Study of intrauterine fetal death cases in a tertiary care center

Background: The death of a fetus is a tragic event not only for the parents but also a great cause of stress for the caregiver. It is thus vital to identify specific probable causes of fetal death to determine the risk of recurrence, prevention or corrective action.Methods: This retrospective observational study was carried out in department of obstetrics and gynaecology, Jhalawar Medical College, Jhalawar, from July 2019 to October 2019. Intrauterine fetal death was confirmed either with ultrasound or on clinical examination. The details of complaints, obstetrics history, examination findings, mode of delivery, fetal outcomes and investigation reports were recorded.Results: A total of 114 intrauterine fetal deaths were reported amongst 2982 deliveries conducted during the study period. The incidence rate of IUFD was 38.22/1000 live births. 85.96% deliveries were unbooked. 59.64% belonged to rural population. 59.64% fetal deaths occurred in women between 20 to 25 years of age. 45.61% women were primigravida. 41.2% IUFD occurred between 26 to 31 weeks of gestation. Among the identifiable cause’s hypertensive disorders (23.68) and placental causes (19.29%) were most common.Conclusions: Unexplained causes, PIH and abruptio placentae were major causes of IUFD. Majority of fetal wastage can be prevented with universal and improved antenatal care

Neonatal and fetal effects of antithyroid peroxidase positivity in hypothyroidism in pregnancy - A hospital-based prospective analytical study

Objectives: The objectives of this study were to evaluate the fetal and neonatal outcomes for pregnant women with autoimmune hypothyroidism and to compare them to hypothyroid and euthyroid women. Methods: A total of 309 women were included in the study. 159 hypothyroid women were categorized as “Cases” and 150 euthyroid women were “Controls.” Serum thyroid-stimulating hormone (TSH) was done for all women, and in hypothyroid women, antithyroid peroxidase (TPO) was also done for the mothers. Cases were subdivided on the basis of anti-TPO positivity. Fetal and neonatal complications were noted in all three groups along with basic parameters such as baby weight and Apgar scores. Meconium aspiration, neonatal intensive care unit (NICU) admission, jaundice, intrauterine growth retardation, intrauterine death (IUD), low or very low birth weight, congenital anomalies, hypothyroidism in the newborn, and neonatal death were the parameters noted. Testing of the babies was done with serum TSH on day of life 3 and serum bilirubin whenever clinically jaundice was suspected. The study period was 2 years. Results: Hypothyroidism is significantly associated with an increased risk of IUD (p=0.038), NICU admissions in babies (p=0.004), neonatal jaundice (p=0.027), low or very low birth weight babies (p=0.0003), congenital anomalies in the babies (p=0.026), and neonatal deaths (p=0.007). Anti-TPO positivity is significantly associated with increased risk of IUD (p=0.044) and hypothyroidism in the newborn of hypothyroid mothers (p=0.045). Conclusions: Anti-TPO positivity and hypothyroidism are both significantly associated with certain fetal complications such as IUD, neonatal jaundice, increased NICU admissions, and hypothyroidism in the newborn. Mothers with hypothyroidism who are TPO positive have a higher risk of neonatal mortality and morbidity, although small. Hence, screening should be done in all hypothyroid women in pregnancy and their babies. Universal screening with serum TSH is recommended in pregnancy and in the newborn on day 3 of life

Comparison of ease of insertion, visibility of strings and continuation rate of post-partum intrauterine copper device insertion by long inserter versus with the help of Kelly’s forceps

Background: The objective of the study was to compare ease of insertion, visibility of strings and continuation rate of post-partum intrauterine copper devices (PPIUCD) insertion by long inserter versus with the help of Kelly’s forceps.Methods: 100 women were enrolled in our study which was conducted in department of obstetrics and gynecology, Subharti medical college and Chattrapati Shivaji Subharti hospital (CSSH), Meerut over a period of 2 years between November 2018 and August 2020. In study comparison was done on insertion technique of PPIUCD.Results: High fundal placement was achieved with long inserter. There was no perforation and decreased infection rate among the users with no increase in incidence of side effects and expulsion. Among 50 insertion, 1 woman (2%) had partial expulsion, 2 women (4%) had complete expulsion and 1 woman (2%) got PPIUCD removed on request. Providers reported 100% easier technique. 96% satisfaction among the users.Conclusions: The dedicated long inserter PPIUCD was found to be safe, with high acceptability among the participants and providers. Study revealed the reduced risk of infection and expulsion, providers also reported increased convenience in insertion compared to standard PPIUCD insertion techniques

Study of the frequency of female genital tract infection using cartridge based nucleic acid amplification test

Background: The aim of the study was to study the frequency of female genital tract infection using cartridge based nucleic acid amplification test (CBNAAT), to study the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CBNAAT.Methods: This prospective observational study was conducted among 100 patients as per inclusion criteria with genital tract infection in Swami Vivekanand Subharti University, Meerut over a period of two years. Investigations including ZN staining for acid fast bacillus (AFB), endometrial sampling for histopathology, CBNAAT and BACTEC culture were sent.Results: In a study of 100 patients’ histopathological examination detected tuberculosis in 2% patients while CBNAAT detected tuberculosis in 5% patients. Tubercle bacilli was found in 3% women on AFB stain while in only 1%-woman genital tuberculosis was diagnosed by BACTEC culture.Conclusions: Female genital tuberculosis is detected most frequently when a woman presents with unexplained infertility. Newer technologies allow genital tuberculosis to be identified at an earlier stage and enable us to provide treatment. CBNAAT being a sensitive test picked up more cases than histopathology, culture, AFB stain. Hence CBNAAT should be widely used for early detection of female genital tuberculosis

Covid-19 Detection using qRT-PCR - A Review

In the ongoing Covid pandemic, the monitoring of SARSnCoV-2 with the help of viral loads/viral kinetics has become more essential via the RT-PCR technique. However, the interpretations of qRT-PCR technique results are made as qualitative and quantitative or semi-quantitative, and day by day, this interpretation is becoming more important. Reverse transcription polymerase chain reaction is the most widely used technique for detecting viruses (rRT-PCR). Due to probable false-negative or false-positive findings, present techniques must be improved to avoid incorrect conclusions. Researchers have developed a multiplex rRT-PCR diagnostic method that simultaneously targets viral genes (RdRP and E) and one human gene (RP). The values of the Cycle threshold called Ct values that are a result of the RT-PCR test are highly affected by the variations attained among the different runs required to be operated and must be determined by the laboratories, especially in the quality control of quantitative RT-PCR. Somewhere, batch effects also play an important role in Ct value. Regrettably, several papers on Covid-19 used ingenuous values for Ct from qRT-PCR, which are the incorrect quantitative analysis unit. Qualitative analysis and Quantitative analysis both are of having different meanings; interpretation of Ct values cannot be interpreted directly as viral load; it must need a reference material with standard curves. The tractability and validity of the standard curve are the basis of the evaluation of the values. These factors help attain the accurate quantification of the expected number of viral copies. &nbsp

Survey Report of Triveni- A Speaking Tree

On the theme of protection of climate and environment, plantation is the main serge in the Indian community and in this notion, everyone is involved in plantation. However, it is important to check the climatic conditions, properties of plants, rhizome microbial community and other requirements is very important aspect. In this connection we are reporting the first time that the three huge plant named as Neem, peepal and bergad are planted together in close vicinity in the Bhiwani district and together called as Triveni. In some places of Bhiwani Devasr, 65 Triveni plants are planted in a small area our survey identified that the growth of one plant is compromised in the Triveni assembly.There is no scientific evidences that growing all three long lasting plant in one small vicinity will have any affects in the environment. As we all know that all these three plants have significant medicinal properties, continuous planting of land with the same or similar plant species can result in the accumulation of harmful soil microbes, which can lead to crop failure. In this article, we explore the influence of constant replanting on the health of short-rotation forestry soil, focusing on the accumulation of deleterious microbes and the decline of beneficial microbes. We also suggest possible practical solutions to address this problem and consider future research that could be conducted to better understand and reduce the build-up of deleterious soil microbes in short-rotation forestry soi

Impact of levonorgestrel intrauterine system on metabolic parameters

Background: Hormonal contraceptive is suggested to affect parameters like body mass index, body weight, blood pressure (BP), blood sugar, lipid protein, and liver function test (LFT) but effect of LNG-IUS on those parameters is still uncertain. The aim of the present study was to study the effects of LNG-IUS on the metabolic parameters.Methods: Sixty women who opted for LNG-IUS for various indications were included in the study. Lipid profile, liver function tests (LFT), glucose levels [fasting and post prandial (PP)], and hemoglobin (Hb) were tested. Bimanual genital examination and transvaginal-ultrasonography was done prior to LNG-IUS insertion. Any problems observed were recorded. The subjects were re-evaluated after 6 and 9 months on their subsequent visits. Data were analyzed using paired “t” test. P value of <0.05 was considered statistically significant.Results: Mean age of the patients was 35.5±6.79 years. Maximum number 50 (83.3%) had abnormal uterine bleeding (ovulatory dysfunction, endometrial, iatrogenic, not yet classified) [AUB (OEIN)]. Mean pictorial blood loss assessment chart (PBAC) score of patients was 164.7±56.72 and mean Hb level 11.15±1.75g/dL. LNG-IUS showed no significant adverse effects on anthropometric parameters at 6- and 9-month follow-up. Significant change was seen in total cholesterol (TC), very low-density lipoprotein (VLDL) and high density lipoproteins (HDL) values at follow-up (p<0.0001).Conclusions: In conclusion, amongst Asian population, the LNG-IUS does not have any adverse effects on metabolic parameters, TGs, LDL and blood sugar levels

Effect of Experiment Environment on Calorimetric Value of Composite Solid Propellants

The calorimetric value (cal-val) of solid rocket propellants and explosives is determined in the presenceof inert atmosphere using industrial nitrogen gas. However, due to presence of trace amount of oxygen, the cal-val is not always correct. To avoid such inaccuracy in cal-val, a systematic study has been carried out by takingdifferent types of solid propellant samples having burning rate in the range of 5 mm/s − 30 mm/s at different pressures.The data obtained were acquired using industrial nitrogen, ultra high pure nitrogen (UHP-N2), ultra high pureargon (UHP-Ar), air and ultra high pure oxygen (UHP-O2). The data reveal that cal-val is highest in the case ofUHP-O2 due to complete combustion while in the case of air and industrial nitrogen it is found to be substantiallyless. Moreover, the cal-val in the presence of UHP-N2 and UHP-Ar meets the standard value with reproducibility.The results, further, confirm that for authentic cal-val, the most suitable environment is UHP-N2/UHP-Ar.Defence Science Journal, 2013, 63(5), pp.467-472, DOI:http://dx.doi.org/10.14429/dsj.63.289

Role of LNG-IUS in adenomyosis in reproductive age group women: a prospective interventional study

Background: The objective of the present study was to observe the efficacy of LNG-IUS in the treatment of heavy menstrual bleeding and dysmenorrhoea associated with adenomyosis.Methods: LNG-IUS was inserted in forty women between 20-50 years of age presenting with heavy menstrual bleeding and dysmenorrhoea associated with adenomyosis diagnosed on transvaginal ultrasonography and followed up after 1 month, 3 months and 6 months of insertion. Subjective assessment of menstrual blood loss was done by pictorial blood loss assessment chart and dysmenorrhoea was assessed on the basis of universal pain assessment tool and side effects were noted at each visit.Results: Mean patients’ age was between 31-40 years (72.5%) and the follow up duration was 6 months. Significant improvements in dysmenorrhea, HMB and haemoglobin levels were observed. There was no significant change in the uterine volume. The most common side effect was prolonged vaginal spotting (n=26, 65%) and pain abdomen (n=13, 32.5%). LNG-IUS expulsion was observed in 1 patient (n=1, 2.5%). 3 patients underwent hysterectomy (n=3, 7.5%). The overall success rate of LNG-IUS was 82.5%.Conclusions: The LNG-IUS appears to be an effective method in alleviating dysmenorrhoea and heavy menstrual bleeding associated with adenomyosis during 6 months of study. It may be a valuable long-term alternative for the treatment of adenomyosis in young and perimenopausal women and it is a good strategy to reduce the number of hysterectomies in women with adenomyosis

Apolipophorin-III Mediates Antiplasmodial Epithelial Responses in Anopheles gambiae (G3) Mosquitoes

Apolipophorin-III (ApoLp-III) is known to play an important role in lipid transport and innate immunity in lepidopteran insects. However, there is no evidence of involvement of ApoLp-IIIs in the immune responses of dipteran insects such as Drosophila and mosquitoes.We report the molecular and functional characterization of An. gambiae apolipophorin-III (AgApoLp-III). Mosquito ApoLp-IIIs have diverged extensively from those of lepidopteran insects; however, the predicted tertiary structure of AgApoLp-III is similar to that of Manduca sexta (tobacco hornworm). We found that AgApoLp-III mRNA expression is strongly induced in the midgut of An. gambiae (G3 strain) mosquitoes in response to Plasmodium berghei infection. Furthermore, immunofluorescence stainings revealed that high levels of AgApoLp-III protein accumulate in the cytoplasm of Plasmodium-invaded cells and AgApoLp-III silencing increases the intensity of P. berghei infection by five fold.There are broad differences in the midgut epithelial responses to Plasmodium invasion between An. gambiae strains. In the G3 strain of An. gambiae AgApoLp-III participates in midgut epithelial defense responses that limit Plasmodium infection