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Background & aim The spinal cord is the continuation of the brain from the lower point of the medulla and the terminal portion of the developing neural tube. The spinal cord develops within the bony canal, called the vertebral canal, formed by the union of individual vertebrae in the vertebral column. Initially, the development of the length of the vertebral column and spinal cord are the same but later on undergo alterations. The growth of the vertebral column is faster than that of the spinal cord because the spinal cord appears to terminate early within the vertebral canal. To measure the length of the spinal cord and lowermost point of conus medullaris in the third trimester gestational age fetuses. Material and methods The present cross-section observational study was carried out on 30 fetuses collected from the museum of the Anatomy Department and Obstetrics and Gynecology Department. Before starting the study, permission and approval from the university's ethical committee were received. The dissection of fetuses includes the incision of the skin, removal of superficial and deep muscles, and a laminectomy. The meninges were cut and removed to note the vertebra level of the termination of the spinal cord. The spinal cord was taken out, and the total length of the spinal cord was measured. The fetuses were categorized into three groups determined by their gestational age (the first group was 28-31 weeks, the second group was 32-35 weeks, and the third group was 36-40 weeks). Observation In the present study, 81.8% of male fetuses were in the 36-40 weeks gestational age group, and 52.6 % of female fetuses were in the 32-35 weeks, gestational age group. The mean length of the spinal cords was 14.74±1.45cm, with a range of 10.95 cm to a maximum of 16.60 cm. In the full-term gestational age group, male fetuses had a greater length of spinal cord than female fetuses. Sixteen fetuses had a spinal cord termination at level L2, followed by eight fetuses at the L3 level and six fetuses at the L4 level. Out of 11 male fetuses, eight fetuses had spinal cord termination at the L2 vertebra level, two at the L3 level, and one fetus at the L4 level. In female fetuses, eight had a spinal cord termination at the L2 level, six at the L3 level, and five at the L4 level. Conclusion The spinal cord length and level of conus medullaris depend on the age of the fetuses. In prenatal diagnosis for different spinal cord pathology, these values can be used as reference values in future studies.
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Background The most frequent thyroid disorder in pregnancy is maternal hypothyroidism. The geographical variation in the prevalence of hypothyroidism during pregnancy is very wide and ranges from 2.5% to 11%. The prevalence of hypothyroidism is more in Asian countries as compared to western countries. Thus, this study was conducted to find out the prevalence of thyroid disorder in pregnancy at our center. Methods The present study was conducted in the Department of Physiology in collaboration with the Department of Obstetrics & Gynecology, Index Medical College, Hospital and Research Center, Indore, MP, India over a period of one and a half years from October 2018 to March 2020. It was a cross-sectional study including 865 pregnant women. The patients' demographic profile was noted in all cases. A detailed history and thorough examination were done in all cases. Serum thyroid-stimulating hormone (TSH), Free T3, and Free T4 (FT3 and FT4) were done along with routine blood investigations as per The Federation of Obstetric and Gynaecological Societies of India-Indian College of Obstetricians and Gynaecologists (FOGSI-ICOG) good clinical practice recommendation. Results In this study, the prevalence of thyroid dysfunction was 10.4%. Of these 90 patients with thyroid dysfunction, subclinical and overt hypothyroidism was found in 5.50% and 0.92%, respectively, whereas subclinical and overt hyperthyroidism was observed in 3.12% and 0.81% pregnant females, respectively. A significant association was found between thyroid dysfunction and maternal age, BMI, parity, and education. Conclusions The prevalence of thyroid dysfunction was 10.4% in this study. Hypothyroidism was more common than hyperthyroidism and subclinical thyroid disorders were more common than overt thyroid disorders in pregnancy. Therefore, we should include thyroid function tests with other routine investigations during pregnancy to detect thyroid dysfunction.
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Background Hirschsprung's disease (HD) is a developmental disorder of the intrinsic component of the enteric nervous system. It is characterized by the absence of ganglion cells in the myenteric and submucosal plexus. Histopathological diagnosis becomes difficult many times due to submucosal ganglionic cells are not easily identifiable. Aims and objective The aim of this study was to examine the clinical and histopathological features of HD and to establish the utility of calretinin staining to diagnose the case of suspicious HD. Materials and methods After taking necessary informed consent, we studied 41 cases in which clinical suspicion of HD had been made, in a study duration of three years (July 2017-June 2020). Open biopsies were taken from spastic segment, transition zone and dilated segment. Histopathological diagnosis had been made in three categories: HD, no Hirschsprung's disease (NHD) and suspicion of HD. Post histopathological diagnosis calretinin immunohistochemistry (IHC) was applied to all cases and interpretations were noted. Results On the basis of histopathological findings, 25 cases were diagnosed as HD, nine cases were marked for suspicion for HD and seven cases as NHD. After evaluating calretinin IHC on the suspicious case, total of 30 cases were confirmed as HD while the remaining 11 cases were confirmed as NHD. Twenty-four patients of HD were males while the remaining six cases were females. The age of patients ranged from four days to 10 years. Median age six days while 22 patients were in the neonatal period. Conclusion Calretinin immunostaining is a useful modality in diagnosing suspicious cases of HD. Its results are easy to interpret by less experienced pathologist with accuracy.
