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Objectives: The objective was to study the relationship of 3-Tesla (3T) diffusion-weighted magnetic resonance imaging (DW-MRI) with apparent diffusion coefficient (ADC) value for distinction of reactive and metastatic lymph nodes (LNs) in head-and-neck carcinoma (HNC) patients and to determine the ADC cutoff value for metastatic LNs at various levels. Materials and Methods: 3T DW and T1- and T2-weighted imaging sequences were done in 34 patients with biopsy-proven primary HNC of 100 cervical LNs ≥1 cm in diameter. The mean ADC values were compared with histopathologically proven LNs using the independent t-test. ADC cutoff value was evaluated with sensitivity, specificity, accuracy, positive predictive value, negative predictive value and a receiver operating characteristic curve analysis. Results: The mean ADC value of reactive LN was 1.2933 × 10-3 mm2/s and metastatic LN was 0.908 × 10-3 mm2/s. An ADC cutoff value was 0.868 × 10-3 mm2/s with 84% sensitivity, 96% specificity, 93% accuracy, 87.5% positive predictive value, and 94.7% negative predictive value. A significant difference in mean ADC value between reactive and metastatic LNs was noted (P< 0.001). Conclusion: 3T DW-MRI is useful in differentiating reactive and metastatic cervical LNs in HNC patients. However, studies with larger sample size have to be performed to validate ADC threshold value with 3T DW-MRI in differentiating between reactive and metastatic LNs for clinical practice
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Background: The objective is to evaluate the preferred methods for labor induction, including incidence of caesarean section, operative and normal vaginal delivery rate, need for oxytocin augmentation, and Apgar score at 1 and 5 min.Methods: This was a hospital-based study carried out in 110 inductions of labour during the study period. misoprostol 50 mcg was inserted in posterior fornix of vaginal in cases with PROM and intracervical 0.5 mg Dinoprostone for other causes in whom induction was decided. Maternal and neonatal outcomes were observed. collected data were analyzed using SPSS and MS excel.Results: Most preferred methods of induction of labour were observed to be Dinoprostone and Misoprostol, augmentation was done by oxytocin. normal delivery rate was 54% in Dinoprostone gel and 58.3% in misoprostol group. Caesarean and operative vaginal delivery rates were 42.8%, 3% in Dinoprostone gel group and 33.3%, 8.3% respectively in misoprostol group. Mean Apgar scores were observed to be similar in both methods of induction at 1st and 5th minutes.Conclusions: It was found that misoprostol had higher percentage of normal and operative vaginal delivery and need for oxytocin augmentation than Dinoprostone. Neonatal outcome as predicted by Apgar score were similar in both groups.
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Background: Preterm birth is the largest unsolved problem in obstetrics and the single most significant cause of neonatal morbidity and mortality. Preterm labour constitutes 5-10% of pregnancies and is the leading cause of neonatal morbidity and mortality worldwide. It is a major public health problem in terms of loss of life, long term disability (cerebral palsy, blindness, deafness, chronic lung disease). The objectives of this study were to determine whether antenatal corticosteroid administration affects the non-stress test. To evaluate the effect of antenatal steroid on foetal movements. To assess the incidence of respiratory distress syndrome and neonatal mortality after antenatal corticosteroid administration.Methods: All antenatal cases between 28-32 weeks of gestation judged to be at risk for preterm delivery attending the outpatient department or admitted in a tertiary care hospital, Tamil Nadu during the study period of 3 years.Results: The present study was undertaken to evaluate the NST for a period of 3 days following antenatal corticosteroid administration and to study the immediate changes in the mother and the foetus. We found out that there was a statistically significant change (p <0.01) in non-stress test when compared with the pre-betamethasone assay.Conclusions: Corticosteroids can cause metabolic alterations in mother, short- and long-term effect in the foetus.
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Background: In recent years due to the changing sedentary life style, irregular periods and infertility has become a major concern. There are many causes for infertility out of which ovulatory disorders contribute to a great extend. The main objective of the study was to assess the clinical and hormonal profile of patients diagnosed with polycystic ovarian disease at tertiary care hospital in Tamil Nadu.Methods: This study was a cross sectional study and was carried out at the Department of Obstetrics and Gynaecology at a tertiary care hospital of Tamil Nadu. The study was done for a period of 6 months. For confirming polycystic ovaries, patients were interviewed thoroughly about their menstrual and fertility history. Blood investigations like LH, FSH were done on D2/D3 of menstrual cycle. 125 patients with PCOS were included in this study. The data was analysed with SPSS-IBM (V.22.0) software.Results: The patients having polycystic ovaries were higher in women of 21-30 years of age. BMI was more than 25. Infertility was found that 57%, hirsutism 45%, oligomenorrhoea 21% and amenorrhea 20%. On day 2, mean serum LH was 5.9±3.6 and serum FSH was 3.9±2.3. This study showed that the proportion of menstrual complaints is reported more in higher age group. Likewise lower income group presented with menstrual complaints. This was found to be statistically significant (P value <0.05).Conclusions: The study showed that patients diagnosed to have PCOS overweight. PCO in obese women had more severe ovulatory dysfunction. Infertility was the most common complaint.
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Introduction: In the intensive care unit (ICU), approximately 30% of all patients require mechanical ventilation. Reintubation isa high-risk procedure in critically ill patients. Anticipating a difficult airway and identifying high-risk patients can be life-saving.10–20% of critically ill patients who are extubated will be reintubated within 72 h which leads to long-term ventilation-relatedcomplications such as ventilator-associated pneumonia and ventilator-associated lung injury, which greatly affect the length ofstay and mortality in the ICU.Aim: The aim is to study the causes, risk factors, and outcomes associated with reintubation.Materials and Methods: In this retrospective study, clinical data of patients who were reintubated were collected and the factorsassociated with reintubation were analyzed.Results: A total of 532 patients were intubated in the ICU, of which 25 cases (9.2%) required reintubation, 19 patients haddiabetes, 17 of them had hypertension, and 14 had coronary artery disease. Majority of the patients improved after intubationand the mean ventilator stay after reintubation is 3.4 days. Among patients who were reintubated 9 patients were dischargedafter recovery, 4 patients were discharged against medical advice, 5 were discharged on request, and 7 patient died.Conclusion: Reintubation is associated with more procedural complications such as hypoxia and hypotension and prolongedICU stay, and the ICU team must be prepared for such complications. Laryngeal edema was also an observed complicationin a few patients.
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The aim of this study was to evaluate whether the impact strength of a commercially available, heat polymerized acrylic denture base material could be improved using reinforcements. A total of 30 specimens [65 mm x 10 mm x 3 mm] were fabricated, the specimens were divided into 3 groups with 10 specimens each. They were Group 1 - conventional denture base resins, Group 2 - high impact denture base resins and group 3 - glass reinforced denture base resins. The impact strength of specimens was measured using charpy's test. One-way analysis of variance [ANOVA] was used to determine statistical differences among the impact strength of three groups. Data were analyzed by SPSS software and the results were obtained. The flexural strength values showed statistically significant differences among experimental groups [P<0.005]. Within the limitations of the study PMMA reinforced with glass fibers showed the highest impact strength values, and this was followed by PMMA reinforced with butadiene styrene and the least strength was observed in the conventional denture base resins
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The glutathione S transferase (GST) family of enzymes play a vital role in the phase II biotransformation of environmental carcinogens, pollutants, drugs and other xenobiotics. GSTs are polymorphic and the polymorphisms in GST genes have been associated with cancer susceptibility and prognosis. Moreover, distinct ethnic differences have been observed in the type and frequency of GST gene polymorphisms. Hence, the present study was aimed to determine the frequencies of GSTM1, GSTT1 and GSTP1 polymorphisms in 255 healthy random volunteers from South India. The GSTM1 and GSTT1 genotypes were determined by PCR and GSTP1 by PCR-RFLP using peripheral blood DNA.The GSTM1 and GSTT1 null genotype frequencies were found to be 22.4% and 17.6% respectively. The GSTP1 allelic frequency was 0.78 for the Ile allele and 0.22 for the Val allele and the genotype frequency was 58.4% for Ile/Ile, 38.4% for Ile/Val, and 3.1% for Val/Val. Comparison of the frequencies of GST polymorphisms observed in the present study with other Indian and world populations revealed a distinctive nature of the South Indian population with respect to polymorphims at the GST gene loci. A better understanding of carcinogen metabolizing gene distribution should contribute to risk assessment of humans exposed to environmental carcinogens.