Perinatal mortality of placenta previa: a 1-year retrospective study

Background: Antepartum haemorrhage is one of the important causes of perinatal mortality and morbidity in India. The increased risk of perinatal morbidity and mortality in placenta praevia is due to preterm birth, low birth weight, birth asphyxia and neonatal sepsis. This is a retrospective study done over a period of 5years to determine the incidence, demographic features, risk factors, obstetric management, maternal mortality and morbidity, and perinatal outcome in women presenting with placenta praevia.Methods: This was a retrospective study done at Nil Ratan Sircar Medical College and Hospital over a period of five years starting from January 2016 to December 2017. Antenatal women with more than 28 weeks of gestational age with a complaint of painless vaginal bleeding or those diagnosed as having placenta praevia on routine ultrasound examination were included in this study and hospitalised.  Among them cases of placenta praevia were 21.Results: There were21 cases of placenta praevia registered amounting to 0.23% incidence. The various antenatal complications seen associated with placenta praevia were severe anaemia (14.28%), coexisting PIH (4.76%), IUD (4.76%), IUGR/Oligohydraminos (4.76%). All the patients in the study had undergone caesarean deliveries. Perinatal morbidity studied as percentage of new-borns requiring resuscitation followed by NICU admission was 33.3%. Among the delivered patients of placenta praevia incidence of perinatal mortality was 23.8%. Prematurity (42.85%) contributed to most cases of perinatal mortality, followed by RDS (14.28%) and asphyxia (14.28%).Conclusions: In this study placenta praevia is seen more commonly in 28-34 weeks of gestation and patients mainly presented with a bout of bleeding eventually had preterm deliveries. Although vaginal deliveries are appropriate in selected cases of placenta paevia liberal use of caesarean section in well-equipped hospitals with availability of blood transfusion services have helped to lower complications.

Impact of hepatitis C virus [HCV] seropositivity on the serum protein electrophoretic pattern

The impact of HCV seropositivity on the serum protein electrophoretic pattern was analyzed. Abnormalities were tested for prediction of hepatic dysfunction. Sera were obtained from 20 asymptomatic patients seropositive for the virus and 20 control subjects. Sera were subjected to further testing of HCV seropositivity using the second generation enzyme immunonassay kit, and the pattern of binding of anti-HCV antibodies to HCV structural [C1 and C2] and non structural [NS3 and NS4] antigens was determined using the immunoblotting technique. The serum protein electrophoretic pattern was determined and the levels of the different fractions were tested for correlation to the levels of the liver enzymes, serum level of immunoglobulins and to the pattern of reactivity to structural and non structural HCV antigents. The results suggested the importance of the hypergammaglobulinemia as a marker of hepatic dysfunction in HCV seropositive patients, its level might be of value in the follow up of patients with normal liver transaminases levels

Peri-and regio-selectivity in cycloaddition reactions of 1-substituted pyridinium-3-oxide

1-methyl- and 1-phenylpyridinium-3-oxides [Ia and Ib] reacted with benzalacetophenone [II] to yield three types of bicyclic adducts. The first proceeded via 2 pi + 4 pi cycloaddition across the 2 6-positions of the pyridine ring to give single regioisomers in favor of endo-6-substituted azabicyclo [3.2.1] octenones [III] and [IV]. The second involved 2 pi + 8 pi, by addition across the C[4]-O, to give the dihydrofuro [2,3-c] pyridine [VII], and the involved C[2]-O to give substituted dihydrofuran V and VI. 1-[4,6-dimethylpyrimidin-2-yl] pyridinium-3-oxide [Ic] reacted with 4-nitrophenylisothiocyanate by addition across the C[2]-O to give the oxazole-2-thione derivative X. Structural assignments were deduced by elemental analysis and spectral evidence

Transformations of 8-azabicyclo [3-2-1] octenones into 4-and 5-methylpyridin-3-ol and indole-tropane derivative

8-[substituted]-2-oxo-8-azabicyclo [3.2.1]-oct-3-ene derivatives Ia and Ib reacted with di-azomethane to give the corresponding two regioisomers of delta 2-pyrazoline derivatives II and III which were transformed directly into 4- and 5-methylpyridin-3-ols on pyrolysis. The synthesized 8-[2-cyanoethyl-8-azabicyclo [3.2.1] octan-6-exocarbonitrile-2-phenylhydrazone VIIa was treated with trifluoromethanesulfonic acid to yield the indole. derivative VIII