ABSTRACT
Background: Platelet count below 1.5 lakh/cumm is called as thrombocytopenia. After anaemia it is the second most common haematological disorder in pregnancy. It affects nearly 6 to 15%; on an average 10% of all pregnancies. Gestational thrombocytopenia is a clinically benign thrombocytopenic disorder usually occurring in late pregnancy. It resolves spontaneously after delivery.Methods: It is a hospital based prospective observational study over a period of 1 year. All pregnant women who attended OPD at the department of obstetrics and gynecology, UPUMS, Saifai for antenatal checkup were included for the study and blood sample was withdrawn.Results: Out of 263 cases enrolled for study, 90 women were found to have thrombocytopenia, and 173 had normal platelet count. Thus, incidence of thrombocytopenia was 34%. Gestational thrombocytopenia accounted for majority of cases of thrombocytopenia in pregnancy (50%) followed by hypertensive disorders (22.4%). It was further followed by ITP (11.11%) and dengue (5.5%).Conclusions: Gestational thrombocytopenia is the most common cause of thrombocytopenia during pregnancy (50%), but other underlying causes must be considered as well. A thorough history and physical examination will rule out most causes.
ABSTRACT
Background: Abnormal uterine bleeding is one of the commonest clinical presentation ac-counts for 33% gynaecological consultations and this proportion rises to 70% in perimenopausal and postmenopausal age group in any gynaecology clinic. The most probable etiology of abnormal uterine bleeding relates to the patients reproductive age. Various diagnostic techniques have been evolved over the periods to determine the etiology of abnormal uterine bleeding in perimenopausal women, but their accuracy has not been compared properly. The aim of study is to evaluate the endometrium by transvaginal ultrasonography and hysteroscopy and its correlation with histopathology in perimenopausal patients with abnormal uterine bleeding.Methods: Total 96 patients in perimenopausal age group, admitted with chief complaints of ab-normal uterine bleeding were included. All patients underwent transvaginal ultrasonography and hysteroscopy, followed by hysteroscopy guided biopsy and histopathological examination. Accuracy, sensitivity, specificity, positive predictive value and negative predictive value were calculated for both methods and compared, considering histopathological diagnosis as gold standard.Results: Mean age of patients was 44.05±3.29. Hysteroscopy has high accuracy, sensitivity, specificity, positive predictive value and negative predictive value than Transvaginal sonography for diagnosis of all endometrial and intrauterine pathologies.Conclusions: Hysteroscopy results are more consistent with the results of histopathology. Hysteroscopy and hysteroscopy guided biopsy has been proven as gold standard for endometrial evaluation of patients with abnormal uterine bleeding. TVS can be used as most cost effective first step investigation in cases of perimenopausal bleeding.
ABSTRACT
Background: Premature rupture of membranes (PROM) is the rupture of the fetal membranes before the onset of labor. Preterm PROM complicates approximately 3 percent of pregnancies and leads to one third of preterm births. It increases the risk of prematurity and leads to a number of other perinatal and neonatal complications.Methods: This was a prospective study carried out at the department of obstetrics and gynaecology, UPUMS, Saifai from April 2018 to September 2018 (6 months study). Patients with Spontaneous rupture of membranes any time beyond 28th week of pregnancy, but before the onset of labour. Patients with following conditions were excluded from the study- meconium stain liquor, cord prolapse, antepartum haemorrhage, active infection at other sites, active liver disease.Results: A total of 103 cases of premature rupture of membrane (PROM) were recorded from April 2018 to September 2019 among 1523 admitted pregnant patients. Most of the patients 56 (54.36%) were delivered by caesarean section (C/S). Previous C/S, oligohydramnios, fetal distress, chorioamnionitis were the common indications for doing C/S. Forty-seven (45.63%) patients were delivered vaginally.Conclusions: Most of the affected women belongs to 20-24 years of age (53.39%). Term PROM was more in comparison to PPROM and most of them were multigravidae. Cesarean section rate was high. Most common complication was of subclinical urogenital infection (51.02%).
ABSTRACT
Background: The aim of study was to find out the frequency and clinical outcome in hypertensive disorder of pregnancy (HDP) in a rural tertiary care centre. Hypertensive disorder of pregnancy is a commonest medical disorder which constitutes about 12-22% of all pregnancies and it is a major cause of maternal morbidity as well as mortality world wide.Methods: It is a retrospective hospital-based study to find out the clinical outcome in different hypertensive disorder of pregnancy in a rural tertiary care centre of western Uttar Pradesh.Results: Present study showed the prevalence of HDP was 4.01% among the study population. Most of the patients were primipara ,unbooked and less than 25 years of age. The most common HDP was mild preeclampsia and HELLP was its commonest complication.Conclusions: Hypertensive disorder of pregnancy (HDP) is still a major cause of maternal mortality and morbidity. Authors intend to aware the pregnant women regarding high risk factors of pregnancy and motivate them for regular antenatal care so that complications of hypertensive disorders can be managed timely.
ABSTRACT
A 20-year-old male presented with asymptomatic peeling of palmar skin of 1 month duration ( Fig. 1). He gave history of similar episodes since 3 years, all of which occurred during the winter season and subsided without treatment in a period of 2 to 3 months. He also complained of excessive sweating over palms. There was no personal or family history of atopy. Cutaneous examination revealed exfoliation of skin over the volar aspect of the palms and fingers. Soles were spared. Palmar hyperhidrosis was also noted. Onset in adulthood, absence of itching and/ or fluid-filled blisters, and negative KOH mount excluded dyshidrotic eczema, acral peeling skin syndrome, epidermolysis bullosa simplex, and dermatophytid and convened the diagnosis of keratolysis exfoliativa. Keratolysis exfoliativa is characterized by annular erythema with an air-filled blister arising in the center, followed by superficial collarette and lamellar peeling of glabrous palmoplantar skin. Synonyms include dyshidrosis lamellosa sicca and lamellar dyshidrosis. Emollients, urea, and lactic acid may be used; however, treatment is not necessary as the condition is asymptomatic.
ABSTRACT
This study was carried out to find the etiological spectrum and clinical profile of acute viral hepatitis in Ludhiana. Hepatitis E was encountered most frequently (44.56%) followed by hepatitis B (29.7%), whereas hepatitis D occurred least frequently (0.99%). The age group most commonly affected was 20-30 years(32,67%) followed by 30-40 years (23.76%). Males showed higher incidence as compared to females in the ratio of 62.4:37.6. The most frequent clinical features were anorexia and jaundice. The disease was found to be more common in urban set up(78.2%) than in rural regions (21.8%). Mortality was mainly because of fulminant hepatitic failure. In 1.98% of cases, etiology remained undecided. Total bilirubin and prothrombin time were found to be useful prognostic indicators.