Safety of vaginal birth after single previous lower segment caesarean: a retrospective analysis of 200 cases

Background: Vaginal birth after Caesarean delivery (VBAC) has long been proposed as a viable measure to reduce overall Caesarean delivery rates. The objective of present study was to assess predictive factors and to study outcome of pregnancy in women with one previous lower segment caesarean section underwent trial of scar, in author’s hospital setting.Methods: This retrospective analysis of 200 pregnant women with one previous lower segment caesarean section underwent trial of scar, was carried out over a period of one year, in department of Obstetrics and Gynaecology, Gajra Raja Medical College, Gwalior (M.P.). The maternal and neonatal data and data concerning the course of delivery were reviewed and subjected to statistical analysis.Results: The success rate of VBAC was 36%. Young maternal age, gestational age <40 weeks, neonate birth weight 2.5-3 kg, admission in active phase of labor, previous caesarean for malpresentation, meconium stained liquor and fetal distress, were associated with successful VBAC. The commonest indication of repeat caesarean section was non-progress of labor in 34.37% women. Admission rate to neonatal intensive care unit was less in VBAC (2.77%) than in repeat caesarean section group (7.03%). There was one case of uterine rupture. There were 3 perinatal deaths and no maternal deaths.Conclusions: Women with a prior caesarean section are at increased risk of subsequent caesarean. Vaginal birth after caesarean should be encouraged in selected cases to reduce the risks of repeated caesarean sections. However, in the event of a failed trial, there is a definite increase in neonatal and maternal morbidity which is also reflected in our study

Uterine tamponade using condom catheter balloon in the management of non-traumatic postpartum hemorrhage

Background: In low-resource countries, Postpartum Hemorrhage (PPH) is the leading cause of maternal mortality. The intrauterine balloon tamponade was recently incorporated into the strategy to manage uterine atony. There are many types of tamponades. Among them, the condom catheter seems to be an efficient and economic intervention for the treatment of PPH in low-resource countries. The aim of present study was to evaluate the effectiveness of the condom catheter balloon in treating postpartum hemorrhage refractory to medical treatment.Methods: The retrospective analysis of 22 cases of PPH, treated with a condom catheter as a conservative therapeutic option, was done in department of Obstetrics and Gynaecology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India.Results: The condom catheter was successful in controlling PPH in 90.9% cases. It was effective in 94.44% women with uterine atony, who did not respond to uterotonic drugs. It was also effective in one case of placental implantation site bleeding and two cases of deranged coagulation function. In 2 cases it failed to control PPH and peripartum hysterectomy was done. The volume of saline solution used to fill the balloon was from 150 -350 ml and the time for which the balloon remained inflated was 36-48 hours. No case of febrile morbidity and wound sepsis was noted. There was no maternal death.Conclusions: Its ease of use and high effectiveness make condom catheter a useful approach for the conservative management of PPH. This device reduces bleeding, shortens the hospital stay and avoids the need for more aggressive procedures

Maternal and perinatal outcomes in eclampsia: a retrospective analysis in a referral hospital

Background: Eclampsia is defined as the development of convulsions and / or unexplained coma during pregnancy or postpartum in patients with signs and symptoms of preeclampsia. The objective of present study was to investigate the incidence of eclampsia, the clinical profile, maternal and perinatal outcomes in eclamptic patients in our hospital setting.Methods: The retrospective analysis of case records of all eclampsia cases was done over a period of one year, in department of Obstetrics and Gynaecology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India.Results: The incidence of eclampsia was13.04/1000 deliveries. Eclampsia was more common in the age group 20-24 years (55.64%), primigravidae (62.90%) and patients from rural areas (76.61%). Majority (91%) of women were referred from different hospitals. 112 (90.32%) patients were unbooked. 74 (59.67%) patients developed eclampsia during antenatal period before onset of labor. 67.01% patients presented at gestational age &gt; 37 weeks. Lower segment caesarean section was the predominant mode of delivery in 66 (68.04%) patients. 11.29% patients required ventilatory support and pulmonary edema developed in 4.83% of cases. Maternal death occurred in 7.25% of cases.with a case fatality rate of 16.07%. Pulmonary edema was the commonest cause of death. 7 (5.6%) patients presented with intrauterine death on admission. There were 5 (4.06%) perinatal deaths reported in present study.Conclusions: Eclampsia is still a common and serious complication of pregnancy. Proper antenatal care, detection of preeclampsia with early management and timely referral of high - risk patients, administration of MgSO4 in correct doses and properly timed caesarean section in selected cases would reduce the incidence of eclampsia associated maternal and perinatal morbidity and mortality in our facility

Torsion in a massive hematosalpinx with a functional rudimentary horn: a rare cause of acute abdomen in adolescence, managed laparoscopically

Congenital anomalies of the female genital tract may remain undiagnosed till adolescence. Unicornuate uterus with a rudimentary horn is rare and found in 1 in 100000 women. A functional rudimentary horn may cause hematometra, hematosalpinx, endometriosis and its complications. This is a case of a 13-year-old girl who had a hematometra in a functional rudimentary horn and a hematosalpinx with torsion giving rise to an acute abdomen and a 16-week mass abdomen. Laparoscopy was done followed by detorsion, salpingectomy and transection of the rudimentary horn. This article should sensitize the need to correct the anomaly while preserving the reproductive potential of the girl. A review of the salient points of laparoscopy in such cases have been further discussed

The Classical Sumudu Transform and its q-Image of the Most Generalized Hypergeometric and Wright-Type Hypergeometric Functions

The q- Calculus has served as a bridge between mathematics and physics, particularly in case of quantum physics. The q-generalizations of mathematical concepts like Laplace, Fourier and Sumudu transforms, Hypergeometric functions etc. can be advantageously used in solution of various problems arising in the field of physical and engineering sciences. The q-Sumudu transform, the q-image of classical Sumudu transform is the theoretical dual of the q-Laplace transform. In view of this, the present paper deals with some of the important applications of classical Sumudu and q-Sumudu transform of generalized hypergeometric function and Wright-type hypergeometric function. The results have been presented in terms of well-known Fox’s H-function. Some special cases have also been discussed

ChemTextMiner: An open source tool kit for mining medical literature abstracts

Text mining involves recognizing patterns from a wealth of information hidden latent in unstructured text and deducing explicit relationships among data entities by using data mining tools. Text mining of Biomedical literature is essential for building biological network connecting genes, proteins, drugs, therapeutic categories, side effects etc. related to diseases of interest. We present an approach for textmining biomedical literature mostly in terms of not so obvious hidden relationships and build biological network applied for the textmining of important human diseases like MTB, Malaria, Alzheimer and Diabetes. The methods, tools and data used for building biological networks using a distributed computing environment previously used for ChemXtreme[1] and ChemStar[2] applications are also described

Antioxidant activity and total phenolic content of various extracts from Mimosa hamata Willd., Mimosaceae

Jinjani (Mimosa hamata Willd., Mimosaceae) is widely distributed in India and Pakistan, which contains several interesting bioactive constituents and possesses health promoting properties. In this study, the antioxidant activity with the total phenolic content of different successive extracts (pet. ether, chloroform, n-butanol and water) from leaves, stem, root and seeds of M. hamata were assessed in an effort to compare and validate the antioxidant potential of the particular part of the plant. The antioxidant activity was determined by 2, 2- Diphenyl-1-picrylhydrazyl (DPPH) assay and total phenolic content was estimated by using Folin-Ciocalteu’s reagent. All tested extracts possessed appreciable antioxidant potential but n-butanol extract of roots was significantly higher in total phenolic content (73.16±0.19 mg GAE/g extract) and in antioxidant assay (IC50 = 5µg/ml). It is also noteworthy that in n-butanol extract of roots higher yield (85.60%) was also observed. This study validates the antioxidant potential of the roots in M. hamata and the positive relationship between total phenolic content and antioxidant activity

ASSOCIATION AND CORRELATION OF MEAN PLATELET VOLUME AND PLATELET COUNT IN ACUTE ISCHEMIC STROKE

Objective: Role of platelets in the pathogenesis of the atherothrombosis and ischemic stroke has been documented. Mean platelet volume (MPV) and platelet count (PC) could be important predictors of acute ischemic stroke (AIS), its severity; therefore we investigated the correlation of MPV &amp; PC in AIS patients. Methods: We studied MPV and PC of 52 AIS patients consecutively admitted in Neurology department at Geetanjali Medical University, India. Platelet variables were measured and compared with control of similar age, sex and without vascular events. Results: Out of 52 patients, 30 (57.69%) had Thirty (57.69%) patients had significantly higher MPV in AIS group (12.45fL compared with normal range of 6–11 fL in control,p&lt;0.001). No significant differences were found between male and females, but the total mean was elevated. The mean of PC was 1.76×105 cells/cumm (normal range) and there was no correlation between the change in PC and AIS in both sexes. Repeated measurements of MPV and PC were also recorded on follow-up which showed no significant changes from the acute phase; however, MPV remained elevated. The comparison of MPV in patients with mRS score 2 versus 4, 2 versus 5, 3 versus 4 and 5, and 4 versus 5 were found to be statistically significant (p&lt;0.05). Conclusion: Increased MPV has an independent association with AIS and its severity and it could not change after acute treatment. It is possible that these changes precede the vascular event, and further studies are warranted to unravel the underlying mechanism

Sirenomelia-the mermaid syndrome: a rare invariably fatal congenital anomaly in a term unsupervised pregnancy

Sirenomelia is a rare congenital anomaly with an incidence of 0.8 to 1 case per 1,00,000 births. The prognosis is grim due to associated genitourinary and gastrointestinal anomalies. Antenatal registration in the first trimester and timely ultrasound go a long way in detection of the anamoly when termination can be still be offered and the mental agony of giving birth to a term neonate with a fatal congenital anomaly can be avoided.