Association of increased platelet distribution width and red cell distribution width with recurrent pregnancy loss

Background: Recurrent pregnancy loss is defined as three or more consecutive pregnancy losses at or less than 20 weeks of gestation or with a fetal weight less than 500 grams. The aim was to compare platelet distribution width and red cell distribution width between pregnant women with a history of recurrent pregnancy loss and pregnant women without a history of pregnancy loss.Methods: This was a prospective study to the evaluation of 70 pregnant women with a history of recurrent pregnancy loss and 70 pregnant women without a history of pregnancy loss in the first trimester.Results: When compared pregnant women with a history of recurrent pregnancy loss and 70 pregnant women without a history of pregnancy loss, the pregnant women with a history of recurrent pregnancy loss had significantly higher platelet distribution width and red cell distribution width (p≤0.001 for both). There was no statistically significant difference between the two groups in terms of age, BMI, Hemoglobin, TLC, hematocrit, platelecrit, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration (p>0.05).Conclusions: An increased platelet distribution width and red cell distribution width with recurrent pregnancy loss

Kisspeptin: new biomarker of pregnancy

Background: The recently identified hormone kisspeptin has been suggested to play an important regulatory role in placentation. The aim and objective of the study is the measurement of serum kisspeptin level in asymptomatic pregnant women and to find out the association of serum kisspeptin with gestational age in women with early pregnancy.Methods: This was a longitudinal study to the evaluation of 178 asymptomatic pregnant women with a gestation of 6 to 16 weeks attending routine antenatal booking visit recruited as study participants from the Antenatal Clinical of Obstetrics and Gynaecology Department, S.M.S. Medical College and Attached Hospitals, Jaipur, Rajasthan, India.Results: After initial clinical examination of every participant, a single blood sample was taken for the measurement of serum kisspeptin. Serum kisspeptin measurement test was performed by ELISA method and results were expressed as ng/ml. Pregnancy outcome was recorded prospectively. Mean serum kisspeptin level of study participants was 2.80±1.87ng/ml and median were 2.41 (Range 0.244-14.06ng/ml). Our result showed the relationship of serum kisspeptin with gestational age (GA) (p<0.000).Conclusions: serum kisspeptin level increases in pregnancy and showed positive relationship with gestational age significantly (p<0.000)

Seroprevalence of celiac diseases in children suffering from severe acute malnutrition in age group of 1–5 years

Introduction: Celiac disease (CD) may be an underlying cause of malnutrition. Aim: The objective of this study was&nbsp;to find out the seroprevalence of CD in children suffering from severe acute malnutrition (SAM) in age group of 1–5 years.&nbsp;Materials and Methods: This was a prospective, observational, hospital-based study carried out at Malnutrition Treatment Centre&nbsp;attached with tertiary care pediatric hospital associated with the medical college of southern Rajasthan, from December 2017&nbsp;to November 2018. A total of 110 children with SAM were enrolled and screened for CD on the basis of celiac serology (tissuetransglutaminase [tTg]-immunoglobulin A/G [IgA/IgG]). Results: Celiac serology was positivity in 30 (27.28%) cases; out of&nbsp;total 30 seropositive cases, 14 (46.66%) cases were seropositive for both tTg-IgA and IgG, while only tTg-IgA and only tTg-IgG&nbsp;were positive in 9 (30%) and 7 (23.33%) cases, respectively. Mean serotiter of serum tTg-IgA and IgG in seropositive cases was&nbsp;134.01±198.74 and 49.05±25.74 unit/ml. Conclusions: High seroprevalence of CD in SAM should be taken as alert as CD may&nbsp;be an underlying cause and responsible for malnutrition. These children should be screened by celiac serology (tTg-IgA/IgG) to&nbsp;rule out CD

Study of rainfall pattern in Chaksu Tehsil, Jaipur, Rajasthan, India

The water storage beneath the ground surface is the function of the Rainfall in an area. The underground water is the main source of irrigation and effect the agriculture production. So directly or indirectly the rainfall influences the agriculture. The years with the good rainfall enjoy the high agriculture production as the requirement of water is facilitated. The paper presents the rainfall pattern for last 25 years in study area with the analysis of variation of rainfall year by year. For the study, different techniques and tools are employed so the variation where it is seasonal or annual can be shown

An unusual case of delivery with central rupture of perineum and intact introitus

Most women experience some degree of tear during childbirth and in some these can be extensive. Obstetrics injuries contribute 0.5-15% of vaginal deliveries. Here authors present a case of 23-year-old primigravida who presented at Safdarjung hospital New Delhi, Delhi, India with complaint of pain in perineum and excessive bleeding per vaginum. On examination, introitus was intact and there was central rupture of perineum which involved anal sphincter proximally and rectal mucosa distally. Patient was shifted to operation theatre for exploration and repair. She received 2 units of blood transfusion, antibiotics and laxatives. Patient was discharged on post-operative day 5 in satisfactory condition. Thus, authors emphasise the need of institutional delivery and prevention of perineal injuries which would further obviate the need for surgical repair and associated morbidity. In present era of easy communication and transport we still receive cases of unsupervised deliveries which gives us a strong motive to spread awareness for antenatal visits and care among this population

A study of high sensitive C-reactive protein in rheumatoid arthritis patients

Background: Rheumatoid arthritis (RA) is not only merely limited to joints but has many extraarticular features. The major cause of mortality in RA is cardiovascular disease (CVD). Inflammation in RA predispose them to succumb to CVD. The aim of this study to observe whether therapy with disease-modifying anti-rheumatic drugs (DMARD) decreases inflammation and if it does so than it can be said that decrease the risk to develop CVD. Aim and objectives were to assess hs-CRP level in early and established RA both at diagnosis and again at 3 months of DMARD therapy and compare between them.Methods: Total 58 early RA (group A) and 58 established (group B) DMARD naïve RA patients were included in the study. Age, BMI, haemoglobin, random blood sugar, lipid profile, ESR, hs-CRP, RA factor and anti-CCP were measured. All of them were treated with DMARD and hs-CRP was again assessed after 3 months.Results: The mean hs-CRP level at diagnosis was 6.14±1.90 mg/l in group A while it was 10.39±3.13 mg/l in group B. The mean hs-CRP level after 3 months of DMARD was 2.56±1.35mg/l in group A while it was 7.91±3.13 mg/l in group B. The mean reduction in hs-CRP level in early RA (3.58±0.99 mg/l) was statistically significantly (p<0.001) higher than that in established RA (2.48±0.09 mg/l).  Conclusions: DMARD decreases level of inflammation in RA more efficiently if initiated early in the course of the disease

Role of Raktamokshana (Bloodletting therapy) in Sandhigata Vata w.s.r. to Lumbar Spondylosis

Low back pain is a commonest clinical presentation in musculoskeletal disorder due to spinal pathology. Change of life style in developing countries has created several disharmonies in biological system. The terms, lumbar osteoarthritis, disc degeneration, degenerative disc disease and spondylosis are being used in literature to describe anatomical changes of lumbar spine including vertebrae and inter-vertebral disc. Basing upon the patho-physiology and symptoms, Sandhigata Vata is equated with lumbar Spondylosis. Sandhigata Vata is a clinical condition develops when the vitiated Vayu becomes localized in Kati Pradesha. During the process of pathogenesis Kaphavrita Vyana Vayu obstructs the circulation of Rasa, Rakta Dhatu and gradually structural changes seen in Kati Pradesha. The symptoms like Shoola, Shopha, Stambha are developed later on. Raktamokshana is an important Para-surgical procedure recommended by Acharyas for treatment of Snayu Sandhigata Vata. It helps to enhance fresh blood supply to the affected lumbar region. It promotes detoxification, purification of nutrition path way by removing Doshas, lodged in inter-vertebral joint spaces. In this way the Raktamokshana process helps to regain the normal function in degenerative joint disorders

A comprehensive overview of Gokshura (Tribulus terrestris Linn.)

Gokshura (Tribulus terrestris Linn.) is very revered herb of the Indian Ayurvedic system of medicine for treatment of various kinds of diseases. Its various parts conatain variety of chemical constituents which are found medicinally important. Although the review articles on this plant are already published, this review article is presented to compile the complete literature review of Gokshura from Brihatrayi and updated information on its pharmacological activities, which are performed by widely different experiments. Various studies which are done on Gokshura revealed the result that the plant possesses Antiurolithiatic, Antimicrobial, Antihelminthic, Cardiotonic, Anti- inflammatory, Hypolipidemic, Immunomodulatory, Antispasmodic, Analgesic, Aphrodisiac, Antidiabetic, Anti-tumour, Hepato-protective, Anticarious, Anti-oxidant, CNS modulator properties. Considering its therapeutic values, a review has been done to gather complete information on different aspects of Gokshura

A rare case of recurrent hypoglycaemia

Very often clinicians are confronted with unconscious patients; the cause being hypoglycaemia. In addition to correction of hypoglycaemia promptly, a search for the cause of hypoglycaemia must be attempted at the earliest with a stepwise approach. Here, the authors present a rare case of recurrent hypoglycaemia where a stepwise approach ultimately led to a diagnosis, but there were various reports which were misleading. The diagnosis was insulinoma which was apparent from the history and presenting features. But, the initial investigations, even though having high sensitivity, were normal, thus leading to a more invasive approach. The patient was ultimately cured by enucleation

Diagnostic utility of neutrophil CD64 as a marker of early-onset sepsis in very low birth weight neonates

Background: Sepsis is a major cause of neonatal morbidity and mortality. It is extremely important to make an early diagnosis of sepsis, as early recognition and prompt institution of treatment is critical for improved outcome. Objectives: This prospective observational study was aimed to evaluate the diagnostic utility of neutrophil CD64 expression for the identification of early-onset sepsis in very low birth weight (VLBW) neonates. Methods: All VLBW neonates with signs and symptoms of sepsis before 72 h of age, born to mother with or without risk factors for sepsis were enrolled. Complete blood cells count, C-reactive protein, absolute neutrophil count, I/T ratio, blood culture, and neutrophil CD64 assessment were performed. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of neutrophil CD64 and its combination with other hematological makers for sepsis were measured. Results: A total of 302 VLBW neonates were enrolled; of which, 151 were cases and 151 were controls. Neutrophil CD64 was significantly increased in cases than in controls (p&lt;0.001). The highest performance of CD64 was at