Meconium stained liquor and fetal outcome: a hospital based follow up study

Background: Meconium staining of the amniotic fluid is a common problem occurring in 10-22% of all deliveries. Meconium aspiration syndrome complicates approximately 1.5% of these deliveries with a reported mortality rate as high as 40%. Objectives of the study were to determine whether meconium stained liquor during labour is associated with fetal distress and to check if there is any correlation in between the degree of meconium staining liquor and fetal outcome.Methods: A clinical study of 200 cases of meconium stained amniotic fluid in cephalic presentation was undertaken among patients who were admitted in labour room were examined in detail and investigations were done. Fetal heart rate and its pattern were noted every fifteen min. Total APGAR score at one minute and five minute was noted down. Odds ratio with 95% confidence interval was calculated. Proportions were analyzed using chi square value.Results: Majority of the study subjects belonged to the age group of 21-30 years. Majority i.e. 54.5% were multigravida. Majority had toxemia in 24% of the cases. Fetal distress and the incidence of forceps delivery or LSCS was significantly more in those with thick meconium compared to those with thin meconium (p<0.05). But fetal asphyxia was not associated with type of stained meconium. It is seen that as the duration of the meconium staining increased, the proportion of babies with low APGAR score, perinatal mortality and morbidity increased.Conclusions: Thick meconium stained amniotic fluid was associated with increased rate of interventions, neonatal morbidity and mortality compared to thin meconium stained meconium fluid

The ‘Stigma’ of Paid Work: Capital, State, Patriarchy and Women Fish Workers in South India

This paper explores the changing dynamics of women’s labor in a Muslim fishing village in the South Indian state of Kerala in the back drop of two global processes viz., state-initiated capitalist modernization of the fisheries sector and state-sponsored livelihood promotion programs. It traces the shifting contexts in which Muslim fisherwomen, alternately, engaged in and disengaged from, paid work outside the household and shows how women experienced different kinds of paid work, as self-employed fish vendors and wage earners of employment guarantee schemes. Changes in women’s labor force participation were mediated by the social institutions of family and religion, community patriarchies and ideologies of female domesticity and the state’s endeavors to constitute women as entrepreneurial actors who take responsibility for the economic well-being of their households. The paper maps women’s struggles to secure and retain paid work in the face of a resurgent domestic feminine ideal and its zealous defenders in their village

Determinants of anemia among pregnant women: A hospital based cross sectional study

Background: The objective was to study the determinants of anemia among pregnant women. There is a negative effect on the health of the mother and as well as that of the child due to anemia in women with pregnancy. Death rate is more in women who are pregnant and having anemia. The objective of this study was to study the determinants of anemia among pregnant women.Methods: A hospital based cross sectional study was carried out among 40 pregnant women over a period of six months. Demographic data like age, residence, occupation etc was recorded. Obstetric data like gravida, parity, previous LSCS was also recorded. The data was presented as means and student’s t test was applied.Results: The mean age was 23.43±3.4 years. Majority were young between the ages of 19-22 years. Majority belonged to urban residents i.e. 57.5%. 20% of the subjects were found to be illiterate. Majority of the mothers were housewives i.e. 82.5%. Majority were multi-gravida i.e. 60%. Majority had no history of abortions in the past i.e. 75%. Out of total 19 repeat pregnancies, majority i.e. 84.2% had lower segment cesarean section. Majority reported that they had normal menstrual history. The mean hemoglobin level was found out to be 7.94 gm/dl. It was found that the mean hemoglobin level did not differ significantly across age, residence, education, occupation, gravidity, history of abortions, type of delivery but differed significantly by abnormal menstrual cycle.Conclusions: Mean hemoglobin level was more in women with normal menstrual history compared to those women with abnormal menstrual history and this difference was found out to be statistically significant. Hence abnormal menses should be promptly treated, hemoglobin assessed

Maternal morbidity in emergency lower segment cesarean section

Background: With a steep fall in maternal mortality and morbidity and with much more liberalization of indications, the incidence of cesarean section rate has greatly increased over the last thirty years and almost doubled in the current decade. The objective of this study was to study incidence of maternal morbidity in emergency lower segment cesarean section.Methods: Hospital based prospective study was carried out among 200 women undergoing emergency lower segment cesarean section. Data relating to demographic characteristics, clinical characteristics, maternal and fetal indications, incidence of morbidity, and types of morbidities, Intra operative complications, and Post operative complications was noted down. Chi square and odds ratio was used for statistical analysis.Results: The incidence of LSCS was 24.21%. Incidence of emergency LSCS was 96.74%. 71% were having primary LSCS and 20.5% were booked cases. The most common maternal indication for emergency LSCS was pregnancy induced hypertension and eclampsia in 32.5% of the cases. The most common fetal indication for emergency LSCS was fetal distress in 60%. Incidence of morbidity was 35% and it was associated with booking status, parity and social class. Incidence of intraoperative complications was 23.5%. Majority (18.5%) developed febrile morbidity followed by wound sepsis in 12.5%, urinary tract infection in 8%, mastitis in 7.5%, respiratory tract infection in 7%, wound gaping in 4%, paralytic ileus in 3%, endometritis in 2.5%, postpartum hemorrhage in 1.5%, 2 cases of burst abdomen and one case of small bowel obstruction.Conclusions: Emergency LSCS was more common than elective LSCS and it was associated with booking status, parity and social class

Pregnancy of unknown location: outcome in a tertiary care teaching hospital

Background: A pregnancy of unknown location (PUL) is a descriptive term used to classify a woman when she has a positive pregnancy test but no intra- or extra-uterine pregnancy is visualized on transvaginal sonography. The objective of present study was to find out the outcome of women with pregnancy of unknown location presenting to a tertiary care teaching hospital.Methods: The prospective study was conducted from from 1st October 2015 to 31st September 2016, to antenatal out-patient department, at Princess Esra Hospital, Deccan College of medical sciences, Hyderabad. Data was collected for women with early pregnancy or with history of amenorrhea, bleeding or pain. These women were investigated with serum beta-human chorionic gonadotrophin levels at interval of 48 hrs and transvaginal ultrasonography. Expectant management was done for failing pregnancy of unknown location while medical or surgical management was considered for persistent pregnancy of unknown location and ectopic pregnancy.Results: During study period, 9210 patients were admitted, and, of them, 960 (10.42%) were patients with early pregnancy. Meeting the inclusion criteria were 112 (11.6%) patients who formed the study sample. There were 104 (92.85%) patients presenting with amenorrhea, 98 (87.5%) had bleeding and 78 (69.64%) presented with pain. Outcome of 42 (48.83%) patients was failing pregnancy, 31 (36.04%) had intrauterine pregnancy, 8 (9.3%) converted to ectopic pregnancy, while 5 (5.81%) had persistent pregnancy of unknown location. All patients with persistent pregnancy of unknown location and 3 patients with ectopic pregnancy were medically treated. Three patients having an ectopic pregnancy were managed surgically.Conclusions: Management of choice for asymptomatic patients having pregnancy of unknown location is expectant management. Most of the patients suspected to have PUL resolved either into F-PUL or IUP with expectant management

A clinical study of ectopic pregnancy

Background: The diagnosis of an ectopic pregnancy is usually unexpected and is often emotionally traumatic. Many women may have only recently discovered they were pregnant when they receive the diagnosis. Some women diagnosed with an ectopic pregnancy do not even know they are pregnant and suddenly must think about the possibility of major surgery or medical treatment. The present study involves a study on all the cases of ectopic pregnancy who were admitted to the Princess Esra Hospital, Deccan College of medical sciences, Hyderabad during November 2014 to October 2015. The objectives of the study were, 1. To know the age group, gravidity, parity and the risk factors with respect to the ectopic pregnancy. 2. To know the clinical presentation of the ectopic pregnancy. 3. To know the outcome of the ectopic pregnancy.Methods: A total of 62 patients who were diagnosed as ectopic pregnancy cases were analyzed. All these cases were analyzed after applying the inclusion and exclusion criteria with respect to the 1. History. 2. Clinical presentation. 3. Investigations. 4. Treatment.Results: The incidence of the ectopic pregnancy in the present study was 1:380 pregnancies. A majority of the cases were multigravidas. Pain abdomen, amenorrhoea and bleeding per vagina in at least 50% of the cases. The tube was ruptured in almost 80% of the cases and there was a haemoperitoneum. Almost all the patients had intraoperative and/ or postoperative blood transfusions. There was no significant post operative morbidity in these cases.Conclusions: The early diagnosis of an ectopic pregnancy is one of the greatest challenges for a physician. It requires a high index of suspicion to diagnose an ectopic pregnancy. The importance of an early diagnosis lies in the fact that the lady can be offered a conservative line of management which can definitely have a beneficial effect on her reproductive career.

Amoxicillin induced toxic epidermal necrolysis

Toxic epidermal necrolysis (TEN) is a rare life-threatening adverse drug reaction associated with mucocutaneous eruptions and peeling of skin (sloughing) mostly caused by drugs like sulphonamides, beta lactams, carbamazepine and non-steroidal anti-inflammatory drugs (NSAIDs). Amoxicillin is a broad spectrum, bactericidal, Beta-lactam antibiotic used in treatment of various infections. Here by we have reported the case of amoxicillin induced severe toxic epidermal necrolysis. A Patient admitted in the hospital with the symptoms of epidermal sloughing that resulted in bare dermis as he received Amoxicillin drug for his diagnosis of fever. After clear examination TEN was confirmed and suspected with the cause due to Amoxicillin. The drug was stopped and patient was treated with other drugs for symptomatic cure. The patient was recovered from his condition and improved significantly

Uterine Endoplasmic Reticulum Stress and Its Unfolded Protein Response May Regulate Caspase 3 Activation in the Pregnant Mouse Uterus

We have previously proposed that uterine caspase-3 may modulate uterine contractility in a gestationally regulated fashion. The objective of this study was to determine the mechanism by which uterine caspase-3 is activated and consequently controlled in the pregnant uterus across gestation. Utilizing the mouse uterus as our gestational model we examined the intrinsic and extrinsic apoptotic signaling pathways and the endoplasmic reticulum stress response as potential activators of uterine caspase-3 at the transcriptional and translational level. Our study revealed robust activation of the uterine myocyte endoplasmic reticulum stress response and its adaptive unfolded protein response during pregnancy coinciding respectively with increased uterine caspase-3 activity and its withdrawal to term. In contrast the intrinsic and extrinsic apoptotic signaling pathways remained inactive across gestation. We speculate that physiological stimuli experienced by the pregnant uterus likely potentiates the uterine myocyte endoplasmic reticulum stress response resulting in elevated caspase-3 activation, which is isolated to the pregnant mouse myometrium. However as term approaches, activation of an elevated adaptive unfolded protein response acts to limit the endoplasmic reticulum stress response inhibiting caspase-3 resulting in its decline towards term. We speculate that these events have the capacity to regulate gestational length in a caspase-3 dependent manne

The purification and properties of a ribonuclease from Salmonella typhimurium extract

A ribonuclease has been purified about 140-fold from extracts of Salmonella typhimurium through ammonium sulfate fractionation, gel filtration, and DEAE-cellulose chromatography. The optimum pH for the hydrolytic breakdown of RNA is 7. The enzyme hydrolyzes polyadenylic acid (poly A), polycytidylic acid (poly C), and polyuridylic acid (poly U) at much faster rates than transfer RNA. Polyinosinic acid (poly I) was not hydrolyzed at all. Higher concentrations of poly A and poly U (above 200 μg per ml) were inhibitory. A mixture of poly A and poly U in the proportion 1:2, which is known to produce maximum secondary interaction, is also inhibitory. These results indicate that the secondary structures of nucleic acids interfere with the action of the nuclease. The first product of hydrolysis is a 2',3'-cyclic nucleotide which is poorly hydrolyzed to the 3'-nucleotide. The enzyme behaves as an endonuclease. The properties of the S. typhimurium nuclease have been compared with those of RNase I of Escherichia coli. Although there are some differences, the S. typhimurium nuclease is like RNase I in its mode of action

Traditional Dye Yielding Plants of Firozabad, U.P., India

District Firozabad is a city of glass work and Bangles. It is also a rich source of ethnobotanical studies. Local weavers and ethnic communities use plant dyes for imparting different shades to their clothes, hands, hairs and food items. About 19 plant species belonging to 17 families of Dicots, mostly trees and herbs have been identified as traditional dye yielding plants