Prospective study to compare abdominal hysterectomy versus non- descent vaginal hysterectomy at a tertiary care hospital

Background: Hysterectomy can be performed by vaginal, abdominal and via laparoscopic route. In the current scenario of importance of non-invasive surgery there has been increase in interest and requirement of vaginal hysterectomy for non-prolapsed uterus i.e. Non-descent vaginal hysterectomy (NDVH) due to scarless surgery. Gynecologist across the world continue to use the abdominal approach for a large majority of hysterectomies that may be performed vaginally despite well documented evidence which says that vaginal hysterectomy do have better outcome. This study aimed to find out to compare outcomes of NDVH and Abdominal hysterectomy (AH).Methods: The study is conducted at department of Obstetrics and Gynecology, at a tertiary care hospital Gujarat, India, between the periods of May 2018 to December 2019 of 100 patients. 50 Patients who underwent hysterectomy by abdominal route are taken as study group A and 50 Patients who underwent hysterectomy by vaginal routes are taken as group B.Results: Out of 100 women we have studied, duration of surgery, intra operative blood loss, intra operative complications, postoperative morbidity and duration of hospital stay, time required to resume normal work are less in group B (NDVH).Conclusions: It can be concluded that NDVH is feasible, safe and better alternative to abdominal hysterectomy for benign gynecological conditions. It also provides greater efficacy and safety with minimal invasiveness

Study of thyroid function in patients with metabolic syndrome

Background: Thyroid disease and the metabolic syndrome are both associated with cardiovascular disease. The aim of this study was to explore the study of thyroid function in patients with metabolic syndrome. Methods: This cross-sectional study was conducted at department of physiology, M P shah medical college Jamnagar, Gujarat. It included 200 patients with metabolic syndrome (MetS) (National Cholesterol Education Program’s-Adult Treatment Panel III Criteria) in the study group and 100 subjects without metabolic syndrome in the control group. Anthropometric variables and blood pressure were taken using standardized technique and body mass index was calculated. Fasting blood sample was analyzed for total cholesterol (TC), triglycerides (TG), high density lipoproteins cholesterol (HDL-C), blood glucose (FBG) and TSH, T4 and T3 were measured using electro-chemiluminescence immuno assay. Statistical analysis was performed using SPSS windows version 20.0 software (SPSS Inc., Chicago, Illinois).Results: The overall prevalence of thyroid dysfunction in patients with MetS was 41.5% with high prevalence of sub clinical hypothyroidism (27%). TSH (P<0.001) was significantly higher in the study group than in control group (P <0.01) but T3 and T4 values of study group were significantly lower than those of control group (P< 0.01). Metabolic components waist circumference, blood pressure, fasting blood glucose and triglycerides were significantly higher in metabolic subject (P<0.001), while HDL-C was significantly lower in study group (P<0.001) then control group. Conclusion:  Hypothyroidism brawny associated with components of metabolic syndrome, therefore increased multifaceted risk of cardiovascular disorders with elevate TSH levels

Study of antioxidant status in malaria patients

Background: Oxidative stress plays an important role in the development of metabolic changes in malaria patients. During infection RBCs are exposed to continual oxidative stress. The univalent reduction of oxygen results in a series of cytotoxic oxygen species such as O2-, H2O2, OH•. Objective was to determine the level of oxidative stress in patients suffering from malaria.Methods: The present study was conducted on 551 malaria patients and 211 age-sex matched controls, in department of Biochemistry, C U Shah Medical College, Surendranagar, Gujarat from April 2012 to May 2013.  In stage-I, day-1 malaria patient’s v/s control group, In stage-II, day-3 v/s day-1 after anti-malarial treatment and in Stage-III day-3 v/s day-1 after anti-malarial + antioxidant treatment.Results: The mean erythrocytic activity of SOD, CAT, GST were decreased (0.71±0.25EU, 9.9±2.4μmol/sec, and 11.7±3.9 U/gmHb% respectively), mean level of GSH and MDA were increased (42.1±6.06gm/Hb%, 10.9±2.83 respectively) significantly (P<0.001) as compared to control group. In the follow up study with anti-malarial treatment the mean levels of erythrocytic GSH and MDA (28.7±7.54gm/Hb% and 8.08±1.95nM/L) decreased significantly (P<0.001 and P<0.01 respectively), whereas mean activity of erythrocytic enzymes like SOD, CAT and GST (0.99±0.15 EU, 15.8±2.68μmol/sec and 22.5±5U/gmHb%) were increased significantly (P<0.001) as compared to day-1.Conclusions: Erythrocytic antioxidant enzymes, GSH and MDA may be considered to be reliable biochemical markers for diagnostic and therapeutic potential in malaria

Study of metabolic changes-glycoprotein and phospholipids levels in patients of malaria

Background: In erythrocytic stage, malarial parasites meet their high glucose requirement only by modulating the host cell membrane by increasing transport of sugar across the host cell membrane. This leads to a transmembrane gradient of the substrate and finally leading to alterations of metabolic changes and permeability of RBC membrane. Therefore, the aim of present study was to determine the parameters which reflect the status of RBC membrane and their association with the severity of malaria in a large cohort of known patients of malaria, which was caused by the Plasmodium Species.Methods: Blood sample were collected in EDTA bulb at the time of admission (day-1) and on third day (day-3). The samples were analyzed within 24 hours of collection. Erythrocytic total phospholipid is measured by modified connerty method, Total sialic acid (TSA) is measured by TBA/dimethyl sulphoxide method.Results: The mean levels of erythrocytic phospholipid, plasma TSA and PBSA in the cases of malaria were significantly increase (P<0.001) as compared to those in the control group. In the follow up study the same parameters were studied in patients post anti-malarial treatment day-3. The level of erythrocyte phospholipid, plasma TSA and PBSA were reversed.Conclusions: On the basis of the present study it is suggested that the anti-malarial drug regimen must be supported by antioxidants and trace elements supplementation to improve the status of deviated biochemical parameters towards normalcy