Anticonvulsant drugs and women with seizures

The incidence of congenital anomalies in children born to mothers under anticonvulsant therapy has been studied, in 2536 women who gave birth to 3348 children. The follow up period varied between 3 to 20 years. The mothers had received barbiturates, hydantoinates and carbamezapine in various combinations. The incidence of congenital anomalies noted was only 41, a figure not greater than the incidence ofanomalies in the general population. A plea is made that anticonvulsant therapy should not be discontinued during pregnancy in women with seizures

Phenotypic and genotypic differences between Indian and Scandinavian women with gestational diabetes mellitus

Objective Gestational diabetes mellitus (GDM) is a transient form of diabetes characterized by impaired insulin secretion and action during pregnancy. Population-based differences in prevalence exist which could be explained by phenotypic and genetic differences. The aim of this study was to examine these differences in pregnant women from Punjab, India and Scandinavia. Methods Eighty-five GDM/T2D loci in European and/or Indian populations from previous studies were assessed for association with GDM based on Swedish GDM criteria in 4018 Punjabi Indian and 507 Swedish pregnant women. Selected loci were replicated in Scandinavian cohorts, Radiel (N = 398, Finnish) and STORK/STORK-G (N = 780, Norwegian). Results Punjabi Indian women had higher GDM prevalence, lower insulin secretion and better insulin sensitivity than Swedish women. There were significant frequency differences of GDM/T2D risk alleles between both populations. rs7178572 at HMG20A, previously associated with GDM in South Indian and European women, was replicated in North Indian women. The T2D risk SNP rs11605924 in the CRY2 gene was associated with increased GDM risk in Scandinavian but decreased GDM risk in Punjabi Indian women. No other overlap was seen between GDM loci in both populations. Conclusions Gestational diabetes mellitus is more common in Indian than Swedish women, which partially can be attributed to differences in insulin secretion and action. There was marked heterogeneity in the GDM phenotypes between the populations which could only partially be explained by genetic differences.Peer reviewe

A Prospective Comparative Study of Reamed vs. Unreamed Nailing in Fractures Shaft of Tibia

BACKGROUND: Although the tibia is one of the most commonly fractured long bones in the body, there are two accepted management techniques: reamed and unreamed nailing. There is not a general consensus as to which technique is more advantageous to the patient. PATIENTS AND METHODS: This was a single centre prospective randomized trial of 38 adults with a tibial shaft fracture who were treated with either reamed or unreamed nailing. RESULTS: Overall fracture healing time was 23 weeks in the reamed group and 25 weeks in the unreamed group. Differences in rate of clinical union, clinical outcome, time for weight bearing and complications in both the groups were not statistically significant. CONCLUSION: There are no clear indications or contraindications to favour either reamed or unreamed nailing over the other. Technique, fracture union, functional outcome and complications are similar in both groups. Considering the ease of technique application and the decreased operative time, unreamed interlocking nailing has an edge over reamed interlocking nailing

Early Complications in Proximal Femoral Nailing Done for Treatment of Subtrochanteric Fractures

AIM: To analyse the early complications following the use of PFN in subtrochanteric fractures. Background: Osteosynthesis with PFN in subtrochanteric fracture features the advantages of high rotational stability of the head–neck fragment, an unreamed implantation technique and the possibility of static or dynamic distal locking. However, the use of the nail requires technical expertise and is accompanied by some risks of error which can lead to osteosynthesis failure. METHODS: Between May 2009 and May 2011, 50 consecutive patients with PFN fixations for subtrochanteric fractures were observed for intraoperative and postoperative complications. RESULTS: We identified intraoperative technical difficulties in four patients and six patients showed postoperative complications. CONCLUSION: When subtrochanteric fractures are to be stabilised with a PFN, the precise and expert technical performance of implantation is the basic surgical requirement. Good reduction with minimal dissection and the use of an appropriate implant is necessary to avoid treatment failure

Flexible Intramedullary Nailing for Paediatric Shaft of Femur Fractures – Does the Number of Nails Alter the Outcome?

BACKGROUND: The use of flexible intramedullary nailing, allowing micro movement at the fracture site, results in excellent outcomes regardless of the number of nails used. We undertook analysis of the outcomes of flexible nailing with reference to the number of nails used. METHODS: Twenty patients with diaphyseal femur fracture aged 5-15 years were treated with retrograde flexible intramedullary nailing. The number of nails varied from single to multiple. The results were analysed with regard to the number of nails used. RESULTS: The mean patient age was 7.9 years; patients were followed up for a mean duration of 13.2 months. Those with two and three nails had similar results. CONCLUSION: A minimum of two flexible nails is needed for optimal fixation in paediatric femur shaft fractures. Also, limiting the number of implants to two is cost effective, decreases operative time, reduces radiation exposure and offers equal results to that of three nails

Performance analysis of multiuser MIMO OFDM systems incorporating feedback delay and feedback error

Abstract In multiuser Multiple Input Multiple Output Orthogonal Frequency Division Multiplexing (MIMO-OFDM) systems the performance can be improved when full Channel State Information (CSI) is available at the transmitter. The characterization of downlink channel is estimated at the receiver and feedback to the transmitter. But the transmitter may acquire false information due to delay or errors in the feedback channel. The resulting channel capacity loss and Bit Error Rate (BER) performance are evaluated. The BER and the capacity of MIMO-OFDM systems are analyzed by varying the parameters of the system.</jats:p

Covid-19: A Challenging Enigma to Global Education

The Global Education landscape has dramatically changed in the past few months due to the spread of the Corona Virus, otherwise known as COVID-19. The article highlights the pulse of prospective students and Educational Institutions throughout this crisis.The article explores the findings, including the impact on student’s careers, online learning offerings, campus management and a range of other areas. Students worldwide have been dramatically impacted by the spread of the Corona Virus, from travel restrictions to social distancing, isolation measures, quarantines, campus closures and border closures.Hence, the objective of the study is to assess the impact of Global Education and to determine the various benefits, challenges and reasons on Virtual Education against the challenging enigma. The COVID-19. Network issues, lack of awareness and lack of training were also stated as a challenging enigma; less attendance and lack of interaction were found to be the significant drawbacks too. Above all, the study also suggested ways to overcome the challenges. “Various studies have been conducted where it appears that different institutions have been adopting and doing well with this new learning environment” (Oblinger and Kidwell, 2000).Thus the COVID-19 changes have brought a promising future of learning and the accelerated changes in modes of delivering quality education. Global learning can continue to be integrated into classes, curricular and co-curricular activities and programs.</jats:p