Are aggressive deliveries of very preterm babies justified?

Background: Every year there are 15 million babies who are born too soon. The objective of this study was to analyze the neonatal morbidity and mortality of preterm neonates at birth.Methods: This was a prospective study conducted in the department of obstetrics and gynecology and neonatology. We included all preterm deliveries from 26 weeks to 36 weeks 6 days period of gestation in one year. Neonatal morbidities and mortalities at birth were noted.Results: The rate of preterm birth was 8.49%. Spontaneous preterm labor accounted for 52% of the causes of preterm. Hyperbilirubinemia was the commonest neonatal morbidity affecting 53.2% of the neonates. Respiratory distress syndrome (RDS) and sepsis was highest in neonates of 26 weeks to 28 weeks gestation. This group saw a mortality of 90%.Conclusions: Prematurity is associated with high mortality and long-term morbidity. Low APGARS might be good predictors of neonatal/ infant mortality.  In the extremely preterm neonate, it may prove worthy to weigh the risks and benefits and thereafter counsel the mother and concerned relatives accordingly to help with decision making.

Infection and acute respiratory distress syndrome during pregnancy: A case series of preventable maternal deaths from southern India

Summary: Introduction: Acute respiratory distress syndrome (ARDS) is common among women admitted to obstetric intensive care units, and it contributes significantly, both directly and indirectly, to maternal deaths. Case series: We present a case series of ARDS in pregnant women caused by non-obstetric causes. The women were treated at a tertiary hospital in southern India. The striking features were delayed referral from the primary care unit and the lack of a primary diagnosis or treatment. Undiagnosed rheumatic heart disease, anemia, and malaria and H1N1 epidemics contributed to these cases of ARDS and maternal death. Conclusion: It is necessary to increase the awareness of evidence-based uniform protocols to tackle common medical complaints during pregnancy. Keywords: Acute respiratory distress syndrome (ARDS), Pregnancy, Maternal mortalit

An audit of indications, complications and justification of hysterectomy at a tertiary hospital

Objective. Aim of this audit was to analyze indications, complications, and correlation of preoperative diagnosis with final histopathology report of all hysterectomies, performed in a premier teaching hospital. Methods. Present study involved all patients who underwent hysterectomy at a premier university hospital in Southern India, in one year (from 1 January, 2012, to 31 December, 2012). Results. Most common surgical approach was abdominal (74.7%), followed by vaginal (17.8%), and laparoscopic (6.6%) hysterectomy. Most common indication for hysterectomy was symptomatic fibroid uterus (39.9%), followed by uterovaginal prolapse (16.3%). Overall complication rate was 8.5%. Around 84% had the same pathology as suspected preoperatively. Only 6 (5 with preoperative diagnosis of abnormal uterine bleeding and one with high grade premalignant cervical lesion) had no significant pathology in their hysterectomy specimen. Conclusion. Hysterectomy is used commonly to improve the quality of life; however at times it is a lifesaving procedure. As any surgical procedure is associated with a risk of complications, the indication should be carefully evaluated. With the emergence of many conservative approaches to deal with benign gynecological conditions, it is prudent to discuss available options with the patient before taking a direct decision of surgically removing her uterus

An Audit of Indications, Complications, and Justification of Hysterectomies at a Teaching Hospital in India

Objective. Aim of this audit was to analyze indications, complications, and correlation of preoperative diagnosis with final histopathology report of all hysterectomies, performed in a premier teaching hospital. Methods. Present study involved all patients who underwent hysterectomy at a premier university hospital in Southern India, in one year (from 1 January, 2012, to 31 December, 2012). Results. Most common surgical approach was abdominal (74.7%), followed by vaginal (17.8%), and laparoscopic (6.6%) hysterectomy. Most common indication for hysterectomy was symptomatic fibroid uterus (39.9%), followed by uterovaginal prolapse (16.3%). Overall complication rate was 8.5%. Around 84% had the same pathology as suspected preoperatively. Only 6 (5 with preoperative diagnosis of abnormal uterine bleeding and one with high grade premalignant cervical lesion) had no significant pathology in their hysterectomy specimen. Conclusion. Hysterectomy is used commonly to improve the quality of life; however at times it is a lifesaving procedure. As any surgical procedure is associated with a risk of complications, the indication should be carefully evaluated. With the emergence of many conservative approaches to deal with benign gynecological conditions, it is prudent to discuss available options with the patient before taking a direct decision of surgically removing her uterus

Nutraceutical Potential of Apiaceae

Apiaceae family is large, with over 3.000 species worldwide cultivated for many purposes. Some plants in this family such as carrots, parsley, parsnip and celery are common vegetable crops, while other members like anise, caraway, coriander, cumin, fennel, lovage, angelica and dill are famous for their medicinal and aromatic properties. Usage of these plants is very popular in everyday diet because of their documented health benefits. Apiaceae are a very important source of phytochemicals – chemicals with biological activity. However, phytochemicals are non-nutritive plant chemicals, also called nutraceuticals. They are widely used for prevention, treatment or cure of conditions or diseases. Bioactive compounds with nutraceutical potential are polyphenolic compounds, polyacetylenes and terpenoids. The aim of this review is to represent selected plants of Apiaceae family currently used as nutraceuticals and describe their nutritional benefits