Pregnancy outcome in pre-gestational and gestational diabetic women: a prospective observational study

Background: India is considered the world capital of diabetes, proper care and management of the same is the demand of society. The present study is carried out to identify the disease burden of GDM/ overt DM among antenatal cases. The main objective was to study the maternal and fetal outcome of diabetes complicating pregnancy.Methods: The present study was conducted at Dr. Rajendra Prasad Government Medical College at Tanda, District KangraHP from October 2015 to September 2016. All antenatal cases were screened for diabetes by OGTT 75 gm, 2-hour blood glucose level as per DIPSI guidelines and labelled as GDM/ overt DM. Those who fulfilled selection criteria were enrolled in the study. A total of 6452 cases who attended antenatal clinic during the study duration and were screened were selected for the study. 116 cases were found to have GDM / overt DM. Seventy-nine had GDM with OGTT>140 mg/dl (DIPSI guidelines) and 37 had overt DM with 2 hours PP >200 mg/dl (WHO criteria). Total 100 cases comprised of study group were followed till delivery to study maternal and fetal outcome.Results: The prevalence of diabetes in pregnancy was found to be low 1.79%. GDM was found to be more prevalent than overt diabetes in pregnant women (66% versus 34%). Among the antenatal maternal complications observed missed abortion (11.8% versus 1.55; p=0.026), polyhydraminos (26.4% versus 10.6%; p=0.04) and preterm labour (17.6% versus 4.5%; p=0.003) were significantly more common in overt diabetics than GDM cases. IUFD (8.8% versus 0; p=0.014) was also significantly more common in overt diabetics than GDM case. RDS was found significantly higher in neonates of overt diabetics as compared to GDM mothers (14.7 % versus 1.5%; p=0.009).Conclusions: Early detection and good glycemia control by MNT and insulin, regular antenatal check-ups, patient counselling and compliance, intrapartum fetal monitoring and early neonatal care are keys to improved outcome.

Heterotopic pregnancy: a case report

Heterotopic pregnancy is defined as the coexistence of intrauterine and extrauterine gestation. The incidence is low and estimated to be 1 in 30,000 of spontaneous pregnancies though it is becoming commoner with assisted reproductive technique. It can be a life-threatening condition and can be easily missed with the diagnosis being overlooked. We present a rare case of spontaneous heterotopic pregnancy with live intrauterine gestation and ruptured left adnexal gestation

Postpartum atypical haemolytic uremic syndrome: a rare clinical entity

P-aHUS has incidence of 1 in 25000 pregnancies. It’s characterized by microangiopathic haemolytic anemia, thrombocytopenia and renal failure. Mrs X, 26 year old lady, G2 P1L1 with 39 weeks POG came to emergency of a tertiary care hospital. She underwent LSCS in view of previous caesarean section not willing for trial of labour. Antenatal, intrapartum and immediate post operative period were uneventful. However, she became anuric 36 hours post operatively. Laboratory investigations suggested hemolysis. Complement system evaluation showed decreased complement levels. Diagnosis of p-aHUS was made by taking multidisciplinary approach and renal biopsy. Patient received 4 sessions of plasmapheresis and symptomatic treatment. Gradually her urine output increased and she was discharged with the baby on post operative day 19. Diagnosis of p-aHUS is tricky owing to similar clinical features with many other pregnancy associated conditions. Timely management and diagnosis are imperative to save the mother’s life

Endometrial stromal nodule: a rare case report

Endometrial stromal nodules (ESN) are benign tumours of mesenchymal origin with features reminiscent of proliferative phase endometrial stroma. Diagnosis of ESNs can be established only by light microscopy and no preoperative diagnostic methods are available. Although ESNs are benign and rare, distinguishing it from other types of invasive stromal tumours is of utmost importance since prognosis and management change considerably with the diagnosis. This was a rare case report of endometrial stromal nodule in a nulliparous woman, 30 years old who presented with complaint of menorrhagia and primary infertility and had a preoperative diagnosis of large leiomyoma with cystic degeneration. She underwent a fertility preserving conservative surgery i.e. myomectomy via abdominal route, histopathology reports of which revealed endometrial stromal nodule that changed the final diagnosis and follow up regime of the patient

Project Awakesure: Intelligent Drowsiness Detection Using Eye Tracking

Being sleepy or drowsy is referred to as being drowsy. A person who is sleepy may feel exhausted or lethargic and struggle to stay awake. People who are sleepy tend to be less attentive and may even nod off, though they can still be awakened. An increasing number of vocations nowadays call for sustained focus. In order for drivers to respond quickly to unexpected incidents, they must maintain a watchful eye on the road. Many road incidents are directly caused by tired drivers. In order to drastically lower the frequency of fatigue-related auto accidents, it is crucial to develop technologies that can identify and alert a driver to a poor psychophysical state. However, there are many challenges in developing systems that can quickly and accurately recognize a driver's signs of fatigue. Using vision-based technology is one technological option for implementing driver fatigue monitoring systems. The available driver drowsiness detection systems are described in this article. Here, we are assessing the driver's level of sleepiness utilizing his visual system. The automated system for preventing accidents and monitoring sleepy drivers developed for this study is based on detecting variations in the length of eye blinks. Our recommended technique makes use of the eyes' postulated horizontal symmetry property to identify visual changes in eye positions. Our novel approach precisely positions a standard webcam in front of the driver's seat to identify eye blinks. It will identify the eyeballs based on a specific EAR (Eye Aspect Ratio)

PYOMETRA IN A JERSEY CROSSBRED COW - DIAGNOSIS AND TREATMENT

The present report focuses on the diagnosis of pyometra and salpingitis by the use of transrectal ultrasonography and its successful treatment with administration of PGF2 α at 72 hr intervals

Optimisation of production of electric vehicles based on configure-to-order

Electric vehicles are gaining popularity in the market as there is rapidly growing awareness regarding their benefits leading to higher adoption rates. Despite the speedily growing market, there is high uncertainty in this industry as it is still an upcoming product and there is time for mainstream adoption of EV. The manufacturers of electric vehicles that provide customisation in customer orders and adopt configure to order production model, face several challenges. This report addresses these challenges and provides a viable methodology for optimisation of the electric vehicle configure to order production. The methodology utilised in this study is to clearly define the issue faced by the manufacturers of EVs. Following this, a detailed study of the electric vehicle manufacturing process was done to identify the objectives and constraints involved. A simulation model was constructed to represent the production system and an optimization study was conducted through the data collected. There were two types of order variety identified, low and high variety of customisation, for which evaluation of two production strategies was carried out. These include, first in first out method and batching of the customer orders. The report discusses the findings of the strategies and the implications of their execution. Thus, the analysis contributes to the development of a viable methodology to optimise the production of EVs which is applicable to companies of varying scale and offerings.Bachelor of Engineering (Mechanical Engineering