Impact of pre-eclampsia on neonatal outcome at tertiary care center

Objective: To determine the impact of pre-eclampsia on neonatal outcome at a tertiary care hospital

Methods: This was a cross-sectional study conducted in the Neonatal Intensive Care Unit [NICU] and High Dependency Unit [HDU] of Liaquat National Hospital over a period of six months, i.e from June 2015 till December 2015. The inclusion criteria includes all neonates born to pregnant women with systolic blood pressure from 130 to 200 mmHg, Diastolic blood pressure of >110mmHg and proteinuria >1 on dip stick or >300mg/l in 24 hour urinary specimen irrespective of gestational age

The exclusion criteria was all babies born to mother with chronic hypertension, glucose intolerance, renal disease, multiple pregnancy, congenitally abnormal fetus or sepsis

Results: A total of 80 babies met the inclusion criteria and were included in our study of which only 39 babies were admitted in NICU. Majority of babies were discharged home. Approximately 48.71 % babies managed to stay for 72 hours. Moreover, the major chunk of babies were delivered moderate to late preterm in the study. A total of 23 out of 39 babies presented with IUGR [Intrauterine Growth Restriction] which constitute about 58.97% of total. Regarding the impact of eclampsia on neonatal hematological profile, 25 [64.10%] developed thrombocytopenia, 8 [20.51%] developed anaemia while 6 [15.38%] were found showing no fluctuation in their haematological profiles

Conclusion: Babies born to pre-eclamptic mothers were found to have higher rates of NICU admissions and longer period of stay compare to those who born to non-eclamptic mothers

Moreover, premature birth and Respiratory Distress Syndrome [RDS] also impose significant risk to newborn babies

Early identification and collaborative approach regarding pre-eclampsia could help us mitigate the poor outcome of neonates born to eclamptic mothers

Conformational analysis and geometry optimization of apomorphine as an Anti-parkinsonian agent

Apomorphine, a dopamine D[1]/D[2] agonist, is an important drug of choice for the treatment of Parkinson's and related disorders. The present study was designed to perform the conformational analysis and geometry optimization of apomorphine. Resultant optimized structure corresponds to a substance as it is found in nature. This could be used for a variety of experimental and theoretical investigations especially in the field of pharmacokinetics. The results indicate that the best conformation of the molecule is present at minimum potential energy -88702.9595 kcal/mol. At this point molecule will be more active as histamine H[1] receptor agonist

Advantages of carotid endarterectomy under local anaesthesia with minimal cerebral monitoring: an experience of 45 cases

To evaluate the benefits, efficacy and safety of local cervical plexus block in the performance of carotid endarterectomy, in the absence of sophisticated cerebral perfusion monitoring. This study was carried out at Combined Military Hospital [CMH] Lahore, Pakistan from January 2012 to May 2013. Quasi-experimental study. A total of 45 cases of ASA II and ASA III physical status were operated for carotid endarterectomy under local block of cervical plexus. After thorough preanaesthetic assessment, the patients physical conditions were optimized before surgery. Premedication was given with midazolam and sedated during operation with small doses of propofol. Local anaesthesia [LA] was completed by injecting bupivacaine in cervical plexuses C2, C3 and C4 areas. During operation vital signs and adequacy of cerebral perfusion were monitored by keeping the patient awake and making clinical neurological observations. Verbal contact was maintained with the patient. Breathing patterns and motor power were assessed in contralateral upper and lower limbs. Postoperatively patients were interviewed and analgesia during operation was assessed with visual analogue scale. Surgeon's satisfaction regarding intraoperative analgesia was also noted. Patients who required added sedation or local anesthetic agent were also noted. Average duration of surgery time was two hours and average stay of the patients in hospital was five days. Out of 45 patients, 37 patients [82%] had smooth and comfortable anaesthesia and analgesia. In only 1 patient [2.2%] LA had to be converted into general anaesthesia [GA]. In 3 cases [7%] LA was supplemented. One patient [2.2%] developed hoarseness and difficulty in breathing and 1 patient [2.2%] developed hemiparesis intra-operatively; while 1 patient [2.2%] developed hypotension in the immediate postoperative period. One patient [2.2%] developed haematoma at infiltration site. Surgeon satisfaction was excellent in 40 [89%] cases. Surgery of carotid endarterectomy can be performed adequately and comfortably under LA. In centers where sophisticated facilities for intraoperative cerebral blood flow measurements are not available, clinical intraoperative assessment of cerebral functions is of immense benefit, which is only possible under LA

Conformational analysis and geometry optimization of buspirone-A 5-HT1A receptor agonist

Buspirone, a partial 5-HTiA receptor agonist, is a clinically prescribed anxiolytic

In the present study, conformational analysis and geometry optimization of buspirone were done as per Hartree-Fock [HF] calculation method by Argus Lab 4.0.1 software

The minimum potential energy was calculated by geometry convergence function by Argus Lab software

The results indicate that the best conformation of molecule is present at minimum potential energy of-100679.5513 kcal/mol. At this point, buspirone will be more active

Report of a recurrent mutation in ARS [component B] gene with severe Mal de Meleda in a large consanguineous Pakistani family

To characterize the disease causing mutation in a large consanguineous Pakistani family with severe Mal de Meleda [MDM] or keratosis palmoplantaris transgrediens, a rare autosomal recessive skin disorder. Single nucleotide polymorphism [SNPs] genotyping was performed using the GeneChip Mapping 250K array [Affymetrix]. Homozygosity mapping and sorting of genomic regions were performed with dedicated software called AutoSNPa. Selected regions were further investigated by genotyping with microsatellite markers derived from known and novel polymorphic repeats. Two-point LOD score calculation was performed by using the MLINK of Fastlink computer package. All three coding exons of ARS [component B] gene were amplified by PCR and sequenced. Sequencing of all the coding exons of ARS [component B] gene in the affected individuals revealed a recurrent missense mutation in exon 3 at base pair 256 from Guanine to Alanine [256G>A] and as a result the amino acid Glycine is replaced by Arginine at position 86 [G86R]. This finding will facilitate control of affected MDM births in the Pakistani families

Varicocele - laparoscopic versus open ligation

Objective: Evaluation of the advantages and disadvantages of laparoscopic varicocelectomy and its comparison with open ligation of varicocele

Design: Prospective comparative study between two techniques of varicocelectomy

Place and Duration Of Study: Surgical unit III of Jinnah Hospital, Allama Iqbal medical college, Lahore over a period of two years from January 1, 2002 through December 31, 2003. Subjects and Methods: Study comprised of two groups [A and B] with 52 consective patients fulfilling the inclusion criteria and comparative variables. Laparoscopic varicocelectomy [LPV] was performed on 26 patients [Group A] and open Palomo varicocelectomy [OPV] was performed on 26 patients [Group B]. Outcome data looked at relapse rate, postoperative hydroceles, wound complication and scrotal edema. Operating time, postoperative hospital stay and pain control were compared. In both groups operation was performed by Palomo technique i.e. ligation of both artery and internal spermatic vein in the retro peritoneum above the internal inguinal ring

Results: In LPV versus OPV group, the recurrence rate of varicocele was 3.8% in-group A versus no recurrence in-group B [p<0.001]. Postoperative hydroceles formation was 7.6% in group A versus 11.4% in group B [p < 0.003].wound complication was 3.8% in group A versus 7.6% in group B [p < 0.001]. Testicular or scrotal edema was 7.6% in group A versus 11.4% in group B.Postoperative hospital stay was 24 hours in group A versus 72 hours in group B [p < 0.001]. Operating time was 20 minutes in group A versus 30 minutes in group B [p <0.001]. Postoperative analgesia required was almost half in group A as compared to group B [p < 0.005]

Conclusion: The study shows that clinical efficacy of laparoscopic varicocelectomy is superior to traditional open varicocelectomy

preliminary survey of the prevalence of toxoplasmosis among pregnant women in and around Lahore

The present study was under taken to evaluate the incidence of toxoplasma gondii IgG and IgM antibodies in pregnant women by ELISA. It was revealed that one third of the pregnant women were in chronic phase of toxoplasmosis, whereas nearly 2% were suffering from acute phase of this infection. Antibodies to Toxoplasma gondii were found equally distributed among three trimesters. 38.7% of women having previous history of obstetric abnormalities i.e., abortion, still birth etc. were found positive. The incidence of toxoplasmosis was found to be directly related with age