A study on fetomaternal outcome of hypertensive disorders of pregnancy

Background: Hypertensive disorders of pregnancy are one of the most common medical disorders seen during pregnancy. Early diagnosis of hypertensive disorders in pregnancy by regular antenatal checkup can help in proper management, thus decreasing the maternal and fetal complications related it. Ensuring timely and effective care requires appropriate use of evidence-based clinical and nonclinical interventions, strengthened health infrastructure, and motivated and competent health care providers. The objective of this study was to study the feto-maternal outcome of hypertensive disorders of pregnancy and complications related to them. Methods: A study was conducted in the department of obstetrics and gynecology at JJ Group of hospitals, Mumbai, India for a duration of 18 months from January 2020 to June 2021. This study had a sample size of 500 antenatal patients. Necessary information such as their detailed clinical, and obstetric history, clinical examination, investigations was noted. Results: In our study, the incidence of hypertensive disorders of pregnancy was 10.2%, being most common in age group of 21-25 years (45.1%) and Primigravida patients (47.1%). The most common type of hypertensive disorder in our study was non severe preeclampsia with incidence of 74.50%. The most common complication was oligohydramnios (11.76%), followed by preterm delivery (9.80%) and IUGR (9.80%). The most common drug used in the management of hypertensive disorder was lobetalol. Most common neonatal complication in PIH group was low birth weight, followed by fetal distress (19.6%), prematurity (9.8%) and IUGR (9.8%). Conclusions: Hypertensive disorders of pregnancy are one of the medical conditions affecting pregnancy. Hypertensive disorders of pregnancy are more prevalent in younger and nulliparous mothers. Early diagnosis and appropriate timely management of hypertensive disorders in pregnant women can prevent the maternal and fetal complications and improve the outcome of pregnancy. These women should be monitored carefully to prevent maternal morbidity and mortality

A study on lactate dehydrogenase levels in hypertensive disorders of pregnancy and its correlation with feto-maternal outcome

Background: Hypertensive disorders of pregnancy are one of the most common medical disorders seen during pregnancy. Lactate dehydrogenase (LDH) is an intracellular enzyme. The objective of this study was to compare lactate dehydrogenase levels in women with hypertensive disorders of pregnancy and normal pregnant women, to correlate lactate dehydrogenase levels with complications of hypertensive disorders of pregnancy and role of lactate dehydrogenase as an early predictor of hypertensive disorders of pregnancy. Methods: A study was conducted in the department of obstetrics and gynecology at JJ group of hospitals, Mumbai, India for a duration of 18 months from January 2020 to June 2021. This study has a sample size of 500 antenatal patients. Necessary information such as their detailed clinical, and obstetric history, clinical examination, investigations was noted. LDH were measured at 12-16 weeks of pregnancy and at the time of delivery. Results: In our study, the incidence of hypertensive disorders of pregnancy was 10.2% There was no association between LDH levels at 12-16 weeks of gestation and development of hypertensive disorders of pregnancy. There was association between levels of lactate dehydrogenase levels at time of delivery and severity of hypertensive disorders in our study. Higher serum LDH levels were associated with increased incidence of maternal and fetal complications like abruption placenta, HELLP syndrome, IUGR, IUFD, prematurity and oligohydramnios in our study. Conclusions: Hypertensive disorders of pregnancy are one of the medical conditions affecting pregnancy. Lactate dehydrogenase levels at 12-16 weeks of gestation is not early predictor of hypertensive disorders of pregnancy. Serum lactate dehydrogenase levels at time of delivery helps in prediction of severity of disease, adverse outcomes and complications of hypertensive disorders of pregnancy. Hence lactate dehydrogenase acts as prognostic factor in hypertensive disorders of pregnancy

Spacetime Singularities in String and its Low Dimensional Effective Theory

Spacetime singularities are studied in both the $D+d$-dimensional string theory and its $D$-dimensional effective theory, obtained by the Kaluza-Klein compactification. It is found that spacetime singularities in the low dimensional effective theory may or may not remain after lifted to the $D+d$-dimensional string theory, depending on particular solutions. It is also found that there exist cases in which spacetime singularities appearing in high/low dimensional spacetimes do not necessarily happen on the same surfaces.Comment: revtex4, 15 pages, 10 figures. Typos are corrected. Version to appear in Inter. J. Mod. Phys.

Impact of HuR inhibition by the small molecule MS-444 on colorectal cancer cell tumorigenesis.

Colorectal cancer (CRC) is the third most common cancer and a leading cause of cancer-related mortality. Observed during CRC tumorigenesis is loss of post-transcriptional regulation of tumor-promoting genes such as COX-2, TNFα and VEGF. Overexpression of the RNA-binding protein HuR (ELAVL1) occurs during colon tumorigenesis and is abnormally present within the cytoplasm, where it post-transcriptionally regulates genes through its interaction with 3\u27UTR AU-rich elements (AREs). Here, we examine the therapeutic potential of targeting HuR using MS-444, a small molecule HuR inhibitor. Treatment of CRC cells with MS-444 resulted in growth inhibition and increased apoptotic gene expression, while similar treatment doses in non-transformed intestinal cells had no appreciable effects. Mechanistically, MS-444 disrupted HuR cytoplasmic trafficking and released ARE-mRNAs for localization to P-bodies, but did not affect total HuR expression levels. This resulted in MS-444-mediated inhibition of COX-2 and other ARE-mRNA expression levels. Importantly, MS-444 was well tolerated and inhibited xenograft CRC tumor growth through enhanced apoptosis and decreased angiogenesis upon intraperitoneal administration. In vivo treatment of MS-444 inhibited HuR cytoplasmic localization and decreased COX-2 expression in tumors. These findings provide evidence that therapeutic strategies to target HuR in CRC warrant further investigation in an effort to move this approach to the clinic

An experimental study on wistar rats to see the effect of Gymnema sylvestre on blood pressure

Background: Hypertension is a leading cause of morbidity and mortality globally. It is a well-known risk factor for an array of adverse cardiovascular outcomes. Obesity is considered as one of the major contributing factors to essential hypertension in humans. Obesity in itself is a risk factor for conditions like insulin resistance, hypertension, stroke, ischemic heart diseases, CHF etc. Undoubtedly in recent times we have achieved great advances in terms of management of hypertension but still we have miles to cover to have dominance over it. Gymnema sylvestre is a valuable indigenous herb. A number of animal and human studies have shown the potential role of Gymnema sylvestre (GS) as an anti-diabetic and anti-obesity agent.Methods: Adult Female Wistar rats, weighing between 150-200 gm, were included in the study. They were randomly divided into five groups with six rats in each group. High Fat Diet (HFD) was given for 4 weeks to induce hypertension in all the groups except group I which was fed with normal chow. Drugs along with respective diets were given to the rats for next 4 weeks by oral feeding cannula. Systolic blood pressure was measured by NIBP controller machine.Results: On feeding rats with HFD for 4 weeks the mean systolic blood pressure increased significantly. After giving drugs GS (100mg/kg), GS (200mg/kg) and Amlodipine (10mg/kg) to groups III, IV, V respectively for next 4 weeks, mean systolic blood pressure fell significantly (p <0.05) as compared to group II (HFD control group). At final evaluation at week 8 (as compared to Group 2) SBP got maximally reduced in Group 5 (35.1%) followed by Group 4 (26.4%), Group 3 (20.1%). On comparing Amlodipine standard (group 5) with other groups, a significant difference was found. This showed that Gymnema sylvestre reduced the elevated systolic blood pressure significantly but this anti-hypertensive effect was inferior to Amlodipine.Conclusions: The present study concludes that Gymnema sylvestre has a potent dose- dependent antihypertensive action but the effect is inferior to Amlodipine. Hence it can be used as an add-on to standard drugs for hypertension

Integrated Green Lean Six Sigma-Industry 4.0 approach to combat COVID-19: from literature review to framework development

Purpose: The Coronavirus (COVID-19) pandemic has led to a surge in demand for healthcare facilities, medicines, vaccines, and other healthcare items. Integrating Green Lean Six Sigma (GLSS) and Industry 4.0 (I4.0) has the potential to meet the modern demand of healthcare units and also leads to improving the quality of inpatient care with better safety, hygiene, and real-time diagnoses. A systematic review has been conducted to determine the tools/techniques, challenges, application areas, and potential benefits for the adoption of an integrated GLSS-I4.0 approach within healthcare facilities from the perspective of COVID management. Further, a conceptual framework of integrated GLSS- I4.0 has been proposed for better COVID management. Methodology: To conduct literature, authors used Preferred reporting items for systematic reviews and meta-analysis (PRISMA) and covers relevant articles from the arrival of COVID-19. Based on the systematic understanding of the different facets of the integrated GLSS- I 4.0 approach and through insights of experts (academicians, and healthcare personnel), a conceptual framework is proposed to combat COVID-19 for better detection, prevention, and cure. Findings: The systematic review presented here provides different avenues to comprehend the different facets of the integrated GLSS-I4.0 approach in different areas of COVID healthcare management. In this study, the proposed framework reveals that IOT (Internet of Things), Big Data, and Artificial Intelligence (AI) are the major constituents of I4.0 technologies that lead to better COVID management. Moreover, integration of I4.0 with GLSS aids during different stages of the COVID management right from diagnosis, manufacture of items, inpatient and outpatient care of the affected person. Implications: This study provides a significant knowledge database to the practitioners by understanding different tools and techniques of integrated approach for better COVID management. Moreover, the proposed framework aids to grab day-to-day information from the affected people and ensures reduced hospital stay with better space utilization and the creation of a healthy environment around the patient. This inclusive implementation of the proposed framework will enhance knowledge-based in medical areas and provides different novel prospects to combat other medical urgencies

The gender perspective in climate change and global health

Background: Population health is a primary goal of sustainable development. United Nations international conferences like the Beijing Platform for Action have highlighted the key role of women in ensuring sustainable development. In the context of climate change, women are affected the most while they display knowledge and skills to orient themselves toward climate adaptation activities within their societies. Objective: To investigate how the gender perspective is addressed as an issue in research and policy-making concerning climate change and global health. Methods: A broad literature search was undertaken using the databases Pubmed and Web of Science to explore the terms &#x2018;climate change,&#x2019; &#x2018;health,&#x2019; &#x2018;gender,&#x2019; and &#x2018;policy.&#x2019; Climate change and health-related policy documents of the World Health Organization (WHO) and National Communications and National Adaptation Programs of Action reports submitted to the United Nations Framework Convention on Climate Change of selected countries were studied. Assessment guidelines to review these reports were developed from this study&#x0027;s viewpoint. Results: The database search results showed almost no articles when the four terms were searched together. The WHO documents lacked a gender perspective in their approach and future recommendations on climate policies. The reviewed UN reports were also neutral to gender perspective except one of the studied documents. Conclusion: Despite recognizing the differential effects of climate change on health of women and men as a consequence of complex social contexts and adaptive capacities, the study finds gender to be an underrepresented or non-existing variable both in research and studied policy documents in the field of climate change and health

Birth prevalence of neural tube defects and orofacial clefts in India: a systematic review and meta-analysis.

BACKGROUND: In the last two decades, India has witnessed a substantial decrease in infant mortality attributed to infectious disease and malnutrition. However, the mortality attributed to birth defects remains constant. Studies on the prevalence of birth defects such as neural tube defects and orofacial clefts in India have reported inconsistent results. Therefore, we conducted a systematic review of observational studies to document the birth prevalence of neural tube defects and orofacial clefts. METHODS: A comprehensive literature search for observational studies was conducted in MEDLINE and EMBASE databases using key MeSH terms (neural tube defects OR cleft lip OR cleft palate AND Prevalence AND India). Two reviewers independently reviewed the retrieved studies, and studies satisfying the eligibility were included. The quality of included studies was assessed using selected criteria from STROBE statement. RESULTS: The overall pooled birth prevalence (random effect) of neural tube defects in India is 4.5 per 1000 total births (95% CI 4.2 to 4.9). The overall pooled birth prevalence (random effect) of orofacial clefts is 1.3 per 1000 total births (95% CI 1.1 to 1.5). Subgroup analyses were performed by region, time period, consanguinity, and gender of newborn. CONCLUSION: The overall prevalence of neural tube defects from India is high compared to other regions of the world, while that of orofacial clefts is similar to other countries. The majority of studies included in the review were hospital based. The quality of these studies ranged from low to moderate. Further well-designed, high quality community-based observational studies are needed to accurately estimate the burden of neural tube defects and orofacial clefts in India