ABSTRACT
Background: The pathways that are involved for the duration of pregnancy and type of parturition are extremely complex, involving maternal as well as fetal systems. The objective of this study was to determine the frequency of types of parturition and their relationship with maternal characteristics among pregnant female patients.Methods: A cross-sectional survey using a non-probability convenient sampling technique was conducted among 195 healthy pregnant females at Obstetrics and Gynaecological Department of Hamdard Hospital, Karachi, from 1st March 2019 to 31st August 2019. After taking written informed consent from the participants, the relevant data were gathered with the help of a structured questionnaire designed specifically for the study. Statistical package for social sciences was used for data entry while the chi-square test was applied for inferential analysis. The duration of the study was six months. Data were entered and analyzed using Statistical Package for Social Sciences version 20.0. Descriptive analysis was performed by generating means and standard deviations for continuous variables while frequencies and percentages for categorical variables. A Chi-square test was applied to perform the inferential analysis while the significance level was set at 0.05.Results: A total of 195 pregnant females were included in the study, whose mean age was 29.29±5.22 years. The study results showed that BMI before pregnancy (p=0.021), rest is taken during pregnancy (p=0.034) and gravida status (p=0.047) were all significantly associated with the type of parturition among the study participants, but spacing in pregnancies and parity were not.Conclusions: Maternal characteristics were found to be significantly associated with the type of parturition among pregnant females. For gynecologists the maternal characteristics identified in this study may serve as a useful indicator of the type of parturition expected in their patients.
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Aim: The present paper investigates the effect on immune responses by a herbo-mineral formulation, Khamira Marwarid [KM], prescribed in the Indian subcontinent as a rejuvenator, especially to convalescing patients of typhoid fever, in murine model. Study Design: KM was administered orally for short, intermediate and long duration [5, 15 and 30 days respectively] at a dose of 2g/kg body weight. Results: Administration of KM enhanced the antigenic and mitogenic activity, induced by ovalbumin and Con A (mitogenic stimuli), of mice whole splenocytes. KM caused a marked increase of production of Th-1 cytokine (IFN-) and a non significant decrease of production of Th-2 cytokine (IL-4) by splenocytes when stimulated with Concanavalin A. Oral administration of KM, by itself did not induce the production of NO by macrophages, but enhanced the production of NO in response to LPS as compared to unstimulated control. However, dose duration related suppression of NO production was observed. KM also enhanced significantly the phagocytosis that was evaluated using the phagocytic rate (PR) and phagocytic index (PI). Conclusion: The results indicate the immunomodulatory potential of KM leading to a Th1 dominant immune state and activation of macrophages and may find use in immunotherapy of tumors.
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Background: Preeclampsia is characterized by development of high blood pressure and proteinuria. It affects 5–8% of all pregnancies and is a major contributor to maternal and fetal morbidity and mortality. There is no single test that fulfils all the criteria for a good predictor of preeclampsia and associated renal damage. Aims & Objectives: To evaluate the role of serum and urine biochemical parameters as early predictors of preeclampsia. To investigate the role of BUN: Creatinine ratio in diagnosing preeclampsia and evaluating prognosis of the disease. Material and Methods: In the present prospective study, one hundred and twenty pregnant women divided into three groups: normotensive (control), women at high risk and with preeclampsia were included. Analyses of different biochemical parameters including BUN: Creatinine were carried out. Results: There was significant difference in the mean value of serum uric acid, blood urea nitrogen, creatinine, urinary protein and BUN: Creatinine ratio in preeclampsia group compared to control group (p < 0.001). There was significant difference (p < 0.05) in serum uric acid between control and preeclampsia group. However, there was no significant change in haematocrit, serum creatinine and urine protein between control and high risk group. Conclusion: BUN: Creatinine ratio in pregnant women with preeclampsia and also in high risk group was significantly increased (t = 15.55, p < 0.001 and t = 8.66, p < 0.001 respectively) in comparison to the control group. This index could be useful in evaluating the severity of preeclampsia and could be used as a predictor in prognosis of preeclampsia and subsequent early renal disease.
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Background & objectives: Studies have demonstrated the effect of CYP2C9 (cytochrome P450) and VKORC1 (vitamin K epoxide reductase complex) gene polymorphisms on the dose of acenocoumarol. The data from India about these gene polymorphisms and their effects on acenocoumarol dose are scarce. The aim of this study was to determine the occurrence of CYP2C9*2,*3 and VKORC 1 -1639G>A gene polymorphisms and to study their effects on the dose of acenocoumarol required to maintain a target International Normalized Ratio (INR) in patients with mechanical heart valve replacement. Methods: Patients from the anticoagulation clinic of a tertiary care hospital in north India were studied. The anticoagulation profile, INR (International Normalized Ratio) values and administered acenocoumarol dose were obtained from the clinical records of patients. Determination of the CYP2C9*2,*3 and VKORC1 -1639G>A genotypes was done by PCR-RFLP (restriction fragment length polymorphism). Results: A total of 111 patients were studied. The genotype frequencies of CYP2C9 *1/*1,*1/*2,*1/*3 were as 0.883, 0.072, 0.036 and that of VKORC1 -1639G>A for GG, AG, and AA genotypes were 0.883, 0.090, and 0.027, respectively. The percentage of patients carrying any of the variant alleles of CYP2C9 and VKORC1 in heterozygous or homozygous form was 34% among those receiving a low dose of ≤20 mg/wk while it was 13.8 per cent in those receiving >20 mg/wk (P=0.014). A tendency of lower dose requirements was seen among carriers of the studied polymorphisms. There was considerable variability in the dose requirements of patients with and without variant alleles. Interpretation & conclusions: The study findings point towards the role of CYP2C9 and VKORC1 gene polymorphisms in determining the inter-individual dose variability of acenocoumarol in the Indian patients with mechanical heart valve replacement.
ABSTRACT
Inflammation caused by infection takes place by the cooperative cascade of cytokines and leukocytes. Tumor necrosis factor, interlukin-1, and interlukin-6 play important roles as proinflammatory cytokines to mediate local inflammation and activate other inflammatory cells e.g. neutrophils, monocytes, and macrophages. At least 15 different low molecular weight cytokine are secreted by activated leukocytes and are responsible for triggering acute phase response in the form of fever, leukocytosis, increased secretion of adreno corticotropic hormones, and production of acute phase proteins. Acute phase proteins are produced in liver under the influence of cytokines, which through blood stream passes to the site of inflammation and kill the pathogens by opsonization and activating complement pathways. The changes in the concentrations of positive acute-phase proteins and negative acute-phase proteins are due to the changes in their production by liver. Three of the best known acute phase proteins are C-reactive protein, serum anyloid A, and haptoglobin. Some disease states are casually related to acute phase proteins. C-reactive protein mediated compliment activation has a key role in some forms of tissue alteration such as cardiac infarction. Elevated S amyloid A levels are seen in chronic arthritis and tuberculosis. Other acute phase proteins show more moderate rise, usually less than fivefold.