Evaluation of outcome of pregnancy complicated by intrahepatic cholestasis of pregnancy

Background: Obstetric cholestasis (OC), also known as intrahepatic cholestasis of pregnancy (ICP), is a hepatic disease unique to pregnancy which presents with intense generalized pruritus without any skin rash. The aim is to study the outcome of pregnancy both maternal and fetal complicated by OC.Methods: This retrospective case control study was conducted at the Department of Obstetrics and Gynecology, Patna Medical College and Hospital, Patna. The medical records of all women with OC who delivered between Jan 2015 and Jan 2016 were reviewed.Results: The incidence of OC was 8.2%. The most common symptom was generalized pruritus which appeared after 28 weeks in 73.3% cases. The cesarean section rate was 93.3%. A higher incidence of meconium staining in amniotic fluid at delivery (17.1% vs 1.1%, p<0.005) and preterm premature rupture of membranes (8.9% vs 1.1%, p<0.01) was noted without an increase in preterm delivery rate (24.4% vs 15.6%). There was no statistically significant difference in the following parameter - pathological cardiotocography, 1-5 minuteApgar score <7, intrauterine growth restriction, neonatal intensive care admission or perinatal mortality. There was no case of postpartum hemorrhage.Conclusions: The incidence of OC is high in the Indian population. Perinatal outcome is good in actively managed women, although at the cost of a high intervention rate

Comparison of modified biophysical profile and vibroacoustic stimulation for intrapartum fetal assessment and prediction of perinatal outcome

Background: Present study was undertaken to evaluate the effectiveness and safety of intrapartum modified biophysical profile along with vibroacoustic stimulation test in the assessment of fetal well-being compared with modified biophysical profile for women with a singleton pregnancy.Methods: This prospective study was carried out on a group of pregnant women of gestational age more than 35 weeks attending the labour room of obstetrics and gynecological department of Patna medical college and hospital, from October 2013 to October 2015. A total 220 pregnant women were selected and randomly divided into two groups, 110 women were given modified biophysical profile and 110 were underwent modified biophysical profile with VAST.Results: Among 110 women, who underwent modified biophysical profile, 80(72.7%) showed reactive response and 30(27.3%) showed non-reactive response. A total 110 women, in whom modified biophysical profile was combined with VAST, 100(91%) showed reactive response and 10 (9%) showed non-reactive response. Statistical comparison for predicting perinatal mortality was done. Modified biophysical profile with VAST had a high sensitivity (100% vs. 80%), specificity (92.5% vs. 75.2%), negative predictive value (100% vs. 98.7%) and positive predictive value (20% vs. 13.3%) as compared to modified biophysical profile. Test accuracy for predicting perinatal mortality was more than mBPP (92.7% vs.75.4%).Conclusions: Addition of VAST in place of NST in modified biophysical profile has high specificity &amp; positive predictive value, shortens the testing time

Comparison of modified biophysical profile and vibroacoustic stimulation for intrapartum fetal assessment and prediction of perinatal outcome

Background: Present study was undertaken to evaluate the effectiveness and safety of intrapartum modified biophysical profile along with vibroacoustic stimulation test in the assessment of fetal well-being compared with modified biophysical profile for women with a singleton pregnancy.Methods: This prospective study was carried out on a group of pregnant women of gestational age more than 35 weeks attending the labour room of obstetrics and gynecological department of Patna medical college and hospital, from October 2013 to October 2015. A total 220 pregnant women were selected and randomly divided into two groups, 110 women were given modified biophysical profile and 110 were underwent modified biophysical profile with VAST.Results: Among 110 women, who underwent modified biophysical profile, 80(72.7%) showed reactive response and 30(27.3%) showed non-reactive response. A total 110 women, in whom modified biophysical profile was combined with VAST, 100(91%) showed reactive response and 10 (9%) showed non-reactive response. Statistical comparison for predicting perinatal mortality was done. Modified biophysical profile with VAST had a high sensitivity (100% vs. 80%), specificity (92.5% vs. 75.2%), negative predictive value (100% vs. 98.7%) and positive predictive value (20% vs. 13.3%) as compared to modified biophysical profile. Test accuracy for predicting perinatal mortality was more than mBPP (92.7% vs.75.4%).Conclusions: Addition of VAST in place of NST in modified biophysical profile has high specificity &amp; positive predictive value, shortens the testing time

Evaluation of outcome of pregnancy complicated by intrahepatic cholestasis of pregnancy

Background: Obstetric cholestasis (OC), also known as intrahepatic cholestasis of pregnancy (ICP), is a hepatic disease unique to pregnancy which presents with intense generalized pruritus without any skin rash. The aim is to study the outcome of pregnancy both maternal and fetal complicated by OC.Methods: This retrospective case control study was conducted at the Department of Obstetrics and Gynecology, Patna Medical College and Hospital, Patna. The medical records of all women with OC who delivered between Jan 2015 and Jan 2016 were reviewed.Results: The incidence of OC was 8.2%. The most common symptom was generalized pruritus which appeared after 28 weeks in 73.3% cases. The cesarean section rate was 93.3%. A higher incidence of meconium staining in amniotic fluid at delivery (17.1% vs 1.1%, p&lt;0.005) and preterm premature rupture of membranes (8.9% vs 1.1%, p&lt;0.01) was noted without an increase in preterm delivery rate (24.4% vs 15.6%). There was no statistically significant difference in the following parameter - pathological cardiotocography, 1-5 minuteApgar score &lt;7, intrauterine growth restriction, neonatal intensive care admission or perinatal mortality. There was no case of postpartum hemorrhage.Conclusions: The incidence of OC is high in the Indian population. Perinatal outcome is good in actively managed women, although at the cost of a high intervention rate

Comparison of esthetic outcome after extraction or non-extraction orthodontic treatment in class II division 1 malocclusion patients

Introduction: The extraction of premolars as a practical form of orthodontic therapy has been accepted for many years, but there remains a controversy regarding the effect of premolar extraction to improve esthetics as well as dentoskeletal relationship. The esthetic impact of the soft-tissue profile might play a major role in deciding on premolar extraction or non-extraction treatment, particularly in borderline patients. This cephalometric study was undertaken to compare the post-treatment soft-tissue profiles of successfully managed Class II, Division 1 malocclusions treated with either all first premolar extractions or treatment with a non-extraction therapy. Materials and Methods: The sample consisted of 100 post-pubertal female patients of Class II Division I malocclusion. Group 1, treated with four first premolar extractions, consisted of 50 female patients with a mean age of 14 years 1 month. Group 2, treated without extractions, consisted of 50 patients with a mean age of 13 years 5 months. Pre-treatment and post-treatment lateral cephalometric radiographs were evaluated. The pre-treatment to post-treatment stage comparison and the intergroup comparison of the treatment changes were conducted between extraction and non-extraction groups of Class II malocclusion samples with t-tests. Results: The soft-tissue facial profiles of the extraction and non-extraction samples were the same following active treatment except for a more retruded lower lip and a more pronounced lower labial sulcus in those patients subjected to extraction. Conclusions: The extraction or non-extraction decision, if based on sound diagnostic criteria, seems to have no systematic detrimental effects on the facial profile

COMPUTATIONAL TOOLS ASSISTED FORMULATION OPTIMIZATION OF NEBIVOLOL HYDROCHLORIDE LOADED PLGA NANOPARTICLES BY 32 FACTORIAL DESIGNS

Objective: The aim of the present study was to formulate and optimize the PLGA polymeric nanoparticle of Nebivolol Hydrochloride for sustain release of drug Methods: The drug-excipients interaction was explored by molecular docking studies by in silico tools. The drug-loaded polymeric nanoparticles prepared by emulsion solvent evaporation method using 32 factorial design and characterized for particle size, zeta potential, and entrapment efficiency. Shape and surface morphology was analysed by SEM and TEM. In vitro drug release study was performed by using a diffusion membrane. Results: The docking analysis inferred that the drug has interacted well with PLGA and PF-68, which could prevent the drug crystal formation. The optimized polymeric nanoparticles had a particle size of 291 nm and entrapment efficiency of 83.4% and were found to be within 95% of CI of the predicted value, which is acceptable. SEM and TEM studies showed that the formed polymeric nanoparticles were smooth, spherical in shape and uniform in size. In vitro drug release study of optimized formulation showed sustained release for prolonged time period Conclusion: Based on the computational studies and in vitro release studies, the developed Nebivolol hydrochloride loaded in PLGA nanoparticles could be a promising formulation in oral drug delivery for the treatment of hypertension