Serum Beta HCG and uterine artery Doppler studies in second trimester to predict preeclampsia and eclampsia

Background: Hypertensive disorders during pregnancy remain amongst the most significant and intriguing unsolved problems in obstetrics. The study aims at testing the hypothesis that women with high serum beta hCG levels and alterations in waveforms in the uterine artery doppler in early second trimester have high risk of developing pre-eclampsia.Methods: Serum Beta hCG estimation was done by Sandwich chemiluminescence immunoassay method. All uterine artery waveforms were obtained using a Toshiba nemio ultrasound machine attached to a 3.5 MHz curvilinear transducer, with colour and pulsed Doppler abilities.Results: For prediction of preeclampsia or eclampsia uterine artery Doppler velocimetry alone shows specificity of 96.30%, sensitivity of 90%, positive predictive value of 94% and negative predictive value of 80%. When it is combined with serum beta HCG sensitivity and specificity are almost same, but alone serum beta HCG levels are showing sensitivity of 96% and specificity of just 76%.Conclusions: Abnormal waveforms on uterine Doppler studies are the better predictors for preeclampsia and eclampsia when done in early second trimester

Study of preoperative GnRh agonist in cutaneous scar endometriosis

Background: Cutaneous scar endometriosis is an uncommon pathology, it is rare and difficult to diagnose, mostly follows obstetrical and gynaecological surgeries. Surgical wide excision is the mainstay of treatment. The objective of this study was to evaluate efficacy of preoperative GnRh agonist in scar endometriosis.Methods: This is prospective randomized case control study performed on all cutaneous scar endometriosis cases reporting to our institute as well as consultants from Dhule obstetrics and gynaecology society. All cases were operated and follow up in our institute by same surgeon.Results: Surgical excision accompanied by preoperative GnRh agonist therapy is helpful for easy excision and reduce recurrence of scar endometriosis.Conclusions: Abdominal scar endometriosis is rare gynecological pathology, should be suspected in any women of child bearing age group complaining of cyclical painful nodule in scar following a previous obstetric and gynaecological procedure

DESIGN IMPROVEMENT IN FRONT BUMPER OF A PASSENGER CAR USING IMPACT ANALYSIS”-A REVIEW

Car accidents are happening every day. We must take into account the statistics – ten thousand dead and hundreds of thousands to million wounded each year. These numbers call for the necessity to improve the safety of automobiles during accidents. Automotive bumper system is one of the key systems in passenger cars which helps to protect the vehicle during impacts. The following paper deals with the design improvements in the front bumper of passenger cars in India, using impact analysis. The modification will be made considering size, shape and material

Impact of the Consistency Model on Checkpointing of Distributed Shared Memory

In this report, we consider the impact of the consistency model on checkpointing and rollback algorithms for distributed shared memory. In particular, we consider specific implementations of four consistency models for distributed shared memory, namely, linearizability, sequential consistency, causal consistency and eventual consistency, and develop checkpointing and rollback algorithms that can be integrated into the implementations of the consistency models. Our results empirically demonstrate that the mechanisms used to implement stronger consistency models lead to simpler or more efficient checkpointing algorithms

Drug utilization study in schizophrenia patients in outpatient department of psychiatry: an observational prospective study

Background: A mental disorder or psychiatry disorder is a behavioural or mental pattern that causes significant distress or impairment of personal functioning. Schizophrenia is one of the most common psychiatric disorders. Aim of the study is to study drug utilization pattern in schizophrenia patients in outpatient department of psychiatry.Methods: A prospective and observational study was conducted in psychiatry outpatient department between May 2018 to October 2018 at Government Medical College and Hospital Aurangabad. Approval from ethics committee was taken. Data collected was of age, sex, final diagnosis, drugs prescribed to patients from case report form. The data obtained was then analyzed in Microsoft excel.Results: Total prescriptions of 129 patients were analyzed. Out of 129 patients 99 (76.74%) were male, while 30 (23.26%) were female. The mean age of the patients admitted in Psychiatry OPD was 36.71±11.76 years. Number of drugs prescribed per patient being 3.40±1.12 (mean±SD). The most common drugs used were olanzapine (66.6%), trihexyphenidyl (51.9%), lorazepam (44.9%), risperidone (39.5%), trifluoperazine (27.9%).Conclusions: Our study shows that atypical antipsychotics were the most common drugs prescribed in patients. Olanzapine was the most common medication used followed by risperidone. Our prospective study is carried out to get a more comprehensive data so that we can improve the drug utilization in our hospital

DRUG UTILIZATION STUDY IN TRAUMA INTENSIVE CARE UNIT

Objective: Trauma is defined as major public health problem worldwide and associated with significant morbidity and mortality both in developed and developing countries and to study prescription pattern in TICU among head trauma patients. Methods: The study was conducted in Trauma Intensive Care Unit of Department of Surgery in a Tertiary Care Hospital. This was a prospective, observational study done at a Tertiary Care Teaching Hospital. A total of 637 patients enrolled in the present study with fulfilling inclusion and exclusion criteria. Patient’s data recorded in case report form and analyzed to study the prescription pattern. Results: A total of 637 cases were enrolled in this study. Trauma was more common in 499 (78.34%) male followed by 138 (21.66%) female. The average duration of stay in TICU was 3.62±1.38 days. In this study, mortality rate in study was 17.27 %. In the current study, the total numbers of drugs prescribed per prescription in TICU are most commonly between 5 and 8 (55.26%) drugs followed by between 9 and 12 drugs were 37.83%. The present study states that the most common prescribed drugs used were ranitidine (100%) followed by ondansetron (89.64%). Among antimicrobials cephalosporins were most commonly used ceftriaxone (31.08%) and cefotaxime (27.63%). Conclusions: The aim of study is monitoring and evaluation of the prescribers as well as recommends necessary modifications to achieve rational medical care. Study outcomes suggesting that admission to TICU is more in middle age group with mean age of 40.2 years. Average numbers of drugs prescribed were 8.76 drugs per patients which shows the trends of polypharmacy in the prescriptions

Comparative study of sonosalpingography versus hysterosalpingography for tubal patency test

Background: Various tubal pathologies accounts for 10% aetiological factors in infertility couples. Easy availability and accessibility of ultrasonography definitely can prove superior to conventional method of diagnosis of tubal patency in such patient. Aims and objectives of the study were to test the sensitivity and specificity of sonosalpingography (SSG) for tubal patency test in cases of infertility patients attending to our OPD and to compare the result of sonosalpingography v/s HSG.Methods: In a non randomised prospective control trial of 50 women complaining of infertility, suspected tubal pathologies underwent various radiological modalities. Sonosalpingography and hysterosalpingography was performed in all cases.Results: By using binomial proportion test there is no significant difference between results of SSG compare to HSG. Acceptability was 100% in SSG compared to 96% in HSG.Conclusions: Various modalities are suggested to evaluate tubal patency test in infertile women. Among those laparoscopic chromopertubation is gold standard method, but for initial workup as cost effectiveness acceptability, accessibility is concerned SSG is always superior to HSG

Functional outcome of type 4 Pipkin classification of femoral head fracture operated by open reduction internal fixation by ganz safe surgical dislocation approach management: a case report

Fracture of the femoral head is a severe, relatively uncommon injury; typically, it may have associated with traumatic posterior dislocation of the hip joint with or without acetabulum fracture. The Pipkin classification is the most commonly used classification system. Controversies include the preferred surgical approach (anterior versus posterior) versus ganz safe surgical dislocation approach and whether to perform femoral head fragment excision or internal fixation. Presenting a case report of 28 years old young male with a motor vehicle road traffic accident and suffered a head of femur fracture on right hip joint with posterior wall of right acetabulum fracture with Judet-Letournel type posterior wall and type 4 Pipkin’s classification of femoral head fracture. This patient was undergone for emergency surgical intervention of open reduction, internal fixation through Ganz approach and insertion of Herbert screws for femoral head and interfragmentary screw for trochanteric osteotomy. The patient was followed up for 1 year and have a complete range of motion at hip joint with painless daily lifestyle. Type 4 Pipkin classification of femoral head fracture managed timely and with surgical intervention by ganz safe surgical dislocation approach provides visualization to femoral head and whole acetabulum with internal fixation of femur head by herbert screw which preserves normal anatomic contour of femoral head shows appropriate reduction of fracture fragments and it may also avoid hemiarthroplasty surgeries. Fracture of the femoral head has been associated with a relatively poor functional outcome and requires timely management and surgical intervention. Specially type 4 Pipkin classification of femoral head fracture treated by ganz safe surgical dislocation approach with internal fixation of femur head by herbert screw shows better outcome and avoid risk of AVN of femoral head. Complications associated with fracture of the femoral head and subsequent treatment include osteonecrosis, post-traumatic osteoarthritis, heterotopic ossification and implant failure