A Cross Sectional Study Of Hellp Syndrome In Pregnancy Complicated By Severe Pre Eclampsia In A Tertiary Care Hospital

Background and objectives Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a dangerous and life threatening complication in severe preeclampsia. It remains as an important cause of maternal and perinatal morbidity and mortality globally. The objective of this study was to find out the incidence of HELLP syndrome in pregnancies complicated by severe pre eclampsia and to assess the maternal and perinatal morbidity and mortality in women with HELLPsyndrome secondary to severe pre eclampsia. Methodology A one year Cross sectional study was conducted in the labour room of KLE Academy of Higher Education and Research (KAHER), Belagavi for the period of one year from January 2016 to December 2016. Ethical clearance was obtained from the JNMC Institutional Ethics committee. The primary objective was to determine the incidence of severe pre eclampsia and HELLPsyndrome in patients of severe pre eclampsia. The secondary objective was to study the associated maternal and perinatal morbidity and mortality. Results During the study period, a total of 6236 number of deliveries were conducted in the hospital. Among them, 312 (5%) pregnant women developed severe preeclampsia and 33 women developed HELLPsyndrome(10.57%). The mean age was 25.18±3.81 years. Labour was induced in 21.21% of the women. Majority (66.67%) of the women had vaginal delivery, while the rest had caesarean section (33%) . The most common indication for LSCS was HELLP 81.82%. Majority (84.85%) of the women had complications of HELLP alone while 9.09% of the women had HELLP syndrome associated with abruption. The mean birth weight was 2.27±0.69 Kgs. All cases had live births. The requirement of NICU admission was noted in 18.18% and the most common cause of NICU admission was Meconium aspiration syndrome with fetal distress (50%). The perinatal mortality rate was 16.67%. Conclusion and interpretation HELLPsyndrome is one of the rare complications of severe pre eclampsia. This study shows 5% incidence of severe preeclampsia and incidence of HELLP syndrome in pregnancy complicated by severe preeclampsia as 10.57%. The incidence in our study is high as our hospital is a tertiary care centre that receives referral cases (high risk with poor prognosis) from North Karnataka for further management.

Restoration of plantar sweat secretion in the feet of leprosy patients.

As part of the studies on nerve damage and its consequences in leprosy, the status of sweat gland function in the anaesthetic sole of the feet of leprosy patients was investigated qualitatively and semi-quantitatively, before and after surgical decompression of the posterior tibial neurovascular bundle. Sweat prints of the feet of the patients were obtained pre-operatively and postoperatively on Whatman's No. 1 filter paper. The paper was treated with one percent Ninhydrin and the intensities of the Ninhydrin positive areas were quantitated. Forty one feet of thirty six patients have been studied in this manner. Sweat print analysis of twenty normal people have also been done, and included for comparison. This operative procedure has been found to effect an improvement in the sweat gland function in the feet of more than fifty percent of leprosy patients studied so far.

Collagen sheet and its usefulness in healing of ulcers in leprosy patients.

Collagen is a natural tissue present in the body. For healing of any part collagen is essential. Collagen has been made available in the form of sheets for clinical use, by the Central Leather Research Institute, Adyar, Madras 20. It has been tried in burns and ulcers. Plantar ulcers are common in leprosy and pose a problem in healing. Therefore, collagen was tried in our Institute on 75 patients having plantar ulcers, other type of ulcers like stasis ulcers and post operative wounds. It has been found from our study that Collagen Sheet hastens the healing of wounds.