Fetomaternal outcome and effect of ursodeoxycholic acid in patients of obstetric cholestasis

Background: The objective of this study was to determine fetomaternal outcome and effect of ursodeoxycholic acid in patients of obstetric cholestasis.Methods: This study was prospective observational descriptive study of 130 women, which was conducted in the department of obstetrics and gynaecology, Deen Dayal Upadhayay Hospital, New Delhi. Statistical analysis was performed using the z test when appropriate. A p value of <0.05 will be considered statistically significant.Results: Spontaneous onset of labour was present in 48.5% of patients, induction was done in 31.5% of patients and in rest 20% of patients LSCS was indicated. Normal vaginal delivery occurred in 97 of 130 patients while emergency LSCS done 33 of 130 patients. Emergency LSCS was done in 16 of 33 patients due to foetal distress. Pre-term delivery and PROM occurred in 8.5% and 9.2% of patients respectively while PPH occurred in 12.3% of patients. Among the 130 cases included in present study 34 patients (27.2%) had fetal distress, 41 patients (31.5%) had MSL and 40 neonates (32.0%) required NICU. 16 neonates out of 130 (12.8%) had birth weight below 2.5 kg. Apgar score was <7 after 5 min in 31 neonates.Conclusions: Ursodeoxycholic acid (UDCA) is useful in relieving symptoms and decreasing the biochemical markers.

Prevalence of metabolic syndrome in women with polycystic ovary syndrome attending a tertiary care hospital in West Delhi, India

Background: The aim of the present study was to evaluate the prevalence of metabolic syndrome in women with polycystic ovary syndrome (PCOS).Methods: All the women attending the gynae out-patient department of our hospital were screened for polycystic ovary syndrome as diagnosed by the Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group, 2004. Two hundred women with PCOS underwent screening for metabolic syndrome as defined by the national cholesterol education program adult treatment panel III (ATPIII) (2001) definition and the prevalence of metabolic syndrome was compared with two hundred age and BMI matched healthy control subjects. A multivariate logistic regression analysis was applied, and significant predictors identified for the prediction of metabolic syndrome.Results: The prevalence of metabolic syndrome among PCOS patients was 42 % in present study group as compared to 14 % in control group (p=0.01). The prevalence of metabolic syndrome was even higher in obese PCOS Vs non obese PCOS (52 % Vs 28.6 %). But even non-obese PCOS had higher prevalence of metabolic syndrome as compared to controls (28.6 % Vs 14 %).Conclusions: The study suggests a high prevalence of metabolic syndrome in patients with PCOS & thus it is important to screen all PCOS patients for manifestations of metabolic syndrome & its cardiovascular sequelae

Epitheloid leiomyoma of vulva: a diagnostic dilemma

Smooth muscle tumours are uncommon lesions of vulva. This case reflects the rare clinical presentation of leiomyoma of vulva, which commonly mimics bartholin gland cyst at presentation. A 25 year old P1L1 presents in GOPD as a painless non tender nodule at right labia majora, which gradually increased in size over last 2 years. Wide local excision was done. Histopathology revealed epitheloid leiomyoma of vulva. Recurrence is rare in benign cases

Clinical Profiles of Dengue Infection during an Outbreak in Northern India

Introduction. Dengue fever is an arboviral disease, which is transmitted by mosquito vector and presents as varied clinical spectrum of dengue fever (DF), dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS), and expanded dengue syndrome (EDS) with atypical presentations, thus posing a diagnostic dilemma. Unless we are aware of these presentations, diagnosis as well as early initiation of treatment becomes difficult. We studied the various clinical presentations of dengue infection during an outbreak of disease in 2015. Materials and Methods. A total of 115 confirmed cases of dengue infection from Department of Medicine of Deen Dayal Upadhyay Hospital, New Delhi, were enrolled in this observational study. Results. The common signs and symptoms of dengue infection were fever, headache, body ache, backache, retro-orbital pain, bleeding manifestations, and rash in 100%, 87%, 86%, 58%, 41%, 21%, and 21%, respectively. Nonspecific or warning signs and symptoms included vomiting, weakness, abdominal pain, breathlessness, vertigo, sweating, and syncope. Other possible signs and symptoms of coinfections, comorbidities, or complications included diarrhea, sore throat, and neurological manifestations. There were seven patients with coinfections and four with comorbidities. The final diagnosis of these patients was DF (73%), DHF (16.5%), DSS (1.7%), and EDS (4.3%). Among EDS patients, the atypical presentations included encephalopathy, lateral rectus nerve palsy, acalculous cholecystitis, and myocarditis. Four patients required ICU care and there was no death in this study. Conclusion. Knowledge of atypical presentations is a must for early diagnosis and timely intervention to prevent life-threatening complications