Assessment of Indications and Complications of Caesarean Section in A Private Medical College Hospital of Bangladesh

Caesarean section (CS) is the most frequently performed major operation in obstetrics. Its frequency is gradually increasing because of extended indications. Now-a-days, caesarean section is also being performed at patient's request in absence of a medical indication. It is necessary to assess the risk and benefits to take a judicious decision to select cases for caesarean section. The cross sectional descriptive type of observational study was carried out among purposively selected 100 pregnant women admitted to the department of Obstetrics and Gynaecology of Community Based Medical College Hospital, Mymensingh, Bangladesh during the period of August 2011 to January 2012 to identify elective and emergency indications of caesarean section, to identify the common complications to identify the risk factors associated with complications and to establish a comparison between complications of elective and emergency caesarean section. The median age group of patients being operated was 20 to 25 years and operation were carried out on patients due to various indications. Principal indications were faetal distress (26%), PROM (15%), failed progress of labour and breech presentation were 8% each, other indications were eclampsia (4%), obstructed labour (5%), scar tenderness (4%), history of previous 2 caesarian section 5%. The rate of elective caesarean section was 21% while emergency operations were done in 79% of cases. Among the 100 patients 19% patients developed complications. Among the complications wound infection was most common (37%), then post partum haemorrhage and urinary tract infection 26% and 11% respectively. Other complications were abdominal distension, Puerperal sepsis, anaemic heart failure, wound dehiscence and Wound haematoma 5% each. We should try to keep the rate of caesarean section within optimum ranges (10%) as recommended by World Health Organization.

MON-725 Transcriptome Profiling in Postnatal Pituitary Gland Identifies Cell Type-Driven Sex-Specific Changes

The pituitary gland is integral to the regulation of growth, metabolism, puberty, reproduction, and stress responses. Previously, we found that many genes associated with age-at-menarche in genome-wide association studies (GWAS) displayed increasingly sex-biased expression across the pubertal transition in the mouse pituitary. However, whether this trend exists beyond puberty-related genes was not known. In addition, the regulatory mechanisms underlying these gene expression changes remained to be explored. To answer these questions, we profiled the transcriptome, including microRNAs, of mouse pituitary in both sexes across pubertal transition in an unbiased manner and leveraged a recently published pituitary single cell transcriptome to explore cellular composition changes. We found that the most dynamic temporal changes in both mRNA and miRNA expression occur prior to puberty, underscoring a role for regulation of early pituitary postnatal development. We also observed ~900 genes displaying sex-biased expression patterns, arising during early development and becoming increasingly biased across puberty, including known sex-biased genes such as Fshb and Lhb. However, sex differences in miRNA expression are less pronounced, only 13 miRNAs were found to be sex-biased, suggesting lesser contribution of miRNAs to sex-biased gene expression relative to other forms of regulation. To assess whether pituitary cellular composition could underlie changes in gene expression across pubertal transition, we performed single cell deconvolution of our bulk pituitary gland gene expression. Interestingly, we found that sex differences in cell proportions were estimated to emerge across puberty: a greater proportion of lactotropes was found among females, and greater proportions of gonadotropes and somatotropes were found among males. We observed sex-biased expression patterns of marker genes for these cell types, including Prl, Fshb, and Gh. This finding suggests that cell proportion differences between sexes likely contribute to whole pituitary transcriptome changes we observed, however, to what extent remains to be studied. Together our study indicates that miRNAs play a substantial role in regulation of pituitary postnatal development but that differences in cellular composition may contribute more robustly to sex-biased gene expression.

The transcriptional regulator CCCTC-binding factor limits oxidative stress in endothelial cells

The CCCTC-binding factor (CTCF) is a versatile transcriptional regulator required for embryogenesis, but its function in vascular development or in diseases with a vascular component is poorly understood. Here, we found that endothelial Ctcf is essential for mouse vascular development and limits accumulation of reactive oxygen species (ROS). Conditional knockout of Ctcf in endothelial progenitors and their descendants affected embryonic growth, and caused lethality at embryonic day 10.5 because of defective yolk sac and placental vascular development. Analysis of global gene expression revealed Frataxin (Fxn), the gene mutated in Friedreich's ataxia (FRDA), as the most strongly down-regulated gene in Ctcf-deficient placental endothelial cells. Moreover, in vitro reporter assays showed that Ctcf activates the Fxn promoter in endothelial cells. ROS are known to accumulate in the endothelium of FRDA patients. Importantly, Ctcf deficiency induced ROS-mediated DNA damage in endothelial cells in vitro, and in placental endothelium in vivo Taken together, our findings indicate that Ctcf promotes vascular development and limits oxidative stress in endothelial cells. These results reveal a function for Ctcf in vascular development, and suggest a potential mechanism for endothelial dysfunction in FRDA.

Visualizing the Vascular Network in the Mouse Embryo and Yolk Sac

Whole mount immunofluorescence is a valuable technique that can be used to visualize vascular networks in early developing embryonic tissues. This technique involves the permeabilization of fixed mouse embryos and yolk sacs, and primary antibody tagging of the endothelial cell marker platelet endothelial cell adhesion molecule 1 (Pecam-1). A secondary antibody tagged with a fluorophore targets the primary antibody, fluorescently labeling endothelial cells and revealing vascular networks.

CTCF counter-regulates cardiomyocyte development and maturation programs in the embryonic heart

Cardiac progenitors are specified early in development and progressively differentiate and mature into fully functional cardiomyocytes. This process is controlled by an extensively studied transcriptional program. However, the regulatory events coordinating the progression of such program from development to maturation are largely unknown. Here, we show that the genome organizer CTCF is essential for cardiogenesis and that it mediates genomic interactions to coordinate cardiomyocyte differentiation and maturation in the developing heart. Inactivation of Ctcf in cardiac progenitor cells and their derivatives in vivo during development caused severe cardiac defects and death at embryonic day 12.5. Genome wide expression analysis in Ctcf mutant hearts revealed that genes controlling mitochondrial function and protein production, required for cardiomyocyte maturation, were upregulated. However, mitochondria from mutant cardiomyocytes do not mature properly. In contrast, multiple development regulatory genes near predicted heart enhancers, including genes in the IrxA cluster, were downregulated in Ctcf mutants, suggesting that CTCF promotes cardiomyocyte differentiation by facilitating enhancer-promoter interactions. Accordingly, loss of CTCF disrupts gene expression and chromatin interactions as shown by chromatin conformation capture followed by deep sequencing. Furthermore, CRISPR-mediated deletion of an intergenic CTCF site within the IrxA cluster alters gene expression in the developing heart. Thus, CTCF mediates local regulatory interactions to coordinate transcriptional programs controlling transitions in morphology and function during heart development.

Properly regulated gene expression in time and space during development and differentiation requires not only transcriptional inputs, but also specific structuring of the chromatin. CTCF is a DNA binding factor that is believed to be critical for this process through binding to tens of thousands of sites across the genome. Despite the knowledge gained in recent years on the role of CTCF in genome organization, its functions in vivo are poorly understood. To address this issue, we studied the effect of genetically deleting CTCF in differentiating cardiomyocytes at early stages of mouse development. Surprisingly only a fraction of genes change their expression when CTCF is removed. Importantly, misregulated genes control opposing genetic programs in charge of development and patterning on one hand, and cardiomyocyte maturation on the other. This imbalance leads to faulty mitochondria and incorrect expression of cardiac patterning genes, and subsequent embryonic lethality. Our results suggest that CTCF is not necessary for maintenance of global genome structure, but coordinates dynamic genetic programs controlling phenotypic transitions in developing cells and tissues.

Ehmt2/G9a controls placental vascular maturation by activating the Notch pathway

Defective fetoplacental vascular maturation causes intrauterine growth restriction (IUGR). A transcriptional switch initiates placental maturation where blood vessels elongate. However, cellular mechanisms and regulatory pathways involved are unknown. We show that the histone methyltransferase Ehmt2, also known as G9a, activates the Notch pathway to promote placental vascular maturation. Placental vasculature from embryos with G9a-deficient endothelial progenitor cells failed to expand due to decreased endothelial cell proliferation and increased trophoblast proliferation. Moreover, G9a deficiency altered the transcriptional switch initiating placental maturation and caused downregulation of Notch pathway effectors including Rbpj. Importantly, Notch pathway activation in G9a-deficient endothelial progenitors extended embryonic life and rescued placental vascular expansion. Thus, G9a activates the Notch pathway to balance endothelial cell and trophoblast proliferation and coordinates the transcriptional switch controlling placental vascular maturation. Accordingly, G9A and RBPJ were downregulated in human placentae from IUGR-affected pregnancies, suggesting that G9a is an important regulator in placental diseases caused by defective vascular maturation.

First Report of Leaf Blight of Chinese Ground Orchid (Phaius tankervilliae) Caused by Botrytis cinerea in India

Chinese ground orchid (Phaius tankervilliae Banks:Blume) is a beautiful, terrestrial orchid, which belongs to the family Orchidaceae. It is used as a cut flower, which lasts for 4 to 5 weeks. This species is considered endangered and rare in nature. In June of 2007, potted plants of P. tankervilliae in Shillong, Meghalaya (northeast India; maximum temperature 24°C, minimum temperature 18°C, and 83.5% relative humidity) exhibited leaf blight. Symptoms included water-soaked lesions and dense, gray mold growing on infected tissues. Thirty-six percent of the plants surveyed were found to have this disease. For isolation, diseased tissue was surface disinfested by soaking it in 0.5% sodium hypochlorite for 1 min, air dried, plated on potato dextrose agar, and incubated at 20°C. Mycelia were initially white but later turned gray. Mature, unicellular, ellipsoid, hyaline conidia (6.3 to 8.2 × 9.6 to 11.4 μm) were formed in botryose heads. Hard, black, irregular-shaped sclerotia (average size 1.8 × 2.3 mm) were formed after 15 days. On the basis of these morphological characters, the pathogen was identified as Botrytis cinerea Pers.:Fr. (1). Pathogenicity was confirmed by spraying plants with a spore suspension (10⁶ spores per ml), which were then maintained under high humidity for 48 h at 20 to 22°C by covering with cheesecloth. Five potted plants were inoculated and five were sprayed with sterile water. Lesions and spore masses that were identical to those observed appeared 5 to 6 days after inoculation. Water-treated control plants remained asymptomatic. B. cinerea was reisolated from inoculated plants. A literature search revealed no previous record of this disease in India. So, to our knowledge, this is the first record of B. cinerea on P. tankervilliae in India. References: (1) M. B. Ellis. Dematiaceous Hyphomycetes. CMI, Kew, Surrey, England, 1971.

Habituation of alpha attenuation responeses in depressed patients and normal subjects

Habituation of alpha attenuation responses (AAR) obtained from a group of 20 depressed patients was compared with a group of 20 matched normal controls. The slope of the AAR habituation curve over trial showed that the normals habituated much quickly than those of patients. The findings were interpreted in terms of the level of arousal of the patients/subjects tested.

Role of trait anxiety and induced arousal in two-flash threshold of neurotic patients

To examine the effects of trait anxiety and induced arousal on two-flash threshold 10 neurotic patients and 10 normal students were tested in aroused (70 dB white noise) and non-aroused conditions. Patients had higher state and trait anxiety than normals. A significant difference in two-flash threshold was observed between the groups during non-arousal only.