Study of Length of Umbilical Cord and Fetal Outcome: A Study of 1,000 Deliveries

Objective

To study the correlation of umbilical cord length with fetal parameters like Apgar score, sex, weight, and length, and its effect on labor outcome.

Design

Prospective study of 1,000 cases.

Setting

Government Hospital

Material and Method

Examination of umbilical cord was done for any loop around neck, trunk, etc; no. of loops of cord and positions; Knots of cord (True or false), any cord abnormalities. Fetal parameters recorded were sex, weight, and length of the newborn. Fetal outcome studied by Apgar score at 1 and 5 min.

Results

In our study, the cord length varied from 24 to 124 cm. The mean cord length was 63.86 cm (±15.69 cm). Maximum cases seen were in the group of cord length between 51 and 60 cm. Lower 5th percentile was considered as short cord and upper 5th percentile was considered as long cord. Short-cord group was associated with significantly higher (p < 0.05) incidence of LSCS cases. Cord length did not vary according to the weight, length, and sex of the baby. The incidence of all types of cord complications increases as the cord length increases (p < 0.001*). Nuchal cords had higher mean cord length than in cases without nuchal cords (p < 0.001). As the number of loops in a nuchal cord increases to more than two loops, the operative interference increases. The significance was tested by using a Chi-square test, and it was found to be statistically significant (p < 0.05). Nuchal cords were seen to be associated with more cases of fetal heart abnormalities (p < 0.001). There is higher incidence of variability in fetal heart rate with extremes of cord length (p < 0.001). The incidence of birth asphyxia was significantly more in long and short cords as compared to cords with normal cord length (p < 0.001).

Conclusion

The present study showed that the length of umbilical cord is variable; however, maximum number of cases had normal cord length. Cases which had short and long cords constituted abnormal cord length. These cases had higher incidence of cord complications, increased incidence of operative interference, intrapartum complications, increased fetal heart rate abnormalities, and more chances of birth asphyxia. But cord length did not vary according to the weight, length, and sex of the baby.     

Individuals with diabetes are at a higher risk of asthma in India: evidence from the National Family Health Survey-3

Asthma is a disease of the lung, and from previous studies, a decrement in lung function was observed in patients with diabetes. These results motivated us to study the prevalence of asthma among diabetics. In this study, we estimated the prevalence of asthma among men and women, and also investigated the risk factors for asthma in diabetic and non-diabetic groups in India. This analysis was based on the National Family Health Survey-3 (NFHS-3) data on 71,776 men aged 15–54 years and 115,642 non-pregnant women aged 15–49 years. X ² test was used to check the dependency of asthma with different socioeconomic, diet-, and lifestyle-related factors. Logistic regression analysis was used to identify the risk factors for asthma. There is significant (p?<?0.001) association between diabetes and asthma. Individuals with diabetes are at a higher risk of asthma as compared to those without diabetes. The results of the study revealed that among diabetic women and men, 14.1 and 12.8 % were asthmatic, respectively. In without diabetes group, the prevalence of asthma in men and women was 1.7 and 1.6 %, respectively. Men with diabetes were 8.691 times (95 % CI: 7.154–10.558) and women with diabetes were 10.106 times (95 % CI: 8.455–12.08) more likely to have asthma than those without diabetes. Occasional/never consumption of fish, use of unclean fuel, lower age level, and not living with a partner were significantly (p?<?0.05) associated with the higher risk of asthma among diabetics.     

A Chemosensitizer Drug: Disulfiram Prevents Doxorubicin-Induced Cardiac Dysfunction and Oxidative Stress in Rats

In the present study, the preventive effects of orally administered disulfiram (DS) against the doxorubicin (DOX)-induced cardiotoxicity were investigated in rats. DS was orally administered for 7 days at doses of 2, 10, and 50 mg/kg/day. DOX (30 mg/kg) was intraperitoneally administered on the 5th day of the initiation of DS treatment. Within 48 h of injection, DOX treatment significantly altered ECG, elevated the ST height, and increased the QT and QRS intervals. It reduced the cardiac levels of injury markers like creatine kinase isoenzyme-MB and lactate dehydrogenase. DOX elevated the serum levels of SGOT and nitric oxide. Its injection significantly induced lipid peroxidation in the cardiac tissue and reduced the activities of innate antioxidants like super oxide dismutase, catalase, and reduced glutathione in the cardiac tissue. DOX treatment raised the TNF-α level and caused histological alterations in the myocardium like neutrophil infiltrations, myonecrosis, and edema. Pre-treatment of rats with DS (2, 10, and 50 mg/kg p. o. for 7 days) prevented the ECG changes, minimized oxidative stress, and normalized the biochemical indicators of the DOX-induced cardiotoxicity. DS also protected rat heart from DOX-induced histological alterations. Recently, DS is reported to exert chemosensitization of cancer cells. Our in vitro investigation using MCF7 cell line revealed that DS reverses the DOX-induced suppression of NF-κB and Nrf2 expression. These findings about the protective activity of DS against the DOX-induced cardiotoxicity warrant a detailed investigation on its utility as an adjunct therapy to cancer chemotherapy.     

Innovative Approach to a Frozen Calot’s Triangle During Laparoscopic Cholecystectomy

The laparoscopic cholecystectomy is now the “gold standard.” In around 2 % of cases, there is a need to convert because of the difficult dissection encountered in the Calot’s Triangle, a “frozen Calot’s triangle.” There is no consensus among surgeons about how to tackle this situation. To lower the conversion rate, there is a continuous attempt made to innovate. The authors present their rationale and experience in 100 difficult cases by creating a retro-gallbladder tunnel and encircling the gallbladder by a gauze for maneuvering.     

Marine natural products as source of new drugs: a patent review (2015–2018)

Introduction: Natural products from plants, animals, microbes, and minerals have long been a traditional source for the treatment of human diseases. In the past decades, research on natural products for the pharmaceutical industry had declined due to numerous challenges. However, the recent developments in analytical technology, spectroscopy, and high-throughput screening have tremendously revived natural product drug discovery, including contribution from marine-based drugs. The marine environment is a unique resource enclosing a massive biological diversity, which if genuinely explored might potentially lead to breakthrough therapies. A growing number of compounds from marine sources are entering clinical trials and thus, the impact of this field on the pharmaceutical industry is increasing.

Areas covered: This review summarizes the progress in the field of marine natural products as therapeutic agents based on an analysis of the patents published in the period January 2015 through June 2018.

Expert opinion: Marine organisms are excellent producers of natural chemicals with diverse structures and pharmacological activities. Cumulative increase in the number of patents published in the last few years clearly justifies the importance of these chemicals as sources of new therapeutic agents and this study. Despite the critical supply challenges, marine-derived actives are being explored as sources for anticancer, antimicrobial, antiviral and anti-inflammatory drugs and treatments for several other conditions.     

CD8 + T Cells Exhibit an Exhausted Phenotype in Hemophagocytic Lymphohistiocytosis

Journal of Clinical Immunology - Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome mainly caused by uncontrolled activation of antigen presenting cells and CD8 T cells. CD8 T...     

Effect of Deep Cryogenic Treatment on Corrosion Behavior of AISI H13 Die Steel

AISI H13 die steel specimens were subjected to heating at 1020 °C followed by oil quenching and double tempering at 520 °C. Subsequently, these specimens were subjected to deep cryogenic treatment at −185 °C in liquid nitrogen environment for 16 h and then subjected to soft tempering at 100 °C once the specimens attained room temperature. Thereafter, the specimens were subjected to scanning electron microscopy (SEM) analysis and electron backscatter diffraction (EBSD) analysis. The electrochemical corrosion activity was investigated in 3.5% NaCl at 23 ± 0.5 °C by evaluating the evolution of open circuit potential over time and potentiodynamic curves, and electrochemical impedance spectroscopy study was also carried out. The heat-treated specimens exhibited better resistance to corrosion through more electropositive values of open circuit potential. This could be attributed to lower grain boundary area in heat-treated specimens as compared to 16 h cryogenically treated specimen as higher grain boundary areas behave as an anode in an electrochemical cell, thereby enhancing the rate of corrosion. According to electrochemical tests, the cryogenically treated surface is more resistant to corrosion, followed by heated alloy. However, both surface modification treatments improved the corrosion behavior of the untreated alloy.     

Docosahexaenoic acid–mediated,targeted and sustained brain delivery of curcumin microemulsion

We disclose microemulsions (ME) of curcumin (CUR) with docosahexaenoic acid (DHA)-rich oil (CUR DHA ME) for targeted delivery to the brain. MEs of CUR (5?mg/mL) with and without DHA-rich oil (CUR Capmul ME) suitable for intravenous and intranasal administration exhibited negative zeta potential, globule size <20?nm and good stability. Following intravenous delivery MEs exhibited high brain concentration with CUR DHA ME exhibiting a 2.8-fold higher C_max than CUR solution. Furthermore, high and sustained concentration was demonstrated even at 24?h, which was 8- and 2-fold higher than CUR solution and CUR Capmul ME, respectively. Brain concentrations following intranasal administration were, however, substantially higher as evident from higher C_max and AUC and sustained compared to corresponding intravenous formulations signifying nose to brain targeting. The high brain concentration of CUR DHA ME is ascribed to the targeting efficiency enabled by DHA-mediated transport across the blood–brain barrier (BBB). Histopathological and nasal toxicity confirmed safety of the MEs. Concentration-dependent cytotoxicity in vitro, on human glioblastoma U-87MG cell line was observed with CUR DHA MEs and with the blank DHA ME, implying anticancer potential of DHA. The dramatically low IC₅₀ value of CUR DHA ME (3.755?±?0.24?ng/mL) is therefore attributed to the synergistic effect of CUR and DHA in the ME. The CUR concentration achieved with CUR DHA ME at 24 h which translated to >66-fold(intranasal) and >21–fold (intravenous) the IC₅₀ value in the U-87MG cell line suggests great promise of CUR DHA ME for therapy of brain cancer by both routes.