A comparative study of surfactant versus nonsurfactant therapy among preterm with respiratory distress syndrome

Background: Respiratory distress is a clinical condition characterized by the presence of one or more signs of increased work of breathing including tachypnea, nasal flaring, grunting, and chest wall retraction. Objective: The objective of the study was to study the outcome of surfactant therapy in preterm with respiratory distress syndrome (RDS). Materials and Methods: A prospective comparative study was conducted in the neonatal intensive care unit of a tertiary care hospital in Cuttack, Odisha, over a period of 2 years. Parents of the babies, who gave their consent for surfactant (who can afford), were assigned as surfactant group while those who could not afford it, were included in nonsurfactant group after matching general characteristics. Results: Overall, mortality was less in the surfactant group (28.94%) than in nonsurfactant group (54.92%). However, the late neonatal death was more in the surfactant group (63.63%) than in nonsurfactant group (53.84%). Sepsis was the most common cause of the death in both groups, contributing 58% to overall death of both groups. Conclusion: Surfactant should be used in preterm with established RDS with due care to neonatal sepsis

Schedulability of Rate Monotonic Algorithm using Improved Time Demand Analysis for Multiprocessor Environment

Real-Time Monotonic algorithm (RMA) is a widely used static priority scheduling algorithm. For application of RMA at various systems, it is essential to determine the system’s feasibility first. The various existing algorithms perform the analysis by reducing the scheduling points in a given task set. In this paper we propose a schedubility test algorithm, which reduces the number of tasks to be analyzed instead of reducing the scheduling points of a given task. This significantly reduces the number of iterations taken to compute feasibility. This algorithm can be used along with the existing algorithms to effectively reduce the high complexities encountered in processing large task sets. We also extend our algorithm to multiprocessor environment and compare number of iterations with different number of processors. This paper then compares the proposed algorithm with existing algorithm. The expected results show that the proposed algorithm performs better than the existing algorithms

RECENT ADVANCES IN HYDROGELS FOR BIOMEDICAL APPLICATIONS

Hydrogels are three-dimensional polymeric network, capable of entrapping substantial amounts of fluids. Hydrogels are formed due to physical or chemical cross-linking in different synthetic and natural polymers. Recently, hydrogels have been receiving much attention for biomedical applications due to their innate structure and compositional similarities to the extracellular matrix. Hydrogels fabricated from naturally derived materials provide an advantage for biomedical applications due to their innate cellular interactions and cellular-mediated biodegradation. Synthetic materials have the advantage of greater tunability when it comes to the properties of hydrogels. There has been considerable progress in recent years in addressing the clinical and pharmacological limitations of hydrogels for biomedical applications. The primary objective of this article is to review the classification of hydrogels based on their physical and chemical characteristics. It also reviews the technologies adopted for hydrogel fabrication and the different applications of hydrogels in the modern era

Adverse perinatal outcome in diabetic mother treated with oral hypoglycemic agents vs. insulin

Background: Insulin has been the primary mode of therapy in diabetic mother for glycemic control as oral hypoglycemic agents (OHA) were initially thought to have teratogenic effect. Recent data supports the use of certain OHA; this study was designed to compare the perinatal outcomes in infants born to diabetic mother treated with insulin vs. oral hypoglycemic agents and to find out the relation of adverse perinatal events to glycemic control in both groups.Methods: This prospective observational study was conducted in a tertiary care hospital. 108 neonates born to diabetic mother between October 2014 to September 2016 were taken for study immediately after delivery after excluding the mothers who were treated with lifestyle modification and/or dietary modification alone only. 60 mothers had received insulin and 48 OHA for glycaemic control. Glycemic control was assessed by HbA1C estimation on the day of delivery. The infants were followed up in neonatal care unit for perinatal complications. Main outcome measure(s): birth weight, gestational age, respiratory problems, birth injury, birth asphyxia, congenital anomalies, hypoglycemia, hypocalcaemia, hyperbillirubinemia.Results: Out of 108 infants, 27 were born to pregestational and 81 to gestational diabetic mothers. 60(55.5%) were treated with insulin and rest with OHA, 53(49.1%) had optimal glycemic control. Both the groups had similar glycemic control in the third trimester. None of the perinatal outcomes showed significant difference between insulin and OHA group except neonatal hyperbillirubinemia. (p=0.013, RR=8 and OR=0.106). Within the optimal glycemic control (HbA1C <8), LGA has significant association with the insulin group than OHA (p=0.012, RR=2.217 and OR=4.2018).Conclusions: As compared to insulin, oral hypoglycemic agents have similar glycemic control and no adverse perinatal outcomes and can be used in pregnant mothers with diabetes mellitus from poor socioeconomic and educational background for its low cost and better patient compliance. Within the glycemic control, maternal treatment with insulin showed significant difference in LGA compared to OHA which needs further studies for validation

Detection of foot-and-mouth disease virus type O in recovered as well as healthy cattle to study carrier status in Assam

200-206Foot and mouth disease (FMD), one of the most contagious diseases of animals, affects different host species including wild animals. Asymptomatic FMD recovered animals may remain as carrier, which may be threat to other healthy animals. Hence, it is necessary to monitor the carrier status of the FMD recovered animals to effectively prevent further spread of the disease. Out of all the seven serotypes of FMD, O serotype is most commonly found in livestock. Therefore, in the present study, we chose to detect serotype ‘O’ in oropharyngeal fluid (OP) and to quantify cytokines, viz. IL-1α, IL-1β and IL-2. A total of 30 OP fluids and 30 blood samples were collected from 10 animals (1 in-contact healthy animal) for 3 months post infection. FMD O serotype could be detected in all the animals (100%). The RQ values were found to be 0.014 to 63.118 and 0.162 to 46.889 for IL-1α and IL-1β genes respectively, while insignificant RQ values were obtained for IL-2. In the second and third months, two animals showed down regulation for IL-1α gene, while IL-1β and IL-2 genes were down regulated in 7 animals and in all 10 animals, respectively for all the three months

Modelling of Rhode Island Red chicken strains

To study the growth pattern in body weight of 3 strains of Rhode Island Red chicken Bertalanffy, gompertz and logistic nonlinear models were fitted. From the data on body weights of three strains of Rhode Island Red, we observed that average body weights of male chicken were higher than the female chicken. Based on the various measures of goodness fit criteria we have observed that in modelling of body weight of the Rhode Island Red chicken Bertalanffy was the best fitted model. In case of Rhode Island Control, Bertalanffy was the best fitted model and for Rhode Island Control male chicken logistic was the best fitted model. In case of Rhode Island White chicken logistic was the best fitted model and in case of Rhode Island White male chicken Bertalanffy was the best fitted model. In case of female chicken of Rhode Island Red, Rhode Island Control and Rhode Island White strains gompertz model was the best fitted model. From these fitted models one can determine the expected average body weight of a group of birds of three strains of RIR chicken at any given age under normal conditions

Antenatal dexamethasone for early preterm birth in low-resource countries

BACKGROUND: The safety and efficacy of antenatal glucocorticoids in women in low-resource countries who are at risk for preterm birth are uncertain. METHODS: We conducted a multicountry, randomized trial involving pregnant women between 26 weeks 0 days and 33 weeks 6 days of gestation who were at risk for preterm birth. The participants were assigned to intramuscular dexamethasone or identical placebo. The primary outcomes were neonatal death alone, stillbirth or neonatal death, and possible maternal bacterial infection; neonatal death alone and stillbirth or neonatal death were evaluated with superiority analyses, and possible maternal bacterial infection was evaluated with a noninferiority analysis with the use of a prespecified margin of 1.25 on the relative scale. RESULTS: A total of 2852 women (and their 3070 fetuses) from 29 secondary- and tertiary-level hospitals across Bangladesh, India, Kenya, Nigeria, and Pakistan underwent randomization. The trial was stopped for benefit at the second interim analysis. Neonatal death occurred in 278 of 1417 infants (19.6%) in the dexamethasone group and in 331 of 1406 infants (23.5%) in the placebo group (relative risk, 0.84; 95% confidence interval [CI], 0.72 to 0.97; P=0.03). Stillbirth or neonatal death occurred in 393 of 1532 fetuses and infants (25.7%) and in 444 of 1519 fetuses and infants (29.2%), respectively (relative risk, 0.88; 95% CI, 0.78 to 0.99; P=0.04); the incidence of possible maternal bacterial infection was 4.8% and 6.3%, respectively (relative risk, 0.76; 95% CI, 0.56 to 1.03). There was no significant between-group difference in the incidence of adverse events. CONCLUSIONS: Among women in low-resource countries who were at risk for early preterm birth, the use of dexamethasone resulted in significantly lower risks of neonatal death alone and stillbirth or neonatal death than the use of placebo, without an increase in the incidence of possible maternal bacterial infection.Fil: Oladapo, Olufemi T.. Organizacion Mundial de la Salud; ArgentinaFil: Vogel, Joshua P.. Organizacion Mundial de la Salud; ArgentinaFil: Piaggio, Gilda. Organizacion Mundial de la Salud; ArgentinaFil: Nguyen, My-Huong. Organizacion Mundial de la Salud; ArgentinaFil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Metin Gülmezoglu, A.. Organizacion Mundial de la Salud; ArgentinaFil: Bahl, Rajiv. Organizacion Mundial de la Salud; ArgentinaFil: Rao, Suman P.N.. Organizacion Mundial de la Salud; ArgentinaFil: de Costa, Ayesha. Organizacion Mundial de la Salud; ArgentinaFil: Gupta, Shuchita. Organizacion Mundial de la Salud; ArgentinaFil: Shahidullah, Mohammod. No especifíca;Fil: Chowdhury, Saleha B.. No especifíca;Fil: Ara, Gulshan. No especifíca;Fil: Akter, Shaheen. No especifíca;Fil: Akhter, Nasreen. No especifíca;Fil: Dey, Probhat R.. No especifíca;Fil: Abdus Sabur, M.. No especifíca;Fil: Azad, Mohammad T.. No especifíca;Fil: Choudhury, Shahana F.. No especifíca;Fil: Matin, M.A.. No especifíca;Fil: Goudar, Shivaprasad S.. No especifíca;Fil: Dhaded, Sangappa M.. No especifíca;Fil: Metgud, Mrityunjay C.. No especifíca;Fil: Pujar, Yeshita V.. No especifíca;Fil: Somannavar, Manjunath S.. No especifíca;Fil: Vernekar, Sunil S.. No especifíca;Fil: Herekar, Veena R.. No especifíca;Fil: Bidri, Shailaja R.. No especifíca;Fil: Mathapati, Sangamesh S.. No especifíca;Fil: Patil, Preeti G.. No especifíca;Fil: Patil, Mallanagouda M.. No especifíca;Fil: Gudadinni, Muttappa R.. No especifíca;Fil: Bijapure, Hidaytullah R.. No especifíca;Fil: Mallapur, Ashalata A.. No especifíca;Fil: Katageri, Geetanjali M.. No especifíca;Fil: Chikkamath, Sumangala B.. No especifíca;Fil: Yelamali, Bhuvaneshwari C.. No especifíca;Fil: Pol, Ramesh R.. No especifíca;Fil: Misra, Sujata S.. No especifíca;Fil: Das, Leena. No especifíca

Cluster-randomised controlled trial of community mobilisation in Mumbai slums to improve care during pregnancy, delivery, postpartum and for the newborn

Background: The United Nations Millennium Development Goals look to substantial improvements in child and maternal survival. Morbidity and mortality during pregnancy, delivery and the postnatal period are prime obstacles to achieving these goals. Given the increasing importance of urban health to global prospects, Mumbai's City Initiative for Newborn Health aims to improve maternal and neonatal health in vulnerable urban slum communities, through a combination of health service quality improvement and community participation. The protocol describes a trial of community intervention aimed at improving prevention, care seeking and outcomes.Objective: To test an intervention that supports local women as facilitators in mobilising communities for better health care. Community women's groups will build an understanding of their potential to improve maternal and infant health, and develop and implement strategies to do so.Design: Cluster-randomized controlled trial.Methods: The intervention will employ local community-based female facilitators to convene groups and help them to explore maternal and neonatal health issues. Groups will meet fortnightly through a seven-phase process of sharing experiences, discussion of the issues raised, discovery of potential community strengths, building of a vision for action, design and implementation of community strategies, and evaluation.The unit of allocation will be an urban slum cluster of 1000-1500 households. 48 clusters have been randomly selected after stratification by ward. 24 clusters have been randomly allocated to receive the community intervention. 24 clusters will act as control groups, but will benefit from health service quality improvement. Indicators of effect will be measured through a surveillance system implemented by the project. Key distal outcome indicators will be neonatal mortality and maternal and neonatal morbidity. Key proximate outcome indicators will be home care practices, uptake of antenatal, delivery and postnatal care, and care for maternal and neonatal illness.Data will be collected through a vital registration system for births and deaths in the 48 study clusters. Structured interviews with families will be conducted at about 6 weeks after index deliveries. We will also collect both quantitative and qualitative data to support a process evaluation.Trial registration: Current controlled trials ISRCTN9625679