Predictive value of admission and intrapartum cardiotocography in normal and high risk antenatal women

Background: Cardiotocography is the most common method for assessing fetal health and reveals brain oxygenation. This study is done for admission and intrapartum cardiotocography in high- and low-risk pregnancies and its correlation with neonatal outcome. Methods: All high-risk and normal antenatal women with more than 34 weeks of pregnancy and vertex presentation who came to the labor room were included in the study. 200 cases were taken, 100 were in the "high risk group," and the remaining 100 were in the "low risk group." On admission CTG and intrapartum CTG tracing were taken after written and informed consent, neonatal outcomes were observed, and adverse neonatal outcomes were noted. Results: Admission CTG results were unsatisfactory for 9% of women in the high-risk group and none in the low-risk group. Intrapartum NST was non reassuring in 51% of high-risk women and 6% of the low-risk group. Of the total number of neonates admitted to the NICU, 14 were from the low-risk group, while 50 were from the high-risk group. Conclusions: On admission NST in both low and high-risk women, the absence of category III NST predicted the absence of an adverse neonatal outcome most accurately. Even during labor in both high-risk and low-risk women, the absence of category III reassured the fetal well-being most precisely

Colposcopic evaluation in cases of persistent inflammatory Pap smear

Background: The aim of the study was to assess the colposcopic evaluation in cases of persistant inflammatory Papanicolaou (Pap) smear.Methods: This was a prospective analytical study, conducted amongst 78 women attending the outpatient department of obstetrics and gynaecology at Subharti Medical College. Pap smear was performed by the conventional method and colposcopy was done for all 78 sexually active women who came with complaints of pain abdomen, irregular cycles, white discharge per vaginum and urinary tract infections. Final correlation of Pap smear and colposcopy were based on histopathology and human papillomavirus deoxyribonucleic acid (HPV DNA).Results: In this study of 78 women, 21% of women had normal colposcopic findings whereas 79% had abnormal colposcopic findings. Histopathological examination (HPE) findings revealed that 69% women had cervical intraepithelial neoplasia (CIN) 1, 23% had CIN II, 6% had CIN III and 3% had SCC. 25% women tested positive for HPV DNA and 75% women tested negative for HPV DNA.Conclusions: Patients with persistent inflammatory Pap smear despite undergoing treatment show changes on Colposcopic directed biopsies.

Anemia and its effect on thyroid profile in pregnant women in tertiary care centre

Background: According to WHO, highest incidence of anaemia is seen in Asia with about half of the anaemic women present in Indian subcontinent only. Various studies in the past have reported that iron deficiency hampers thyroid function. The thyroid hormones are essential for both foetal and maternal well-being. Our aim was to study anemia among pregnant women and its effect on thyroid profile. Methods: In this prospective observational cohort study 200 women were enrolled (100 anemic and 100 non anemic) and subsequent thyroid profile was done. Confounders like high risk pregnancy, chronic diseases like coronary heart disease, renal failure/insufficiency, liver disease, Astro-intestinal diseases, known cases hypothyroidism was excluded. The women were followed up till delivery. The data was be tabulated and analysed using Chi square test in case of qualitative data and student t test in case normally distributed quantitative data. Results: Four percentages of pregnant women had overt hypothyroidism in anemic group as compared to 3% in non-anemic group. 35% in anemic group had sub-clinical hypothyroidism as compared to 16% in non-anemic group and the difference was statistically significant. The comparison of TSH values in anemic and non anemic women was statistically significant (p=0.002). There was no association found with severity of anemia with TSH, ft3, ft4 values. Conclusions: The present study found a significant association between anemia and hypothyroidism. However thyroid dysfunction was not associated with the severity of anemia. Further studies are warranted to directly identify the causal relationship between the two

Presentation of acute pulmonary edema in severe pre-eclamptic pregnant women: a case report

Pulmonary edema refers to an excessive accumulation of fluid in the pulmonary interstitial and alveolar spaces. It may occur in low risk pregnancies but one very important predisposing factor is association with pre-eclampsia. Acute pulmonary edema during pregnancy is very rare and occurs in 0.08% pregnancies. About 3% of severe pre-eclamptic patients develop acute pulmonary edema. Several risk factors have been identified: preeclampsia or eclampsia, use of tocolytic therapy, severe infection, cardiac disease, iatrogenic fluid overload, and multiple gestations. This case examines one such presentation and reviews some of the diagnostic possibilities

Spectrum of gynecological disorders in geriatric women: a tertiary care centre study

Background: Older women constitute the fastest growing segment of Indian population. Postmenopausal phase is important and primary care physicians should be aware of common gynaecologic concerns and the potential impact of these on the function and quality of life of older women.Methods: A Prospective cross-sectional study was conducted over a period of one year on 100 postmenopausal women aged 65 years or above, who attended OPD or were hospitalised between November 2015 and October 2016.Results: Literacy rate was 30%. Study population was drawn equally from rural and urban population. Genital tract malignancy was the major gynecological disorder (32%), the commonest being the carcinoma cervix. Next in order was carcinoma ovary and carcinoma endometrium. This was followed by pelvic organ prolapse (26%) and urogenital infections (17%). POP was grade 3 in 85% patients.Conclusions: Pelvic organ prolapse, genital tract malignancies and urogenital infections were the major gynecological problems faced by older women. Moreover, postmenopausal bleeding was a possible underlying cause of malignancy, of which carcinoma cervix tops the list, emphasizing the need for a screening programme in Indian women. There is urgent need to develop dedicated geriatric units and to encourage women to receive routine gynecological check-ups in the early post menopausal period that will enable early diagnosis and treatment

A comparative study of efficacy and safety of intravenous ferric carboxymaltose versus iron sucrose in the treatment of iron deficiency anaemia of pregnancy in a tertiary care hospital

Background: Anaemia is a global public health problem. To optimize iron delivery in pregnancy, new intravenous complexes like Ferric carboxymaltose (FCM) have been developed in the few years. This study aims to compare the efficacy and safety of FCM vs the iron sucrose during pregnancy.Methods: This study was conducted in the Department of Obstetrics and Gynaecology, Shri Maharaja Gulab Singh (S.M.G.S.) Hospital, Government Medical College Jammu, Jammu and Kashmir over a period of 1 year. 100 pregnant females with haemoglobin (Hb) in the range 7-9.9 g/dl between 28 to 36-week gestation, were selected randomly out of which 50 were administered FCM (Group A) and 50 were administered Iron Sucrose (Group B). Hb and serum ferritin were assessed 2 weeks and 4 weeks after treatment and side effects of each drug was studied.Results: The rise in mean Hb level at 2 weeks and 4 weeks in FCM group was significantly higher as compared to Iron Sucrose group (1.09 versus 0.52 g/dl and 1.80 versus 1.09 g/dl, respectively). Similarly, the rise in mean serum ferritin level at 2 weeks and 4 weeks was more in FCM as compared to Iron Sucrose group (144.25 vs 95.84 mcg/L and 121.31 vs 84.46 mcg/L, respectively). The adverse reactions were observed in 30% of patients in FCM group and 48% patients in iron sucrose group.Conclusions: Ferric carboxymaltose was found to be more safe and efficacious as compared to iron sucrose

Comparison of intravenous hydralazine and intravenous labetalol in the management of severe hypertensive disorders of pregnancy: a tertiary care centre study

Background: Severe hypertension in pregnancy (SBP ≥160 mmHg &/or DBP ≥ 110 mmHg) must be treated judiciously to prevent maternal and fetal complications. The study was conducted to compare the efficacy, adverse effects, maternal and fetal outcome between Hydralazine and Labetalol which are the most commonly used drugs for the purpose.Methods: In a prospective study, 130 pregnant patients each with severe hypertension presenting to SMGS Hospital Jammu were randomized in 2 groups and administered hydralazine or labetalol intravenously. The efficacy of the two drugs was measured in terms of number of doses required to obtain target BP and the timing to achieve the same. The incidence of adverse effects, maternal and fetal outcomes were also compared. Comparisons among the two groups was performed by using independent Student’s t test for normally distributed variables, Fishers’ exact test, and Pearson Chi Square test for categorical variables. The level of significance was set at p<0.05 for all analysis.Results: There was no statistical difference between the two drugs in terms of efficacy. Significantly more low-birth weight infants were born in the hydralazine group. Also, the adverse effects were significantly more in the hydralazine group.Conclusions: Both hydralazine and labetalol can be used to treat hypertensive emergencies of pregnancy but hydralazine is associated with more side effects

Counterspeeches up my sleeve! Intent Distribution Learning and Persistent Fusion for Intent-Conditioned Counterspeech Generation

Counterspeech has been demonstrated to be an efficacious approach for combating hate speech. While various conventional and controlled approaches have been studied in recent years to generate counterspeech, a counterspeech with a certain intent may not be sufficient in every scenario. Due to the complex and multifaceted nature of hate speech, utilizing multiple forms of counter-narratives with varying intents may be advantageous in different circumstances. In this paper, we explore intent-conditioned counterspeech generation. At first, we develop IntentCONAN, a diversified intent-specific counterspeech dataset with 6831 counterspeeches conditioned on five intents, i.e., informative, denouncing, question, positive, and humour. Subsequently, we propose QUARC, a two-stage framework for intent-conditioned counterspeech generation. QUARC leverages vector-quantized representations learned for each intent category along with PerFuMe, a novel fusion module to incorporate intent-specific information into the model. Our evaluation demonstrates that QUARC outperforms several baselines by an average of 10% across evaluation metrics. An extensive human evaluation supplements our hypothesis of better and more appropriate responses than comparative systems.Comment: ACL 202