RESUMEN
Background: The present study was conducted with the objective to assess the spectrum of liver disease in pregnancy, and its course and effect on maternal and fetal outcomes.Methods: The present study was conducted as a prospective follow up study in the department of Obstetrics and Gynaecology, J. K. Hospital for a period of 1 year. The pregnant women between the ages of 18-35 years presenting with symptoms suggestive of underlying liver disease were selected. Socio demographic details and clinical history was obtained from all the participants and they were subjected to liver function test (LFT). All patients were followed till 2 weeks post-partum period. The maternal and fetal outcomes were noted.Results: The following results were obtained: pregnancy-induced hypertension (PIH) was the most common cause of abnormal LFT (46.66%), about 57.5% patients delivered at term, 63.3% patients delivered vaginally, mostly cases delivered a term healthy neonate between 2.5-3.0 kg weight with Apgar score >7 at 5 minutes after birth and maternal complications were seen in 10.82% cases.Conclusions: Our study shows that though liver disease is uncommon in Indian pregnant women, but it is associated with high maternal and perinatal morbidity. A high index of suspicion of liver disease, early diagnosis, prompt referral to a higher centre when required, appropriate supportive management, and a proactive policy of early delivery when indicated may improve the maternal and fetal outcomes in pregnant women with liver disease. Thus LFT should be conducted as a routine investigation in all pregnant females during first and second trimester.
RESUMEN
Triphala, a well known ayurvedic formulation is used against number of ailments since ancient times. It consists of Emblica officinalis, Terminalia chebula and Terminalia bellerica in equal proportion. Triphala as a whole and its three individual constituents show specific antimicrobial activity against certain bacteria and fungi. Antimicrobial activity of aqueous extract of triphala and its constituents was studied against P.aeruginasa, E.coli , B.subtilis, K. pneumoniae and S.aureus by cup-plate method. Triphala was found strongly bactericidal against P. aeruginosa with 1.8 cm of inhibitory zone. This was on account of T. chebula which showed 1.2 cm of inhibitory zone against the same pathogen, followed by E. coli and other two Gram positive bacteria. T. bellerica however showed maximum inhibitory activity against B.subtilis by showing 2.2 cm of inhibitory zone. It was confirmed that antimicrobial activity against Gram negative bacteria is due to T. chebula and E. officinalis while antimicrobial activity against Gram positive bacteria is on account of T. bellerica. Antifungal activity of Triphala and its constituents was studied against two pathogenic fungi viz. Aspergillus niger and Candida albicans by the same method. Triphala was found more efficient against A. niger, this was on account of T. bellerica which showed nearly 2 cm zone of inhibition. T. bellerica and Triphala showed more than 2 cm inhibitory zone against C. albicans. Inhibitory zone of Emblica officinalis was observed to be of 1.5-2 cm against both the fungi, whereas T. chebula did not show inhibitory activity against C. albicans but showed nearly 1 cm of inhibitory zone against A. niger. This confirms that the antifungal activity of Triphala is primarily due to T. bellerica and E. offiicinalis.