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Introduction:Performing elective caesarean section prior to 39 completed weeks,it can lead to breathing problems in neonates as compare to those, who are born through caesarean section without antenatal Corticosteroid. WHO recommends the administration of intramuscular corticosteroids either dexamethasone or betamethason (total 24mg in divided doses) in the antenatal period, when there is a risk of preterm birth. The advantages and disadvantages of a similar regimen given after 37 weeksof pregnancy prior to elective caesarean section (LSCS) to prevent respiratory morbidity in a newborn is yet a topic of discussion.In Pakistan still,many clinicians are doing caesarean section at 37 or 38 weeks without antenatal Corticosteroids. The rationale is to emphasize the use of steroidsbefore caesareanat 39 weeks. Objective:To compare neonatal respiratory distress in neonates delivered between 37 --38+6 weeks of gestation by elective caesarean section with and without antenatal Corticosteroid. Study design:Randomized controlled trial. Setting:Department of Gynae & Obstetrics, unit 2, Shalamar Hospital, Lahore. Duration:Six months from 12th September 2018 to 12th March 2019. Materials and Methods:The study included women who were, planned for elective LSCS at 37-38+6 weeks, divided into two groups .The sample size was 140 (70 in each group),recruited by non-probability consécutive sampling. Inclusion criteria were singleton pregnancy, at 37 to 38+6 weeks for elective LSCS due to indications like primi breech, previous caesarian scar/scars, and maternal wish. All eligible participants were allocated to one of the following groups. Group (A) received an injection of dexamethasone 48 to 72 hours before elective LSCS. Group (B), did not receive an injection of dexamethasone. The outcome to be measuredinthis study were the Apgar score at 1& 5 minutes, the incidence of transient tachpnea of the neonate (TTN) and respiratory distress syndrome (RDS) in newborns,and the need for mechanical ventilation among neonates from two different groups. The data was collected and analyzed by SPSS version 20.Descriptive statistic were applied to calculate the mean and SD for age, gestation age & BMI. Student T-test was used to compare the continuous outcome measures. Neonatal respiratory morbidity was compared in two groups by using the chi-square test at the level of significance of 0.05.Results:Mean age in Group-A was 28.12± 5.6 and in Group-B was 28.97± 6.3 years. There was no statistically significant difference in these groups in termsof Body mass index, gestational age at the time of delivery, age of mother, birth weight, Apgar score at 1 and 5 min,and indications for cesarean section. Neonatal respiratory morbidity was higher in Group-B as compared to Group-A (30% vs.12.9%)p-value-0.013. Conclusion:Antenatal dexamethasone administration significantly reduces the respiratory morbidity among neonates delivered at 37 to 38+6by elective cesarean section. But further studies are required to assess the beneficial role of dexamethasone in the reduction of neonatal respiratory morbidity with a large sample size.Keywords:Neonatal respiratory morbidity, transient tachypnea of newborn, elective caesarean section, antenatal corticosteroids.

The purpose of this study is to investigate the behavior of charged stellar structures in the f (R , ϕ) theory of gravity, where R denotes the Ricci scalar and ϕ represents the scalar potential, respectively. For our current analysis, we consider Krori–Barua metrics to discuss the spherically symmetric solutions in f (R , ϕ) gravity. We further develop some matching conditions between the spherically symmetric spacetime as interior geometry with Reissner–Nordstrom as exterior geometry. Moreover, we consider the observational data of three distinct stars namely Vela X − 1 , SAX J 1 8 0 8. 4 − 3 6 5 8 and 4 U 1 8 2 0 − 3 0 for present work. We investigate the behavior of energy density, radial pressure, tangential pressure, anisotropic parameter, equation of state parameters, equilibrium condition, sound speeds, Abreu's criteria, adiabatic index and energy conditions respectively. Moreover, we investigate some other properties of the stellar structures including mass-radius relation, compactness factor, and surface redshift. Our investigation reveals that the observed anisotropic findings are physically appropriate and have the highest level of precision in the background of f (R , ϕ) modified theory of gravity. [ABSTRACT FROM AUTHOR]

Introduction: Glaucoma is one of the leading cause of irreversible blindness worldwide. Among the affected ones, approximately 50% are not aware of it, because of its asymptomatic nature, especially in the early stages. Ripasudil Hydrochloride Hydrate is a novel drug, being the Rho-associated coiled-coil- containing protein kinase (ROCK) inhibitor eye drop that increases conventional aqueous outflow through the trabecular meshwork and Schlemm’s canal and thus lowers the intraocular pressure. Material and Methods: This prospective study included the first 150 consecutive eyes in patients of uncontrolled glaucoma with IOP > 21 mmHg despite maximal topical anti-glaucoma medications in at least one eye and aged eighteen or above. The patients with neovascular glaucoma, closed or barely open anterior chamber angle or with history of ocular surgery including refractive surgery were excluded. The purpose and nature of the study were explained in detail, and informed consent was obtained from all patients. Results: This study included 115 patients with 150 affected eyes. The mean age of patients in this series was 43.6 years with a range of 24-73 years. Right eye was affected in 47, left in 33 patients and the remaining 35 patients had bilateral involvement. The mean pachymetry was 521.13 μm in right eye and 523.53 μm in left eye and the mean cup disc ratio was 0.8 and 0.7 in right and left eye respectively. The mean baseline intraocular pressure in our series was 18.60 mmHg +- 7.60 mmHg. The mean IOP at six month follow up visit (final follow-up) was 11.83mmHg +- 4.45, which was statistically significant. The mean reductions in IOP at one month was 12.64mmHg, at 3 months follow up 12.07mmHg. Conclusion: The results of our study implies that ripasudil is a favourable anti glaucoma drug that can lower intraocular pressure. The additive pressure lowering effects of ripasudil in addition to existing maximal therapy can be because of different mechanism of action, it can delay or evade surgery in glaucoma. Transient conjunctival hyperaemia, not necessitating discontinuation was the most common complication in this series. [ABSTRACT FROM AUTHOR]

Fe+3- and Fe+2-enriched magnetic composites were prepared using mango seed shell-based biomass (MSS-biomass) and characterised by SEM, FTIR and TGA. Magnetic property employed best for the adsorption of 2, 4, 6 trichloro-phenol from wastewater. The performance of magnetic composites along native biomass was investigated in batch mode. Optimum values of parameters that were found from batch experiments are pH5, temperature, 35°C (BN) and 55°C (BMc), adsorbent dose 0.05 g, concentration of pollutants 35 mg/L and contact time 120 min. Doubinin-Radushkevich and Langmuir isotherms found best-fitted on experimental data with correlation values (R2 0.938 and 0.986) for MSS andBMc, respectively, along other four equilibrium models, kinetic study revealed pseudo-second-order kinetic model as best-fitted one on the experimental data of both adsorbents. Similarly, thermodynamic parameters were also calculated from experimental results. Efficiency of adsorbents in the presence of heavy metal ions and electrolytes was examined at optimum experimental conditions. Reliability and re-usability of magnetic composites in comparison with the native MSS-biomass were investigated in desorption experiments. About 68% and 81% of 2,4,6-TCP was recovered from BN and BMc respectively. Magnetic composites found more efficient (with qe 31.27 mg/g) as compared to MSS-biomass (with qe 23.55 mg/g) for the adsorption of 2,4,6-TCP from wastewater. Column study experiments were performed to check out the working of magnetic composites at pilot scale. Maximum uptake of 2,4,6-TCP were obtained as 16.65 mg/g onto 3-cm bed-height of adsorbent. Experimental data were also analysed by column study models; BDST and Thomas to compare the calculated and experimented values. [ABSTRACT FROM AUTHOR]