Effect of Core Stability Training on Trunk Function, Standing Balance, and Mobility in Stroke Patients: A Randomized Controlled Trial

Background. Trunk function is important for standing balance, mobility, and functional outcome after stroke, but few studies have evaluated the effects of exercises aimed at improving core stability in stroke patients. Objective. To investigate the effectiveness of core stability training on trunk function, standing balance, and mobility in stroke patients. Methods. An assessor-blinded, randomized controlled trial was undertaken in a stroke rehabilitation ward, with 32 participants randomly assigned to an experimental group or a control group (n = 16 each). The experimental group received 400 minutes of core stability training in place of conventional programs within total training time, while the control group received only conventional programs. Primary outcome measures were evaluated using the Trunk Impairment Scale (TIS), which reflects trunk function. Secondary outcome measures were evaluated by pelvic tilt active range of motion in the sagittal plane, the Balance Evaluation Systems Test–brief version (Brief-BESTest), Functional Reach test, Timed Up-and-Go test (TUG), and Functional Ambulation Categories (FAC). A general linear repeated-measures model was used to analyze the results. Results. A treatment effect was found for the experimental group on the dynamic balance subscale and total score of the TIS (P = .002 and P < .001, respectively), pelvic tilt active range of motion (P < .001), Brief-BESTest (P < .001), TUG (P = .008), and FAC (P = .022). Conclusions. Core stability training has beneficial effects on trunk function, standing balance, and mobility in stroke patients. Our findings might provide support for introducing core stability training in stroke rehabilitation.

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HISTOPATHOLOGICAL STUDY OF SOFT TISSUE TUMORS (A STUDY OF 140 CASES) IN TERTIARY CARE CENTER

2016-11-07T23-22-35Z
Source: International Journal of Current Research and Review
Jobanputra G.P., Parikh U.R., Goswami H.M..
Background: Soft tissue tumors are defined as mesenchymal proliferations which occur in the extraskeletal nonepithelial tissues of the body, excluding the viscera, coverings of brain and lymphoreticular system. Soft tissue tumours are a highly heterogeneous group of tumours that are classified on a histogenetic basis according to the adult tissue they resemble Objective: To study the incidence of Soft tissue tumors at Tertiary Care Teaching Hospital and to study the morphological incidence of various Soft tissue tumors among different age groups and sex. Methods: In the Present Study, all operated cases; excised biopsies and resected specimens are taken into consideration. After processing detail microscopic examination was carried out. Results: The peak age of incidence of soft tissue tumors was between 3rd to 4th decades of age, with the male: female ratio 1.37:1. Benign tumors (89.3%) are more common than malignant tumors (10%). Most common soft tissue tumor is Lipomatous tumors. Conclusion: The study can contribute to epidemiologic knowledge of soft tissue tumors.


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EFFECT OF GENDER ON THE ANTHROPOMETRIC PARAMETERS OF NEWBORNS OF UDAIPUR DISTRICT

2016-11-07T23-22-35Z
Source: International Journal of Current Research and Review
Neha Vijay, Ghanshyam Gupta.
Introduction: The health and growth of fetus is entirely depending upon the mental and physical health of a mother. Apart from maternal factor one more important infantile factor affects the anthropometric parameters of newborn i.e. the gender of babies. Aim: the aim of study was to know the effect of gender on anthropometric parameters of newborns of Udaipur district of Rajasthan. Method: A Cross sectional study was conducted in the Department of Anatomy, RNT Medical College and Hospitals, Udaipur, Rajasthan, India. All the anthropometric parameters of 1422 newborns were taken from; newborns delivered at Government health institutes of Udaipur district, at Pannadhay Ward of Maharana Bhopal Government Hospital of RNT Medical College and Hospitals. Results: Mean values of Birth weight, Crown Heel Length, Head Circumference, Chest Circumference, Foot Length and Skin Fold Thickness were significantly higher in male. Mean values for Abdominal Circumference, Thigh Circumference, Mid arm Circumference and Calf Circumference was also higher in male; however it was not statistically significant. Conclusion: The anthropometric parameters of newborns revealed a significant difference between male and female newborns.


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CHANGES IN BIOCHEMICAL COMPOSITION IN THE HAEMOLYMPH OF FIFTH INSTAR LARVAE OF PHILOSAMIA RICINI DURING THERMAL STRESS

2016-11-07T23-22-35Z
Source: International Journal of Current Research and Review
Shuchita Chandorkar, Shobha Shouche, JPN Pathak.
Haemolymph of Philosamia ricini is a water reservoir which maintains homeostasis. When the insect is exposed to stresses naturally then it passes through various changes in biochemical composition. Fifth instar larvae of eri silk worm Philosamia ricini were kept under thermal stress of low and high temperature to observe the changes in carbohydrates, proteins and free amino acids. At high temperature carbohydrates showed a significant increase and a significant decrease at low temperature. Proteins and amino acids showed a significant decrease at high temperature and increase at low temperature.


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Cytogenetic and Molecular Characterization of B-Genome Introgression Lines of Brassica napus L.

Brassica napus introgression lines (ILs), having B-genome segments from B. carinata, were assessed genetically for extent of introgression and phenotypically for siliqua shatter resistance. Introgression lines had 7-9 % higher DNA content, were meiotically stable and had almost normal pollen fertility/seed set. Segment introgressions were confirmed by fl-GISH, SSR analyses and SNP studies. Genotyping with 48 B-genome specific SSRs detected substitutions from B3, B4, B6 and B7 chromosomes on 39 of the 69 introgression lines whereas SNP genotyping detected a total of 23 B-segments (≥ 3Mbp) from B4, B6, B7 introgressed into 10 of the 19 (C1, C2, C3, C5, C6, C8, C9, A3, A9, A10) chromosomes in 17 introgression lines. The size of substitutions varied from 3.0 Mbp on chromosome A9 (IL59) to 42.44 Mbp on chromosome C2 (IL54), ranging from 7% to 83% of the recipient chromosome. Average siliqua strength in introgression lines was observed to be higher than that of B. napus parents (2.2 mJ to 6.0 mJ vs. 1.9 mJ to 4.0 mJ) while siliqua strength in some of the lines was almost equal to that of the donor parent B. carinata (6.0 mJ vs.7.2 mJ). These introgression lines, with large chunks of substituted B-genome, can prove to be a useful pre-breeding resource for germplasm enhancement in B. napus, especially for siliqua shatter resistance.

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The Physical Genome Mapping of Anopheles albimanus Corrected Scaffold Misassemblies and Identified Inter-arm Rearrangements in Genus Anopheles

The genome of the Neotropical malaria vector Anopheles albimanus was sequenced as part of the 16 Anopheles Genomes Project published in 2015. The draft assembly of this species consisted of 204 scaffolds with an N50 scaffold size of 18.1 Mb and a total assembly size of 170.5 Mb. It was among the smallest genomes with the longest scaffolds in the 16 Anopheles species cluster, making An. Albimanus the logical choice for anchoring the genome assembly to chromosomes. In this study, we developed a high-resolution cytogenetic photomap with completely straightened polytene chromosomes from the salivary glands of the mosquito larvae. Based on this photomap, we constructed a chromosome-based genome assembly using fluorescent in situ hybridization of PCR-amplified DNA probes. Our physical mapping, assisted by an ortholog-based bioinformatics approach, identified and corrected 9 misassemblies in 5 large genomic scaffolds. Misassemblies mostly occurred in junctions between contigs. Our comparative analysis of scaffolds with the An. Gambiae genome detected multiple genetic exchanges between pericentromeric regions of chromosomal arms caused by partial-arm translocations. The final map consists of 40 ordered genomic scaffolds and corrected fragments of misassembled scaffolds. The An. Albimanus physical map comprises 98.2% of the total genome assembly and represents the most compete genome map among mosquito species. This study demonstrates that physical mapping is a powerful tool for correcting errors in draft genome assemblies and for creating chromosome-anchored reference genomes.

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iSeq: A New Double-Barcode Method for Detecting Dynamic Genetic Interactions in Yeast

Systematic screens for genetic interactions are a cornerstone of both network and systems biology. However, most screens have been limited to characterizing interaction networks in a single environment. Moving beyond this static view of the cell requires a major technological advance, to increase the throughput and ease of replication in these assays. Here we introduce iSeq, a platform to build large double barcode libraries and rapidly assay genetic interactions across environments. We use iSeq in yeast to measure fitness in three conditions of nearly 400 clonal strains representing 45 possible single or double gene deletions, including multiple replicate strains per genotype. We show that iSeq fitness and interaction scores are highly reproducible for the same clonal strain across replicate cultures. However, consistent with previous work, we find that replicates with the same putative genotype have highly variable genetic interaction scores. By whole-genome sequencing 102 of our strains, we find that segregating variation and de novo mutations, including aneuploidy, occur frequently during strain construction and can have large effects on genetic interaction scores. Additionally, we uncover several new environment-dependent genetic interactions, suggesting that barcode-based genetic interaction assays have the potential to significantly expand our knowledge of genetic interaction networks.

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Ruxolitinib-associated tuberculosis – A rare complication of a novel drug!

2016-11-07T08-16-08Z
Source: International Journal of Medical Science and Public Health
Vinod R Patil, Chandrakala S, Nilesh P Wasekar, Farah Jijina, Aniket B Mohite.
Primary myelofibrosis (PMF) is a myeloproliferative disorder characterized by bone marrow fibrosis, abnormal cytokine expression, abnormal proliferation of megakaryocytes, and splenomegaly. Ruxolitinib (INCB018424) is a novel nonspecific Janus-like kinase inhibitor available for the management of PMF as it reduces spleen size and gives significant symptomatic relief. Very few case reports are available depicting opportunistic infections associated with this drug. We present a case of 35-year-old female - A known case of PMF on follow-up since 7 years. She was started on ruxolitinib in view of symptomatic progressive splenomegaly and weight loss. She was asymptomatic till 4th month of starting drug when she developed fever, body ache, and right axillary swelling. The right axillary lymph node biopsy revealed necrotizing granulomatous lymphadenopathy of tuberculous etiology (acid-fast bacilli [AFB] positive). X-ray of the chest was normal. She was started on antituberculosis (TB) treatment, and ruxolitinib was also continued. Patient is currently asymptomatic and has gained weight. She is on continuation phase of anti-TB treatment.


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Study of variations in lipid profile in different trimesters of pregnancy

2016-11-07T08-16-08Z
Source: International Journal of Medical Science and Public Health
Manish Kumar Mishra, Rina Sharma, Deependra Sharma, Avanish Mishra, Diwaker Sharma.
Background: This study has been conducted to show a correlation of rise in lipid profile in all three trimesters when compared with nonpregnant controls. Objectives: As previous studies showed that increased lipid profile during pregnancy may lead to serious complications in both mother and fetus. Hence, the aim of our study is to monitor the lipid profile values during all the three trimesters of pregnancy and prevent the complications in both mother and fetus. Materials and Methods: A total 180 pregnant patients were taken with 60 in each trimester. 60 healthy nonpregnant women were taken as control subjects. In both study and control groups, we estimated lipid profile which includes total cholesterol (TC), serum triglycerides (TGs), high-density lipoprotein (HDL), and low-density lipoprotein (LDL). Results: In comparison between study and control groups, the levels of TC, serum TGs, and HDL were significantly high in all the three trimesters, but the levels of LDL were significantly high in the second and third trimesters only. Conclusion: Deranged lipid metabolism in pregnancy is associated with complications in mother and fetus. Therefore, it is recommended to get lipid profile done as a routine investigation in all the three trimesters of pregnancy to avoid maternal and fetal morbidity and mortality.


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Potential benefits of mindfulness during pregnancy on maternal autonomic nervous system function and infant development

Abstract

Mindfulness is known to decrease psychological distress. Possible benefits in pregnancy have rarely been explored. Our aim was to examine the prospective association of mindfulness with autonomic nervous system function during pregnancy and with later infant social-emotional development. Pregnant women (N = 156) completed self-report mindfulness and emotional distress questionnaires, and had their autonomic function assessed in their first and third trimesters, including heart rate (HR), indices of heart rate variability (HRV), preejection period (PEP), and systolic (SBP) and diastolic blood pressure (DBP). The social-emotional development of 109 infants was assessed at 4 months of age. More mindful pregnant women had less prenatal and postnatal emotional distress (p < .001) and higher cardiac parasympathetic activity: root mean square of successive differences (RMSSD: p = .03) and high-frequency (HF) HRV (p = .02). Between the first and third trimesters, women's overall HR increased (p < .001), and HRV (RMSSD, HF HRV, and low-frequency (LF) HRV: p < .001) and PEP decreased (p < .001). In more mindful mothers, parasympathetic activity decreased less (RMSSD: p = .01; HF HRV: p = .03) and sympathetic activity (inversely related to PEP) increased less (PEP: p = .02) between trimesters. Their offspring displayed less negative social-emotional behavior (p = .03) compared to offspring of less mindful mothers. Mindfulness in pregnancy was associated with ANS changes likely to be adaptive and with better social-emotional offspring development. Interventions to increase mindfulness during pregnancy might improve maternal and offspring health, but randomized trials are needed to demonstrate this.

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Elevated ischemia associated lysyl oxidase activity in delayed graft failure 6 -12 months post-renal transplantation

Abstract

The present investigation was undertaken to evaluate the potential biochemical changes associated with renal parenchyma 6–12 months after renal transplantation and delayed graft failure. Serum TGF beta concentrations of these subjects always remained elevated. In addition, tissue examination from needle biopsies confirmed that there were consistent changes in the enzyme, lysyl oxidase, which functions as an amine oxidase, modifies lysine residues on collagen and cross-links in a process of modulation of the extracellular matrix. Parenchymal levels of hypoxia inducible factor and fibronectin were elevated, as detected by western blotting. These indicates an ongoing ischemic insult, which may result from increased tissue fibrosis, or in some cases, may be additive from pre-existing pathophysiologic factors that constrain proper renal hemodynamics. Thus, increased lysyl oxidase activity, which we assayed, is a potential unfavorable mechanism occurring in these kidneys undergoing failure and which probably causes increased fibrosis within the organ, causes ischemia, renovascular hypertension, and a cascade leading to renal dysfunction and failure.

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Clinical And Embryological Rationale Of Occipitalization Of Atlas

2016-11-07T04-31-28Z
Source: The Southeast Asian Journal of Case Report and Review
Alok Saxena,Kishor Kumar Agarwal,Amal Rani Das.
Introduction Anatomical variations have always been fascinating topics for research, revealing the hidden and rare findings. We have observed a skull assimilated with first cervical vertebra (atlas) leaving some perforations along the line of fusion. Atlas does not bear body like other cervical vertebrae, forms atlano-occpital joint which allow flexion, extension particularly nodding movement to the head. Case Report We have come across with total fusion of atlas with skull during undergraduate medical teaching. The skull was completely examined. The lateral mass showed complete fusion with occipital condyles. Anterior arch was completely fused with occipital bone whereas there were some perforations along the line of fusion between posterior arch and occipital bone. Conclusion Occpitalization of atlas may severe complications ranges from headache to spinal cord compression. This condition may be characterised by headache, cervical pain, postural abnormality, restricted flexion and extension of neck specially nodding movement, pain and numbness in the upper limb(s).


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The effect of α1-adrenergic blockade on post-exercise brachial artery flow-mediated dilatation at sea-level and high-altitude

Abstract

We examined the hypotheses that 1) at rest, endothelial function would be impaired at high-altitude compared to sea-level, 2) endothelial function would be reduced to a greater extent at sea-level compared to high-altitude after maximal exercise, and 3) reductions in endothelial function following moderate-intensity exercise at both sea-level and high-altitude are mediated via an α₁-adrenergic pathway. In a double-blinded, counter-balanced, randomized and placebo-controlled design, nine healthy participants performed a maximal-exercise test, and two 30-min sessions of semi-recumbent cycling exercise at 50% peak Watt following either placebo or α₁-adrenergic blockade (prazosin; 0.05mg kg ⁻¹). These experiments were completed at both sea-level (344m) and high-altitude (3800m). Blood pressure (finger photoplethysmography), heart rate (electrocardiogram), oxygen saturation (pulse oximetry), and brachial artery blood flow and shear rate (ultrasound) were recorded prior to, during, and following exercise. Endothelial function assessed by brachial artery flow-mediated dilatation (FMD) was measured prior to, immediately following, and 60-min post-exercise. Our findings were: 1) at rest, FMD remained unchanged between sea-level and high-altitude (placebo P = 0.287; prazosin: P = 0.110); 2) FMD remained unchanged after maximal exercise at sea-level and high-altitude (P = 0.244); 3) the 2.9 ± 0.8% (P = 0.043) reduction in FMD immediately after moderate-intensity exercise at sea-level was abolished via α₁-adrenergic blockade. Conversely, at high-altitude, FMD was unaltered following moderate-intensity exercise, and administration of α₁-adrenergic blockade elevated FMD (P = 0.032). Our results suggest endothelial function is differentially affected by exercise when exposed to hypobaric hypoxia. These findings have implications for understanding the chronic impacts of hypoxemia on exercise, and the interactions between the α₁-adrenergic pathway and endothelial function.

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Acute and chronic effects of noradrenergic enhancement on transcranial direct current stimulation (tDCS)-induced neuroplasticity in humans

Abstract

Noradrenaline affects cognition and motor learning processes via its impact on long-term potentiation (LTP) and depression (LTD). We aimed to explore the impact of single dose and chronic administration of the selective noradrenaline reuptake inhibitor (NRI) reboxetine (RBX) on plasticity induced by transcranial direct current stimulation (tDCS) in healthy humans via a double-blinded, placebo-controlled, randomized crossover study. 16 healthy volunteers received placebo or single dose RBX (8 mg) before anodal or cathodal tDCS of the primary motor cortex. Afterwards, the same subjects took RBX (8 mg day⁻¹) consecutively for 21 days. During this period, two additional interventions were performed (RBX with anodal or cathodal tDCS), to explore the impact of chronic RBX treatment on plasticity. Plasticity was monitored by motor evoked potential amplitudes elicited by transcranial magnetic stimulation. Chronic administration of RBX increased and prolonged the LTP-like plasticity induced by anodal tDCS for over 24 h. Chronic RBX significantly converted cathodal tDCS-induced LTD-like plasticity into facilitation, as compared to the single dose condition, for 120 min after stimulation. The results show a prominent impact of chronic noradrenergic enhancement on plasticity of the human brain which might partially explain the delayed therapeutic impact of selective NRIs in depression and other neuropsychiatric diseases.

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Evidence of viscerally-mediated cold-defence thermoeffector responses in man

Abstract

Sudomotor activity is modified by both warm and cold fluid ingestion during heat stress, independently of differences in core and skin temperatures, suggesting independent viscerally-mediated modification of thermoeffectors. The purpose of the present study was to determine whether visceral thermoreceptors modify shivering responses to cold stress. Ten males (27 ± 5y, 1.73 ± 0.06 m, 78.4 ± 10.7 kg) underwent whole-body cooling via 5 °C water perfusion-suit, on four occasions, to induce a steady-state shivering response, at which point two aliquots of 1.5 ml/kg (SML) and 3.0 ml/kg (LRG), separated by 20- min, of either 7°C, 22°C, 37°C or 52°C water were ingested. Rectal, mean skin and mean body temperature (T_b), electromyographic activity (EMG), metabolic rate (M) and whole-body thermal sensation on a visual analogue scale (WBTS) ranging from 0 mm [very cold] to 200 mm [very hot] were all measured throughout. T_b was not different between all fluid temperatures following SML (7°C:35.7 ± 0.5°C, 22°C:35.6 ± 0.5°C, 37°C:35.5 ± 0.4°C, 52°C:35.5 ± 0.4°C; P = 0.27) or LRG (7°C:35.3 ± 0.6°C, 22°C:35.3 ± 0.5°C, 37°C:35.2 ± 0.5°C, 52°C:35.3 ± 0.5°C; P = 0.99) fluid ingestion. With SML ingestion, greater metabolic rate and cooler thermal sensations were observed with 7°C (M:179 ± 55 W, WBTS:29 ± 21 mm) compared to 52°C (M:164 ± 34 W, WBTS:51 ± 28 mm; all P < 0.05) ingestion. With LRG ingestion, compared to shivering and thermal sensations with 37 °C ingestion (M:215 ± 47 W, EMG:3.9 ± 2.5%MVC, WBTS:33 ± 2 mm) values were different (all P < 0.05) following 7°C (M:269 ± 77 W, EMG:5.5 ± 0.9%MVC, WBTS:14 ± 12 mm), 22°C (M:270 ± 86 W, EMG:5.6 ± 1.0%MVC, WBTS:18 ± 19 mm) and 52°C (M:179 ± 34 W, EMG:3.3 ± 2.1%MVC, WBTS:53 ± 28 mm) ingestion. In conclusion, ingesting 52°C fluids decreased shivering and the sensation of coolness, whereas 22°C and 7°C fluids increased shivering and sensations of coolness to similar levels, independently of core and skin temperature.

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Tonotopic action potential tuning of maturing auditory neurons through endogenous ATP

Abstract

Synaptic refinement and strengthening are activity dependent processes that establish orderly arranged cochleotopic maps throughout the central auditory system. The maturation of auditory brainstem circuits is guided by action potentials (APs) arising from the inner hair cells in the developing cochlea. The AP firing of developing central auditory neurons can be modulated by paracrine ATP signaling, as shown for the cochlear nucleus bushy cells and principal neurons in the medial nucleus of the trapezoid body. However, it is not clear whether neuronal activity may be specifically regulated with respect to the nuclear tonotopic position, i.e. sound frequency selectivity. Using slice recordings before hearing onset and in vivo recordings with iontophoretic drug applications after hearing onset we show that cell-specific purinergic modulation follows a precise tonotopic pattern in the ventral cochlear nucleus of developing gerbils. In high-frequency regions, ATP responsiveness diminished before hearing onset. In low-to-mid frequency regions, ATP modulation persisted after hearing onset in a subset of low-frequency bushy cells (CF<10 kHz). Down-regulation of P2×2/3R currents along the tonotopic axis occurs simultaneously with an increase in AMPAR currents, thus suggesting a high-to-low frequency maturation pattern. Facilitated AP generation, measured as higher firing frequency, shorter EPSP-AP delay in vivo, and shorter AP latency in slice experiments, is consistent with increased synaptic efficacy caused by ATP. Finally, by combining recordings and pharmacology in vivo, in slices, and in HEK cells it was shown that the long lasting change in intrinsic neuronal excitability is mediated by the P2×2/3R.

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KMT2D p.Gln3575His segregating in a family with autosomal dominant choanal atresia strengthens the Kabuki/CHARGE connection

Choanal atresia is rarely reported in Kabuki syndrome, but is a common feature of CHARGE syndrome. Otherwise, the two conditions have a number of overlapping features, and the molecular links between them have recently been elucidated. Here, we report a case of a mother and her two children who presented with congenital choanal atresia. We performed whole exome sequencing on DNA from the mother and her two unaffected parents, and identified a de novo, novel variant in KMT2D. KMT2D p.Gln3575His segregated with disease status in the family, and is associated with a unique and conserved phenotype in the affected family members, with features overlapping with Kabuki and CHARGE syndromes. Our findings further support the potential etiological link between these two classically distinct conditions. © 2016 Wiley Periodicals, Inc.

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Acute myeloid leukemia-associated DNMT3A p.Arg882His mutation in a patient with Tatton-Brown–Rahman overgrowth syndrome as a constitutional mutation

DNA methylation plays a critical role in both embryonic development and tumorigenesis and is mediated through various DNA methyltransferases. Constitutional mutations in the de novo DNA methyltransferase DNMT3A cause a recently identified Tatton-Brown–Rahman overgrowth syndrome (TBRS). Somatically acquired mutations in DNMT3A are causally associated with acute myeloid leukemia (AML), and p.Arg882His represents the most prevalent hotspot. So far, no patients with TBRS have been reported to have subsequently developed AML. Here, we report a live birth and the survival of a female with the TBRS phenotype who had a heterozygous constitutional DNMT3A mutation at the AML somatic mutation hotspot p.Arg882His in her DNA from peripheral blood and buccal tissue. Her characteristic features at birth included hypotonia, narrow palpebral fissures, ventricular septal defect, umbilical hernia, sacral cyst, Chiari type I anomaly. At the age of 6 years, she exhibited overgrowth (> 3 SD) and round face and intellectual disability. This report represents the first documentation of the same variant (DNMT3A p.Arg882His) as both the constitutional mutation associated with TBRS and the somatic mutation hotspot of AML. The observation neither confirms nor denies the notion that mutations responsible for TBRS and those for AML might share the same mode of action. Larger data sets are required to determine whether TBRS patients with constitutional DNMT3A mutations are at an increased risk for AML. © 2016 Wiley Periodicals, Inc.

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Novel findings of left ventricular non-compaction cardiomyopathy, microform cleft lip and poor vision in patient with SMC1A-associated Cornelia de Lange syndrome

Relatively few patients with Cornelia de Lange syndrome (CdLS) due to SMC1A mutation have been reported, limiting understanding of the full extent of the phenotype. Compared to children with classic NIPBL-associated CdLS, patients with SMC1A-associated CdLS have a milder physical phenotype with prominent intellectual disability, high rate of cleft palate and absence of limb reductions. We present a patient with SMC1A-associated CdLS who had typical features including developmental delay, seizure disorder, feeding difficulties, hirsutism, and cleft palate. She also was found to have three novel features: (i) left ventricular non-compaction (LVNC) cardiomyopathy; (ii) microform cleft lip; and (iii) severe hyperopia and astigmatism. These features have implications regarding potential insight into the pathogenesis of the disorder, screening, and medical management. Hypertrophic cardiomyopathy has previously been reported in SMC1A-associated CdLS, but to our knowledge this is the first reported child with LVNC. Previous reports have included children with isolated clefts of the palate without involvement of the lip. When cleft palate alone is associated with a disorder, the underlying pathophysiology for clefting is sometimes secondary due to mechanical blocking of the fusion of the palatal shelves with the developing tongue. The presence of microform cleft lip in this patient suggests that the pathophysiology of clefting in SMC1A is primary rather than secondary. Few studies report ophthalmologic findings specific to SMC1A. Based on these findings, LVNC cardiomyopathy and cleft lip should be considered features of SMC1A-associated CdLS. All patients should receive echocardiogram and undergo thorough ophthalmologic evaluation as part of routine CdLS care. © 2016 Wiley Periodicals, Inc.

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“They Can't Find Anything Wrong with Him, Yet”: Mothers’ experiences of parenting an infant with a prenatally diagnosed copy number variant (CNV)

Chromosome microarray (CMA) testing is used widely in prenatal settings. Some copy number variants (CNVs) detected using CMA are associated with variable or uncertain phenotype and/or possible neurocognitive involvement. Little is known about parenting an infant following such findings. Researchers conducted interviews with 23 mothers of infants diagnosed prenatally with a potentially pathogenic CNV to elicit perspectives on the child's development and disclosure of results to others. Interviews were audiotaped and analyzed for common themes. Most respondents reported their infants were developing typically. The majority expressed concern about their child's future development given the CNV. They reassured themselves their child was unaffected by: comparing him/her to siblings, scrutinizing the child's appearance and behavior, or following provider reassurances. Even without developmental and neurological concerns, some remained acutely observant of their child's neurocognitive development, leading to enrollment in early intervention or ongoing medical assessments. Mothers who were unconcerned stated they would likely attribute atypical behavior or developmental to the CNV. All interviewees shared the result with pediatricians, relatives, or friends, and many shared across groups. Most shared information with pregnant friends considering prenatal testing, but withheld partial or full information from family members due to stigma, lack of understanding, inability to explain the CNV, or presumptions that the child was unaffected. Research must address the long-term consequences of returning uncertain results for parent-child bonding and costs of ongoing assessment and early intervention for typically developing children. Follow up appointments will permit providers to screen for anxiety and assuage worry in the absence of symptoms. © 2016 Wiley Periodicals, Inc.

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Hyperinsulinemic hypoglycemia in Beckwith–Wiedemann, Sotos, and Kabuki syndromes: A nationwide survey in Japan

Beckwith–Wiedemann syndrome (BWS) is a congenital overgrowth syndrome that is occasionally associated with hyperinsulinemic hypoglycemia (HH) in the neonatal period. Sotos syndrome (SS) and Kabuki syndrome (KS) are other malformation syndromes that may be complicated with HH, however, the detailed clinical characteristics of HH accompanied with these syndromes remain unclear. We herein conducted a nationwide questionnaire survey in Japan. We sent a primary questionnaire concerning the clinical experience for these syndromes to 347 perinatal care institutions. As a result, 222 departments or hospitals returned the questionnaires and the total numbers of BWS, SS, and KS patients were 113, 88, and 51, respectively. We sent a secondary questionnaire to 31 institutions where patients with these syndromes presented with HH during infancy. The secondary questionnaires were returned from the institutions and the numbers of patients were 16 for BWS, 9 for SS, and 3 for KS, respectively. Then, we compared the clinical characteristics of infants suffering from transient HH with and without these dysmorphic syndromes. As a result, BWS, SS, and KS patients showed significantly larger body size, lower Apgar scores, higher insulin levels at HH, and shorter durations of HH than non-dysmorphic infants with transient HH. We propose that a careful observation for the signs of HH, even if not specific to the syndromes, is important for the diagnosis of patients with BWS, SS, and KS in the postnatal period. © 2016 Wiley Periodicals, Inc.

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Delineation of Ehlers–Danlos syndrome phenotype due to the c.934C>T, p.(Arg312Cys) mutation in COL1A1: Report on a three-generation family without cardiovascular events, and literature review

Classical Ehlers–Danlos syndrome (cEDS) is a rare connective tissue disorder primarily characterized by hyperextensible skin, defective wound healing, abnormal scars, easy bruising, and generalized joint hypermobility; arterial dissections are rarely observed. Mutations in COL5A1 and COL5A2 encoding type V collagen account for more than 90% of the patients so far characterized. In addition, cEDS phenotype was reported in a small number of patients carrying the c.934C>T mutation in COL1A1 that results in an uncommon substitution of a non-glycine residue in one Gly-Xaa-Yaa repeat of the pro-α1(I)-chain p.(Arg312Cys), which leads to disturbed collagen fibrillogenesis due to delayed removal of the type I procollagen N-propeptide. This specific mutation has been associated with propensity to arterial rupture in early adulthood; indeed, in literature the individuals harboring this mutation are also referred to as "(classic) vascular-like" EDS patients. Herein, we describe a three-generation cEDS family with six adults carrying the p.(Arg312Cys) substitution, which show a variable and prevalent cutaneous involvement without any major vascular event. These data, together with those available in literature, suggest that vascular events are not a diagnostic handle to differentiate patients with the p.(Arg312Cys) COL1A1 mutation from those with COL5A1 and COL5A2 defects, and highlight that during the diagnostic process the presence of at least the p.(Arg312Cys) substitution in COL1A1 should be investigated in cEDS patients without type V collagen mutations. Nevertheless, for these patients, as well as for those affected with cEDS, a periodical vascular surveillance should be carried out together with cardiovascular risk factors monitoring. © 2016 Wiley Periodicals, Inc.

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A case for cannabidiol in Wolf–Hirschhorn syndrome seizure management

Complex, and sometimes intractable, seizures affect the quality of life and cognitive development of over 90% of individuals with Wolf–Hirschhorn syndrome (WHS). Fine resolution genotype–phenotype mapping of the WHS locus recently identified a candidate gene whose probable function has led to insights into a mechanism connecting WHS seizures with those of Dravet syndrome, a distinct condition caused by mutations in SCN1A and SCN1B. In addition to this possible molecular mechanistic connection, these disorders' seizures share a strikingly similar constellation of features, including clinical presentation, seizure types, early age of onset, EEG pattern, and responses to specific anti-epileptic drugs. Based in part on these similarities, we suggest that a highly successful Phase III clinical trial of a formulation of cannabidiol for Dravet syndrome seizures may be directly translatable into possible benefits for WHS individuals with challenging seizure patterns. © 2016 Wiley Periodicals, Inc.

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Six uneventful pregnancy outcomes in an extended vascular Ehlers–Danlos syndrome family

Vascular Ehlers–Danlos Syndrome (vEDS) is caused by heterozygous mutations in COL3A1 and is characterized by fragile vasculature and hollow organs, with a high risk of catastrophic events at a young age. During pregnancy and delivery, maternal mortality rates up until 25% have been reported. However, recent pedigree analysis reported a substantial lower pregnancy-related mortality rate of 4.9%. Here, we describe an extended vEDS family with multiple uneventful pregnancy outcomes. In the proband, a 37-year-old woman, DNA-analysis because of an asymptomatic iliac artery dissection revealed a pathogenic mutation in COL3A1 (c.980G>A; p. Gly327Asp). She had had three uneventful vaginal deliveries. At the time of diagnosis, her 33-year-old niece was 25 weeks pregnant. She had had one uneventful vaginal delivery. Targeted DNA-analysis revealed that she was carrier of the COL3A1 mutation. Ultrasound detected an aneurysm in the abdominal aorta with likely a dissection. An uneventful elective cesarean section was performed at a gestational age of 37 weeks. The 40-year-old sister of our proband had had one uneventful vaginal delivery and an active pregnancy wish. Cascade DNA-screening showed her to carry the COL3A1 mutation. Computed Tomography Angiography (CTA) of her aorta revealed a type B dissection with the most proximal entry tear just below the superior mesenteric artery. Pregnancy was therefore discouraged. This familial case illustrates the complexity and challenges of reproductive decision-making in a potentially lethal condition as vEDS, and highlights the importance of a multidisciplinary approach. Moreover, it suggests that previous pregnancy-related risks of vEDS may be overestimated. © 2016 Wiley Periodicals, Inc.

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ORAL LICHEN PLANUS: AN UPDATE

2016-11-07T02-16-15Z
Source: International Journal of Current Research and Review
Md. Asad Iqubal, Mobeen Khan, Umesh Chandra Chaudhary, Swetarchi, Bushra Farhat, Nazish Akhtar.
Lichen planus is a mucocutaneous disease affecting approximately 1.5 to 2% of the world population. Oral lichen planus (OLP) is a chronic mucosal condition. It has various oral manifestations, the reticular form being the most common. The course of the disease is usually unpredictable with bouts of remission and exacerbation being common. The most widely accepted treatment for lesions of OLP involves topical or systemic corticosteroids to modulate the patients immune response.


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A STUDY OF NEONATAL HYPERBILIRUBINEMIA IN A TERTIARY CARE HOSPITAL IN THE NORTH EASTERN REGION OF INDIA

2016-11-07T02-16-15Z
Source: International Journal of Current Research and Review
Sungdirenla Jamir, Arunkumar Singh Ngangom, Davina Hijam, Chubalemla Longkumer, Abhishek Dubey, M. Amuba Singh, Kh. Ibochouba Singh.
Neonatal jaundice is yellow colouration of the skin and the sclera of newborn babies due to accumulation of bilirubin. This is associated with hyperbilirubinaemia, a condition where bilirubin level is raised in the circulation. Objectives: To assess the etiological factors of neonatal hyperbilirubinemia and therapeutic interventions in a tertiary care hospital in the north eastern region of India. Methods: A prospective cohort study was carried out in the Department of Biochemistry, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur for a period of two years. One hundred fifty newborns with jaundice aged up to 28 days, both term and preterm were included in this study. Careful clinical assessments were done to assess the possible etiologies. Serum bilirubin was determined by colorimetric method as described by Jendrassik and Grof [12]. Monitoring of serum bilirubin was done by serial measurements once a day in the morning. Results: Significant hyperbilirubinemia (TSB>15mg %) was seen in 58 (38.7%) neonates while 92 (61.3%) had TSB


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A STUDY TO EVALUATE DEPRESSION, ANXIETY AND STRESS AMONG UNDERGRADUATE PHYSIOTHERAPY STUDENTS - AN INSTITUTION BASED PILOT STUDY

2016-11-07T02-16-15Z
Source: International Journal of Current Research and Review
Tarpan Shah, Megha D. Patel, Hiral Shah.
Introduction: At colleges nationwide, large percentage of college students are feeling overwhelmed, sad, hopelessness and so depressed that they are unable to function well. It is seen that Anxiety disorders affect a lot to adults every year, and its levels among college students have been rising since long. The objective of the present study was to explore the severity of depression, anxiety and stress among undergraduate physiotherapy students. Methodology: 246 undergraduate physiotherapy students from one institute have been selected for the study purpose .Questionnaire based survey study was done. A DASS 21 questionnaire was given to the students and the aim of the study was explain to them. Duly completed forms were taken away for research study purpose. Result: Among all of total 246 students; Depression-145 were reported under normal category, 52 of them in mild, 35 in moderate level, 10 in severe category and 4 had fallen in the extremely severe category. The Anxiety scale reported 125 in normal, 34 in mild, 49 in moderate level, 20 in severe and 18 of them have been under extremely severe category. The study reported 159 normal cases for Stress scale, 35 were in mild, 31 in moderate, 20 in severe and 1 case in extremely severe score. Conclusion: Present study revealed maximum number of students in the normal category and some students in raised level of anxiety and stress among undergraduate Physiotherapy students. Discussion: Consequently it is advised that the institute should take appropriate steps for reducing the level of depression and stress by undertaking counseling of the students and help them to cope up with their difficulties up to the institutional limit.


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PREVALENCE AND CHARACTERISTICS OF PERIPHERAL RETINAL DEGENERATION IN MYOPIC INDIAN ADULTS

2016-11-07T02-16-15Z
Source: International Journal of Current Research and Review
Nutan Bedi, Sharda Punjabi.
Objective: To evaluate the relationship between peripheral retinal lesions and axial length of the myopic patients. Material and Methods: A sample of 360 eyes from 224 myopic patients was examined at eye out patient department of tertiary care hospital from July 2008 to March 2010. Sonography was used for measurement of axial length of Eye ball and peripheral retina was studied by indirect ophthalmoscope examination and slit lamp microscopy. Chi square test for these qualitative variables with 5% significance was used for statistical analysis. Results: The average age was 45.32±11.34 years and the myopia was between 0.5 and 20 dioptres. The peripheral retina showed benign changes including pigment clumps in 128 eyes (35.55%), paving stone degeneration in 102 eyes (28.33%). Snowflakes degenerations were present in 40 eyes (11.11%) and white without pressure degeneration was found in 18 eyes (5%) of patients While 36 eyes (10%) of patients had lattice degeneration, and only 36(10%) patients had normal peripheral retina. Conclusions: Myopia is a pathological condition associated with peripheral retinal lesions and it can also predispose to various retinal disorders, so it important to diagnose early and treat these patients so that future complications can be minimize.


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CLINICOPATHOLOGICAL AND IMMUNOPHENOTYPIC CHARACTERISTICS OF EWINGS SARCOMA FAMILY OF TUMORS: SPECIAL EMPHASIS ON ROLE OF FRIEND LEUKEMIA INTEGRATION - 1(FLI-1) ANTIBODY AND OCCURRENCE OF TUMOR ON RARE SITES

2016-11-07T02-16-15Z
Source: International Journal of Current Research and Review
Alka Mittal, Jayanti Mehta, Kalpana Mangal, Alpana Jain, Neetu Agarwal, Madan Kumar Solanki.
Objective: Ewings sarcoma /Primitive neuroectodermal tumor (ES/PNET) is one of the aggressive malignant round cell tumors affecting mainly children and adolescents. This study aimed to emphasize the role of FLI-1 antibody along with CD99 in diagnosing ES/PNET and to keep this tumor in differential diagnosis even at some rare sites. Material and Method: This descriptive and retrospective study was conducted from January 2014 May 2016 and included 58 patients of ES/PNET. Histopathological and IHC findings were reviewed and the diagnosis of ES/PNET was confirmed. The tumors were further categorized into classic Ewings, PNET and atypical subtypes. Panel of IHC markers included vimentin, CD99, FLI-1, PanCK, LCA, Desmin, Myogenin, NSE, Synaptophysin, S100 and Chromogranin. Results: Clinical Findings- We studied 58 patients of ES / PNET of whom 63% (37/58) were males, 37% (21/58) were females. The age ranged between 3- 65 years (mean 20 years). Histological Findings: 57% of cases (33/58) exhibited classic morphology, 40% (23/58) were classified as PNET. There were only two cases of atypical Ewings sarcoma including large cell and Clear cell variant. Immunohistochemical Findings: Strong membranous CD99 expression was seen in 100%, FLI -1 nuclear staining in 85% , NSE in 50%, S100 in 30%, Synaptophysin in 10% and EMA in 2% (1/58) cases. All other markers included in the panel were negative. Tumor on Rare Sites: 10 Cases were of primary extradural spinal PNET, 1 intramedullary spinal, 2 brain parenchyma, 2 nose & nasopharynx , and one rare case of urinary bladder. Conclusion: Clinical details, histomorphology and IHC includingCD99 and monoclonal FLI-1antibodies may help in supporting diagnosis of EFT if cytogenetic and FISH techniques are not available at any centre.


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AUDITORY PLASTICITY AND COCHLEAR IMPLANTS IN CHILDREN- A REVIEW

2016-11-07T02-16-15Z
Source: International Journal of Current Research and Review
Muhammed Ayas, Hakam Yaseen, Ahmed Munzer Alwaa.
Aim: The review article is aimed at highlighting the importance of Auditory Plasticity for the positive outcomes in cochlear implantation, which is intrinsic to the critical age period. Method: Various electronic databases such as PubMed/ Medline, Science Direct, CINHAL etc. were used to extract the articles. The keywords used for the search engine were auditory plasticity, deprivation, and cortical re organization, cochlear implants. Discussion: The current review suggests that auditory plasticity is important in achieving proper wiring of acoustic sensation in the congenial hearing loss cases. Critical age period for the intake of new information and learning occurs before 3.5 years of age and post critical period the language learning is delayed. Conclusion: Auditory plasticity and its related functions are critical in influencing the outcome after the CI in children. The advent of electrophysiology into clinical research has paved a path breaking journey in understanding the complex processing of auditory signals in the primary and secondary cortical areas.


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INCIDENCE OF VARIOUS FUNGAL SPECIES IN OCULAR INFECTIONS

2016-11-07T02-16-15Z
Source: International Journal of Current Research and Review
Amrita Bajpai, Rajesh Bareja, Munesh Sharma, Vashishth Mishra, Hiba Sami.
Background: The fungi are significant pathogens causing ocular infections due to their frequent involvement and difficulty in establishing definitive diagnosis. The present study was aimed to detect various fungal and bacterial agents that can cause ocular infections. Material & Methods: An ophthalmologist collected the corneal scrapping that was smeared onto two slides and stained with Grams stain and mounted with 10% KOH (potassium hydroxide) for microscopic examination. Material collected was inoculated directly onto 5% sheeps blood agar in the form of C streak, Sabouraud dextrose agar (SDA), and sent to the Microbiology department for further processing and identification of causative agent. Results: Out of three hundred and sixty samples, ten cases were found to be fungal culture positive. Aspergillus species were accounting for 40% cases followed by Curvularia species (30%), Alternaria species (1%), Fusarium species (1%) and Scytalidium dimidiatum (1%). Conclusion: Fungal infection is a life threatening condition, which needs early diagnosis and treatment to save the patients eye.


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Functional outcome and result of intra-articular injection hyaluronic acid in treatment of osteoarthritis of knee

2016-11-07T01-40-29Z
Source: International Journal of Research in Medical Sciences
Deepak Chaudhary, Yasir Ali Khan.
Background: Osteoarthritis (OA) is the most common disease of joints in adults around the world. Worldwide, it is estimated to be the fourth leading cause of disability. Objective of the study was to assess functional outcome and results of injection of hyaluronic acid in symptomatic osteoarthritis knee. Methods: It was a prospective clinical study with 3 months of follow-up. Clinically proven sixty patients of osteoarthritis knee (OA) included in study according to inclusion and exclusion criteria on OPD basis after getting written and informed consent, treated by weekly intra articular injection of Hyaluronic acid (20 mcg/2ml) in affected knee joint for 5 weeks by single author . Functional outcome and clinical assessment was done by pain at visual analogue score (VAS) and by knee range of movements, patients global assessment of treatment and physician global assessment of treatment. The occurrences of adverse events were also assessed at 3 month. Results: Sixty patients participated in study and reported statistically significant improvement in VAS score in mild and moderate osteoarthritis of knee from 4.46±0.52 and 6.57±0.72 points respectively pre-treatment level to 2.26±0.43 and 4.36±0.24 points respectively at three months post Hyaluronic acid injection follow up, improvement in joint tenderness and patients & physicians global assessment score also improved significantly clinically as well as statistically in mild to moderate group while in severe group no clinical and statistically significant improvement was observed in any parameters, change in range of motion at three months was not significant in any group. Conclusions: Visco-supplementation with intra articular injection hyaluronic acid should be considered as safe and effective modality of treatment in selected group of mild to moderate osteoarthritis before mechanical changes takes place and patient complies with regular exercise, weight control and postural habits.


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A randomized control trial: effect of tranexamic acid on the need of post-operative blood transfusion following total hip replacement surgery

2016-11-07T01-40-29Z
Source: International Journal of Research in Medical Sciences
Deepak Chaudhary, Yasir Ali Khan.
Background: Total hip replacement surgery is one of the most advanced and technically demanding surgeries in orthopaedics in which blood loss is inevitable. Most of the patients are elderly with multiple co morbidities and the estimated one-year mortality is about 25%. Objective of the study was to assess the need of post-operative blood transfusion in total hip replacement surgery in patients given tranexamic acid versus control. Methods: It was a randomized controlled trial. Hundred patients of both sexes undergoing total hip replacement surgery included in study according to inclusion and exclusion criteria after getting written and informed consent. Equal patients 50-50 (50%) divided in two groups tranexamic acid group and control group based on a computer-generated random number table. The tranexamic acid group received two doses of 10mg/kg body weight of tranexamic acid just before surgery and two hours later intravenously. The control group received two doses of 10mg/kg body weight of normal saline at similar intervals. Numbers of blood transfusions required postoperatively were noted based on the postoperative haemoglobin readings. Results: Mean post-op haemoglobin for the tranexamic acid group was 10.4±2.6 g/dl and for the control group it was 8.6±2.4 g/dl (p=0.007). Eight patients (16%) in intervention group required blood transfusion compared to 22 (44%) in control group (p=0.009). The relative risk (RR) for transfusion was 0.51 when TXA was administered compared to when placebo was administered. Conclusions: Perioperative tranexamic acid is a safe and useful method of reducing intra op bleeding and need of post-operative blood transfusion postoperatively in THR patients.


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Retinoblastoma – pattern, presentation and management: a quintessential experience of 5 years

2016-11-07T01-40-29Z
Source: International Journal of Research in Medical Sciences
Anvesh Karthik Yalavarthy, Manjunath I. Nandennavar, Shashidhar V. Karpurmath.
Background: Retinoblastoma (RB) is the most common intraocular malignancy of childhood. It accounts for 10-15% of cancers that occur in infants. Objective of the study was to determine the pattern, presentation and management of Retinoblastoma (RB) patients at a tertiary cancer care center in South India, during a period of 5 years (1st November 2009 to 1st December 2014). Methods: This study was a retrospective analysis of the medical records of patients diagnosed as having retinoblastoma obtained from hospital information system and our cancer registry. Data sought was demographic characteristics, clinical presentation, investigations done, the methods of management and the treatment outcome of retinoblastoma patients. Results: Total number of cases studied was 31 and total number of eyes studied was 47. Out of 31 cases, 58% were female. 52% had bilateral involvement. The median age at presentation was 24 months. The commonest mode of presentation was leukocoria (55%) followed by proptosis (22%). Out of 47 eyes studied, 87% were advanced tumours belonging to Group D or Group E. Metastasis to the central nervous system was noted in 22.6% patients belonging to either Group D or Group E. Out of the 31 patients, 64.6% patients underwent enucleation. 6 out of 31 cases succumbed to death. Conclusions: Retinoblastoma continues to be a challenge in developing countries. Lack of awareness and inaccessibility to proper healthcare facilities are major stumbling blocks in achieving high cure rates. Educating the public and healthcare professionals, importance of early diagnosis and prompt referral are vital in reducing morbidity and mortality associated with the disease.


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The origin and evolution of cell types

Nature Reviews Genetics. doi:10.1038/nrg.2016.127

Authors: Detlev Arendt, Jacob M. Musser, Clare V. H. Baker, Aviv Bergman, Connie Cepko, Douglas H. Erwin, Mihaela Pavlicev, Gerhard Schlosser, Stefanie Widder, Manfred D. Laubichler & Günter P. Wagner

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Does preoperative bowel preparation reduce surgical site infections during elective ventral hernia repair?

Journal of the American College of Surgeons

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Endoscopic and clinical responses to anti-tubercular therapy can differentiate intestinal tuberculosis from Crohn's disease

Alimentary Pharmacology and Therapeutics

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Comparison of two-dimensional shear wave elastography and real-time tissue elastography for assessing liver fibrosis in chronic hepatitis B

Digestive Diseases

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Trichotillomania in celiac disease

Case Reports in Gastroenterology

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Tremelimumab in combination with ablation in patients with advanced hepatocellular carcinoma

Journal of Hepatology

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Non-contrast-enhanced MR hepatic arteriography with time-spatial labeling inversion pulses: Comparison of imaging with flow-in and modified flow-out methods

Acta Radiologica

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Geriatric factors analyses from FFCD 2001-02 phase III study of first-line chemotherapy for elderly metastatic colorectal cancer patients

European Journal of Cancer

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Salt-inducible kinase 2 and -3 are downregulated in adipose tissue from obese or insulin-resistant individuals: Implications for insulin signalling and glucose uptake in human adipocytes

Diabetologia - Clinical and Experimental Diabetes and Metabolism

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Do directly acting antiviral agents for HCV increase the risk of hepatic decompensation and decline in renal function? Results from ERCHIVES

Alimentary Pharmacology and Therapeutics

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Interstitial pneumonia in a patient treated with TAS-102 for metastatic colorectal cancer: A case report

Journal of Medical Case Reports

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EGFR gene copy number predicts response to anti-EGFR treatment in RAS wild type and RAS/BRAF/PIK3CA wild type metastatic colorectal cancer

International Journal of Cancer

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Single-site laparoscopic percutaneous extraperitoneal closure of the internal ring using an epidural and spinal needle: Excellent results in 1464 children with inguinal hernia/hydrocele

Surgical Endoscopy

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Meta-analysis of invagination and duct-to-mucosa pancreaticojejunostomy after pancreaticoduodenectomy: An update

International Journal of Surgery

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Clinicopathologic profile, immunophenotype, and genotype of CD274 (PD-L1)-positive colorectal carcinomas

Modern Pathology

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Right lower transverse incision versus vertical transumbilical incision for laparoscopic specimen extraction in patients with left-sided colorectal cancer: A comparative study of two mini-laparotomy techniques

World Journal of Surgical Oncology

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Impact of a nationwide training program in minimally invasive distal pancreatectomy (LAELAPS)

Annals of Surgery

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The FOXD3/miR-214/MED19 axis suppresses tumour growth and metastasis in human colorectal cancer

British Journal of Cancer

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Thiamin, Pyridoxine, Vitamin D, and Carotene Deficiency in a Malnourished Patient Following Billroth II Gastrectomy

Nutrition in Clinical Practice

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Adverse effects of anastomotic leakage on local recurrence and survival after curative anterior resection for rectal cancer: A systematic review and meta-analysis

World Journal of Surgery

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Diffuse infiltrative hepatocellular carcinoma with portal vein tumor thrombosis completely cured by transcatheter arterial chemoembolization: Case report with 8-year follow-up

Case Reports in Gastroenterology

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Neonatal outcomes as per gestational age in late preterm births: a retrospective study

2016-11-07T00-10-25Z
Source: International Journal of Contemporary Pediatrics
Ankur Gupta, Soujanya B. S., Kamath K. Madhava.
Background: Late preterm infants (34 week to 36 week + 6 days of gestation) are physiologically immature and have limited compensatory responses to the extra-uterine environment. Aim of the study was to compare the incidence of neonatal complications of late preterm infants compared to those born at term gestation and admitted in neonatal intensive care unit in a tertiary care hospital in south India. Methods: We retrospectively analyzed late preterm deliveries reported in 24 months period. Late preterm were divided in 3 sub-groups according to gestational age at delivery: 34 week + 6 days, 35 week + 6 days, 36 week + 6 days of gestation. The incidence of major clinical complications was evaluated. Statistical analysis was performed by using the Z- test. All babies admitted from March 2014 to February 2016 were retrospectively studied. Results: Among late preterm deliveries 53% were admitted to the neonatal intensive care unit. Out of which 35% presented with neonatal jaundice, 27% Respiratory distress syndrome (RDS), and sepsis 18 % .The incidence of RDS, jaundice and sepsis was significantly higher at 34 0/6 and 35 0/6 weeks of gestation, compared to full-term infants. Finally, the incidence of jaundice and RDS results significantly higher in all the 3 subgroups of late preterm, in contrast to full term infants. Conclusions: Results demonstrated an increased risk of morbidity in the late preterm period in contrast with term infants. Results also displayed that the gestational age at delivery of late preterm can influence the risk of adverse neonatal outcomes


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