Study of primary caesarean section in multigravida patients

Background: Caesarean section is the most commonly performed major surgery among women. The aims and objective of this study was to know the incidence of primary Caesarean section in multigravidas, its indications and to know the maternal and foetal outcome among these patients.Methods: It was a prospective study of primary caesarean section in multigravida admitted at Kamla Raja Hospital, G.R. Medical College and J. A. Group of Hospitals, Gwalior (Madhya Pradesh, India) during the period of 1 year from September 2014 to August 2015. Multigravida with pregnancy of >28 weeks gestation (gravida 2 and above), each of whom has had a previous vaginal delivery of > 20 weeks gestation were included. Women with previous abortions and previous section and Pregnancy with medical disorders were excluded.Results: During the study period of one year, total 8185 deliveries occurred, out of which 3061 (37.39%) underwent caesarean section and 386 (12.61%) were primary caesarean section in multigravida. Out of these multigravida patients who underwent primary caesarean section- most of the patients were unbooked (77.72%). Majority of the cases were direct admission in the hospital (61.13%). Maximum number of the patients were in the age group of 25-30 years (55.95%). Two third of the patients were literate (69.44%) Maximum number of patients were Gravida 2 (49.72%). Almost all of them (95.85%) underwent emergency caesarean section. The most common indication for primary LSCS in multigravida patients was Malpresentation 115 (29.79%) followed by Fetal distress in 71 (18.39%) patients, APH in 71 (18.39%), Obstructed labour in 33 (8.55%), Severe preeclampsia and Antepartum eclampsia in 39 (10.1%), Twin pregnancy in 21 (5.44%). Most common maternal complication was pyrexia 40 (10.36%). Postoperative morbidity was 21.24% among unbooked, 14.25% in Referred, 23.58% in those operated as an emergency, 12.43% in patients belonging to of low socioeconomic status and 3.88%, in patients with moderate to severe anemia. Birth asphyxia was found in 6.21% of neonates. Neonatal mortality was 2.33%. Neonatal mortality is more in Unbooked cases (90.47%).Conclusions: Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular antenatal care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality

Effect of Ultrasonic Irradiation on Preparation and Properties of Ionogels

Silica-gel matrices containing ionic liquid (IL) 1-butyl-3-methylimidazolium hexafluorophosphate viz. ionogels have been synthesized using one-pot nonhydrolytic sol-gel method and taking tetraethyl orthosilicate (TEOS) as starting precursor. Effect of ultrasonic irradiation on pore parameters of ionogels and vibrational properties of the IL upon confinement in the porous matrix has been investigated. The synthesized gels have been characterized by BET, DSC, TGA, and FTIR. BET analysis shows some changes in the pore parameters due to ultrasonic irradiation. DSC results indicate shift in glass transition temperature upon confinement of the IL. The FTIR spectra show changes in vibrational bands on confinement, particularly, the bands related to the imidazolium ring; aliphatic chain and anion PF6 − of the IL are found to shift upon confinement in porous silica matrix obtained due to ultrasonic irradiation. Ultrasonic irradiation has been found to affect the gelation dynamics and kinetics and pore parameters

Impact of comorbidity on patients with COVID-19 in India: A nationwide analysis

BackgroundThe emergence of coronavirus disease (COVID-19) as a global pandemic has resulted in the loss of many lives and a significant decline in global economic losses. Thus, for a large country like India, there is a need to comprehend the dynamics of COVID-19 in a clustered way.ObjectiveTo evaluate the clinical characteristics of patients with COVID-19 according to age, gender, and preexisting comorbidity. Patients with COVID-19 were categorized according to comorbidity, and the data over a 2-year period (1 January 2020 to 31 January 2022) were considered to analyze the impact of comorbidity on severe COVID-19 outcomes.MethodsFor different age/gender groups, the distribution of COVID-19 positive, hospitalized, and mortality cases was estimated. The impact of comorbidity was assessed by computing incidence rate (IR), odds ratio (OR), and proportion analysis.ResultsThe results indicated that COVID-19 caused an exponential growth in mortality. In patients over the age of 50, the mortality rate was found to be very high, ~80%. Moreover, based on the estimation of OR, it can be inferred that age and various preexisting comorbidities were found to be predictors of severe COVID-19 outcomes. The strongest risk factors for COVID-19 mortality were preexisting comorbidities like diabetes (OR: 2.39; 95% confidence interval (CI): 2.31–2.47; p < 0.0001), hypertension (OR: 2.31; 95% CI: 2.23–2.39; p < 0.0001), and heart disease (OR: 2.19; 95% CI: 2.08–2.30; p < 0.0001). The proportion of fatal cases among patients positive for COVID-19 increased with the number of comorbidities.ConclusionThis study concluded that elderly patients with preexisting comorbidities were at an increased risk of COVID-19 mortality. Patients in the elderly age group with underlying medical conditions are recommended for preventive medical care or medical resources and vaccination against COVID-19

Comparative genomic analysis reveals habitat-specific genes and regulatory hubs within the genus Novosphingobium

© The Author(s), 2017. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in mSystems 2 (2017): e00020-17, doi:10.1128/mSystems.00020-17.Species belonging to the genus Novosphingobium are found in many different habitats and have been identified as metabolically versatile. Through comparative genomic analysis, we identified habitat-specific genes and regulatory hubs that could determine habitat selection for Novosphingobium spp. Genomes from 27 Novosphingobium strains isolated from diverse habitats such as rhizosphere soil, plant surfaces, heavily contaminated soils, and marine and freshwater environments were analyzed. Genome size and coding potential were widely variable, differing significantly between habitats. Phylogenetic relationships between strains were less likely to describe functional genotype similarity than the habitat from which they were isolated. In this study, strains (19 out of 27) with a recorded habitat of isolation, and at least 3 representative strains per habitat, comprised four ecological groups—rhizosphere, contaminated soil, marine, and freshwater. Sulfur acquisition and metabolism were the only core genomic traits to differ significantly in proportion between these ecological groups; for example, alkane sulfonate (ssuABCD) assimilation was found exclusively in all of the rhizospheric isolates. When we examined osmolytic regulation in Novosphingobium spp. through ectoine biosynthesis, which was assumed to be marine habitat specific, we found that it was also present in isolates from contaminated soil, suggesting its relevance beyond the marine system. Novosphingobium strains were also found to harbor a wide variety of mono- and dioxygenases, responsible for the metabolism of several aromatic compounds, suggesting their potential to act as degraders of a variety of xenobiotic compounds. Protein-protein interaction analysis revealed β-barrel outer membrane proteins as habitat-specific hubs in each of the four habitats—freshwater (Saro_1868), marine water (PP1Y_AT17644), rhizosphere (PMI02_00367), and soil (V474_17210). These outer membrane proteins could play a key role in habitat demarcation and extend our understanding of the metabolic versatility of the Novosphingobium species.This work was supported by grants from the Department of Biotechnology (DBT), R.K., S.H., K.P., A.B., and U.S. gratefully acknowledge the National Bureau of Agriculturally Important Microorganisms (NBAIM), Science and Engineering Research Board (SERB), N-PDF (PDF/2015/000062), (PDF/2015, 000319), University Grant Commission (UGC) for the Dr. D. S. Kothari Postdoctoral Fellowship and UGC for providing fellowships, respectively

A Giant Scrotal Neurofibroma in a Child Masquerading as Filariasis: Uncommon Presentation of a Common Disease

Neurofibroma of the scrotum is a very uncommon benign neoplasm, specifically when it affects teenagers and is not associated with neurofibromatosis type I. To the best of our knowledge, only a couple of cases of neurofibroma in children have been documented. Here, we report a case study of a 17-year-old boy who had a giant scrotal lump for ten years masquerading clinically as filariasis. A provisional diagnosis of benign nerve sheath neoplasm was made based on cytology findings. The lump was surgically removed from the patient, and a histopathological and immunohistochemistry examination established the diagnosis of neurofibroma. The combined clinical, preoperative cytological, histological, and immunohistochemistry findings were not presented in the literature in any of the formerly documented cases of scrotal neurofibroma. The current case expands the spectrum of differential diagnoses for scrotal tumours that clinicians have previously observed

ISSN 2347-954X (Print) Seroprevalence of Hepatitis A Virus Infection in Children

Abstract: Hepatitis A is one of the most common cause of hepatitis in paediatric age group and the most common cause of Fulminant Hepatic Failure (FHF) in children in India. Hepatitis A is a water born disease and its seroprevalence reflect the status of water sanitation & hygiene. High endemicity obviates the need for vaccine in the community but it is required as individual immunization. We studied 116 children in Outdoor Patient Department to know the seroprevalence of Hepatitis A Virus (HAV) total Antibodies and effect of various demographic and water sanitation variables on it. Study includes children attending Pediatric outpatient department with minor problems in medical college hospital. It is a descriptive, cross-sectional, sero-epidemiologic investigational study. Blood sample of randomly selected children was collected and Competitive ELISA test was done for detection of total (both IgM and IgG) anti HAV antibody using commercial available ELISA kit. The statistical analysis was performed by chi-squared test using Epi Info software 3.5.4.Version 2012. Seroprevalence in Children from upper social class was 54.5% Vs 87.2% in lower social class (p=0.00075). Among children from rural background 90.9% were seropositive Vs 77.1 % among urban children. Mother's education above and below secondary level had a seropositivity for HAV in children up to 69.23% and 87.1% respectively. Method of water treatment using Boiled water, Mechanical filtration, filtration plus UV treatment and no treatment had a seropositivity of 50.0% , 83.33% , 37.5% and 84 % respectively(p= 0.0036 ). Seropositivity was highest in water source using Municipal bore well pipeline88.88% followed by municipal dam water through pipeline79.16% and personal bore well 68.16% (p= 0.026). In conclusion, children of this geographical area have high seroprevalence for HAV antibodies at younger age with a significant difference between social classes and water source and treatment methods. Very high seroprevalence at a younger age is observed. Water sanitation needs to be improved and immunization in low seroprevalence group children should be recommended

Study of primary caesarean section in multigravida patients

Background: Caesarean section is the most commonly performed major surgery among women. The aims and objective of this study was to know the incidence of primary Caesarean section in multigravidas, its indications and to know the maternal and foetal outcome among these patients.Methods: It was a prospective study of primary caesarean section in multigravida admitted at Kamla Raja Hospital, G.R. Medical College and J. A. Group of Hospitals, Gwalior (Madhya Pradesh, India) during the period of 1 year from September 2014 to August 2015. Multigravida with pregnancy of >28 weeks gestation (gravida 2 and above), each of whom has had a previous vaginal delivery of > 20 weeks gestation were included. Women with previous abortions and previous section and Pregnancy with medical disorders were excluded.Results: During the study period of one year, total 8185 deliveries occurred, out of which 3061 (37.39%) underwent caesarean section and 386 (12.61%) were primary caesarean section in multigravida. Out of these multigravida patients who underwent primary caesarean section- most of the patients were unbooked (77.72%). Majority of the cases were direct admission in the hospital (61.13%). Maximum number of the patients were in the age group of 25-30 years (55.95%). Two third of the patients were literate (69.44%) Maximum number of patients were Gravida 2 (49.72%). Almost all of them (95.85%) underwent emergency caesarean section. The most common indication for primary LSCS in multigravida patients was Malpresentation 115 (29.79%) followed by Fetal distress in 71 (18.39%) patients, APH in 71 (18.39%), Obstructed labour in 33 (8.55%), Severe preeclampsia and Antepartum eclampsia in 39 (10.1%), Twin pregnancy in 21 (5.44%). Most common maternal complication was pyrexia 40 (10.36%). Postoperative morbidity was 21.24% among unbooked, 14.25% in Referred, 23.58% in those operated as an emergency, 12.43% in patients belonging to of low socioeconomic status and 3.88%, in patients with moderate to severe anemia. Birth asphyxia was found in 6.21% of neonates. Neonatal mortality was 2.33%. Neonatal mortality is more in Unbooked cases (90.47%).Conclusions: Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular antenatal care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality

Relation of Body Image perception and Nutritional status of School going and Not school going Adolescents

Abstract Background: Adolescents are very much concerned regarding their body image. Body image concerns indirectly affect the social relations and scholastic performance. It has an important relation with nutritional status. There is paucity of data regarding body image among adolescents with different BMI groups. Objective: To assess the perceived body image and degree of dissatisfaction among different BMI group of adolescents and study the other factors associated with it. Method: A cross sectional survey was done among 1600 different BMI group of adolescents to assess their body image perception and degree of dissatisfaction using Body Image Questionnaire (BIQ). Additional data regarding their socio-demographic profile were collected. Results: Overall 49% with BMI >90 percentile whereas 34% adolescents with BMI < 3rd percentile were unsatisfied with their body image. Overweight adolescents had the maximum discrepancy and maximum dissatisfaction for their body image factors followed by optimum weight adolescents and least among the underweight adolescents. There was significant association of height with mean BIQ among overall and school going adolescents, whereas no variation in non school going adolescents was observed. Lower paternal education was associated with high BMI of adolescents whereas graduate level of maternal education had a peak BMI. Conclusion: Large proportion of overweight adolescents are unsatisfied with their body image. Adolescents mean BIQ was significantly associated with height. Lower paternal education was associated with more mean BIQ and vice versa. Keywords: Body Image, Body Image Questionnaire (BIQ), Body Mass Index (BMI), Adolescence

Conformational States of Ionic Liquid 1‑Ethyl-3-methylimidazolium Bis(trifluoromethylsulfonyl)imide in Bulk and Confined Silica Nanopores Probed by Crystallization Kinetics Study

The nonaqueous sol–gel process has been used to synthesize the “ionogels” by confining ionic liquid (1-ethyl-3-methyl­imidazolium bis­(trifluoro­methyl­sulfonyl)­imide; [EMIM]­[TFSI]) into silica gel matrices. The present study is concerned mainly with probing the conformational states of the IL ([EMIM]­[TFSI]) through crystallization kinetics study of the bulk and confined ionic liquid (IL) in nanopores of silica matrix. The crystallization kinetics has been studied by the isothermal method using differential scanning calorimetry (DSC). For bulk IL, DSC result shows three crystallization peaks due to different conformations of IL molecules. DSC results show that one of these crystallization peaks disappears upon confinement due to interaction of IL molecules with the silica pore wall surfaces. The crystallization kinetics of bulk and confined IL is quantified using the Avarami analysis. Confinement of IL results in a decrease of the Avarami exponent, indicating one-dimensional crystal growth. To support the results obtained from crystallization kinetics study, investigate the properties of confined IL, and to study the morphological properties of silica gel matrices, some other characterization techniques, viz. TGA, XPS, FTIR, BET, SEM, and TEM, have been used. The XPS and FTIR results show the change in the binding energy of constituents of IL molecule and vibrational bands related to IL, respectively. BET, SEM, and TEM analyses display the uniform pore structures in IL confined silica matrices