Pregnancy outcome following spontaneous abortions

Background: The objective of the present study was to study pregnancy outcome in patients with history of previous spontaneous abortions.Methods: A prospective study included patients with history of previous spontaneous abortion admitted in the Department of Obstetrics and Gynaecology, GR Medical College and Kamla Raja Hospital, Gwalior between September 2008 and February 2009. The patients were either booked (minimum 3 visits in antenatal outdoor clinic) or admitted for the first time as an emergency. The detailed history about previous abortions was taken and routine as well as investigations for possible etiologies of previous abortions were done. Cases with history of mid-trimester abortion were investigated for cervical incompetence. All the patients were observed for complications during present pregnancy like threatened abortion, preeclampsia, preterm labour, intrauterine death and final outcome.Results: A total of 70 patients with history of previous spontaneous abortion were admitted, out of which 40 (57.2%) patients were booked and 30 (42.8%) reported first time in emergency. Majority (57.1 %) of patients belong to the age group 21-29 years. Educational status of the patients showed 61.4% had no formal education or only up to primary level.  Anemia was found to be very severe in 4.3 %, severe in 10% and moderate in 30 % patients. Maximum patients (45.7%) were with history of previous one abortion followed by previous two abortions (38.6%). Incidence of abortions after one, two, three and four abortions was 9.4, 14.8, 20 and 100 percent respectively. The final outcomes were term live birth (74.3%), abortion (14.3%), preterm delivery (8.6%), and still birth (2.8%).  In the present study 10 (14.3%) pregnancies ended with abortion, out of which 4 were in booked and 6 in emergency patients. Live babies were of 90% booked mothers whereas 70% in emergency patients. Caesarian section was done in 23.3% patients for various indications.Conclusions: Previous history of spontaneous abortion is associated with adverse pregnancy outcome. There is increased risk of abortion, preterm delivery, need for caesarean sections and fetal loss in cases of previous spontaneous abortions. These complications and fetal loss can be reduced by booking the patients and giving due antenatal care

Work related musculoskeletal disorders among medical laboratory professionals: a narrative review

Work related musculoskeletal disorders are common health problem and increasing cause of disability. Laboratory professionals are unique group of healthcare professionals who play an essential part in diagnosis and therapy planning and often their work is associated with potential health hazards. Objective of current study was to review literature on prevalence of work-related musculoskeletal disorders among medical laboratory professionals. Electronic databases and bibliographies were searched and identified papers evaluated against inclusion criteria. The searching strategy uncovered 13 reports. Total 7 studies were included for the review. A high degree of heterogeneity among studies was observed. The overall prevalence’s ranges from 40-60%. With neck being more prevalent 18-78%. However additional high quality studies are required in this area

Prevalence of goitre and its associated factors in a coastal district of Karnataka

Context: Iodine deficiency Disorders (IDDs) are a major public health problem globally. In India more than 200 million are at risk for this disorder. It affects people of all ages and both sexes. The mental impairment caused by IDD especially in children is an important consequence of IDD. Aim: To find the prevalence of IDDs and the associated factors with it. Settings and Design: A school based cross – sectional study. Methods and Material: The study was done in Udupi district of Karnataka using a pretested, semistructured questionnaire. The villages of the three talukas (Udupi, Kundapur and Karkala) of Udupi district were sampled according to Probability Proportionate to Size (PPS).One school was chosen for the study from each of the 30 selected villages. Minimum of 90 students were selected from each school. Salt and urine samples were collected for Iodine estimation from a sub sample. Goitre was graded according to WHO/UNICEF/ICCIDD criteria. Results: A total of 3023 children were examined (M = 49.1%, F = 50.9%). The prevalence of goitre in Udupi district was 19.8%. The prevalence of goitre was found to be more amongst females compared to males (p = 0.021) and also was found to be increasing with the increasing age (p = 0.003). Of the 539 salt samples analyzed 23.7 % were inadequately iodized. Education of the father, fish consumption and occupation of the mother were found to be significant predictors of goitre. Conclusions: Goitre is a public health problem in Udupi district of Karnataka. The adequately Iodized salt coverage which should have been more than 90 % is not fulfilled. More awareness is required amongst the people about IDDs and its predictors

Mechanisms of Response to Salt Stress in Oleander (Nerium oleander L.)

[EN] mulation, activation of antioxidant systems), have been studied in Nerium oleander, a xerophytic species widely used as ornamental. Salt strongly inhibited growth, but the plants survived one month in the presence of 800 mM NaCl, indicating that the species is also relatively resistant to salt stress. Salt induced a slight increase in the levels of proline, glycine betaine and soluble sugars; the latter compounds showed much higher absolute contents, suggesting a functional role in osmotic adjustment, and the presence of constitutive mechanisms of response to salt stress. High salinity generated oxidative stress in the plants, as shown by the increase of malondialdehyde levels. Antioxidant systems, enzymatic andKumar, D.; Al Hassan, M.; Vicente Meana, Ó.; Agrawal, V.; Boscaiu Neagu, MT. (2016). Mechanisms of Response to Salt Stress in Oleander (Nerium oleander L.). BULLETIN OF UNIVERSITY OF AGRICULTURAL SCIENCES AND VETERINARY MEDICINE. 73(2):249-251. doi:10.15835/buasvmcn-hort:12287S24925173

‘It Takes Two Hands to Clap’: How Gaddi Shepherds in the Indian Himalayas Negotiate Access to Grazing

This article examines the effects of state intervention on the workings of informal institutions that coordinate the communal use and management of natural resources. Specifically it focuses on the case of the nomadic Gaddi shepherds and official attempts to regulate their access to grazing pastures in the Indian Himalayas. It is often predicted that the increased presence of the modern state critically undermines locally appropriate and community-based resource management arrangements. Drawing on the work of Pauline Peters and Francis Cleaver, I identify key instances of socially embedded ‘common’ management institutions and explain the evolution of these arrangements through dynamic interactions between individuals, communities and the agents of the state. Through describing the ‘living space’ of Gaddi shepherds across the annual cycle of nomadic migration with their flocks I explore the ways in which they have been able to creatively reinterpret external interventions, and suggest how contemporary arrangements for accessing pasture at different moments of the annual cycle involve complex combinations of the formal and the informal, the ‘traditional’ and the ‘modern’

Effects of salinity and drought on growth, ionic relations, compatible solutes and activation of antioxidant systems in oleander (Nerium oleander L.)

[EN] Nerium oleander is an ornamental species of high aesthetic value, grown in arid and semi- arid regions because of its drought tolerance, which is also considered as relatively resistant to salt; yet the biochemical and molecular mechanisms underlying oleander¿s stress toler- ance remain largely unknown. To investigate these mechanisms, one-year-old oleander seedlings were exposed to 15 and 30 days of treatment with increasing salt concentratio ns, up to 800 mM NaCl, and to complete withholding of irrigation; growth parameters and bio- chemical markers characteristic of conserved stress-response pathways were then deter- mined in stressed and control plants. Strong water deficit and salt stress both caused inhibition of growth, degradation of photosynthetic pigments, a slight (but statistically signifi- cant) increase in the leaf levels of specific osmolytes, and induction of oxidative stress¿as indicated by the accumulation of malondialdehyde (MDA), a reliable oxidative stress marker ¿accompanied by increases in the levels of total phenolic compounds and antioxidant fla- vonoids and in the specific activities of ascorbate peroxidase (APX) and glutathione reduc- tase (GR). High salinity, in addition, induced accumulation of Na + and Cl - in roots and leaves and the activation of superoxide dismutase (SOD) and catalase (CAT) activities. Apart from anatomical adaptations that protect oleander from leaf dehydration at moderate levels of stress, our results indicate that tolerance of this species to salinity and water deficit is based on the constitutive accumulation in leaves of high concentratio ns of soluble carbohydrates and, to a lesser extent, of glycine betaine, and in the activation of the aforementioned antiox- idant systems. Moreover, regarding specifically salt stress, mechanisms efficiently blocking transport of toxic ions from the roots to the aerial parts of the plant appear to contribute to a large extent to tolerance in Nerium oleanderThis work was financed by internal funds of the Polytechnic University of Valencia to Monica Boscaiu and Oscar Vicente. Dinesh Kumar’s stay in Valencia was financed by a NAMASTE fellowship from the European Union, and Mohamad Al Hassan was a recipient of an Erasmus Mundus pre-doctoral scholarship financed by the European Commission (Welcome Consortium).Kumar, D.; Al Hassan, M.; Naranjo Olivero, MA.; Agrawal, V.; Boscaiu, M.; Vicente, O. (2017). Effects of salinity and drought on growth, ionic relations, compatible solutes and activation of antioxidant systems in oleander (Nerium oleander L.). PLoS ONE. 12(9). doi:10.1371/journal.pone.0185017Se018501712

HLA-DQA1*05 carriage associated with development of anti-drug antibodies to infliximab and adalimumab in patients with Crohn's Disease

Anti-tumor necrosis factor (anti-TNF) therapies are the most widely used biologic drugs for treating immune-mediated diseases, but repeated administration can induce the formation of anti-drug antibodies. The ability to identify patients at increased risk for development of anti-drug antibodies would facilitate selection of therapy and use of preventative strategies.This article is freely available via Open Access. Click on Publisher URL to access the full-text

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo