Data were extracted and summarized into evidence tables independently by two reviewers.</p> <p>Results</p> <p>One hundred twenty-eight evaluation studies provide a large body of evidence -to be interpreted with caution- concerning the effects of P4P on clinical effectiveness and equity of care. However, less evidence on the impact on coordination, continuity, patient-centeredness and cost-effectiveness was found. P4P effects can be judged to be encouraging or disappointing, depending on the primary mission of the P4P program: supporting minimal quality standards and/or boosting quality improvement. Moreover, the effects of P4P interventions varied according to design choices and characteristics of the context in which it was introduced.</p> <p>Future P4P programs should (1) select and define P4P targets on the basis of baseline room for improvement, (2) make use of process and (intermediary) outcome indicators as target measures, (3) involve stakeholders and communicate information about the programs thoroughly and directly, (4) implement a uniform P4P design across payers, (5) focus on both quality improvement and achievement, and (6) distribute incentives to the individual and/or team level.</p> <p>Conclusions</p> <p>P4P programs result in the full spectrum of possible effects for specific targets, from absent or negligible to strongly beneficial. Based on the evidence the review has provided further indications on how effect findings are likely to relate to P4P design choices and context. The provided best practice hypotheses should be tested in future research.</p

Role of percutaneous computed tomography-guided radiofrequency ablation in treatment of osteoid osteoma

Aim: The aim of the study was to evaluate efficacy of percutaneous computed tomography (CT)-guided radiofrequency ablation (RFA) of nidus in osteoid osteoma (OO). Materials and Methods: RFA was performed on fifty patients with clinically and radiologically diagnosed OO. RFA was done in the department of radio-diagnosis in our institute (a tertiary care providing institute in Ahmedabad, Western India). Ablation was performed by putting at an electrode tip (3–5 mm) into nidus under CT guidance with targeted temperature of 90°C for 3 min. Results: All procedures were technically successful. No immediate major or minor complications were observed. Complete clinical success was achieved in 46 patients. Only four patients required second intervention. Conclusion: Our experience indicates a 98% success rate. No major complications were noted

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Not AvailableExperimental bottom trawling was conducted from MFV Sagarkripa at five transects of water depths 15-20 m, 21-25 m, 26-30 m, 31-35 m and 36-40 m in commercial trawling grounds to assess the impact of bottom trawling on the epifauna off Veraval coast. Trawling was conducted for 17 months in a span of 20 months (September 2005-April 2007) excluding the trawl ban period (June to August). Altogether 41 species of gastropods, 1 species of scaphopod, 19 species of bivalves, 3 species of crab, 3 species of shrimps, 2 species of Balanus, 1 species of stomatopod, 4 species of finfishes, 2 species of brown algae and 4 species of octocorals were identified. The soft corals found were Litophyton sp. and Studeriotes sp. (Christmas tree soft coral). The gorgonians collected were young stages of Subergorgia suberosa and Juncella juncea (Whip coral). The presence of octocorals recorded in the month of October, immediately after the closed season (June to August) when the sea bottom is not heavily trawled suggests that this area is an abode of corals and a favourable site for coral reef formation. But intense trawling in the succeeding months destroys these valuable entities of ecosystem and the samples were not encountered in the subsequent months. The changes before and after trawling in biodiversity indices were significant at 15-20 m. The abundance-biomass curve showed that the rate of stress increased with water depth. The shallow depths are lightly trawled due to intermittent rocky nature of bottom and as water depth increases, the trawling intensity increases. The analysis of similarity of percentages in Simper showed that the dissimilarity of fauna before and after experimental trawling was more evident in lightly trawled area and remained masked in heavily trawled area. Suggestions are made for the promotion of eco-friendly gears and for conducting studies on appropriate un-trawled control sites for comparative assessment. Management strategies have to be adopted for the conservation and biodiversity protection of octocorals.Not Availabl

The role of denatured synovial fluid proteins in the lubrication of artificial joints

CoCrMo ball-on-flat wear tests were carried out with 25 wt% bovine calf serum (25BCS) and human synovial fluid (HSF) to investigate artificial joint lubricating mechanisms. Post-test the wear scar on the disc was measured and surface deposits in and around the rubbed region were analysed by Micro InfraRed Reflection Absorption Spectroscopy (Micro-IRRAS). In most tests the HSF samples gave higher wear than the 25BCS solution; in some cases, up to 77%. After rinsing a similar pattern of surface deposits was observed in and around the wear scar for both the model and HSF. Micro-IRRAS showed the deposits were primarily denatured proteins with an increased β-sheet content. In some cases, trans-alkyl chain/carbonyl components were also present and these were assigned to lipids. Thioflavin T fluorescent imaging also indicated aggregated non-native β-sheet fibrils were present in the deposits and their presence was associated with lower wear. The formation of insoluble, denatured protein films is thought to be the primary lubrication mechanism contributing to surface protection during rubbing. From this and earlier work we suggest inlet shear induces denaturing of proteins resulting in the formation of non-native β-sheet aggregates. This material is entrained into the contact region where it forms the lubricating film. Patient synovial fluid chemistry appears to influence wear, at least in the bench test, and thus could contributes to increased risk of failure, or success, with metal-metal hips. Finally using 25BCS as a reference screening fluid gives an overly optimistic view of wear in these systems

A Rare Case of Amyloid Goiter: Ultrasonographic Findings and Thioflavin T Staining

Background: Clinically significant enlargement of the thyroid gland by amyloid deposition is rare. A case study of 22-year-old lady with gradual enlargement of the thyroid gland has been presented. Routine haemological, biochemical test including thyroid function tests were normal. Ultrasonographic findings were nonspecific. Amyloid goiter has to be differentiated from other types of goitre and malignancy. FNAC was found to be suspicious for the presence of amyloid. Special staining with thioflavin T confirmed amyloid deposition

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Not AvailableThe present communication is a study on the impact of bottom trawling on the sediment characteristics along Veraval coast, which is the largest trawler port of India. Experimental bottom trawling was conducted from MFV Sagarkripa at five transects of water depths 15–20 m, 21– 25 m, 26–30 m, 31–35 m and 36–40 m in commercial trawling grounds. Trawling was conducted for 12 months in a span of 15 months excluding the trawl ban period (June to August). The sediment texture was analysed by pipette analysis and organic matter by wet oxidation method. The variations in organic matter and sediment texture were prominent between the stations selected at different depths. The sedimentary organic matter exhibited variations with different water depths and seasons. The organic matter content decreased with depth. Experimental trawling considerably reduced the organic matter content at all depths. Continued and incessant trawling operation can cause even more drastic reductions, where organic matter content is already very small. The sand proportion showed depth-wise variation; but seasonal and trawling effect was not significant showing highest values at 36–40 m depth. The silt proportion did not exhibit significant depth-wise variation. The seasonal variation of silt was significant whereas trawling effect imparted to silt was not evident. Trawling has no significant effect on clay concentration. But seasonal variation had great influence on the clay distribution and indicated significantly high depth–season interaction. The sediment of the study area was predominant in silt proportion. It was observed that the seasonal/natural variations were more prominent masking the trawling effect on silt.Not Availabl