Pregnancy complicated by cardiac disease: fetomaternal outcome

Background: Heart disease complicating pregnancy is an important indirect cause of maternal morbidity and mortality. The study aimed to know the prevalence of heart disease in pregnancy, type of lesions, maternal outcome (obstetric and cardiac) and fetal outcome.Methods: A retrospective study of 508 women with pregnancy complicated by cardiac disease who delivered at gestation age >28 weeks was carried out at Lok Nayak Hospital associated with Maulana Azad Medical College, New Delhi over a period of 2 years.Results: Among 508 patients, only 330 were booked cases and 92 were unbooked. 24 patients came to emergency first time with congestive heart failure. Rheumatic heart disease was the predominant lesion seen in 77.5% cases. Cardiac disease was diagnosed during index pregnancy in 43.5% cases. 12 cases underwent surgical intervention during pregnancy as they were refractory to medical management. Cesarean section was performed in 109 (21.4%) cases mainly for obstetric indication. Overall cardiac complication rate was 38.38%. Maternal mortality was seen in 6 cases. Small for gestation age was seen in 26.4% cases and preterm labor in 19.9 % cases.Conclusions: Patients in NYHA I /II have better fetomaternal outcome than in NYHA III/IV. Vaginal delivery is a safe option and caesarean section should be reserved mainly for obstetric indication. Multidisciplinary team approach can significantly improve maternal and fetal outcome

Mid-trimester rupture uterus: case series

Uterine rupture is an obstetric catastrophe with significant maternal and fetal morbidity and mortality which occurs mainly in the third trimester of pregnancy or during labour, especially in previously scarred uterus. The occurrence of rupture in first and second trimester in women with unscarred uteri is quite rare. We report two cases of rupture uteri managed in our centre at 24 and 26 weeks gestation in women with unscarred uteri. First case was G3P1L1A1, 24 weeks with epigastric pain, stable vitals, epigastric tenderness, USG inconclusive, CT scan showed out pouching of amniotic sac through fundus. Laparotomy done, there was 8-9 cm fundal rupture extending between cornua, uterine repair done. Second case was G3P1L1A1 26 weeks with abdominal pain, stable vitals, corresponding fundal height, head engaged, USG revealed outpouching amniotic sac at the fundus. Laparotomy performed, there was 10 cm rent extending trans-fundal, uterine repair done. Unscarred uterine rupture, especially in early pregnancy is a rare event, posing significant difficulty in diagnosis. Uterine rupture should be first ruled out in all pregnant women presenting with acute abdomen irrespective of gestational age. Search for non-gynaecological causes can delay crucial obstetric intervention that can lead to loss of obstetric function, morbidity and mortality

A rare case of severe hypertriglyceridemia induced pancreatitis in pregnancy

Acute pancreatitis is caused by various causes such as Gall stone disease, alcoholism, drug abuse but rarely caused by severe hypertriglyceridemia. It typically presents as acute or recurrent pancreatitis. The hypertriglyceridemia can be gestation induced or familial. The family history of the pregnant women needs to be taken in detail. The serum triglyceride levels in the range of 1000 to 2000 mg/dl in patients with type I, III, IV and V hyperlipoproteinemia (Friedrickson's classification) is the identifiable risk factor. The clinical course of hypertriglyceridemia induced pancreatitis is similar to other causes. We hereby report a case of 21-year-old lady G3P1L0A1 with 37 weeks of pregnancy without any family history of hypertriglyceridemia and but with history of recurrent episodes of acute pancreatitis

Stress and infertility: a review

Most of the couples suffering from infertility report it to be the most stressful and depressing period of their life. Stress can be a contributor to infertility and can adversely affect the treatment success, Recent scientific evidence suggest that psychological therapy, especially mind body therapy to counter stress can significantly improve pregnancy rates in women undergoing ART. Yoga is an ideal mind body therapy that is indigenous and one that can be effectively applied in the Indian scenario to optimize the psychological milieu of the sub fertile undergoing treatment. Infertility and ART from well-structured government run IVF centres can greatly reduce the financial burden of the infertile couple and further reduce their stress levels. Thus stress reducing strategies and low cost infertility treatment facility offer to be the ideal combination to fulfill the dreams of parenthood for the suffering sub fertile couples in India

Real-Time Detection System for Suspicious URLs

Twitter is prone to malicious tweets containing URLs for spam, phishing, and malware distribution. Conventional Twitter spam detection schemes utilize account features such as the ratio of tweets containing URLs and the account creation date, or relation features in the Twitter graph. These detection schemes are ineffective against feature fabrications or consume much time and resources. Conventional suspicious URL detection schemes utilize several features including lexical features of URLs, URL redirection, HTML content, and dynamic behavior. However, evading techniques such as time-based evasion and crawler evasion exist. In this paper, we propose WARNINGBIRD, a suspicious Real-Time URL detection system for Twitter. Our system investigates correlations of URL redirect chains extracted from several tweets. Because attackers have limited resources and usually reuse them, their URL redirect chains frequently share the same URLs. We develop methods to discover correlated URL redirect chains using the frequently shared URLs and to determine their suspiciousness. We collect numerous tweets from the Twitter public timeline and build a statistical classifier using them. Evaluation results show that our classifier accurately and efficiently detects suspicious URLs

Automatic Raaga Identification System For Carnatic Music Using Hidden Markov Model

As for as the Human Computer Interactions (HCI) is concerned, there is broad range of applications in the area of research in respective of Automatic Melakarta Raaga Identification in music. The pattern of identification is the main object for which, the basic mathematical tool is utilized. On verification, it is observed that no model is proved consistently and effectively to be predicted in its classification. This paper is, therefore, introduces a procedure for Raaga Identification with the help of Hidden Markov Models (HMM) which is rather an appropriate approach in identifying Melakarta Raagas. This proposed approach is based on the standard speech recognition technology by using Hidden continuous Markov Model. Data is collected from the existing data base for training and testing of the method with due design process relating to Melakarta Raagas. Similarly, to solve the problem of automatic identification of raagas, a suitable approach from the existing database is presented. The system, particularly, this model is based on a Hidden Markov Model enhanced with Pakad string matching algorithm. The entire system is built on top of an automatic note transcriptor. At the end, detailed elucidations of the experiments are given. It clearly indicates the effectiveness and applicability of this method with its intrinsic value and significance

Characterisation of cell-wall-derived polypeptide antigens from different species of mycobacterium

Cell walls from different species of mycobacterium were purified on a sucrose step gradient. The components derived from these preparations were characterised by sodium dodecyl sulphate-polyacrylamide gel electrophoresis, followed by staining or by western blotting. Surface-exposed polypeptide molecules were also identified by biotinylation. Many protein and glycoprotein molecules were identified in the cell walls. Some of these molecules were immunogenic in man and experimental animals and showed wide variability from species to species. The data suggest that these molecules could be of significance in the diagnosis and pathophysiology of mycobacterial diseases

Primary Hepatic Leiomyosarcoma Report of a rare case with review of literature

Primary hepatic leiomyosarcoma is an extremely rare tumor with a dismal prognosis and difficulty in diagnosis. We present a 36-year-old female who presented with complaints of pain in right hypochondrium and epigastric region. Real-time ultrasonography revealed an enlarged liver with multiple hypoechoic lesions of varying sizes in both the lobes of the liver. USG guided core biopsy from the lesion showed an infiltrating malignant spindle cell neoplasm positive for smooth muscle actin and caldesmon-H confirming the diagnosis of leiomyosarcoma. It is vital to diagnose these lesions even on limited biopsies as early diagnosis can reduce hospital and operative morbidity and mortality rates in the patients

Zero till in wheat from the gender perspective in Nepal

Different tillage practices such as zero-till direct-seeded rice (ZTDSR), zero-till maize (ZTM), and zero-till wheat (ZTW) were implemented in the farmer's field of Sunsari district were evaluated. However, the focus was on ZTW because of high its competitiveness with cheaper wheat from abroad. Focus Group Discussion (FGD), Famers households keeping records, field monitoring, key informant interviews were the primary source of data whereas literature and desktop review were done for secondary data. Zero till wheat operation scale out of the machine use had been increased, by 61.25% out of 109.63ha land in Bhokraha and 66.49 % out of 55.3ha of land in Kaptangunj. Whereas, a new node Chitaha was established with the initiation of non-respondent farmer's where the area occupied 26ha in the year of 2019 respectively as compared to the base year that of 2014. Yield advantage was not much higher with ZTW, the additional benefit of almost 34% over conventional till wheat (CTW) was sufficient enough for the farmers to decide to adopt zero tillage technology. Farmers perceived about 17% saving in seed requirement, 13% saving in irrigation amount and time, and 44% saving in total labor cost with ZTW to make it more profitable as compared to CTW. Among different methods of extension, farmers’ field day with 63% and field trial with 48% with women's participation shows the most effective method to create awareness. Although the percentage of the working hour for the female worker is higher the number of the total hour has been decreased for both the man and women and the total 303.64hr/ha has been saved

Potable Water Identification with Machine Learning: An Exploration of Water Quality Parameters

In this research, we aim to determine the water potability using three machine learning classification algorithms: decision tree, gradient boosting and bagging classifier. These algorithms were trained and tested on a dataset of water quality measurements. The outcomes of the experiment showed that the gradient boosting algorithm achieved the highest F1-score of 0.78 among all the algorithms. This indicates that the gradient boosting algorithm was most effective in correctly identifying both the safe and contaminated water samples. The results of this study demonstrate that gradient boosting is a promising approach for determining water potability and can be used as a reliable method for water quality assessment