ABSTRACT
Background: Labour pain is among the most severe pain experienced by women. Most women like to experience labour birth with active involvement and as naturally as possible. Hence, the need for analgesia to overcome labour pains is highly requested by women today. In developing nations where availability of facilities is the main limiting factor, intra muscular opioids can be used. The aim was to know the effect of Tramadol in labour analgesia and reduction in the duration of labour and to know the maternal and neonatal outcome after administration of TramadolMethods: This study was conducted in tertiary teaching care hospital in 400 low risk primigravidae who fulfilled selection criteria with full-term pregnancy with vertex presentation in late latent phase of labour were selected and given 100 mg tramadol hydrochloride intramuscularly.Results: The degree of pain relief in 1 st and 2 nd stage of labour, duration of labour, Apgar score of neonates and side effect of drugs were studied. In this study 23.5% of patients had grade II pain, 38.5% of patients had grade III pain and 38% of patients had no pain relief after Tramadol administration. Before drug, the mean pain score is 3.86 in stage I. After drug administration the mean pain score is 3.14 in stage I and 3.81 in stage II. The duration of first and second stage of labour also shortened.Conclusions: In low risk Primigravidae, IM Tramadol hydrochloride appears to be effective without side effects. Hence, in developing nations, where availability of facilities is the main limiting factor, IM opioids can be considered as suitable alternatives.
ABSTRACT
Background: This study compares the efficacy of intramuscular oxytocin and oxytocin with sublingual misoprostol administration among the primary postpartum hemorrhage (PPH) mothers of vaginal deliveries. The aim is to compare the effectiveness of intramuscular oxytocin versus oxytocin with sublingual misoprostol in blood loss reduction among women at risk of PPH undergoing vaginal deliveries.Methods: Each group, 50 mothers were selected from the risk of PPH vaginal mothers in the labour ward of the study area.Results: The two groups’ mothers were not statistically significantly differed (P>0.05) in respect of their demographic and clinical variables such as age, gravida, risk factors, the onset of labour and type of delivery. The mean blood loss of group I was 315.4±111.4 ml and group II mean blood loss was 241.4±191.2 ml. The difference between the two groups’ blood losses was statistically significant (P<0.05).Conclusions: Oxytocin with sublingual misoprostol significantly reduced the blood loss during 3rd stage labour than only oxytocin administration.
ABSTRACT
Background: Estimation of adiponectin levels in diabetic and non-diabetic fatty liver and healthy controls. Methods: We studied 25 subjects for diabetic fatty liver, 25 subjects for non-diabetic fatty liver and 25 healthy controls. Clinical evaluation included anthropometric measurements, BMI, biochemical investigations and adiponectin estimation by ELISA. Results: There were 15 males (60%) and 10 (40%)females subjects in the DFL group, 18 males (72%) and 7 females (28%) subjects in the NDFL group and 13 males (52%) and 12 females (48%) subjects in the control group. 80% (20) of the DFL patients and 72% (18) subjects of NDFL group had BMI >25kg/m2. 80% (12 males and 8 females) of subjects in the DFL group and 68% (12 males and 5 females) had a waist circumference that indicated central obesity as per Indian cut-offs (>90 cm for females and >80 cm for males). The mean adiponectin (μg/ml) ± SD levels in DFL were 4.03 ± 0.43, NDFL was 5.01 ± 0.55 and in controls was 7.63 ± 0.66, the difference being statistically significant with P <0.001. The difference in the adiponectin levels was statistically significant between each of the three groups with P <0.001. There was no difference in serum adiponectin levels between males and females in all three groups. Conclusion: The chief conclusion of this study are that serum adiponectin levels are lower in subjects with NAFLD than those without it; adiponectin levels are inversely related to the degree of steatosis in NAFLD, with the lowest levels in more severe forms of steatosis.