A study of postdatism: its incidence and associated morbidities in a tertiary care centre: a prospective observational study

Background: The study shows the incidence of postdatism in a pregnancy, and to find out the incidence of maternal and fetal complications, perinatal mortality in postdated pregnancy. Methods: All registered ANC patients coming to OPD and labour ward completed 40 weeks of gestational age by date (who were sure of the date of last menstrual period) or by scan (considering early weeks scan) are considered in the study. History and examination of the patients are done and mode of delivery was decided accordingly. Fetal monitoring was done using non stress test, ultrasonography and DFKC charting maintained. Results: Postdatism is very common in primigravida (61%) than multigravida, and is common in age group of 21-30 years (67%), most common mode of delivery was vaginal delivery with approximately 30% undergoing LSCS due to various reasons. In perinatal assessment there was one IUFD and 5 NICU admissions in a total of 100 postdatism pregnancies. Maternal morbidities like sepsis, postpartum hemorrhage, perineal tear ivo shpulder dystocia and big baby will also be present in small number of cases. Conclusions: This study shows the incidence of postdatism according to gravida score and age factors. It also shows the associated perinatal and maternal morbidities in a patient with postdatism

Study of chronic pelvic pain by laparoscopy in tertiary care hospital

Background: Laproscopy in chronic pelvic pain can revel findings that cannot be detected clinically, by ultrsonography, so it can be treated and diagnosed at the same sitting. This study was undertaken to evaluate role of laproscopy in chronic pelvic pain. Methods: Study design is a prospective study conducted in JJ hospital and Cama and Albless Hospital. A total of ‘44’ women presenting in OPD with chronic pelvic pain for more than 6 months duration were taken for the study. Results: Out of 44 patients who presented with pelvic pain 1 (2.27%) patient had no detectable pelvic pathology by laparoscopy. Prior ultrasound done in these 44 patients revealed that 14 (31%) had normal pelvic scan. Hence, ultrasound underdiagnosed 13 patients who actually had pelvic pathology on laparoscopy. Out of 44 patients 3 (6%) had normal clinical diagnosis, hence clinical examination under-diagnosed 2 other patients who on laparoscopy did not have any pelvic pathology. Conclusions: Laparoscopy is valuable in definitive diagnosis of pelvic pain. Use of laparoscopy for diagnostic and therapeutic purposes helps in avoiding laparotomy in majority of patients and morbidity and mortality associated with it

Fracture of jammed colloidal suspensions

Concentrated colloidal suspensions display dramatic rises in viscosity, leading to jamming and granulation, with increasing shear rate. It has been proposed that these effects result from inter particle friction, as lubrication forces are overcome. This suggests the jamming of concentrated colloidal suspensions should exhibit some shared phenomenology with macroscopic granular systems where friction leads to two different types of jammed state. Here we show that transient rheological measurements can be used to probe the processes of granulation in concentrated colloidal suspensions. Our results support the idea that frictional contacts are created between jammed particles. The jamming behaviour displays two qualitatively different regimes separated by a critical strain rate with qualitatively different types of fracture/break up behaviour. In the lower strain rate regime, it is found that vibrations can be used to control jamming and granulation, resulting in a flowable fluid

Calibration of myocardial T2 and T1 against iron concentration.

BACKGROUND: The assessment of myocardial iron using T2* cardiovascular magnetic resonance (CMR) has been validated and calibrated, and is in clinical use. However, there is very limited data assessing the relaxation parameters T1 and T2 for measurement of human myocardial iron. METHODS: Twelve hearts were examined from transfusion-dependent patients: 11 with end-stage heart failure, either following death (n=7) or cardiac transplantation (n=4), and 1 heart from a patient who died from a stroke with no cardiac iron loading. Ex-vivo R1 and R2 measurements (R1=1/T1 and R2=1/T2) at 1.5 Tesla were compared with myocardial iron concentration measured using inductively coupled plasma atomic emission spectroscopy. RESULTS: From a single myocardial slice in formalin which was repeatedly examined, a modest decrease in T2 was observed with time, from mean (± SD) 23.7 ± 0.93 ms at baseline (13 days after death and formalin fixation) to 18.5 ± 1.41 ms at day 566 (p<0.001). Raw T2 values were therefore adjusted to correct for this fall over time. Myocardial R2 was correlated with iron concentration [Fe] (R2 0.566, p<0.001), but the correlation was stronger between LnR2 and Ln[Fe] (R2 0.790, p<0.001). The relation was [Fe] = 5081•(T2)-2.22 between T2 (ms) and myocardial iron (mg/g dry weight). Analysis of T1 proved challenging with a dichotomous distribution of T1, with very short T1 (mean 72.3 ± 25.8 ms) that was independent of iron concentration in all hearts stored in formalin for greater than 12 months. In the remaining hearts stored for <10 weeks prior to scanning, LnR1 and iron concentration were correlated but with marked scatter (R2 0.517, p<0.001). A linear relationship was present between T1 and T2 in the hearts stored for a short period (R2 0.657, p<0.001). CONCLUSION: Myocardial T2 correlates well with myocardial iron concentration, which raises the possibility that T2 may provide additive information to T2* for patients with myocardial siderosis. However, ex-vivo T1 measurements are less reliable due to the severe chemical effects of formalin on T1 shortening, and therefore T1 calibration may only be practical from in-vivo human studies

Research priorities in children and adults with congenital heart disease: a James Lind Alliance Priority Setting Partnership

Objective To bring together patients, parents, charities and clinicians in a Priority Setting Partnership to establish national clinical priorities for research in children and adults with congenital heart disease. Methods The established James Lind Alliance methodology was used to identify and prioritise research on the management of congenital heart disease, focusing on diagnosis, treatment and outcomes. An initial open survey was used to gather potential uncertainties which were filtered, categorised, converted into summary questions and checked against current evidence. In a second survey, respondents identified the unanswered questions most important to them. At two final workshops, patients, parents, charities and healthcare professionals agreed the top 10 lists of priorities for child/antenatal and adult congenital heart disease research. Results 524 respondents submitted 1373 individual questions, from which 313 out of scope or duplicate questions were removed. The remaining 1060 questions were distilled into summary questions and checked against existing literature, with only three questions deemed entirely answered and removed. 250 respondents completed the child/antenatal survey (56 uncertainties) and 252 completed the adult survey (47 uncertainties). The questions ranked the highest by clinicians and non-clinicians were taken forward to consensus workshops, where two sets of top 10 research priorities were agreed. Conclusions Through an established and equitable process, we determined national clinical priorities for congenital heart disease research. These will be taken forward by specific working groups, a national patient and public involvement group, and through the establishment of a UK and Ireland network for collaborative, multicentre clinical trials in congenital heart disease