ABSTRACT
Background: Management of critically ill obstetric patients involve intensive monitoring in intensive care unit. In present scenario there are significant number of obstetric patients with sepsis, tropical diseases and medical illness that require ICU care. The aim of this study was to evaluate in more detail the non-haemorrhagic causes of obstetric ICU admissions and to identify and adopt high risk strategies as prime learning objective.Methods: It is a prospective ongoing study conducted in 50 patients in SGRDUHS, Amritsar from December 2016 to October 2019, who were admitted in obstetric ICU, out of them 30 cases were attributed to non-haemorrhagic obstetric causes. All demographic parameters along with gestational age, diagnosis on admission, intervention done prior to shift to ICU and details of treatment given in ICU were evaluated. Patient outcome, review of mortality and area of improvement were also noted.Results: Majority of the patient (70.1%) were admitted in 3rd trimester. Obstetric sepsis (13.33%), infective diseases (16.66%), tropical conditions (16.66%), medical disorders (26.66%) and hypertensive disorders (26.66%) were the major causes of admission to obstetric ICU. There were 33.3% mortalities observed in present study and 40% were due to respiratory failure. In ICU mechanical ventilation was done in 63.3% cases and blood products were given in 33.3% of patients.Conclusions: A multidisciplinary approach is ideal to handle non-haemorrhagic situations especially related to medical disorders and tropical diseases. Review of the ICU admissions and periodic audit can improve management of morbidities as well as reduce maternal mortalities.
ABSTRACT
Cervical cancer is the second most common cancer among women worldwide. Infection with the Human Immunodeficiency Virus (HIV) is associated with an increased risk of prevalence of HPV. Cervical cancer is most common in age group 45-55 years. The various risk factors include age at first intercourse, multiple sexual partners, use of oral contraceptives pills, parity, family history, associated genital infections, and immunosuppression etc. Sexually transmitted human papilloma virus (HPV) infection is the most important risk factor for cervical intraepithelial neoplasia and invasive cervical cancer. Objective: To study the prevalence of HPV in the study group comprising of 100 HIV positive women and 100 HIV negative women. Methods: The present study was conducted in the department of Pathology, GMC, Patiala on 100 cervical brushings prepared from HIV positive patients attending ART Centre and 100 HIV negative femalesat GMC andRajindra hospital, Patiala. The cervical brushings were analysed in the Department of Pathology, Government Medical College Patiala. HPV detection was done on samples of cervical brushings. Results: In the 200 cases studied, 74 cases were positive for HPV infection. Out of 74 cases, 51 (51%) cases were HIV positive and 23 (23%) cases were HIV negative. Conclusion: It was seen that prevalence of HPV was higher in HIV positive cases as compared to HIV negative cases.
ABSTRACT
Background: Implantation of blastocyst anywhere else, other than uterine cavity is considered as ectopic pregnancy. About 95% of ectopic pregnancies are implanted in the various segments of fallopian tube. Fertilization takes place in the lumen of fallopian tube, from where, aided by the ciliated columnar epithelium of the tube, the fertilized ovum makes its way to the uterine cavity and the implantation occurs. Methods: A study was carried out on 50 patients in the department of pathology, GMC Patiala.to the compare the histopathological and anatomical changes in the lining of the fallopian tube. Results: The routine Haematoxylin and Eosin stain was done and the histopathological study was done. Conclusion: It was concluded that early diagnosis and treatment before rupture still remains the main option of management.
ABSTRACT
The management of disorders of sexual differentiation (DSD) involves a multidisciplinary approach. The main aim of analysis was to study the phenotype-karyotype correlation in North Indian children with DSD. The records of pediatric DSD were retrieved and characteristics noted. Of total of 58 children, 43 (74.1%) and 10 (17.2%) were raised as males and females respectively. The mean age at presentation was 31.3±9 months. The karyotype was 46XY in 45 (77.6%) and 46XX in 12 (20.7%). CAH was commonest cause of DSD (36.2%), followed by gonadal dysgenesis. Of the 15 patients of 46 XY CAH, there were 5 with 17-α hydroxylase deficiency, 2 with 3-β HSD deficiency and one case of lipoid adrenal hyperplasia. There was an excess of genetic males, possibly due to prevalent socio-cultural factors and gender bias favoring males. There is a need to improve the diagnostic facilities and incorporate a team approach in management of DSD.
Subject(s)
Chi-Square Distribution , Child, Preschool , Disorders of Sex Development/diagnosis , Disorders of Sex Development/epidemiology , Female , Humans , India/epidemiology , Infant , Karyotyping , Male , PhenotypeABSTRACT
A randomised study of 100 cases undergoing hysterectomy in the age group of 20-70 years was carried out and clinicopathological correlation was done. Maximum number of women who underwent hysterectomy were in the age group of 31-50 years. Abnormal menstrual flow was the most common complaint (66%). Clinically main indications for hysterectomy were fibroid (34%), dysfunctional uterine bleeding (DUB) (26%) and uterine prolapse (24%). Abdominal hysterectomy was the procedure of choice in conditions other than uterovaginal prolapse. Out of 34 cases, clinically diagnosed as fibroid uterus, leiomyoma was found on histopathology in 25 cases and adenomyosis in 3 cases. In 3 cases, both leiomyoma and adenomyosis were present. Out of 26 cases, clinically diagnosed as DUB, histopathological examination revealed leiomyoma in 6 cases, adenomyosis in 9 cases, endometrial polyp in 3 cases. Hence, after exclusion of organic pathology, DUB was confirmed in 8 cases.