Knowledge, attitudes, and practices regarding HIV/AIDS among pregnant females attending the antenatal clinic: a study at Dr. S. N. Medical College in Jodhpur, India

Background: AIDS, caused by HIV, is a global health threat that weakens the immune system and leads to life-threatening infections. India has been heavily affected by the HIV/AIDS epidemic due to a lack of accurate information and prevention efforts. Mother-to-child transmission (MTCT) is a significant factor in HIV spread. Knowledge of HIV status through voluntary counseling and testing (VCT) is crucial. Despite efforts, HIV/AIDS remains a major public health challenge in India. Methods: A study at Dr. S.N. Medical College focused on pregnant women in the antenatal clinic. Using a questionnaire, data was collected from 100 participants on socio-demographics, HIV/AIDS knowledge, attitudes, and practices. Results: Most participants were aged 21-30, with 48 having 6-10 years of education. The majority identified as Hindu, and 89 were housewives. The study revealed gaps in HIV/AIDS knowledge, with many participants lacking awareness and having misconceptions. Stigma and fear were also prevalent, but recognition of abstinence as a preventive measure was observed. Conclusions: Targeted interventions, education, and awareness campaigns are necessary to enhance knowledge, dispel misconceptions, and reduce HIV/AIDS stigma among pregnant women in antenatal clinics. Policies, programs, and preventive strategies should be developed to reduce HIV/AIDS incidence and prevalence. Future research should address knowledge gaps, promote understanding of HIV/AIDS, and focus on preventing mother-to-child transmission, ultimately working towards ending AIDS as a public health threat

Exploring the role of serum β-HCG levels in predicting hypertensive disorders of pregnancy: a prospective observational study

Background: Hypertensive disorders of pregnancy pose significant risks to maternal and fetal health, contributing to global morbidity and mortality. Despite extensive research, these disorders remain a public health concern, necessitating the identification and prediction of associated risks for effective prevention and management. Methods: A prospective observational study was conducted in a hospital setting, involving 200 antenatal women visiting the Department of Obstetrics and Gynecology for routine checkups over a six-month period. Sample size calculation was based on expected sensitivity and prevalence rates. Inclusion criteria were defined, and clinical examinations were performed on the participants. Results: Higher serum β-HCG levels were significantly associated with hypertensive disorders of pregnancy. Low levels correlated with 12 out of 122 cases, while high levels correlated with 59 out of 78 cases. Two deaths were linked to hypertensive disorders. Age did not show a significant association, but variations were observed among religious groups. Conclusions: This study concludes that higher serum β-HCG levels are significantly associated with the development of hypertensive disorders of pregnancy. Age did not show a significant association with these disorders, suggesting the involvement of other contributing factors. The findings provide valuable insights for clinical management and further research in this field, contributing to a better understanding of the etiology and predictors of hypertensive disorders of pregnancy

Role of ultrasonography in third trimester pregnancy for early diagnosis of embryonic demise

Background: The objective of antenatal care is to assure that every wanted pregnancy culminates in the delivery of healthy baby without impairing the health of the mother. The first trimester of intrauterine life is the most crucial period which needs careful eyes on the growing fetus inside. The aim and objective of this study was visualization & localization of the gestational sac and early identification of embryonic demise and other forms of nonviable gestation.Methods: A prospective study of 500 randomly selected patients with first trimester pregnancy at Dr. S. N. Medical College and attached group of hospitals, Jodhpur during May 2013 – November 2014. Ultrasound examination of these patients was performed to screen for fetal abnormalities & uterine anomalies and identify those embryos that are still alive but at increased risk for embryonic and fetal demise.Results: Out of 500 cases studied, 196 (39.2%) pregnancies were normal. 304 cases had abnormal Ultrasonography findings. Out of these 304 cases, 87 had missed abortion, 70 had incomplete abortion and 53 cases had threatened abortion.Conclusions: Ultrasonography has an important role in screening of early pregnancies for early diagnosis of fetal demise, fetal abnormalities and uterine anomalies With recent advances in technology, first trimester sonography can now detect, or at least suggest, many structural abnormalities

Comparative role of non-stress test and colour doppler in high risk pregnancy predicted by placental histopathology and foetal outcome

Background: Assessment of the foetal wellbeing is done by various biophysical methods. Non stress test (NST) is the most commonly used test for antepartum evaluation of foetal status. It involves the use of doppler-detected foetal heart rate acceleration coincident with foetal movement perceived by mother. Duplex sonography and its off-shoot, colour duplex sonography, are relatively newer methods that combine the pulsed echo technique of sectional image formation with the doppler evaluation of blood flow.Methods: The comparative study was carried out on 200 booked term pregnant patients in the department of Obstetrics and Gynaecology, Dr. S. N. Medical College, Jodhpur Rajasthan, India. All patients were subjected to non-stress test and colour doppler and were evaluated for placental histopathology and foetal outcome in terms of low APGAR score, number of NICU admissions and perinatal mortality.Results: In our study it was found that in high-risk group 25% had non-reassuring NST and 19% had doppler findings suggestive of foetal hypoxia. In the control group 13% had non-reassuring NST and 4% had doppler findings suggestive of foetal hypoxia. It was seen that when either NST was non-reassuring or colour doppler suggested foetal hypoxia or both, these patients required admissions antenatally, had meconium stained liquor suggestive of foetal distress, had operative delivery for foetal distress, had low APGAR score, required NICU admission, and higher perinatal mortality.Conclusions: Doppler and NST are effective in predicting a normal healthy foetus. Doppler depicts chronic hypoxic changes while NST can detect acute events in presence or absence of chronic hypoxia

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Species diversity, community structure, and distribution patterns in western Himalayan alpine pastures of Kashmir, Pakistan

Western Himalayan alpine pastures are among the most diverse ecological locations on the globe. Four alpine pastures were investigated to study species distribution patterns, richness, similarity, and community structure in Bagh District, Azad Kashmir, Pakistan. Four communities, Poa–Primula–Sibbaldia, Primula–Caltha–Primula, Poa alpina–Poa pratensis–Scirpus, and Sibbaldia–Poa–Scirpus, were identified on the basis of an importance value index. The average value of species richness was 1.42; Simpson's and Shannon–Wiener's diversity values were 3.13 and 0.91, respectively; the degree of maturity index was 44.1; and species evenness was 0.901. Local alpine flora was dominated by a hemicriptophytic life form with microphyllous leaf spectra. The species–environment correlation was analyzed using canonical correspondence analysis. A negative correlation of both diversity and richness was revealed with altitudinal gradient. Anthropogenic disturbances showed a significant negative impact on distribution of medicinal and palatable species. Unpalatable species dominated the local flora, indicating the heavy grazing pressure in the area. Development and implementation of regional conservation strategies are recommended to protect the threatened Himalayan alpine biodiversity

Optimization of Regeneration and <i>Agrobacterium</i>-Mediated Transformation Protocols for Bi and Multilocular Varieties of <i>Brassica rapa</i>

The regeneration of the high-yielding multilocular types has not been attempted, although successful regeneration and transformation in brassica have been done. Here, we report efficient regeneration and transformation protocols for two B. rapa genotypes; UAF11 and Toria. The B. rapa cv UAF11 is a multilocular, non-shattering, and high-yielding genotype, while Toria is the bilocular type. For UAF11 8 shoots and for Toria 7 shoots, explants were observed on MS supplemented with 3 mg/L BAP + 0.4 mg/L NAA + 0.01 mg/L GA3 + 5 mg/L AgNO3 + 0.75 mg/L Potassium Iodide (KI), MS salt supplemented with 1 mg/L IBA and 0.37 mg/L KI produced an equal number of roots (3) in UAF11 and Toria. For the establishment of transformation protocols, Agrobacterium-mediated floral dip transformation was attempted using different induction media, infection time, and flower stages. The induction medium III yielded a maximum of 7.2% transformants on half-opened flowers and 5.2% transformants on fully opened flowers in UAF11 and Toria, respectively, with 15 min of inoculation. This study would provide the basis for the improvement of tissue culture and transformation protocols in multilocular and bilocular Brassica genotypes