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A retained placenta is suspected when there is failure of expulsion of the placenta even after 30 minutes of delivery of the fetus. Retained placenta is a common cause of PPH and, hence, a significant cause of maternal mortality and morbidity in developing countries. Thus, early intervention is necessary to prevent this post-delivery of the baby. We present a case of retained placenta in a young primigravida with oligohydramnios with fetal horse horseshoe-shaped kidney and a foetal echogenic bowel loop. Her clinical findings and investigations were not significant at the time of admission. She was induced with dinoprostone gel intra-cervically and delivered via vaginal route. There was failure of expulsion of the placenta even after 30 minutes of delivery of the baby. Inj. syntocin 5 units were given via the umbilical cord. In the event of this failure, the patient was shifted inside the OT, and manual removal of the placenta was done under general anaesthesia f/b evacuation retained bits of placental membranes with ovum forceps under USG guidance. Retained placenta can lead to severe PPH and its consequences in the postpartum period. Thus, it requires timely intervention to prevent PPH and reduce maternal mortality and morbidity. Cases of retained placenta can occur even in the absence of any known identified risk factors and should be managed in a tertiary care centre with OT facilities.
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Background: Induction of labour is the artificial initiation of labour before its spontaneous onset for the purpose of achieving vaginal delivery of the feto-placental unit. It is a common obstetric procedure which is indicated when the benefits to mother or fetus outweigh the benefits of continuing the pregnancy. Most common indication for induction is postdated pregnancy.Methods: Longitudinal Study carried out in department of obstetrics and gynaecology, RIMS, Imphal, Manipur, conducted for duration of two calendar years, with effect from January 2021 in 168 primigravidas who had reached full term or late term pregnancy admitted in ante-natal ward of RIMS, Obstetrics and Gynaecology department.Results: Study was conducted on 168 pregnant women, most of the participants belonged to the age group of 18-34 years (77.9%). Vaginal delivery was the most common mode of delivery (64.8%). Most of the babies (72%) delivered were having birth weight of between 2.5 kg to 3.9 kg. PPH and uterine hyperstimulation are comparatively more in the late term pregnancy as compared to full term pregnancy. Meconium-stained liquor was slightly more in late term pregnancy group as compared to full term pregnancy. Babies delivered by full term pregnant women were having better APGAR score in 1 minute and 5 minutes than the babies delivered by late term pregnancy.Conclusions: Late term Pregnancy is comparatively common in low socio-economic group. The CS rate is comparatively high in Late term pregnancy as compared to Full Term Pregnancy. Poor APGAR score is highly associated with Late term Pregnancy outcome.
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Background: Contraception is the need of the hour in India. The family planning program in India offers a basket of choices. These choices are governed by the decisions of their partners, socio economic status of patients and even wishes of other family members.Methods: This observational study was carried out in obstetrics and gynaecology department of ESIC medical college and hospital for a period of 1 year from March 2023 to February 2024. All the patients who were in immediate post-partum period after normal vaginal delivery, caesarean section and medical termination of pregnancy were included in the study.Results: With the introduction of PPIUCD in national family programs more women are inclining towards long term spacing methods and not resorting to permanent sterilisation alone.Conclusions: It is undeniable that most women do not desire a pregnancy immediately after delivery but are not informed enough about the methods of contraception they can use.
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Background: Severe acute malnutrition (SAM) with severe wasting remains a major killer of children. In Bihar, 48% of children are stunted, 21 % are wasted, and 7% are severely wasted. Even during the first six months of life, 31% are wasted. The objective of this study was to study wasting trends and contributing factors responsible for changes in Bihar among children 0-5 years. Methods: This cross-sectional study was done using a data of NFHS-5 survey in Bihar (N=35,834) conducted in all 38 districts of the state from July, 2019 to February, 2020. The Bihar NFHS-5 report and factsheets, including NFHS-4 data, were downloaded and converted to excel to enable data visualization and trend analysis. The outcome variable Wasting was measured using NFHS-5 relevant questionnaires given under nutrition category. We analyzed trends between NFHS-5 and NFHS-4 Bihar data for severe wasting/wasting, determinants, and coverage of interventions.Results: The prevalence of severe wasting has increased from 7% to 8.8%, while wasting increased from 20.8% to 22.9% (NFHS-5). The severe wasting and wasting has reversed or worsened in 27 districts. There is a mixed picture of infant feeding- early initiation of breastfeeding worsening and some improvements in exclusive breastfeeding and timely introduction of complementary feeding. Consistent improvement across districts for underlying determinants, but slight, in women抯 education, teenage pregnancy, and marriage before 18 years. Conclusions: Need to invest in improving maternal determinants-age at marriage, education, ANC coverage, and teenage pregnancy. It is imperative to focus on preventing, identifying, and treating wasting.
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Ovarian torsion refers to partial or complete rotation of ovarian vascular pedicle. This study explored the presenting symptoms and management of ovarian torsion in a newly established ESIC Medical College and Hospital, Bihta, Patna. This report presents two cases of ovarian torsion, the presenting symptoms and management. This underscores the need of prompt diagnosis and management to improve postoperative outcomes.
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Background: Pregnant women with underlying heart disease are at increased risk for adverse maternal, obstetric, and neonatal outcomes. One can successfully treat the majority of these incidents if detected early by accurate individual risk assessment and careful follow-up. The aim and objectives of this study were to compare the foeto-maternal outcome in pregnancy with and without heart diseases with period of gestation >32 weeks.Methods: This study was carried out in a tertiary care teaching hospital of Imphal, the capital city of Manipur, using a standard-questionnaires among patients admitted. Data was analysed using SPSS 21.0 with statistical significance set at p<0.05.Results: Study was conducted on 112 pregnant women. The prevalence of heart disease was higher (71.4%) among the primiparous women. Highest occurrence of heart disease (66.1%) was seen in the housewife group. There was increased incidence of pre-term deliveries among pregnant women with heart disease (26.8%). Caesarean section (62.5%) and maternal complications (42.9%) were found to be higher among the pregnant women with heart disease. The incidence of NICU admission of babies was higher among mothers with heart disease (17.9%) compare to 5.4% in mothers without heart disease.Conclusions: Early detection by accurate individual risk assessment and careful follow-up are key to improving outcomes.
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Implanon is a single rod contraceptive implant which provides protection for three years. The development of subdermal contraceptive implant has been an important improvement in the contraceptive technology in India. Mechanism of action of Implanon is by ovulation inhibition and increase in viscosity of cervical mucus. The side effects associated with Implanon includes irregular periods, weight, gain, acne, headache and breast tenderness. Insertion of implant is an operating procedure done in day care by a skilled care worker. Implanon is proving to be a safe and highly effective long-acting reversible contraceptive.
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Current evidence posits a central role for gut microbiota and the metabolome in the pathogenesis and progression of inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) has been established as a means to manipulate this microbiome safely and sustainably. Several aspects of the technical improvement including pretreatment with antibiotics, use of frozen stool samples as well as short donor-to-recipient time are proposed to improve its response rates. Its efficacy in ulcerative colitis has been proven in clinical trials while data is emerging for Crohn’s disease. This review describes briefly the biology behind FMT, the available evidence for its use in IBD, and the host, recipient and procedural factors which determine the clinical outcomes.
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Background/Aims@#Patients of ulcerative colitis (UC) on follow-up are routinely evaluated by sigmoidoscopy. There is no prospective literature to support this practice. We assessed agreement between sigmoidoscopy and colonoscopy prospectively in patients with disease extent beyond the sigmoid colon. @*Methods@#We conducted a prospective observational study at a tertiary care institute for agreement between sigmoidoscopy and colonoscopy. We assessed endoscopic activity using the Mayo Endoscopic Score (MES) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and histological activity using the Nancy Index (NI), Robarts Histopathology Index (RHI), and Simplified Geboes Score (SGS). @*Results@#Sigmoidoscopy showed a strong agreement with colonoscopy for MES and UCEIS with a kappa (κ) of 0.96 and 0.94 respectively. The misclassification rate for MES and UCEIS was 3% and 5% respectively. Sigmoidoscopy showed perfect agreement (κ = 1.00) with colonoscopy for assessment of the presence of endoscopic activity in the colon using MES ≥ 1 as activity criteria and strong agreement (κ = 0.93) using MES > 1 as activity criteria. Sigmoidoscopy showed strong agreement with colonoscopy for assessment of the presence of endoscopic activity using UCEIS (κ = 0.92). Strong agreement was observed between sigmoidoscopy and colonoscopy using NI (κ = 0.86), RHI (κ = 1.00), and SGS (κ = 0.92) for the detection of histological activity. The misclassification rate for the detection of histological activity was 2%, 0%, and 1% for NI, RHI, and SGS respectively. @*Conclusions@#Sigmoidoscopy showed strong agreement with colonoscopy for endoscopic and histologic disease activity. Sigmoidoscopy is adequate for assessment of disease activity in patients with UC during follow-up evaluation.
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Bacillus Calmette-Guérin (BCG) is an attenuated strain of Mycobacterium bovis. Although it was developed as a prophylactic vaccine against tuberculosis (TB), researchers have also evaluated it for preventing cancer development or progression. These studies were inspired by the available data regarding the protective effects of microbial infection against cancers and an inverse relationship between TB and cancer mortality. Initial studies demonstrated the efficacy of BCG in preventing leukemia, melanoma and a few other cancers. However, mixed results were observed in later studies. Importantly, these studies have led to the successful use of BCG in the tertiary prevention of non-muscle invasive bladder cancer, wherein BCG therapy has been found to be more effective than chemotherapy. Moreover, in a recently published 60-year follow-up study, childhood BCG vaccination has been found to significantly prevent lung cancer development. In the present manuscript, we reviewed the studies evaluating the efficacy of BCG in cancer prevention and discussed its putative mechanisms. Also, we sought to explain the mixed results of BCG efficacy in preventing different cancers.
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Neonatal septicemia continues to be a significant cause of neonatal morbidity and mortality. Acute otitis media may be associated with sepsis, though the association is not very common. Facial nerve palsy is a rare complication of otitis media in neonates. Other more common causes of facial nerve palsy are traumatic (birth trauma) and idiopathic (Bell抯 palsy). Through this article, we report a rare case of facial nerve palsy secondary to otitis media in a neonate with sepsis.
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Background: Cervical cancer is one of the major causes of mortality among women worldwide. It has taken fourth place among malignancies that affect women, the first leading is breast cancer. In developing countries including India, it is the leading cause of morbidity and mortality. It is readily preventable and can be diagnosed at the pre invasive stage with adequate and repetitive cytological screening and Papanicolaou smears.Methods: This observational study was aimed to screen the patients attending gynae OPD of ESIMCH, Bihta. The main purpose was to study the incidence of premalignant and malignant lesions in population in and around ESICMCH, Bihta. A total of 100 patients attending gynaecology OPD of ESIC, Bihta were screened during a period of one year from October 2022 to September 2023.燩ap smears are taken from women visiting gynaecological OPD between ages of 25 to 70 with different gynaecological complaints using Ayer抯 spatula. Smears were reported according to Bethesda system 2001.Results: A total of 200 pap smears were examined. There were 68 patients with NILM, and 67 patients with inflammatory smear. ASCUS was found in 12 patients, LSIL in 10 patients, HSIL in 7 and squamous cell carcinoma in 1 patient. This study concluded that a simple pap smear test could be offered to vast populations for diagnosing premalignant conditions of the survey this has and will in future continue to aid us with the early diagnosis of survival cancer.Conclusions: PAP smear is useful in diagnosing malignant and premalignant lesions of the cervix. In developing countries such as India this screening method is cheap and can be widely used. It can be used by trainers and para medical staffs.
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Background: Post term pregnancy has been defined as a pregnancy that persists beyond 294 days or 42 weeks of gestation. It most likely occurs in less than 5% gestation and has been associated with increased perinatal mortality rate. There is a strong body of evidence that the induction of labour at term and prior to 42 weeks of gestation is associated with reduction in perinatal complications without an associated increase in CS rates.Methods: This observational study was carried out in obstetrics/gynaecology department of ESIC Medical College and Hospital, Bihta. All the primi or multi gravida beyond the expected date of delivery and coming under the inclusion criteria were taken. Taking in consideration about the incidence of cases of post term deliveries last year, we are getting 6 to 7 cases every month. So,70 cases in 1 year of study duration was taken from October 2022 to September 2023.Results: This observation study showed that the incidence of postdated pregnancy was higher in primi gravida. Incidence of fetal distress and NICU admissions increased as the period of gestation increases.Conclusions: Post dated pregnancy was associated with perinatal complications like fetal distress, meconium aspiration syndrome and fetal asphyxia. There was increased risk of obstetric complications like postpartum haemorrhage, perineal tear, cervical tear and shoulder dystocia. Management of postdated pregnancy is a challenge to obstetrician and policies regarding induction of labour beyond expected date of delivery can reduce untoward complications.
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The study focused on the identification and characterization of Colletotrichum musae as a significant post-harvest fungal pathogen causing anthracnose disease in bananas. Symptoms included sunken, water-soaked spots on infected tissues, leading to soft, red-brown to black-coloured spots with irregular shapes. The pathogen was isolated and cultured on Potato dextrose agar medium, and its pathogenicity was confirmed by inoculating healthy banana fruits, resulting in typical anthracnose-like spots. Cultural characteristics of C. musae on PDA revealed whitish to black colonies, and microscopic examination showed oblong to cylindrical, single-celled conidia. Acervuli, which were salmon-coloured initially and later turned dark brown to black, were observed on the lesions. The fungus exhibited maximum growth and sporulation on PDA, followed by oat meal agar and Richard’s agar. Additionally, the study highlighted the morphological features of C. musae, including septate, irregularly branched, and vacuolated mycelium. The findings contribute to understanding the pathology and characteristics of C. musae, providing valuable information for managing post-harvest anthracnose in bananas.
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The research was conducted to minimize the activity of harmful microorganism which is responsible for deterioration of fruit quality. The eight treatments were taken during the in-vitro study from which viz., six fungicides and two bioagents were tested for fruit dip treatment against anthracnose of banana. As a result of study, the most effective treatment was found carbendazim 12 % + mancozeb 63 % WP, which is showing the least disease intensity (20.26 %) and the highest reduction in banana anthracnose (52.56 %). Carbendazim and propiconazole also demonstrated significant disease reduction. Among non-hazardous chemicals, chitosan was the most effective (31.11 % disease intensity, 34.24 % reduction), followed by edible paraffin wax and yeast. Hot water treatment showed the highest disease intensity (44.49 %) and the least disease control (20.86 %). The study concluded that, carbendazim 12 %+ mancozeb 63 % WP and chitosan was the most effective against the post-harvest anthracnose disease of banana.
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In an in-vitro study evaluating eight different fungicides against C. musae, carbendazim, carbendazim 12% + mancozeb 63%, and azoxystrobin 11% + tebuconazole 18.3% exhibited 100% inhibition of fungal growth at concentrations of 0.1%, 0.25%, and 0.1%, respectively. Propiconazole (0.05%) was also the most effective fungicide, showing 83.03% mycelial inhibition, followed by carboxin 37.5% + thiram 37.5% (73.51%) and chlorothalonil (76.84%) at concentrations of 0.25% and 0.2%, respectively. Mancozeb exhibited the minimum mycelial inhibition (66.44%) at a concentration of 0.25%, while copper oxychloride showed the least inhibition (48.96%) at 0.25% concentration. In addition, five biocontrol agents were screened for linear growth inhibition of C. musae through the dual culture method. Among the Trichoderma isolates, T. harzianum demonstrated the highest growth inhibition (84.38%), followed by Pseudomonas fluorescens (80.16%).
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From a public health perspective, the spread of the COVID-19 virus has become a problem. The incredible rise in disease-related infection and death rates has brought the world to a standstill in dealing with its negative consequences. This has led to a global lockdown to prevent further spread of the virus. The blockade had a huge social and economic impact. However, it also has some positive effects on the environment, especially air quality, as many research institutes point to reduced nitrogen dioxide and carbon monoxide problems in major cities (PM) around the world. Ni#trogen dioxide emissions were reduced by 20-30% in China, Italy, France and Spain, while nitrogen dioxide emissions were reduced by 30% in the United States. Compared to last year, China's air quality improved by 11.4%. NO (-77.3%), NO2 (-54.3). Compared to five years per month, 3% and carbon monoxide (-64.8%) (Signs point to a decrease) content were found during Partial shutdown in Brazil. There are about -51.84, -53.11, -17 in India 97%, -52.68, -30.35, 0.78, and -12.33 reductions in PM10, PM2 concentrations. They are SO2, NO2, CO, O3 and NH3. This article focuses on the environmental impact of closures and also discusses air pollution before and after closures in major cities around the world. Various aspects of the environment were studied and evaluated, including air, water, noise and waste management before and after closure. Therefore, this research will serve as a guide for environmentalists, leaders, and frontline activists as they look for ways to beat this disease and reduce its long-term impact on health and the environment.
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A field experiment was conducted on experimental farm of Dept. of Agricultural Meteorology, Vasantrao Naik Marathwada Krishi Vidyapeeth, Parbhani, Maharasthra, India during the during kharif season 2015 under rainfed condition to find the relationship of pheno thermal and heat use efficiency indices with yield. The field experiment was laid out in factorial randomized bock design with five sowing dates (i.e. 25th, 26th, 27th, 28th and 29th SMW) and three varieties (viz., BDN-711, BSMR-736 and BSMR-853) with three replications. The sowing dates significantly influenced on the phenology, growth, development and yield attributes. The dry spell experienced during sowing to emergence period in first sowing date (25th SMW sowing) and thereafter no rainfall condition during remaining period of sowings viz., 26th, 27th, 28th and 29th SMW, therefore, emergence and final plant count was observed lowest in 25th SMW (30 and 29 %) and highest in 27th SMW sowing (92 %). Hence, significantly highest dry matter plant-1, no. of pods plant-1, seed weight and seed yield plant-1 was observed in 25th SMW sowing; seed yield (417.7 kg ha-1), seed yield heat use efficiency (0.20 kg ha-1 0C day-1) was recorded highest in 27th SMW sowing and lowest in 25th SMW sowing. Significantly highest no. of pods plant-1, seed weight and seed yield plant-1, seed yield heat use efficiency, pheno thermal index was observed in BDN-711 variety and significantly lowest in BSMR-853 variety. The significantly highest total dry matter plant-1 was observed in BSMR-853 and lowest in BDN-711 variety. Significantly highest GDD, HTU and PTU required for completion of different phenophases were recorded in BSMR-736 variety and significantly lowest in BDN-711 variety. Weather indices viz., GDD, HTU, PTU, PTI showed non-significant correlation at all the phenophases with seed yield of pigeonpea. The yield prediction model based on thermal indices and seed yield heat use efficiency at floral bud initiation to 50 % flowering and at 50 % flowering to 50 % pod formation phenophases was found useful in assessing the crop yield one and half to one month in advance.
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The present investigation was conducted to Evaluate the effect of Integrated Nutrient Management (INM) on the Economic and Physical attributes of Aonla (Emblica officinalis Gaerten). The research was carried at Main Experiment Station, Horticulture, Acharya Narendra Deva University of Agriculture and Technology, Kumarganj, Ayodhya (U.P.) during the year 2021. It was laid out in a randomized block design with 10 treatments, namely: T1 – Control, T2- RDF 100% (1kg.N: 0.5kg.P:1kg.K per tree), T3- FYM (10kg./tree) + RDF 100%, T4- Poultry Manure (7.5kg./tree) + RDF 100%, T5- FYM (10kg./tree) + RDF 50% + Azospirillium (10ml./tree), T6- Poultry Manure (7.5kg/tree) + RDF 50% + Azospirillium (10ml./tree), T7 -FYM (10kg./tree) + RDF 50% + PSB (10ml./tree), T8- Poultry Manure + RDF 50% + Azospirillium (10ml./tree), T9 –FYM (10kg/tree) + RDF 50% + Azospirillium (10ml./tree) + PSB (10ml./tree) and T10- Poultry Manure (7.5kg/tree) + RDF 50% + Azospirillium (10ml/tree) + PSB (10ml./tree).The experiment was replicated three times. Results showed treatment T10 outperformed the rest with maximum fruit set percent (78.56%), fruit retention (20.29%), fruit yield (102.78 kg/tree), fruit weight (41.89 g), fruit length (3.87 cm), specific gravity (1.05 g/cm3 ) and maximum gross return/ha Rs. (128264), Net return Rs. (92154) and Cost: benefit ratio was evaluated with the use of treatment combination T10. Thus, the treatment combination T10 is therefore recommended for application to Aonla trees in eastern Uttar Pradesh in order to obtain high yields with better quality fruits.
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Organic amendments have emerged as a pivotal component in the trajectory of sustainable agriculture, given their multifaceted contributions to soil health, crop yield, and environmental conservation. This comprehensive review delves into the intricacies of organic amendments, spanning their historical context, types, sources, nutrient profiles, and their interplay with soil and plant health. Special emphasis is laid on the integration of modern technological advancements with traditional amendment practices, exploring the synergistic potential of digital agriculture and precision farming in enhancing the efficacy of organic inputs. The review also sheds light on the economic, social, and environmental ramifications, emphasizing the role of organic amendments in smallholder versus large-scale agricultural systems and their influence on farmer resilience and consumer perceptions. Crucially, this review addresses the challenges and limitations inherent in organic amendment practices, including concerns related to quality variation, scalability, over-application, and regulatory nuances. Concomitantly, the work culminates with a forward-looking perspective, highlighting emergent trends and innovations that portend the future of organic amendments in global agriculture. The findings underscore the significance of organic amendments not merely as soil additives but as integral elements in the blueprint for a sustainable, resilient, and food-secure future.