To study the correlation between severe oligohydramnios with perinatal outcome along with histopathology of placenta

The aim: To study the correlation between severe oligohydramnios with perinatal outcome and the placenta's histopathology. Materials and methods: comprised of 100 patients with oligohydramnios diagnosed after 28 weeks of gestation, admitted on an emergency basis, both booked / unbooked, who were willing to cooperate, were chosen. All patients with oligohydramnios (AFI<5 %) were included in the study. Results: 3 cases came with intra-uterine death. All three were totally unbooked cases. 2 preterm babies died neonatal intensive care unit after 4 days due to meconium aspiration syndrome. Thus the perinatal mortality was 5 %. 44 % of neonates required admission into the neonatal intensive care unit. In our study, it was found that neonatal mortality and morbidity increased significantly when oligohydramnios was associated with complications like IUGR and pregnancy-induced hypertension in mothers. All the cases associated with these histopathological changes had adverse perinatal outcomes. Hence estimation of the amount of liquor is important in the antenatal period because oligohydramnios gives insight into the associated maternal complications or fetal anomalies and has a significant bearing on the perinatal outcome. The placental examination will illuminate all the conditions affecting the perinatal outcome. Without associated complications, oligohydramnios does not have adverse perinatal outcomes. Conclusions: Thus, in cases of oligohydramnios with no associated complications, expectant management can be tried for a better fetal outcome. Only oligohydramnios may be the first sign of placental insufficiency and an independent manifestation of the placental-related complications spectrum

A clinicoepidemiological study of geriatric dermatoses

Skin diseases are a common and inevitable consequence of ageing. Moreover, the clinical presentation is not as classical as they do in the younger population. A lifetime of solar exposure, along with intrinsic changes in the dermal structures, predisposes to a variety of skin diseases. The aim: to study the spectrum of various geriatric dermatoses among our patient population at the Department of Dermatology, Venereology, and Leprosy at Kamineni Academy of Medical Sciences and Research Centre. Materials and methods: in this study, a total of 200 patients aged 60 years and above attending the DVL OPD of Kamineni Academy of Medical Sciences and Research Centre were included. Results: maximum number of patients in this study belonged to 60-65 years (60 %), Male to female ratio was 1.86:1. Most of the males had agriculture work, and most of the females were housewives. Diabetes mellitus was the commonest associated systemic disease seen in 68 cases (34 %), and generalised pruritus was the commonest symptom seen in 64 (32 %) cases, of which 42 cases (65.6 %) were associated with xerosis. Pathological skin disorders and eczematous conditions were seen in 56 out of 200 cases. Of this, asteatotic eczema was the common finding among the eczematous conditions seen in 14 cases (7 %). Psoriasis was seen in 32 (16 %) and lichen planus in 10 cases (5 %). Infectious diseases were seen in 78 cases (39 %). Of these, fungal infections were common, seen in 28 cases (14 %). The benign tumour was seborrheic keratosis in this study, seen in 61 cases (30.5 %); among the malignant tumours, 4 cases (2 %) of basal cell carcinoma and 2 cases (1 %) of squamous cell carcinoma were seen. Among 16 cases of bullous disorders, bullous pemphigoid was seen in 12 (6 %) cases. Among 22 cases of psychocutaneous disorders, delusional parasitosis was seen in 10 cases (5 %), and perforating folliculitis in 15 cases (7.5 %). Loss of luster was the commonest nail change seen in 182 cases (91 %), followed by nail plate thickening in 54 cases (27 %). Greying of the hair was seen in all cases. Out of 70 females, diffuse hair loss was seen in 58 cases (82.9 %), and out of 130 males, androgenetic alopecia was seen in 72 cases (55.4 %). Conclusion: skin diseases cause considerable morbidity in the elderly, particularly if associated with other comorbid conditions. Health education on proper skin care, avoidance of irritants and self-medication etc., would help to reduce the incidence of common dermatoses

Improvement of the scheme of preventive and treatment measures for associated respiratory infections in cats

The aim of the research was to study the etiological structure of associated infectious rhinotracheitis in cats. It has been established that infectious rhinotracheitis is registered among cats in association with infectious diseases of bacterial aetiology. Materials and methods. The research was conducted based on a private veterinary clinic in the city of Kharkiv in 2021–2023. A total of 48 cats with signs of respiratory tract damage were examined in the clinic. Samples for laboratory diagnosis were obtained by oropharyngeal swab and transnasal lavage. To confirm the laboratory diagnosis of infectious rhinotracheitis in cats, we used the PCR method (using the Rynovir test system), as well as rapid IXA tests (FHV Ag) manufactured by ASAN PHARM (China) or ZRbio (China). To detect specific antibodies, the method of serological (retrospective) ELISA diagnostics was used using the immunoComb Feline VacciCheck device-free ELISA test system manufactured by Biogal, Israel. Bacteriological studies were carried out according to well-known methods using special nutrient media for the selection and identification of associated bacterial microflora. The sensitivity of selected dominant cultures of bacteria to antibiotics was determined by diffusion in agar using discs containing antibiotics. Results. It was investigated that Bordetella bronchiseptica was determined as the dominant pathogen in the bacterial association – 52.0 %. Isolated cultures of Bordetella bronchiseptica were sensitive to cefamycin. The proposed science-based scheme for the treatment of infectious rhinotracheitis in association with feline bordetelliosis ensures high therapeutic efficiency. Conclusions. For the treatment of infectious respiratory diseases in cats, it is necessary to carry out individual complex etiotropic, pathogenetic and symptomatic therapy. Homoeopathic therapy relieves the symptoms of the disease, promotes faster recovery, and is an addition to the main methods of treatment. The main specific measure of disease prevention is timely vaccination (inoculation), the effectiveness of which, according to our research, ranges from 71 % to 100 %

Comparison of serum copper levels between coronary artery disease patients and normal individuals: a case-control study

Cardiovascular diseases (CVD) are the leading causes of death in technologically developed and developing countries. Copper, an active redox element, is involved in energy production through various mechanisms. Copper and coronary artery disease can be associated directly, through its direct effect on the vascular endothelium, or indirectly through lipoprotein metabolism. Hence an evaluation of copper in the coronary artery disease individual is important. The aim is to compare the relationship of serum copper levels between coronary artery disease patients and control individuals based on age, sex, hypertension and diabetes mellitus. Materials and methods: The study design was a case-control study in which proven coronary artery disease patients attending cardiology OPD were selected as cases. Control individuals were mainly selected from the master health check-up. Serum copper levels, plasma glucose, cholesterol, serum triglycerides, and serum HDL & LDL cholesterol were done. Glycated haemoglobin (HbA1C) was also measured. The data were analyzed using IBM SPSS software version 24. Result: The correlation of serum copper level with other quantitative parameters is determined by calculating Pearson’s correlation coefficient among cases and controls. Conclusion: The serum copper level is significantly (p=0.001) higher in CAD patients than in age, sex, DM, and HT-matched controls. The serum copper level has a significant (p=0.001) effect on disease, and the adjusted odds ratio is 1.032 (CI 1.011–1.054). In addition, the serum copper level has a significant (0.01) negative correlation with LDL cholesterol and total cholesterol

Impact of low birth weight and breastfeeding practices on the nutritional status of children aged 2 to 5 years in the slums

Malnutrition among children in developing countries is a major public health problem, especially in India. Inappropriate feeding practices, in combination with other causes such as infection and food shortage, may be responsible for 1/3rd of malnutrition. Moreover, the risk of mortality is inversely related to children's height-for-age and weight-for-height. The aim: To assess the nutritional status of children aged 2 to 5 years in the urban field practice area of SVIMS-Sri Padmavathi Medical College for Women, Tirupati and to determine the impact of low birth weight, breastfeeding practices and other related factors on the nutritional status of the above study population. Materials and methods: This is a community-based observational cross-sectional study conducted among 282 children aged 2 to 5 years in the urban field practice area of SVIMS-Sri Padmavathi Medical College for Women, Tirupati. Socio-demographic data, Birth history, breastfeeding practices and anthropometric measurements were noted in the study questionnaire. Nutritional status was determined using HAZ, WHZ and WAZ scores of WHO child growth standards. Data was entered and analyzed using IBM SPSS Statistics 26 version to test for association between categorical variables, and a p-value < 0.05 was considered statistically significant. Results: A total of 282 school children with mean age of 39.9 (+10.4) months participated in the study, of which 132 (46.8 %) were boys and 150 (53.2 %) were girls. This study observed exclusive breastfeeding in 193 (68.4 %) children. Prevalence of stunting, wasting and being underweight were 22 %, 12.4 % and 23.8 %, respectively. A statistically significant association was found between stunting (p=0.006) and underweight (p=0.001) with low birth weight children. Conclusions: The present study revealed a high prevalence of malnutrition, especially stunting, a common outcome of long-term malnutrition among young children. Low birth weight and inappropriate breastfeeding practices result in long-term adverse consequences on the nutrition of preschool children, which should be prevented through appropriate strategies

Synchronous metastatic colon carcinoma presenting as ovarian metastasis: a case report

The aim of the study was to discuss a rare case of synchronously metastatic colon cancer, which clinically manifested as intestinal obstruction due to the presence of ovarian metastasis. Materials and methods. The clinical case of a 47-year-old patient with synchronously metastatic colorectal cancer with an affected disease, peritoneal carcinomatosis and metastatic ovarian lesions was analyzed. Case presentation. In July 2021, patient R., 47 years old, developed a clinic of sub-compensated intestinal obstruction. According to CT and MRI data, a volume formation of the small pelvis with a diameter of about 15 cm with compression of the surrounding soft tissues and metastases of the 6th and 4a segments of the liver were determined. According to a colonoscopy, a neoplasm of the sigmoid colon was verified as adenocarcinoma. The presence of peritoneal carcinomatosis was determined intraoperatively; the operation was performed in the following scope: SS-0 (complete cytoreduction) – right-sided ovariectomy with a tumour, resection of the sigmoid colon with a tumour, resection of the rectum with TME, extirpation of the cervical stump with the left ovary and pelvic peritonectomy en block resection and diathermocoagulation of foci of peritoneal carcinomatosis on the visceral peritoneum of the small intestine, omentectomy, radiofrequency ablation of a liver tumour under ultrasound guidance. According to histopathological examination: adenocarcinoma (G2) with foci of mucus production in the sigmoid colon, metastatic lesion of the right ovary, cervix, peritoneum, and liver. Subsequently, from September 2021 to July 2022, the patient underwent 8 courses of adjuvant polychemotherapy according to the FOLFOX scheme and 2 courses according to the FOLFOX scheme and bevacizumab. In August 2022, due to signs of disease progression, the patient underwent SS-0 cytoreductive surgery: removal of tumour nodes of the parietal and visceral peritoneum, partial peritonectomy of the anterior abdominal wall, argon plasma coagulation of foci of peritoneal carcinomatosis of the parietal and visceral peritoneum, resection of the round ligament of the liver, NIRES. According to the results of the histological examination, metastases of mucinous adenocarcinoma of the intestinal type with the II-III degree of medical pathomorphosis were determined. From September 2022, the patient received 2 courses according to the IRINOX + bevacizumab regimen and 6 courses according to the FOLFIRI + bevacizumab regimen. According to the control MRI of the abdominal organs with intravenous contrast, metastases of the 7th and 8th segments of the liver were determined. Performed percutaneous radiofrequency ablation of liver metastases under ultrasound control Results. According to the results of the MRI of the OCP with intravenous contrast, there are currently no data on the progression of the disease. The patient's quality of life is satisfactory; the ESOG score is 0. It has been 22 months since the onset of the disease. Conclusions. Cytoreductive surgical interventions for synchronously metastatic colorectal cancer can significantly improve patients' quality of life and their oncological outcomes rather than only symptomatic treatment

Prenatal gender selection: medical, ethical and psychological aspects

The aim: to summarize the methodology of prenatal gender selection and the ethical aspects of its implementation. Materials and methods: the authors conducted the review in the database of scientific periodicals PubMed. Results: based on scientific publications, the principal techniques to determine sex in the pre-implantation period, in the embryo and fetus, are presented. Invasive and non-invasive procedures of prenatal diagnosis are described. Invasive procedures include examination of the fetus by chorionic villus sampling karyotyping of cells obtained by amniocentesis. Non-invasive techniques related to pregnant women's blood biochemistry and ultrasound markers of Down syndrome are given. Fetal blood DNA testing is a more sensitive diagnostic parameter that reduces the indication for invasive procedures. The newest and most effective method of sex determination in the pre-implantation period is sperm separation screening. Medical and non-medical reasons for prenatal gender determination, such as prevention of X-linked genetic disorders in a child, a couple's choice to balance the sex of children in the family and social gender preferences are shown. Gender selection for the prevention of X-linked disorders is justified. Ethical issues regarding the balance of children in the family, giving preference to certain sex with the help of advanced diagnostic techniques, and selective abortion are discussed. The bioethical principles for preventing selective abortion resulting from gender reasons are established. Conclusion: for preventing prenatal gender discrimination is highlighted more strongly by the need legal regulation and the ethical control of scientific technologies in reproductive medicine

Evaluate the importance of giving antenatal corticosteroids in respiratory distress syndrome in preterm neonates

Respiratory distress syndrome (RDS) is one of the leading causes of early neonatal morbidity and mortality in late preterm infants (LPIs) worldwide. The aim: The study is intended to evaluate the importance of giving antenatal corticosteroids in decreasing respiratory distress syndrome in preterm neonates. Materials and methods: Prospective cohort study done in all preterms delivered in the hospital attached to those admitted in our neonatal intensive care unit during the study duration are taken as the source. All preterm babies are admitted to the neonatal intensive care unit. Results: The overall incidence of RDS in this study was 30 (15 %), among which 7 (7 %) were exposed to steroids, and 23 (23 %) were not exposed to steroids. Antenatal corticosteroids were significantly associated with reduced incidence of RDS in preterms (neonates born between 28–37 weeks of gestational age). The overall incidence of TTN (transient tachypnea) was found to be 46 (28 %) in this study, among which 14 (14 %) were exposed to steroids, and 32 (32 %) were not exposed to steroids. Antenatal corticosteroids were significantly associated with reduced incidence of TTN in preterms. Antenatal corticosteroids significantly reduce the need for supplemental oxygen, NICU admission, need for CPAP and mortality rate. The dose of antenatal corticosteroids was significantly associated with the incidence of RDS and TTN. 2 doses of steroids reduced RDS and TTN significantly compared to the single dose, which was just significantly associated. This study found no significance between RDS and TTN with gestational age, mode of delivery, birth weight and RDS among steroid-exposed babies. Conclusion: The use of antenatal corticosteroids should be promoted because they successfully lowered morbidity and mortality among premature newborns in the population studied. In order to optimise proper and timely prenatal corticosteroid treatment, this study underlines the necessity for quality improvement initiatives

A clinical study of perinatal and maternal morbidity and mortality in gestational hypertension, preeclampsia and eclampsia

In India, hypertensive disorders complicating pregnancy are common and continue to be responsible for the largest proportion of perinatal deaths resulting from prematurity and IUGR and are major contributors to perinatal and maternal morbidity and mortality. The aim: The present study is undertaken to analyse the cases of preeclampsia and eclampsia, including consequences concerning preterm delivery, IUGR, IUD and stillbirth and for the evaluation of a safe motherhood program at the population level. Materials and methods: The present study was conducted on 105 selected cases from the census (sample of 12,589 patients) of pregnancy-induced hypertension (gestational hypertension, preeclampsia and eclampsia). Results: Hypertensive cases complicating pregnancy of the foetal deliveries conducted during the study period, out of which Gestational hypertension (GTN) cases reported were 44. Preeclampsia (PE) cases were 39, severe preeclampsia (SPE) were 1 and Eclampsia cases were 21. Labetalol alone was used in 62 cases, and 44 babies were born without any complications. As an anticonvulsant magnesium sulphate (MgSO4, 7H2O) was used in all cases of imminent eclampsia and eclampsia (MgSO4 PRITCHARD Regime) in a total number of 38 cases. Preterm / prematurity was the most common cause of perinatal death. The total number of NICU admissions was 42 (40 %). Conclusions: The early use of anti-hypertensive drugs, the optimum timing of delivery, strict fluid balance, and anticonvulsants in cases of eclampsia will help to achieve a successful outcome. Early transfer to a specialist centre is important, and the referral centres should be well-equipped to treat critically ill patients

A study of clinico etiological profile of children with cerebral palsy in a tertiary care centre

The clinical spectrum of Cerebral palsy (CP) can differ in various places depending upon the knowledge of the people and resources for prevention, diagnosis and management. Although studied extensively in high-resource countries, adequate data related to CP from resource-constraint settings are lacking. The aim: The present study is a descriptive study done on clinical profiles, aetiology, and comorbidities. Materials and methods: Present study is a hospital-based descriptive study of 80 children with Cerebral Palsy from January 2020 to June 2021 (18 months) admitted to Niloufer Hospital for Child Health, cases chosen as per inclusion criteria guided by "The Definition and classification of cerebral palsy, April 2006 International consensus". Clinical history and clinical examination and necessary investigations using a systematically designed proforma Results: The most common types were spastic type (78.9 %) and hypotonic type (12.5 %). Spastic quadriparesis (55 %) was the most common among subtypes. Males were more affected than females, with more rural than urban distribution. 48.8 % belonged to the lower middle and 37.5 % to the upper lower class of socio-economic status. Consanguinity was observed in 33 %, and 3 % had a similar family history. A high incidence (65 %) was seen in firstborn children. Term gestation was commonest at 87 % and prematurity at 13 %. 91.3 % of the cases were institutional deliveries. For causes of cerebral palsy, 45 % required resuscitation at birth, 2.5 % had neonatal sepsis, 1.25 % had a cerebral malformation, 7.5 % had an intracranial bleed, 7.5 % had post-meaning encephalitic sequelae, 1.3 % had TORCH infection. Comorbidities Like mental retardation were seen in 90 %, seizure disorder in 87.5 %, visual problems in 24.8 %, hearing problems in 13.75 %, 56.25 % of cases were malnourished. Conclusions: Comorbidities are significantly observed in cases of cerebral palsy. Appropriate screening and management of comorbidities, especially vision, hearing, speech, seizures, and nutrition, improve the overall prognosis in cases of Cerebral palsy