Exploring the Bilateral Comparisons of Articular Surfaces of Talus: An Observational Study at Tertiary Health Care Center in Pune City

Background: The existing conclusive data show variations in the subtalar joint regarding its morphological features and articulation of bones. Inadequate studies exist on the morphometry of articular surfaces of the talus which may help in surgical interventions and development of implants and prostheses in diverse populations. Purpose: The current study was undertaken to conduct a bilateral comparison of parameters of articulating surfaces of talus. Material and Methods: An observational study design was carried out at one of the private medical colleges in the Pune district of Maharashtra. A total of 100 (fifty-one from right side and forty-nine left-sided tali) dry human talar bones were collected and various dimensions of articular surfaces of bones were measured by Digital Vernier Caliper and Ruler. The data analysis was performed and results were tabulated and presented graphically. Results: There was a statistically significant difference (p<0.05) in bilateral measurements of lateral articular surface height (LASH) of talar bones. The difference was not significant (p>0.05) for all other parameters. Conclusions: The study inferences can be applied as a guide and baseline information for surgical measures, inflammatory disease management, and forensic anthropologists.

Vaginal progesterone after tocolytic therapy in threatened preterm labour

Background: Currently preterm labour is one of the most challenging problem faced by both obstetricians and perinatologists, this episode in the course of woman’s pregnancy takes a heavy tool for perinatal mortality which accounts for approximately 50-75%. The incidence of preterm labour is estimated to be 5-10% of all pregnancies.Methods: It was a prospective randomize control trail over a period of 3 year at department of obstetrics and gynecology, tertiary care hospital Pune, Maharashtra, India. Total 100 subjects were randomized into two groups with group one receiving vaginal micronized progesterone and group two control group receiving only tocolytics and steroids. Subsequently authors compared the safety and efficacy of vaginal micronized progesterone versus placebo as a maintenance therapy in preventing preterm labour.Results: This analysis showed that women who randomized to progesterone prophylaxis had a significantly increase in duration of pregnancy. The mean of birthweight in Group A and Group B was 2963±36 gm and 2567±49 gm and respectively which confirmed the positive effects of progesterone on increasing infants’ weights at birth.Conclusions: Authors concluded that progesterone therapy had acceptable efficacy in the prevention of preterm labor in terms of prolongation of delivery and by increasing gestational age at delivery.

Trends of caesarean section: an analytical overview of indications

Background: Caesarean section is one of the commonly performed surgical procedures in obstetrics. An increasing trend has been observed in both primary and repeat caesarean sections. The reasons for its increase are multifaceted. So, this study was carried out to compare the rates of caesarean delivery and to analyse various indications contributing to it.Methods: This retrospective study was conducted over a period of three year from 1st January 2016 to 31st December 2018 at the department of obstetrics and gynaecology, tertiary care hospital Pune, Maharashtra, India. All caesarean delivery (primary and repeat) taken place during the study period. The rate and indications of caesarean section was calculated over the study period to find out the trends in caesarean delivery. The data so collected was presented with graphical representation. Statistical analysis was performed with SPSS software and t-test was used for continuous data and pearson chi square test for discrete data.Results: There were a total of 12373 deliveries during the study period out of which, 3701 had delivered via Caesarean Section. So, the rate of caesarean section in the study was found to be 29.91%.Conclusions: Being a tertiary care hospital, a high rate of caesarean deliveries was observed, Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit caesarean section rates.

Comparative study on usefulness of modified WHO Partograph in management of labour at one of the rural teaching institutes of Gujarat, India

Background: Modified WHO Partograph is a simple, inexpensive pre-printed form on which labour observation are recorded. It generally comprises three sections of information: maternal condition, fetal condition and labor progress. To study on usefulness of Modified WHO Partograph in management of labour of low risk women, this indirectly improved maternal and perinatal outcome.Methods: In this study the progress of labour of 150 women with uncomplicated full term pregnancies with cephalic presentation in active labour was studied using modified WHO partograph. 150 historical matched controls comprising of low risk women who delivered without the use of partograph were identified from the labour register and their course of labour studied. The hospital records were studied to obtain the demographic variables. Maternal and perinatal outcome was analyzed for both cases and controls.Results: The emergency cesarean section rate was reduced from 38.7% in controls to 24.7% in cases and both are significant statistically. None of the cases had labour beyond 16 hours, thus indicating significant reduction in prolonged labour. Neonatal intensive care admissions decreased from 18.6% in controls to 6% in cases indicating an improved maternal and neonatal outcome.Conclusions: Modified WHO Partograph work as “early alarming warning system” which help in detecting delayed progress of labour which improves maternal as well as perinatal outcome.

Prospective study on outcome of post-partum intrauterine contraceptive device insertion at tertiary level rural health institute of Gujarat, India

Background: This study was conducted to evaluate the acceptance, safety, efficacy, complications and expulsion rate of post-partum intrauterine contraceptive device (PPIUCD) insertion among post-partum pregnant women in a rural tertiary care center. Objective of this study was assessment of the efficacy and safety of post-partum IUCD insertion. Comparing the complications and client satisfaction in both groups (intra caesarean insertion versus vaginal route of insertion).Methods: This is a prospective study conducted at one of the rural tertiary care teaching institution. A total of 150 patients with caesarean or vaginal deliveries had PPIUCD insertions and they were followed up for a period of one year. The outcome measures analyzed were menstrual irregularities, vaginal discharge, pelvic infection and perforation and efficacy measures - failure, expulsion and removal. Data are expressed in frequency and percentage. Chi square test was used for comparison and P value <0.05 was considered significant.Results: The study shows that PPIUCD is an effective intervention in both caesarean and vaginal delivery with non-significant differences in safety and efficacy depending on the route of insertion. There was no case of perforation and no significant risk of infection in either caesareans or delivery. Spontaneous expulsion occurred in two cases inserted by vaginal route. Missing string incidence is high in the caesarean group compared to vaginal insertion.Conclusions: PPIUCD is a safe, effective and long term reversible method of contraception and should be encouraged by public awareness and community acceptance.

Minimal deviation adenocarcinoma of endometrium: A rare entity in a 72‑year‑old female.

Minimal deviation adenocarcinoma (MDA) of endometrium is considered a differentiated state of endometrioid adenocarcinoma. It is a low‑grade tumor associated with areas histologically typical of endometrioid adenocarcinoma in the majority of the cases. Due to deceptively benign microscopy, MDA may be overlooked leading to incorrect assessment of tumor extend and staging.

An osteological study of morphometry of hard palate and its importance.

Background: The hard palate is an essential part of human skull, the detailed knowledge of which plays an important role in the passive articulation of speech. Methods: The present study was conducted on 65 dry skulls from the department of anatomy, MVJMC & RH, Bangalore. With vernier caliper, palatine length, palatine breadth and heights were measured. Palatine index and palatine height index were calculated. Results: Mean palatine length was 48.47 ± 4.66 mm. Mean palatine breadth was 36 ± 4.41 mm and height was 8.62 ± 2.76 mm. According to the palatine index range, 66% of the hard palate belongs to leptostaphyline, 18.5% belongs to mesostaphyline and 15. 5% was brachystaphyline. As per palatine height index, 72.3% of hard palate showed chamestaphyline followed by 26.1% orthostaphyline and 1.6% hypistaphyline. Conclusions: These observations can be utilised for ethnic and racial classification of crania, anthropological studies, fabricating complete maxillary dentures for edentulous patients and performing certain surgical procedures in hard palate & soft palate.

Study of Acetyl Cholinesterase, Butyryl Cholinestrase and β - Glucuronidase in Organophosphorus Poisoning.

Organophosphorus poisoning is common problem throughout the world. It occurs due to accidental exposure; suicidal and homicidal attempt. Many deaths occur within hours of ingestion of organophosphorus compounds like pesticides. For its prevention, speedy diagnosis and prompt treatment is required; which requires sensitive marker/s. The aim of this study was to find such marker/s. In this regard, activities of Acetylcholinesterase, Butyrylcholinesterase and β-glucuronidase were estimated in 80 samples including 40 controls and 40 organophosphorus poisoning cases (mild = 07, moderate = 19 and severe = 14). Results indicated that activities of Acetylcholinesterase and Butyrylcholinestrase decrease in mild, moderate and severe Organophosphorus poisoning in proportionate manner whereas, β-glucuronidase activity increases as severity of Organophosphorus poisoning progresses. Thus, all the three enzymes showed alterations in their activities however, the degree of change in activity was maximum in case of Acetylcholinesterase. Thus, Acetylcholinesterase activity is the most sensitive marker amongst three enzymes in Organophosphorus poisoning.

Serostatus Disclosure and Safer Sex in HIV-positive Man: Case Study.

Disclosure of one’s human immunodeficiency virus (HIV)-positive serostatus to a spouse or sex partner is important, particularly to inform the partner of the need to take precautions to prevent HIV transmission. Thus, understanding the process of disclosure is important to facilitating it to occur more often. Such understanding can best be achieved through a qualitative study (in-depth-interview) that elicits and systematically explores individuals’ stories of what has happened to them after disclosure of HIV.

Morphometric Study of the Atlas Vertebra using Manual Method

The atlas (first cervical vertebra) has undergone many structural modifications. It is critically located and close to the ‘life centres’. For this study, one hundred dried intact human atlas vertebrae from the Indian population were measured using a digital Vernier calliper that provides accurate resolution up to 0.01 mm. The distance between the tips of the transverse process, the outer and the inner distance between the foramen transversaria and various diameters of vertebral foramen were measured. The mean width of the measured atlases was 69.37 mm. The mean distance between the lateral margins of foramen transversaria was 55.66 mm and the inner distance was 45.93 mm. The mean thickness of vertebral artery grooves was 3.72 + 1.06 mm. The observations made in the present study may help in improving understanding of various bony dimensions while operating close to important structures like nerve roots and the vertebral artery.

Challenges of collaborative research.

In 2009, as a supplement to a National Institutes of Health (NIH) -funded collaboration between the Indian Council of Medical Research (ICMR) and the NIH, a formative study was conducted with 30 HIV-positive people and 18 HIV-related service providers to understand sexual risk-taking, HIV-related disclosure, and other behavioural patterns among HIV-positive individuals in Baroda, Gujarat. One goal of this research was to determine how to adapt a counselling intervention which had been tested in the United States, in order to make it culturally and linguistically relevant for PLWHA(People living with HIV/AIDS) here.