Epidemiological study of maternal and outcomes in abruptio placenta

INTRODUCTION: Abruptio placenta is still a grave obstetric emergency contributing large number of maternal deaths in developing countries. Bleeding from the maternal reproductive tract in which the cause is unclear is dangerous to the fetus also. Early diagnosis of abruption is very important for improving maternal and fetal outcome to great extent. Premature separation of placenta affects the fetus mostly and the perinatal mortality as a consequence of this problem is very high. In our hospital we have 8,118 deliveries of which the incidence of abruption was 1.26%. AIM OF THE STUDY: 1. To conduct an in depth analysis of abruption in order to find out the influence of various parameters. 2. To find out the incidence of abruption 3. To find out the relationship of incidence to age and parity. 4. To find out maternal and perinatal mortality rate 5. To find out various maternal morbidity parameters and their incidence. 6. To find out the factors contributing to maternal and perinatal morbidity and mortality. MATERIALS AND METHODS: This is a prospective study conducted in Annal Gandhi Memorial Govt Hospital, Trichy. During the period of 2008 to 2009. Inclusion criteria: All patients are diagnosed mainly on clinical signs and symptoms / ultrasound. Exclusion criteria: 1. All patient who came with the history of Ante partum hemorrhage but where diagnosed as having local causes were excluded. 2. All patients referred to the hospital for the management of post partum complication were excluded from this study Methods: 1. Careful elucidation of history from the patients. 2. Meticulous clinical assessment so as to exclude from placenta previa. 3. Ultrasonogram done for placental localization and for retroplacental clots. 4. Venous sample taken for blood group and Rh type, cross matching, hemoglobin estimation, estimation of serum fibrinogen and clot observation test. Estimation of renal function test and liver function test whenever indicated. 5. Vital signs should be monitored regularly 6. Clot observation test repeated hourly 7. Blood transfusion and fluid infusion monitored closely. 8. Coagulation failure treated with fresh blood transfusion and fresh frozen plasma. 9. Appropriate management of renal failure when it occurs. 10. The aim of management of abruption was to expedite the delivery so as to shorten the abruption delivery interval. Liberal caesarian section was done. CONCLUSION: Abruption is still one of the most serious obstetric emergencies. Aetiology remains obscure in many cases and it often present without warning. Fortunately maternal mortality from abruption was reduced considerably due to implementation of good obstetric care and blood transfusion services. But, it is still an important cause of maternal morbidity and mortality and perinatal loss. Elucidation of precise history, etiology and prevention especially abruption remains the principal challenge of future

DIAGNOSIS OF MYOCARDIAL ISCHEMIA USING PLASMA FREE FATTY ACID AS A BIOMARKER

Objective: Diagnosis of myocardial ischemia (MI) in patients attending emergency intensive care unit (ICU) with symptoms of an acute coronarydisease is often difficult. Biochemical markers such as cardiac troponin (cTn) and creatinine kinase MB (CK-MB) may not rise during reversible MI.Previous studies suggest unbound free fatty acid (FFA) increased significantly in ischemic related events. Thus, plasma FFA has shown to be an earlybiochemical marker. To diagnose MI using plasma FFA as a biomarker.Methods: Blood samples were collected from 30 ischemic heart disease (IHD) patients admitted to ICU and 30 healthy volunteers for plasma FFA.Patients were diagnosed as IHD based on the clinical presentation, electrocardiogram (ECG), and coronary angiography findings, cTn, CK-MB. PlasmaFFA was measured enzymatically with (acyl-CoA synthetase- acyl-CoA oxidase) non-esterified fatty acid kit (Randox Laboratories Ltd., Co.Antrium,United Kingdom) on Bayer RA 50 analyzer in both normals and IHD patients.Results: Around 93.3% of the patients presented with the chest pain as a major symptom and 6.7% of the patient presented with dyspnea. Allthe patients showed a positive ECG change and angiographic findings suggestive of IHD. Plasma FFA (1.134±0.21) in IHD was significantly higher(p<0.0001) than the control (0.5233±0.13). With respect to lipid profile triglycerides, low-density lipoprotein (LDL), very LDL was significantly higherin MI when compared to normal with p<0.001, whereas HDL was significantly higher in normals than the study group with p<0.05. There was nostatistical difference in total cholesterol and hemoglobin value between the study group and the normals. Further standard biomarker like cTn waselevated in 60% (18) and CK-MB in 63% (19) of the patients when compared to FFA, which was elevated in 86% (26) of the patients.Conclusion: Thus, plasma FFA can be used as a simple, quick, and early marker of MI. However, should FFAs be measured routinely as a standarddiagnostic marker of ischemia still warrants further studies?Keywords: Myocardial ischemia, plasma FFA, cardiac troponin, creatinine kinase M

Methyl N-({[2-(2-meth­oxy­acetamido)-4-(phenyl­sulfan­yl)phen­yl]amino}[(meth­oxy­carbonyl)imino]methyl)carbamate

In the title compound, C20H22N4O6S, the phenyl and benzene rings form a dihedral angle of 58.75 (5)°. Intra­molecular N—H⋯O and N—H⋯N hydrogen bonds generate two S(6) and one S(7) ring motif, respectively. In the crystal, mol­ecules are linked via N—H⋯O, N—H⋯N, C—H⋯S and C—H⋯O hydrogen bonds, forming two-dimensional networks parallel to the bc plane

(E)-1-(4,4′′-Difluoro-5′-meth­oxy-1,1′:3′,1′′-terphenyl-4′-yl)-3-(6-meth­oxy­naphthalen-2-yl)prop-2-en-1-one

In the title compound, C33H24F2O3, the central benzene ring makes dihedral angles of 44.71 (10), 47.80 (10) and 63.68 (9)° with the two fluoro-substituted benzene rings and the naphthalene ring system, respectively. In the crystal, mol­ecules are connected via inter­molecular C—H⋯F and C—H⋯O hydrogen bonds. Furthermore, the crystal structure is stabilized by weak C—H⋯π and π–π inter­actions [centroid–centroid distance = 3.6816 (13) Å]

1-(4,4′′-Difluoro-5′-meth­oxy-1,1′:3′,1′′-terphenyl-4′-yl)ethanone

In the title compound, C21H16F2O2, the central benzene ring is inclined at dihedral angles of 30.91 (8) and 46.88 (7)° to the two terminal fluoro-substituted rings. The dihedral angle between the two terminal fluoro-subsituted rings is 68.34 (8)°. An intra­molecular C—H⋯O hydrogen bond generates an S(6) ring motif. The crystal structure is stabilized by weak C—H⋯π inter­actions

Eventration of Diaphragm: A Rare Cadaveric Case Report

The respiratory diaphragm is a barrier between the thoracic and abdominal cavities. It is a chief skeletal muscle of respiration that plays a critical role in the process of inspiration. The defective diaphragm may be clinically present with or without obvious symptoms. Depending on the severity of its defects, it can lead to mild to severe fatal consequences. Protrusion of abdominal contents into the thoracic cavity through the weakened or defective part of the diaphragm is known as a diaphragmatic hernia. Such herniations will exist either in the form of congenital birth defects or acquired defects in the diaphragm. An acquired hernia may be due to spontaneous or iatrogenic causative factors. Congenital Diaphragmatic Hernia (CDH) can occur due to the disruption of various cellular mechanisms involved in organogenesis during the gestation period. Such herniations may exist with or without content protrusions into the cavity of the thorax, later referred to as Eventration of the Diaphragm (ED). In the Department of Anatomy at JSS Medical College, Mysuru, Karnataka, India, a rare case of diaphragmatic eventration was noticed in a male cadaver aged about 70 years, during the routine dissection class of preclinical medical students. In this rare case report, diaphragmatic eventration along with various factors involved in its presentation would be considered holistically

Effectiveness of Television Advertisement on Purchase Intention

ABSTRACT: Advertising has become the most effective ways for the companies to transmit the product information's to the target consumers. The words, graphics and images are used to display the products in such a way with the intention to attract the consumers and make them to think and purchase the product among the other available other companies products. The main ways of attracting the consumer is by using all types of endorsement, using celebrity appearance, message strategy, and the involvement strategy. The previous researches have proved that celebrity endorsement, advertising appeal and advertising effect significantly and positively affects the consumers purchase intentions. There is a strong perception and purchase intentions are also reported in the research findings. The purchase intentions were positively correlated with perceptions with the message strategy and with the celebrity endorsement and with the involvement factors

N′-(4-Fluoro­benzyl­idene)-2-(4-fluoro­phen­yl)acetohydrazide

In the title compound, C15H12F2N2O, the dihedral angle between the two benzene rings is 48.73 (8)°. The hydrazine group is twisted slightly, with a C—N—N—C torsion angle of 172.48 (12)°. In the crystal, mol­ecules are connected by strong N—H⋯O and weak C—H⋯O hydrogen bonds, forming supra­molecular chains along the c axis. The structure is consolidated by π–π [centroid–centroid separation = 3.6579 (10) Å] and C—H⋯π inter­actions