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Background: Hysterectomy is one of the most common operation performed in Obstetrics and Gynecology next to caesarean section. Due to its advantages vaginal hysterectomy are more and more performed now. Only drawback is lack of expertise. Present study focuses on comparison between outcomes in abdominal versus vaginal hysterectomy and to determine which route of hysterectomy is superior, safer and effective.Methods: The study is a prospective study conducted in the department of obstetrics and Gynecology. Civil hospital, Ahmedabad between the period of Jan 2016 to 2017. Of 100 patients. Fifty patients who underwent hysterectomy by vaginal route are taken as study group A, and the remaining 50 patients who underwent by the abdominal route are taken as study group B.Results: Majority of women undergoing hysterectomy were in age group of 30-50 years; postmenopausal age group women were less;13 NDVH and 5 in AH. Majority of the women were multipara in both age groups. Menorrhagia was found to be major indication with 42 in NDVH and 40 in AH. There is much significant difference in the postoperative pain in both groups with less in NDVH group. There is not much significant difference in blood loss in both the groups. Postoperative complications were more with AH.Conclusions: Thus, it can be concluded that NDVH is feasible, safe and provide more patient comfort without increasing the duration of surgery and other post-operative complications.
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Background: Pregnancy comes as a temporary complication in the disease process of a patient with a cardiac lesion. It is the 4th common cause of maternal mortality and one of the most important non-obstetrical causes of maternal death. Previously most women with diagnosed heart disease were advised to avoid pregnancy and labor and termination was advised. But in modern obstetrical practice, pregnancy in a patient with a heart disease is no longer an unacceptable hazard. The objective of this study is to find out incidence of cardiac diseases in pregnancy, to evaluate their management and to find out maternal and fetal outcome in pregnancy with cardiac disease.Methods: This study is a prospective cohort study in which an analysis of maternal and fetal outcome in 30 cases of cardiac diseases in pregnancy was carried out in the department of Obstetrics and Gynaecology in our institute at Civil hospital Ahmadabad from 01/01/2017 to 31/12/2017.The study included all known case of RHD, CHD, or newly diagnosed case or surgically corrected case with prosthetic heart valves during current pregnancy.Results: Majority of women having pregnancy with cardiac disease were in the age group of 20-30 years. Majority of them were primigravida and suffered from rheumatic heart diseases with grade 1 NYHA severity. Majority of women got delivered by normal vaginal delivery with healthy fetal outcome. Most of the babies born to cardiac mother had their baby weight ranging between 2.0-2.5kg.Conclusions: The results of present study indicate that heart disease forms a considerable proportion of medical illness complicating pregnancy. Cardiac disease presents problems both to the obstetrician and as well as to the physician, cardiologist and to the neonatologist. But the majority of pregnancies complicated by heart disease are uneventful with a favorably good outcome for both the mother and the fetus.
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Background: The present study was undertaken to evaluate the incidence and pattern of adverse drug reaction (ADRs), causality, severity and preventability of ADRs.Methods: Data was collected and analyzed with the information such as patients’ demographic details, associated co-morbid conditions and detailed drug related information gathered from ADR reporting forms. World Health Organization (WHO) scale was used for assessing causality, modified Hartwig scale was used for assessing severity and modified Schumock and Thorntons scale were used for assessing preventability of ADRs. Data was analyzed using descriptive statistics.Results: Total 154 ADRs were reported in a period of one year (August 2016- July 2017). Out of 154 ADRs analyzed, 120 (77.9%) were in adults, 33 (21.4%) pediatric and 01 (0.7%) in geriatric patients. The most common ADR recorded was cutaneous reactions (43.5%) and the most common causative class of drugs for the same was found to be antimicrobials (46.7%) followed by non-steroidal anti-inflammatory drugs (15.6%). Causality assessment scale indicated 68.8% ADRs possible and 24% ADRs as probable. Severity assessment revealed that 45.5 % were mild, 50.6% moderate and 3.9% ADRs severe. Preventability assessment showed 84.4% of the cases were probably non-preventable.Conclusions: In this study it was found that, most of the ADRs were of possible category with mild to moderate severity and majority being non-preventable. Antimicrobial drugs being the most common offending drug class causing ADRs. Strategies targeting appropriate and cautious use of this class of drugs may benefit in reducing the number of ADRs and therefore the cost involved in the treatment.
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Background: Coronary artery disease (CAD) is a major cause responsible for mortality more in younger age group than in elderly. Studies have reported underuse of four evidence based medicines namely aspirin, β-blockers, angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARB), and statins in patients with CAD, particularly in developing countries. Therefore, this study was planned to analyse the prescriptions of patients with CAD to determine the appropriateness of the prescriptions.Methods: After obtaining the Institutional ethics committee permission, a cross sectional observational study was conducted at a tertiary care hospital. Total 150 patients were enrolled from the outpatient department, wards and intensive care unit of medicine department. Total 150 patients’ prescriptions presenting with varied category of CAD were screened and analysed.Results: The most common categories of CAD encountered was ST segment elevated myocardial infarction (N=50, 33%) followed by chronic stable angina (N=29, 20%). Among the drugs prescribed, antiplatelet drugs were prescribed to 135 (90%), hypolipidemics to 134 (89%), nitrates to 114 (76%), beta blockers to 97 (65%), ACE inhibitors to 94 (64%), anticoagulants to 60 (40%) and miscellaneous drugs to 52 (35%), patients. Of 68 (45%) patients with type 2 diabetes mellitus, 15 (22%) were prescribed only metoprolol and others were given ACE-I or ARBs.Conclusions: Among four evidence based drugs, use of 3 drugs, antiplatelets, beta blockers and hypolipidemics was apparent in 90% of prescriptions. Use of ACE inhibitors and ARBs was observed in type 2 diabetic patients with CAD, reflecting rational prescribing behavior of clinicians.
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Background: Needle stick injury are the most common reason behind occupational blood exposure and most important source of exposure to another person’s blood.Methods: A cross-sectional observational questionnaire-based study of 450 undergraduate medical students which includes 100 from each years, Second year: Part I (II/I: Third Semester), Second year: Part II (II/III: Fifth Semester), Third Year (III: Seventh Semester), Fourth year (IV: Ninth Semester) MBBS and 50 Interns. The participation was voluntary and written consent was taken prior to enrollment. The objectives of study were explained, and validated questionnaire was administered to the students and collected in a single visit after 30-40 minutes.Results: The average age was 21.91±2.03 years. About 406 students were aware of disease transmitted by NSI. 189 students felt that occurrence of NSI, first person to be contacted is Medicine Physician. 208 don’t know of existence of PEP. 164 felt PEP is to be given for 4 weeks. According to 138 students PEP guidelines were proposed by NACO while 101 students felt WHO. 261 students felt that most probable chance of getting NSI was in emergency ward. 363students felt that need for NSI PEP training before clinical exposure is very important. 345 felt the need for insurance of HCWs for diseases transmitted by NSI.Conclusions: Medical students are highly vulnerable to NSI and there is need to provide adequate preventive measures, frequent training for needle stick injury and postexposure prophylaxis to all healthcare workers.
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Background: Ayurvedic literature claims that Boerhavia diffusa possesses rejuvenative properties especially related to the urinary system. Objective: To evaluate effect of aqueous extract of root of Boerhavia diffusa in gentamicin‑induced nephrotoxicity in rats. Materials and Methods: Study was conducted in two parts, using 40 rats in each part. Rats were equally divided into five groups for each part. Group 1: Normal control, Group 2: Disease control and Groups 3, 4, and 5: α‑lipoic acid (ALA) and 200 and 400 mg/kg of B. diffusa, respectively. All groups, except Group 1, concomitantly received gentamicin 150 mg/kg/day for 10 days. Parameters measured in part I were blood urea nitrogen (BUN), serum creatinine, kidney malondialdehyde (MDA), and glutathione (GSH) levels, kidney injury on histopathology; in part II, paraaminohippurate (PAH) clearance. Statistical Analysis: Mean ± SD of body weight, creatinine, BUN, MDA, GSH and PAH clearance were compared using parametric tests. Median histopathology scores were compared using Kruskal–Wallis test. ‘P’ value of < 0.05 was considered significant. Results: High dose of gentamicin caused significant elevation in BUN, serum creatinine and kidney MDA, fall in kidney GSH and histopathological damage in disease control group as compared with normal control (P < 0.05). Treatment with B. diffusa prevented changes in above parameters, comparable to ALA. Effects of both doses of B. diffusa were significantly better than disease control (P < 0.05). B. diffusa did not show significant improvement in PAH clearance, which was reduced due to gentamicin damage. Conclusion: B. diffusa exerted protection against structural and functional damage induced by gentamicin possibly due to its antioxidant properties.
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The aim of the study is to determine birth weights, placental weights and feto-placental ratio in consecutive, live singleton term births and study their relationship with some maternal and fetal factors. Method: Fifty placentae were obtained from the labour room of the department of obstetrics and gynecology , Civil hospital, Sola , Ahmedabad between September to December 2010. Each placentae was weighed and the feto-placental ratio and insertion percentage was calculated. Maternal data, including name, age, hospital number, date of last menstrual period, parity, duration of pregnancy, hematological findings and the gestational age were recorded and correlated with birth weight and placental weight. Result: There was 52% of female and 48 % of male babies. The mean birth weight of female babies was 2.58 Kg and that of male babies was 2.69 Kg . The mean placental weight of female babies was 472.70 gms and that of male babies was 513.75 gms. The mean feto-placental ratio of female and male babies was 5.46 and 5.28 respectively. The mean placental weight was found lower with mother’s age < 20 years , increase number of parity and Hb less than 8 gm %. The mean placental weight was found slightly higher in mother’s with blood group A +ve and AB +ve. The site of insertion of umbilical cord was central in 40 %, medial in 38 %, lateral in 14 % and marginal in 8 %. The birth weight of babies was directly proportional to their placental weight. Conclusion: With extra precautions for the factors reducing placental weight and or birth weight one can reduce further risk to mother and foetus.