Role of amniotic fluid index in pregnancy outcome.

Background: Amniotic fluid is vital to the well-being of the fetus. Disorders of liquor amnii has a significant impact on pregnancy and fetus, it prompted us to carry out this study with sincere efforts to find out its effect on pregnancy outcome. Aim and objectives: To find out incidence of polyhydramnios and oligohydramnios in our setup and to study possible etiological factors for abnormal AFI. Material and methods: We performed a study on 200 patients over a period of one year. Detailed history, general examination and local examination were done. All the cases were subjected to ultrasonography to see for maturity, AFI, congenital anomalies. Analysis were made regarding mode of delivery and perinatal outcome which includes maturity, birth weight, incidence of SGA or macrosomia, NICU admission, maconium stained amniotic fluid, low apgar score, incidence of birthasphyxia and congenital anomalies. Results: There were total 82 cases of oligohydramnios and 18 cases of polyhydramnios. And 100 cases with normal AFI. In ultrasonography 154 cases had full term maturity and 46 cases were preterm 82 cases had AFI ≤5 cm, 18 cases had AFI > 24, and 100 cases had AFI between 6-23. Conclusion: Amniotic fluid index assessment has become an important part of ante-partum fetal surveillance and also it has a prognostic value for fetal and newborn outcome.

Role of amniotic fluid index in pregnancy outcome.

Background: Amniotic fluid is vital to the well-being of the fetus. Disorders of liquor amnii has a significant impact on pregnancy and fetus, it prompted us to carry out this study with sincere efforts to find out its effect on pregnancy outcome. Aim and objectives: To find out incidence of polyhydramnios and oligohydramnios in our setup and to study possible etiological factors for abnormal AFI. Material and methods: We performed a study on 200 patients over a period of one year. Detailed history, general examination and local examination were done. All the cases were subjected to ultrasonography to see for maturity, AFI, congenital anomalies. Analysis were made regarding mode of delivery and perinatal outcome which includes maturity, birth weight, incidence of SGA or macrosomia, NICU admission, maconium stained amniotic fluid, low apgar score, incidence of birthasphyxia and congenital anomalies. Results: There were total 82 cases of oligohydramnios and 18 cases of polyhydramnios. And 100 cases with normal AFI. In ultrasonography 154 cases had full term maturity and 46 cases were preterm 82 cases had AFI ≤5 cm, 18 cases had AFI > 24, and 100 cases had AFI between 6-23. Conclusion: Amniotic fluid index assessment has become an important part of ante-partum fetal surveillance and also it has a prognostic value for fetal and newborn outcome.

Fine needle aspiration cytology role in head and neck lesions.

Introduction: Fine Needle Aspiration Cytology (FNAC) is a simple, quick and inexpensive method in the head and neck region. It also affords a practicable and means of rationally planning surgery and causes minimal trauma to the patient and carries no risk of complications. Aim and objectives: The aim of this study was to see the frequency of various pathological conditions detected on FNAC in patients presenting with head and neck swellings and to evaluate the role of FNAC in diagnosis of head and neck swelling. Material and methods: A retrospective study was conducted in Department of Pathology, SMIMER Medical College, Surat from July 2014 to June 2015which included 250 patients with head and neck swellings presenting to Outpatient clinics. Fine Needle Aspiration Diagnosis was correlated with detail of relevant clinical findings and investigation. Results: Maximum incidence was observed in the age group 31-40 years with higher incidence among males. Out of 250 cases, 160 cases of lymph node lesions were diagnosed of which non- specific lymphadenitis was the commonest diagnosis (47%) followed by Tuberculous lymphadentities (25%). 57 cases of thyroid lesions were diagnosed, in which incidence rate of benign thyroid lesions was (84%). 12 cases of salivary gland lesions were found, among which pleomorphic adenoma was common (67%). Conclusion: It was concluded that non-Specific lymphadenitis is the commonest condition in patients presenting with neck swellings. FNAC is a simple, safe and inexpensive tool for the assessment of patients with head and neck swellings. It could differentiate the infective process from neoplastic one and avoids unnecessary surgeries. Thus, FNAC can be recommended as a first line of investigation in the diagnosis of head and neck swellings.

Laparoscopic appendicectomy surgery using spinal anesthesia.

Laparoscopic abdominal surgery is conventionally done under general anesthesia. Spinal anesthesia is usually preferred in patients where general anesthesia is contraindicated. We have presented here our experience using spinal anethesia as the first choice for laproscopic surgery for ever 2 years with the contention that it is good alternative to genral anesthesia.

Immunoglobulin M nephropathy nephropathy in adults and adolescents in India: A single-center study of natural history.

Background: Immunoglobulin M nephropathy (IgMN) is an idiopathic glomerulonephritis (GN) usually presenting clinically as steroid resistant/dependent nephrotic syndrome (NS) with pathology of mesangial proliferative GN or focal and segmental glomerulosclerosis with diffuse predominant mesangial IgM deposits. Not much information is available about its natural history. This is the first Indian study to our knowledge on IgMN in adults and adolescents. Materials and Methods: We evaluated renal biopsies performed at our center between January,'04 to September,'09. Biopsies of all adolescents and adults were evaluated for IgMN and we studied their age, gender distribution, blood pressure (BP), disease duration, steroid/immunosuppressive management and serial serum creatinine (SCr), urinary proteins, and BP values. Patients with other systemic diseases/infections and children were excluded. Results: IgMN constituted 4.3% of 2702 adult renal biopsies. No significant gender predilection was noted. Males presented at average age of 23.1 years, females at 30 years. Steroid-dependent NS was the commonest presentation noted in 75% followed by steroid-resistant NS. Hypertension was noted in 10% patients. Mesangial proliferative GN (MePGN) was commonest histopathological finding noted in 74.4%, followed by focal segmental glomerulosclerosis (FSGS) in 16.2%, and minimal change disease (MCD) in 9.4% biopsies. Sole IgM deposits were noted in 88.5%. All MCD, 35.6% MePGN reached remission, FSGS progressed to renal failure by 1 year. Hypertension, proteinuria, interstitial fibrosis, and FSGS were bad prognosticators. Conclusions: This is the first Indian study of IgMN in adults and adolescents carried out over a period of 5.8 years, which has shown that hypertension, proteinuria, and interstitial fibrosis at presentation have bad prognosis.