Maternal and perinatal outcomes in women with first trimester vaginal bleeding

Background: First trimester bleeding is one of the common complications during pregnancy which affects almost 16-25% of all pregnancies. To evaluate and ascertain the adverse maternal and perinatal outcomes in pregnant women presenting with first trimester vaginal bleeding.Methods: Prospective case-control study. A case control study involving 60 pregnant women with vaginal bleeding in the first 13 weeks + 6 days of gestational age with 60 matched controls. The study period was from March 2015 to March 2016 and conducted at PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu.Results: The complications seen in the study group were: first trimester abortion (16.7%), second trimester abortion (6.7%), preterm labour (25%), abruption (6.7%), neonatal intensive care admission (25%), ectopic (6.7%), IUGR (10%), IUD (1.7%) and PROM (8.3%). When compared with the parity matched controls there was statistically significant increase in first and second trimester abortions, preterm labour, abruption, NICU admission and ectopic pregnancy whereas there was no significant difference between the two groups with regard to intrauterine growth restriction (IUGR) and intrauterine death (IUD).Conclusions: Women with first trimester vaginal bleeding had several adverse outcomes in both the mother and the fetus, and it is very important to explain about the possibility of these outcomes and ensure proper follow up with close antenatal surveillance

Maternal and Perinatal Outcomes in Pregnant Women with First Trimester Vaginal Bleeding

INTRODUCTION : In the field of obstetrics and gynecology, a health care provider will come across many patients with bleeding per vaginum who are not aware of their pregnancy status. Any female patient with vaginal bleeding in reproductive age group show be evaluated for possibility of pregnancy. Hence a better knowledge about the consequences following first trimester bleeding in the ongoing pregnancy is very important for the obstetricians and the mother. In this prospective study we evaluated these women and had a complete follow up throughout their pregnancies and the various adverse effects on the mother and the fetus was studied, as there was no studies publishing the obstetrical and fetal outcomes following threatened miscarriage in south Indian population as far as our knowledge. AIM : To study the maternal and perinatal outcomes in pregnant women presenting with first trimester vaginal bleeding. INCLUSION CRITERIA : - All pregnant women presenting with first trimester vaginal bleeding EXCLUSION CRITERIA : - Multiple pregnancies - Bad obstetric history - Women with congenital uterine abnormality - Known case of any bleeding disorders - Women with chronic medical complications including diabetes and hypertension. EVALUATION PLAN : All pregnant women (chemically proven UPT-+) attending antenatal clinic with first trimester vaginal bleeding (<12weeks) will be included in this study. The eligible subjects are explained about the study and after getting consent they are put under surveillance till they deliver. Sonography was performed for all women as routine. The women should attend the clinic once a month during 6 months of pregnancy, once in two weeks during 7th and 8th month and weekly in the last month of pregnancy, the collected data will be analyzed and the important findings of the study will be highlighted. CONCLUSION : Our study provides a good evidence that spotting or light bleeding per vaginum, without pain abdomen , do not increases the risk of any miscarriage . Considering the outcome of my study, the symptom of first trimester vaginal bleeding has several adverse outcomes of both the mother and the fetuses, and it is very important to explain about these outcomes and ensure proper follow up with close care antenatal checkups. Further, the intervention by the clinicians has an important role in not only helping the women to continue the pregnancy but also help in reducing the maternal and fetal complications in the high risk pregnancies. Hence a precise treatment and planning is very essential by the physicians

Development and Validation of New RP-HPLC Method for the Simultaneous Determination of Codeine Phosphate and Triprolidine Hydrochloride in Cough Syrup Formulation

Codeine phosphate is an opioid analgesic which binds with stereo specific receptors at many sites within the CNS to alter processes affecting both the perception of pain and the emotional response to pain. There are multiple sub types of opioid receptors, each mediating various therapeutic and/or side effects of drugs. Codeine has about one-sixth the analgesic activity of morphine. Codeine is readily absorbed from the gastro-intestinal tract and metabolized by O-and N-demethylation in the liver to morphine and nor codeine which with codeine are excreted almost entirely by the kidney, mainly as conjugates with glucuronic acid. Most of the excretion products appear in the urine within 6 hours and 40 to 60 percent of the codeine is excreted free or conjugated, approximately 5 to 15 percent as free and conjugated morphine and about 10 to 20 percent as free and conjugated norcodeine. AIMS AND OBJECTIVES: 1. Codeine phosphate and Triprolideine hydrochloride combination is an Antitussive, Analgesic and Antagonist of the H1 histamine receptor. Codeine phosphate is often sold in combination with other ingredients such as in many cough analgesic medications. 2. Codeine phosphate is an opioid analgesic which binds with stereo specific receptor at many sites within the CNS to alter processes affecting both the perception of pain and the emotional response. Triprolidine hydrochloride binds to the histamine H1 receptor. 3. Codeine phosphate and Triprolidine hydrochloride are official in the Indian Pharmacopoeia from the literature survey. It was found that there were only few RP-HPLC methods reported for the Simultaneous determination of content of Codeine phosphate and Triprolidine hydrochloride in cough syrup formulation. Hence, the main aims and objectives of the present work is to develop new RP-HPLC method for the Simultaneous determination of content of Codeine phosphate and Triprolidine hydrochloride in cough syrup formulation and to validate for the developed method by validated parameters (as per ICH guidelines) like System suitability, Accuracy, Precision, Specificity, Linearity, Robustness and Ruggedness. CONCLUSION: Development of new analytical methods for the determination of drugs in pharmaceutical dosage forms is more important in pharmacokinetic, toxicological and biological studies. Today pharmaceutical analysis entails much more than the analysis of active pharmaceutical ingredients or the formulated product. The pharmaceutical industry is under increased scrutiny from the government and the public interested groups to contain costs and at consistently deliver to market safe, efficacious product that fulfill unmet medical needs. • The pharmaceutical analyst plays a major role in assuring identity, safety, efficacy, purity and quality of a drug product. The need for pharmaceutical analysis is driven largely by regulatory requirements. The commonly used tests of pharmaceutical analysis generally entail compendia testing method development, setting specifications and method validation. • Analytical testing is one of the more interesting ways for scientists to take part in quality process by providing actual data on the identity, content and purity of the drug products. New methods are now being developed with a great deal of consideration to worldwide harmonization. As a result, new products can be assured to have comparable quality and can be brought to international markets faster. • In the present study a new RP-HPLC method was developed for the simultaneous determination of Codeine phosphate (CP) and Triprolidine hydrochloride (TH) in cough syrup formulation. A sample preparation is very simple and the analysis time is short. • The analysis is resolved by using an Inersustain C18 (250 x 4.6 mm, 5μ) column, in isocratic mode, with mobile phase containing buffer (pH 3.0 with Orthophosphoric acid) and methanol in the final ratio of 55:45 v/v was used. The flow rate was 1.0 ml/min and the analyte was monitored at 280 nm. The retention time for Codeine phosphate and Triprolidine hydrochloride were about 2.8 min. and 12.4 min. respectively

Morphometric and Radiological study of Proximal Femur

INTRODUCTION: The Femur is the strongest bone in human body. Fractures of proximal femur involving neck and trochanters are common in orthopaedic surgical practice. Elderly patients need surgical interventions to avoid complications of prolonged bedridden. The aim of the operation is to restore the normal anatomy as far as possible. The implants used in surgeries are designed to match the dimensions of proximal femur. The dimensions described are based on studies in the western population which might be different from those of the Indians. AIM OF THE STUDY: The present study was aimed at analysing the proximal femur in morphometric and radiological aspect. MATERIALS AND METHODS: Hundred adult human dry femora from the Institute of Anatomy, Madras Medical College and fifty X-ray films of hip joint, fifty CT scans of hip joint from the archives of Barnard Institute of Radiology, Rajiv Gandhi Government General Hospital, Chennai were used for the study. RESULTS: In the present study mean Femoral head diameter was 43.32mm+/-3.202 in dry bone, 44.08mm+/-3.87 in X-ray films, 39.62mm+/-3.057 in CT films, mean Width of Femoral Neck 29.99mm+/-3.40 in dry bone, 30.90mm+/-3.51 in X-ray films, 30.96mm+/-4.52 in CT films, mean Femoral Neck Length 36.046mm+/-3.432 in dry bone, 30.76mm+/-6.27 in X-ray films 33.31mm+/-5.59 in CT films. The mean Femoral Neck Shaft Angle 129.29°+/-5.89 in dry bone, 130.54°+/-5.52 in X-ray films, 132.53°+/-5.345 in CT films. Mean Angle of Anteversion in dry bone 13.17°+/-5.57. Incidence of Retroversion noted in 7% of femora and incidence of Neutral version in 2%. CONCLUSION: Proper sizing and placement of the prosthetic components are crucial to the success and long-term survival after replacement. This study will be useful for Biomechanical engineers who will design the Hip Replacement prosthesis and also for Orthopaedicians and Radiologists

Comparative outcome and recurrence in double pterygium surgery – amniotic membrane graft vs conjunctival autograft

AIM OF THE STUDY: To compare the clinical results of conjunctival autograft and amniotic membrane transplantation after double pterygium excision. We also compared the final cosmetic outcome of these two techniques in an effort to determine whether amniotic membrane transplantation yields acceptable cosmetic results as conjunctival autografting in pterygium surgery. STUDY DESIGN: Prospective interventional double masked randomised controlled clinical trial. MATERIALS AND METHODS: Patients who came to Aravind Eye Hospital with double pterygium were assessed. A total of 31 patients were included in the study. Recruitment period was from October 2011 to March 2012. After pre-operative assessment is over, the patients are randomly assigned into any of the following two groups. Group – A: Double Pterygium excision with Amniotic Membrane on Nasal side and Conjunctival Autograft on Temporal side. Group – B: Double Pterygium excision with Amniotic Membrane on Temporal side and Conjunctival Autograft on Nasal side. On first post operative day, patients were examined and started on steroid antibiotic eye drops 4 times a day for 3 weeks. Follow up visits were 3rd week, 3rd month, 6th month and 12th month. RESULTS: Out of 31 patients (Group A -15, Group B -16), 8 patients (25.8%) had recurrence. Among them, 4 patients (50%) belong to Group A and 4 patients (50%) belong to Group B. All the 8 recurrences were on the side of amniotic membrane. DICUSSION: Although successful results have been reported with the CAT technique, this technique has 2 important limitations: It is difficult to close the large conjunctival defects, and there is a need to reserve conjunctiva for glaucoma surgery with a filtering bleb (which may be required in the future). Moreover, in cases where the conjunctiva is scarred from previous surgery for pterygium, alternative surgical techniques must be used. These problems necessitate the use of the amniotic membrane in pterygium surgery. Besides a lack of potential disadvantages associated with CAT, it is suggested that it has anti inflammatory effects and reduces scar formation; both of which act to decrease pterygium recurrence. Owing to these properties of the amniotic membrane, it is a favourable alternative technique to CAT for pterygium surgery. CONCLUSION: Although it was proven that conjunctival graft was better than amniotic graft, amniotic graft would be of great use in double pterygium, glaucoma patients where conjunctiva has to be preserved and in casesof subconjunctival fibrosis

Method Development and Validation of Dexibuprofen for Related Substances in Tablet Dosage form by Reverse Phase High Performance Liquid Chromatography.

The present study exhaustive literature survey revealed that none of the most recognized pharmacopoeias or any journals includes the determination of related substances of Dexibuprofen. So it is felt essential to develop a liquid chromatographic procedure which will serve a reliable, accurate, sensitive, and stability indicating method for the simultaneous determination of related substances of Dexibuprofen from tablets. To develop and validate stability indicating related substances analytical method for the Dexibuprofen tablets using HPLC. In this project, a high versatile HPLC was used for estimation of related substances of dexibuprofen in tablets. The separation was achieved by using Waters symmetry column with acetonitrile and ortho phosphoric acid as mobile phase. The retention time was 30.6 min for dexibuprofen at 214 nm. The system suitability parameters like Relative standard deviation, Resolution, Theoretical plate count were determined and found to be in acceptance limit. A stability study was carried out with an efficient HPLC method for the quantification of related substances of Dexibuprofen in tablets was developed and validated. The present study was validated as per the ICH guidelines. Validation experiments proved that the HPLC analytical method is linear in the range of 40 μg/ml as well as accurate, precise (repeatability and intermediate precision levels) and specific, being able to separate the main drug from its degradation products. The proposed method was also found to be robust with respect to flow rate, column oven temperature and composition of mobile phase. Due to these characteristics, the method has stability indicating properties being fit for its intended purpose, it may find application for the routine analysis of the related substances of Dexibuprofen in tablets

Study on the reproductive behavior among women of rural areas of Pondicherry

Background: The fertility rate in India is declining and it is necessary to know the factors responsible for such decline in different states. It was decided to study reproductive behavior of women contributing to decline in fertility in Pondicherry. The aim and objective of this study is known the reproductive behavior of women in the rural areas on Pondicherry.Methods: Sample of 300 married women aged between 30 and 60 years were selected randomly from village belonging to Katerikuppam PHC and the data collected using the pre tested semi open ended questionnaires by interviewing the subjects at their doorsteps during September to November 2014.Results: The mean age of the subjects was 41.5 ± 9.5 years. There were 793 total pregnancies and live births were 701 and abortions accounted for ten percent and still births were 9 in number. The mean number of pregnancies and live births were 2.6 ± 1.1 and 2.3 ± 1.0 per women respectively. The mean age at menarche, marriage and first pregnancy were 14.3 ± 1.4, 19.6 ± 3.1 and 21.1 ± 3.1 years respectively. The mean number of pregnancies were declined from currently older age to the lower age of the subjects and found to be statistically significant.Conclusions: The mean age at marriage and first pregnancy is increasing and the differences in the mean number of pregnancies and live births are showing declining trend.

Response of flower quality and physiological characters of Jasminum sambac (L.) to modified planting system and pruning schedule

Increasing planting density in Jasminum sambac (L.) is a recent trend among farmers and an effective strategy for improving flower productivity without affecting the standard of flower buds. This study aimed to establish the effect of varied plant density with different pruning levels on the flower quality during off, peak and lean seasons in J. sambac during 2021-‘22. The treatments comprised of four levels of plant density viz., D1- one plant pit-1 (control), D2 - two plants pit-1, D3 - three plants pit-1, D4 - four plants pit-1 and two levels of pruning viz., P1 - one pruning year-1(control), P2 - two prunings  year-1. The trial was laid out in Factorial Randomized Block Design (FRBD) with three replications. The important traits on flower quality parameters namely the total length of the flower bud, length of the flower bud without corolla tube and corolla tube length, were influenced significantly (P&lt;0.05) by three plants pit-1 (D3) and two prunings year-1 (P2). But there was no interaction effect between plant density and pruning frequency for these flower quality parameters. The interaction effect was also significantly (P&lt;0.05) influenced by the physiological and biochemical traits, namely chlorophyll content, total phenol content, soluble protein and Indole Acetic Acid (IAA) oxidase activity. The pooled analysis data of the treatment T6 (D3P2) was found superior due to increased plant density combined with alteration in pruning. This performed better with enhanced number of new shoots and produced good quality flower buds through enhancement of physiological activity in all three seasons (off, peak and lean) when compared to conventional planting T1 (D1P1) method

The effect of light, temperature, ph on stability of anthocyanin pigments in Musa acuminata bract

The anthocyanin pigment was extracted from Musa acuminata bract using the acidified methanol. The extracted anthocyanin pigments then were exposed to number of environmental conditions, which could destabilize the anthocyanin molecules. These environmental conditions were included fourteen different pHs, various temperatures and presence or absence of light. The temperature stability of the anthocyanin extract was calculated by reaction velocity constants (k) as well as the half-life time (t1/2). The results of the study showed that increasing in pH, temperature or exposure to light is able to spoil the anthocyanin molecule. Copigmentation of anthocyanin resulting in increase in both hypochromic effects and bathochromic shifts. Musa acuminata bract anthocyanin extract was more stable at pH 5.1 and 6.0, temperature at 20° C and 30° C both in the presence and absence of light. This characteristic differs from other anthocyanins. This property could facilitate its application as a natural food colorant

A Novel Attack Graph Approach For Attack Detection And Prevention Using Nice

DDoS attacks usually take up early stage actions such as multi-step exploitation, low frequency vulnerability scanning and compromising identified vulnerable virtual machines as zombies and lastly DDoS attacks through the compromised zombies. Within the cloud system particularly the Infrastructure-as-a-Service (IaaS) clouds the detection of zombie study attacks is extremely hard. This is for the reason that cloud users may set up vulnerable applications on their virtual machines. To prevent susceptible virtual machines from being compromised in the cloud we propose a multi-phase distributed vulnerability detection, measurement and countermeasure selection method called NICE which is built on attack graph based on analytical models and reconfigurable virtual network-based countermeasures.