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Background: Preeclampsia is a clinical condition in which the patient is suffering from hypertension and proteinuria, which may be associated with pathological edema. There are multiple systems involved in pre-eclampsia which is the main culprit to complicate the pregnancy. In developing nations, approximately 4–18% of pregnancies are complicated by preeclampsia which is a major cause of morbidity and mortality globally. It does not affect pregnant females only, but may be life-threatening for growing fetuses too. If we consider the mortality in all pregnant females, about 10–15% of maternal deaths are due to pre-eclampsia. Aims and Objectives: The main objective of this study is to compare the serum calcium, magnesium, sodium and potassium level in preeclampsia patients and normal pregnant women. Materials and Methods: After taking written consent from the patients, randomly 50 pregnant females diagnosed by a gynecologist as suffering from preeclampsia were selected and for the control group 50 pregnant females who came for routine checkups were selected. 5 ml of blood was collected in the clot activator tube. The samples were analyzed for serum calcium, magnesium, sodium, and potassium on a fully automated biochemistry analyzer ”Erba XL 640” in HiTech, clinical biochemistry laboratory, B.J medical college, Ahmedabad. Results: The result showed a decreased level of serum calcium, magnesium, sodium, and potassium in the study group compared to the control group. The S. calcium level was (7.624 ± 0.84) and (8.52 ± 0.80) mg/dl in the study and control groups respectively. The S. magnesium level in the study and control were (1.47 ± 0.25) and (1.79 ± 0.18) mg/dl, respectively. S. sodium levels were (131.46 ± 6.96) and (139.92±7.86) mEq/L in the study and control groups, respectively. And the level of S. potassium in the study and control groups was (3.39 ± 0.52) and (3.67 ± 0.38) mEq/L, respectively. All the parameter values are significantly lower in a study group in comparison to control group patients (P < 0.001). Conclusion: From our study, we have concluded that the serum level of some parameters such as calcium, magnesium, sodium, and potassium was significantly decreased in patients suffering from preeclampsia. We can also conclude that these parameters can be used as a biomarker for the diagnosis of preeclampsia.
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Background: Contraception is the intentional use of artificial methods or other techniques to prevent pregnancy as a consequence of sexual intercourse. Progesterone only injectables are highly effective in preventing in pregnancy as they do not rely on daily usage of contraceptions as such as oral contraceptive pills and barrier methods. Injection depot-medroxyprogesterone acetate (DMPA) is an effective contraceptive method in lactating mother and postabortal patients. Aims and Objectives: The aims of this study were to study utilization pattern, acceptance, effectiveness, and adverse effects of DMPA in postpartum and postabortal women. Materials and Methods: It was a prospective and observational single-center study and was conducted at tertiary care teaching hospital. The data were collected in patient received Inj. DMPA 150 mg intra muscularly immediately after abortion and delivery before discharge. The follow-up was done after administration of DMPA (usually every 3 months). Results: In this study, 56 (53.34%) patients were in the age group of 18–25 years, while 38 (36.19%) patients were 26–35 years whereas 11 (10.47%) were more than 36 years. Out of 105 patients, 12 patients were administered only one injection, 16 patients administered two injections and 16 patients given three injections of DMPA. Common adverse effects of DMPA are irregular bleeding (43.8%), amenorrhea (22.8%), and heavy bleeding (5.7%). Out of 24 patient who developed amenorrhea after injections of DMPA, total 11 patients had amenorrhea after fourth injection, 5 patients after first injection, and 2 patients after second injection of DMPA. Average time for return of fertility after last injection of DMPA was 9 months. Conclusion: DMPA is very effective contraceptive and apart from menstrual troubles that there are no significant major side (weight gain, mood changes, etc.) effects related to its use. DMPA may cause a delay in the return of fertility, the return of fertility takes 7–10 months from date of last injection, but it is completely reversible.
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Introduction: Blood pressure transient spikes have been considered to be noise and only a hindrance to a proper assessment of typical blood pressure, which is defined as the actual underlying average blood pres-sure over a long period of time. The current study aimed to see if the highest Self measured Systolic blood Pressure could be utilized to forecast the occurrence of Target organ damage and evaluate the independent association between the maximum Self measured Systolic blood Pressure and Target organ damage in indi-viduals with untreated hypertension. Method: We evaluated the urine albumin/creatinine ratio (UACR) and carotid intima-media thickness (IMT) using ultrasonography in 462 hypertensive individuals who had never taken treatment for their hypertension. Residential blood pressure was recorded. Result: The maximal Self measured Systolic blood Pressure had considerably higher association coefficients with left ventricular mass index (LVMI) and carotid intima-media thickness than the mean Self measured Sys-tolic blood Pressure. Irrespective of the mean Self measured Blood pressure level, multivariate regression studies showed that the maximal Self measured Systolic blood Pressure was independently related with left ventricular mass index and carotid intima-media thickness. Conclusion: Transiently high blood pressure measurements recorded at Self measured shouldn't be dis-missed as noise but rather taken seriously as significant warning signs of hypertensive Target organ damage in the heart and arteries.
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Background: Birth preparedness is an important strategy to reduce MMR. It includes knowledge of key danger signs; identification of: birth place; birth attendant, fund, transport and compatible blood donor for emergency use beforehand. Objective: This study aims to explore birth preparedness in Surat and determine factors associated with it. Methods: Study conducted facility based cross-sectional study among 310 antenatal women at Urban Health Training Centre attached to Government Medical College, Surat, Gujarat. Predesigned, semi- structured, pretested questionnaire was used for data collection after acquiring informed written con-sent. Result: A total of 310 women participated in the study. Mean age of participants was 22.9 + 3.6 years. Almost one-third (30.3%) of participants were illiterate. Almost six-tenth (61.9%) of participants were involved in unskilled or semi-skilled work and two-fifth (38.1%) of participants were homemakers. Ma-jority of participants (96.7%) were registered in first trimester. Most known factor during pregnancy as danger sign was bleeding (81.9%). BPACR index was calculated as ∑Indicator/7 which was observed to be 62.3%. There was statistically significant association between awareness about health problems dur-ing pregnancy and type of family. Conclusion: Raising awareness regarding components of BPACR among antenatal women will help to reduce morbidity and mortality in antenatal women and achieve sustainable development goal
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Background:Laparoscopy is a widely used procedure in gynecological cases both for diagnostic and operative procedures. It is recommended due to lesser hospital stay, less post operative pain and better panoramic vision. Aim of the study is to assess the effectiveness of laparoscopic intervention of adnexal masses with benign pathology in recent series of consecutive patient. The focus is on pathology findings, length of stay, operating time, complications and laparotomy conversion rate. Material And Methods: This was a prospective observational study conducted at tertiary care hospital in Department of Obstetrics & Gynaecology during period of 1stAugust 2018 to 31st July 2020.This study consists of 70 patients, who presented with symptoms like pain in abdomen, bleeding per vaginum, irregular menses, excessive white discharge, distension of abdomen, infertility visiting outdoor patient department either diagnosed clinically(sign and symptoms) or by ultrasonography of adnexal masses. Result:Maximumpatients in this study were in age group 21-30 years. Maximum patients(21.42%)were having simple cyst. Among laparoscopic procedure most common procedure was left ovarian cystectomy(38.57%). Mean operative duration was 40.78 min and average duration of hospital stay was 3 days. There were minimal peri-operative complications; commonest being postoperative fever. Conclusion:Ade quatesurgical skill, case selection, multi disciplinary team approach and expert laproscopic surgical team are imperative for good patient outcome. This study gives an overview of experience in favour of laproscopic management of benign adnexal mass
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Background:In current maternal mortality situation in India, it is pertinent to determine the relationship between booking status of mother and maternal and fetal outcomes. Material And Methods:In present study 1500 patients were studiedfrom July 2019 to June 2021 in department of Obstetrics and Gynaecology Smt. S.C.L general hospital, Ahmedabad. Amongst these 1000 were booked (>= 3 antenatal visits) and 500 were emergency (unbooke d) cases (<3 antenatal visits). Result:Majority of patients was between 21 to 30 year age group, lower socioeconomic class and from urban area. In booked patients incidence of Antepartum, Intrapartum, Postpartum complications, medical complications, blood transfusion requirement, rate of caesarean section, incidence of Preterm babies, low birth weight babies, NICU admission, perinatal mortality and maternal mortality was less. Conclusion:In booked cases fetomaternal outcome was good. Hence targeted, integrated, patient friendly, affordable, accessible health services need to be delivered in an equitable manner and through routine screening, monitoring and follow up complications, mortality and morbidity can be reduced.
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Although fungus being part of the commensal skin micro-structuring, various pathogenic commensals colonizes on human skin leading to superficial fungal infections. Owing to the resistance of present therapeutic treatments available, microbial resistance and serious hypoallergic reactions have been a concern to explore the phyto-therapeutic nutrients for treatment of fungal infections. One such plant essential oil-based formulation is thyme oil derived from the leaves of thymus vulgaris. The aim of present work i.e. development of thyme oil based microemulsion for treatment of fungal infections due to candida and trichophyton species. The thyme oil loaded microemulsion based gel was constructed using D-optimal design and the optimized final formulation contains 0.82% of oil, 9.22% of Smix and 89.95% of water. The optimized microemulsions was pale yellow to amber transparent microemulsion with globule size of 14.23 ± 0.3 nm, zeta potential of -0.69 mV and PDI value 0.00143 indicating a stable microemulsion. The microemulsion based gel formed had a pH of 6.03, appreciable viscosity and rheological properties. The drug release of formulation was 100.0 ± 0.22%. The % of drug permeated in skin layers was found to be 15.53 ± 0.22%. While % drug retention on the skin surface was found to be 26.32 ± 0.26% and within skin layers was found to be 58.47 ± 0.22%. The microemulsion based MBG was found to be safe on the dermis and efficacious then the marketed product and hence, promises its utilization as a safe and efficacious formulation for treatment of dermal infections.
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Introduction: Abnormal uterine bleeding should include all abnormalities of menstruation like hypermenorrhea as well as hypomenorrhea. Abnormal bleeding is synonymous only with excessive menstruation. Abnormal uterine bleeding (AUB) is one of the most common conditions for which women consult their gynaecologists. Material and methods: This was a retrospective study done in Dhiraj Hospital over a period of six month on patients presenting with AUB. Patients were selected based on clinical details. The study material included a total no. of 60 patients which were inclusive of endometrial samples. Patients with isolated endometrial causes of abnormal uterine bleeding were included for this study and those with pregnancy, profusely bleeding per vaginum, anemic patients were excluded. All specimens were transported in 10% formalin to the pathology laboratory. The gross morphology was recorded. Microscopic examination was done by two pathologist so as to reduce inter observer findings. The data collected for this study was statistically analyzed using chi-square test.
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Introduction: Organophosphorus compound (OPC) poisoning has assumed alarming proportions and it is primarily a problem of the developing countries. Serum cholinesterase levels are easier to estimate and usually depressed after OP poisoning. Peradeniya OP poisoning scale has not been studied much in Indian scenario. So, we decided to have first hand information and hence conducted this study. Aim and objectives: To find out severity of patients with OP poisoning by calculating Peradeniya OP Poisoning score, level of plasma and RBC cholinesterase level of patients of OP poisoning on admission before any treatment, and correlate the level with severity and outcome of patients and requirement of ventilator support with OP poisoning. Material and methods: All patients who presented to emergency department with history of poisoning with known compound were taken as study subjects. A detailed history, clinical examination and relevant biochemical investigations were performed. Peradeniya OP poisoning scale Patel P, Patel VP, Patel H, Rathod GB. Study of prognostic value of serum and RBC acetyle cholinesterase level in organophosphorus poisoning and its correlation with the outcome. IAIM, 2016; 3(3): 147-157. Page 148 was applied to all study subjects and the severity of OP poisoning was graded as mild, moderate, severe. In all study subjects, 3 ml of plain blood was collected on admission before administration of atropine and plasma cholinesterase and RBC cholinesterase was estimated. Results: Most of the patients consumed poison with a suicidal intent. Majority had consumed poison orally. Most patients had consumed 50 – 100 ml of poison. Quantity of poison consumed did not correlate with severity of poisoning. In this study, requirement of ventilatory support was seen in 16% of patients. Mortality in our study was 9%. Pseudo cholinesterase levels were significantly depressed in patients who required ventilatory support and correlated with mortality. Miosis, Bradycardia, increased respiratory rate, impaired level of consciousness, all correlated well with need for ventilatory support and increased mortality. Peradeniya OP poisoning score of more than 8 correlated in predicting the need for ventilatory support and mortality. RBC and Plasma cholinesterase levels estimation in conjunction with Peradeniya OP poisoning score is a useful parameter for grading severity of OP poisoning and in predicting the need for ventilatory support and mortality. Conclusion: The POP scale and RBC Che and plasma cholinesterase levels both showed a significant association in predicting the need for ventilatory support and outcome. Lower grade of poisoning had a better outcome whereas higher severity of poisoning had a poorer outcome.
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Background: Esophagogastroduodenoscopy (EGD) is an important tool to visualize the upper part of the gastrointestinal tract up to the duodenum. It has the added advantage of being not only a diagnostic but also a therapeutic tool. It’s importance in follow up cases is also well documented. It has indeed become a cost effective and reliable tool to modern surgery. Materials and methods: Clinically symptomatic cases of upper GI tract were made to undergo Upper GI Endoscopy after an informed written consent. The study covered 200 patients who were then analysed for different parameters. Our study showed that majority of patients were in their 3rd decade with a male: female ratio of 2.03:1. Pain in abdomen was the main presenting complaint. Study showed that 62% of patients were smokers whereas 71% were non alcoholic. Gastritis was the prominent finding in 41 (20.5%) cases followed by Hiatus Hernia and Reflux Esophagitis in 19.5% and 13% respectively. The study was found to be normal in 28 cases (14%). This study was also able to detect rare findings like esophageal polyp and Mallory Weiss tear. Endoscopy was also done in post Gastojejunostomy patients to assess the stoma from within. Conclusion: Endoscopy has proved to be a valuable tool in diagnosing as well as therapeutically treating patients with various pathologies. Upper GI endoscopy correlated well with the sign and symptom presentations in majority of patients and proved superior to conventional radiological studies. Thus endoscopy is not only useful and superior to many radiological investigations, but also helpful in therapeutic interventions as well as in follow up cases.
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Introduction: The partograph, a graphic recording of labour and features in the mother and fetus has been used since 1970 to detect labour that is not progressing normally. The partograph serves early warning system and assist in early decision of transfer, augmentation and termination of labour. It also increases the quality and regularity of observing mother and fetus in labour. Material and methods: It was a prospective observational study conducted in the Department of Obstetrics and Gynaecology at Dhiraj General Hospital, Pipariya, Waghodiya during the period of 6 months. Total 100 patients were enrolled in my study. Plotting on partogram was started at cervical dilation > 4 cm dilation on alert line. Induction was done in needed cases. Augmentation was done as per requirement. Results: 48% cases were Primigravida and 52% cases were multigravida. Mean gestational age was 38.8 weeks. In 88% cases delivered spontaneous and 12% cases required induction of labour. 18.2% of spontaneous onset patients crossed the alert line as compared to 66.66%in the induced group. 72.7% patients in spontaneous group had vaginal delivery, 23.86% had LSCS and 3.4% had instrumental delivery. 25% patients in induced group had vaginal delivery, 75% had LSCS. 96% neonate had no morbidity. Conclusion: The proper use of partograph and application of the right decision at the right time that we can achieve the best for maternal and neonatal outcome
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Toxic epidermal necrolysis is a severe cutaneous drug reaction, mainly involving skin and mucous membranes. We have presented here a case report of 16 year old female patient who was diagnosed with toxic epidermal necrolysis clinically as well as histopathologically. The patient presented with history of fever, oral cavity ulcer, skin lesions which were ill defined, erythematous macular with darker hemorrhagic centre. Skin biopsy showed full thickness necrosis of dermis, dermal-epidermal separation and paucity of upper dermal cellular infiltration. The patient was treated with intravenous immunoglobulins, low dose steroids and systemic antibiotics and the patient improved significantly. The main purpose of the case report was to emphasize that even one single dose of amoxycillin can induce a toxic epidermal necrolysis.
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Background: Sex hormones and impaired glucose metabolism resulting from Insulin abnormalities are the major important determinants in the development of coronary heart disease (CHD) in females. The present work was envisaged to study the effect of sex hormonal changes on serum lipids in females of different age groups and physiological status i.e. menstruation and menopause. Methodology: The comparisons were made between diabetic females of both the phases (menstruation and menopause) and age matched non-diabetic females. Further comparisons were made between diabetic females of menopause phase and diabetic females of menstruation phase. Results: In the study when comparisons were made between menstruating diabetics and menstruating non-diabetics, the former group showed significant increase in plasma glucose, serum total cholesterol (TC), Triglyceride (TG), low density lipoprotein (LDL) and very low density lipoprotein (VLDL) levels. Similarly comparisons were made between menopausal diabetics and menopausal non-diabetics, the former group showed significantly higher levels of plasma glucose, serum TC, TG, LDL and VLDL. However it is noticed that HDL levels did not very significantly in both the comparisons. Also in diabetic menopausal females there is a significant increase in serum TG levels as compared to diabetic menstruating females. Conclusions: In present study, in non-diabetic menopausal females there is a significant increase in plasma glucose, serum TC, TG, LDL and VLDL concentration levels as compared to non-diabetic menstruating females. Also in diabetic menstruating and menopausal females, there is a significant increase in plasma glucose, TC, TG and VLDL levels as compared to non-diabetic menstruating and menopausal females.
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Background and Aim: The World Health Organization (WHO) defines an Adolescent as “an individual between 10-19 years of age”. As adolescents are not a homogenous group, their needs vary with their sex, stage of development, life circumstances & their socioeconomic conditions. Inspite of existing Adolescent Friendly Health Services (AFHS), adolescents are reluctant to utilize them because of lack of privacy & confidentiality. Aims of this study are (1) To study reproductive health needs of adolescent girls (2) To assess awareness & utilization of AFHS. Methodology: Community based cross sectional study was conducted in Urban Health Training Centre (UHTC) field practice area of Govt. Medical College, Bhavnagar among 532 Adolescent girls during February 2014 to August 2014. Information about their reproductive health needs, awareness about AFHS & its utilization were collected by pretested prestuctured questionnaire. Data entry & analysis done in Epi info software (version3.2). Results: In the present study regarding reproductive health needs, more than half (54.71%) girls desired correct information about reproductive health system , problems & hygiene & most of the girls (53.20%) choose seminar as best source to provide such information. 21.99% girls desired supply of sanitary pads at lower cost than market. An important finding was that very few (14.1%) girls were aware of AFHS. Among those who were aware of AFHS, 38.67% girls had visited & satisfied with services. The major reason for not utilizing AFHS was shyness among 54.35% girls. Conclusion: Information about reproductive health (54.71%) & supply of sanitary pad at lower prices than market (21.99%) are two important reproductive health needs of adolescent girls. Awareness & utilization of AFHS is very less among adolescent girls due to various barriers.
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Introduction: Fine Needle Aspiration Cytology (FNAC) is a simple, quick and inexpensive method in the head and neck region. It also affords a practicable and means of rationally planning surgery and causes minimal trauma to the patient and carries no risk of complications. Aim and objectives: The aim of this study was to see the frequency of various pathological conditions detected on FNAC in patients presenting with head and neck swellings and to evaluate the role of FNAC in diagnosis of head and neck swelling. Material and methods: A retrospective study was conducted in Department of Pathology, SMIMER Medical College, Surat from July 2014 to June 2015which included 250 patients with head and neck swellings presenting to Outpatient clinics. Fine Needle Aspiration Diagnosis was correlated with detail of relevant clinical findings and investigation. Results: Maximum incidence was observed in the age group 31-40 years with higher incidence among males. Out of 250 cases, 160 cases of lymph node lesions were diagnosed of which non- specific lymphadenitis was the commonest diagnosis (47%) followed by Tuberculous lymphadentities (25%). 57 cases of thyroid lesions were diagnosed, in which incidence rate of benign thyroid lesions was (84%). 12 cases of salivary gland lesions were found, among which pleomorphic adenoma was common (67%). Conclusion: It was concluded that non-Specific lymphadenitis is the commonest condition in patients presenting with neck swellings. FNAC is a simple, safe and inexpensive tool for the assessment of patients with head and neck swellings. It could differentiate the infective process from neoplastic one and avoids unnecessary surgeries. Thus, FNAC can be recommended as a first line of investigation in the diagnosis of head and neck swellings.
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Background: Amniotic fluid is vital to the well-being of the fetus. Disorders of liquor amnii has a significant impact on pregnancy and fetus, it prompted us to carry out this study with sincere efforts to find out its effect on pregnancy outcome. Aim and objectives: To find out incidence of polyhydramnios and oligohydramnios in our setup and to study possible etiological factors for abnormal AFI. Material and methods: We performed a study on 200 patients over a period of one year. Detailed history, general examination and local examination were done. All the cases were subjected to ultrasonography to see for maturity, AFI, congenital anomalies. Analysis were made regarding mode of delivery and perinatal outcome which includes maturity, birth weight, incidence of SGA or macrosomia, NICU admission, maconium stained amniotic fluid, low apgar score, incidence of birthasphyxia and congenital anomalies. Results: There were total 82 cases of oligohydramnios and 18 cases of polyhydramnios. And 100 cases with normal AFI. In ultrasonography 154 cases had full term maturity and 46 cases were preterm 82 cases had AFI ≤5 cm, 18 cases had AFI > 24, and 100 cases had AFI between 6-23. Conclusion: Amniotic fluid index assessment has become an important part of ante-partum fetal surveillance and also it has a prognostic value for fetal and newborn outcome.
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Background: Amniotic fluid is vital to the well-being of the fetus. Disorders of liquor amnii has a significant impact on pregnancy and fetus, it prompted us to carry out this study with sincere efforts to find out its effect on pregnancy outcome. Aim and objectives: To find out incidence of polyhydramnios and oligohydramnios in our setup and to study possible etiological factors for abnormal AFI. Material and methods: We performed a study on 200 patients over a period of one year. Detailed history, general examination and local examination were done. All the cases were subjected to ultrasonography to see for maturity, AFI, congenital anomalies. Analysis were made regarding mode of delivery and perinatal outcome which includes maturity, birth weight, incidence of SGA or macrosomia, NICU admission, maconium stained amniotic fluid, low apgar score, incidence of birthasphyxia and congenital anomalies. Results: There were total 82 cases of oligohydramnios and 18 cases of polyhydramnios. And 100 cases with normal AFI. In ultrasonography 154 cases had full term maturity and 46 cases were preterm 82 cases had AFI ≤5 cm, 18 cases had AFI > 24, and 100 cases had AFI between 6-23. Conclusion: Amniotic fluid index assessment has become an important part of ante-partum fetal surveillance and also it has a prognostic value for fetal and newborn outcome.
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Laparoscopic abdominal surgery is conventionally done under general anesthesia. Spinal anesthesia is usually preferred in patients where general anesthesia is contraindicated. We have presented here our experience using spinal anethesia as the first choice for laproscopic surgery for ever 2 years with the contention that it is good alternative to genral anesthesia.
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Background & Objectives: Besides spiritual achievements, the practice of yoga is accompanied by a number of beneficial physiological effects in the body. The regular practice of yoga integrates the mind and the body.It produces many systemic psycho-physical effects in the body, besides its specific effects on the respiratory functions.The aim of the present study was to assess the beneficial effects of yoga in the improvements in the pulmonary functions of young healthy adults. Methods: The study group consisted of 30 young adults (19 males and 11 females) who were students of first year M.B.B.S.,medical college Baroda.They were motivated to participate in yoga workshop for one hour daily for four weeks. The first phase of the recording of the pulmonary parameters (M.V.V,FVC,FEV1,PEFR) was done at the beginning of their course. The second phase of the recording was done after 4 weeks of the regular yoga practice. The data were analyzed using student’s Paired T – test. Results: Participants had a mean±SD age of 17.81 ± 0.48 years, height of 164.21±5.09 cm and weight of 54.34±5.63kg. The MVV(L/MIN) - before yoga practice showed a value of 97.4±24.4 and after , it showed a value of 119±28. The FVC(ml) - before yoga practice showed a value of 2575 ±631and after , it showed a value of 2768 ±618. The FEV1(ml)- before yoga practice showed a value of 2270± 636 and after , it showed a value of 2476 ±570. The PEFR(L/MIN) - before yoga practice showed a value of 479±103 and after , it showed a value of 585±120. For all the parameters, a P value of <0.01 was considered as statistically significant. Conclusion: There was a statistically significant increase in all the above lung parameters in the regular yoga practitioners.This study proposes that regular practice of yoga can improve health related aspects of physical fitness and general wellbeing.