Study of thrombocytopenia in pregnancy: clinical presentation and outcome at tertiary care rural institute

Background: Platelet count below 1.5 lakh/cumm is called as thrombocytopenia. After anaemia it is the second most common haematological disorder in pregnancy. It affects nearly 6 to 15%; on an average 10% of all pregnancies. Gestational thrombocytopenia is a clinically benign thrombocytopenic disorder usually occurring in late pregnancy. It resolves spontaneously after delivery.Methods: It is a hospital based prospective observational study over a period of 1 year. All pregnant women who attended OPD at the department of obstetrics and gynecology, UPUMS, Saifai for antenatal checkup were included for the study and blood sample was withdrawn.Results: Out of 263 cases enrolled for study, 90 women were found to have thrombocytopenia, and 173 had normal platelet count. Thus, incidence of thrombocytopenia was 34%. Gestational thrombocytopenia accounted for majority of cases of thrombocytopenia in pregnancy (50%) followed by hypertensive disorders (22.4%). It was further followed by ITP (11.11%) and dengue (5.5%).Conclusions: Gestational thrombocytopenia is the most common cause of thrombocytopenia during pregnancy (50%), but other underlying causes must be considered as well. A thorough history and physical examination will rule out most causes

Examining the Need of Digital Citizenship Education for Adolescents in the Current Digital Landscape

Adolescents are growing up in a digital era, and the increasing role of technology in our lives presents both challenges and opportunities. A survey study was conducted to address the need for Digital Citizenship Education (DCE) in school-going adolescents, as they need to learn how to make sound judgments when navigating the digital world. The study found that 79% of students have digital access at home, 83% purchase products online, and 73% have social media accounts, with 24% talking to strangers online. However, only 21% use the internet at school, and 78% are unaware of the term DCE. The survey also revealed that many students lack awareness of cyber laws, struggle to determine the reliability of online information, and believe everything they see online is true. This research emphasizes the importance of developing a customized DCE curriculum for adolescents to participate safely, ethically, effectively, and responsibly in the digital community

Digital Citizenship Education in Higher Education: A Study in Indian Perspective

In recent years, higher education in India has undergone significant changes and advancements, particularly with the integration of technology and innovation into the learning process. With the increasing use of digital tools and platforms, individuals must understand the responsibilities and ethics associated with the use of technology. This is where digital citizenship education comes into play. In the context of higher education, digital citizenship education can play a crucial role in preparing students to become responsible and informed digital citizens. The purpose of this study is to examine the technological innovation in higher education in India, with a special emphasis on digital citizenship education, and to analyse the factors that influence its integration. The study aims to provide insights into the challenges and opportunities related to the implementation of digital citizenship education in Indian universities and to make recommendations for its effective integration into the higher education curriculum

A retrospective study on causes of unsafe abortions in referred patients, at a tertiary care centre in western Uttar Pradesh

Background: Unsafe abortions occur when pregnancy is terminated by unqualified person or in an environment that do not conform to minimal medical standards or both. The aim of this study was to analyse the causes in referred patients of unsafe abortions, methods used and complications with which patients were admitted.Methods: A retrospective observational study conducted in the department of Obstetrics and Gynaecology, SIMS Hapur Uttar Pradesh, India from 1stJune 2019 to 29thFebruary 2020. Data was collected from previous hospital records. Total 150 women aged between 18-40 years, admitted with complications of unsafe abortions and who had taken advice for termination outside our institute, were included. The demographic profile, detailed history, first contact person for abortion advice, abortion service provider, method of termination and prior ultrasound were noted. Exclusion criteria was period of gestation more than 20 weeks and spontaneous abortions.Results: The study showed 92% contacted unqualified person, out of which 22.5%were uncertified doctors, 30.4% ANM’s, 16.7% Nurses, 12.3% consulted quacks and 10.9% Chemists. Among the abortion service providers 23.6% were uncertified doctors, 45.7% Chemists, 15% Nurses, 5.7% Quacks, 3.6% ANM’s and 6.4% had taken self-medication. Prior ultrasound was done in 28% cases. Method of termination was medical in 78.7% and surgical in 21.3% cases. Period of gestation was <8 weeks in 69.3%, 8-12 weeks in 27.3%, 12-16 weeks in 2%. 37.3% had parity 2 and 55.3% were Hindus.Conclusions: Despite availability of safe abortion services, unsafe abortion practices are still prevalent. Approved MTP centres, skilled and certified abortion providers must be easily accessible to women even in rural areas to safeguard their health

A rare case of gartner duct cyst presenting as a genital prolapse: a case report

Mullerian cysts are usually small, ranging from 0.1 to 2 cm in diameter. Rarely, they may be enlarged and mistaken for other structures such as uterovaginal prolapse/cystocele/rectocele or urethral diverticulum. Posterior vaginal wall cyst is a very rare case. We present a case of patient presenting with mass coming out from vagina, which, after clinical evaluation and USG, was diagnosed as a Gartner’s cyst. Gartner’s duct cyst is a derivative of Wolffian duct (mesonephric duct) in females. Assessment of the lesion via history taking and pelvic examination is important to confirm both the lesion’s size and location, but appropriate clinical evaluation supported with investigations clinched the diagnosis easily

Hypertensive disorders of pregnancy: a clinical study in a rural tertiary care centre of western Uttar Pradesh, India

Background: The aim of study was to find out the frequency and clinical outcome in hypertensive disorder of pregnancy (HDP) in a rural tertiary care centre. Hypertensive disorder of pregnancy is a commonest medical disorder which constitutes about 12-22% of all pregnancies and it is a major cause of maternal morbidity as well as mortality world wide.Methods: It is a retrospective hospital-based study to find out the clinical outcome in different hypertensive disorder of pregnancy in a rural tertiary care centre of western Uttar Pradesh.Results: Present study showed the prevalence of HDP was 4.01% among the study population. Most of the patients were primipara ,unbooked and less than 25 years of age. The most common HDP was mild preeclampsia  and HELLP was its commonest  complication.Conclusions: Hypertensive disorder of pregnancy (HDP) is still a major cause of maternal mortality and morbidity. Authors intend to aware the pregnant women regarding high risk factors of pregnancy and motivate them for regular antenatal care so that  complications of  hypertensive disorders can be  managed timely

Positive Sensitivity Analysis In Linear Programming With Bounded Variables

Abstract The present paper discusses positive sensitivity analysis (PSA

Incidence of cesarean delivery after induction of labour with dinoprostone gel at term in nulliparous women with unfavourable bishops score

Background: The aim of induction of labour is to achieve vaginal delivery in advance of the normal timing of parturition and to avoid operative delivery. The objective was to study the incidence of instrumental delivery and cesarean section in nulliparous women with unfavourable bishops score at term.Methods: This study was conducted on 200 patients in nulliparous women with unfavourable bishop score, cephalic presentation and no previous history of abortion.Results: The most frequent cause of induction of labour was postdatism (47.5%) followed by PIH (25.5%) and PROM (13%). 143 (71.5%) women had normal vaginal delivery whereas in 54 women (27%) cesarean section was done. 2 women (1%) had forceps application for delivery and remaining 1 women (0.5%) had ventouse delivery. Out of 200 patients 9 had maternal complication of induction of labour.Conclusions: In present study 71.5% women had normal vaginal delivery, 27% had cesarean section. Mean bishop score at induction was 3.31 which improved to 4.0 after 12 hours of gel instillation. The mean induction to delivery interval was 13.38 hrs in present study, 54.5% patients were delivered within 12 hours of gel instillation in this study. Most common indication of cesarean section was failed progress followed by fetal distress

Comparative study of abdominal hysterectomy and vaginal hysterectomy in non-descent cases a prospective study

Background: In the present times, the emphasis on minimally invasive surgery has lead to a resurgence of interest and importance of VH for non-prolapsed indications i.e. non-decent vaginal hysterectomy (NDVH) as the scar less hysterectomy. It has several benefits over abdominal hysterectomy in terms of cosmetic advantages, lesser post-operative morbidity and faster recovery. The objectives of the study was to compare and assess various factors like operative duration of surgery, intra operative blood loss, intra operative and post-operative complications, post-operative analgesia requirement, post-operative ambulation and duration of post-operative hospital stay and to put forward best route of hysterectomy.Methods: Hundred cases fulfilling, the selection criteria were included in the study. Patients were randomly divided in two groups-NDVH (non-decent vaginal hysterectomy) and abdominal hysterectomy.Results: Operative time, intra operative blood loss and post-operative morbidity was less in NDVH groups.Conclusions: Non-decent vaginal hysterectomy is a better alternative to abdominal hysterectomy in cases with benign pathology of the uterus, uterine size <14 weeks, uterus with good mobility and adequate vaginal access

Evaluation of endometrium by transvaginal ultrasonography and hysteroscopy and its correlation with histopathology in perimenopausal women with abnormal uterine bleeding at tertiary rural centre

Background: Abnormal uterine bleeding is one of the commonest clinical presentation ac-counts for 33% gynaecological consultations and this proportion rises to 70% in perimenopausal and postmenopausal age group in any gynaecology clinic. The most probable etiology of abnormal uterine bleeding relates to the patients reproductive age. Various diagnostic techniques have been evolved over the periods to determine the etiology of abnormal uterine bleeding in perimenopausal women, but their accuracy has not been compared properly. The aim of study is to evaluate the endometrium by transvaginal ultrasonography and hysteroscopy and its correlation with histopathology in perimenopausal patients with abnormal uterine bleeding.Methods: Total 96 patients in perimenopausal age group, admitted with chief complaints of ab-normal uterine bleeding were included. All patients underwent transvaginal ultrasonography and hysteroscopy, followed by hysteroscopy guided biopsy and histopathological examination. Accuracy, sensitivity, specificity, positive predictive value and negative predictive value were calculated for both methods and compared, considering histopathological diagnosis as gold standard.Results: Mean age of patients was 44.05±3.29. Hysteroscopy has high accuracy, sensitivity, specificity, positive predictive value and negative predictive value than Transvaginal sonography for diagnosis of all endometrial and intrauterine pathologies.Conclusions: Hysteroscopy results are more consistent with the results of histopathology. Hysteroscopy and hysteroscopy guided biopsy has been proven as gold standard for endometrial evaluation of patients with abnormal uterine bleeding. TVS can be used as most cost effective first step investigation in cases of perimenopausal bleeding