Assessing Success Of Vaginal Birth After Cesarean By FLAMM Model In A Retrospective Observational Design

Background: After year 2000 cesareanrates have increased from 15% to 30-50% worldwide. Practice of Trial of labor after cesarean has decreased from last two decades of 20thcentury. Predictors of vaginal birth after cesarean are not uniform and not suitable equally for all populations. FLAMM model was tested in this study for its predictability for a successful vaginal birth after previous one cesarean. Material And Methods:For an observational, retrospective study 72 patient files admitted in 2018 in Obstetric Department of C R Gardi Hospital were included which fulfille d criteria of having second pregnancy after cesarean for non recurrent indications like fataldistress, failure of induction of labor, pre-eclampsia, eclampsia, twins and others. Indication of contracted pelvis, rupture uterus, previous classical cesarean section; and multiple pregnancy, medical complications and obstetric complications in this pregnancywere excluded. FLAMM scoreparameters; cervical dilatation, effacement, presence of previous vaginal birth before cesarean, indication of it and age of woman wereused. Observations of successful and failed trial were done by scoring system. Chi square test was used to compare data. Study variables were success of trial in various FLAMM parameters. Result:Higher scores in cervical dilatation (p<0.001), effacement (p<0.001) and prior vaginal delivery (p=0.03) were significantly associated with a successful outcome. Higher theaggregate FLAMM score, higher were chances of successful trial. A non-recurrent indication other than non-progress of labor for previous cesarean had no statistical association with success of trial. Aggregate score of 6 and more has 100 % predictability for a successful vaginal birth. Conclusion:Prediction by FLAMM model resulted in 62. 5%successful trial. FLAMM model maybe used for near to accurate prediction of successful trial of labor after cesarean.

The Synthesis, Screening Of Novel 1-Substituted-3-(4-Oxo-2-Phenylquinazolin-3(4h)-Yl) Urea And Thiourea Analogues As Potent Antibacterials

Objective: The proposed study is an attempt to determine antibacterial activity of synthesized novel 1-substituted-3-(4-oxo-2-phenylquinazolin-3(4H)-yl) urea and thiourea analogues as potent antibacterials against S. aureus and E. coli bacteria. Methods: The present study reports new series of 1-substituted-3-(4-oxo-2-phenylquinazolin-3(4H)-yl) urea and thiourea derivatives as potent antibacterial agents. Reagents used in the present study were of synthetic grade and solvents were used after distillation. Novel quinazolinone analogues were synthesized by considering substitution pattern, characterization of the synthesized analogues was performed using various techniques like Thin layer chromatography, Melting point, Infrared spectroscopy, Proton NMR spectrometry and Mass spectrometry. TLC of the synthesized analogues was carried out by using (toluene: methanol in the ratio 2:1), melting point was found by open capillary method, IR spectrum was recorded on JASCO V-530, 1H NMR was recorded on Bruker Avance Spectrometer and Mass spectra were obtained from G6460A, triple quadrupole/MS/MS system. In vitro antibacterial activity was performed against S. aureus and E. coli. Results: Six derivatives of quinazolinone analogues were synthesized. The structures of 1-substituted-3-(4-oxo-2-phenylquinazolin-3(4H)-yl) urea and thiourea derivatives were confirmed by physical and spectral analysis. Synthesized molecules showed Rf of 0.45-0.80 in toluene: methanol mobile phase, melting point was carried out by open capillary method and were in range of 90-210 ° C, IR spectrum was recorded in range of 14000-400 cm-1and showed characteristic peaks of NH and of C-O-NH, 1H NMR of the compounds was distinct to confirm structures with delta values in the range of 7.53-11.960, Mass spectra proved parent peaks of synthesized compounds confirming molecular weight. The compounds were assayed for antibacterial activity against S. aureus and E. coli using ciprofloxacin as standard. The synthesized analogues have shown good yield and comparable antibacterial. Conclusion: The present study delivers a convenient and efficient protocol for the quinazolinone analogues synthesis.

Synthesis And Anticancer Screening Of Triazine Analogues

Objective: The study was aimed to investigate the cytotoxic effect of S-5H-[1,2,4]-triazino (5,6-b) indol-3-yl-3,4-phenylethane-thioate derivatives as epidermal growth factor Receptor (EGFR) inhibitors. Methods: In the present study 14 novel triazine analogues were synthesized and characterized using different spectroscopic techniques such as FT-IR, NMR and Mass Spectroscopy. The anticancer activity was performed using MCF-7 (breast cancer) and K-562 (leukaemia) cell lines. Further, molecular docking was carried out using Vlife Molecular Docking Software (MDS) on crystal structure of epidermal growth factor receptor (EGFR) to identify the binding mode of interaction with an active site. Results: Compounds MA-7, MA-8, MA-12, MA-13 and MA-14 show potent activity against cancer cell lines in the range of<10 to 84.4 µg/ml. Further molecular docking on EGFR also supports that there is a strong correlation between in silico and in vitro biological activity. The results of this study may be further useful for lead optimization process. Conclusion: The results of this study indicates that the synthesized triazine analogues can give a potential lead as an anticancer agent.

Pregnancy Following Surgery Of Multiple Pelvic Hydatid Cysts.

Abstracts: Background: Hydatid cyst in pelvic region is very rare. A patient was admitted in Gynaec ward with complaints of , lump and pain in lower abdomen and, constipation since, five months. General examination was normal. Abdominal and gynaecological examination lead to diagnoses as ovarian cyst ? Multiple uterine subserous fibroids? Ultra sonography diagnosis was Hydatid cysts abdomen / Mucininious cystadenoma ovaries . CT Scan abdomen and pelvis confirmed USG findings of Hydatid cysts. On Laprotomy multiple hydatid removed from pelvic region , omentum , ileocaecal junction and liver . Patient put on chemotherapy and follow up was satisfactory.

Ovarian Pregnancy.

Primary ovarian pregnancy is a rare type of extra-uterine pregnancy, and occurs in 1:7000 to 1: 40,000 deliveries. This is a case that occurred in a 26 years old multiparous woman. She had presented with pain abdomen and bleeding per vaginum and was hemodynamically stable, negative pregnancy test, but vaginal examination showed painful cervical movements, slight bleeding through external os, uterus just bulky, tender mass felt in right adnexa. Ultrasonography revealed—Right tubo-ovarian mass with fluid in peritoneal cavity. Laparotomy showed Right Ovarian Pregnancy. Managed by Right Ovariectomy.

Comparative Evaluation of Hystero-Salpingography and Laparoscopy For Determination of Tubal Patency.

Objective: To find out whether Hysterosalpigography (HSG), can be used as initial method for assessing tubal factor of infertility, instead of more invasive method like diagnostic laparoscopy. Methods: Retrospective analysis of 75 cases, who had attended infertility Clinic at Medical College, Ujjain, and underwent HSG as initial test followed by Laparoscopy from November 2005 to December 2010. Results: Primary infertility was the major cause of tubal factor of infertility (75%) and majority of women were between 20-25 years (60%). In comparison to laparoscopy, HSG has 80.8% sensitivity & 100% specificity for determination of tubal patency. HSG also has a high sensitivity (100%) for determination of unilateral or bilateral blockage with specificity of 100% & 85.3% respectively. HSG can detect only endo-tubal and intrauterine pathology, whereas laparoscopy can detect pelvic pathology. Conclusion: HSG should be used as initial test to assess tubal patency whereas laparoscopy should be limited to selected cases.

Study of primary caesarean section in multiparous women.

Background: This prospective study was carried out to assess, indication, maternal & fetal outcome of primary caesarian in multiparous women. Materials & Methods: 50 women with primary CS (caesarean section) studied in multiparous women studied and analysed. Results: Most of women belonged to >25yrs age group, rural, & low socio-economic group, Malpresentation, Low AFI (amniotic fuid index), Fetal Distress were most common indications. Post operative uneventful in majority of cases. Conclusion: Antenatal care in multigravida, USG (ultra-sonography) Analysis Close monitoring can reduce CS(caesarean section) in multipara.