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Background@#Many benefits are associated with early antenatal booking which include but are not limited to accurate dating, early detection of medical and obstetrical disorders that could make the pregnancy a high-risk pregnancy and affect its outcome, and objective assessment of maternal baselines such as identifying pre-existing risk factors, taking weight, blood pressure, blood sugar level and urinalysis. If done early, it may provide a picture of the pre-pregnancy condition of the woman. @*Aim@#In the time period and setting looked at in this research, it was found that majority of the mothers booked late, however reasons for booking late were not sought as this was only a quantitative retrospective cohort study. From the outcomes measured, it was seen that anaemia was the most significant outcome associated with late bookers. PPH was also found to be significant amongst late bookers however other statistical analysis deemed it insignificant.@*Results@#The results of this study found that majority of the women (76,58%) booked late. Of these, women who booked late fell in the 15 to 25 age range, were of I-taukei ethnicity, were married, did domestic duties, attended secondary level of education and were multiparous. The most significant pregnancy outcome that was associated with late booking was found to be anaemia. The remaining outcomes were found to be insignificant.
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Purpose: To record and evaluate the reliability parameters (fixation loss (FL) %, false positive (FP) %) and global indices (mean sensitivity (MS), mean deviation (MD), pattern standard deviation in dB) in three visual field test sessions within two weeks to assess the learning effect in normal healthy subjects and POAG patients and comparison of learning effect gender wise and age wise in primary open?angle glaucoma (POAG) patients. Methods: This study was a prospective observational study. An oculus visual field testing was done and analyzed in 30 eyes of POAG patients and 30 eyes of normal healthy subjects in three visits. Results: There were 16 (53.3%) males and 14 (46.6%) females in the POAG group and 16 (53.33%) males and 14 (46.66%) females in the normal healthy subject group. A significant difference in data change between each visit in FL, FP, MD, MS was found though the difference was more pronounced in the second visit than in the third visit. The pattern standard deviation does not change significantly in subsequent visits in both groups. Gender wise and age wise no significant difference was found in the POAG group. Conclusion: Significant improvement in reliability parameters and global indices with each subsequent visit in both the POAG group and normal patients signifies the importance of learning effect on these parameters and the need to perform at least three tests to get the baseline perimetry chart, especially in POAG patients, while in normal subjects, second perimetric result can be accepted. It was also concluded that the learning effect is not influenced by age and gender.
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Background: Slightly more than half the total number of childhood leprosy cases worldwide are from India. Aim: To analyze the clinical and epidemiological trends of childhood leprosy over 20 years in a tertiary care hospital. Methods: We retrieved the medical records of all children less than 15 years of age registered in the leprosy clinic between April 1998 and March 2018. We tabulated and analyzed data pertaining to demographic details along with clinical findings such as cutaneous lesions, nerves involved, sensory loss, deformities, reactions, smear status, histopathology and treatment. Results: Out of total 1548 leprosy cases registered during the study period, 55 (3.55%) cases of childhood leprosy were diagnosed. Thirty five (63.6%) children were in the age group of 11–15 years and 83.7% were migrants from other states. Thirteen (23.6%) children reported contact with a diagnosed case of leprosy, mainly in close contacts. Fifty three (96.4%) children presented with cutaneous lesions while 2 (3.6%) had pure neural involvement. Borderline tuberculoid leprosy was the most common clinical presentation in 27 (49.1%) followed by borderline lepromatous leprosy in 11 (18%). Thickened peripheral nerve trunks were detected in 42 (76.4%), most commonly the ulnar nerve. Reactional episodes occurred in 12 (21.8%) cases (Type 1 reaction, 10 (18.2%); Type 2 reaction, 2 (3.6%)). Grade 2 disability was detected in 4 (7.3%). Multidrug therapy was started in all patients, multibacillary (MB) regimen in 42 (76.3%) patients and paucibacillary (PB) regimen in 13 (23.7%). Twenty five (45.4%) children defaulted from the treatment. On comparing the data of 2008-18 with that of the previous decade (1998–2007), there was a higher proportion of migrant cases as compared to local cases (3:1–11:1) and MB cases as compared to PB cases (2:1–6:1). The proportion of treatment defaulters declined from 60% to 36%. Limitations: Relapse rate could not be calculated due to inadequate follow-up period. As it is a hospital-based retrospective study with no active surveys, these findings may not reflect trends in the community. Conclusion: Childhood leprosy continues to be a significant problem. There is a clear need to strengthen early detection, treatment and regular follow-up of these cases in both high and low endemic settings.
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We are spiritual beings with human experience, but how can we realize that we are spiritual beings is a tedious task for which the whole world is trying for ages. Spiritual world starts from Kundalini, Chakras, 5 Tatva etc origin of all connects us with our spiritual self but it's very complicated and needs lot of hand holding from an enlightened Guru. We have created a structure where a simple analogy when connected to few breathing exercises and touching the point again and again with Beejmantra invokes the spiritual being inside. Thus the spiritual being outside the body can be identified and thus can be connected. While studying neuroscience several micro networks were observed in the human body by scientists, human health has deep connection with immunity, inner peace, justice and happiness. Behavior has become increasingly prominent in psychological theory of biological models, especially in neuro-imaging tools development. Thus one can realize that every particle bears intelligence and there is a cumulative intelligence which governs the course of action of one single particle, creator of Intelligence is the spiritual being who created the cosmos. This thought when applied time and again connected everyone on a divine knowledge path where everything starts connecting and the person becomes a master of all traits. Connecting soul seat increased conversion of air, fire & water to Pran, Tej & Oaj and reduced Vaat, Pitta & Kapha thus Bala increased and body attained strong immunity against diseases and longevity. Resistance against disease increased on physical, mental, emotional & spiritual level. Thus connecting with soul seat, its understanding and how and where it influences the society is the scope of the study.
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The synthesis of magnetite nanoparticles and their applications after surface modification have drawn in the eye of researchers toward it all through the previous a few times. In the present study, the synthesis of citric acid-modified magnetic nanoparticles has been reported. Numerous technical approaches such as x-ray diffraction, field emission scanning electron microscopy, thermogravimetric analysis and fourier transform infrared spectroscopy were accustomed to characterize these synthesized magnetite nanoparticles. The main emphasis of this examination was to study the adsorption behavior of these synthesized nanoparticles for ciprofloxacin drug from aqueous solution. The influences of various experimental parameters including pH, the contact time, amount of nanoparticles and initial concentration of ciprofloxacin drug, were investigated simultaneously. Moreover, isotherm study was observed to follow Langmuir isotherm model and the value of maximum adsorption capacity was 20.65 mg/g as calculated. Furthermore, the kinetic study was found to fit well with pseudo-second-order kinetics model. The overall study suggested that these functionalized magnetite nanoparticles can be utilized as a proficient tool for the adsorption of drug from aqueous solution. The antibacterial behavior of these drug loaded nanoparticles was also scrutinized.
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Ayurveda considers only 3 Aushadhi Daivavyapashray (taking refuge of your Aatma (soul)), Yukti Vyapashraya (how one can immediately bring relief to patient Yukti (idea)), Sattvavajay (purity of thoughts). Daivavyapashraya Chikitsa includes all Mantra Chikitsa in Ayurveda for healing Doshas caused due to past life Karmas. Our Aatma is Drishta of all our Karmas in a lifespan. Aatma is connected with Parmatma. Invocation of Parmatma is done through Mantras. Mantra is a broader term with its application under Vedic Texts, Tantrik Texts, Tarka Shastra, Yagya & Tapa. Mantra as a concept is often misunderstood that it only connected with Tantra. Tantra is not appreciated because of Panch Makaar. This review will highlight the Correct Panchmakaar and why so it was consumed as Aushadhi. Since Mantra is invocation of divine under different approach systems. The Rishis who were called Mantra Drishta highlights the importance of concept creation over language. This review will help in establishing the importance of Panchmakaar as Aushadhi for Mantra Chikitsa under Ayurveda for treatment of diseases/disorders. Removing confusion and pursue healthy spiritual journey is the purpose of this research paper. This controversial subject of Panchmakar was the major reason for avoiding spiritualist/ Tantriks (those seeking path of spirituality). These misinterpretations created Bhram though it was supposed to connect with Brahma. Panch Makaar's were widely misunderstood and misinterpreted by all.
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Background & objectives: Endometrial serous carcinoma (ESC) is a high-grade epithelial neoplasm with increased risk for metastasis and recurrence. This study was aimed to assess various histomorphological features of ESC and their clinicopathological association with disease-free survival (DFS) and overall survival (OS). Methods: A total of 205 slides (belonging to 120 patients) diagnosed as ESC from January 2009 to December 2015 were reviewed. Receiver operating characteristics (ROC) curves were established for the diagnostic performance of depth of invasion (DOI), tumour-free distance (TFD) to serosa and percentage myometrial invasion (MI%). OS and DFS were generated by Kaplan-Meier curves and prognostic significance by Cox regression analysis. Results: The mean age at diagnosis was 61.8 yr and the mean tumour size was 4.01 cm. Majority of the females were multiparous (84%; n=94) and postmenopausal (89.2%; n=107). On histopathology, <50 per cent of MI was identified in 37 of the 104 (35%), while 62/104 (59.61%) patients had ?50 per cent MI. Seven (6.7%) patients had full-thickness invasion with serosal involvement, while five (4.8%) patients had no microscopic MI (minimal uterine serous carcinoma). Information about MI was not available in 16 patients. TFD ?7.0 mm, DOI ?6.0 mm and MI% ?40 were significant variables in univariate analyses for OS; however, on multivariate analysis; none of these turned out to be an independent predictor in terms of OS. For DFS, DOI (?6.0 mm) and MI% (?40%) showed a significant association, in univariate as well as multivariate analysis; however, TFD (?7.0 mm) did not show any significant association with DFS. Follow up data were available in 111 of the 120 (92.5%) patients with a five-year OS and DFS of 22.2 and 17.2 per cent, respectively. Interpretation & conclusions: Conventionally calculated DOI (less than or more than half thickness) did not show significance in the present study. Thus, calculating the actual myometrial DOI, MI% and TFD to serosa have the potential for contributing meaningfully to prognostication of ESC
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Background: Neisseria gonorrhoeae and Chlamydia trachomatis are the two most prevalent bacterial sexually transmitted infections. For over two decades, treatment guidelines have recommended empirical co-treatment for N.gonorrhoeae and C.trachomatis as symptoms overlap and co-infection is common. Studies from India estimating the same are limited and mostly based on conventional techniques. Aim and Objective: The aim of this study was to determine the frequency of N.gonorrhoeae and C.trachomatis coinfection using nucleic acid amplification tests. Further, we assessed the utility of pus cell estimation in Gram stained smears as a screening tool for inclusion of samples for molecular diagnosis. Methods: This was a prospective study conducted at two tertiary care hospitals; 100 patients (55 females and 45 males) with genitourinary discharge attending STI clinics were recruited, and endocervical or urethral swabs were collected. PCRs for N.gonorrhoeae and C.trachomatis were put up. In addition, microscopy and culture for gonococcus was performed followed by antimicrobial susceptibility testing. Statistical analysis was performed using the SPSS 16 software. Results: N.gonorrhoeae infection was more common than C.trachomatis. A total of 14 patients were positive by PCR (9 males and 5 females) for gonococcus. However, culture was positive only in 8 male patients. PCR for C.trachomatis was positive in 9 (4 males and 5 females) and the co-infection rate was 5%. The sensitivity and negative predictive value of pus cell estimation was 100% for males and 64% and 94.6% respectively for females. All isolates were susceptible to extended spectrum cephalosporins and azithromycin. Limitation: The sample size of the study was small. Conclusion: Frequency of N.gonorrhoeae/C.trachomatis coinfection in symptomatic STI patients is low. Coinfection is considerably overestimated and necessary confirmation of etiological diagnosis could reduce widespread empirical administration of broad-spectrum antibiotics.
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Background: Protamine neutralises heparin a?er separa?on from cardiopulmonary bypass. This study aimed to evaluate the effects of lidocaine on protamine induced pulmonary vascular constric?on in paediatric cardiothoracic surgery. Methods: This was a single-centre, prospec?ve, double-blind and randomised study conducted among eighty pediatric pa?ents with acyano?c congenital cardiac disease, scheduled for elec?ve on-pump cardiac surgery under general anaesthesia. In the study, the par?cipants were divided into four groups: Group NPHL- nonpulmonary hypertension with lidocaine precondi?oning, group NPHS- nonpulmonary hypertension with normal saline (as placebo), group PHL- pulmonary hypertension with lidocaine precondi?oning, and group PHS- pulmonary hypertension with normal saline (as placebo). Results: Pulmonary vasoconstric?on occurred in 11.25% of cases a?er protamine administra?on. Both the NPHS and PHS groups exhibited an increase in mean airway pressure (Paw), Respiratory index (RI), alveolar-arterial oxygen difference (A-aDO2), pulmonary artery pressure (PAP) and decreased dynamic pulmonary compliance (Cydn) and oxygen index (OI) a?er protamine administra?on. However, these changes were not observed in the NPHL and PHL groups with lidocaine precondi?oning. Plasma levels of TXB2 in the NPHS and PHS groups were higher than the NPHL and PHL groups, but 6-keto-PGF1 alpha levels were lower in the NPHS and PHS groups than in the NPHL and PHL groups. Conclusion: In congenital heart disease, repair without cardiopulmonary bypass is not possible in most cases. Prior to reversing heparin with protamine, precondi?oning lidocaine reverses protamine-induced pulmonary vasoconstric?on and improves lung func?on.
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Multiple studies had been conducted world wide on the prevalence of thyroid hormone disorder in past and recent years. Hypothyroidism during pregnancy is also very common affecting both mother and foetus. A prospective study is conducted in department of pathology, GRMC Gwalior including 1554 patient with symptoms and previous history and analysed by SNIBE MAGLUMI series fully automated ChemiluminescenceImmunoassay analyzer (Clia) for the quantitative determination of thyroid hormone profile. Out of 1554 patients, prevalence of thyroid hormone disorders discussed separately in 1271 cases and 283 antenatal cases. Among 1271 patients, prevalence of thyroid hormone disorder is 32.9% where as 67.1% were euthyroid with higher prevalence of hypothyroidism (26.3%) than hyperthyroidism (6.6%). Females are affected more than male (7:1) and most commonly affected age group is 20 to 39 years. Prevalence of primary, secondary and subclinical hypothyroidism were 4.16%, 2.04% and 20.06% respectively where as in case of hyperthyroidism were 0.94%. 5.43% and 0.23% respectively. Antenatal cases shows 33.6% prevalence of hypothyroidism and 0.4% prevalence of hyperthyroidism. Women in first trimester shows maximum prevalence of 15.9% including 15.55% hypothyroidism and 0.35% hyperthyroidism followed by 9.9% and 8.13% prevalence of hypothyroidism in second and third trimester respectively. Our study conclude that prevalence of thyroid hormone disorders are increasing with recent advances and time and further evaluation is needed to rule out the cause behind increasing trends
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The genus Corynebacterium is composed of Gram-positive, aerobic, non-motile, non-spore-forming bacilli that are widely distributed throughout the environment. They are usually found as commensals on the skin and are often considered as mere contaminants when isolated from clinical samples. We describe a patient with skin and soft-tissue infections due to Corynebacterium striatum following exploratory laparotomy identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. The clinical importance and pathogenic potential of Corynebacterium species, especially C. striatum, cannot be underestimated. This report is a reminder to physicians of the possible pathogenicity of non-diphtherial Corynebacteria.
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Background/Aims@#Exclusive enteral nutrition (EEN), an established modality for pediatric Crohn’s disease (CD) is seldomly utilized in adults. The present study reports the outcome of EEN in adult CD patients at a tertiary care hospital in India. @*Methods@#This was a retrospective analysis of CD patients who received EEN as a sole modality/adjunct to other treatment. The primary and secondary outcomes changed in Crohn’s Disease Activity Index (CDAI), and clinical response (decline in CDAI > 70), respectively, at 4 and 8 weeks. Subgroup analysis evaluated response across different phenotypes, EEN formulations and prior treatment. Linear mixed effect model was created to assess the predictors of EEN response. @*Results@#Thirty-one CD patients received EEN over median duration of 4 weeks (range, 2–6 weeks). CDAI showed a significant improvement post EEN at 4 (baseline 290 [260–320] vs. 240 [180–280], P= 0.001) and 8 weeks (baseline 290 [260–320] vs. 186 [160–240], P= 0.001), respectively. The cumulative clinical response rates at 4 and 8 weeks were 37.3% and 80.4% respectively. The clinical response rates at 8 weeks across B1 (n = 4), B2 (n = 18) and B3 (n = 9) phenotypes were 50%, 78.8% and 100% respectively (log-rank test, P= 0.093). The response rates at 8 weeks with polymeric (n = 8) and semi-elemental diet (n = 23) were 75% and 82.6%% respectively (log-rank test, P= 0.49). Baseline CDAI (odds ratio, 1.008; 95% confidence interval, 1.002–1.017; P= 0.046) predicted response to EEN. @*Conclusions@#EEN was effective in inducing clinical response across different phenotypes of CD. Baseline disease activity remained the most important predictor of clinical response to EEN.
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Background/Aims@#Exclusive enteral nutrition (EEN), an established modality for pediatric Crohn’s disease (CD) is seldomly utilized in adults. The present study reports the outcome of EEN in adult CD patients at a tertiary care hospital in India. @*Methods@#This was a retrospective analysis of CD patients who received EEN as a sole modality/adjunct to other treatment. The primary and secondary outcomes changed in Crohn’s Disease Activity Index (CDAI), and clinical response (decline in CDAI > 70), respectively, at 4 and 8 weeks. Subgroup analysis evaluated response across different phenotypes, EEN formulations and prior treatment. Linear mixed effect model was created to assess the predictors of EEN response. @*Results@#Thirty-one CD patients received EEN over median duration of 4 weeks (range, 2–6 weeks). CDAI showed a significant improvement post EEN at 4 (baseline 290 [260–320] vs. 240 [180–280], P= 0.001) and 8 weeks (baseline 290 [260–320] vs. 186 [160–240], P= 0.001), respectively. The cumulative clinical response rates at 4 and 8 weeks were 37.3% and 80.4% respectively. The clinical response rates at 8 weeks across B1 (n = 4), B2 (n = 18) and B3 (n = 9) phenotypes were 50%, 78.8% and 100% respectively (log-rank test, P= 0.093). The response rates at 8 weeks with polymeric (n = 8) and semi-elemental diet (n = 23) were 75% and 82.6%% respectively (log-rank test, P= 0.49). Baseline CDAI (odds ratio, 1.008; 95% confidence interval, 1.002–1.017; P= 0.046) predicted response to EEN. @*Conclusions@#EEN was effective in inducing clinical response across different phenotypes of CD. Baseline disease activity remained the most important predictor of clinical response to EEN.
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Background: Abnormal uterine bleeding (AUB) is a very common, challenging gynaecological problem in all age group women. Neoplastic lesions are responsible for very less number of cases but they should be diagnosed early. Endometrial biopsy is necessary for histopathological diagnosis of endometrial lesions and to rule out any malignancy. In present study, we evaluated histopathological pattern of endometrium and different clinical parameters in AUB patients.Methods: A retrospective observational study done in Obstetrics and Gynecology department of SSMC Rewa, Madhya Pradesh in 2 year from 1st October 2017 to 30th September 2019. AUB patients who fulfilled inclusion criteria were included in study. All data were collected from department records in predesigned proforma and statistically analyzed by statistical package for the Social sciences (SPSS) version 20.Results: Total 366 AUB patients were included in study; most frequent clinical presentation was HMB (56%). Mostly patient’s age ranged from 24-84 years, belonged to 41-50 years age group (44%), multiparous (78%), and premenopausal (53%). On histopathological evaluation of endometrium most commonly nonneoplastic lesions (75%) were seen, out of which proliferative phase endometrium was most frequent. Neoplastic lesions were seen in 25% cases. Out of which benign lesions were noted in 7%, premalignant in 17.3% and malignant in 1% (all in >45 year patients).Conclusions: Endometrial biopsy should be done in all AUB patients >45 years and in selected premenopausal in order to get early diagnosis, to rule out malignancy and to help in management. Endometrial biopsy should be considered as first diagnostic modality.
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Vein of GALEN aneurysmal malformation (VGAM) is a rare congenital disease caused by arteriovenous shunts between the choroidal arteries and the porencephalic ectatic vein. The diagnosis is often made in utero or during infancy, endovascular treatment remains the most suitable therapeutic means in a well-equipped environment. Here we report here the case of a patient complaining of headache for 1 year, and whose brain CT imaging showed the presence of Galen veinaneurysm with associated non-communicating hydrocephalus. In the absence of the appropriate technical platform, the placement of a ventriculoperitoneal shunt relieved our patient’s symptoms
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Background: The present study was to assess the indication and study the intraoperative and postoperative complications of bilateral internal iliac artery ligation. Aim of this study was to evaluate the effectiveness of internal iliac artery ligation in arresting postpartum haemorrhage.Methods: This is a retrospective study carried out between January 2015 to December 2018 at Shrimati Kashibai Navale Medical College and General Hospital, Pune. This study included 48 patients with life-threatening PPH. Bilateral internal iliac artery ligation was done by anterior approach in 7 patients and by posterior approach in 41 patients.Results: Intraoperative and postoperative complications were noted in all patients. Of the total patients, 10 required massive blood transfusion and 12 underwent obstetrical hysterectomies (n=12; 25%). Internal iliac vein injury was seen in 1 patient (n=1; 2.08%) and external vein thrombosis was noted in 3 patients (n=3; 6.25%). Maternal mortality was observed in 1 patient due to DIC on day 9 (n=1; 2.08%). The uterine salvage rate was 75%.Conclusions: Internal iliac artery ligation (IIAL) safe, rapid, effective, time tested method of controlling bleeding from genital tract.
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The 2019 novel coronavirus (COVID-19) has rapidly spread from its origin in Wuhan City of China to other countries. In response to the rapid spread of COVID-19, preventive measures such as social distancing have resulted in the global closure of all means of entertainment or recreational activities. Owing to the lockdown phase and more tendencies for sedentary lifestyle than earlier, there is a higher probability of the population to suffer from musculoskeletal issues during this phase. This can further result in various physical health issues in terms of reduced endurance, reduced muscle strength, obesity, and metabolic problems associated with decreased physical activity (PA), etc. Aerobic exercise has shown that the peripheral number of lymphocytes in the blood is significantly raised; precipitating the idea that exercise helps to "stimulate" the immune system during exercise. PA has various health benefits including reduced incidence of disease and decreased systemic inflammation. A physically active lifestyle has a direct impact on an individual's state of well-being, quality of life, and cognitive function. Thus, PA is related to a decreased chance of cognitive decline and dementia. Previous studies have shown that daily PA leads to lower death rates and infection incidence rates. Both physical activity and exercise are positively related to beneficial metabolic and immunological health outcomes. Besides, they have proven to be effective with direct effects on physical health for most of the chronic diseases. Routine exercises improve the improve physical wellbeing. Therefore, individual prescription and guidance are required to establish an effective exercise program aimed in sustaining or enhancing the key health-related components of physical fitness. This article gives an overview of the musculoskeletal awareness in lockdown phase owing to increased sedentary lifestyle during the lockdown phase.
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Induction of labour is an intervention to artificially stimulate uterine contractions leading to progressive dilation and effacement of cervix. This results in delivery of foetus before the onset of spontaneous labour. Dinoprostone gel and Misoprostol are commonly used drugs for cervical ripening. We wanted to compare the efficacy and safety of Dinoprostone with Misoprostol for cervical ripening and induction of labour in women with unfavourable cervix. METHODSThis is a prospective study conducted among 200 antenatal women who required induction of labour for different indications. 100 patients with an indication for induction were given 25 mcg of intravaginal misoprostol and repeat dose up to a maximum of 3 doses every 4 hours as needed. The other 100 patients were given 0.5 mg of intracervical dinoprostone gel and repeated for a maximum of 3 doses every 6 hours as needed. Progress of labour was monitored. Bishop score was determined. RESULTSPostdatism was the most common cause of induction (45% and 58%) in both the groups. The difference in values of mean induction delivery time in both primipara and multipara was not significant statistically for both the drugs. Study showed that the number of caesarean sections was significantly (p value 0.028) reduced with the use of misoprostol for induction of labour. The most common indication for operative delivery was foetal distress (11% in the misoprostol group and 17% in the dinoprostone group). Maternal and foetal complication rate in both the groups was similar. CONCLUSIONSCaesarean rate was significantly less with intravaginal misoprostol group compared to dinoprostone group. Other factors had no statistical significance. Vaginal misoprostol is thus a better option for induction of labour.
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A cornual gestation is one of the most hazardous and life-threatening type of ectopic pregnancy with a mortality rate of 2-5 times higher than other ectopic pregnancies. Because of the myometrium stretch ability, they usually present late around 7-12 weeks of gestation. Thus, the diagnosis and treatment of such cases become challenging. In the case of ruptured cornual ectopic pregnancy, the patient usually presents with hemodynamic instability. Presenting a case report of a 28-year-old female who presented to the labour room of ESI hospital, Okhla, New Delhi at 12 weeks of pregnancy in a state of shock. A provisional diagnosis of ruptured cornual ectopic was made based on clinical examination and ultrasound report. Resuscitation followed by emergency laparotomy done as a life-saving procedure for the patient. Ruptured cornual ectopic needs urgent intervention and multidisciplinary approach. However, with the advancement and expertise in the field of radiology and early diagnosis can be made which can contribute towards more conservative management of such cases.
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Background: Syphilis is a sexually transmitted disease (STD) caused by the bacterium treponema pallidum, but little is known about its mechanism of action. In pregnancy it leads to adverse outcomes among more than half of the women with active disease, including early fetal loss, stillbirth, prematurity, low birth weight, neonatal and infant death.Methods: It is an observational study in the department of obstetrics and gynecology Mahatma Gandhi Memorial Medical College Maharaja Yashwant Rao Hospital, Indore between January 2014 to December 2015 total 20870. In Include written informed consent, All the patients attending STI/RTI clinic with clinical diagnosis of STD. In Exclusion criteria include patients not give informed consent. Case definition: All VDRL + TPHA positive patients.Results: Out of 20870 females on which VDRL was performed 77 (0.036%) were found to be positive. The seroprevalence at study hospital thus came out to be 0.036%. These were further confirmed by TPHA and 73 (94.8%) out of 77 samples were positive. A total agreement was seen between TPHA and VDRL with a titer of 1 in 8 and above. Among total 20870 screened females, 77% (16101) were ANC patients of which 26 cases out of 77 that is 33.76% females were syphilis positive.Conclusions: Low prevalence of syphilis in pregnant women and adult general population is very encouraging. participation of people and public health approach to promote awareness of syphilis among physicians and populations at risk in India are very urgently needed to avoid the adverse consequences which could result from undiagnosed or improper treatment.