Analytical study on indications of primary cesarean section in tertiary care hospital

Background: Cesarean delivery is a commonest obstetric surgical procedure performed. WHO stated that regional cesarean section rate should not exceed 10 to 15%. However in many countries cesarean delivery has increased steadily over years. Hence present study is conducted to analyze various indications of primary cesarean section in a tertiary hospital, with an aim to reduce cesarean section rate.Methods: This is a retrospective study conducted in Cheluvamba hospital, Mysore Medical College Research Institute, Mysore, which is a tertiary care centre. For a period of 6months from 1st June 2018 to 31st November 2018Inclusion criteria: All primary cesarean section done at Cheluvamba hospital during study period were included.Exclusion criteria: Previous cesarean section, patients with previous history of laparotomy done for any obstetric or gynecological cause were excluded.Results: During the study period there was 3799 number of cesarean section. Amongst these 983 cases were primary cesarean section done for varying indications. Hence the rate of cesarean section in our hospital is 25.87%. There were 40.3% cases of fetal distress, failed induction (13.6%), breech (10%), CPD (8%), IUGR with poor BPP (1.8%) Ante partum haemorrhage (3%), DTA (3.5%).Conclusions: From our study, we would conclude that rising trend in cesarean section is an alarming issue. Measures need to be taken to reduce cesarean delivery like Regular use of partograph, Judicious use of amniotomy, oxytocin with inducing agents, Expertization of skills to conduct instrumental vaginal delivery, which is a lost art in modern obstetrics.

Dysplasia epiphysealis hemimelica (Trevor’s disease): a rare case report with oral manifestations.

Dysplasia epiphysealis hemimelica, also known as Trevor’s disease, is an extremely rare skeletal developmental disorder of unknown etiology, characterized by an osteocartilaginous outgrowth of one or more epiphyses or of a tarsal bone during childhood. It is a rare skeletal hemimelica disorder characterized by asymmetric growth of cartilage in one or more epiphyses. Due to the unusual presentation and variability of the picture, there is no standardized treatment and outcome is very different. Also such an unusual, unique case with craniofacial manifestations has not been reported in the literature. We report a case of a 14-year-old male, who complained of irregularly placed teeth in upper and lower front teeth region. On general physical examination we noticed some skeletal abnormalities with the patient and hence we subjected him to radiographic investigations. The images were consistent with epiphyseal dysplasia hemimelica. The prognosis of DEH is variable and depends basically on its location and size. Carriers of this unusual dysplasia should be periodically monitored for the risk of recurrence.

Gingival Enlargement: Revisited: A Case Series.

Gingival enlargement can be hereditary or acquired. More than 20 prescription medications are associated with gingival overgrowth. A detailed review on the risk factors and pathogenesis from various peer reviewed journals has been discussed in this article. The aim was to discuss the role of drugs causing gingival enlargement, the hereditary gingival fibromatosis (HGF) and its possible pathogenesis. The following case series highlights four cases of gingival enlargement, one being a case of HGF and the other three being drug-induced gingival enlargement. Variable etiopathogenesis such as age, genetic predisposition, pharmacokinetic variables, tissue homeostasis, inflammation and growth factors have been associated with this disease. Inflammatory changes that occur within the gingival tissues appear to orchestrate the interaction between the “modified fibroblast” and the drug. Alternatively, these drugs influence directly the inflammatory response in the form of enlargement. This information is valuable for the clinician as it will have implication to treat the patient effectively.

Efficacy of 5-(2-aroyl)aryloxy methyl-2-phenyl-1,3,4-oxadiazoles as antibacterial and antifungal agents.

Research and development of potent and effective antimicrobial agents represent one of the most important advances in therapeutics; the main aim of these efforts is not only control the serious infections, but also prevention and treatment of some infectious complications of other therapeutic modalities. A series of 5-(2- aroyl)aryloxy methyl-2-phenyl-1,3,4-oxadiazoles were screened for their antibacterial and antifungal activities. Anti-bacterial activity against B. cereus, S. aureus, B. subtilis, S. aureus (MRSA), E. aerogenes, M. luteus, K. pneumonia, P. aeruginosa, S. typhimurium, E. coli, paratyphi-B, P. vulgaris bacterial strains and anti-fungal activity against C. albicans, A.niger, F.solani, A.flavus, B.cinerea, C.krusei, M. pachydermatis, C.parapsilosis, F.moniliforme, C.gloeosporioides fungal strains were carried out. The bioassays indicated that most of the synthesized compounds showed potential antibacterial and anti-fungal activity.

Antimicrobial and Antioxidant activity of leaf and flower extract of Caesalpinia pulcherrima, Delonix regia and Peltaphorum ferrugineum.

The present study was undertaken to determine antimicrobial and antioxidant activities of leaf and flower extracts of Caesalpinia pulcherrima, Delonix regia and Peltaphorum ferrugineum. Antimicrobial activity was tested against Staphylococcus aureus, Salmonella typhi, Candida albicans and Cryptococcus neoformans by Agar well diffusion assay. Antioxidant activity was determined by DPPH free radical scavenging assay, ABTS free radical scavenging assay, Ferric reducing assay and Total antioxidant capacity determination. Total phenolic content of extracts was estimated by Folin-Ciocalteau Reagent method. S. typhi and C. neoformans were susceptible to extracts to greater extent than S. aureus and C. albicans among bacteria and fungi respectively. Except C. pulcherrima extract, the leaf extracts were more effective in inhibiting bacteria than flower extracts. Leaf extracts have shown high antifungal activity than flower extracts. The extracts have shown dose dependent scavenging of DPPH and ABTS radicals. Scavenging of ABTS radicals was more efficient than that of DPPH radicals as revealed by low IC50 values. All leaf extracts except C. pulcherrima displayed stronger scavenging activities than flower extracts. Similar results were observed in ferric reducing assay and total antioxidant capacity determination. Total phenolic content was found to be higher in leaf extracts (except C. pulcherrima) than flower extracts. A correlation has been observed between phenolic content of leaf and flower extracts and the antioxidant activity. A marked antimicrobial and antioxidant activity of leaf and flower extracts was observed which may be attributed to the presence of phenolic compounds and other phytochemicals. The plants can be used to control infectious diseases and oxidative damage.

Genetic molecular analysis of Coffea arabica (Rubiaceae) hybrids using SRAP markers

In Coffea arabica (arabica coffee), the phenotypic as well as genetic variability has been found low because of the narrow genetic basis and self fertile nature of the species. Because of high similarity in phenotypic appearance among the majority of arabica collections, selection of parental lines for inter-varietals hybridization and identification of resultant hybrids at an early stage of plant growth is difficult. DNA markers are known to be reliable in identifying closely related cultivars and hybrids. Sequence Related Amplified Polymorphism (SRAP) is a new molecular marker technology developed based on PCR. In this paper, sixty arabica-hybrid progenies belonging to six crosses were analyzed using 31 highly polymorphic SRAP markers. The analysis revealed seven types of SRAP marker profiles which are useful in discriminating the parents and hybrids. The number of bands amplified per primer pair ranges from 6.13 to 8.58 with average number of seven bands. Among six hybrid combinations, percentage of bands shared between hybrids and their parents ranged from 66.29% to 85.71% with polymorphic bands varied from 27.64% to 60.0%. Percentage of hybrid specific fragments obtained in various hybrid combinations ranged from 0.71% to 10.86% and ascribed to the consequence of meiotic recombination. Based on the similarity index calculation, it was observed that F1 hybrids share maximum number of bands with the female parent compared to male parent. The results obtained in the present study revealed the effectiveness of SRAP technique in cultivar identification and hybrid analysis in this coffee species. Rev. Biol. Trop. 59 (2): 607-617. Epub 2011 June 01.

En Coffea arabica (café arabica), el fenotipo y la variabilidad genética son bajos debido a la estrecha base genética y la autofecundación de la especie. Por su alta similitud fenotípica entre la mayoría de las colecciones de arábica, la selección de líneas parentales para hibridación entre variedades, y la identificación de los híbridos resultantes en una fase inicial de crecimiento, es difícil. Para la identificación de variedades estrechamente relacionadas y sus híbridos, los marcadores de ADN son confiables, pero los polimorfismos de amplificación de secuencias relacionadas (SRAP, por sus siglas en inglés) constituyen una nueva tecnología de marcadores moleculares basada en PCR. En este trabajo, sesenta progenies arábica híbridas, pertenecientes a seis cruces, fueron analizadas utilizando 31 marcadores altamente polimórficos. El análisis reveló siete tipos de perfiles de marcadores que son útiles en la discriminación de los progenitores y los híbridos. El número de bandas amplificadas por pares de cebadores estuvo entre 6.13 a 8.58 con un promedio de siete bandas. Entre las seis combinaciones de híbridos, el porcentaje de bandas compartidas entre híbridos y sus progenitores estuvo entre 66.29% y 85.71% con bandas polimórficas que variaron entre 27.64% y 60.0%. El porcentaje de fragmentos híbridos específicos obtenidos en diversas combinaciones híbridas varió entre 0.71% y 10.86% lo que se atribuye a la recombinación meiótica. Con base en el cálculo del índice de similitud, se observó que los híbridos F1 compartieron un número máximo de bandas con el progenitor femenino que con el masculino. Los resultados obtenidos en este estudio muestran la eficacia de la técnica de SRAP en la identificación de cultivos e híbridos de esta especie de café.

Prevalence, species distribution and antifungal sensitivity of vaginal yeasts in infertile women.

A total of 326 high vaginal swabs from infertile women attending the Institute of Reproductive Medicine were cultured from June 1999 to May 2000. Candida species was isolated from 42(12.88%) patients. Candida albicans (40.47%) followed by Candida glabrata (38.09%) were the most common isolates. Other species included Candida tropicalis (14.28%) and Candida krusei (7.14%). All isolates were tested for sensitivity by disc diffusion method on Yeast Nitrogen Agar base towards four antifungals. Seven (16.7%) candida strains showed resistance to Fluconazole and 19(45.23%) of the strains showed resistance to Itraconazole, and 4(9.5%) strains showed resistance to Nystatin. There was no resistance to Amphotericin B. Of the 7 strains resistant to Fluconazole, 3 were Candida krusei, 3 were Candida glabrata and 1 was Candida tropicalis.

Vaginal carriage of group B Streptococcus in infertile women.

From May, 1999 to April, 2000, 256 high vaginal swabs were culture from asymptomatic infertile women attending the out-patient department of the Institute of Reproductive Medicine. 41 strains of Streptococcus agalactiae were isolated from 33 patients (12.89%). Five patients had repeated isolations even after adequate therapy.