ABSTRACT
Background: Placental abnormality is one of the initial events seen in patients who are destined to develop preeclampsia. The objective was to study whether ultrasonically identified; placental laterality and uterine artery resistance can be used as a predictor for development of preeclampsia. Methods: This prospective observational study was conducted at GMERS Medical College, Dharpur-Patan tertiary care teaching institute in North Gujarat from January 2013 to December 2014. A total 400 non high risk primigravida with singleton pregnancy were included, all patients with diabetes, hypertension, renal disease, and history of smoking were excluded. In all these patients, location of placenta was determined by ultrasonography at 18 to 22 weeks of gestation. Patients who had lateral placenta were subjected for colour Doppler study for determining uterine artery resistance index. All 400 patients were followed till delivery for occurrence of preeclampsia as per ACOG guidelines. All data was analyzed and statistical significance was determined by x2 test and value of p<0.05 is considered significant. Results: Out of 400 cases, 80 (20%) cases had laterally located placenta on ultra sound examination done at 18-24 weeks of gestation. Out of the 80 women with laterally located placenta, 28 (35%) developed preeclampsia. This relationship was statistically significant. All 80 patients who had lateral placenta, 26 patients had raised uterine artery resistance and out of those 26 patients, 22 developed preeclampsia and 54 had no change in uterine artery resistance. Out of those 54 only 6 had preeclampsia (p<0. 001). The sensitivity of determining uterine artery resistance as a predictive test was 84.6%, the specificity 88.8 %, positive predictive value 78.5 % and negative predictive value 92.3%. Conclusion: A chance of preeclampsia is more in patients with lateral placenta but its sensitivity and specificity increases significantly when it is combined with uterine artery velocimetric waveform study, and we can predict preeclampsia in patient who is having lateral placenta and raised uterine artery resistance.
ABSTRACT
Background: A school is a key location for educating children about health, hygiene and nutrition, and for putting in place interventions to promote the health of children. Objectives: of current study were 1) To study the socio demographic profile of children of boarding schools. 2) To study the growth, nutritional and hygiene status of children of boarding schools. Methods: The study was a cross sectional study. After taking the permission of principal of resident schools and consent of the parents of children, 867 children from 8 boarding schools were interviewed during February-March 2011. A self-administered questionnaire was used for data collection. Results: Age of the study children (total 867) ranged from 5-19 years. (Mean age = 13.80 ± 1.96 years). Out of 867, 434 (49.9%) were boys and 433 (50.1%) were girls. 32.6% belonged to socio economic class IV. There were only 122 (14.1%) children who had been in boarding school since 4 and more than 4 years. Good personal hygiene was observed in only 75 (8.7%) children followed by fair personal hygiene in 292 (33.7%) children and poor personal hygiene in 500 (57.7%) children. 220 (50.8%) female children had fair personal hygiene and 343 (79.0%) male children had poor personal hygiene and this difference was statistically significant. Prevalence of malnutrition in this study was 7.2% (Females = 4.2%; Males = 10.1%; P <0.001).The bulk of the malnutrition cases were constituted by the grade-I P.E.M. cases (66.1%) followed by grade-II P.E.M. cases (25.8%) and there were 5 (8.1%) cases of grade-III malnutrition only in female children. Conclusion: Poor personal hygiene, poor nutritional status among these children needs great attention and health education.