Comparison of modified biophysical profile and Doppler ultrasound in prediction of perinatal outcome in high-risk pregnancies

Background: The objective of this present study was to compare MBPP and umbilical artery Doppler flow in high-risk pregnant women in prediction of perinatal outcome.Methods: A cohort study was done on 150 high-risk pregnant women over 16 months. Antenatal women with singleton pregnancy who delivered within 48 hours of performing MBPP and Doppler USG, with presence of ≥1 high-risk factor like pre-eclampsia/gestational HTN, BOH, post-dated pregnancy, FGR, GDM, maternal heart disease, anaemia, hypothyroidism and IHCP were included in the study. MBPP (NST and AFI) and umbilical artery Doppler was performed. Perinatal outcome was measured in terms of stillbirth/IUD, LBW, Apgar <7 at 5 minutes, admission to NICU, neonatal death within 48 hours of delivery, MSL and neonatal seizures within 24-48 hours. Quantitative variables were compared using independent t-test/Mann Whitney test. Qualitative variables were correlated using Chi square test/Fisher exact test. Sensitivity, specificity, NPV, PPV were calculated and p-value <0.05 was considered statistically significant. Data analysis was done using social sciences (SPSS) licensed version 21.0.Results: Majority belonged to the age group 21-25 years and were between 37-40 weeks of gestation. It was found that highest perinatal complications occurred in those with both abnormal MBPP and Doppler followed by those with only abnormal MBPP (p-value<0.0001).Conclusions: MBPP is a better predictor of perinatal outcome compared to umbilical artery Doppler USG in high-risk pregnant women. MBPP should be done in all high-risk pregnancies even if Doppler is normal. Both the tests must be performed in all high-risk pregnancies to improve perinatal outcome.

Antioxidant and immunomodulatory properties of Spilanthes oleracea with potential effect in chronic fatigue syndrome infirmity

Background: Chronic fatigue syndrome (CFS) holds a mystery for researchers due to its multifactorialnature; hence, its diagnosis is still based on symptoms and aetiology remains obscured. Number ofscientific evidences regarding the role of oxidative stress, immune dysfunction in CFS and alleviation ofsymptoms with the help of nutritional supplements guided us to study effect of ethanolic extract ofSpilanthes oleracea (SPE) in CFS.Objectives: Present study was designed to evaluate antioxidant, immunomodulatory properties of S.oleracea flower to ameliorate CFS infirmity in mice.Materials and method: In order to induce fatigue, experimental animals were stressed by chronic water eimmersion stress model. Meanwhile, parameters like immobility period and tail withdrawal latencywere assessed. On the 21st day, mice blood was collected and they were immediately sacrificed forbiochemical estimations.Results: Biochemical analysis results revealed that CFS elevates lipid peroxidation, nitrite level and diminishes the endogenous antioxidant enzyme like catalase level in stressed animal’s brain homogenate.Stressful condition developed muscle fatigue leading in alteration of lactate dehydrogenase level (LDH),Blood urea nitrogen (BUN) and Triglycerides (TG) levels. Concurrent and chronic treatment of SPE for 21days restored all these behavioural despairs and associated biochemical adaptation in mice in dosedependent manner.Conclusion: The outcome of this study indicates ability of SPE in amelioration of CFS by mitigating theoxidative stress and thus provide a powerful combat against CFS which may be due to its antioxidant andimmunomodulatory properties.© 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V

The prevalence and clinical significance of irregular antibodies other than ABO in Rh negative pregnant women in tertiary care hospital

Introduction: Routine pre transfusion testing consists of ABO and Rh typing, antibody screening and compatibility testing. The purpose of the antibody screen is to detect red blood cell antibodies other than Anti-A or Anti-B. These antibodies are called ‘unexpected’ because only 0.3 to 2% of the general population have positive antibody screen. Objective: This study was undertaken to know the prevalence of irregular antibodies in Rh negative pregnant women and also to analyse the clinical significance of these antibodies in the form of neonatal outcome. Materials and method: A Prospective study was conducted on the study population from September 2011 to Feuary 2013. During this period all the antenatal cases reporting in the department of Obstetrics and Gynaecology, Safdarjung hospital, New Delhi were typed for ABO and D antigen. Out of these antenatal cases 500 Rh negative pregnant women were included in the study and were screened for red blood cell alloantibodies by performing Indirect Coomb’s test(ICT). The specificity of the antibody was identified by further testing of those samples that gave positive reaction on initial screening.All these Rh negative antenatal cases were followed up and their neonates were examined for the evidence of hemolysis in the form of anaemia, jaundice, splenomegaly. Results: This study noted the prevalence of irregular red cell antibodies in 4.2% of pregnant women. Anti-D is the most common Antibody identified. accounting for 66.7%. Anti-C and anti-D together accounted for 23.9%. Anti-Kell and Anti-Jkb were identified in 0.4%. Incidence of neonatal anemia is significantly higher in babies born to mothers with RBC antibodies. Conclusion: The prevalence of irregular Red Cell Antibodies in Rh negative women is 4.2%.

Laparoscopic cholecystectomy in patients with previous renal transplantation.

Objective: To analyse and present our experience of laparoscopic cholecystectomy in patients with previous renal transplantation. Materials and Methods: Records of patients who have undergone laparoscopic cholecystectomy after kidney transplantation from January, 2010 to December, 2010 were reviewed. Data, in form of, demographics, medications used, indication of transplantation, manifestation of gallstones, operative findings, duration of hospitalisation and postoperative complications were obtained and analyzed. Results: Ten patients have undergone laparoscopic cholecystectomy. All patients were admitted on the day of surgery. Immunosuppression regimen was not modified during hospitalisation. Indications of cholecystectomy were billiary colic (4), acute cholecystitis (4) and asymptomatic gallstones (2). Laparoscopic cholecystecomy was uneventful in all cases. Postoperative complications were nausea and vomiting in two patients and port site infection in one patient. Conclusion: Laparoscopic cholecystectomy is safe and feasible in patients who have undergone renal transplantation.

Double-barrel common bile duct: a rare cause of extrahepatic biliary obstruction.

Double-barrel common bile duct is rare. We report a 50-year-old woman with defective canalization of the common bile duct, presenting with extrahepatic biliary obstruction due to stones in one compartment. CT scan highlighted this anomaly. After failed attempts at stone extraction at ERCP, she was successfully operated on.