Morphometric Analysis of Placenta and Fetal Doppler Indices in Normal and High-Risk Pregnancies.

Background High-risk pregnancies, encompassing pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), preeclampsia toxemia (PET), and intrauterine growth restriction (IUGR), represent intricate medical challenges with potential repercussions for maternal and fetal health. This research undertakes a comprehensive comparative investigation into the variations of Doppler indices and placental parameters within the context of these high-risk conditions when juxtaposed against pregnancies characterized as normal. Methodology Employing a rigorous cross-sectional study design, a diverse cohort of pregnant individuals with gestational diabetes, IUGR, PIH, and preeclampsia was meticulously assembled. Additionally, a group of normal pregnant women served as the comparative reference. Doppler ultrasound assessments, viz, pulsatility index (PI), were carefully performed to estimate blood flow velocities within critical maternal and fetal vessels, while placental parameters were meticulously quantified, encompassing dimensions, vascular architecture, and morphological features. Results Except in the GDM group, all high-risk groups had reduced estimated placental weight and actual birth weight than normal pregnant women. All high-risk groups showed a highly significant elevation of the PI of the umbilical artery and PI of the middle cerebral artery (MCA) than normal but the PI of MCA was significantly reduced in the PET group than in normal individuals. The cerebro-placental ratio in the GDM and IUGR groups revealed markedly greater values, whereas PET showed lower values. IUGR and PIH groups showed a substantial reduction in the fetal birth weight. All high-risk groups (GDM, IUGR, PIH, and PET) showed a highly significant reduction in luminal area umbilical artery 1 than the normal pregnant women. In IUGR, marginal placental insertion was very high, followed by GDM and PET groups. Conclusions This study reveals that Doppler indices, placental parameters, newborn weight, and their related ratios may be utilized to anticipate gestation difficulties and gain insight into the pathophysiology of problematic conceptions.

Design, Fabrication, and Validation of a Polymethyl Methacrylate Head Phantom for Dosimetric Verification of Cranial Radiotherapy Treatment Plans.

PURPOSE: The present study aims to design and fabricate a novel, versatile, and cost-effective Polymethyl Methacrylate (PMMA) head phantom for the dosimetric pretreatment verification of radiotherapy (RT) treatment plans. MATERIALS AND METHODS: The head phantom designing involves slice-wise modeling of an adult head using PMMA. The phantom has provisions to hold detectors such as ionization chambers of different sizes, Gafchromic films, gel dosimeter, and optically stimulated luminescence dosimeter. For the point dose verification purpose, 15 volumetric modulated arc therapy patient plans were selected, and doses were measured using a CC13 ionization chamber. The percentage gamma passing rate was calculated for acceptance criteria 3%/3 mm and 2%/2 mm using OmniPro I'mRT film QA software, and Gafchromic EBT3 films were used for 2D planar dose verification. RESULTS: Treatment planning system calculated, and the measured point doses showed a percentage deviation ranged from 0.26 to 1.92. The planar dose fluence measurements, for set acceptance criteria of 3%/3 mm and 2%/2 mm, percentages of points having gamma value <1 were in the range of 99.17 ± 0.25 to 99.88 ± 0.15 and 93.16 ± 0.38 to 98.89 ± 0.23, respectively. Measured dose verification indices were within the acceptable limit. CONCLUSIONS: The dosimetric study reveals that head phantom can be used for routine pretreatment verification for the cranial RT, especially for stereotactic radiosurgery/RT as a part of patient-specific quality assurance. The presently fabricated and validated phantom is novel, versatile, and cost-effective, and many institutes can afford it.

Effect of feeding diet with alternate protein sources and quality protein maize on performance and nutrient utilization in broiler chickens.

The experiment was conducted to study the effect of feeding diets with quality protein maize (QPM) along with cottonseed meal (CSM) and guar meal (GM) on nutrient utilization, body weight (BW) gain (BWG), feed efficiency, and antioxidant status in broiler chickens. The biological trial was conducted on day-old broiler chicks (n = 240), which were randomly distributed into 6 dietary groups having 8 replicates with 5 chicks. Six experimental diets were formulated to contain maize (diet I), QPM (diet II), maize+CSM80 g/kg + GM40 g/kg (diet III), maize + CSM120 g/kg + GM60 g/kg (diet IV), QPM+CSM80 g/kg + GM40 g/kg (diet V), and QPM+CSM120 g/kg + GM60g/kg (diet VI). The BWG and feed intake were recorded at weekly intervals. Supplementation of CSM and GM along with QPM or maize depressed (P < 0.05) BWG, feed conversion ratio, and slaughter variables in commercial broilers. Improvement of BWG and breast weight was recorded among the groups supplemented 80 g/kg CSM and 40 g/kg GM with a QPM-based diet compared with those groups fed 120 g/kg CSM and 60 g/kg GM with maize or QPM. The energy and protein utilization decreased among the groups supplemented CSM and GM. However, protein and energy utilization was increased (P < 0.05) among the groups fed QPM-based diets compared with those groups fed CSM and GM with maize or QPM. Therefore, it has been concluded that the performance and other parameters did not differ between the groups fed maize- and QPM-based diets in the present experiment. However, QPM with CSM and GM improved the performance, slaughter parameters, and nutrient utilization over CSM and GM with maize.

A mixed methods evaluation of yoga as a fall prevention strategy for older people in India.

BACKGROUND: Falls are an emerging public health issue in India, with the impact set to rise as the population ages. We sought to evaluate the acceptability, feasibility and likely impact of a yoga-based program aimed at improving balance and mobility for older residents in urban India. METHODS: Fifty local residents aged 60 years and older were recruited from urban Hyderabad, Andhra Pradesh. They were invited to attend a 1-h yoga class, twice weekly for 3 months. Mixed methods were used to evaluate the acceptability and feasibility (qualitative) and likely impact (quantitative). Two focus groups and eight interviews with participants were conducted to evaluate the acceptability and feasibility of a yoga program. Thematic analysis was conducted in context of perceptions, barriers and benefits of yoga participation and fall ascertainment. Physical performance using the Short Physical Performance Battery, fear of falling, blood pressure and weight loss were measured before and after the program. RESULTS: The interviews and focus groups provided insights into the preferred format for classes, including session times, level of supervision and location. Improvements were seen in the Short Falls Efficacy Scale-International (Short FES-I (15.9 ± 4.0 vs 13.8 ± 2.1 s, p = 0.002)), the number of steps taken in the timed 4-m walk (T4MW (9.0 ± 1.8 vs 8.6 ± 1.8, p = 0.04)), Short FES-I scores (9.4 ± 2.9 vs 8.6 ± 2.9, p = 0.02) and weight (63.8 ± 12.4 vs 62.1 ± 11.6, p = 0.004) were lower. No changes were seen in standing balance, blood pressure or T4MW time. CONCLUSION: Yoga was well accepted and resulted in improved ability to rise from a chair, weight loss, increased step length and reduced fear of falling. These results provide impetus for further research evaluating yoga as a fall prevention strategy in India.