ABSTRACT
BACKGROUND:Patients with Mild Carpal tunnel syndrome (CTS) may not be picked up by routine nerve conduction methods. So, this study was performed to identify the most sensitive way to detect mild to moderate Carpal tunnel syndrome and to evaluate the sensitivity of different methods for diagnosis of carpal tunnel syndrome.MATERIALAND METHOD: We included sixty clinically confirmed CTS patients in our study. We recorded the clinical characteristics and laboratory features in a proforma. We also included sixty healthy age and sex-matched asymptomatic individuals as controls in our study. We excluded patients with underlying peripheral neuropathy. We included Median distal motor latency, Median distal sensory latency, Median-versus-ulnar 2nd Lumbrical-interossei comparison study, Median-versus-ulnar wrist-to-digit four comparison study, Median -versus- Radial thumb sensory study, Median-versus-ulnar motor distal latency difference, and Median-versus-ulnar sensory latency difference tests in our study.RESULTS:Out of sixty patients, female: male ratio was 2.3:1, and the mean age was 44.28±11.41 years. The mean symptom duration was 0.76±0.03 years. Out of 42 females, 38(90.4%) were engaged in daily household activities. In patients group median nerve distal motor latency was 5.024±2.05 ms, whereas sensory latency was 3.53±0.75 ms. We found maximum sensitivity in Median-versus-ulnar wrist-to-digit four comparison study (90.19%). In Median-versus-Radial thumb sensory study sensitivity was 88.23%, followed by Median-versus-ulnar 2nd Lumbrical- interossei comparison study (86.27%). We found lowest sensitivity (72.55%) in Median distal motor latency test.CONCLUSION:Electrophysiological tests including Median-versus-ulnar wrist-to-fourth digit comparison study, and comparative study of Median-versus-ulnar 2nd Lumbrical- interossei should be included to diagnose mild CTS patients with normal Median distal motor latency, and median distal sensory latency tests
ABSTRACT
Background: Hypertensive disorders complicate 5-10% of all pregnancies and form a dangerous triad with haemorrhage and infection that contribute greatly to maternal morbidity and mortality. The fetus is dependent on placenta for growth and development. Many disorders of pregnancy like hypertension are accompanied by gross pathological changes in placenta. Aim: The aim of the study was to assess the gross morphology of placentae of women with pregnancy induced hypertension and to compare them with normal pregnancies. Material and methods: An observational comparative study was carried out in the Department of Anatomy, S. M. S. Medical College, Jaipur, Rajasthan. Total 80 placentae, 40 from pregnancy induced hypertensive pregnancies and 40 from normal pregnancies were studied for the morphology and compared. Gross morphological features of placentae like weight, shape, insertion of umbilical cord, number of cotyledons, diameter, surface area and central thickness in both groups were recorded and analyzed using ‘Chi square’ and ‘Z’ test of significance. Results: The mean placental weight, numbers of cotyledons, diameter, surface area and central thickness were significantly less (p<0.05) in placentae from pregnancy induced hypertensive women. They also showed increased incidence of marginal insertion of umbilical cord (p<0.01), while the shape of placentae did not show significant variation (p>0.05). Conclusion: The placentae from hypertensive pregnant women showed significant morphological changes as compared to controls which may alter the perinatal outcome.
ABSTRACT
Background: The fetus, placenta and mother constitute a triad of contributors to pregnancy outcome. When pregnancy is complicated by a medical problem like, diabetes mellitus which affects maternal health, architecture and functions of the placenta may even jeopardize the fetal normalcy. The placenta being the bridge between maternal and fetal activities, considered as a window through which maternal dysfunctions and their impacts on fetal well being can be understood. Aim: The aim was to study gross morphology of placentae of women with gestational diabetes mellitus and to compare the results with normal pregnancies. Methods: It was an observational study. After due approval from institutional ethics committee, 40 placentae from pregnant women clinically diagnosed with gestational diabetes mellitus and 40 placentae from uncomplicated normal pregnant womenwere collected from labour room and operation theatre of department of obstetrics and gynaecology of government medical college hospital in Jaipur (Rajasthan). Confirmed gestational diabetic caseswere selected purposively while controls were taken sequentially. Grossmorphological features of each placentawere recorded. The statisticalmethods usedwere unpaired ‘t’ test and chi square test. Results: The results showed that weight, diameter, surface area, central thickness and number of cotyledons of placentae from diabetic mothers were significantly more than placentae from normal uncomplicated pregnancies, while no significant differences were observed in shape and site of umbilical cord insertion. Conclusion: The gross morphology of placentae with gestational diabetes mellitus significantly differs from normal pregnancies which may be associated with alteration in physiological functioning of placenta and ultimately fetal outcome.