Maternal and neonatal outcome after the use of low dose sublingual 25 µg misoprostol for labour induction in women with term pregnancy

Background: Aim of this study was to assess the maternal and fetal/neonatal outcome after the use of low dose (25 µg) misoprostol for labour induction in women with term pregnancy (gestational age >37 weeks POG) with a live foetus.Methods: The prospective interventional study was designed at the department of obstetrics and gynaecology of a tertiary health care hospital, with a sample size of 150 pregnant ladies who had to undergo induction of labour, were selected depending on the defined inclusion and exclusion criteria. Data was analysed using SPSS 18. Descriptive statistics were used to describe the data. Qualitative variables were presented as frequencies and percentage.Results: About 41% (61 patients) of the total study population was in the age group of 26 to 30 years with only two patients aged >35 years of age. The study group comprised of 88 primigravida (59%) and 62 multigravida (41%). The most common indication for induction of labour in my study was post-dated pregnancy (47%) followed by PROM (22%).Conclusions: The use of low dose (25 µg) misoprostol sublingually is definitely very effective in cervical ripening and induction of labour in term pregnancies particularly in those with poor Bishops score. There was no significant neonatal or maternal morbidity associated with induction of labour with low dose sublingual misoprotol.

Role of office hysteroscopy in gynecology: retrospective observational study at a tertiary care hospital

Background: Hysteroscopy being the gold standard for evaluation of uterine cavity can be utilized for varied gynaecological indications. Conventionally, hysteroscopy is performed under general anaesthesia but with technical advances over years, it is now possible to do the procedure in ambulatory office setting with same diagnostic accuracy. Aim of this study was to assess the role of hysteroscopy as a diagnostic tool in office setting, to evaluate various gynaecological conditions.Methods: Study performed retrospective analysis on 1920 patients who underwent office hysteroscopy between Jan 2011 to Apr 2015, at outpatient department of a tertiary care centre at Maharashtra, India. The procedure was done in office setting without any sedation or anaesthesia. Approach used was vaginoscopic free hand technique with minimal instrumentation and the findings were documented after evaluation of uterine cavity, ostea and endocervical canal.Results: Office hysteroscopy could be successfully performed in 1920 out of 1938 patients. Most common indications were primary infertility (38.0%), secondary infertility (11.2%), abnormal uterine bleeding (36.6%) and postmenopausal bleeding (8.3%). The procedure done in office setting was tolerated well. The procedure was also used for evaluation in patients with breast and endometrial carcinoma.Conclusions: Office hysteroscopy by vaginoscopic approach is a simple and convenient method for evaluation of uterine cavity and cervical canal. It has the potential to come out from formal operation theatre to more patient friendly outpatient department

Clinical study comparing outcome of post in vitro fertilisation triplet pregnancy reduced to twins versus non reduced in vitro fertilisation triplet pregnancies

Background: There has been an upsurge in the number of multiple pregnancies with its attributability to increasing use of artificial reproductive techniques. To study clinical outcome of post IVF triplet pregnancy reduced to twin pregnancies   compared to those without triplet reduction.Methods: Hospital designed comparative study. 31 subjects were studied for comparative study design with triplets obtained after infertility treatment (assisted post-IVF). Out of 31, 15 subjects were expectantly managed who refused reduction while 16 subjects chose reduction to twins. Outcomes like prematurity, complications in neonate, birth weight discordance, neonatal mortality and maternal complications were studied.Results: The fetal (triplet) reduction group was associated with significant (p<0.002) higher neonatal birth weight as compared to non-reduced group. The fetal reduction group had significantly lower incidence of prematurity and neonatal complications like hyperbilirubinemia, respiratory distress syndrome and neonatal sepsis. The maternal complications were also higher in nonreduced in terms of PPROM, gestational hypertension, gestational diabetes mellitus, intrahepatic cholestasis of pregnancy and gestational hypertension.Conclusions: It is indicated that the reduction of triplet to twins is effective considering more complications with non-reduced group and hence reduction improves favorable pregnancy outcomes

Levonorgestrel intrauterine system: A first line medical therapy for idiopathic heavy menstrual bleeding

Heavy menstrual bleeding or menorrhagia is a common menstrual disorder. Currently, both medical and surgical treatment options are available for the management of heavy menstrual bleeding. Hysterectomy, one of the surgical treatment options is associated with risks and is a costly procedure. Medical treatment may be preferred for the management of heavy menstrual bleeding. Oral medical treatments have various limitations for their use. For instance, cost is a limiting factor for tranexamic acid. Limited data is available to support the effectiveness of oral contraceptives. Poor patient compliance and intolerable adverse events are some other limitations especially in long term use. Levonorgestrel intrauterine system (LNG-IUS) is one of the common medical modalities in the management of heavy menstrual bleeding. LNG-IUS has been compared with other medical options like tranexamic acid, mefenamic acid, combined estrogen-progestogen, or progesterone alone, cyclic oral medroxyprogesterone acetate (MPA) oral norethisterone and low-dose combined oral contraceptive. LNG-IUS is more effective than usual medical treatment and also reduces the effect of heavy menstrual bleeding on quality of life. Similarly, it has shown similar therapeutic effects compared to endometrial ablation. Based on its efficacy, convenience and cost of therapy, it can be considered as the first line medical therapy for the management of heavy menstrual bleeding

Prenatal Ultrasonographic Diagnosis of Proximal Focal Femoral Deficiency

Proximal focal femoral deficiency (PFFD) is a developmental defect of acetabulum and proximal femur. Prenatal diagnosis of this condition is increasing with widespread use of ultrasonography. We report a case of unilateral PFFD with absent fibula. Clinical findings, diagnosis and management of this rare skeletal dysplasia are discussed. [Med-Science 2014; 3(4.000): 1708-12

Role of office hysteroscopy in gynecology: retrospective observational study at a tertiary care hospital

Background: Hysteroscopy being the gold standard for evaluation of uterine cavity can be utilized for varied gynaecological indications. Conventionally, hysteroscopy is performed under general anaesthesia but with technical advances over years, it is now possible to do the procedure in ambulatory office setting with same diagnostic accuracy. Aim of this study was to assess the role of hysteroscopy as a diagnostic tool in office setting, to evaluate various gynaecological conditions.Methods: Study performed retrospective analysis on 1920 patients who underwent office hysteroscopy between Jan 2011 to Apr 2015, at outpatient department of a tertiary care centre at Maharashtra, India. The procedure was done in office setting without any sedation or anaesthesia. Approach used was vaginoscopic free hand technique with minimal instrumentation and the findings were documented after evaluation of uterine cavity, ostea and endocervical canal.Results: Office hysteroscopy could be successfully performed in 1920 out of 1938 patients. Most common indications were primary infertility (38.0%), secondary infertility (11.2%), abnormal uterine bleeding (36.6%) and postmenopausal bleeding (8.3%). The procedure done in office setting was tolerated well. The procedure was also used for evaluation in patients with breast and endometrial carcinoma.Conclusions: Office hysteroscopy by vaginoscopic approach is a simple and convenient method for evaluation of uterine cavity and cervical canal. It has the potential to come out from formal operation theatre to more patient friendly outpatient department

Optical fiber nanoprobe preparation for near-field optical microscopy by chemical etching under surface tension and capillary action

We propose a technique of chemical etching for fabrication of near perfect optical fiber nanoprobe (NNP). It uses photosensitive single mode optical fiber to etch in hydro fluoric (HF) acid solution. The difference in etching rate for cladding and photosensitive core in HF acid solution creates capillary ring along core-cladding boundary under a given condition. The capillary ring is filled with acid solution due to surface tension and capillary action. Finally it creates near perfect symmetric tip at the apex of the fiber as the height of the acid level in capillary ring decreases while width of the ring increases with continuous etching. Typical tip features are short taper length (~4 µm), large cone angle (~38°), and small probe tip dimension (<100 nm). A finite difference time domain (FDTD) analysis is also presented to compare near field optics of the NNP with conventional nanoprobe (CNP). The probe may be ideal for near field optical imaging and sensor applications

Ultrafine Fiber Tip Etched in Hydrophobic Polymer Coated Tube for Near-Field Scanning Plasmonic Probe

We propose a novel one-step etching technique for the preparation of an optical fiber tip using a hydrophobic polymer coated tube (HP) containing 48% hydrofluoric acid (HF) to etch photosensitive single-mode fiber (PSMF). Dipping of PSMF in an HP tube suppresses the convex meniscus (CM) of the HF solution in the tube due to formation of a concave surface tension meniscus (SM) around the PSMF. The continuous etching reduces the diameter of PSMF and shortens the SM along PSMF resulting in elevation of CM around PSMF. The elevation of the CM and faster etching rate of the PSMF core digs a capillary ring along the fiber core-cladding boundary. Capillary action fills the ring with HF, which finally recedes and creates a tip at the apex of the fiber. We have fabricated a typical tip with typical features of tip height m, base diameter m, cone angle , and aperture nm. For the theoretical analysis, a tip similar to the fabricated one is modeled to estimate surface plasmon (SP)enhancement, , at the end of the tip with a silver coating

Point prevalence & risk factor assessment for hospital-acquired infections in a tertiary care hospital in Pune, India

Background & objectives: Hospital-acquired infections (HAIs) are a major challenge to patient safety and have serious public health implications by changing the quality of life of patients and sometimes causing disability or even death. The true burden of HAI remains unknown, particularly in developing countries. The objective of this study was to estimate point prevalence of HAI and study the associated risk factors in a tertiary care hospital in Pune, India. Methods: A series of four cross-sectional point prevalence surveys were carried out between March and August 2014. Data of each patient admitted were collected using a structured data entry form. Centers for Disease Control and Prevention guidelines were used to identify and diagnose patients with HAI. Results: Overall prevalence of HAI was 3.76 per cent. Surgical Intensive Care Unit (ICU) (25%), medical ICU (20%), burns ward (20%) and paediatric ward (12.17%) were identified to have significant association with HAI. Prolonged hospital stay [odds ratio (OR=2.81), mechanical ventilation (OR=18.57), use of urinary catheter (OR=7.89) and exposure to central air-conditioning (OR=8.59) had higher odds of acquiring HAI (P<0.05). Interpretation & conclusions: HAI prevalence showed a progressive reduction over successive rounds of survey. Conscious effort needs to be taken by all concerned to reduce the duration of hospital stay. Use of medical devices should be minimized and used judiciously. Healthcare infection control should be a priority of every healthcare provider. Such surveys should be done in different healthcare settings to plan a response to reducing HAI