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Background: Pregnancy complicated with pulmonary artery hypertension (PAH), lies at increased risk of maternal and neonatal complications. Although studies have reported mortality rates of up to 56% associated with pregnancy in PAH, however, with a multidisciplinary approach including obstetrics, anesthesia, and cardiology, care in women with PAH has improved. It is necessary to investigate if such a modern multidisciplinary approach has led to a reduction in maternal mortality and has improved maternal and fetal outcomes. Aim: Our study evaluates maternal and fetal outcomes in pregnant women with PAH in a tertiary care setting in North Eastern India with a multidisciplinary approach. Materials and methods: This retrospective, hospital-based, time-bound study was done on 54 pregnancies complicated by PAH, over one and a half years. Patients were evaluated for the development of any cardiac complications like arrhythmia, congestive cardiac failure, thromboembolism, and atrial fibrillation. Maternal obstetric complications were evaluated like postpartum hemorrhage, anemia, and pregnancyinduced hypertension. Gestational age at delivery and mode of delivery were also noted. Fetal complications like preterm delivery, fetal growth restriction, intrauterine fetal death, and congenital cardiac disease were noted. Results: The mode of delivery was LSCS in the majority (77.7%), with the mean gestational age of delivery being 38 weeks and 5 days. On the assessment of PAH, the mild degree was seen in the majority of cases (55.6%), moderate PAH in around 29.6%, and a severe degree of PAH was seen in only 14.8% of cases. The majority of cardiac defects associated with PAH were congenital cardiac diseases in the form of ASD and VSD (68.5%). The majority of patients had spinal anesthesia (42.85%) during LSCS. General anesthesia was used in only 10 cases (23.8%). Preterm deliveries and fetal growth restriction were seen in around 14 and 33% of cases respectively, with no intrauterine fetal death. Cardiac complications occurred in 11% of cases and maternal obstetric complications occurred in 29.6% of cases. No maternal death was noted in the study group. On further analysis, it was seen that maternal complications were significantly higher among those with a higher degree of PAH (p = 0.006). Also, the baby's birth weight was significantly lower with an increase in the severity of PAH. On Bonferroni post hoc analysis, the association was between mild and severe PAH (p < 0.01) and between moderate and severe PAH (p = 0.016). Conclusion: Our study has shown no maternal mortality over a group of 54 pregnant women. This study thereby appraises the contribution of a multidisciplinary approach in the management of these patients. [ABSTRACT FROM AUTHOR]

Anaemia is a well‑known global health concern in the South Asian countries, and it is estimated that India has the utmost prevalence of anaemia and maternal deaths due to iron deficiency anaemia. This study aims to assess the efficacy and safety of intravenous ferric carboxymaltose (FCM) in antenatal women with anaemia in the second and third trimesters of pregnancy. Methods: A single‑arm prospective cohort (before–after) study among 60 antenatal women with moderate to severe anaemia in the second and third trimesters was conducted from December 2020 to December 2022, and the eligible women were given 1000 mg of intravenous FCM injection. Efficacy was assessed by rate of improvement in haemoglobin and ferritin at 2 weeks post infusion. Safety analysis was done by assessing adverse drug reactions and foetal heart monitoring during the infusion. Results: A total 60 antenatal women with a median gestational age of 32.5 weeks at presentation received 1000 mg of intravenous FCM. There was a rise in mean haemoglobin from 8.05 gm% pre‑infusion to 10.93 gm% 2 weeks post infusion, showing a mean rise of 2.88 gm%. Similar improvement was noted in mean serum ferritin levels from 25.92 pre‑infusion to 253.96 post FCM infusion. There were no reports of drug‑related major adverse effects in the mother or the foetus. Conclusions: FCM is found to be safe and effective treatment with rapid replenishment of haemoglobin and ferritin levels in a single dose, which makes it suitable and compels consideration as the first choice for treatment of iron‑deficiency anaemia. [ABSTRACT FROM AUTHOR]

Wireless-based sensing of physical environments has garnered tremendous attention recently, and its applications range from intruder detection to environmental occupancy monitoring. Wi-Fi is positioned as a particularly advantageous sensing medium, due to the ubiquity of Wi-Fi-enabled devices in a more connected world. Although Wi-Fi-based sensing using Channel State Information (CSI) has shown promise, existing sensing systems commonly configure dedicated transmitters to generate packets for sensing. These dedicated transmitters substantially increase the energy requirements of Wi-Fi sensing systems, and hence there is a need for understanding how ambient transmissions from nearby Wi-Fi devices can be leveraged instead. This paper explores the potential of Wi-Fi-based sensing using CSI derived from ambient transmissions of Wi-Fi devices. We demonstrate that CSI sensing accuracy is dependent on the underlying traffic type and the Wi-Fi transceiver architecture, and that control packets yield more robust CSI than payload packets. We also show that traffic containing upload data is more suitable for human occupancy counting, using the Probability Mass Function (PMF) of CSI. We further demonstrate that multiple spatially diverse streams of Wi-Fi CSI can be combined for sensing to an accuracy of 99 % . The experimental study highlights the importance of training Wi-Fi sensing systems for multiple transmission sources to improve accuracy. This research has significant implications for the development of energy-efficient Wi-Fi sensing solutions for a range of applications. [ABSTRACT FROM AUTHOR]

Background and Aim: Ectopic pregnancy (EP) is still one of the leading preventable causes of maternal morbidity and mortality in the first trimester. Amidst the use of sensitive assays for β-HCG and high-definition ultrasonography for the identification of EP, the search for a more reliable and sensitive marker remains a challenge till date. Our aim was to determine the validity of creatine phosphokinase (CPK) and its isoenzyme (CPK-MB) in the prediction of tubal EP. Materials and Methods: A prospective and comparative diagnostic accuracy study was conducted among 105 pregnant women in the first trimester who met the eligibility criteria in the Department of Obstetrics and Gynecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS). The study included 35 patients each with tubal EP (EP), abortive intrauterine pregnancy (AP), and normal intrauterine pregnancy (NP). CPK, CPK-MB, and β-HCG were measured among all the participants, and the participants were followed up longitudinally. Results: A total of 105 pregnant women were included. The mean CPK and CPK-MB levels were significantly higher among the women with EP when compared to NP (P < 0.05) and AP (P < 0.05) women; however, there was no significant difference between the NP and AP groups (P > 0.05). Moreover, the receiver operating characteristic (ROC) curve showed that both CPK and CPK-MB were good predictors of EP, with CPK (area under the curve [AUC] = 0.764) being a better predictor than CPK-MB (AUC: 0.650) in the diagnosis of EP. Conclusion: Early diagnosis of EP allows appropriate and timely management, which would not only reduce mortality and morbidity associated with the condition but also enable preservation of fertility and improve future pregnancy outcome. Hence, the need of the hour is a reliable biochemical diagnostic marker for EP, such as CPK. [ABSTRACT FROM AUTHOR]

We construct a universal epidemic curve for COVID-19 using the epidemic curves of eight nations that have reached saturation for the first phase and then fit an eight-degree polynomial that passes through the universal curve. We take India's epidemic curve up to January 1, 2021 and match it with the universal curve by minimizing square-root error between the model prediction and actual value. The constructed curve has been used to forecast epidemic evolution up to February 25, 2021. The predictions of our model and those of supermodel for India (Agrawal et al. in Indian J Med Res, 2020; Vidyasagar et al. in https://www.iith.ac.in/~m%5fvidyasagar/arXiv/Super-Model.pdf, 2020) are reasonably close to each other considering the uncertainties in data fitting. [ABSTRACT FROM AUTHOR]

The second wave of COVID-19, which began in India around 11 February 2021, has hit the country hard with daily cases reaching nearly triple the first peak value as on 19 April 2021. The epidemic evolution in India is complex due to regional inhomogeneities and the spread of several coronavirus mutants. In this study, we characterize the virus spread in the ongoing second wave in India and its states until 19 April 2021, and also examine the dynamic evolution of the epidemic from the beginning of the outbreak. Variations in the effective reproduction number (Rt) are taken as quantifiable measures of virus transmissibility. Rt value for every state, including those with large rural populations, is greater than the self-sustaining threshold of 1. An exponential fit on recent data also shows that the infection rate is much higher than in the first wave. Subsequently, characteristics of COVID-19 spread are analysed region-wise, by estimating test positivity rates (TPRs) and case fatality rates (CFRs). Very high TPR values for several states present an alarming situation. CFR values are lower than those in the first wave, but are recently showing signs of increase as the healthcare system is being over-stretched with the surge in infections. Preliminary estimates with a classical epidemiological model suggest that the peak for the second wave could occur around mid-May 2021, with daily count exceeding 0.4 million. The study strongly suggests that an effective administrative intervention is needed to arrest the rapid growth of the epidemic. [ABSTRACT FROM AUTHOR]

Objective: Adhesive capsulitis or frozen shoulder is a painful condition affecting up to 5% of the general population. We conducted this study with the aim of evaluating the results of physiotherapy plus intra-articular methylprednisolone injection versus physiotherapy alone in idiopathic frozen shoulder.Methods: This prospective clinical study was conducted in a tertiary care center between August 2016 and August 2018. Patients who were diagnosed with idiopathic frozen shoulder were included in the study, and each patient was randomly allocated to one of two groups: physiotherapy alone (group A) and physiotherapy plus intra-articular steroid injection (group B).Results: A total of 52 cases diagnosed with idiopathic frozen shoulder were included and treated with the two modalities. There was a significant improvement in group B compared to group A at 6 weeks and 3 months in the range of flexion, abduction, and external rotation. The Shoulder Pain and Disability Index showed improvement in both pain and disability score in group B -compared to group A, and improvement was significant at 6 weeks and 3 months.Conclusion: The results demonstrate the advantages of physiotherapy plus intra-articular steroid injection in idiopathic frozen shoulder. The predictability of results with physiotherapy plus intra-articular steroid injection in selected patients is excellent, and it is a better modality of treatment compared to physiotherapy alone. [ABSTRACT FROM AUTHOR]

The present study was conducted to identify the link between increased uric acid and osteoarthritis and to find out the prevalence of hyperuricemia in population suffering from osteoarthritis of knee. Material and Method: The study was conducted on 100 patients (male and female between the age of 40- 70 years) with knee pain for more than 6 weeks to establish a correlation between knee osteoarthritis and hyperuricemia. Result: In the current study female preponderance was seen. Mean age of the patients was 50.10 years and maximum patients were in the age group of 40-50 years. KOA patients had higher values of uric acid as compared to patients without KOA however no stastically significant relation was found between increasing uric acid levels and severity of KOA with p-value .668 being insignificant. The mean BMI of patients with KOA was higher than the patients without KOA but no statistical significant relation was found between increased incidence of KOA in females as compared to males with increasing BMI p-value 0.777 being insignificant. There was no statistically significant correlation between hyperuricemia and either gender with p-value being >.0.05 (0.119). VAS and WOMAC scoring was done at 0 and 16 weeks however no significant improvement was seen except for the pain component which improved in KOA patients. Conclusion: In this present study we observed increased prevalence of OA knee in females and in patients with hyperuricemia and also with patients with higher BMI. Serum levels of CRP and ESR also show positive prevalence in patients with KOA in this study. However, no s statistically significant correlation was observed between levels of hyperuricemia and severity of KOA. Hence in conclusion our study points towards positive correlation between hyperuricemia and KOA. Limitations of our study included inability to homogenise groups in terms of BMI, age, activity level, smoking, alcohol etc. [ABSTRACT FROM AUTHOR]

Introduction: In cases of infected Nonunion of long bones Antibiotic coated nail provides mechanical support for the affected bone with delivery of high concentration of antibiotics for infection control and a conclusive environment for fracture healing. The aim of the study was to observe and study the treatment of infected non-union of long bones with antibiotic coated nailing in infection control and bony union. Material and Method: The study was conducted on 30 patients (male and female between the age of 18‑70 years). All patient on admission were subjected to detailed history, relevant investigations and thorough clinical examinations. Minimum follow-up period was 6 months. Radiological and blood investigations were done for infection control and bony union. Result: In the current study of 30 patients with mean age of 43.67 years, Infection control and bony union was achieved in 27 patients without any need for subsequent procedures. Current study provides an alternative to external fixation alone as a means of stabilizing non-unions while providing a high concentration of antibiotic locally for combating this difficult problem. Conclusion: The clinical results and final outcome after antibiotic coated I.M. nailing in infected nonunion of long bones are both satisfactory and reproducible as evident by the comparison of this present study with the previous literature available. [ABSTRACT FROM AUTHOR]

Glioblastoma (GBM) is the most frequently diagnosed primary central nervous system tumor in adults. Despite the standard of care therapy, which includes surgical resection, temozolomide chemotherapy, radiation and the newly added tumor-treating fields, median survival remains only ∼20 months. Unfortunately, GBM has a ∼100% recurrence rate, but after recurrence there are no Food and Drug Administration-approved therapies to limit tumor growth and enhance patient survival, as these tumors are resistant to temozolomide (TMZ). Recently, our laboratory reported that lucanthone slows GBM by inhibiting autophagic flux through lysosome targeting and decreases the number of Olig2+ glioma stem-like cells (GSC) in vitro and in vivo. We now additionally report that lucanthone efficiently abates stemness in patient-derived GSC and reduces tumor microtube formation in GSC, an emerging hallmark of treatment resistance in GBM. In glioma tumors derived from cells with acquired resistance to TMZ, lucanthone retains the ability to perturb tumor growth, inhibits autophagy by targeting lysosomes, and reduces Olig2 positivity. We also find that lucanthone may act as an inhibitor of palmitoyl protein thioesterase 1. Our results suggest that lucanthone may function as a potential treatment option for GBM tumors that are not amenable to TMZ treatment. SIGNIFICANCE STATEMENT: We report that the antischistosome agent lucanthone impedes tumor growth in a preclinical model of temozolomide-resistant glioblastoma and reduces the numbers of stem-like glioma cells. In addition, it acts as an autophagy inhibitor, and its mechanism of action may be via inhibition of palmitoyl protein thioesterase 1. As there are no defined therapies approved for recurrent, TMZ-resistant tumor, lucanthone could emerge as a treatment for glioblastoma tumors that may not be amenable to TMZ both in the newly diagnosed and recurrent settings., (Copyright © 2024 by The American Society for Pharmacology and Experimental Therapeutics.)

We simulate Korteweg-de Vries (KdV) and dissipationless Burgers equations using δ-correlated random noise as an initial condition. We observe that the energy fluxes of the two equations remain zero throughout, thus, indicating their equilibrium nature. We characterize the equilibrium states using Gaussian probability distribution for the real space field, and using Boltzmann distribution for the modal energy. We show that the single soliton of the KdV equation too exhibits zero energy flux, hence, it is in equilibrium. We argue that the energy flux is a good measure for ascertaining whether a system is in equilibrium or not.

Introduction Fracture of the clavicle bone is a very common injury owing to its subcutaneous location. Controversy exists about the optimal treatment of midshaft clavicle fractures in the presence of significant displacement and comminution of the fracture. Traditionally, non-surgical management was considered the first treatment option for most clavicle fractures. However, recent evidence shows that the non-surgical option causes more complications than previously reported. The purpose of this study was to compare the clinical and radiological outcomes of conservative treatment and surgical treatment for midshaft clavicle fractures. Materials and methods A total of 45 patients meeting the inclusion criteria were included in this randomized study. The patients were allocated to two groups: conservative and operative on an alternate basis. Patients in the conservative group were managed with figure-of-eight bandage, whereas patients in the operative group were treated surgically by plate fixation. Primary outcome was recorded at six weeks, three months, six months, and 12 months follow-up using the Disabilities of the Arm, Shoulder, and Hand (DASH) and American Shoulder and Elbow Surgeons (ASES) scores. We also assessed patient's satisfaction after the treatment, fracture union, and complication rates among the study cohort. Results The ASES scores were significantly better in the operative group at three months and six months follow-up; however, at 12 months follow-up, there was no significant difference in the score between the groups. Although not statistically significant, the DASH score was better in the operative group than in the conservative group at all the follow-ups. This study showed that the time to union was lesser, rate of non-union was lower, and return to work was faster on the operative group. The mean satisfaction score in the operative and conservative groups was 4.16±0.76 and 4.05±1.24, respectively (p = 0.76). Conclusion This study suggests that open reduction and internal fixation with plate reduced the incidence of mal-union and non-union; however, surgical treatment showed no significant difference in the functional outcome as compared to conservative treatment., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Pathak et al.)

Introduction Various treatment options for patients with an intraarticular distal radius fracture are available, but in cases of comminuted fractures, these narrow down to either a volar locking plate, an external fixator, or a combination of these two. We conducted this prospective study to compare the external fixation and internal fixation of intraarticular fractures of the distal radius in terms of clinical/functional outcome and complications and with the available literature. Material and method This prospective randomized study consisted of a total number of 30 patients with intraarticular fractures of the distal end of the radius divided randomly into two groups (A and B), treated by external fixation (Group A) and volar plating (Group B), in a tertiary care institute during the study period. Result The most patients were males >50 years of age, with injury to the right dominant hand most commonly caused by a fall on an outstretched hand. As per the modified Green & O'Brien scoring system, the volar plating group showed the final result as excellent in two (13.33%), good in seven (46.6%), fair in four (26.6%), and poor in two (13.3%) whereas an excellent outcome was seen in one (6.66%), good and fair in five patients each (33.3%), and poor in four (26.66%) patients at the six months follow-up. Conclusion Overall, both fixation techniques seem to apply sufficient stabilization to restore function and retain anatomy; however, volar locking plates have certain advantages over external fixator in the early postop period in terms of earlier recovery and mobilization., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Sharma et al.)