A prospective study of the pattern of morbidity and medication use during antenatal and perinatal period in mothers of neonates admitted to neonatal intensive care unit of a tertiary care hospital

Background: Most drugs taken by pregnant women can cross the placenta (except high molecular weight drugs like heparin) and expose the foetus to pharmacologic and teratogenic effects. The drugs used in the late antenatal and intranatal period may have a potential perinatal and neonatal outcome.Methods: The pattern of maternal morbidity and drug use was assessed prospectively in 150 consecutive mothers of neonates admitted to NICU. The number of drugs used, therapeutic class, dose, route, frequency and purpose of use were recorded. The efficacy and safety of medications was assessed by neonatal outcome.Results: The most common maternal morbidity during pregnancy was PIH, eclampsia, hypothyroidism, GDM, PROM, oligohydromnias, anemiaorpolyhydromnias, and 4% (n=6) had more than one complication. Different therapeutic classes of drugs were used as per the prevailing clinical conditions or complications. The total number of drugs used was 26, with an average of 3.68 per subject. AMAs were the most commonly used drugs, chosen empirically and used in combination for prophylaxis or control of infections. Other classes of drugs were used for specific indications. None of the NICU admissions in the present study seem to be related to antenatal or perinatal drug exposure. The treatment outcome was very good in most of the subjects and no drug related adverse events or interactions were observed.Conclusions: Maternal morbidity and drugs administered to mother play an important role in improving the neonatal outcome.

Uncommon Peritoneal Anomaly of Spleen Associated with the Unusual Relationship of Spleen with the Left Lobe of the Liver

Though congenital anomalies of the spleen are quite common, the peritoneal anomalies of the spleen are very rare. In the present case, we observed two unusual phrenico-splenic ligaments connecting the spleen to the diaphragm. Apart from this, the left lobe of the liver was elongated and was related to the diaphragmatic surface of the spleen. The splenic artery had a straight course to the spleen, indicating the possible restricted movements of the spleen. Knowledge of such unusual relation of spleen is essentially important for the surgeons as the elongated left lobe of the liver might get ruptured in addition to the spleen in the fractures of the left 9th, 10th and 11th ribs. Awareness of the straight course of the splenic artery is also of importance to Radiologists performing arterial splenoportography.

Fungal infections of the oral mucosa.

Fungal infections in humans occur as a result of defects in the immune system. An increasing emergence in oral Candidal and non-Candidal fungal infections is evident in the past decade owing to the rise in the immunodeficient and immunocompromised population globally. Oral Candidal infection usually involves a compromised host and the compromise may be local or systemic. Local compromising factors include decreased salivation, poor oral hygiene, wearing dentures among others while systemic factors include diabetes mellitus, nutritional deficiency, HIV infection/AIDS and others. Oral candidiasis is generally a localized infection and rarely appears as a systemic fungal disease whereas oral non-Candidal fungal infections are usually signs of disseminated disease. Some of the non-Candidal fungi that were once considered exotic and geographically restricted are now seen worldwide, beyond their natural habitat, probably attributed to globalization and travels. Currently infections from these fungi are more prevalent than before and they may present either as primary oral lesions or as oral manifestations of systemic mycoses. This review discusses the various predisposing factors, clinical presentations, clinical differential diagnosis, diagnosis and management of oral candidiasis, as well as briefly highlights upon a few of the more exotic non-Candidal fungi that infect the oral mucosa.

Sialo-odontogenic cyst--a case report.

Sialo-odontogenic cyst is an uncommon cyst of odontogenic origin that occurs in the tooth bearing areas of the jaws. These lesions are histopathologically unique, biologically aggressive and may sometimes warrant distinction from central muco-epidermoid carcinoma and botryoid variant of the lateral odontogenic cyst. Sialo-odontogenic cysts tend to recur and various factors are quoted for their recurrence viz., the presence of microcysts, thin connective tissue wall, etc. We are herewith reporting a case of sialo-odontogenic cyst for its relative rarity among the odontogenic cysts.

Basaloid squamous cell carcinoma report of a case and review of literature.

Basaloid squamous cell carcinoma (BSCC) is an aggressive distinct variant of squamous cell carcinoma that mandates recognition as a separate entity owing to the difference in its clinical behaviour. Histologically this tumor can mimic other neoplasms like adenoid cystic carcinoma, neuroendocrine carcinoma and basal cell adenocarcinoma. BSCC occurs most commonly in older men and has a site predilection for the upper aero-digestive tract. We report a case of basaloid squamous cell carcinoma for its relative rarity, which was diagnosed in a 52 year old woman, with a brief review of literature.