Partographic study of progress of labour in primigravida

Background: The objective of this study was to assess the value of partographic studies in the management of labour in primigravidae at term and to study the outcome of labour and mode of delivery.Methods: Three hundred consecutive primigravid women were selected for this study according to the inclusion criteria at Dr. Panjabrao Deshmukh Memorial Medical College, Amravati (M.S.) during August 2009 - August 2011. 118 women who delivered before alert line served as control group, or group I, women who delivered after the alert line but before the action line; group II and group III; women who delivered after the action line. Maternal and neonatal outcomes were studied in each of three groups.Results: Among the 300 women analysed, 118 (39.33%) belonged to group I, 147 (47%) to group II and 35 (11.67%) belonged to group III. Mean duration of active phase of labour were 4.55 hrs, 6.90 hrs and 10.16 hrs in group I, group II and group II respectively. Cervical dilatation in group I, group II & group III was at the rate of 1.41 cm/hr, 0.88 cm/hr and 0.59 cm/hr. respectively.Conclusions: The number of LSCS, NICU, admissions and instrumental deliveries increased in group III, as compared to group I and II. Mean duration of active phase of labour increased as the partographic curve fell to the right of alert and action line

Rare case of leiomyoma in Mayer-Rokitansky-Kuster-Hauser syndrome

Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a cause for primary amenorrhea. It is characterized by the presence of XX karyotype, normal ovarian function and blind vaginal pouch. The uterus is usually represented by bilateral rudimentary primordia. Presence of functioning endometrial tissue may lead to development of hematometra in one or both primordia. Rarely myomas, neoplasms and adenomyosis can develop in the rudimentary bulbs. MRKH syndrome is frequently associated with urologic and skeletal abnormalities. In this case, a 45 year old patient presented with primary amenorrhea and lower abdominal pain. On examination, she had a blind vaginal pouch and a pelvic mass. She was investigated and taken for laparotomy with a provisional diagnosis of hematometra or ovarian tumor. The mass turned out to be leiomyoma in one of the rudimentary bulbs which was confirmed on histopathology. Our patient had vertebral abnormalities too. The incidence of MRKH syndrome is less and its association with pelvic tumor is even rarer. Hence this case is reported. 

Study of maternal and fetal outcome in various types of placenta previa

Background: Placenta previa is one of the life-threatening complications in obstetrics which affects maternal and neonatal outcome. Now-a-days its incidence is increasing due to previous operative procedures. The objective of the present study was to study out maternal and fetal outcome in various types of placenta previa.Methods: A prospective study was conducted in our tertiary care hospital on 78 patients in order to know the cause and outcome of placenta previa.Results: Early termination was carried out in major PP group due to APH. 13 out of 17 patients presenting with APH had major degree of PP. Abnormal lie and presentation are commonly seen in cases of PP however cephalic constituted 83.3% cases of fetal presentations in present study followed by breech 10.2%, oblique 3.9%, face 1.3% and transverse 1.3%. In this study, 92.2% neonates were born alive while neonatal death and intrauterine death (IUD) was observed in 5.2% and 2.6% neonates respectively.Conclusions: Combined efforts for prevention of risk factors for PP, timely diagnosis and planned institutional deliveries can only reduce the morbidity and mortality associated with PP

Effect of maternal body mass index on pregnancy outcomes

Background: BMI is widely accepted as a better measure of underweight or overweight than weight alone. The developing countries including India are facing a dual burden of undernutrition and obesity. Extremes of BMI in pregnancy have been associated with multiple complications affecting maternal and perinatal outcome. The objectives of the present study was to observe distribution of antenatal patients in underweight, normal, overweight and obese categories according to booking BMI and to examine the association of BMI with obstetric and perinatal outcomes in singleton pregnancies.Methods: This was an observational prospective study with a sample size of 610 patients carried out during the period Dec 2016 to Nov 2017 in Dr PDMMC, Amravati. The antenatal patients were categorized into four categories of BMI according to WHO classification and pregnancy outcomes were compared.Results: Depending on booking BMI, 73.8% patients enrolled in the study had normal booking BMI and 16.7%, 8.5% and 1% were underweight, overweight and obese respectively. Postdatism, preterm births, induction of labour, LSCS and prolonged hospital stay were commoner in overweight patients while IUGR, oligohydramnios and BOH were seen more in underweight group. Neonatal resuscitation and neonatal complications were common in both underweight and overweight patients as compared to normal BMI patients.Conclusions: Based on this study, we conclude that majority of antenatal patients being catered in our hospital have normal BMI. Adverse maternal and perinatal outcomes are seen more commonly with the extremes of BMI

Smart Automation System for Office Environment

A smart automation system for office environment is being designed in this system. Various controlling systems based on lighting, ventilating, luminance are discussed respectively. Various sensors are used to extract the real time information i.e. temperature, light intensity, humidity, smoke, motion sensor are used. This data is send to ARM 11 Controller. It is then send to PC where data is saved. Through Network switch this data is send to other PC’s. The data collected is stored as database and can be accessed anytime. The data is send to the android or any internet enabled device. This system also provides need based emergency services like Ambulance call, fire alarm. Biometric fingerprint is used for security purpose. Manual mode and automatic mode are two alternative modes designed to promote the usability of smart office system. Control of electric lighting fixtures of different office spaces is done

Seroprevalence of human immunodeficiency virus among antenatal patients and incidence of mother- to- child transmission using single dose nevirapine: a cohort study in Maharashtra

Background: Objective was to study the seroprevalence of human immunodeficiency virus (HIV) in antenatal patients and to find out the incidence of mother to child transmission (MTCT) using single dose nevirapine (sdNVP) to mother- baby pairs in labour.Methods: This prospective study was conducted in the department of Obstetrics & Gynecology, Dr. PDMMC, Amravati, Maharashtra from February 2010 to May 2015. All pregnant women attending the antenatal clinic were subjected to pretest counseling and HIV testing after informed consent. The HIV +ve pregnant patients who opted for delivery at our hospital were included in the study. sdNVP was administered to mother- baby pairs according to NACO guidelines. Babies of these patients were followed up to 18 months of age for HIV testing.Results: 12077 antenatal patients underwent pretest counseling. 11957 antenatal patients were tested for HIV of which 28 were detected positive. Therefore, the seroprevalence in this study was found to be 0.23%. 23 patients delivered at our hospital during the study period and babies of 2 patients tested positive for HIV. Hence the incidence of MTCT was found to be 9.5% in our study.Conclusions: Universal screening of pregnant patients for HIV and judicious use of PPTCT regimens can significantly reduce MTCT of HIV and prevalence of pediatric HIV infection. Single dose nevirapine use over last few years has successfully reduced MTCT, but our aim should be to reduce it further with more effective ART regimens for the seropositive antenatal patients and their babies.

A rare case of leiomyosarcoma arising from vault post-hysterectomy

Fibroid/Leiomyoma is the most common benign tumor of the uterus, arising from uterine smooth muscle. Atypical leiomyomas are rare forms of Myoma (fibroid uterus), of which recurrent atypical leiomyoma post hysterectomy is rarer and its converting in leiomyosarcoma arising from vault is rarest.  Here we report an unusual case of a 76yrs female, with leiomyosarcoma in an atypical leiomyoma arising from vault post-hysterectomy. A 76-year-old P3L3 patient presented with pain and distension of abdomen, post hysterectomy done 4 years back for chronic inversion and cervical fibroid polyp she was diagnosed as atypical leiomyoma. Laparotomy was done with a provisional diagnosis of leiomyosarcoma. Though Rarest (0.13-0.26%), a differential diagnosis of neoplastic changes should be kept in mind in patients with atypical leiomyoma, in patients presenting with any mass/pain abdomen, irrespective of any gynaecological complaints. This case shows that though it is unexpected after hysterectomy, leiomyosarcoma has to be considered in a case of abdominal mass. Atypical leiomyoma develops approximately in one to five cases out of 1,000 women with fibroid and it getting converted in leiomyosarcoma is rarest. Hence, diagnosis of leiomyosarcoma should always be kept in mind though the patient is hysterectomised

Degenerated fibroid - a diagnostic challenge

Leiomyoma of the uterus is the most common type of tumor affecting the female pelvis and arises from uterine smooth muscle. The size of leiomyoma varies from microscopic to giant; giant myoma is exceedingly rare. We report an unusual case of a large, cystic, uterine leiomyoma mimicking a primary malignant ovarian tumor on sonography and CT. A 39 year old infertile nulliparous woman presented with a history of lump in abdomen since 2 years and 6 months of amenorrhea. Sonography and CT examination showed a large mass that filled the abdomen. A preoperative diagnosis of a primary malignant ovarian tumor was made. The patient underwent laparotomy with total abdominal hysterectomy preserving tubes and ovaries. The histology revealed a leiomyoma with extensive hyaline degeneration. The current established management of uterine fibroids may include expectant, surgical, or medical management or uterine artery embolization or a combination of these treatments. A surgical approach is preferred for management of giant leiomyomas. Leiomyomas should be considered in the differential diagnosis of a multilocular and predominantly cystic adnexal mass

ACOUSTICAL STUDIES OF COPOLYMER OF P-HYDROXY BENZOIC ACID AND FORMALDEHYDE IN N, N-DIMETHYL FORMAMIDE AND DIMETHYL SULFOXIDE BY ULTRASONIC VELOCITY MEASUREMENTS

The density (Ï), viscosity (η) and ultrasonic speeds (U) of copolymer of p-hydroxy benzoic acid and formaldehyde in dimethyl formamide (DMF) and dimethyl sulfoxide (DMSO) solutions have been investigated to understand the effect of substituent's on intermolecular interactions at 283K, 288K, 293K, 298K, and 303K. Various acoustical parameters such as adiabatic compressibility (β), intermolecular free length (Lf), acoustical impedance (Z), internal pressure (Ï€), relaxation time (Ï„) and relative association (RA) were determined and correlated with concentration (C). A good correlation between a given parameter and concentration is observed at all temperatures and solvent systems studied. The results have been used to discuss the nature and strength of intermolecular interactions in the system