ABSTRACT
Background: Prolongation of labor is one such dilemma that every obstetrician tries to avoid. The ultimate aim of the obstetrician is to accomplish the delivery in the shortest possible time without compromising maternal and fetal safety. Prolonged labor often ends up in great suffering to the parturient because of dehydration, confusion, and infection. This study aims to compare the efficacy of drotaverine hydrochloride with hyoscine butyl bromide for increasing the rate of cervical dilatation and to compare their duration of labor. Methods: This was a prospective interventional study conducted on 60 women who were randomly allocated to Group I, which was control group, women in Group II were injected hyoscine butylbromide one ampoule (20 mg) and the women in Group III were injected drotaverine hydrochloride one ampoule (40 mg) intramuscular at 3 cm dilatation of cervix. The data collected was statistically analyzed using SPSS version 15. Results: When compared to Group I (control group), Group II and Group III took lower time for all the three stages of labor. However, intergroup difference was significant only for Stage I (p<0.001). However, no significant difference was observed between Groups II and III (p=0.964). A significant difference among group was observed in total duration of labor too (p<0.001). Between group comparisons for Stage II and Stage III did not show a statistically significant intergroup difference for any of the comparisons (p>0.05). Conclusions: The finding in this study suggested a significant impact of both the drugs in first stage as well as total duration of labor as compared to control group. However, no significant difference between two study groups was observed. Thus, both drotaverine hydrochloride and hyoscine butylbromide could effectively reduce first stage as well as total duration of labor.
ABSTRACT
Holt-Oram syndrome is an inherited disorder that causes abnormalities of the hands, arms and heart. The diagnosis can be established clinically. The diagnostic criteria have been validated with molecular testing. An upper-limb malformation involving the carpal bone(s) and, variably, the radial and/or thenar bones-An abnormal carpal bone, present in all affected individuals and identified by performing a posterior-anterior hand x-ray, may be the only evidence of disease. 24 years unbooked Hindu female G2P1+0 presented in OPD at term. Her USG examination showed-small deformed upper limbs with poorly appreciable upper limb skeleton. Induction of labour was done and patient delivered vaginally a female baby with deformed upper limbs. This case emphasizes the importance of proper history taking (family history), early diagnosis of such anomalies and proper counseling the parents.
ABSTRACT
Background: Scrub typhus usually affects previously healthy active persons and if undiagnosed or diagnosed late, may prove to be life‑threatening. Diagnosis of scrub typhus should be largely based on a high index of suspicion and careful clinical, laboratory and epidemiological evaluation. Objective: To describe the diverse clinical and laboratory manifestations of scrub typhus diagnosed in Mahatma Gandhi Medical College and Hospital, Jaipur. Materials and Methods: All cases of febrile illness diagnosed as scrub typhus over a period of 3 months were analysed. Diagnosis was based on ELISA test for antibody detection against 56 kDa antigen. Results: Forty‑two cases of scrub typhus were seen over a period of 3 months (October, 2012‑December, 2012). Common symptoms were high grade fever of 4‑30 days duration, cough, haemoptysis and breathlessness. Eschar was not seen even in a single patient. Liver enzymes were elevated in nearly all cases (95.9%). Multiple organ dysfunction syndrome (MODS) was present in 16.66% of our patients (7 out of 42). Hypotension (6 patients, 14.2%), renal impairment (9 out of 15 patients, 60%), acute respiratory distress syndrome (4 patients, 9.52%) and meningitis (4 patients, 9.52%) were some of the important complications. There was a dramatic response to doxycycline in nearly all the patients, but initially when the disease was not diagnosed, seven patients had died. Conclusion: Scrub typhus has emerged as an important cause of febrile illness in Jaipur. Empirical treatment with doxycycline is justified in endemic areas.
ABSTRACT
Resistance to broad spectrum beta lactams, mediated by extended spectrum beta lactamase (ESbetaL) and AmpC betaL enzymes is an increasing problem worldwide. Presence of these in clinical infections can result in treatment failure if one of the second or third generation cephalosporins is used. Therefore, it is recommended that any ESbetaL-producing organism according to the National Committee for Clinical Laboratory Standards (NCCLS) criteria can be reported as resistant to all extended spectrum beta lactam antibiotics regardless of the susceptibility test results. In this study, a total of 250 Escherichia coli (E. coli) isolates were subjected to Double disc test and AmpC disc test for the detection of ESbetaL- and AmpC betaL-producing strains, respectively. Prevalence of ESbetaL- and AmpC betaL-producing strains among E. coli isolates, over a 3-month-period in the hospital-based population of Jaipur, was 64.80% (162/250). AmpC betaL producers were 24.00% (60/250) and co-existence of ESbetaL and AmpC betaL was detected in 8.00% (20/250) of the isolates.