ASSESSMENT OF INDICATIONS OF LOWER SEGMENT CESAREAN SECTION AT TERTIARY CARE CENTER: A RETROSPECTIVE STUDY

Background: Cesarean section (CS) is one of the most common and widely performed surgical procedures in obstetrics in India and Worldwide. It is mainly evolved as a lifesaving procedure for mother and fetus during the difficult delivery. To study, various indications for the lower segment CS at our tertiary care center were the objective of the present study. Methods: This is a descriptive, retrospective study of all the patients who were underwent CS in the Department of Obstetrics and Gynecology, Jhalawar Medical College, Jhalawar from January 1, 2021, to March 31, 2021 for the duration of 3 months. Data of patients who delivered by C-Section in our hospital during the defined study period were recorded and a statistical analysis was done for various indications of the lower segment CS (LSCS). Results: The total numbers of women delivered by CS over the study period were 806 among these 339 (42.05%) patients were primiparous and 467 (57.95%) were multiparous. 550 (68.23%) cases were from age group 20–25 years and 153 (18.98%) were had age group 26–30 years, 20 (2.48%) were from age group below 19 years, and 76 (10.29%) patients were above 31 years age. The previous LSCS was the leading indication to the LSCS (31.14%) followed fetal distress (13.88%), malpresentation 95 (11.78%) (including breech presentation in maximum women (86), transverse and oblique lie (9 each), and face presentation (3)) (11.78%), meconium stained liquor with fetal distress 60 (7.44%), severe oligohydramnios 48 (5.95%), non-progress of labor 32 (3.97%), cephalopelvic disproportion 23 (2.85%), pre-eclampsia 20 (2.48%), obstructed labor 19 (2.35%), big baby 19 (2.35%), pregnancy-induced hypertension 18 (2.23%), maternal request and post-dated pregnancy 15 (1.86%) each, gestational hypertension and eclampsia 11 (1.36%) each, placenta previa 10 (1.24%), induction failure 8 (0.99%), and intrauterine growth retardation and antepartum hemorrhage 7 (0.86%) and 14 (1.73%). Patients had other indications such as Abruptio placentae, gestational diabetes, twin pregnancy, uterine rupture, and deep transverse arrest. Conclusions: In this study, CS rate (40.68%) is found to be higher as compared to other studies and the WHO guidelines. CSs rate is high probably because Jhalawar Medical College, Jhalawar acts as a government tertiary care center. The previous LSCS was a common indication in 31.14% of mothers in present study. Besides, previous LSCS, fetal distress, malpresentation (Breech presentation/transverse lie, oblique lie, and face presentation) MSL with fetal distress, and severe oligohydramnios were the common indications for LSCS, which are seen in the present study

STUDY OF EFFECTS OF SPONTANEOUS DELIVERY OF PLACENTA VERSUS MANUAL REMOVAL OF PLACENTA DURING CESAREAN SECTION AT TERTIARY CARE CENTRE

Objectives: The aim of the study was to compare the effects of manual removal of placenta and spontaneous delivery of placenta during cesarean section. Methods: This was a hospital-based prospective comparative study conducted in the Department of Obstetrics and Gynecology, Jhalawar Medical College, Jhalawar. 400 antenatal women at term and singleton pregnancy posted for cesarean section from October 2018 to September 2019 for 1 year duration. The study populations were divided into two groups (200 each). Group A in whom placenta deliver spontaneously and Group B in whom placenta was removed manually. Comparison was done in term of blood loss, fever, endometritis, and delayed complications. Results: The manual removal of placenta associated with greater blood loss (p<0.0001, statistically significant), the greater fall in hemoglobin (p<0.0001, statistically significant). Manual removal of placenta was associated with leukocytosis (p=0.0009), higher incidence of fever, post-operative uterine tenderness, and sub involution of uterus (p<0.05 statistically significant). This is reflected by increased incidence of endometritis with manual removal (p=0.001, Significant). The overall time taken between delivery of baby to delivery of placenta was significantly lesser in manual removal method (p<0.0001). Conclusion: Manual method seems to decrease the time interval between delivery of baby and that of placenta. Manual removal of placenta does more harm than benefit by increasing the incidence of fall in hemoglobin and delayed complication

Obeticholic acid for the treatment of non-alcoholic steatohepatitis: interim analysis from a multicentre, randomised, placebo-controlled phase 3 trial

Background Non-alcoholic steatohepatitis (NASH) is a common type of chronic liver disease that can lead to cirrhosis. Obeticholic acid, a farnesoid X receptor agonist, has been shown to improve the histological features of NASH. Here we report results from a planned interim analysis of an ongoing, phase 3 study of obeticholic acid for NASH. Methods In this multicentre, randomised, double-blind, placebo-controlled study, adult patients with definite NASH,non-alcoholic fatty liver disease (NAFLD) activity score of at least 4, and fibrosis stages F2–F3, or F1 with at least oneaccompanying comorbidity, were randomly assigned using an interactive web response system in a 1:1:1 ratio to receive oral placebo, obeticholic acid 10 mg, or obeticholic acid 25 mg daily. Patients were excluded if cirrhosis, other chronic liver disease, elevated alcohol consumption, or confounding conditions were present. The primary endpointsfor the month-18 interim analysis were fibrosis improvement (≥1 stage) with no worsening of NASH, or NASH resolution with no worsening of fibrosis, with the study considered successful if either primary endpoint was met. Primary analyses were done by intention to treat, in patients with fibrosis stage F2–F3 who received at least one dose of treatment and reached, or would have reached, the month 18 visit by the prespecified interim analysis cutoff date. The study also evaluated other histological and biochemical markers of NASH and fibrosis, and safety. This study is ongoing, and registered with ClinicalTrials.gov, NCT02548351, and EudraCT, 20150-025601-6. Findings Between Dec 9, 2015, and Oct 26, 2018, 1968 patients with stage F1–F3 fibrosis were enrolled and received at least one dose of study treatment; 931 patients with stage F2–F3 fibrosis were included in the primary analysis (311 in the placebo group, 312 in the obeticholic acid 10 mg group, and 308 in the obeticholic acid 25 mg group). The fibrosis improvement endpoint was achieved by 37 (12%) patients in the placebo group, 55 (18%) in the obeticholic acid 10 mg group (p=0·045), and 71 (23%) in the obeticholic acid 25 mg group (p=0·0002). The NASH resolution endpoint was not met (25 [8%] patients in the placebo group, 35 [11%] in the obeticholic acid 10 mg group [p=0·18], and 36 [12%] in the obeticholic acid 25 mg group [p=0·13]). In the safety population (1968 patients with fibrosis stages F1–F3), the most common adverse event was pruritus (123 [19%] in the placebo group, 183 [28%] in the obeticholic acid 10 mg group, and 336 [51%] in the obeticholic acid 25 mg group); incidence was generally mild to moderate in severity. The overall safety profile was similar to that in previous studies, and incidence of serious adverse events was similar across treatment groups (75 [11%] patients in the placebo group, 72 [11%] in the obeticholic acid 10 mg group, and 93 [14%] in the obeticholic acid 25 mg group). Interpretation Obeticholic acid 25 mg significantly improved fibrosis and key components of NASH disease activity among patients with NASH. The results from this planned interim analysis show clinically significant histological improvement that is reasonably likely to predict clinical benefit. This study is ongoing to assess clinical outcomes

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Not AvailableBiotic stresses cause significant loss in crop plants and management of biotic stresses (Diseases and pests) not only increases the cost of production but also has implications on environment and ecology. Increasing use of chemical agents for biotic stress management is concern for growers, exporters and animal and human health. The best method is to use resistant varieties which are economical, healthier and eco-friendly approach. Breeding for disease and pest resistance is major objective in most of the breeding programs across the crop species and world. The resistance breeding requires the resistant source or donor which may be the same species, related species of same genera or family, or altogether an alien species. There is need of recipient or target species and method of transfer of resistance. There are different approaches for breeding for resistance against different kinds of stress which involve both conventional and modern tools. Resistance breeding approach is to be at least one step ahead of the pathogen or pest in question. Achieving the goal of development of a resistant variety also needs attention on the durability of resistance for which the knowledge of resistance on the inheritance, expression and interaction with fellow genes and environment aspects. In this chapter emphasis has been given on importance of biotic stresses, inheritance, resistance sources, breeding approaches, and modern tools.Not Availabl

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Not AvailableHuman exploitation of earth’s resources is leading to new problems day by day and hence newer methods are devised to overcome the same. The long-term goal of crop improvement for abiotic stress tolerance in plants is a traditional objective of breeders. World population is expected to increase by 1.8 billion as of 2030 and by 2.5 billion as of 2050, reaching 9.2 billion. By 2030 food demand is expected to increase by 50 percent because of continued population growth and higher incomes (www.popcouncil. org). If global population reaches 9.1 billion by 2050, the FAO says that world food production will need to rise by 70 per cent, and food production in the developing world will need to double. On the other hand food productivity is decreasing due to the effect of various abiotic stresses; therefore minimizing these losses is a major area of concern for all nations to cope with the increasing food requirements. However, abiotic stresses and climate change are becoming increasingly serious threats to crop production worldwide at a time when food staple supply will need to be significantly higher to meet the demand of the growing human population. Drought is the main abiotic factor followed by soil salinity. Now-a-days, agriculture has new huge challenges due to population growth, the pressure on agriculture liability on the environmental conservation, and climate change. To cope with these new challenges, many plant breeding programs have reoriented their breeding scope to stress tolerance in the last years. One such case is breeding for abiotic stress, utilizing even non arable land, to feed the ever increasing population. Research is the key to meeting the challenges of modern agriculture in a sustainable and positive fashion. So, in this chapter, emphasis has been given on importance of abiotic stresses specially on drought and salinity, sources of abiotic stress tolerance, genetics of abiotic stress tolerance, plant breeding presents the conventional (selection and introduction, pedigree method, modified bulk pedigree method, shuttle breeding, mutation breeding, diallele selective mating system supplemented by MAS, back cross method and recurrent selection), and most recent advances and discoveries (somaclonal approach, F1 anther culture, marker assisted selection and genetically modified crop) applied to abiotic stresses, discussing the breeding methods, and modern molecular biological approaches to develop improved cultivars tolerant to most sorts of abiotic stresses. In this chapter more discussed about successful example of conventional breeding methods and non conventional methods because the breeding procedure of each breeding methods is not possible in one chapter.Not Availabl

Role of Bromelain as Herbal Anti-Inflammatory Compound Using In Vitro and In Vivo Model of Colitis

International audienc

Not Available

Not AvailableHuman exploitation of earth’s resources is leading to new problems day by day and hence newer methods are devised to overcome the same. The long-term goal of crop improvement for abiotic stress tolerance in plants is a traditional objective of breeders. World population is expected to increase by 1.8 billion as of 2030 and by 2.5 billion as of 2050, reaching 9.2 billion. By 2030 food demand is expected to increase by 50 percent because of continued population growth and higher incomes (www.popcouncil.org). If global population reaches 9.1 billion by 2050, the FAO says that world food production will need to rise by 70%, and food production in the developing world will need to double. On the other hand food productivity is decreasing due to the effect of various abiotic stresses; therefore minimizing these losses is a major area of concern for all nations to cope with the increasing food requirements. However, abiotic stresses and climate change are becoming increasingly serious threats to crop production worldwide at a time when food staple supply will need to be significantly higher to meet the demand of the growing human population. Drought is the main abiotic factor followed by soil salinity. Now-a-days, agriculture has new huge challenges due to population growth, the pressure on agriculture liability on the environmental conservation, and climate change. To cope with these new challenges, many plant breeding programs have reoriented their breeding scope to stress tolerance in the last years. One such case is breeding for abiotic stress, utilizing even non arable land, to feed the ever increasing population. Research is the key to meeting the challenges of modern agriculture in a sustainable and positive fashion. So, in this chapter, emphasis has been given on importance of abiotic stresses specially on drought and salinity, sources of abiotic stress tolerance, genetics of abiotic stress tolerance, plant breeding presents the conventional (selection and introduction, pedigree method, modified bulk pedigree method, shuttle breeding, mutation breeding, diallele selective mating system supplemented by MAS, back cross method and recurrent selection), and most recent advances and discoveries (somaclonal approach, F1 anther culture, marker assisted selection and genetically modified crop) applied to abiotic stresses, discussing the breeding methods, and modern molecular biological approaches to develop improved cultivars tolerant to most sorts of abiotic stresses. In this chapter more discussed about successful example of conventional breeding methods and non-conventional methods because the breeding procedure of each breeding methods is not possible in one chapter.Not Availabl

Dataset on antioxidant system of non-model halophytes Urochondra setulosa and Dichanthium annulatum in saline environment

The antioxidant potential of halophytes, Dichanthium annulatum and Urochondra setulosa, was examined under the influence of high salinity. These halophytes were grown in lysimeters filled with saline soil and further irrigated with saline water to maintain different salt levels of ECe 30, 40 and 50 dS m−1 along with the one set in normal field soil without saline irrigation serving as control. The leaf samples were collected after saline irrigation and analyzed for the antioxidative enzymes i.e., Catalase (CAT), Peroxidase (POX), Superoxide dismutase (SOD), Ascorbate peroxidase (APX), Monodehydroascorbate reductase (MDHAR), Dehydroascorbate reductase (DHAR) and Glutathione reductase (GR), including the ROS metabolites such as H2O2 content, malondialdehyde content (MDA), ascorbic acid content and total glutathione content. The mechanism of scavenging the reactive oxygen species in both the halophytes was characterized

International Journal of Phytoremediation

Not AvailableSalt stress induced modulations in different ionic ratios and ROS system were studied in ten halophytic species, namely Atriplex lentiformis, Tamarix aphylla, Sporobolus marginatus, Suaeda nudiflora, Urochondra setulosa, Arundo donax, Aeluropus lagopoides, Heliotropium ramossimum, Atriplex nummularia, Leptachloa fusca at salinity level of ECe - 30 dS/m (300 mM NaCl) to explore their possible role in salt tolerance ability of these halophytes. These halophytes were categorized for their salt tolerance levels based on the ratios of Na/K, Na/Ca, Na/Cl and Na + Cl/K + Ca. Variable responses were observed among all halophytes where Atriplex lentiformis had lowest leaf Na/K (0.44) which is one of the best indicator of salt tolerance, Heliotropium ramossimum had lowest Na/Ca and Na/Cl (0.97 and 0.18), whereas Sporobolus marginatus had lowest Na + Cl/K + Ca (0.79). Specific enzymes activities of ascorbate peroxidase (APX), superoxide dismutase (SOD), catalase (CAT) and peroxidase (POX) were also assessed to get better comprehension of the ROS scavenging system under salinity in these halophytes. Urochondra setulosa showed highest APX and SOD activity followed by Atriplex lentiformis. Most efficient enzyme in degrading hydrogen peroxide i.e. CAT showed highest activity in Suaeda nudiflora followed by Atriplex nummularia and Urochondra setulosa, whereas Atriplex nummularia and Atriplex lentiformis showed higher POX activity. Significant variability in H2O2 and MDA content was also observed. These results possibly suggest higher inbuilt genetic potential of these halophytes to combat high salinity induced oxidative stress via higher antioxidant activities

pH-Mediated Collective and Selective Solar Photocatalysis by a Series of Layered Aurivillius Perovskites

Semiconductor photocatalysis under natural sunlight is an emergent area in contemporary materials research, which has attracted considerable attention toward the development of catalysts for environmental remediation using solar energy. A series of five-layer Aurivillius-phase perovskites, Bi5ATi4FeO18 (A = Ca, Sr, and Pb), are synthesized for the first time. Rietveld refinements of the powder X-ray diffraction data indicated orthorhombic structure for the Aurivillius phases with Fe largely occupying the central octahedral layer, whereas the divalent cations (Ca, Sr, and Pb) are statistically distributed over the cubo-octahedral A-sites of the perovskite. The compounds with visible-light-absorbing ability (Eg ranging from ∼2.0 to 2.2 eV) not only exhibit excellent collective photocatalytic degradation of rhodamine B–methylene blue (MB) and rhodamine B–rhodamine 6G mixture at pH 2 but also show almost 100% photocatalytic selective degradation of MB from the rhodamine B–MB mixture at pH 11 under natural solar irradiation. The selectivity in the alkaline medium is believed to originate from the combined effect of the photocatalytic degradation of MB by the Aurivillius-phase perovskites and the photolysis of MB. Although a substantial decrease in MB adsorption from the mixed dye solution (MB + RhB) together with slower MB photolysis at the neutral pH makes the selective MB degradation sluggish, the compounds showed excellent photocatalytic degradation activity and chemical oxygen demand removal efficacy toward individual RhB (at pH 2) and MB (at pH 11) under sunlight irradiation. The catalysts are exceptionally stable and retain good crystallinity even after five successive cyclic runs without any noticeable loss of activity in both the acidic and alkaline media. The present work provides an important insight into the development of layered perovskite photocatalysts for collective degradation of multiple pollutants and selective removal of one or multiple pollutants from a mixture. The later idea may open up new possibilities for recovery/purification of useful chemical substances from the contaminated medium through selective photocatalysis