Clinical profile and fetal outcome in women with preterm labor pains

Background: Preterm labor is a potential cause of preterm birth. Certain demographic and presenting features in pregnant women may correlate to the severity of the problem and progression to delivery. The aim of the study was to find out the clinical profile and fetal outcome in women with preterm labor pains in a tertiary care hospital of North India.Methods: 83 women with preterm labor were included in the study. Antenatal corticosteroids and tocolytic therapy were given. Women who delivered preterm comprised of Group A and who delivered at term were Group B. Clinical profile and fetal outcome was compared and statistically analyzed.Results: 39 (47.0%) women had preterm delivery (Group A) and 44 (53.0%) women delivered at term (Group B). 23.1% women in group A and 4.5% in group B had a previous preterm birth (p=0.021). 16 (41%) women in group A and 4 (9.1%) in group B had a positive microbial growth on high vaginal swab (p=0.001). The odds of having a preterm birth with cervical length of <2 cm was calculated to be 5.281 (p=0.000). A statistically significant difference was observed in the mean birth weight, Apgar score and nursery admissions in both the groups (p=0.000).Conclusions: A prior history of preterm birth, a positive growth on high vaginal swab and a cervical length of less than 2 cm were found to be significantly associated with preterm birth.

Studies on the Effect of Vacuum Packaging on Some Quality Changes in Labeo Rohita During Frozen Storage Period.

This study was designed to investigate the influence of vacuum packaging on nutritional, chemical and microbial parameters of rohu fillets during frozen storage. Quality assessment of vacuum packaging rohu for up to 1 month at -12°C was done by the monitoring of nutritional quality, free fatty acids (FFA), thiobarbituric acid (TBA), pH and expressible moisture (EM). Results showed that free fatty acid, primary and secondary oxidation products, expressible moisture and pH value of vacuum packaging samples were significantly lower than those in control samples (p<0.05). Results indicated that vacuum packaging was effective in reduce lipid oxidation and increased shelf life of rohu frozen fillets. Similarly the microbial load of vacuum packaging samples was significantly lower as compared to control samples. Thus the employment of vacuum packaging alone or in combination with other protective strategies is recommended.

Prospective study to evaluate the outcome of early enteral nutrition in severe acute pancreatitis.

Background and Objectives: Severe acute pancreatitis (SAP) affects the nutritional status of the patient. This prospective study was carried to assess the tolerance and outcome of early enteral nutrition via naso-jejunal feeding tube (NJFT).Methods: 30 patients of SAP were given enteral feeding via endoscopically inserted NJFT within 48 – 72 hours of admission. The volume of the feeds was increased as per tolerance. The patients who tolerated the feed (Group A) and those who did not tolerate (Group B) were followed up by biochemical parameters, amount and duration of feeding. The patient outcome noted and the results statistically analyzed. Results: 27 (90%) patients tolerated the feed, reached the goal feed volume and were subsequently started on oral feeds. No complication related to NJFT insertion was encountered. A significantly higher ICU stay (p=0.04) and number of complications (p = 0.048) was observed in Group B patients than in Group A. All nutritional parameters improved in patients in Group A with significant improvement in serum calcium, serum albumin and fasting blood glucose levels. Conclusion: Enteral nutrition is an economical and effective way to provide nutrition to patients with severe acute pancreatitis. The patients who tolerated feeds had less morbidity, mortality and hospital stay.

Clinical profile and outcome of severe acute pancreatitis.

Background and Objectives: Around 20% of the patients of acute pancreatitis develop acute severe pancreatitis in the form of extensive pancreatic or peripancreatic fat tissue necrosis with associated peripancreatic collections. These patients run a protracted clinical course, multiorgan failure, high morbidity and mortality. Methods: Clinically and radiologically diagnosed 30 patients of acute severe necrotizing pancreatitis were prospectively evaluated for the clinical outcome with respect to extent of pancreatic necrosis and severity in terms of CTSI. Results: 18 patients had pancreatic necrosis between 30-50% (Group A) whereas 12 patients had necrosis more than 50% (Group B). The rate of organ dysfunction and mortality (11.11% versus 50.50%) the rate of was significantly higher in the group B. Multiorgan failure (MOF) was present in 5.56% of group A and 58.33% of group B patients. 66.67% patients were managed conservatively of whom 80% survived and 33.33% patients underwent surgical intervention of whom 60% survived. Conclusion: CECT is the modality of choice to help stage the severity of pancreatic necrosis, depict severity of inflammatory processes and local complications. Patients with pancreatic necrosis with transient end organ dysfunction can be treated conservatively with favorable outcome. The need for intervention should be individualized and based on the clinical condition of patient.

Prospective study of the clinical profile of hospitalized patients of malaria.

Background & Objectives: To study the clinical profile of hospitalised patients of malaria aged 15-60 years. Methods: This was a prospective analysis of patients suffering from malaria diagnosed by malaria serology and/or peripheral smear. The mode of presentation, clinical course, treatment history, laboratory investigations and complications were recorded and the data statistically analyzed.Results: P. vivax was the most common (80.39%) plasmodium species, the rest (19.61%) being P. falciparum. The mortality rate was 6.54%. A fall in hemoglobin (p=0.005) and platelet count (p=0.040) was observed in the patients who expired. There was an improvement in the final platelet counts in both the groups (p=0.00052). The mean total bilirubin at admission was higher in P. falciparum group than P. vivax group (p = 0.00789). Renal failure was observed in 16.34% patients. The mean systolic and diastolic blood pressure in patients who expired was lower than patients who were discharged (p=0.007, 0.001). The mean heart rate was higher (109.40) in patients who expired (p = 0.002). Conclusion: Factors associated with poor prognosis in malaria are moderate grade fever, hypotension, tachycardia, anaemia, thrombocytopenia, hyperbilirubinemia, high transaminase and renal failure. A high clinical suspicion, early diagnosis and treatment is recommended in highly prone areas.

Clinical profile of dementia and its association with homocysteine.

Background & Objectives : Dementia is a serious loss of cognitive ability in a previously unimpaired person, beyond what might be expected from normal ageing. This cross sectional study was undertaken to study clinical profile of dementia and its association with plasma homocysteine levels. Methods : 30 patients (indoor or outdoor) > 55 years with dementia were screened on Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR) Scale. A clinical dementia rating questionnaire was asked and plasma homocysteine levels measured by ELISA using Bio-rad reagents. Data was collected and statistically analyzed. Results : There was a statistically significant correlation between loss of memory (p = 0.047), orientation (p = 0.038), judgement/problem solving (p = 0.048), outer (p = 0.042), household (p = 0.048) and personal care activity (p = 0.0099) with hyperhomocysteinemia. A statistically significant correlation was found between CDR (p = 0.0081) and MMSE (p = 0.0095) score with hyperhomocysteinemia. Interpretation & Conclusion : A significant correlation was seen between memory loss, worsening of cognitive dementia, limitation of household activity, worsening of personal care, impairment of judgment and problem solving with hyperhomocysteinemia. As hyperhomocysteinemia can be effectively treated with a low cost therapy of B vitamin supplements, it is important to recognize these problems and treat them early.

Frequency of ABO and Rh blood groups in blood donors: a study from a Tertiary Care Teaching Hospital in India.

Background & Objectives: Out of total 328 antigens recognized by the International Society of Blood Transfusion (ISBT), ABO and RhD antigens are the most important from the transfusion medicine perspective. The present study was conducted with larger sample size than prior studies to determine frequencies of ABO and Rh alleles and obtain distribution of ABO and RhD blood group pattern among blood donors. Methods: A retrospective study was conducted in the Department of IHBT, Civil Hospital, Ahmedabad from October 2007 to September 2012. ABO grouping and RhD typing was done using conventional tube technique on a total of 109771 donors. Commercial anti-sera and in-house prepared cells were used for cell and serum grouping respectively in those tests. Departmental Standard Operating Procedures (SOPs) were followed for each aspect of testing. Observed ABO and RhD antigen frequencies were noted. Bernstein and Hardy-Weinberg equations were applied to determine the allele frequencies of ABO and RhD respectively. Results: Blood group B has the highest prevalence (35.81%) in the population under study followed by O (32.74%), A (22.68%) and AB (8.77%). Female donors comprised only 1.75% of the sample size. Rh D positivity was noted in 94.48% donors. Conclusion: Results obtained were quite similar to prior studies from Ahmedabad with smaller sample size. Remarkable differences were noted as compared with western population. The data generated in the present study combined with several other studies of different geographical region of India has significant implications in inventory management of blood transfusion services.

Feasibility of blood bank data management system (Bdms) in record keeping and prevention of near miss events: an experience at Tertiary Care Center.

Introduction and Aim-Objective: Regulatory authority and voluntary accreditation organization require particular records and documents to be maintained for the operation of the blood bank. It can be accomplished using blood bank data management (BDMS) software in a less labor-intensive manner as compared to manual methods provided that the technical staff is properly trained. Many of the near miss events could be prevented with the use of blood bank software ensuring better patient safety. Hemovigilance scheme though not yet well established in our country which requires robust data management and compilation can be easily retrieved from the software. We present below reports on the effectiveness of Blood Bank Data Management System in strengthening of Blood Transfusion Services. The main aim of the study was to compare computer software with traditional hand-written documents for record management and evaluate BDMS in prevention of near-miss events. Materials and Methods: A comparative study between record keeping by conventional registers and Blood bank Data Management System (BDMS) software was done for period of six months from September 2011 to February 2012. Each of the entry was duplicated in both during this study period. Each of the technicians using the software was asked to rate the user friendliness of the system using an objective method of scoring to prevent any bias. The time taken to enter each donor/patient data manually and on software was also compared. Results: All mandatory registers were electronically maintained. The time taken for the each register was significantly less by the software. The inventory of consumables was excellently managed. Also, the equipment records required to be maintained were available at the click of a mouse. 6 out of 15,220 samples were found to contain Wrong Blood In Tube (WBIT) based on traceability system of prior sample received of the same patient which could have been undetected with manual methods and 4 out of these 6 would have resulted in fatal Hemolytic Transfusion Reaction. Apart from this, two-way traceability of blood products was maintained. 30 out of 35 technicians rated the software as “Excellent” with respect to user friendliness. Conclusion: BDMS is a reinforcing tool in the data management and prevention of near miss events leading to improved safety in Blood transfusion Services.

Rare presentation of spontaneous acquired diaphragmatic hernia.

Spontaneous acquired diaphragmatic hernia without any apparent history of trauma is a very rare condition and is very difficult to diagnose. We present a case of a 21-year-old male who presented with abdominal pain for one month and four episodes of vomiting for one day. Clinical suspicion, chest radiography with nasogastric tube in situ and computed tomography (CT) confirmed the diagnosis. The diaphragmatic defect was repaired surgically. The patient had an uneventful post-operative recovery.

Antidiabetic, antihypercholesterolaemic and antioxidant effect of Ocimum sanctum (Linn) seed oil.

Antihyperlipidaemic and antioxidant effect of Ocimum sanctum Linn. seed oil (OSSO) was investigated in rabbits. Administration of OSSO (0.8 g/kg body weight/day) for four weeks, in cholesterol (100 mg/kg body weight/day) fed rabbits significantly decreased serum cholesterol, triacylglycerol and LDL-+VLDL-cholesterol as compared to untreated cholesterol fed group. There was significant fall in atherogenic index in OSSO treated group. In addition, treatment with OSSO decreased lipid peroxidation and increased reduced glutathione content in blood. Antidiabetic effect of O. sanctum seed oil was evaluated in alloxan diabetic rabbits. Two weeks treatment of diabetic rabbits with OSSO (0.8 gm/kg/day) showed no significant hypoglycaemic effect. Results of the present study show that OSSO has hypocholesterolaemic and antioxidant effects but it does not have antidiabetic effect.

An unusual case of complete heart block with triplet pregnancy.

A young primigravida presented at 36 weeks of gestation with complete heart block and triplet pregnancy. She underwent a lower segment cesarean section, and was managed successfully. The patient remained asymptomatic and did not require antiarrhythmic drugs or pacing.

A study of prevalence of Chlamydia trachomatis infection in women with first trimester pregnancy losses.

The study included 125 patients in the first trimester of pregnancy, who were divided into group A (50 control subjects with normal intrauterine pregnancy), Group B (50 patients with spontaneous abortion), group C (25 patients with ectopic pregnancy). All the patients were investigated including routine blood and urine tests and special tests related to the cause of pregnancy loss. The patients were tested for IgG antibodies to Chlamydia trachomatis by ELISA technique and conjunctival smear were tested for presence of inclusion bodies to C. trachomatis. It was concluded that C. trachomatis is one of the important cause of spontaneous abortion and ectopic pregnancy. It is highly prevalent in our population, the prevalence being 10% in group A, 26% in group B, 28% in group C. Conjunctival smear showed presence of inclusion bodies in 0.8% patients. With abortions then risk of lower genital tract chlamydia infection spreading to upper genital tract increases. ELISA for C. trachomatis should be done when women are being investigated for the cause of spontaneous abortion and ectopic pregnancy.