Ruptured cornual ectopic pregnancy: a case report

A cornual gestation is one of the most hazardous and life-threatening type of ectopic pregnancy with a mortality rate of 2-5 times higher than other ectopic pregnancies. Because of the myometrium stretch ability, they usually present late around 7-12 weeks of gestation. Thus, the diagnosis and treatment of such cases become challenging. In the case of ruptured cornual ectopic pregnancy, the patient usually presents with hemodynamic instability. Presenting a case report of a 28-year-old female who presented to the labour room of ESI hospital, Okhla, New Delhi at 12 weeks of pregnancy in a state of shock. A provisional diagnosis of ruptured cornual ectopic was made based on clinical examination and ultrasound report. Resuscitation followed by emergency laparotomy done as a life-saving procedure for the patient. Ruptured cornual ectopic needs urgent intervention and multidisciplinary approach. However, with the advancement and expertise in the field of radiology and early diagnosis can be made which can contribute towards more conservative management of such cases.

A prospective study of demographic profile, risk factors and pregnancy outcome in Hepatitis B and Hepatitis C virus positive pregnant women in a tertiary care centre

Background: Viral hepatitis is the most common liver disease in pregnancy and is also the most common cause of jaundice in pregnancy in tropical countries. Risk factors for transmission are intravenous drug abuse, surgical and dental procedures done without adequate sterilization of instruments, sexual route etc. Early diagnosis and management can prevent maternal and fetal complications. This study was done to evaluate the frequency, risk factors and pregnancy outcome in hepatitis B virus (HBV) and hepatitis C virus (HCV) positive antenatal women.Methods: This case control study was conducted in Teerthankar Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India from January 2017 to June 2018 on total 2511 pregnant women. The serum samples were checked for presence of hepatitis B surface antigen (HBsAg) and presence of IgG antibodies to HCV. Analysis of sociodemographic profile, risk factors and pregnancy outcome were done in all HBV and HCV positive women.Results: Out of 2511 pregnant women, 292 were tested positive for hepatitis. Maximum number of women were in the age group of 21-30 years. Most of the seropositive women were multipara. Frequency of positivity was maximum for HCV (67.1%). The risk factors for transmission in study population were intravenous drug abuse, blood transfusion, history of surgery and tattooing.Conclusions: Hepatitis infection rate is increasing. Universal screening for HBV and HCV can be recommended in pregnant women in developing countries. Education and awareness of public and health care workers can reduce the risk of transmission.

Bakri postpartum balloon: an obstetrician’s armamentarium in managing post-partum haemorrhage

Background: Post-partum haemorrhage (PPH), an obstetric emergency that can complicate vaginal or cesarean deliveries and associated with serious complications. Guidelines for the management of PPH involve a stepwise escalation of pharmacological and eventual surgical approaches. In women who do not respond to uterotonics or medical treatment, a variety of procedures, such as arterial embolization, surgical ligation of the uterine arteries or obstetric hysterectomy, may be used. The Bakri balloon is an intrauterine device indicated to reduce or control PPH temporarily when conservative treatment is warranted. Here, we are presenting case series of primary atonic PPH and which were managed by Bakri Balloon Tamponade (BBT).Methods: This case series included five women with PPH managed by Bakri balloon as a conservative therapeutic option.Results: All five women were in age group between 23 years to 34 years. The causes of PPH were uterine atony, retained placenta and central placenta previa. The Bakri balloon was successful in controlling hemorrhage in all women (five of five) who did not respond to medical uterotonic treatment.Conclusions: Bakri balloon is a simple, easy to use and effective method for conservative management of acute PPH. This device reduces bleeding, shortens the hospital stay and avoids the need for more aggressive procedures.

Prevalence of goitre among school going children in urban area of Dehradun.

Background: Iodine is an important micro-nutrient required for human nutrition. Iodine Deficiency Disorders (IDDs) are one of the major world-wide public health problems of today which causes wide spectrum of disabilities. It includes impairment of reproductive functions, lowering of IQ levels in school age children, goiter, deaf mutism, mental defects, weakness and paralysis of muscles as well as lesser degree of physical dysfunction. Methods: Selection of population: The school children in age group of 6-18 years from both the sexes were screened from SGRR Schools of different locations at Dehradun, after taking approval from principal and the parents. Results: The prevalence of goitre among school going children was 5%. Prevalence of goitre among female was 6.4% compare to male were 4.1%. There was significant association found between prevalence of goitre and vegetarian diet. In pre pubertal age (11-14 years) maximum (7.6%) cases of goitre were seen. A significant association of goitre with pallor was also observed Conclusion: The sustained efforts in implementing the guidelines of National Iodine Deficiency Disorders Control Programme (NIDDCP) have been able to reduce the prevalence of goitre in Uttrakhand state. In spite of reduction in prevalence over years, goitre continues to be a major public health problem in the state.

prospective study of immediate postpartum intra uterine device insertion in a tertiary level hospital.

Background: In India there is an unmet need for contraception. Intrauterine device is a long acting reversible method. This study was done to determine the efficacy and safety of immediate Post-Partum Intrauterine Device (PPIUD) and to compare the outcome of PPIUD insertion after vaginal delivery and caesarean section. Methods: A total of 113 women who underwent PPIUD insertion were followed up at 6 weeks and 6 months post-partum. Outcome in term of side effects, removal and expulsion was compared in vaginal delivery and caesarean section insertions. Results: In 61.45% women there was no complaint. Menstrual disturbances were found in 16.66% women and pelvic pain in 13.54% women. The expulsion rate was 5.20% and IUD removal was done in 13.54% women. Incidence of removal was more in vaginal insertions than in caesarean insertions and this difference was statistically significant. Continuation rate at 6 months was 81.25%. Conclusion: Immediate postpartum IUD insertion is a safe, convenient and effective method.

Colposcopic evaluation of cervical lesions: a prospective study.

The present study was undertaken to evaluate the role of colposcopy as a screening and diagnostic tool for cervical cancer and other cervical lesions in high risk women. Methods: All the women included in the study were subjected to colposcopic examination. Colposcopic findings were compared with cytology and histopathological examination. Accuracy of colposcopic examination was calculated by standard statistical methods. Sensitivity, specificity, Positive Predictive Valve (PPV) and Negative Predictive Valve (NPV) of colposcopic examination was calculated. Results: Three hundred patients underwent colposcopic examination. The overall sensitivity and specificity of colposcopy was 85.85% and 87.65% respectively. Positive predictive value was 75.83% and negative predictive value was 95.38%. The percentage of false negative as well as that of false positive was calculated to be 13.74%. The accuracy of colposcopy was found to be more for high grade lesions as composed to low grade lesions. Conclusions: Colposcopy gives immediate and accurate results and its value as diagnostic modality is undisputed. It should also be considered as a primary screening test for high risk women living in remote areas where women cannot visit the doctor repeatedly as the ideal screening triage cannot be implemented in such situations.

Epidemiological Study of Morbidity Pattern of Critically Ill Children Admitted in Child Intensive Therapy Unit.

Background : In India 34.3% of the total population is constituted by the most vulnerable segment of our society i.e. infants and children. Malnutrition, respiratory and diarrhoeal diseases are three main scourges of the children but the great devils hovering upon them are lack of proper treatment and management. The present study was conducted to find out the morbidity pattern of our vulnerable children. Aims and Objectives : 1. To find out the prevalence of critically ill children admitted in the hospital. 2. To find out the morbidity pattern of critically ill children admitted in the child intensive therapy unit, in a hospital. Research Question : What is the epidemiological pattern of morbidity in critically ill children of age 1 month to 12 years? Study Design : Cross-sectional Study. Study Participants : All critically ill children coming to the emergency unit of the hospital during study period. Statistical Analysis : Simple percent and proportions, Chi square test.

In vivo evaluation of antioxidant activity of alcoholic extract of Rubia Cordifolia and its influence on lead nitrate induced damage to tissue.

To evaluate the in vivo antioxidant activity of alcoholic extract of the roots of Rubia cordifolia (RC). Male mice, were exposed, either to lead nitrate at a dose containing 40mg/kg body weight or combined with Rubia cordifolia for the first period of 40 days, where the animals were sacrificed for oxidative studies and biochemical studies. Lead has induced a significant increase in LPO, where as significant depletion SOD, CAT and GSH in liver and testis tissues. Rubia cordifolia alone had moderate effect on mice, where as coadministration of lead nitrate with Rubia cordifolia reversed the effect of lead. Ingestion of Pb (NO3)2 showed significant elevation in AST, ALT, ACP, ALP, and total cholesterol, level in tissue homogenate whereas Total protein content decreased significantly in comparison to control animals. On the other hand Alcoholic extract of Rubia cordifolia (low and high dose), along with lead nitrate decreased, elevated levels of AST, ALT, ACP, ALP, and total cholesterol, as compared to lead nitrate intoxicated mice. A significant rise in the level of total protein was also noticed. Preliminary analysis has revealed that Rubia cordifolia has significant amount of GSH, Vitamin C, other important antioxidants and polyphenols. In addition it also contains important trace elements like Zn, Cu, Vd, Se and Mo. These contribute to its antioxidant properties.

Protective role of coriandrum sativum (coriander) extracts against lead nitrate induced oxidative stress and tissue damage in the liver and kidney in male mice.

The present study describes antioxidant effect of Coriandrum sativum against lead nitrate induced toxicity in mice. Oxidative stress was induced in mice by a daily dose of lead nitrate (40 mg/kg body weight by oral gavage) for seven days. From day eight, after lead nitrate treatment, experimental animals received an oral dose of coriander extracts (aqueous extract - 300 mg/kg body weight and 600 mg/kg body weight; ethanolic extract - 250 mg/kg body weight and 500 mg/kg body weight) daily. The effect of these treatments in influencing the lead induced changes on hepatic and renal oxidative stress and biochemical changes along with histopathological alterations in soft tissues was studied. The data showed significant increase in liver and kidney LPO levels in animals treated with lead nitrate while the effect was attenuated by the plant extracts. Also, lead caused a significant decrease in antioxidant enzyme activity and this effect was reversed in groups treated with plant extract. Treatment with coriander significantly reduced the adverse effects related to most of biochemical parameters altered in animals treated with lead, related to hepatic and renal oxidative stress. Oral administration of Coriander to lead treated mice attenuated the deranged histopathological changes to some extent. It can be concluded from these results that Coriandrum sativum protects against lead toxicity and warrants the identification and isolation of active compounds responsible for its antioxidant effects.

Macroinvertebrates as indicators of pollution.

Various pollution indicators of stream Ban-Ganga have been identified on the basis of presence/absence/numerical abundance at various stations. They have been categorized as pollution tolerant, facultative and pollution intolerant groups in relation with the water quality at different stations of stream.