Comparison of two different techniques of uterine closure in caesarean section: Continuous single layer technique versus Babu and Magon technique

Background: To compare size of the caesarean scar and residual myometrial thickness (RMT) between continuous single non-interlocking and Babu and Magon technique for uterine closure following primary elective caesarean section (CS).Methods: An observational prospective cohort study was conducted at 6 weeks and 4 months postpartum following primary elective CS. Group A included 25 patients who underwent continuous single layer technique and Group B included 25 patients who underwent Babu and Magon technique for uterine closure. Baseline demographic profile, obstetric score, details of the CS and associated complications were studied. Two-dimensional Transvaginal ultrasonography (TVS) measurements of the length, width and depth of the caesarean scar and RMT were compared.Results: Mean age of study population was 29.6 years. Malpresentation (44%) was the most common indication for CS. Mean Bishops score at the time of CS was <4. The duration of surgery (-2.8 min, 37.96 ±5.660min) and estimated amount of blood loss (-51.6 ml, mean 671.20 ±136.208ml) was less in Group A compared to Group B (40.76 ±4.68min, 722.80±132.083ml respectively). The caesarean scar measurements were similar in both groups at both visits. The mean RMT in Group B at 6 weeks and 4 months postpartum (8.05mm±2.06 and 7.10mm±2.04 respectively) was statistically higher than Group A (6.23mm ± 1.76 and 5.36mm ± 1.70 respectively), p=0.002.Conclusions: We conclude that Babu and Magon technique for uterine closure in caesarean section could result in better healing of the scar and probably reduce the adverse outcomes in subsequent pregnancies

Aetiology of jaundice in pregnancy: observational study in a tertiary care hospital

Background: Jaundice in pregnancy has potentially serious consequences to both mother and foetus. This study aims to find out the aetiology of jaundice and its severity in pregnancy.Methods: This is an observational prospective study over a period of one and a half years conducted in the Department of Obstetrics and Gynaecology, Government Medical College, Kozhikode. Antenatal patients who presented with jaundice was included in this study.Results: Out of 24060 deliveries in the study period of one and a half years there were 52 cases of jaundice complicating pregnancy. Incidence of jaundice complicating pregnancy was found to be 0.22%. Largest number of women belonged to the age group 21-25 years of age. Most of the cases occurred in the third trimester. 55.8% of the cases were multigravidas Most common cause of jaundice in pregnancy was found to be HELLP syndrome (34.6%) followed by Hepatitis A (32.7%) 67.3% of the cases had only mild elevation of bilirubin levels (2-5.9mg/dl). 65.4% had an SGOT value of less than 200U/litre and 67.3 % had an SGPT value of less than 200U/litre.Conclusions: The decrease in the number of cases of viral hepatitis may be due to the increased awareness about the transmission of disease and improvement in sanitary conditions

MCMA acardiac twin: a trap?

Acardiac twining or Twin Reverse Arterial Perfusion (TRAP) is a rare complication of monozygotic twin occurring due to retrograde perfusion of acardiac twin by structurally normal pump twin through abnormal arterio-arterial anastomosis in the placenta. Here we report a case of unexpected occurrence of acardiac twin diagnosed as monozygotic monoamniotic twin (MCMA) gestation with single foetal demise due to multiple anomalies, delivered vaginally suggesting a role for expectant management

Results from the first Argo float deployed by India

Argo is a revolutionary concept in ocean observation system that envisages real-time sampling of the temperature and salinity profiles of the global oceans at an approximate spatial resolution of 300 km, once in ten days. Argo float is an autonomous drifting profiler that pops up and down in the ocean from the surface up to 2000 m, measuring two most important physical properties of the water column, viz. temperature and salinity as a function of pressure (depth). Moreover, it can provide an estimate of currents both at the surface and at the parking depth in near-real time. India is an active participant in the Argo programme and has already deployed 31 out of 150 proposed floats. In this article, we describe the data received from the first Argo float deployed by India in the southeastern Arabian Sea. The data demonstrate that the temperature and salinity profiles from Argo floats present possibilities for oceanographic studies and spatial and temporal scales that had been hitherto impossibl

The Indian Ocean forecast system

In order to meet the ever growing demand for the prediction of oceanographic parametres in the Indian Ocean for a variety of applications, the Indian National Centre for Ocean Information Services (INCOIS) has recently set-up an operational ocean forecast system, viz. the Indian Ocean Forecast System (INDOFOS). This fully automated system, based on a state-of-the-art ocean general circulation model issues six-hourly forecasts of the sea-surface temperature, surface currents and depths of the mixed layer and the thermocline up to five-days of lead time. A brief account of INDOFOS and a statistical validation of the forecasts of these parametres using in situ and remote sensing data are presented in this article. The accuracy of the sea-surface temperature forecasts by the system is high in the Bay of Bengal and the Arabian Sea, whereas it is moderate in the equatorial Indian Ocean. On the other hand, the accuracy of the depth of the thermocline and the isothermal layers and surface current forecasts are higher near the equatorial region, while it is relatively lower in the Bay of Bengal

Appositeness of artificial intelligence in modern medicine

Artificial intelligence (AI) can be demonstrated as intelligence demonstrated by machines.AI research has gone through different phases like simulating the brain, modeling human problem solving, formal logic, large databases of knowledge and imitating animal behavior. In the beginning of 21st century, highly mathematical statistical machine learning has dominated the field, was found useful and considered in helping to solve many challenging problems throughout industry and academia. The domain was discovered and work was done on the assumption that human intelligence can be simulated by machines. These initiate some discussions in raising queries about the mind and the ethics of creating artificial beings with human-like intelligence. Myth, fiction, and philosophy are involved in the creation of this field. The debates and discussion also point to concerns of misuse regarding this technology.

Closing the sea surface mixed layer temperature budget from in situ observations alone: Operation Advection during BoBBLE

Sea surface temperature (SST) is a fundamental driver of tropical weather systems such as monsoon rainfall and tropical cyclones. However, understanding of the factors that control SST variability is lacking, especially during the monsoons when in situ observations are sparse. Here we use a ground-breaking observational approach to determine the controls on the SST variability in the southern Bay of Bengal. We achieve this through the first full closure of the ocean mixed layer energy budget derived entirely from in situ observations during the Bay of Bengal Boundary Layer Experiment (BoBBLE). Locally measured horizontal advection and entrainment contribute more significantly than expected to SST evolution and thus oceanic variability during the observation period. These processes are poorly resolved by state-of-the-art climate models, which may contribute to poor representation of monsoon rainfall variability. The novel techniques presented here provide a blueprint for future observational experiments to quantify the mixed layer heat budget on longer time scales and to evaluate these processes in models

Understanding Iodine Chemistry Over the Northern and Equatorial Indian Ocean

Observations of halogen oxides, ozone, meteorological parameters, and physical and biogeochemical water column measurements were made in the Indian Ocean and its marine boundary layer as a part of the Second International Indian Ocean Expedition (IIOE-2). The expedition took place on board the oceanographic research vessel Sagar Nidhi during 4–22 December 2015 from Goa, India, to Port Louis, Mauritius. Observations of mixed layer depth, averaged temperature, salinity, and nitrate concentrations were used to calculate predicted iodide concentrations in the seawater. The inorganic iodine ocean-atmosphere flux (hypoiodous acid [HOI] and molecular iodine [I2]) was computed using the predicted iodide concentrations, measured atmospheric ozone, and wind speed. Iodine oxide (IO) mixing ratios peaked at 0.47 ± 0.29 pptv (parts per trillion by volume) in the remote open ocean environment. The estimated iodide concentrations and HOI and I2 fluxes peaked at 200/500 nM, 410/680 nmol·m−2·day−1, and 20/80 nmol·m−2·day−1, respectively, depending on the parameterization used. The calculated fluxes for HOI and I2 were higher closer to the Indian subcontinent; however, atmospheric IO was only observed above the detection limit in the remote open ocean environment. We use NO2 observations to show that titration of IO by NO2 is the main reason for this result. These observations show that inorganic iodine fluxes and atmospheric IO show similar trends in the Indian Ocean marine boundary layer, but the impact of inorganic iodine emissions on iodine chemistry is buffered in elevated NOx environments, even though the estimated oceanic iodine fluxes are higher

BoBBLE: ocean-atmosphere interaction and its impact on the South Asian monsoon

The Bay of Bengal (BoB) plays a fundamental role in controlling the weather systems that make up the South Asian summer monsoon system. In particular,the southern BoB has cooler sea surface temperature (SST) that influence ocean-atmosphere interaction and impact on the monsoon. Compared to the southeast, the southwestern BoB is cooler, more saline, receives much less rain, and is influenced by the Summer Monsoon Current(SMC). To examine the impact of these features on the monsoon, the BoB Boundary Layer Experiment (BoBBLE) was jointly undertaken by India and the UK during June–July 2016. Physical and bio-geochemical observations were made using a CTD, five ocean gliders, a uCTD, a VMP, two ADCPs, Argo floats, drifting buoys, meteorological sensors and upper air radiosonde balloons. The observations were made along a zonal section at 8◦N between 85.3◦E and 89◦E with a 10-day time series at 89◦E, 8◦N. This paper presents the new observed features of the southern BoB from the BoBBLE field program, supported by satellite data. Key results from the BoBBLE field campaign show the Sri Lanka Dome and the SMC in different stages of their seasonal evolution and two freshening events during which salinity decreased in the upper layer leading to the formation of thick barrier layers. BoBBLE observations were taken during a suppressed phase of the intraseasonal oscillation; they captured in detail the warming of the ocean mixed layer and preconditioning of the atmosphere to convection