two year analysis of cesarean delivery at CMH Hyderabad

Objective: To determine the frequency and factors leading to cesarean deliveries and its outcome in a Military Hospital of Sindh province

Study Design: Descriptive study

Place and Duration of Study: Obstetrics and Gynecology Department of Combined Military Hospital Hyderabad from 1st January 2011 to 31st December 2012

Material and Methods: All women admitted for delivery were included in the study. However those delivered by spontaneous vaginal and instrumental delivery were excluded from the study. Details of all the cases who underwent cesarean section [CS] were further evaluated. Neonates were also examined at birth and before discharge

Results: A total of 2874 deliveries were conducted during the 2 years study period. CS was done on 1206 [41.96%] patients while normal vaginal delivery was conducted in 1668 [58.04%] patients. A total of 34.16% patients underwent elective, while in 65.84% patients CS was done in emergency. Majority [60.03%] of patients were un-booked and rest of them [39.97%] were booked. Most common indication was repeat CS, followed by CPD and mal-presentation; other indications were failed trial of labor, fetal distress, and eclampsia /preeclampsia. In our study, maternal morbidity was observed in 12.77% patients and the maternal mortality was 0.33%. A total of 1199 babies were born alive and total perinatal deaths were 73

Conclusion: Cesarean delivery rate was mainly influenced by previous cesarean. Being a referral hospital for the families of armed forces personnel in this region, is also an important contributing factor to high CS rate. It was concluded that reduction of primary and repeat CS should be the main target of any strategy. Othermeasures to reduce the CS rate were the early referral and regular antenatal visits

Antibacterial Effect of Silver Nanoparticles Synthesized Using Curcuma Aromatica Leaf Extract.

This article reports an ecofriendly approach for the synthesis of Ag nanoparticles (Ag NPs) using aqueous leaf extract of Curcuma aromatica. The synthesized Ag NPs were characterized using UV-visible spectroscopy, FTIR, XRD and TEM analyses. UV–Visible spectra of the aqueous medium containing Ag NPs showed a gradual decrease of the absorbance peak observed at 442 nm. The biomolecules responsible for the reduction of Ag NPs were analyzed by FTIR. XRD result confirmed the presence of AgNPs with FCC crystal structure. The calculated crystalline size using Scherrer formula is in the range from 20 to 80 nm. TEM analysis ascertained spherical nature of the Ag NPs. The synthesized Ag NPs exhibited good antibacterial performance against gram-positive and gramnegative bacteria strains, which was studied using standard disc diffusion method. The synthesis of Ag NPs by this method is rapid, cost effective and can be used for various applications.

Effect of Ramadan Fasting on Serum Lipid Profile of Bangladeshi Female Volunteers.

The study was conducted to evaluate the effects of fasting for a period of one month during Ramadan on the lipid profile of Bangladeshi female volunteers who fasted during the Arabic month of Ramadan, when there occurs a change, both in the pattern and timing of dietary intake. Findings of the study showed that Ramadan fast significantly reduced serum Total cholesterol (TC) (p=0.030) and Low density lipoprotein (LDL-C) (p=0.011). A statistically nonsignificant elevation of triglyceride (TG)) was observed (p=0.598). High density lipoprotein cholesterol (HDL-C) also found to be raised significantly at the end of fasting (p = 0.037). Findings of the study revealed that fasting during the month of Ramadan changes lipid profile pattern in an aniatherogenic direction and may be beneficial to health.

Correlations of Serum Magnesium and Potassium in Acute Myocardial Infarction, Chronic Ischemic Heart Disease and Normal Healthy Volunteers of Bangladesh.

Magnesium (Mg) and potassium (K) are the major intracellular cations whose presence in the serum are low, but minor changes of those may show a remarkable change in the various body functions specially in the heart. The study was designed to find out the correlation between serum Mg and K in acute myocardial infarction (AMI), chronic ischemic heart disease (CIHD) and normal healthy volunteers. It was carried out over a period of 18 months in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration with Department of Cardiology, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH) and Atomic Energy Center, Dhaka. A total of 101 subjects were included in which 32 subjects were AMI, 34 CIHD and 35 normal healthy volunteers. Serum glucose and serum creatinine were estimated to exclude diabetes and renal dystrophies. Estimation of serum CK-MB and ECG tracing were done as diagnostic tools of AMI and to categories the subjects into various groups. Serum Mg was estimated by Atomic absorption spectrophotometer and serum K by Ion sensitive electrode. The present study shows that there is a strong positive correlation of serum Mg and K in AMI, CIHD and healthy control subjects (r = 0.566, p<0.01 level). So it is suggested to estimate and supplement both Mg and K in IHD patients for their better management.

Changing epidemiological pattern of leprosy in rural Chhattisgarh.

The study presents findings of a retrospective cohort analysis of 2972 new cases registered between 1 January 1987 and 31 December 2001 in the rural field practice area of RLTRI, Raipur. An analysis was carried out with the objective of describing the epidemiological pattern of leprosy in the preceding 15 years. The patients in the study were also followed up prospectively till December 2003 to record any development of relapse or reactions. Data collected were grouped into three time-blocks and analysed at five-yearly intervals. Epidemiological indicators in different periods were also compared. 2972 new cases were included in the analysis; of these, 15.6% were registered in time-block 1, 20.9% in time-block 2 and 63.5 % in time-block 3. The P/D ratio, which was 8.5 in 1986 declined to 6.6 in 1991, 1.3 in 1996 and 0.4 in 2001 after which it rose marginally to 0.8 in December 2002. The proportion of MB cases showed a rise of 15.3% in 1991, 25.1% in 1996 and 28.7% in 2001. The mean age at registration showed a significant decline during different time periods from 35.2 +/- 16.9 in time-block I to 28.9 +/- 15.9 in time-block 3. The proportion of grade II deformity was 3.2% in time-block 1; it rose to 6.3% in time-block 2 and 5.9% in time-block 3. The proportion of cases completing treatment was 28.2% and 17.6% for MB and PB groups respectively in time-block 1, rose to 69.9% and 77.0% in the 2nd, and 74.9% and 81.6% in the 3rd. The proportion of relapse also came down markedly in time-blocks 2 and 3. The median duration of treatment was 28.0 months in time-block 1, came down to 9.0 months in time-block 2 and 7.0 months in time-block 3 following the introduction of MDT. The proportion of child cases and reaction rates showed a rise in time-blocks 2 and 3.

Antibiotic susceptibility profile of group B streptococcus [streptococcus agalactiae] at the Maternity hospital, Kuwait

This study was designed to determine the antibiotic susceptibility profile of clinical isolates of group B streptococcus [GBS, Streptococcus agalactiae] and to use the information for formulating appropriate intrapartum antibiotic policy for GBS carriage in pregnancy. Materials and A total of 1,166 clinical isolates [single isolates] of GBS obtained from vaginal/rectal samples of pregnant mothers seen at the Maternity Hospital, Kuwait were studied over a period of 43 months between May 1998 and December 2001. The isolates were identified by st and ard methods and their susceptibility to penicillin, ampicillin, cephalothin, clindamycin and erythromycin was determined by disk diffusion technique, minimal inhibitory concentration [MIC] using the Vitek automated sensitivity card system and E-test methods. All the GBS isolates were fully susceptible to penicillin, ampicillin and cephalothin. Only 0.7 and 1.7% were resistant to erythromycin and clindamycin, respectively. Disk diffusion results interpreted by the st and ard interpretative criteria recommended by the National Committee on Clinical Laboratory St and ards correlated well with Vitek results as well as the E-test for penicillin. The MIC of penicillin against all isolates ranged between 0.016 and 0.064 micro g/ml. For the 6 months of 1998 and throughout 1999, the percentages of isolates susceptible at MICs of 0.016, 0.023, 0.032, 0.047 and 0.064 micro g/mi were 6.5, 9.9, 31, 38.8 and 12%, respectively. The trend was similar in the subsequent years except that the percentage of isolates susceptible at MIC of 0.064 micro g/ml increased to 26.6% in 2000, but went down to 4.4% in 2001. The trend in susceptibility of GBS to a variety of often used antibiotics for therapy and prophylaxis remained unchanged over nearly a 4-year period. The apparent increase in the number of isolates susceptible at higher MIC values of penicillin [0.047 and 0.064 micro g/ml] in 2000 appears to be a bleb that cannot be explained by any event in the hospital for that year. Our data, based on susceptibility profiles, supports the use of penicillin or ampicillin for intrapartum chemoprophylaxis to prevent early-onset neonatal GBS infections

Brucellosis in children in south Jordan

Retrospectively we evaluated the records of 68 children with brucellosis. We found 58.2% had consumed unpasteurized milk and dairy products. Nonspecific manifestations included: arthralgia [78%], fever [75%] and sweating [60%]. Localized manifestations included limping [75%] and arthritis [54%]. Leukopenia was found in 51% of children and anaemia in 24%. Brucella species was cultured for blood of 16 [23.5%] patients. Combination therapy containing streptomycin was more effective than gentamicin combinations