ABSTRACT
Background: Anemia, the decrease of haemoglobin (Hb) concentration is a common disorder complicating pregnancy mostly due to hemodilution, increased demand of iron and poor dietary intake of iron. The aim of this study was to evaluate whether parenteral iron sucrose can be used as an alternative to daily oral iron during pregnancy.Methods: It was a prospective interventional study conducted in the Department of Obstetrics and Gynaecology, Rohilkhand Medical College and Hospital, Bareilly involving pregnant women at 16-24 weeks with Hb 7-10 g/dl. They were randomly allocated to two groups I and II. Group I (oral group) was given oral iron tablets containing 100 mg of elemental iron and 0.5 mg of folic acid as per therapeutic requirement. Group II (parenteral group) were admitted as day care patients and given a total calculated dose of iron sucrose in divided doses of 200 mg each in 100 ml of normal saline as slow intravenous infusion. Hb, packed cell volume (PCV), blood indices were measured at the start, 2 weeks and 4 weeks of treatment. Any side-effects of treatment were also studied.Results: A statistically significant increase in values of Hb, hematocrit, reticulocyte count, red blood cells (RBC's) indices: mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular hemoglobin (MCH) coupled with no serious side effects with iron sucrose as compared with oral iron.Conclusions: Intravenous iron sucrose complex is safe, convenient and effective alternative to oral iron for treatment of iron deficiency anemia in pregnancy.
ABSTRACT
Background: Non-stress test (NST) is a graphical recording of changes in fetal heart activity and uterine contraction along with fetal movement when uterus is quiescent. NST is primarily a test of fetal condition and it differs from contraction stress test which is a test of uteroplacental function. The present study aimed at evaluating the efficacy and diagnostic value of NST for antenatal surveillance in high-risk pregnancy and comparing the mode of delivery with test results.Methods: A clinical study of NST was done between November 2014 to October 2015. NST was used for their surveillance from 32 weeks of gestation and NST was recorded weekly, biweekly, on alternate days or even on daily basis depending on high risk factors and were followed up.Results: A total of 100 cases were enrolled in the study. The mean age of patients was 25.09±3.78 years. In all 14 cases (23.3%) with reactive NST underwent lower caesarean section (LSCS) whereas 36 cases (90%) with non-reactive NST underwent LSCS. The mean NST delivery interval with reactive NST was 9.8±7.1 hours and in cases with non-reactive NST it was 9.2±8.6 hours, the difference was statistically not significant (p=0.70).Conclusions: NST tells about acute fetal hypoxia and decision to delivery time can be made for those patients with fetal distress so that a major improvement in the outcome among parturient can be achieved with abnormal NST results. An abnormal NST should alert the clinician of fetal compromise and has to be followed up by other biophysical tests.
ABSTRACT
Megalencephalic Leukoencephalopathy is a rare entity which was first described by Van Der Knaap et al in 1995.[1] It is a progressive neurodegenerative disorder characterized by slow progression of mental deterioration. Megalencephaly sets in early in the disease usually in first year and can be more than 4 standard deviation above the mean. Seizures are present in almost all the patients. [2] We present typical MRI findings in a case of megalencephalic leukodystrophy with sub-cortical cysts.Megalencephalic leukoencephalopathy with sub-cortical cysts is a rare entity that presents with macrocephaly and seizures. Mental deterioration is often mild with slow progression. Macrocephaly may be present at birth or develops in first year. Typical magnetic resonance imaging (MRI) findings help to clinch the diagnosis.
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The pathophysiology and clinical course of focal fat infarction of appendage of falciform ligament is similar to other acute fat infarction abdominal conditions like omental infarction and epiploic appendagitis in that it presents with acute abdominal pain and responds well to conservative treatment. Importance of radiological diagnosis is to avoid unnecessary surgery.[1] Torsion and focal fat infarction of appendage of falciform ligament is an extremely rare condition which presents with acute abdomen. It can mimic other serious abdominal conditions which require urgent surgical intervention. It is important to be aware of its computed tomography (CT) findings so as to avoid unnecessary surgical intervention. We present CT findings in case of focal fat infarction of appendage of falciform ligament in a young male who presented with acute epigastric pain.
ABSTRACT
DNET is a low grade cortical neoplasm which closely resembles cortical dysplasia on magnetic resonance imaging (MRI). It is usually non-enhancing but can show some enhancement on about one third of case. Rarely enhancement can be ring like and when the mass is large in size, it can cause considerable diagnostic problem from higher grade gliomas. However, age of the patient and associated features like calcification, lack of mass effect and long duration of symptoms should assist in reaching the correct diagnosis. Dysembryoplastic neuroepithelial tumour (DNET) is low grade cortical glioma which is most commonly seen in temporal lobe. It is usually a non-enhancing tumour but sometimes it can show enhancement and occasionally it can be ring like, which can cause diagnostic confusion with higher grade gliomas. We report a case of DNET which showed ring like enhancement of post contrast images.
ABSTRACT
Schwannomas are benign tumours arising from neoplastic transformation of Schwann cells around the nerve fibres. Tumours situated deeply like in retroperitoneum or pelvis are usually asymptomatic and may not be detected. Such long standing tumours may undergo extensive degenerative changes giving rise to ancient schwannomas.[1] Ancient schwannoma is an uncommon variant of schwannomas characterized by extensive degenerative changes and hypocellular areas. Presacral ancient schwannomas are rare and most of the reported cases are in females. We describe computed tomography (CT) findings in a case of presacral ancient schwannoma in a 49 year old male patient.
ABSTRACT
Post-traumatic isolated mesenteric tear with associated small bowel gangrene is a rare event after blunt abdominal trauma and has been reported previously in literature. [1] Post-traumatic thrombosis of inferior vena cava (IVC) is a very rare event with only isolated case reported in literature. [2] We report a rare case of mesenteric tear with segmental small bowel infarction. There was also right adrenal gland haematoma with associated thrombosis of right adrenal vein, which was extending into inferior vena cava causing its partial thrombosis. Post blunt trauma focal mesenteric tear and segmental small bowel gangrene is a rare event. Posttraumatic right adrenal haematoma is well described in literature while traumatic inferior vena cava (IVC) thrombosis is exceedingly rare. We report a rare case showing association of focal mesenteric tear with segmental small bowel gangrene and associated right adrenal haematoma with adrenal vein haematoma extending into IVC causing its partial thrombosis. To the best of our knowledge, such unusual association has not been reported previously in literature.
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Background: The objective of the present study was to compare the changes in serum lipid profile in normal pregnant women with those in patients with pre-eclampsia. Methods: In this study total 140 study subjects were evaluated, 70 normotensive pregnant women as a control group and 70 pre-eclamptic patients as a study group. Study Subjects were between the age group of 20-35 years and in the second and third trimester of pregnancy. Fasting blood samples were collected and serum level of Triglycerides (TG), Total Cholesterol (TC), High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), and Very Low Density Lipoprotein (VLDL) were measured by enzymatic colorimetric method. Results: There was a significant rise in TC, TG, LDL and VLDL and significant decrease in HDL level in pre-eclamptic group as compared to normal pregnant women.Conclusion: The findings of the present study are consistent with previous studies suggesting an altered lipid profile has a potential role in the genesis of endothelial dysfunction and expression of pre-eclampsia.
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Background: To find out the correlation of bacterial vaginosis (BV) in idiopathic preterm labour and find its association with an adverse pregnancy outcome in patients with idiopathic preterm labour. Methods: This is a comparative study, comprising of 150 pregnant females in study group admitted with preterm labour without any obvious cause and 150 pregnant women with singleton pregnancy at term in the control group. Both the groups were tested for BV by using Amsel's criteria and Nugent's criteria. Diagnosis of BV was stamped based on gram staining of vaginal discharge smear. All patients were followed till delivery. Results: In the study group, significantly large number of women tested positive for BV on gram staining of vaginal discharge as compared to control group (20.6% vs 8.0%). In the study group, an adverse pregnancy outcome in the form of preterm delivery (<37 weeks) was noted in 93.4% women testing positive for BV and only in 47.9% women testing negative for BV. The majority of women with BV +ve were more likely to deliver before or at 34 weeks (58.06%) compared to women with BV-ve (14.28%).Conclusion: BV was significantly associated with preterm labour and preterm delivery and adverse perinatal outcomes.