A prospective study on maternal and perinatal outcome of gestational diabetes mellitus

Background: To identify risk factors, study maternal, fetal and perinatal outcome of pregnancy in relation to the glycemic control and different modalities of management in pregnancy complicated by Gestational Diabetes Mellitus (GDM).Methods: Descriptive study conducted in Department of OBG, Government TD Medical College Alappuzha, during the one year period January 2005 to December 2005. Study group comprised of 134 women who are diagnosed to have GDM. The aim was to study the maternal, fetal and perinatal outcome.Results: Despite early diagnosis and treatment the GDM patients in the present study had a statistically significant higher incidence of pregnancy induced hypertension (11.9%) induction of labor about (37.2%), caesarean section (58.96%) preterm delivery (2.99%) macrosomia (2.9%). Incidence of perinatal morbidity was 29.8%, common causes being neonatal hypoglycemia (32.5%), hyperbilirubinemia (12.5%) meconium aspiration syndrome (7.5%). Admission to neonatal unit required in (25%). There were 2 cases of intrauterine deaths, 2 cases of neonatal deaths and no still births. Perinatal mortality was 2.9%.Conclusions: The occurrence of GDM is a high-risk situation. Maternal morbidity, perinatal morbidity and mortality are increased in women with GDM. All pregnant women should be screened for GDM with a 50gm oral glucose load followed by a glucose determination 1 hour later. This helps to detect all GDM cases earlier and so timely intervention can be done which will reduces the complications. Proper management of GDM during the antenatal period will improve pregnancy outcome

Techno-Economic Analysis of Hybrid Layered Manufacturing

Subtractive manufacturing (CNC machining) has high quality of geometric and material properties but is slow, costly and infeasible in some cases; additive manufacturing (RP) is just the opposite. Total automation and hence speed is achieved in RP by compromising on quality. Hybrid Layered Manufacturing (HLM) developed at IIT Bombay combines the best features of both these approaches. It uses arc welding for building near-net shapes which are finish machined to final dimensions. High speed of HLM surpasses all other processes for tool making by eliminating NC programming and rough machining. The techno-economic viability of HLM process has been proved through a real life case study. Time and cost of tool making using HLM promises to be substantially lower than that of CNC machining and other RP methods. Interestingly, the material cost in HLM was also found to be lower. HLM is a cheaper retrofitment to any 3 or 5 axis CNC milling machine or machining center.Mechanical Engineerin

Simplified Production of Large Prototypes using Visible Slicing

Rapid Prototyping (RP) is a totally automatic generative manufacturing technique based on a “divide-and-conquer” strategy called ‘slicing’. Simple slicing used on 2.5-axis kinematics of the existing RP machines is responsible for the staircase error. Although thinner slices will have less error, the slice thickness has practical limits. Visible Slicing overcomes these limitations. A few visible slices exactly represent the object. Each visible slice can be realized using a 3- axis kinematics machine from two opposite directions. Visible slicing is implemented on Segmented Object Manufacturing (SOM) machine under development. SOM can produce soft large prototypes faster and cheaper with accuracy comparable to that of CNC machining.Mechanical Engineerin

Proportion and risk factors of postnatal depression among women delivering in a government tertiary care hospital in Kerala, India

Background: The burden of postpartum depression is significant because it remains unrecognized and it not only affects the mother adversely but also has a negative consequence on the family life and the development of the infant. This research aims to aid the early diagnosis of postnatal depression using Edinburgh postnatal depression scale (EPDS) and the psychosocial and reproductive risk factors of postnatal depression among women delivering in a tertiary hospital in Kerala state, India.Methods: 500 women were subjected to a standard questionnaire for assessing psychosocial and reproductive characteristics. The diagnosis of postnatal depression was made using a pretested and validated Malayalam version of EPDS with a score cut off of 13 or more.Results: The proportion of postnatal depression six weeks after delivery at TD Medical College, Alappuzha was found to be 8.6%. Marital harmony (p value=0.002) was significantly associated with postnatal depression. Diabetes (p value=0.037), hypertensive disorders (p value=0.013), antepartum hemorrhage (p value=0.036), neurological disorders (p value <0.001), type of delivery (p value=0.042), postpartum complications (p value=0.003), mode of infant feeding (p value=0.001), infant illness (p value=0.001), symptoms of maternity blues (p value <0.0001), premenstrual syndromes (p value=0.008) and infertility treatment (p value=0.03) were significantly associated with postnatal depression.Conclusions: Early screening of the women and counselling of women and their family will reduce the maternal morbidity and adverse child outcomes

LAVH or TAH – choosing it wise and making it safe

Background: Hysterectomy is the most commonly performed surgery in our gynaecological practice, abdominal route being the most common. Here we compare the various features and outcomes of laparoscopically assisted vaginal hysterectomy (LAVH) with total abdominal hysterectomy (TAH).Methods: The study design is a retrospective observational study. Outcome measures were indication, duration, complications of surgery, post op recovery and cost following TAH and LAVH.Results: A total of 116 cases underwent hysterectomy. Of these 98 underwent TAH and 18 underwent LAVH. Commonest indication for TAH in our study was fibroid followed by abnormal uterine bleeding (AUB); whereas in LAVH it was AUB followed by fibroid. Mean operating time in TAH was 118 minutes whereas in LAVH it was 166 minutes. One patient who underwent LAVH had ureteric injury and another had vault abscess. There were no major complications among TAH cases. A few patients had minor complications like fever, wound infection and urinary tract infection following TAH whereas fever was the only minor complication seen in a minority of the LAVH patients. Mean fall in haemoglobin in TAH was 1.05 gm% whereas in LAVH it was 0.95 gm%. None of the patients required postoperative blood transfusion. A few patients following TAH required additional analgesics apart from routine whereas in LAVH none required it. Mean duration of hospital stay following TAH was 6.84 days where as in LAVH it was 3.1 days. Mean hospital expenses in TAH were INR 28480, while for LAVH it was 44360.Conclusions: Undoubtedly expertise is the decisive factor behind the success of hysterectomy. LAVH though advantageous in many aspects like less post operative pain and cosmetic benefits, it could be technically demanding with availability only in well-equipped centres and cost factors. Surgeons need to be trained in all modalities of hysterectomy

Results of exploratory trawl fishing on the continental slope of the south west coast of India by M.F.V. 'Kalava'

So far, extensive deep sea trawling, in waters beyond 100 fathom depths, has not been attempted in Indian waters except for occasional hauls taken by the INVESTIGATOR (Alcock, 1891-1900) and other Expedition vessels (Gunther, 1887, Max Weber, 1913. Norman, 1939). During March-May 1963 M.F.V. 'Kalava' of the Indo-Norwegian Project, carried out 9 exploratory cruises off Alleppey and Ponnani on the South West Coast of India at depths ranging between 150 to 205 fathoms (274-374 m.). Large quantities of bathypelagic fish were taken during these cruises, in areas on the continental slope (Fig. 1). 24 species belonging to 23 genera and 19 families have already been described by Tholasilingam et al. (1964). Nearly 82% of the catch was represented by about 11 bathypelagic species taken at the rate of up to 496 kg. per hour of trawl, in the richest grounds. Since such occurrence has not been recorded so far, a quantitative assessment of these bathypelagic fishes along with deep sea prawns, lobsters and squids, has been given in the following pape

PHYLOGENETIC ANALYSIS OF COLD SHOCK PROTEINS IN PSEUDOMONAS SPECIES

Objective: The present study focuses on the determination of the relativity of the different types of cold shock proteins.Methods: Our study was to determine the relationship among the types of CSPs. Three different strains of pseudomonas genus, Pseudomonas fluorescens, Pseudomonas aeruginosa and Pseudomonas putida were chosen and molecular profiling was performed. The sequences thus obtained were subjected to multiple sequence analysis in ClustalW database. The molecular evolution and phylogenetic study have been carried out using phylodraw.Results: The phylogenetic analysis has clearly revealed the evolutionary pattern of cold shock proteins in pseudomonas species and the current stress of mutation among the strains.Conclusion: Phylogenetic analysis of cold shock proteins has clearly shown that important conserved sequences can be very useful to study the phylogeny of bacteria

A double-blind study of oral salbutamol supplement and repeat sputum smear microscopy in enhancing diagnosis of smear-negative tuberculosis in south India

Background: As routine culture facilities are not available in TB control programme in low income countries like India, there is an urgent need to improve the sensitivity of sputum microscopy, especially in diagnosis of smear negative pulmonary TB. Methodology: In a double blind placebo controlled study, the role of repeat sputum microscopy after antibiotics and oral salbutamol supplement in improving the diagnosis of smear negative TB suspects was investigated in an urban TB clinic. We undertook culture examinations for all study patients to find out proportions of TB cases in this series. Results: Of 206 enrolled, (101 salbutamol (S), 105 placebo (P) groups) 26 were positive by repeat sputum smear examination; similar in two groups (S 16, P 10, p = 0.25). In all, 40 (S 23, P 17) including 26 smear- positives, were culture -positive for M. tuberculosis. Conclusions: Two thirds of initially smear negative but culture positive TB patients were smear positive on repeat sputum examination. Thus, repeat sputum smear microscopy for TB suspects improved the diagnosis, nevertheless oral salbutamol therapy was not beneficial. In resource poor settings, repeat sputum smear microscopy after a trial of antibiotics, could significantly improve the diagnosis of smear-negative PTB patients

A facile one pot synthetic approach for C3N4-ZnS composite interfaces as heterojunctions for sunlight-induced multifunctional photocatalytic applications

Herein, we report a facile one pot synthetic protocol for the creation of C3N4-ZnS composite interfaces by the co-pyrolysis of a precursor mix containing zinc nitrate, melamine, and thiourea at 550°C in air. The organic-inorganic semiconductor heterojunctions thus formed displayed increased absorbance in the longer wavelength region and facilitated broad absorption of visible light compared to pure ZnS, C3N4 and conventionally synthesized hybrid samples. The decreased emission intensity, increased photocurrent generation and decreased fluorescence lifetime revealed reduced exciton recombinations in the co-pyrolysed sample containing C3N4-ZnS heterostructures. The samples displayed sunlight driven photocatalytic reduction of nitrophenol as well as hydrogen generation (4 mmol g-1 h-1) by water splitting. © The Royal Society of Chemistry 2016