A study of the obstetric and perinatal outcomes of eclampsia and the use of levetiracetam in its management

Background: Hypertensive disorders are a common cause of maternal morbidity and mortality complicating 3 to 10% of pregnancies. Eclampsia is a major complication of hypertensive disorders of pregnancy, particularly in developing countries, resulting in poor foeto-maternal outcomes. In some cases of eclampsia use of the gold standard i.e. magnesium sulphate, is restricted and is sometimes ineffective when used as monotherapy. Levetiracetam is an anti-epileptic drug that is relatively safe in pregnancy, does not require intensive monitoring and has potential use in eclampsia. The primary aim of this study was to establish the incidence of eclampsia and its maternal and perinatal outcomes. It also aimed at studying the utility of levetiracetam in the treatment of eclampsia.Methods: It is a retrospective, observational study conducted at Seth G. S. Medical College and K.E.M Hospital, Mumbai (a tertiary care centre). Data of a period of one year was collected from hospital records. The eclamptic patients’ demographic profile, maternal and perinatal outcomes and the use of levetiracetam were noted.Results: The incidence of hypertensive disorders of pregnancy was 7.53% while that of eclampsia was 0.737%. The maternal and perinatal case fatality rates were 18% and 26% respectively. 50% of the cases had other concurrent maternal complications. 44.11% of the live births required neonatal intensive care unit admission. 55% of the cases who were treated with levetiracetam, either as monotherapy or in combination with magnesium sulphate, made a complete recovery.Conclusions: The significant number of hypertensive disorders of pregnancy complicated by eclampsia and its associated co-morbidities indicate the need for early detection of hypertension in pregnancy and timely intervention

Successful maternal and perinatal outcome of hepatitis E in pregnancy with fulminant hepatic failure

Hepatitis E infection is an important cause of fulminant hepatic failure (FHF) in pregnancy in developing countries like India, with a high mortality rate. It is postulated that immunological and hormonal changes in pregnant women predispose them to developing FHF secondary to hepatitis E infection as compared to the less severe form seen in the non-pregnant population. A variation in the natural course of the disease is also seen amongst different geographical areas. Hepatitis E infection is seen to be less severe in parts of the world like Egypt, Europe and the USA as against the Indian subcontinent. The mainstay of management of acute viral hepatitis (AVH) and fulminant hepatic failure secondary to hepatitis E virus is supportive treatment. Since an increased severity of the disease is associated with the pregnant state, termination of pregnancy to alter its course is an option worth considering. Our case study showed promising results of induction of labour in a case of FHF (hepatic encephalopathy with disseminated intravascular coagulation) caused by hepatitis E, in the third trimester of pregnancy

Successful management of a young patient with yolk sac tumour

Yolk sac tumours, synonymous with endodermal sinus tumours, are rare, malignant germ cell neoplasms occurring usually in gonads. Yolk sac tumours are more commonly seen in patients of early age group, the median age being 18 years. We report a case of a yolk sac tumour of the ovary in a 21 year old female, managed by surgery and chemotherapy

A near-miss case of obstetric haemorrhage managed successfully

Functioning of health systems with respect to maternal health were previously audited using indicators like maternal mortality ratio. However, maternal morbidity as a consequence of pregnancy-related complications is not accounted for in these indicators. Thus, the World Health Organization (WHO) has formulated a maternal near-miss approach to pregnancy complications for a more thorough evaluation of health care systems across the world. In practical terms, women are said to be maternal near-miss cases when they survive lethal conditions during pregnancy or in the postpartum period. We report one such case of traumatic variety of postpartum haemorrhage subsequent to a lower segment caesarean section with immediate post-operative removal of cervical cerclage threads that resulted in a maternal near-miss case

Conservative management options for morbidly adherent placenta

Background: Morbidly adherent placenta is still a very significant cause of obstetric hemorrhage.Methods: A retrospective, descriptive study was undertaken over a period of one and a half year in a tertiary care hospital of all diagnosed cases of morbidly adherent placenta which were managed conservatively and the maternal and perinatal outcomes were noted. Preparation for conservative management of cases of adherent placenta in the antenatal period included informing interventional radiologists and placement of internal iliac balloon catheters just before classical caesarean section. Post-operative methotrexate was used in a few patients.Results: 11 cases of morbidly adherent placenta diagnosed on Doppler ultrasound scan, and confirmed by MRI were identified. All patients underwent classical caesarean section. 9 patients had internal iliac balloon placement. 5 patients received methotrexate. 3 patients required obstetric hysterectomy. 1 maternal and 2 perinatal mortalities were noted.Conclusions: Interventional radiology and methotrexate can be used to avoid peripartum hysterectomy and to optimize maternal and perinatal outcome

Bio-efficacy of phytoextracts and oil cakes on Macrophomina phaseolina (Tassi) causing stem rot disease of jute, Corchorus spp.

In the present study efforts were made to explore the efficacy of various plant extracts and oil cakes against Macrophomina phaseolina. The efficacy of eight different plant species, Zingiber officianale, Aloe indica, Lawsonia inermis, Chenopodium album, Allium cepa, Piper betel, Murraya koenigii, Parthenium hysterophorus aqueous extracts including oil cakes of mustard and neem were evaluated by using of poisoned food technique in vitro for their inhibitory effect on mycelial growth of M. phaseolina causing stem rot of jute (Corchorus olitorius and C. capsularis). The rhizome extract of Z. officinale produced maximum growth inhibition (74.59%) of the pathogen followed by leaf extracts of A. indica (63.57%), and leaf extract of L. inermis (60.17%) at the concentration of 10%. The maximum mycelial growth inhibition (52.40%) was recorded with neem cake (Azadirachta indica) at the concentrations of 20% followed by 42.61% and 29.60% with concentration of 15% and 10%, respectively. However, maximum mycelial growth inhibition (19.42%) was recorded with mustard cake (Brassica juncea) at the concentration of 20% followed by 16.64% and 12.20% at the concentration of 15% and 10% respectively. In general mycelial growth inhibition was dose dependent and it was maximum in case of neem cake than mustard cake. The present study revealed that, these plant extracts and oilcake extracts could be exploited for the possible control of deadly pathogen M. phaseolina. Accordingly, this is an important proactive measure in preventing the spread of the stem rot disease through a more ecofriendly approach

Successful management of a near miss case of eclampsia with intracranial haemorrhage requiring craniotomy

Large population-based studies on stroke report that intracerebral haemorrhage is rare in young women however it is a grave and disturbing complication of pregnancy. Preeclampsia is usually clinically silent, but may cause symptoms of neurological dysfunction such as headache, visual disturbances and impairment of consciousness. Eclampsia is in the occurrence of seizures in the context of preeclampsia and is often, but not always, preceded by the above neurological symptoms. Most published data support the view that preeclampsia and eclampsia are important causative factors for pregnancy related ICH. Sparse data is available with respect to the management of such cases. Identification of near miss cases is an important step in reducing mortality. Herein we report a near miss case of eclampsia with intracranial haemorrhage requiring craniotomy

PHYSICO CHEMICAL STUDIES ON SOAP NUT [SAPINDUS TRIFOLIATUS] OIL FOR SOURCE AS BIODIESEL

Sapindus trifoliatus is a small tree belongs to the family Sapindaceae. Soap nut powder is a very good antibacterial and antifungal agent. It is mostly used in the cosmetic and contraceptive creams.It has a number of health benefits besides the famous benefit of keeping the hair long and healthy. It is useful in the treatment of lice's and dandruff. It is also used as detergent, bio-surfactant and remedial for organic soil pollution in the modern science. In this present study .The Physico- Chemical Properties of the Soap nut oil was analyzed by blending with conventional diesel at 10% (B10) and 20% (B20) proportions. The properties assessed in the physical parameters include, pH, Density Salinity, Viscosity, Specific gravity, Conductivity, Total dissolved oxygen and Total dissolved solid. The significant biodiesel characters like   flash point, fire point, smoke point, pour point, cloud point and carbon residue were analysed. The ultrasonic characters like ultrasonic velocity, adiabatic compressibility, acoustic impedance, relaxation time were also assessed. The chemical parameters estimated such as Acid value, Iodine value and Saponification value. The values of the parameters were compared with the ASTMT standards of biodiesel. The biodiesel blend B20 is found to be within the ASTM standard and it can serve as a potential source for biodiesel.Keywords: Soap nut, Sapindus trifoliatus, Conductivity, Ultrasonic velocity, Saponification

Comparative Studies on Russell-Saunders Atomic Term Symbols (Terms) for Equivalent Electrons of nf 4 and nf 10 Configurations

There are two coupling schemes for obtaining Russell Saunders atomic term symbols (terms) for the equivalent electrons, one is Russell-Saunders (L-S) coupling scheme and another is spin-orbit (j-j) coupling scheme. The Russell Saunders atomic term symbol provide the information about spectral and magnetic properties of an atom. For this work computation is done to calculate all the possible microstates and atomic terms for equivalent electrons of nf 4 and nf 10 configurations and a comparative study is carried out between the Russell Saunders atomic terms of nf 4 and nf 10 configurations. The possible microstates counted for these configurations are 1001 and the terms obtained from these states are 47, these terms are quintets (5), triplet

Existence of Vitamin C Fruit Sources in the Kani Tribal Settlements of South TamilNadu

Kani tribes are one of the important tribals of the Western Ghats of south India. They are well versed in traditional medicines to treat various ailments. Their food materials are rich in all vital compounds necessary for the day to day life. Their main occupation is agriculture. They cultivated many fruits including citrus plants. A field study was conducted in the Kani trible settlement of Kanyakumari district of TamilNadu and borders of kerala. From them we were able to collect 15 different kinds of plant species cultivated by the Kani tribes which belong to 8 different families contain vitamin C in the fruits. The vitamin C content for the 15 fruits were estimated and among the 15 plants sources, the Bambilimas has the maximum vitamin C content