A Study of Placental Changes in Polycystic Ovarian Syndrome Patients with Gestational Diabetic Mellitus

Placenta is a vital organ for the development of foetus and maintenance of pregnancy. Placenta helps in the development and growth of foetus in uterus. In between maternal and foetal circulation the transfer of waste products and nutrients was done by the placenta which is a complex organ of a short life span. The diabetic pregnancy is characterised by numerous disturbances in foetal growth and development.METHODSA cross sectional study on placental changes in 60 pregnant women was done over a period of 18 months. Pregnant women in the age group of 25 years to 40 years who were suffering from polycystic ovarian syndrome (PCOS) were included in the study. Placental specimens were collected from obstetrics department and fixed overnight in 10% formalin. Thorough gross examination was done and few bits from the abnormal areas were given for microscopic examination. Routine histopathological process was followed for microscopic examination.RESULTSOut of 60 pregnant women with PCOS, seven patients were found to be having PCOS with gestational diabetes mellitus. These seven patients showed gross and microscopic changes in the placenta when compared with non-diabetic PCOS pregnant women.CONCLUSIONSPlacenta of diabetic women with PCOS showed both gross and microscopic abnormalities which may affect the growth and development of baby during intrauterine life.

Study of Bone Mineral Density, Vitamin-D and Body Mass Index in Asthmatic ACOS and COPD Cases: Those who are on Prolonged (more than 3 Years) use of Inhaled Corticosteroids

Introduction: Inhaled corticosteroids are the prime choice of treatment for Asthma, ACOS, and COPD cases, but using inhaled corticosteroids with the influencing factors for a longer duration may cause cachexia, skeletal muscle abnormalities, and metabolic syndromes. Objectives: To determine whether the use of inhaled corticosteroids has a harmful effect on bone, in case of Asthma, ACOS, and COPD. To assess the correlation between low bone mineral density with low vitamin D levels and low body mass index. To assess the fracture risk with the effect of inhaled corticosteroids in asthma, ACOS and COPD cases. Methods: A total of 260 subjects (123 males and 137 females) aged ≥ 25 years attended the routine check-up for NRI Institute of Medical Sciences, Visakhapatnam. The pulmonology department was grouped into 4. Data was collected and filed by using data collection sheet, measured bone mineral density with the ultra-sonogram machine, did investigative procedures to know the blood calcium and vitamin-D levels. Results: Our study revealed that all quantitative and qualitative parameters were measured and analyzed with the SPSS software version 18, (vitamin-D, bone mineral density, body mass index, allergies, family, smoking histories and others) obtained a statistically significant p-value. Conclusion: Effect of disease and inhaled corticosteroids use respiratory diseases for a longer duration or in high doses resulting in decreased bone mineral density along with the decreased body mass index.

Ulnar Nerve, Its Termination and Superficial Branches in Hand: A Cadaveric Study.

Introduction: Nerves supplying the hand are notoriously variable in their divisions and their course; do not follow any standard pattern. The palmar aspect of hand is supplied by median and ulnar nerve. The clinical importance of Guyon’s canal is emphasized due to the various branching patterns of the ulnar nerve in this canal. The palmar aspect of hand is usually supplied by ulnar nerve and median nerve. Medial one and a half fingers are supplied by ulnar nerve and lateral three and a half fingers are supplied by the median nerve. The branches of ulnar nerve are notoriously variable morphologically and no standard pattern can be given regarding the course of these branches. Presence of trifurcation of ulnar nerve or communications of superficial branches to median nerve do not cause symptoms usually but becomes important during surgical and orthopaedic interventions. Material and Methods: The study was conducted on 40 hands (20 left and 20 right ) of preserved adult human cadavers.The roof of the Guyon’s canal was opened with care not to disturb the stuctures. The ulnar nerve observed for its terminal branches, the course of its superficial branches was observed. The point of division of superficial branch into digital branches was measured from bistyloid line. The point of origin of superficial communicating branch from superficial branch or digital branch of ulnar nerve to median nerve was observed from bistyloid line. Observations: In 29 hands the ulnar nerve showed bifurcation, in 10 hands it trifurcated in the Guyon’s canal and in 1 right hand of a male cadaver there was higher division of the ulnar nerve and trifurcation.The superficial branch was observed for its course and division from bistyloid line. The superficial branch gave rise to 2 digital branches in 27 hands and it gave 3 branches i.e. 2 digital branches and 1 communicating branch to medialmost digital branch of median nerve in 13 hands. The typical ramus communicans from digital branch of ulnar nerve to the medial most digital branch of median nerve was observed in 27 hands.(67.5%). Conclusion: This study attempted at exploring the superficial anatomy of ulnar nerve in hand.The branching pattern of the ulnar nerve in Guyon’s canal is variable as there is no exact level at which the nerve terminates.The superficial communicating branch to median nerve though present in all the hands but the typical ramus communicans was observed in 67.5% of specimens. Thus surgical procedures in hand should be planned carefully keeping in mind in advance such variations which can be encountered.