Study to Evaluate the Doppler Indices of Umbilical and Middle Cerebral Arteries for Predicting the Perinatal Outcome in Patients with Pre-Eclampsia

Pre-eclampsia is one of the leading causes of maternal and fetal morbidity and mortality. The main goal of antepartum fetal surveillance is to identify fetuses at increased risk for perinatal mortality and morbidity. Doppler ultrasound allows a noninvasive assessment of fetal haemodynamics. This study was done to evaluate the usefulness of Doppler indices of umbilical & middle cerebral arteries, in patients with pre-eclampsia for predicting the perinatal outcome. Methods: It is a prospective study which was conducted in the Department of Radiodiagnosis in accord with the Department of Obstetrics and Gynecology at Dr. RPGMC Kangra at Tanda, Himachal Pradesh. All pregnant females>28 weeks of gestation, diagnosed of having pre-eclampsia were evaluated with fetal doppler. Data obtained was evaluated and compared with the clinical outcome. Results: During the study period, 104 patients suffering from pre-eclampsia presented to the department and were included in the study. Abnormal Doppler indices were observed in 29(27.9%) patients. 26(89.6%) of these 29 pregnancies had an abnormal perinatal outcome. Conclusions: Because the changes in the umbilical and middle cerebral artery strongly correlated with the perinatal outcome, Doppler ultrasound was found to be a primary tool for fetomaternal surveillance in hypertensive pregnancy and could reinforce the obstetric management by accurately timing the delivery and thereby reducing the morbidity and subsequent mortality

Clinical presentation and outcome of ectopic pregnancies in a tertiary care rural hospital

Background: Ectopic pregnancy is the commonest cause of the maternal morbidity and mortality in the first trimester of the pregnancy. The aim of this study was to see the clinical presentation, associated risk factors, mode of treatment and outcome.Methods: Retrospective study conducted in a tertiary care rural hospital. Women with diagnosis of ectopic pregnancy admitted between August 2016 to September 2018 were studied. Medical record files were scrutinized to get the details. Data was analyzed using Microsoft Office Excel (version 2007). Numerical data were subjected to descriptive analysis, with mean±standard deviation (SD) and categorical data as frequency and percentage.Results: Forty cases of ectopic pregnancy were included who were unbooked, non-smokers, married and belonged to rural areas. Eighty percent were in the age group of 20 to 30 years.  Maximum were gravida 3 or 4 with commonest presentation was pain, site was tubal. Laparotomy was done in 95% of women salpingectomy was the commonest surgical procedure done in 32 (80%) women. Salpingoophrectomy was done in one woman and lifesaving hysterectomy in 2 (5%) women for cervical and ruptured interstitial ectopic pregnancy one each. Blood transfusion was required in 28 (70%) women. No mortality was seen.Conclusions: Women of reproductive age group with pain abdomen and menstrual complaints, even without amenorrhoea, ectopic pregnancy should be ruled out. Treating reproductive tract infections / PID and offering contraceptives will decrease the incidence of ectopic pregnancy. Medical and paramedical staff should do the timely referral to higher centres.

Role of Magnetic Resonance Imaging in Diagnosing Patients Presenting with Non-Traumatic Hip Pain at a Tertiary Care Hospital in Sub-Himalayan Region

Background: Hip pain with a nonspecific history and clinical findings can present a diagnostic dilemma for a clinician. This study aimed to characterize the Magnetic Resonance Imaging (MRI) findings of various conditions which caused non-traumatic hip pain. Methods: An observational study was conducted on all patients who were referred to the Department of Radiodiagnosis at Dr Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh for MRI evaluation of non-traumatic hip pain. After being evaluated physically, MRI of the hip was done on a 1.5 Tesla MRI machine (Signa Excite, GE Healthcare). Images were obtained in the axial, coronal and sagittal planes. Data was analysed descriptively and tabulated. Results: During the study period, 61 consecutive [36 (59%) males and 25 (41%) females] patients with a history of non-traumatic hip pain were included, of which 54 patients were found to have a pathology. The most common intra-articular pathologies detected were infective arthritis in 22 (36%) cases, avascular necrosis (AVN) in 14 (23%), Perthes disease in 5 (8.2%), bone tumors in 2 (3.3%), inflammatory arthritis in 1 (1.6%), posterior labral calcification in 1 (1.6%), femoroacetabular impingement in 1 (1.6%) and stress fracture of femoral neck in 1(1.6%) patient. The extra-articular pathologies detected were bone tumors in 2 (3.3%) patients, stress fracture of pubic rami in 2 (3.3%), sacroilitis in 1 (1.6%), potts spine with bilateral psoas abscess in 1 (1.6%) and tendinits in 1 (1.6%) patient. Conclusions: This study presented our MRI observations of a wide spectrum of clinical cases which were referred to our department with non-traumatic hip pain. MRI assessments are sensitive and specific and enabled us to diagnose conditions in their early stages.