Perinatal outcome in relation to maternal glycaemic control in gestational diabetes mellitus

Background: Early diagnosis and treatment of gestational diabetes with adequate antenatal care are essential to reduce the adverse neonatal outcomes.Methods: All selected women were subjected to a detailed history taking comprising of age, parity, prepregnant body weight, medication history, family history, medical history, detailed obstetric history. Then they were subjected to clinical examination and routine laboratory investigations. Antenatal women were diagnosed with GDM, when 75gm GCT ≥140mg/dl based on DIPSI criteria. Fasting and postprandial blood sugars (2hours) were done and if FBS and PPBS were normal, the patient was labelled as GDM on meal plan. If fasting > 96 mg/dl and 2-hr postprandial blood sugar >121 mg/dl, Inj.insulin was started. Patients were managed according to the FBS and PPBS values throughout antenatal period and the perinatal outcomes were studied.Results: Among 150 patients, multiparous women constitute 65.3% and primi 34.7%. 60% of the patients were in age group of 26 to 30 years.59.3% of patients were in BMI of range 25 to 30.Family history of diabetes was present in 24.7% of the patients. Previous history of GDM was present in 27.3% of cases.98% of GDM were detected in 2nd trimester. The percentage of cases presented with macrosomia was 8.7%, RDS 3.3%, hypoglycaemia 6%, hyperbilirubinemia 3.3%, IUD 0.7%, perinatal injury 1.3%, NICU admission requiring ≥3 days of admission was 12%.Conclusions: There is association of elevated FBS and PPBS values with occurrence of adverse perinatal outcome

Association of dyslipidemia in second trimester of pregnancy with preeclampsia

Background: The study aimed to determine whether dyslipidemia in the second trimester of pregnancy is associated with pre-eclampsia and to investigate and compare the levels of serum lipids among preeclampsia and normal pregnant women.Methods: This prospective cohort study was done between March 2016 to February 2017. Fasting lipid profile was taken for about 200 selected antenatal women between 18-20 weeks of gestation. The patients who developed pre-eclampsia were grouped as preeclampsia group and the rest of the patients were grouped as normal group. The maternal characteristics compared between two groups were age, parity, BMI and socioeconomic class according to modified Kuppuswamy scale.Results: There is statistical significance among the two groups with respect to BMI and parity whereas no significance with age distribution. Mean total cholesterol in Preeclampsia was 240.24±46.63 mg/dl and normal pregnancy was 186.10±28.02 mg/dl. Mean HDL in preeclampsia was 47.49±4.40mg/dl and normal pregnancy was 52.11±8.918 mg/dl. Mean LDL in preeclampsia was 140.43±36.92 mg/ dl and normal pregnancy was 94.6±24.5 mg/dl. Mean VLDL in preeclampsia was 64.48±15.76mg/dl and in normal pregnancy was 33.54±9.38 mg/dl, Mean Triglycerides in preeclampsia was 291.95±82.33 mg/dl and normal pregnancy was 166.78±48.83 mg/dl. Total cholesterol, Low density lipoprotein, very low-density lipoprotein, triglycerides were increased in preeclampsia when compared to normal pregnancy, which is statistically significant.Conclusions: Detecting dyslipidemia before 20 weeks of gestation helps to recognise pregnancies at high risk for preeclampsia and to detect and treat the disease earlier for a better maternal and perinatal outcome

Structural, optical, and magnetic properties of Zn1-xMnxs (x = 0.00, 0.01, and 0.03) nanoparticles

Zn1 – xMnxS (x = 0.00, 0.01, and 0.03) nanoparticles of size ~2 nm were synthesized using a co-precipitation method. Structural characterization by X-Ray diffraction (XRD) measurement revealed that all the synthesized samples were crystallize in the monophasic cubic zinc blende structure and monotonous decrement in the lattice constants with increasing Mn content, due to the effective Mn doping. The quantum confinement nature of nanoparticles was tested from UV-Vis absorbance measurement and the particle sizes were calculated and compared with XRD. Two emission bands observed in doped nanoparticles were attributed to defect related emission (blue) of ZnS and Mn2+ (orange) respectively, where the intensity of emission peak increases without any significant shift for increase in Mn2+ concentration. Magnetic measurements showed that all the samples exhibit antiferromagnetic with diamagnetic behavior, at room temperature. When you are citing the document, use the following link http://essuir.sumdu.edu.ua/handle/123456789/2791

Study on permanent tubal sterilisation in a semi-urban based medical college hospital

Background: Tubal sterilisation is a permanent method of contraception in use for many years. Main objective of our study is to find the acceptance of permanent method of tubal sterilisation in women delivering in a semi-urban based medical college hospital.Methods: Retrospective analysis was carried to find the number of women undergoing tubal sterilisation in our hospital for period of one year from April 2015 to March 2016.Results: Total women delivered over a period of one year were 10959 out of them 2619 women underwent tubal sterilisation. Analysis showed acceptance was high when combined with lower segment cesarian section (LSCS) and more among women in the age of 20-29 years.Conclusions: The present study showed the acceptance of tubal sterilisation following vaginal delivery to undergo mini lap is still low compared to concurrent sterilisation with LSCS. High order births are still prevalent in semi-urban based hospitals. Not only motivation, also regular review of registers that update the eligible couples, identification of complications and timely referral to higher centers will help in achieving the goal of bringing down the number of high order birth which in turn will reducing the maternal and perinatal mortality and morbidity

Structural, optical, and magnetic properties of Zn1-xMnxs (x = 0.00, 0.01, and 0.03) nanoparticles

Zn1 – xMnxS (x = 0.00, 0.01, and 0.03) nanoparticles of size ~2 nm were synthesized using a co-precipitation method. Structural characterization by X-Ray diffraction (XRD) measurement revealed that all the synthesized samples were crystallize in the monophasic cubic zinc blende structure and monotonous decrement in the lattice constants with increasing Mn content, due to the effective Mn doping. The quantum confinement nature of nanoparticles was tested from UV-Vis absorbance measurement and the particle sizes were calculated and compared with XRD. Two emission bands observed in doped nanoparticles were attributed to defect related emission (blue) of ZnS and Mn2+ (orange) respectively, where the intensity of emission peak increases without any significant shift for increase in Mn2+ concentration. Magnetic measurements showed that all the samples exhibit antiferromagnetic with diamagnetic behavior, at room temperature. When you are citing the document, use the following link http://essuir.sumdu.edu.ua/handle/123456789/2791

Acceptance of postplacental intrauterine contraceptive device: recent increase in trend

Background: IUCD is a temporary method of contraception in use for many years. Our main objective is to find the acceptance of (postplacental intrauterine contraceptive device) PPIUCD in recent years.Methods: Retrospective Analysis was carried out to collect information regarding IUCD insertion in all women delivered at semi urban based medical college in Tamil Nadu from April 2014 to March 2016.Results: Total women delivered in our hospital were 20949 over a period of two years. Two year comparative study revealed significant increase in acceptance of PPIUCD insertion among primipara from 39.1% TO 68.9%. Acceptance of PPIUCD in primipara was 51.6% in first year (April 2014 to March 2015) to 87.8% in second year (April 2015 to March 2016).Most of the women were in the age group of 20 to 29 years (81.5%).Conclusions: The present study being retrospective analysis showed sudden increase in coverage rate of PPIUCD from 2014-2015 to 2015-2016. Though the patients were motivated in the same way throughout the period, training and motivation given to the staff nurses and duty doctors in the labour ward for PPIUCD insertion and daily review instead of weekly had brought the significant increase in the coverage. This clearly shows the role of service provider in the success of a national program though acceptor is always ready in most of the times

A Comparative Study on Clinical Profile and Substance Use of Patients with Bipolar Versus Unipolar Depression

INTRODUCTION: Depression is common illness worldwide. Number of studies have attempted to distinguish the phenomenology of depression in major depressive disorder and bipolar disorder. For planning a proper treatment, it is important to know how these two conditions differ from each other. This study assessed illness parameters, clinical variables and use of substance among two groups. MATERIALS AND METHODS: This is comparative cross-sectional study. 50 patients in each group, who were diagnosed with either bipolar disorder or major depressive disorder, currently presents with depressive episode were included and detailed socio demographic, illness profile, substance use and phenomenology was assessed. Scales such as HAM-D, BPRS, AUDIT, FAGERSTORM SCALE were applied to assess severity and analysed data using appropriate statistical tests. RESULTS: Bipolar depression group had early onset, more number of hospitalisations, frequent episodes,greater use of substance when compared to unipolar depression group. Deliberate self-harm, psychotic symptoms and anxiety symptoms was significantly higher among bipolar depression. Logistic regression was done to find predictors of bipolarity in this study. CONCLUSION: By early identification of bipolarity spectrum during episode of depression, would help to prevent further episodes and would improve overall functioning and quality of life of such patients

Effect of socio-economic differentials on growth and development of children in five metropolitan cities of India

Background: Children’s growth and development depend on their parents’ socio-economic status. Adequate nutrition of children influence their anthropometric measures proper growth and development and reduces morbidity and mortality among children. Objective: To understand the growth and development pattern of children dwelling in the slum environment and to compare some of their growth parameters with non-slum children. Methods: This was a record review of National Family Health Survey-3 (NFHS-3) data, freely available from Measure DHS USA. Data for five major metropolitan cities, namely, Delhi, Mumbai, Kolkata, Chennai, and Hyderabad were used for this study. The households classified as slum and non-slum by two agencies, viz., NFHS and census of India were considered for analysis. Variables more relevant as an indicator for the growth and development of children, viz., height, weight, hemoglobin, standard of living index (SLI), age (in months), and place of residence were selected for this study. Place of residence (slum or non-slum) and SLI, which is proxy to socio-economic status, were considered to understand their influence on height, weight, and hemoglobin values of the children. Results: About 75% of the slum dwellers were in low SLI category, and 69% of non-slum residents were in high SLI category. There is a significant difference (p=0.001) between slum and non-slum residence on the proportions of SLI. Multivariate analysis showed that all the variables significantly differ by SLI except age of the children. Conclusion: It is concluded that the observed difference between slum and non-slum children’s height, weight, and hemoglobin are due to differences in SLI. Growth and development of children dwelling in slum or non-slum area depend on the socio-economic status of their parents and not by their place where they are growing

Klippel trenaunay syndrome-an obstetric challenge

Klippel Trenaunay Syndrome is a rare congenital disease characterized by triad of extensive cutaneous haemangiomas (most common), venous varicosities and hypertrophy affecting a leg and/or arm on one side. We report two cases of pregnant women with Klippel Trenaunay syndrome of which one patient presented with Kasabach Merritt Syndrome (refractory coagulopathy). 24-year-old primigravida of 29 weeks with KTS presented with bleeding gums for two days. Known case of diabetes, hypothyroid on treatment and treated TB lymphadenopathy. She had hypertrophy with varicosities and haemangiomas on left lower limb and vulvar region. She was treated for thrombocytopenia at 19 weeks gestation with steroids. Laboratory studies revealed thrombocytopenia. Steroids were given as per haematologist opinion for thrombocytopenia. She had emergency caesarean section with platelet transfusion at 35 weeks as per vascular surgeon opinion. Postoperatively she was given anticoagulants and steroids. 28-year-old primigravida of 39 weeks with KTS admitted for safe confinement. She had surgery for haemorrhoids at 14 years of age and had bleeding per rectum two years back. She had hypertrophy of left lower limb and cutaneous nevus in multiple dermatomes on left half of body. Doppler left lower limb shows superficial varicosities. Laboratory studies revealed normal. With multidisciplinary approach, she had elective caesarean in view of primigravida/breech-footling presentation. Post operatively she was given anticoagulants. The success in the management of these patients requires the participation of multidisciplinary approach. The use of prophylactic anticoagulant is generally advised during the pregnancy and postpartum period

LaQshya- an uphill climb: a review of implementation of LaQshya programme at a tertiary centre in Chennai

LaQshya- labour room quality improvement initiative, a National Quality Assurance Programme was launched by the National Health Mission, Government of India in 2017 for improving the quality of services provided at the time of delivery and immediate post-partum period. The programme has been implemented at the Institute of Social Obstetrics, Government Kasturba Gandhi Hospital for women and children from the year 2019. A plethora of changes have been brought about at the legendary institution since then. A retrospective programme review of the changes brought about at the Institute of Social Obstetrics, Government Kasturba Gandhi Hospital for Women and Children in the dimensions described under the LaQshya program i.e.; structural improvement and process improvement and henceforth a comparison of the various outcome as key performance indicators before and after the implementation of the programme. The quality of Institute of Social Obstetrics Government Kasturba Gandhi Hospital started at the bottom with 40%, under the guidance of LaQshya has improved to an astounding 93% making us the proud bearers of the prestigious platinum badge which was evident with the obvious improvement in various outcome indicators.  Despite the implementation, LaQshya was an uphill trudge, to break old habits and restrain into new norms and guidelines, the results as mentioned proved to be a beautiful view at the end of the climb. LaQshya is indeed a boon not only to the mothers benefiting from it but also to the service provider as a tool to be a better health care personnel