A programmed labour protocol for optimizing labour and delivery

Background: Objectives: 1) To evaluate the effect of programmed labor on duration of labor 2) To assess efficiency of analgesics in reducing severity of labor pains and 3) To find out any maternal and fetal/neonatal complications.Methods: 100 primigravida pregnant women meeting inclusion criteria admitted in labor room 50 were randomly enrolled in study group and 50 in control group.Results: Significant reduction in duration of active phase of labor and 43 (86%) cases had pain relief. Out of them 20 (40%) cases experienced excellent pain relief while in controls, only 22% had pain relief.Conclusions: Labour analgesia ensures pain relief, avoid maternal hyperventilation controls alteration of placental circulation thereby safe guarding the fetus against hypoxia. Thus programmed labor is easy, simple and effective method for painless deliver

Carbepenam resistance prevalence in north India: A retrospective analysis

Background: We investigated the clinical consequences of healthcare-associated bacteremia in light of rising antimicrobial resistance and limited therapy choices for carbapenem-resistant bacteremia. Methods: Between March 2020 and March 2022, a retrospective observational study of carbapenem-resistant Gram-negative bacteremia was conducted at a tertiary care hospital in North India. Results: Patients in our study spent an average of 11.76 days in the intensive care unit (ICU), with a mean time to bacteremia of 6.4 days following admission. Klebsiella pneumoniae was the most prevalent pathogen (44 percent). Patients receiving combination treatment had a reduced death rate (44.8%) than those receiving colistin monotherapy (66.6%) (P = 0.35). Conclusion: Carbapenem resistant bacteremia is a late-onset illness that affects patients who have been exposed to antibiotics in the ICU and has a 60 percent mortality rate after 30 days

Variations in the origin of iliolumbar artery with its clinical significance

Introduction: The Iliolumbar artery mainly arises from the posterior division of the internal iliac artery. It extends oblique superiorly and laterally in front of the sacroiliac joint and lumbosacral trunk. It crosses the obturator nerve and external iliac vessels & reaches the medial edge of the psoas major. The aim of our study was to know the origin variability of the Iliolumbar artery. This helps to prevent any iatrogenic injury during various surgeries. Materials and Methods: 50 formalin-fixed adult human pelvic halves with known sex were procured from the Department of Anatomy, Medical College, Baroda. Site of origin of the Iliolumbar Artery was identified. Results: In the current study, we observed that the origin of the Iliolumbar Artery was from the posterior division of IIA in 52%, 38% from the trunk of the internal iliac artery, 4% from the single trunk with obturator artery from posterior division, and 6% absent. Conclusion: The variable origins of the ILA from different branches of the internal iliac artery should be taken into account during the surgical procedures involving the lower abdominal & pelvic region so as to modify the surgical tactics to prevent undesired hemorrhagic complications

Comparative study of sevoflurane versus propofol for laryngeal mask airway insertion in adults

Background: Propofol is a preferred induction agent for laryngeal mask airway (LMA) insertion due to its propensity of suppressing oropharyngeal and cough reflexes. Sevoflurane is a nonpungent inhalation anesthetic agent which can be used as an induction agent. The aim of the present study was to compare Sevoflurane versus Propofol for laryngeal mask airway insertion in adults. Material and methods: The present study was carried out in 300 patients to compare Sevoflurane versus Propofol for laryngeal mask airway insertion in adults. In Group-A: induction with propofol and in Group-B: induction was done with inhalational sevoflurane 8. Various vital parameters and other clinical parameters were recorded and compared in both the groups. The statistical analysis was done. Results:Propofol  needed leser time to loss of eyelash reflex, Time to jaw relaxation, Time to completion of successful insertion of Laryngeal Mask Airway. The percentage of patients who had successful LMA insertion at first attempt was larger with propofol. The duration of apnea was longer in group propofol. Excitatory movement was more in group propofol. Cough, laryngospasm was absent in propofol. Hiccups was absent in both groups. During insertion of LMA, coughing, gagging was absent in group sevoflurane and laryngospasm was absent in propofol.&nbsp

Morphometry of coronary sinus and its role in cardiac cannulation

Introduction:- The coronary sinus is a collection of veins, joined together to form a large vessel that collects blood from the heart muscle (myocardium) 1. Most cardiac veins drain into the wide coronary sinus, 2 or 3 cm long, lying in the posterior atrioventricular groove between the left atrium and ventricle.2 The sinus opens into the right atrium between the opening of the inferior vena cava and the right atrioventricular orifice. An endocardial fold may guard the entrance of sinus valve of the coronary sinus or Thebesian Valve. The fold may be absent or may cover the ostium of the sinus completely or partially. Material & Method:- The present study was conducted in the anatomy department of medical college Baroda, Gujarat. One hundred formalin-fixed hearts specimens were taken for the study The dimensions of the coronary sinus ostium in millimetres was measured with the help of digital vernier calliper. Craniocaudal and transverse length were measured and recorded in Microsoft excel. Result :- In the current study, we observed that 58 hearts had the coronary sinus with a thebesian Valve and the rest 42 were without a thebesian Valve.&nbsp

Carbepenam Resistance Prevalence in North India: A Retrospective Analysis

Background: We investigated the clinical consequences of healthcare-associated bacteremia in light of rising antimicrobial resistance and limited therapy choices for carbapenem-resistant bacteremia. Methods: Between March 2020 and March 2022, a retrospective observational study of carbapenem-resistant Gram-negative bacteremia was conducted at a tertiary care hospital in North India. Results: Patients in our study spent an average of 11.76 days in the intensive care unit (ICU), with a mean time to bacteremia of 6.4 days following admission. Klebsiella pneumoniae was the most prevalent pathogen (44 percent). Patients receiving combination treatment had a reduced death rate (44.8%) than those receiving colistin monotherapy (66.6%) (P = 0.35). Conclusion: Carbapenem resistant bacteremia is a late-onset illness that affects patients who have been exposed to antibiotics in the ICU and has a 60 percent mortality rate after 30 days

Estimation of the parasitic burden of soil-transmitted helminths among pregnant women in the Maharashtra State of India using qPCR: A community-based study

Background: Soil-transmitted helminth (STH) infections are widespread in developing countries with inadequate sanitation facilities. These infections can lead to malnutrition, anemia, and other complications that can negatively impact both the mother's and fetus's health during pregnancy. This study aimed to estimate the burden of STH by Kato-Katz microscopy and quantitative polymerase chain reaction (qPCR) in pregnant women from rural India. The diagnostic accuracy of these two methods was also compared. Material and Methods: A community-based cross-sectional study was conducted in rural areas of Wardha district of Maharashtra state. We randomly selected and interviewed 688 pregnant women. A total of 534 (77.61%) participants gave stool samples. Two containers (60 mL) labeled with a unique identification number were given to pregnant women to collect stool samples for Kato-Katz microscopy and qPCR. Stool specimens were transported to an accredited lab and examined within 24 hours. Suitable examinations were conducted to compare sensitivity between two tests. Results: The results are presented for 534 participants who gave stool samples. The prevalence of any STH by Kato-Katz stool microscopy was 6.55% (95%CI 4.46–12.19), and that by qPCR was 20.41 (95%CI 17.53–29.40). The sensitivity of Kato-Katz microscopy was 29.17% compared to sensitivity of 90.83% by qPCR (P = 0.001). Pregnant women with STH infection have a significantly lower weight gain during pregnancy, and the majority were either mild or moderate anemic compared to those without STH. Conclusion: The study highlighted significant differences in prevalence of STH among pregnant women by Kato-Katz microscopy and qPCR. The sensitivity of qPCR for detecting STH was higher than that of Kato-Katz microscopy