Gross and histological alteration in the placenta of mothers suffering from gestational diabetes.

OBJECTIVE: This descriptive study aimed to observe the anatomical including both and microscopic changes in diabetic placenta to increase our knowledge as very few studies are done on anatomy of placenta

INTRODUCTION: The placenta is a dynamic organ of unique function with short life-span. It is physiological site of exchange between maternal-fetal circulation. It is responsible for respiratory, nutritional, excretory, endocrine, and immunological functions

MATERIALS AND METHODS: Macroscopic and microscopic examination was carried out on total of 50 freshly delivered placentae from diabetic's mothers. Variables used for macroscopic examination are weight, diameter, number of cotyledons. On histology degenerative changes, fibrinoid necrosis, vessel thrombosis and infarction were examined

RESULTS: Morphological examination of placentae of diabetic mothers showed larger, heavier and more cotyledons. Similarly microscopic examination revealed dilated blood vessels, necrotic and degenerative foci, thrombosis and infarction in placentae of diabetic mothers

CONCLUSION: An adequate knowledge of the placental changes can prove to be valuable in the understanding the complications to fetus caused by diabetes. This study shows significant changes in placentae on gross as well as on microscopy. Out of many abnormal changes infarction is single most important change. Infarction lead to fibrin deposition in villi and leading to avascularity hence uteroplacental insufficiency which is important factor for fetal development

Excessive placental calcification observed in PIH patients and its relation to fetal outcome

Objective: to see the morphological changes in excessive placental calcification in pregnancy induced hypertension [PIH] and its relation with fetal outcome

Study design: prospective comparative study

Place and duration: this study was conducted from June 2008 to July 2009 at the department of Anatomy of Liquate University of Medical and Health Sciences Jamshoro and placentae were collected from department of Gynecology and Obstetrics of Liquate University Hospital

Material and methods: eighty freshly delivered placentae were collected from labor room and gynecology operation theatre of Liquate University Hospital. Forty placentae from parturient that had pregnancy induced hypertension [PIH] and forty placentae from parturient belonged to uncomplicated pregnancy [control group]. Ages of all parturient were between 17 to 32 years. Fetal outcome and data was recorded. Placentae were measured on a weighing machine graduated in grams and diameter was measured with the help of a measuring tape in centimeters. Approximately five mm piece of placenta was taken and processed for histological examination

Results: the weight of placenta in control group ranges from 450 to 650 gm with a mean weight of 526.25+/-8.414 gm having diameter from 19 to 24 cm with a mean of 21.225+/-0.2148cm. In PIH group weight of placenta ranges from 200 to 550gm with a mean weight of 432.25 +/- 11.889gm with diameter ranges from 10 to 16cms with a mean14.208 +/- 0.1914cm. The difference in weight and diameter of placenta in PIH was found statistically significant when compared with weight and diameter of normal placentae. The birth weight of new born babies in control group was 1.8 kg to 3.6 kg with mean of 2.790+/- 0.0689kg. In PIH group the fetal weight was 1.4 kg to 3.0 kg with mean weight of 2.195 +/-0.0703kg

Conclusion: fetal outcome in terms of birth weight of newborn to mother having PIH and calcification of placentae [grossly and microscopically] was poor as compared to control group

Appraisal and Improvisation of Undergraduate Practical Curriculum in Physiology

no abstract available

pattern of urinary tract symptoms during pregnancy

During pregnancy remarkable changes occur, in structure and functions of urinary tract. These changes often predispose to the development of urinary tract disorder or may predispose to worsening of renal disease and its sequelae. Our objective was to determine the pattern of urinary tract symptoms during pregnancy. This descriptive study included 520 pregnant patients, out of 2134 admitted in the antenatal and labour wards of the Department of Obstetrics and Gynecology, Unit-III, Liaquat University Hospital, Hyderabad from 1st April 2006 to 31st March 2007. Women with history of diabetes, chronic renal failure or complaining of urinary symptoms before index pregnancy were excluded. Other variables of study were urinary symptomatology. All women underwent complete examination of urine through various tests including culture and sensitivity. During the study period, 520 patients were analyzed. Out of these, 49 [9.4%] patients were diagnosed as having urinary problems. Urinary tract infections were diagnosed in 34 out of 520 [6.5%] gravidas, acute renal failure in 11 [2.1%], nephrolithiasis in 2[0.4%], acute urinary retention in 2[0.4%] of patients. Majority of the patients belonged to the age group 21-25 years. Majority were multi gravidas and in the third trimester. Data analysis of our study showed that 316[60.8%] of the study population reported the symptom of frequency of micturition. Stress incontinence and voiding difficulties were reported by 37% and 35.2% respectively. Common urinary problems in pregnancy are urinary tract infections, acute renal failure, nephrolithisis, and acute retention of urine. Common symptoms are frequency of micturition, stress incontinence and voiding difficulties

A Study of Prevalence of Risk Factors for Coronary Artery Diseases in Asymptomatic Middle Aged and Elderly Subjects

This study was conducted to determine the prevalence of risk factors for coronary artery disease (CAD) in apparently healthy middle aged and elderly population and to find the different between urban and rural group.Atotal of 160 individuals (80 urban and 80 rural) were included in the study. All the subjects underwent detailed history and physical examination with special emphasis on cardiovascular system. The biochemical investigations were done in all the subjects which included blood sugar, serum LDL and serum triglyceride levels. The prevalence of 2 or more than 2 risk factors were observed in 95% subjects. The prevalence of smoking was 63%, which was more prevalent in the rural population. The sedentary lifestyle was seen in 80% subjects more in females and urban group. The prevalence of asymptomatic hypertensives and isolated systolic hypertension were seen in 34% and 10% individuals respectively. Other risk factors were-diabetes mellitus (4%), Increase LDL (38%), hypertriglyceridemia (23%) and central obesity (27.50%). The two most common risk factors for CADwere sedentary lifestyle and smoking. These risk factors are modifiable and their reduction during adulthood can lead to marked reduction in the burden of CAD in middle aged and elderly Indian population.