Programmed labour compared with expectant management: is it truly a need of new millennium?

Background: The mechanism triggering the initiation of human parturition is still an enigma. At term a series of complex physiological, biochemical and physical processes cascade resulting in delivery of the fetus. This study deals exclusively with comparison of normal labour, induction of labour with prostaglandin, and with augmentation by intracervical insertion of PGE2 tablets, amniotomy and smooth muscle relaxant. Advantages and disadvantages of each of the above methods are compared with expectant management of labour. Aim of this study was to compare pros and cons of programmed labour that to with expectant management.Methods: Study was conducted in Department of Obstetrics and Gynaecology, Bharati Hospital and Research Centre, Pune. It was a prospective randomized clinical trial. 100 pregnant full term women, were selected for each group. At 0 hour primiprost tablet is inserted into the vagina close to the cervix. Frequency of repetition of tablet will be at three hours interval. Patient will be monitored.Results: The youngest one being of age 17 years and the eldest being of age 29 years. In this, we observed those primi and 2nd gravida patients 2-2 tablets each in latent phase and 1-1 tablets in active phase. The induction delivery Interval in primigravida was observed to be of average of 9 hours. While in II Gravida was 6.5 hours, in III Gravida 5.5 hours and in IV Gravida 4 hours.Conclusions: It has been proved beyond doubt that by programmed labour, the patient definitely can get the benefit of decrease in duration of labour

A comparative study between placental alpha microglobulin-1 rapid immunoassay and standard diagnostic methods for detection of rupture of membranes

Background: To determine the efficacy of an immunoassay to measure levels of placental alpha-microglobulin-1 in cervico-vaginal secretions.Methods: 100 ANC cases admitted in Dr D. Y. Patil Hospital with symptoms of rupture of membranes during study period. Inclusion criteria-Pregnant women who presented with symptoms of ROM either in labour or not in labour, gestational age from 28 weeks onwards and who have given consent.Results: In 9 cases, the immunoassay test was negative, in 91 cases, it was positive and in one case, the liquor had a lot of meconium, the woman had to undergo an emergency cesarean section. This patient was deemed to have a false negative result by the test. Pooling was positive in 87 cases, nitrazine test in 86 cases and ferning in 88 cases. Hence, in comparison to immunoassay test which had 100% specificity and 98.91% sensitivity due to incomplete evaluation, nitrazine test had 95.58% sensitivity and 100% specificity, Pooling has 97.79% sensitivity and 100% specificity, whereas ferning has 98.34% sensitivity and 100% specificity.Conclusions: The PAMG1 is a non-invasive, rapid, one step test with very high sensitivity, specificity and accuracy as compared to the conventional methods together and also individually. Preforming this test instead of conventional methods can aid the early detection of rupture of membranes and largely affect the outcome of maternal and fetal health as timely decision can be taken once diagnosis is confirmed

Planetary Candidates Observed by Kepler. VII. The First Fully Uniform Catalog Based on The Entire 48 Month Dataset (Q1-Q17 DR24)

We present the seventh Kepler planet candidate catalog, which is the first to be based on the entire, uniformly processed, 48 month Kepler dataset. This is the first fully automated catalog, employing robotic vetting procedures to uniformly evaluate every periodic signal detected by the Q1-Q17 Data Release 24 (DR24) Kepler pipeline. While we prioritize uniform vetting over the absolute correctness of individual objects, we find that our robotic vetting is overall comparable to, and in most cases is superior to, the human vetting procedures employed by past catalogs. This catalog is the first to utilize artificial transit injection to evaluate the performance of our vetting procedures and quantify potential biases, which are essential for accurate computation of planetary occurrence rates. With respect to the cumulative Kepler Object of Interest (KOI) catalog, we designate 1,478 new KOIs, of which 402 are dispositioned as planet candidates (PCs). Also, 237 KOIs dispositioned as false positives (FPs) in previous Kepler catalogs have their disposition changed to PC and 118 PCs have their disposition changed to FP. This brings the total number of known KOIs to 8,826 and PCs to 4,696. We compare the Q1-Q17 DR24 KOI catalog to previous KOI catalogs, as well as ancillary Kepler catalogs, finding good agreement between them. We highlight new PCs that are both potentially rocky and potentially in the habitable zone of their host stars, many of which orbit solar-type stars. This work represents significant progress in accurately determining the fraction of Earth-size planets in the habitable zone of Sun-like stars. The full catalog is publicly available at the NASA Exoplanet Archive.Comment: Accepted to the Astrophysical Journal Supplement Series. 30 pages, 9 figures, 7 tables. We make the DR24 robovetter decision code publicly available at http://github.com/JeffLCoughlin/robovetter, with input and output examples provided using the same data as contained in the full paper's table

Kepler: A Search for Terrestrial Planets - Kepler Data Characterization Handbook

The Kepler Data Characteristics Handbook (KDCH) provides a description of all phenomena identified in the Kepler data throughout the mission, and an explanation for how these characteristics are handled by the final version of the Kepler Data Processing Pipeline (SOC 9.3).The KDCH complements the Kepler Data Release Notes (KDRNs), which document phenomena and processing unique to a data release. The original motivation for this separation into static, explanatory text and a more journalistic set of figures and tables in the KDRN was for the user to become familiar with the Data Characteristics Handbook, then peruse the short Notes for a new quarter, referring back to the Handbook when necessary. With the completion of the Kepler mission and the final Data Release 25, both the KDCH and the DRN encompass the entire Kepler mission, so the distinction between them is in the level of exposition, not the extent of the time interval discussed

The Kepler Science Data Processing Pipeline Source Code Road Map

We give an overview of the operational concepts and architecture of the Kepler Science Processing Pipeline. Designed, developed, operated, and maintained by the Kepler Science Operations Center (SOC) at NASA Ames Research Center, the Science Processing Pipeline is a central element of the Kepler Ground Data System. The SOC consists of an office at Ames Research Center, software development and operations departments, and a data center which hosts the computers required to perform data analysis. The SOC's charter is to analyze stellar photometric data from the Kepler spacecraft and report results to the Kepler Science Office for further analysis. We describe how this is accomplished via the Kepler Science Processing Pipeline, including, the software algorithms. We present the high-performance, parallel computing software modules of the pipeline that perform transit photometry, pixel-level calibration, systematic error correction, attitude determination, stellar target management, and instrument characterization

Compare Outcomes Of Single Stage Vs Two Stage Urethroplasty For Panurethral Strictures Including Pre-Operative And Post-Operative Course

Aim: The aim of the present study was to compare outcomes of single stage vs two stage urethroplasty for panurethral strictures including pre-operative and post-operative course. Methods: The Observational study was conducted at Dr. D.Y. Patil Medical College and Research Centre, Pimpri for the period of 2 years. The study was conducted in 40 patients randomly dividing into two groups, 20 patients underwent single stage urethroplasty and 20 underwent two staged urethroplasty with or without buccal mucosal graft urethroplasty based on size of urethral plate. Results: In the present study, majority of the patients belonged to 41-50 years age group followed by 31-40 years age group and it was found that age groups were not statistically significant. Majority of the patients had Balanitis xerotica obliterans (LS) etiology followed by Post instrumentation/catheter and the results were not statistically significant. Majority of the patients had 13-15 cms length of stricture. In the present study, 12 and 16 were narrow external uretheral meatus in single and two stage respectively. In the two stage, Johanson’s urethroplasty procedure was done and in single stage, Kulkarni’s full length dorsal onlay BMG urethroplasty procedure was done. In single and two stage, Urethrocutaneous Fistula and Epididymo-orchitis complications were noted. In single stage, success was noted in 16 patients and in two stage, success was noted in 17 patients. Conclusion: The single stage repair in patients with LS had good results with less re-stricture rates. The use of BMG as a substitution in single stage repair had re-stricture rates compared to flaps substitution. The two-stage repair should be limited to complex urethral strictures, failed urethroplasty and obliterated urethral stricture urethral caliber is less than 6F

Effect of third component on separation behavior of water+t-butanol+Na2SO3/Na2SO4 system at 298±2 K

The liquid-liquid and liquid-liquid-solid equilibria for the ternary t-butanol-water-Na2SO3/Na2SO4 system is reported at ambient pressure and at 298±2 K. The solubility data of solutions of Na2SO3/Na2SO4 in water, t-butanol and solutions of varying compositions of t-butanol in water are reported. The phase diagrams for the studied systems are developed and salting-out effect of salt anion has been described. The structural properties of aqueous t-butanol solutions and the salting-out effect of SO32- and SO42- ions to cause phase separation have been explained. The salting-out ability of Na2SO3 is higher than that of Na2SO4 since the Gibbs free energy of hydration (ΔGhyd) of SO42- (−1080 kJ mol-1) is lower than that of SO32- (−1295 kJ mol-1) ion

Nimotuzumab-cisplatin-radiation versus cisplatin-radiation in HPV negative oropharyngeal cancer

BACKGROUND: Addition of nimotuzumab to weekly cisplatin and radiation improves outcomes in head and neck cancer. HPV negative oropharyngeal cancer has unsatisfactory treatment outcomes and is a candidate for escalation of treatment. We wanted to determine whether the addition of nimotuzumab to cisplatin-radiation could improve outcomes in these poor-risk tumors.METHODS: This was a subgroup analysis of a phase 3 randomized study. In this study, locally advanced head and neck cancer patients undergoing definitive chemoradiation were randomly allocated to weekly cisplatin (30 mg/m2 IV)- radiation (66–70 Gy) {CRT arm} or nimotuzumab (200 mg weekly) -weekly cisplatin (30 mg/m2)-radiation (66–70 Gy) {NCRT arm}. The data of HPV negative oropharyngeal cancer was extracted from the database of this study for the analysis. HPV testing was done with p16 immunohistochemistry (IHC) staining and reported according to the CAP criteria. The outcomes assessed were progression-free survival (PFS), disease-free survival (DFS), locoregional control, and overall survival (OS). Interaction test was performed between the study arms and HPV status prior to doing any HPV specific analysis for each of the studied outcomes. Kaplan Meier estimates for 2 year OS with 95% CI was calculated. The hazard ratio was obtained using COX regression analysis.RESULTS: We had 187 HPV negative oropharyngeal cancers, 91 in the CRT arm and 96 in NCRT arm. The interaction test was significant for PFS (p = 0.000), locoregional control (p = 0.007) and overall survival (p = 0.002) but not for DFS (p = 0.072). The 2- year PFS was 31.5% (95%CI 21.5–42) in CRT arm versus 57.2% (95%CI 45.8–67.1) in NCRT arm (HR -0.54; 95%CI 0.36–0.79, p = 0.002). The 2-year LRC was 41.4% (95%CI 29.8–52.6) in the CRT arm versus in 60.4% (95%CI 48.7–70.2) in the NCRT arm (HR -0.61; 95%CI 0.4–0.94, p = 0.024). The addition of nimotuzumab also lead to an improvement in 2-year OS from 39.0% (95%CI 28.4–49.6) to 57.6% (95%CI 46.3–67.4) (HR-0.63, 95%CI 0.43–0.92, p = 0.018).CONCLUSIONS: The addition of nimotuzumab to weekly cisplatin-radiation improves outcomes inclusive of OS in HPV negative oropharyngeal cancers.<br/

In Vivo Evaluation of the Biocompatibility of Surface Modified Hemodialysis Polysulfone Hollow Fibers in Rat

Polysulfone (Psf) hollow fiber membranes (HFMs) have been widely used in blood purification but their biocompatibility remains a concern. To enhance their biocompatibility, Psf/TPGS (d-α-tocopheryl polyethylene glycol 1000 succinate) composite HFMs and 2-methacryloyloxyethyl phosphorylcholine (MPC) coated Psf HFMs have been prepared. They have been evaluated for in vivo biocompatibility and graft acceptance and compared with sham and commercial membranes by intra-peritoneal implantation in rats at day 7 and 21. Normal body weights, tissue formation and angiogenesis indicate acceptance of implants by the animals. Hematological observations show presence of post-surgical stress which subsides over time. Serum biochemistry results reveal normal organ function and elevated liver ALP levels at day 21. Histological studies exhibit fibroblast recruitment cells, angiogenesis and collagen deposition at the implant surface indicating new tissue formation. Immuno-histochemistry studies show non-activation of MHC molecules signifying biocompatibilty. Additionally, Psf/TPGS exhibit most favorable tissue response as compared with other HFMs making them the material of choice for HFM preparation for hemodialysis applications