The effect of abnormal amniotic fluid volume (oligohydramnios) on maternal and fetal outcome: an observational study

Aims: To study the effects of abnormal amniotic fluid (oligohydramnios) on maternal and fetal outcome. Material and Methods: This prospective observational study was carried out in the Department of Obstetrics and Gynecology at Patna Medical College and Hospital Patna, Bihar India, from November 2017 to February 2019. All pregnant women having singleton pregnancy with cephalic presentation,at POG 34-40 weeks, presenting with abnormal liquor  (oligohydramnios ) AFI less than 5,were included in the present study.Results: 85% of patients were in 20-30 years age group and 9% patients were in above 30 years age group. Mean maternal age was 23.61 years. Incidence of oligohydramnios was more in primipara (55%) in our study. And operative morbidity was also more in primipara 54.55%. Most common cause of Oligohydramnios is idiopathic (55%). Second commonest cause is PIH (28.5%). Operative morbidity is highest in PIH (52.64%)). Operative morbidity was significantly higher in NST non-reactive (58.62%) group than NST reactive (27.46%) group. All patients underwent Doppler study. 10% were found with fetoplacental insufficiency. Most common reason to perform caesarean section  was fetal distress which was either due to cord compression or IUGR. Oligohydramnios was related to higher rate of growth retardation and NICU admission.Conclusion: Oligohydramnios is frequent occurrence and demands intensive fetal surveillance and proper antepartum and intrapartum care. Due to intrapartum complication and high rate of perinatal morbidity and mortality, rates of caesarean section are rising, but decision between vaginal delivery and caesarean section should be well balanced so that unnecessary maternal morbidity be  prevented and on the  other side timely intervention can reduce perinatal morbidity and mortality.   Keywords: Oligohydramnios, Maternal Outcome, Fetal Outcome

Annotated Speech Corpus for Low Resource Indian Languages: Awadhi, Bhojpuri, Braj and Magahi

In this paper we discuss an in-progress work on the development of a speech corpus for four low-resource Indo-Aryan languages -- Awadhi, Bhojpuri, Braj and Magahi using the field methods of linguistic data collection. The total size of the corpus currently stands at approximately 18 hours (approx. 4-5 hours each language) and it is transcribed and annotated with grammatical information such as part-of-speech tags, morphological features and Universal dependency relationships. We discuss our methodology for data collection in these languages, most of which was done in the middle of the COVID-19 pandemic, with one of the aims being to generate some additional income for low-income groups speaking these languages. In the paper, we also discuss the results of the baseline experiments for automatic speech recognition system in these languages.Comment: Speech for Social Good Workshop, 2022, Interspeech 202

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Pregnancy outcome in patients with first trimester vaginal bleeding: an observational study

This study was conducted to assess the maternal and perinatal outcome in pregnant women who present with first trimester vaginal bleeding. Materials & Methods: This prospective observational study was carried out in the department of Obstetrics and Gynecology at Patna Medical College and Hospital ,Patna Bihar, India from November 2017 to October 2018. All women with vaginal bleed in first trimester of pregnancy(pregnancy was confirmed chemically and ultrasonologically) were studied. Results: In this study, 200 women with vaginal bleeding in the first trimester of their pregnancy were studied. The mean (± SD) of birth weight was 3025± 369 gram in babies of studied women. The mean (± SD) of gestational age at the end of pregnancy was 272± 14 day in studied women. In women the pregnancy termination due to premature labor was 27%, followed by placental abruption in 11% and 16% patients had no complication. Normal vaginal delivery was 30% and Caesarean section was 35% Among 200 women, 170 ended the pregnancy successfully.Conclusions: Considering the results of present study , first trimester bleeding can be a predicting factor in terms of consequence of pregnancy and it is necessary to increase the knowledge of pregnant women in this regard for closer care. Also, because the clinical interventions of attending doctor has an important role in not only the continuance of pregnancy but also reducing the fetal complications in these high risk pregnancies.Precise management and planning by the obstetrocian is required. Keywords: First trimester bleeding, Pregnancy outcome, Vaginal bleeding

A prospective study of association of body mass index with menstural disturbances in a tertiary care setting

Aims: To establish the association between body mass index and menstrual disturbances. Materials and Methods: A prospective study was conducted in the department of obstetrics and gynaecology in Patna medical college and hospital ,Patna, Bihar India for a period of one year. Total 200 patients were included in the study. Patients with age ranging from 20-40yrs, coming to the departmental OPD with presenting history of menstrual irregularities were included. Patients with normal cycles and  pregnancy were excluded. Data regarding age, marital status, parity, symptoms, menstrual history, obstetric history, examination, co-morbidities, investigation findings, associated pathology and treatment modality were noted.  Results: The mean age of the study participants was 32.12 (±8.12) years and their mean age at menarche was 12.47 (±1.82) years. Majority of the study participants were belonging to class IV (lower middle class 30%) and class III (middle class 25%) socio-economic status. Most of the females were married (85%), Majority of the females were housewives (60%) followed by working women (35). Those belonging to nuclear family (55%). More than 60% of the females who participated in the study were educated till high school. Around 50 (25%) women have BMI within the normal range, 20 (10%) are underweight, 120 (60%) women falls in overweight category and 10 (5%) of the study participants were obese as per the WHO standards. Among the obese women, more than 76.92% have menstrual irregularities suggesting a strong relationship between the two when compared to women with normal BMI. Conclusion: BMI plays a very important role in menstrual cycle regulation. Life style modifications and nutritional counselling could decrease the incidence of menstrual irregularities. Healthy eating habits and maintaining optimal BMI improves menstrual health.  Keywords: Body mass index, Menstrual cycle, Menorrhagia, Obesity

India\u27s Take on Legal Remedy of Passing Off: A Celebrity\u27s Perspective

The development of mass media led to the development of intrigue and curiosity around celebrities and their persona, and the profits hidden therein. Harping upon this intrigue, stakeholders realised the brand power behind celebrity personalities. However, problems arose when there was an increase in the unauthorised exploitation of celebrity personalities. While on the legal front, several remedies are resorted to, William Prosser narrowed down these into four, i.e., intrusion into one’s private space, disclosure of one’s personal and private facts, disclosure of incorrect facts that puts one under a false light and misappropriating one’s personality for commercial gain. Hinged on the brand value of a celebrity’s personality, the right to publicity emphasises the right of a celebrity to claim control over the commercial value of their identity. Remedy against the unauthorised commercial exploitation of a celebrity’s identity is commonly found in the tort of passing off. The article assesses the contours of the remedy of passing off as availed by celebrities and implemented by the Indian Courts. The article also draws a comparison with the approaches employed by American and English law in their understanding of celebrity personality, contrasting the same with the Indian approach