4 research outputs found
A study on seroprevalence of HIV among women attending obstetric care in a tertiary care hospital of South India with maternal and perinatal outcomes
Background: HIV is prevalent in epidemic proportions in India. Identifying the target population and effective intervention reduces chances of vertical transmission and new infection. Authors studied the seroprevalence of HIV among women attending obstetric care in a tertiary care hospital of South India and associated maternal and perinatal outcomes among seropositive women.Methods: Retrospective descriptive study of all women who were screened for HIV at Integrated Counselling and Testing Centre, Vani Vilas hospital, from January 2014 to December 2017 in their antenatal, intranatal and postnatal period. Demographic data of seropositive women, obstetric outcomes and status of children at 18months were obtained.Results: Of the 35,455 women who were screened, 0.28% were found positive for HIV. Percentage prevalence of HIV was highest in 2014 (0.32%). Majority of the seroprevalence belonged to age group of 25-29 years (44%), 32% illiterates, 82% homemakers and 79% belonged to urban areas. Unknown partner status in 22% and majority were diagnosed in antenatal period (66%). Of them 82% had favourable CD4 count. 74 % of them delivered live baby. Three maternal deaths were observed and anaemia (65%) was the major associated co-morbidity. Vaginal route was common mode of delivery (84%). Thirteen babies required NICU admission and 6 neonates deaths were encountered. Exclusive breastfeeding was practised in 91% of live births. 62% of children were found seronegative at 18 months follow up.Conclusions: Authors observed with adequate treatment to mother and prophylaxis to the baby, the burden of vertical transmission can be significantly reduced
A study of outcome of induction of labour with foley’s balloon in previous LSCS cases
Background: Induction of labour in a scarred uterus is a controversial topic in Obstetric practice, but in carefully selected and monitored cases never the less the outcome is gratifying. When the baby is non-salvageable, or in cases of IUFD, it is always desirable to achieve a vaginal delivery. Many of the professional organizations recommend induction of labour in previous LSCS. Thus, this study was done to evaluate the success rate, determinants of failure and complications of induction of labour with foley’s catheter in patients with previous 1 LSCS.Methods: 62 patients were recruited over a period of 1 year and studied at Vani Vilas Hospital, Bangalore Medical College and Research Institute, all with previous 1 LSCS. 34% of them were with past h/o 1 or more vaginal delivery. 8% were term pregnancies, 64% were between 28-32 weeks. Induction was done for IUFD in 56% and, HDP warranting termination in 44%. Induction done with Foley’s catheter, expulsion of catheter with filled bulb and uterine contraction initiation was taken as successful induction. The patient profile in cases of failure was noted.Results: 83% was the success rate for induction out of which 30% cases required additional PGE2 gel. Oxytocin and ARM alone or together were used for augmentation in 90% cases. Induction to foley’s expulsion average duration was 14 hours. Post expulsion delivery happened at an average time interval of 5 hours. One patient had rupture uterus during the course of augmentation.Conclusions: Induction can be done safely in carefully selected cases of previous LSCS with Foley’s Balloon
A study on seroprevalence of HIV among women attending obstetric care in a tertiary care hospital of South India with maternal and perinatal outcomes
Background: HIV is prevalent in epidemic proportions in India. Identifying the target population and effective intervention reduces chances of vertical transmission and new infection. Authors studied the seroprevalence of HIV among women attending obstetric care in a tertiary care hospital of South India and associated maternal and perinatal outcomes among seropositive women.Methods: Retrospective descriptive study of all women who were screened for HIV at Integrated Counselling and Testing Centre, Vani Vilas hospital, from January 2014 to December 2017 in their antenatal, intranatal and postnatal period. Demographic data of seropositive women, obstetric outcomes and status of children at 18months were obtained.Results: Of the 35,455 women who were screened, 0.28% were found positive for HIV. Percentage prevalence of HIV was highest in 2014 (0.32%). Majority of the seroprevalence belonged to age group of 25-29 years (44%), 32% illiterates, 82% homemakers and 79% belonged to urban areas. Unknown partner status in 22% and majority were diagnosed in antenatal period (66%). Of them 82% had favourable CD4 count. 74 % of them delivered live baby. Three maternal deaths were observed and anaemia (65%) was the major associated co-morbidity. Vaginal route was common mode of delivery (84%). Thirteen babies required NICU admission and 6 neonates deaths were encountered. Exclusive breastfeeding was practised in 91% of live births. 62% of children were found seronegative at 18 months follow up.Conclusions: Authors observed with adequate treatment to mother and prophylaxis to the baby, the burden of vertical transmission can be significantly reduced
Impaired mobility drives disability in psoriatic arthritis – An observational study from Karnataka Psoriatic Arthritis Cohort (KPsAC)
Introduction: Psoriatic arthritis (PsA) is a chronic inflammatory disease with significant functional impairment. Health Assessment Questionnaire-Disability Index (HAQ-DI) is a reliable and validated outcome measure for a variety of arthritides including PsA.
Objective: The objective of this study was to assess the disability as an outcome measure in PsA using the Indian version of HAQ (I-HAQ).
Methods: The I-HAQ was administered to PsA patients diagnosed as per the Classification Criteria for PsA. The I-HAQ comprises 12 questions (nine basic and three advanced activities of daily living (ADLs), on the standard HAQ format) relevant to the Indian population.
Results: In the 549 participants, the mean I-HAQ was 0.31 (0.45) and 48.2% had mild-to-moderate disability (I-HAQ>0–1). Female gender, older age, higher skin, joint scores, and Disease Activity Index for PsA were associated with some disability (I-HAQ>0). Symmetric polyarthritis (0.34) and spondyloarthritis (0.32) had a significantly higher disability compared to other subsets. Analyzing the individual questions of I-HAQ, squatting in the toilet or sitting cross-legged on the floor (r = 0.78), walking 3 km (r = 0.77), and climbing a flight of stairs (r = 0.74) correlated maximally to the total I-HAQ. ADL which was affected most frequently was “climbing a flight of stairs.” I-HAQ was significantly lower in patients who had been on disease-modifying antirheumatic drugs for 6 months or more (P = 0.0001).
Conclusions: The Indian version of HAQ-DI could be efficiently employed to assess outcomes in our cohort. Nearly half of the cohort had mild-to-moderate disability suggesting a high burden of inflammation. Higher joint activity scores are strongly associated with disability