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Cancer drug resistance is associated with metabolic adaptation. Cancer cells have been shown to implicate acetylated polyamines in adaptations during cell death. However, exploring the mimetic of acetylated polyamines as a potential anticancer drug is lacking.We performed intracellular metabolite profiling of human breast cancer MCF-7 cells treated with doxorubicin (DOX), a well known anticancer drug. A novel and in-house vertical tube gel electrophoresis assisted procedure followed by LC-HRMS analysis was employed to detect acetylated polyamines such as N1-acetylspermidine. We designed a mimetic N1-acetylspermidine (MINAS) which is a known substrate of histone deacetylase 10 (HDAC10). Molecular docking and molecular dynamics (MDs) simulations were used to evaluate the inhibitory potential of MINAS against HDAC10. The inhibitory potential and the ADMET profile of MINAS were compared to a known HDAC10 inhibitor Tubastatin A. N1-acetylspermidine, an acetylated form of polyamine, was detected intracellularly in MCF-7 cells treated with DOX over DMSO-treated MCF-7 cells. We designed and curated MINAS (PubChem CID 162679241). Molecular docking and MD simulations suggested the strong and comparable inhibitory potential of MINAS (–8.2 kcal/ mol) to Tubastatin A (–8.4 kcal/mol). MINAS and Tubastatin A share similar binding sites on HDAC10, including Ser138, Ser140, Tyr183, and Cys184. Additionally, MINAS has a better ADMET profile compared to Tubastatin A, with a high MRTD value and lower toxicity. In conclusion, the data show that N1-acetylspermidine levels rise during DOX-induced breast cancer cell death. Additionally, MINAS, an N1-acetylspermidine mimetic compound, could be investigated as a potential anticancer drug when combined with chemotherapy like DOX.
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Aims/ Objectives: Effect of soil propagation media and bio-fertilizers on seedling germination and seedling vigour in Aonla.Study Design: Completely Randomized Block Design.Place and Duration of Study: Research Field, Department of Fruit Science, College of Horticulture, Mandsaur, Madhya Pradesh during 20th February 2021 to 05th April 2021.Methodology: The experiment was laid out using Completely Randomized Block Design with 18 different combinations of growing media. In the preparation of media and filling of polybags the soil was sieved and mixed FYM, Vermicompost and Neemcake in the ratio of 1:1:1:1 then added the bio-fertilizers.Results: In this study we found that treatment GM18- Soil + Neemcake + Vermicompost + FYM + Rhizobium + Trichoderma spp. @ 2.5 g found minimum days taken to seed germination (10.00 days), maximum number of seedlings sprouted (13.32), maximum survival percent (81.03%), maximum germination percentage (94.54%), maximum seedling height (8.94 cm), maximum number of leaves per plant (7.27), maximum leaf area (17.80 cm2),maximum fresh weight of shoot (4.34 g), maximum dry weight of shoot (2.21 g), maximum length of roots (7.21 cm), maximum diameter of roots (1.05 mm), maximum fresh weight of roots (1.04 g), maximum dry weight of root (0.44 g), maximum speed of germination (7.56), maximum mean daily germination (3.53), maximum peak value (1.33), maximum germination value (4.68).Conclusion: On the basis of results obtained in present investigation it is concluded that treatment GM18 (Soil + Neemcake + Vermicompost + FYM + Rhizobium + Trichoderma spp. @ 2.5 g) was found to be the best for seed germination characters and seedling vigour characters.Directions of Further Use: The experiment should be done with different concentrations of growth regulator to find the best combination.
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Rice crop yield data and weather data were considered in this study, covering the past twenty-nine years (1991-2019) in Prayagraj District, Uttar Pradesh. The data was sourced from DACNET and the College of Forestry, SHUATS Prayagraj. The analysis comprised a calibration period of 26 years (90% of the dataset) and a validation period using the remaining data (10%). In this study, 75.9% of the data were utilized for training the Artificial Neural Network (ANN) model, while the remaining 24.1% were allocated for testing and validation, ensuring comprehensive model assessment. The primary evaluation metric employed for model efficiency was the Normalized Root Mean Squared Error (nRMSE), with a focus on achieving the lowest values. Both a Stepwise Linear Regression technique and a Neural Network were employed for rice yield prediction. Notably, the regression-based model exhibited superior performance compared to the ANN model, as indicated by the nRMSE values. This conclusion was drawn from the observation that the regression-based model yielded the best-fitting results. The study's findings highlight the significance of Bright Sunshine Hours in relation to nRMSE and the coefficient of determination, which were recorded at 0.00025 and 0.94, respectively. This underlines the importance of this meteorological factor in accurately predicting rice crop yield.
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Background: Groundwater is important source of drinking water particularly in rural communities though river, dam water too is also used globally. Many sicknesses, deaths are due to water, major media for carrying causes of illnesses. Community based study was carried out to know about drinking water sources, action before consumption by rural communities.Methods: Community based qualitative study using predesigned tool was carried out in tribal communities of 140 villages of forestry hilly region over one year with 25 women of 15 to 60 years randomly included from each village, total 4500. Results: Reported sources of drinking water at home were public taps in 1671 (37.1%), public borewells 1195 (26.6%), wells in outskirts of villages 929 (20.6%), rivers 381 (8.5%), other sources 324 (7.2%) (harvested rainwater, dams). Of 4500 study subjects, total 1522 (33.8%) women reported no road for going to collect water. Only 1936 (43.0%) women had drinking water at work places, (310 (16.0%) borewell, 313 (16.2%) matka (mud pot), 999 (51.6%) well, 314 (16.2%) other sources. Those who did not have water at work places, 393 (15.3%) took water from home, 767 (29.9%) went to river. Before use at home, 3510 (78.0%) women did filtration, usually with cloth torn from old saree, 690 (15.3%) boiled, 300 (7.3%) used other methods (bleaching powder or alum).Conclusions: In present era in well doing province untreated river water for drinking at home, work places are real dangerous practices, much more dangerous at work places as water is consumed directly from river without any action.
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The current study was undertaken to analyze the genetic variability, correlation and path for yield and its attributing traits at agriculture research farm, Department of Genetics and Plant Breeding, School of Agriculture, Lovely Professional University, Punjab during during Rabi 2021-22 and 2022-23. Augmented design with F2 seeds planted in ear to row fashion in 4 rows were used to study variability, correlation and path including 2 parent and its 6 F2’s for the 9 traits viz. plant height, spike length, number of tillers per plant, number of spikes per plant, number of spikelets per ear, number of grains per ear, biological yield, harvest index and grain yield. Finding revealed that grain yield revealed positive and highly significant correlation with number of tillers per plant (rp= 0.8387, rg= 0.8709) and biological yield (rp= 0.9671, rg= 0.9965) while positive and significant correlation with Number of spikes per plant (rp= 0.7168, rg= 0.7253) at both phenotypic and genotypic level. Biological yield per plant revealed highest positive direct effect (1.0642, 0.8700) with significant association with grain yield (0.9965, 0.9671) whereas Number of tillers reveals least positive direct effect on grain yield (0.0183, 0.0834) at both genotypic and phenotypic level. PCV was higher than GCV for all the traits indicated an influence of environment over the traits. Number of spikelets per ear recorded highest PCV and GCV followed by Grain yield. Heritability (h2b) found higher for grain yield (84.2) followed by Number of spikelets per ear (83.4), Number of Grains per ear (82.7) and Plant height (80.1). Genetic advance (GA) recorded higher Number of spikelets per ear (35.07) followed by Grain yield (11.93). Moderate GA recorded for Plant Height (7.67) and Biological yield (6.88) whereas Spike length (0.62) recorded lowest GA. Hence, selection for these mentioned characters could bring improvement in yield and yield components.
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Background: Variations in rates of hysterectomy have been observed and have been associated with women demographic characteristics such as race, socio-economic status, educational status and geographic location. However, with the advent of novel medical and conservative measures, there are doubts on justification of hysterectomy. Aims and objectives were to study prior treatment taken with respect to clinical profile in women undergoing hysterectomy in a tertiary care centre.Methods: An observational study was conducted by collecting data from medical records of 72 consenting subjects undergoing hysterectomy for benign gynaecological reasons in a tertiary care centre over a period of 12 months after ethics approval.Results: Out of 72 subjects, only 34 subjects (47.22%) had taken a prior medical treatment before undergoing hysterectomy. 100% of the subjects with endometriosis, chronic PID and DUB had taken some form of prior treatment whereas 27.5% of subjects with fibroid and 68.75% of subjects with adenomyosis had taken prior treatment.Conclusions: Our study indicates that prior medical management is not being adequately discussed and trialled among women undergoing hysterectomy. Hence, improving the counselling and understanding the women抯 perspective for resistance towards medical management is an important area for research in improving quality of health care.
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Background: Obstetric anaesthetists while providing anaesthesia for caesarean sections, provide care for both the mother and the unborn baby. This study was performed to evaluate the adverse effects of spinal anaesthesia for Caesarean section. Methods: The present study is a prospective observational study carried out on 100 full-term, low risk pregnant patients who had caesarean section under spinal anaesthesia at Varun Arjun medical college, Shahjahanpur, U. P., India from January 2022 to December 2022.Results: In our study, 43 (43%) patients were between 26-30 years, 32 (32%) patients were between 31-35 years, 16 (16%) patients were between 36-40 years. The 62 (62%) patients were primigravida while 38 (38%) patients were multigravida. The 66 (66%) patients were delivered by emergency caesarean section while 34 (34%) were delivered by emergency caesarean section. In our study, adverse anaesthetic effects were less. 12 (12%) patients had spinal hypotension, 11 (11%) patients had spinal headache, 10 (10%) patients had pruritus, 9 (9%) patients had shivering, 5 (5%) patients had nausea and vomiting, 4 (4%) patients had less visceral pain and neonatal Apgar score each, 3 (3%) patients had failed regional anaesthesia, 3 (3%) patients had bradycardia while 2 (2%) patients had high spinal anaesthesia, 10 (10%) patients had visceral pain.Conclusions: In our study, combination of bupivacaine and a low dose of fentanyl (0.25 ?g/kg) provided excellent surgical anaesthesia with short-lasting postoperative analgesia. There were very few adverse side effects.
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Many techniques have been developed to overcome the bioavailability problem of poorly soluble drugs. The nanonization is one of the techniques in that micronized particle is converted in nanoparticle. Several processes are applied for nanocrystal production, including precipitation, milling, high pressure homogenization and combination method. The nanocrystal formulation is administered via various routes like oral, intravenous, intramuscular, pulmonary, ocular and dermal but due to safety, patient compliance and ease of administration, oral drug delivery is preferred. There are two basic ways to prepare drug nanocrystals like “bottom-up” and “top-down” technologies. The present literature provides an overview of the achievement in improving the bioavailability of the poorly soluble drug by using different methods.
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Background: The comparison of triclosan-coated sutures (TCS) was made with conventional nonantimicrobial-coated sutures (NCS) to reduce surgical site infection (SSI). This study demonstrates the efficacy and economic outcome of TCS versus NCS for SSIs in mastectomy in India. Methods: In this retrospective analysis, 100 patients were included for both conditions桾CS and NCS梖rom a private and public hospital in India. A systematic literature search of available evidence for both SSI incidences and TCS efficacy data in India were gathered. We collected cost data from a private and public hospital, respectively, for mastectomy in India. The cost-effectiveness of TCS in comparison with the conventional NCS was calculated using a decision-tree deterministic model. We performed a one-way sensitivity analysis to compare TCS with NCS. Results: Cost savings with the use of TCS increased with an increase in SSI incidence and an increase in efficacy for mastectomies in both public and private hospitals. We found a base cost saving of Indian rupees (INR) 27,299 at a private hospital and INR 2,958 at a public hospital for mastectomies. The incremental cost of TCS suture was 0.01% in a private hospital whereas 0.17% in a public hospital. Conclusion: The use of TCS resulted in reduced SSI incidence and cost savings for mastectomy in India.
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In present work new series of 7-chloro-4-aminoquinoline analogs were designed to discover chemically diverse antimalarial leads. The widely used computational tool molecular docking is applied to study molecular recognition, which aims to predict analogs’ binding mode and binding affinity to the active site. The potential binding of the selected analogs to the Plasmodium falciparum lactate dehydrogenase enzyme (PfLDH) active site was analyzed using SYBYL X2.0 software running on a core-2 duo Intel processor workstation. Compounds F5, F9 and F1 showed highest binding affinity in term of total scores 9.50, 7.86 and 7.01, respectively. Analogs with the best dock score were synthesized and evaluated for antimalarial potential against chloroquine sensitive RKL-2 strain. Compounds F5, F28 and F9 showed good antimalarial activity in term of MIC50 value 0.35, 0.45 and 0.56 ?g/mL, respectively. Further optimization and exploration of 7-chloro-4-aminoquinoline lead could be useful to identify novel, antimalarial molecules.
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There is a lack of evidence regarding the use of betel quid (BQ) and its potential contribution to oral cancer. Limited attention has been directed towards investigating the involvement of BQ-derived organic acids in the modulation of metabolic-epigenomic pathways associated with oral cancer initiation and progression. We employed novel protocol for preparing saliva-amalgamated BQ filtrate (SABFI) that mimics the oral cavity environment. SABFI and saliva control were further purified by an in-house developed vertical tube gel electrophoresis tool. The purified SABFI was then subjected to liquid chromatography-high resolution mass spectrometry analysis to identify the presence of organic acids. Profiling of SABFI showed a pool of prominent organic acids such as citric acid. malic acid, fumaric acid, 2-methylcitric acid, 2-hydroxyglutarate, cis-aconitic acid, succinic acid, 2-hydroxyglutaric acid lactone, tartaric acid and β-ketoglutaric acid. SABFI showed anti-proliferative and early apoptosis effects in oral cancer cells. Molecular docking and molecular dynamics simulations predicted that SABFI-derived organic acids as potential inhibitors of the epigenetic demethylase enzyme, Ten-Eleven Translocation-2 (TET2). By binding to the active site of α-ketoglutarate, a known substrate of TET2, these organic acids are likely to act as competitive inhibitors. This study reports a novel approach to study SABFI-derived organic acids that could mimic the chemical composition of BQ in the oral cavity. These SABFI-derived organic acids projected as inhibitors of TET2 and could be explored for their role oral cancer.
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ABSTRACT Objective: To compare the initial stress distribution and displacement on mandibular dentition using extra and inter-radicular mini-implants for arch distalization, by means of finite element analysis. Methods: For this study, two finite element models of the mandible were designed. The models consisted of periodontal ligament (PDL) and alveolar bone of all teeth until second molars. In the Case 1, bilateral extra-radicular buccal-shelf stainless steel mini-implants (10.0-mm length; 2.0-mm diameter) were placed between first and second permanent molars. In the Case 2, bilateral inter-radicular stainless steel mini-implants (10.0-mm length; 1.5-mm diameter) were placed between second premolar and first permanent molar. Power hook was attached between canine and first premolar at a fixed height of 8mm. In the two cases, 200g of distalization force was applied. ANSYS v. 12.1 software was used to analyze and compare von Mises stress and displacement in the mandibular dentition, PDL and bone. Results: Higher stresses were observed in mandibular dentition with the inter-radicular implant system. The amount of von Mises stress was higher for cortical bone (85.66MPa) and cancellous bone (3.64MPa) in Case 2, in comparison to cortical bone (41.93MPa) and cancellous bone (3.43MPa) in Case 1. The amount of arch distalization was higher for mandible in Case 1 (0.028mm), in comparison to Case 2 (0.026mm). Conclusion: Both systems were clinically safe, but extra-radicular implants showed more effective and controlled distalization pattern, in comparison to inter-radicular implants, in Class III malocclusion treatment.
RESUMO Objetivo: Comparar a distribuição da tensão inicial e o deslocamento na dentição inferior usando mini-implantes extra e inter-radiculares para distalização da arcada, por meio da análise de elementos finitos. Métodos: Dois modelos de elementos finitos da mandíbula foram criados, os quais consistiram de ligamento periodontal (PDL) e osso alveolar de todos os dentes até os segundos molares. No Caso 1, mini-implantes extra-radiculares de aço inoxidável (10,0 mm de comprimento; 2,0 mm de diâmetro) foram colocados bilateralmente na buccal-shelf entre o primeiro e o segundo molares permanentes. No Caso 2, mini-implantes de aço inoxidável inter-radiculares (comprimento de 10,0 mm; diâmetro de 1,5 mm) foram colocados bilateralmente entre o segundo pré-molar e o primeiro molar permanentes. Um Power hook foi preso entre o canino e o primeiro pré-molar a uma altura fixa de 8mm. Nos dois casos, foi aplicada força de distalização de 200g. O software ANSYS v. 12.1 foi usado para analisar e comparar a tensão de von Mises e o deslocamento na dentição inferior, ligamento periodontal e osso. Resultados: Maiores tensões foram observadas na dentição inferior com o sistema de implantes inter-radiculares. A quantidade de tensões de von Mises foi maior para osso cortical (85,66MPa) e osso esponjoso (3,64MPa) no Caso 2, em comparação com osso cortical (41,93MPa) e osso esponjoso (3,43MPa) no Caso 1. A quantidade de distalização da arcada inferior foi maior no Caso 1 (0,028 mm), em comparação com o Caso 2 (0,026 mm). Conclusão: Ambos os sistemas foram clinicamente seguros, mas os implantes extra-radiculares mostraram um padrão de distalização mais eficaz e controlado, em comparação com os implantes inter-radiculares, para tratamento da má oclusão de Classe III.
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Purpose: To assess the efficacy and clinical outcome of Tenon’s patch graft (TPG) in corneal perforation and descemetocele. Methods: In this retrospective study, medical records of 83 patients (85 eyes) who underwent TPG for corneal perforation (58, 68%) or descemetocele (27, 32%) between July 2018 and October 2021 were reviewed. Clinical examination and anterior segment optical coherence tomography (AS?OCT) were performed on every follow?up visit. Anatomical success was considered as the restoration of the structural integrity with the formation of scar and anterior chamber (AC). Results: The mean size of the corneal lesions (corneal perforation or descemetocele) was 4.20 ± 1.01 mm. The mean follow?up period was 9.2 ± 5.48 months. The common underlying etiologies were infectious keratitis in 48% and autoimmune disorders in 35% of cases. TPG successfully restored the globe integrity in 74 (87%) eyes (83% in perforation and 96% in descemetocele). Anatomical failure occurred in 11 eyes (13%). The failures were due to graft dehiscence (8 eyes), graft ectasia (1 eye), and scarring with flat AC (2 eyes). The median time to epithelialization and scar formation were 3 and 15 weeks, respectively. Logistic regression analysis showed few predictors for a successful outcome: descemetoceles, noninfective causes, viral keratitis in infectious etiology, and paracentral or peripheral lesions. Conclusion: TPG can be considered an effective and inexpensive treatment for restoring the structural integrity in the eyes with perforations and descemetoceles, particularly when the donor tissue is unavailable. AS?OCT is a valuable noninvasive tool for monitoring the graft status
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ABSTRACT The most frequently reported ophthalmic manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is conjunctivitis. We have described a case of Purtscher-like retinopathy in a patient with severe coronavirus disease 2019 (COVID-19)-associated coagulopathy. A young woman with multiple comorbidities was admitted for COVID-19-related acute respiratory distress syndrome. Her course was complicated by fungemia. Ophthalmic examination revealed bilateral posterior pole, intraretinal lesions and fluconazole was added for presumed fungal retinitis. At 1-week follow-up, widespread peripapillary cotton-wool spots and hemorrhages suggestive of Purtscher-like retinopathy were observed. The levels of D-dimers, fibrinogen, and C-reactive protein were markedly elevated prior to our consultation, indicating preceding prothrombotic and pro-inflammatory states. Subsequent venous duplex revealed deep venous thrombosis in the right subclavian and internal jugular veins. Von Willebrand factor indices were markedly elevated, suggesting severe COVID-19-associated coagulopathy. Purtscher-like retinopathy, a rare occlusive microangiopathy has been described in various pro-inflammatory and prothrombotic conditions. To the best of our knowledge, this is the first report of Purtscher-like retinopathy in COVID-19-associated coagulopathy.
RESUMO A manifestação oftálmica mais frequentemente relatada da infecção por SARS-CoV-2 é a conjuntivite. Trata-se de estudo de caso de retinopatia tipo Purtscher em uma paciente com coagulopatia grave associada ao COVID-19. Uma jovem com múltiplas comorbidades foi admitida por síndrome do desconforto respiratório agudo relacionado ao COVID-19. Seu quadro foi complicado pela fungemia. O exame oftálmico revelou pólo posterior bilateral, lesões intraretinianas e o fluconazol foi adicionado para tratar a retinite fúngica presumida. No decorrer de uma semana, manchas largas peripapilares de algodão e hemorragias sugestivas de retinopatia tipo Purtscher foram observadas. Os dímeros D, o fibrinogênio e a proteína c-reativa estavam acentuadamente elevados antes da nossa consulta, indicando um estado pró-trombótico e pró-inflamatório precedente. O duplex venoso subsequente revelou trombose venosa profunda nas veias subclávia direita e jugular interna. Os índices de fatores von Willebrand estavam marcadamente elevados, sugerindo coagulopatia grave associada ao COVID-19. A retinopatia tipo Purtscher, uma microangiopatia oclusiva rara foi descrita em várias condições pró-inflamatórias e pró-trombóticas. Para nosso conhecimento, este é o primeiro relatório de retinopatia tipo Purtscher com coagulopatia associada ao COVID-19.
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Background:To describe the transthoracic echocardiographic findings of moderate to severe COVID-19 patients admitted to ICU.Methods: We studied thetransthoracic echocardiographic findings performed within 48 hours on admission toICU of 426 moderate to severe COVID-19 patients from July 2020 to September 2020 during their course of treatment. Echocardiographic study included left ventricular (LV) systolic and diastolic function, left ventricle wall motion abnormalities and right ventricular (RV) assessment.Results: The median age of patients was 58.2 (range 19 to 92 years) and majority of patients were male (71%). Pre-existing comorbidities were reported in 95.5% of patient’s, majority being hypertension (42.7%) and diabetes mellitus (39.2%).Abnormal echo findings were noted in 40.8% (n=174) with majority of abnormal findingsnoted in age group of 60-69 (n=54), men (n=114) and in patients with pre-existing coronary artery disease (CAD)(n=28). The common pattern of cardiac abnormalities was LV systolic dysfunction (n=73, 17.1%), RV dysfunction (n=30, 7%) and abnormal PA pressures (n=144, 85.2%). Abnormal echo findings were noted in 46% of patients who died and 33.9% of patients who required hospital stay of more than 10 days.Conclusions:Forty percent of admitted patients to ICU had abnormal echocardiography findings with around eighty five percent of them having raised pulmonary artery pressure
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Purpose: Antioxidants have been lately postulated as supportive and prophylactic supplements for various retinal disorders, especially age?related macular degeneration (AMD). Forty?eight brands of such supplements containing lutein and zeaxanthin are available in India. The aim of the study was to assess the market leaders in supplements for ophthalmology in view of AREDS recommendations. Methods: Descriptive review of top?selling supplements for eye health were compared to the contents of the AREDS?recommended levels. Results: None of the top 10 selling brands had exact or near similar composition as recommended in the AREDS?2 study, which is the most widely accepted level?1 evidence in AMD prevention. Conclusion: Physicians prescribing these antioxidants, especially for the prevention of advanced AMD, should be vigilant and aware of the contents of the prescribed brands.
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Introduction: Maternal mortality is defined as the death of a woman while pregnant orwithin 42 days of termination of pregnancy irrespective of the duration and site of thepregnancy from any cause related to or aggravated by the pregnancy or its management, butnot from accidental or incidental causes. The death of a mother has profound consequenceson social and economic health and also on the development of a family and a nation. Theobjective of the current study is to determine the proportion of maternal mortality at ourtertiary care teaching hospital, to analyse the epidemiological parameters and causes ofmaternal mortality, to determine the importance of antenatal, intranatal and postnatal care inrelation to maternal mortality and to suggest preventive measures to reduce maternalmortality.Material and Methods: This retrospective observational study was carried out from 16thMay 2018 to 15th December 2020 at a tertiary care teaching hospital.Results: Out of 15,164 deliveries, there were 15,006 live births. During the study period, 29maternal deaths were recorded. Hence, Maternal Mortality Ratio (MMR) was 193.2.Majority, 12(41.4%) patients were in the age group of 21-25 years. Inadequate antenatal carewas taken by 14 (48.3%) patients and 11 (37.9%) patients had not taken any antenatal care.Maternal mortality occurred in 12(41.3%) and 17(58.7%) patients during antenatal andpostnatal period respectively. In 19(65.5%) patients, maternal mortality occurred due todirect obstetric causes and in 10 (34.5%) maternal mortality occurred due to indirect causes.Majority of mortality occurred due to delay in women seeking help.Conclusion: Majority of maternal mortality occurred due to delays at a community level inrecognizing an emergency situation and/or delays in decision to seek care at a health facility.Community awareness regarding the importance of antenatal care, danger signs, high riskpregnancy, institutional deliveries, postnatal care and family planning can help in reducingmaternal mortality by preventing delay at community level.
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India shoulders a heavy burden of diabetes mellitus (DM), the management of which is suboptimal globally. Objectives: Insulin Management: Practical Aspects in Choice of Therapy (IMPACT) survey was designed to gain insight into the ground (in-clinic) reality of DM management by physicians in India. Methods: A survey consisting of 12 multiple-choice questions was conducted by SurveyMonkey ® , focusing on practice profile, patient profile, and other aspects of DM management. Results: The survey included 2424 physicians. Majority of them were general physicians (58.5%) followed by diabetologists (31.1%). Most (49.2%) of the respondents specified that the ideal time for a DM consultation is 15 min. However, 73.4% of them provided consultation of <10 min because of heavy patient load. Nearly half of the respondents reported that their patients consumed a diet with carbohydrate content of 60% to 80%, and 79.4% of them admitted that <50% of their patients adhered to dietary advice. About 73.5% of the respondents believed controlling fasting plasma glucose (FPG) level alone would not adequately control postprandial plasma glucose (PPG) level, and 93.0% of them preferred an insulin therapy at the initiation that controls both FPG and PPG levels. Conclusion: Limited consultation time, high-carbohydrate diet, and a need for choosing insulin regimens that provide control for both PPG and FPG levels are some ground realities of DM management in India. These realities need to be factored in while choosing treatment options to achieve the desired glycemic control and improve the status of diabetes care.h
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Purpose: To determine the causes of severe visual impairment and blindness in children in schools for the blind in Maharashtra, India. Methods: Children aged <16 years, enrolled in the schools for the blind in Maharashtra state, India were examined between October 2018 and December 2019. The anatomical sites and etiology for blindness were recorded using the World Health Organization’s standard reporting form. Causes of blindness were compared among different regions of the state and also by different age groups. Results: Of the 1,969 students examined from 39 schools for the blind, 188 children (9.5%) had severe visual impairment and 1,666 children (84.6%) were blind. Whole globe anomalies (794, 42.8%) were the most common anatomical site of vision loss in children, followed by corneal (289, 15.6%) and retinal abnormalities (280, 15.2%). Corneal causes were second most common in the poorer districts of Vidarbha (15.3%) and Marathwada (14.6%), whereas retinal causes were second most common in the wealthier regions of western Maharashtra (18.3%) and Khandesh (24.1%). Nearly one?third (593, 32%) of children were blind from potentially avoidable causes. Preventable blindness consisting of corneal causes and retinopathy of prematurity was seen in 281 (15.2%) cases, whereas treatable causes comprising of lens?related causes, glaucomas, refractive errors, amblyopia, and uveitis accounted for another 311 (16.8%). Among the younger children (?10 years), the proportion of corneal blindness was lower (83/623, 13.3% vs. 206/1232, 16.7%) and that of retinal blindness was higher (119/623, 19% vs. 163/1232, 13.2%) than the older children. Conclusion: Whole globe anomalies constitute a major cause of SVI and blindness in Maharashtra. There seems to be an increase in the proportion of retinal blindness, especially retinopathy of prematurity, suggesting a need for increased screening coverage