This is to certify that the dissertation entitled “ A STUDY ON PREDICTION OF PREECLAMPSIA BY MATERNAL SERUM BETA HCG LEVELS IN EARLY SECOND TRIMESTER (13 TO 20 WEEKS ) OF PREGNANCY - A COHORT STUDY ” is the bonafide original work of Dr.S. Vanitha in partial fulfilment of the requirements for MS Obstetrics and Gynaecology branch II examination of the Tamilnadu Dr.MGR Medical university to be held in April 2015 .The period of Postgraduate study and training from June 2012 to April 2015.
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Earlier studies have indicated that low IgG avidity is a marker of recent infection (7, 10, 12, 13, 16, 22). However, those studies either included a limited number of serum sam- ples (7, 10, 12) or correlated the results to the time that had elapsed, not from the acquisition of infection until the collec- tion of the serum sample but from the time when the first sample showing toxoplasma antibody was collected, which may be several weeks after the time of infection (13, 16). The first symptoms of lymphadenopathy, used as a point of reference, may also be detected some time after the acquisition of infec- tion (10, 22). Our study showed that a low IgG avidity in some cases persisted for more than 20 weeks after the time of ac- quisition. Thus, a low IgG avidity could not accurately identify an acute infection within the previous 13 to 20 weeks of preg- nancy.
Compared to rodents, the pig is a more suitable model for studies of human salivary gland diseases due to the similar size, shared morphological characteristics including the ductal system and the distribution of distinct types of acini, as well as the similar saliva flow rate . The miniature pig model has successfully predicated the clinical efficacy of Aqp1 gene therapy , and verified the essential role of microvessel damage in IR-induced hyposalivation . In order to verify the potential therapeutic effects of transient Hh activation on irradiated salivary glands in large animal models comparable to those of humans, we performed intragland Shh gene delivery in miniature pigs who received unilateral IR at the parotid region. We observed effectively preserved function of irradiated parotids up to 20 weeks after IR as indicated by the improved parotid saliva flow rate, the preservation of acinar structures and expression of acinar markers, and the inhibition of fibrogenesis. Consistent with our previous studies in mouse models, transient Hh activation in pig parotid glands preserved microvessels and parasympathetic innervation. Moreover, we confirmed that IR induced cellular senescence in pig parotid glands similarly to that in mouse SMGs, and found that transient Hh activation after IR effectively inhibited cellular senescence and preserved proliferation capacities of pig parotid cells, which likely also contributes to the Hh-mediated preservation of salivary gland function. In addition, we found that IR inhibited autophagy in parotid glands, whereas intragland Shh gene delivery preserved autophagy in both short-term and long-term likely through AMPK-ULK1 pathway.
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upto 3 months, but the studies on immunization by Theodar et al showed that 94 – 100% seroconversion can be expected only after 2 primary doses of SA 14-14-2 vaccine at intervals of 1 month and 2.5 month. In this study also eventhough only one dose was given, the seroconversion was 98.3% after 12 weeks. Thus there is variation in seroconversion after viral infection and immunisation. The viral vaccines are prepared by serial cell culture passages and neuro attenuation, hence the nucleotide sequence of the vaccine gets varied. So the immune response in the disease may not be similar to that after vaccination.
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Background: Ultrasonography has become an indispensible tool in the management of obstetric patients. Accurate determination of fetal gestational age (FGA) has posed great challenge to patient management as the accuracy of traditional biometric parameters decreases with advance in gestation age. Accuracy of fetal kidney length (FKL) in the determination of FGA at third trimester has been documented in other population. This study is aimed to create baseline reference values of fetal kidney lengths in a Nigerian population as previous studies show population specific variations. Methods: This prospective cross sectional study was carried out on 534 pregnant women between 20 and 40 weeks of gestation who met the inclusion criteria at Diamond Biomedical Services Ltd. A pilot study was conducted on 20 patients to determine the reproducibility and reliability of ultrasound measurement of FKL. Fetal kidney lengths were calculated as mean of three separate measurements. The 5th, 50th and 95th percentiles were calculated using least squared regression analysis. Third polynomial regression models were used to establish the relationship between right and left FKL and FGA. Results: Both FKL measurements are highly reproducible with excellent correlation and agreement within and between sonographers. It correlates strongly with gestational age while the relationships between right and left kidney lengths with gestational age were established using the following regression equations: RKL = − 11.18 + 1.193 × FGA − 0.0350 × FGA 2 + 0.00037 × FGA 3 and LKL = − 12.57 + 1.332 × FGA − 0.0390 × FGA 2 + 0.00040 × FGA 3 for right and left kidneys respectively.
(I)Gestational Hypertension: According to the NHBPEP & ACOG, A sustained rise of blood pressure to 140/90mmHg or more on atleast two occasions 4 or more hours apart beyond 20 th week of pregnancy or during the first 24 hours after delivery without significant proteinuria in a previously normotensive woman is called Gestational Hypertension.
This retrospective study was approved by the institutional review board of the Children’s Hospital of Eastern Ontario, Canada. All referrals for feMRI followed a dedicated fetal neurosonographic study. No written informed consent was obtained at the Medical Imaging Department, but feMRI requisitions are discussed with a multidisciplinary team prior to booking the MR imaging, as per departmental practice. A search of the Medical Imaging Depart- ment data base was performed to identify feMRI studies per- formed with a 3T system (Magnetom Skyra; Siemens, Erlangen, Germany) and a 1.5T MR imaging system (Sigma HD; GE Health- care, Milwaukee, Wisconsin) from July 2010 to January 2016. Patients were identified by searching for the term “normal fetal brain” in the final report and having a gestational age between 20 and 24 weeks.
Michigan, USA) before methanolic NaOH solution is added. The solution will be vortexed, caped and placed in a water bath at 37°C for 60 min. This is followed by fur- ther dilution with distilled water and then acidification to pH 3 with hydrochloric acid before being extracted with hexane. Following gentle rotation and centrifugation at 3000 × g, hexane extracts will be removed and discarded. The aqueous layer will then be extracted twice with ethyl acetate, with extracts pooled and dried under nitrogen. Once dry, the samples will be reconstituted with ace- tonitrile, vortexed and transferred into 300 μL glass inserts and dried ready for derivatisation. The derivatization method will be based on that used by Mori and colleagues . To the dried extract, pentafluorobenzylbromide and 20 μL diisopropylethylamine will be added and incubated at room temperature for 30 min. Following incubation, samples will be further dried under nitrogen to give the F 2 - isoprostane pentafluorobenzyl ester. Samples will then be treated with pyridine, bis(trimethylsilyl)trifluoroaceta- mide and trimethylchlorosilane and incubated at 45°C for 20 min to yield the trimethylsilylethers. After incuba- tion, hexane will be added to each sample, mixed and
The present observational comparative study on efficacy and safety of conventional versus newer antidepressants in patients with depressive episode was conducted in Department of Psychiatry, Victoria hospital over a period of 1year 6 months. We enrolled 90 patients into the study who were divided into three groups of 30 each and followed up for a period of 12 weeks after receiving the study drugs. There are numerous similar studies comparing the treatment modalities of an acute episode of depression and most of them have followed up the patients up to 6-8 weeks. However, an episode of acute depression lasts for about 12 weeks and hence we have followed up the patients up to 12 weeks. WHO recommends continuation of the antidepressants for at least 12 months to prevent relapse.
The preoperative finding of hip dysplasia in the major- ity of dogs used in this study suggests that hip dysplasia may be common in hounds purpose-bred for research, and several groups have suggested that canine hip dys- plasia is a complex genetic trait with high prevalence in large breeds. (Bartolomé, 2015) If this type of dog is used in the future to study tissue-engineered cartilage con- structs and hip dysplasia is identified pre-operatively, wear patterns of any implant may approximate those seen in the population of human patients expected to benefit most from these technologies, but may also complicate analysis and increase variability of results, particularly of functional outcome measures. Spontaneous cartilage lesions in dogs with hip dysplasia are initiated in the dorsal femoral head, adjacent to the insertion of the ligamentum capitis femoris, in a similar location to the perifoveal location of cartilage fibrillation seen in human hip osteoarthritis (Maroudas et al. 1973; Burton-Wurster et al. 1999). The full effect of preexisting hip dysplasia on the results of this study is unknown, since no unaffected control group was available for comparison. However, based on radiographic scores as well as DIs (laxity) and CIs (congruency) of control limbs, we were unable to detect any progression of these abnormalities over the 6-month duration of the study. In addition, DI (laxity), but not CI (congruency), was tightly correlated with radiographic score at both preoperative and 20-week time points, for the control limb (Additional file 3: Table S2). These findings are consistent with previous studies (Gold et al. 2009). Interpretation of accelerome- try data may have been confounded by preoperative hip dysplasia. For example, increased radiographic score of the control limb was correlated with increased number of preoperative daytime rest periods. Increased number of daytime rest periods preoperatively was associated with shorter total duration of daytime rest periods at 20 weeks postoperatively and increased overall daytime activity. In summary, hip osteoarthritis in dogs leads to complex changes in gait (Bockstahler et al. 2012), and in this study we found complex interactions of preexist- ing and induced osteoarthritis on functional outcome measures. Therefore, as has been suggested previously (Cook et al. 2010), dogs should be screened for preexisting
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In patients with COPD without ischemic heart disease, diabetes, or hypercholesterolemia, simvastatin 20 mg once daily for 6 weeks compared with placebo was associated with a nonsignificant improvement in aortic stiffness despite a sig- nificant lowering of cholesterol. In those with high baseline aortic PWV, a large and significant reduction in aortic PWV was demonstrated on simvastatin compared with placebo. This may signify a potential benefit in terms of CV mortality in a high-risk group of patients, in whom statins would not previously have been routinely considered.
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Major histocompatibility complex (MHC)-matched ma- caques that allow for the transfer and persistence of cells between animals provide a powerful tool for dissecting the correlates of immunity in attenuated SIV vaccines (10, 19). We characterized a unique population of cynomolgus macaques from the Indian Ocean island of Mauritius with limited diversity among their MHC class I and class II genes. MHC-matched animals could be readily identified in sufficient numbers for adoptive transfer ex- periments (20). Cells transferred between MHC-matched Mauri- tian cynomolgus macaques (MCM) persist for up to 17 days in recipient macaques, while they are undetectable as early as 1 day posttransfer in MHC-mismatched macaques (21, 22). Here we used adoptive transfers to investigate correlates of immune pro- tection in SIVmac239⌬nef-vaccinated animals. After vaccinating six macaques with SIVmac239 ⌬ nef and mock vaccinating six con- trol animals, we were able to transfer between 1.25 ⫻ 10 9 and 3.00 ⫻ 10 9 mononuclear cells into MHC-matched recipients. We
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Diet and Nutrition: There is no clear evidence that advising pregnant women to increase their energy intake, providing energy or protein supplements, or prescribing a low energy diet to overweight women protects against pre-eclampsia. Also unclear is whether advice to reduce dietary salt intake during pregnancy has any impact. Several nutritional agents have been suggested to have a role in preventing pre-eclampsia. Dietary supplementation with at least 1 g of calcium a day reduces the relative risk of pre-eclampsia, but with no clear effect on the risk of stillbirth or the baby dying before discharge from hospital (9 trials, 6763 babies; relative risk 1.04, 95% confidence interval 0.65 to 1.66). The effects seemed strongest for high risk women and those with low dietary calcium. Data from the recent World Health Organization trial of women with low calcium intake support a modest reduction in the risk of pre-eclampsia associated with calcium supplementation rather than placebo (171/4151 v 186/4161; relative risk 0.91, 0.69 to 1.19). There were also reductions in the risk of severe gestational hypertension (relative risk 0.71, 0.61 to 0.82), eclampsia (0.68, 0.48 to 0.97), and delivery before 32 weeks (0.82, 0.71 to 0.93). Antioxidants, primarily vitamins C and E, also seem to reduce the risk of pre- eclampsia  . This seems to be associated with an increase in preterm
Based on previous literature of the association between malaria parasitaemia during pregnancy and foetal growth, the potential modifying effects of primigravidity ( vs. multigravidity), female foetal sex ( vs. male), and baseline maternal mid-upper arm circumference (MUAC) ≤24.3 cm (i e, the lowest quartile of the full study population) ( vs. “normal” MUAC) were examined. MUAC is a proxy for pre-pregnancy weight . Poten- tial confounders included maternal age, education, foetal sex, and socioeconomic status (SES). “Low SES” was defined as a binary composite variable, with unemployed women (or their partners) living in a home with few ma- terial assets (no toilet, no water, no electricity) categor- ized as “low SES”.
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the acromion and seventh cervical vertebra) , the upper neck muscles (UNE) (2 cm laterally to the vertical line of the axis in level with the 4’th cervical vertebra) [17, 18], and the anterior tibialis muscle (TIA) (as the point of reference) . A handheld electronic pressure algometer was used (Type II Algometer, Somedic Production AB, Sweden). The algometer was pistol-shaped with a pressure-sensitive strain gauge at the tip. The contact area had a diameter of 1 cm 2 . Compression pressure was ap- plied perpendicularly to the skin with a rate of 20 kPa/s. A digital display on the pressure algometer was used to keep the rate of pressure stable. Measurements were performed three times in a fixed order: 1) right TRA, 2) left TRA, 3) right UNE, 4) left UNE, and 5) right TIA. A rest period of approximately 1 min was given between measurements conducted on the same PPT point. Participants were given a hand held control switch and were instructed to imme- diately press the switch when the sensation of “pressure” changed to “pain”. When the switch was pushed the com- pression was stopped and the pressure was released . A low level of pain sensitivity therefore equals a high PPT value, and a high level of pain sensitivity equals a low PPT value. The maximum applied pressure registered was re- corded before resetting the algometer. A maximal pressure of 1000 kPa was allowed for TRA and TIA and 700 kPa for the UNE. The algometer was calibrated before each test.
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The patient, a thirty-four-year old Caucasian woman, was diagnosed with HHF3 at twenty-three years of age. She was obese with BMI of 34 and smoked 20 cigarettes per day but was otherwise healthy. The patient had no history of severe hypoglycemic episodes, defined as having low blood glucose levels that requires assistance from another person to treat. Yet, she reported intermittent light-headedness, headache and hunger, especially during exercise and when trying to lose weight. In 2004, at the time of diagnosis,
The means of AUC (0–24 weeks) values on the log scale were estimated using an analysis of variance model with treatment as a factor. Two-sided 90% confidence intervals (CIs) for the test (EE-drospirenone-levomefolate calcium) to reference (EE-drospirenone + folic acid) geometric mean ratio of the AUC (0–24 weeks) were calculated for plasma and RBC folate exposure to assess whether they were contained within the limits for bioequivalence (range 80%–125%). Plasma and RBC folate AUC (0–24 weeks) values, uncorrected or corrected for baseline folate concentrations, were analyzed with inferential statistical methods using the per protocol set, which consisted of all treated women who did not present any major protocol deviations.
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We collected prenatal brain MR imaging examinations of sin- gleton pregnancies, between 20 and 24 weeks of gestational age (GA), which were performed for the indications reported in Table 1. Exclusion criteria were the following: 1) clear or suspected brain abnormalities at prenatal MR imaging, 2) poor image qual- ity, 3) chromosomal abnormalities, 4) pregnancies complicated by infections, and 5) extra-CNS malformations frequently asso- ciated with CNS malformations (eg, cardiac rhabdomyoma). Gestational age was calculated by obstetricians and gynecologists on the basis of the menstrual period and ultrasound criteria and expressed as completed weeks.
linemia (Figure 1, F and G, left panels), despite the similar degrees of obesity and insulin resistance shown by both HF diet–fed groups. Although the wild-type mice on the HF diet developed mild dia- betes by 20 weeks, because of the compensatory hyperinsulinemia they never developed severe diabetes (Figure 1, F and G, right panels). After 20 weeks, the insulin-to-glucose ratio 30 minutes after a glucose load (the insulin secretory index) revealed a signifi- cantly increased insulin response to glucose in the wild-type mice on the HF diet compared with those fed standard chow, where- as the Gck +/– mice on the HF diet had an insulin secretory index
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Abstract: Hemivertebra is a rare congenital spinal malformation, where only one side of the vertebral body develops, resulting in deformation of the spine, such as scoliosis, lordosis, or kyphosis. We present the ultrasonographic features of a fetus with hemivertebra at 20 weeks’ gestation confirmed by post mortem radiography and pathological examination. The prenatal literature on this disorder is also reviewed. Useful background information is provided for both clinicians and other health professionals who are not familiar with this condition.