High diversity in the vaginal microbiome in women following preterm premature rupture of membranes and its effect on fetomaternal outcome

Background: Premature rupture of the membranes (PROM) complicates 3% of pregnancies and its associated with adverse perinatal outcome. Methods: This was a case control study conducted over a period of two years. Our aim was to evaluate the bacterial colonization of genital tract of antenatal patients who presented with preterm premature rupture of membranes and their maternal and neonatal complications. We studied 6023 patients during our study period among which 156 patients presented with preterm premature rupture of membranes. Results: PPROM was found more commonly among age 25-30 years (46.79%) with p<0.001. Out of 156 pregnant women with PPROM, only 16 patients (10.26%) developed clinical chorioamnionitis. We observed that 43.59% patients (n=68) with PPROM underwent LSCS which was significantly higher than control group (19.93%). Among them 81.41% (n=127) of the patients delivered within 24 hours of admission. Among 156 patients, 94 (59.12%) mothers had babies with birth weight ranging between 1.5-2.5 kg as compared to control group where 30.51% mothers had low birth weight babies. The difference was statistically significant. Approximately 18.24% babies developed respiratory distress syndrome requiring ICU care in study group as compared to 3.03% in control group and the difference was statistically significant. Conclusions: It is important to diagnose the PPROM early and manage the patient until delivery for better outcome. Timely intervention after proper analysis of risk and benefit of early termination helps in reducing adverse perinatal outcomes, reduced NICU admissions and unnecessary interventions for neonates.

Exam Anxiety and Its Associated Risk Factors Among Indian Medical Undergraduates

Background: Exam anxiety is a global troublesome psychological problem, impairing the academic perfor-mance of medical students. This study was planned to estimate the prevalence and associated risk factors of Exam anxiety among Indian medical students Methodology: A cross-sectional analytical study was conducted among 230 Indian medical undergraduate students. Westside Test Anxiety Inventory (WTAI) was used to estimate the level of Exam anxiety among medical students. We utilized multivariable logistic regression to identify independent risk factors among medical students. Results: The prevalence of high Exam Anxiety among medical students was 49.6 % (95% CI 43.9-57.0). The mean age of the students was 21.3 years. Multivariable logistic regression revealed the presence of excessive course load [AOR=2.22,95% CI:(1.03,4.78)], the presence of psychological stress [AOR=2.89,95% CI:(1.51,5.48)] and low self-esteem [AOR=8.15,95% CI:(1.51,43.96)] to be independent risk factors for exam anxiety. Conclusions: Our studyfindings suggest that the prevalence of Exam anxiety is very high among Indian un-dergraduate medical students. Our study also showed that the perception of excessive course load, psycholog-ical stress and low self-esteem were the independent risk factors in medical students.

Quality of life in COVID survivors and post COVID manifestations in a tertiary care hospital, Nalanda, Bihar

Background: COVID-19 pandemic had affected majority of the population across the world. Majority of the cases still complaining of post COVID symptoms. This study was undertaken to study the various pattern of post COVID-19 manifestations in this region in a group of patients attending hospital. Methods: An observational study was undertaken in a group of 120 patients attending a tertiary care hospital. The patients were subjected for a detailed history and thorough physical examination and the details were entered in to a proforma. The data thus obtained was compiled and analysed. Results: This study had shown than majority of cases were aged more than 50 years and most of them were females. The common post COVID-19 manifestations included joint pain, continued loss of taste and smell, dyspnoea, Anxiety/ depression and sleep disturbances in this study. Conclusions: This study had observed continued symptoms from the episode of disease varying from mild to severe manifestations. This study urges for a comprehensive rehabilitation program for all COVID-19 patients.

Preliminary evaluation of records of antenatal care at sub-centre in Western Maharashtra

Background: Health record are essential for monitoring and evaluation of programmes and routine data collection at facility level. Antenatal care is an important intervention for preventing maternal morbidity and mortality. The aim of study is to assess the antenatal care records at sub-centre level. The objective are evaluation of antenatal registration and completeness of antenatal register.Methods: A record based cross sectional study was conducted at a sub-centre in Western Maharashtra. Study period was for 1 month. Data collection was done one year i.e., recent record from November 2017 to October 2018 is selected for study.Results: Out of 141 entries from registers, level of completeness of various data entries in the register were as follows. Mother’s name was 100% (141), mother’s ID was 69.5% (98), expected date of delivery was 97.87% (138), initial weight of mother was 16.31% (23), tetanus toxoid received by mother was 9% (13). Whereas records of address of mother, height of mother and 4 antenatal visits which includes haemoglobin, blood pressure, urine albumin/sugar details were completely lacking. Only 64.5% (91) of antenatal registration were within 12 week of pregnancy.Conclusions: Early registration of pregnancy is less and needs to be increased for proper antenatal care. Incomplete records lead to loss of important health data; hence staff should be made aware of the need to keep records updated. Sub-centre-specific reasons for incomplete records e.g., lack of training, lack of time or motivation needs to be identified for improvement.

Cardio vascular response to core stability exercises in healthy individuals

Background: Low back pain is the most common problem which is present among 60 to 80 percent of population in the world at least once in their life time. It is considered as the most influencing aspect of health of an individual as well as their daily living status. Objective: To examine the cardiovascular responses (Heart Rate, Systolic Blood pressure and Rate Pressure Product) in the abdominal techniques that are (bracing and hollowing) used in core stability exercises. Core stability exercises have been used in the management of low back pain. The cardiovascular effects of exercises that involve postural stabilization, arms and exercises in a lying position are well known. Therefore, the purpose of this study was to examine the cardiovascular effects of 6 core stability exercises on cardiac patients which were used commonly for the treatment of low back ache. Materials and methods: This was a descriptive study which was conducted on a single group of 40 healthy males and females volunteers between age group of 18-25 years. With the mean age group of 21.12+1.042. Subjects were undergraduate students of MNR Sanjeevani College of physiotherapy, Sangareddy and were taken on the basis of convenient sampling. Prior to the participation all subjects were explained briefly about the aims and objectives of the study, health benefits of the core stability exercises and about the procedure of measuring Heart rate (HR), Systolic Blood pressure (SBP) and Rate Pressure product (RPP). All subjects were screened and a detail medical history was taken to exclude any serious illness. Health screening tool questionnaire (AACVPR) was used to identify the serious illness in the subject. One day before to the exercise session subjects were taken to the Gayathri Balakavi, Sreenivasu Kotagiri, Anup Kumar Songa, S. Purna Chandra Shekhar. Cardio vascular response to core stability exercises in healthy individuals. IAIM, 2019; 6(10): 35-42. Page 36 experimental room for familiarization of the procedure. The selected core stability exercises were demonstrated and subjects were instructed not to eat an hour before and not to wear tight clothes, Exercise protocol was designed properly and perfectly for the subjects so that they will be able to perform the exercises easily and effectively and the subjects were asked to participate in the exercise sessions after taking all the necessary measures. Pre and post exercise measurements of Systolic Blood pressure (SBP), Heart rate (HR) and Rate pressure product (RPP) values were measured. Before starting the exercise session subjects were made to relax for 15- 20 minutes, then the initial parameters of cardiovascular performance Systolic Blood pressure (SBP) were measured using automatic BP apparatus Omron M 10. BP cuff was tied to the left arm and patient was in high sitting position with arm supported at heart. Heart rate (HR) and Rate pressure product (RPP) were also measured at the same time along with (SBP). Subjects were asked to do 5 repetitions of all the exercises without any rest period. Post exercise Heart rate (HR), Systolic Blood pressure (SBP), and Rate Pressure Product (RPP) were recorded immediately after they finish the exercise. Now they were made to take rest till resting heart rate (RHR) was achieved. So for the given exercise sessions Systolic Blood pressure (SBP), Heart rate (HR) and, Rate Pressure Product (RPP) were measured for pre and post exercises. Results: There was marked increase in the cardiovascular parameters (heart rate, Systolic Blood pressure, and Rate Pressure Product). After exercise was performed, all the exercises were hemodynamically demanding. The study was done on single group of 40 healthy subjects with the mean age of 21.12 ± 1.04 in which 20 were males and 20 were female subjects. The baseline systolic blood pressure was 110.30 ±11.00 and baseline rate pressure product was 8797.15 ± 1419. The study was done with the aim to measure the acute cardiovascular responses to the core stability exercises. Repeated measures of ANOVA were used as the statistical tool. Conclusion: Core stability exercises can have cardiovascular effects in people with no cardiovascular or cardiopulmonary conditions. These cardiovascular effects may be important with respect to cardiac work, in Cardiac patients for whom these exercises are indicated. So, There was a significant increase in the cardiovascular parameters (Heart Rate, Systolic Blood Pressure, Rate Pressure Product) after the entire exercise session was performed by the subjects of the study.