A comparative study between PGE1 and PGE2 for induction of labour in premature rupture of membrane at term

Background: Premature rupture of membranes at term can be managed expectantly with good results. However, low bishop score may lead to undue latency. It can lead to complications if no intervention done. So, timely intervention by labour induction in selected cases can improve maternal and fetal outcome. Prostaglandins has very vital role for induction of labour. This study is to compare the effectiveness between the two molecules of prostaglandins PGE1 and PGE2 for induction of labour in term premature rupture of membrane (PROM).Methods: It is a prospective interventional study performed at a tertiary hospital attached to a medical college. It was conducted upon randomly selected 100 women of term PROM from April 2011 to April 2015. They were divided into two comparable groups each containing 50 women. Both the groups were comparable in age, parity and bishop score. One group was induced with PGE1 (Tab Misoprostol) and the other with PGE2 (Dinoprostone gel).Results: Among 100 women, a good number of women were primigravida (76%). Majority of women were induced in between 6 to 12 hours after PROM (69%). Vaginal deliveries were 68% in tab. Misoprostol group while 80% in dinoprostone gel group which are comparable in both the groups. The significant difference observed was average induction delivery interval, which was 11.26 hours in tab. misoprostol group and 14.72 hours in dinoprostone gel group (P=0.004). The other women (26%) underwent cesarean section. Among them 46.15% were done for fetal distress and 43.84% for induction failure.Conclusions: Both the molecules of prostaglandins are efficient for labour induction in term PROM.  Though, PGE1 (tab. Misoprostol) is faster acting as compare to PGE2 (dinoprostone gel) even with low bishop score. But it can lead to complications like hyperstimulation, fetal distress and postpartum hemorrhage if not used properly. So, tab misoprostol is not a safe drug where continuous monitoring of women is not available

Network Intrusion Detection Using Multiclass Support Vector Machine

Intrusion detection is a topic of interest in current scenario. Statistical IDS overcomes many pitfalls present in signature based IDS. Statistical IDS uses models such as NB, C4.5 etc for classification to detect Intrusions. Multiclass Support Vector Machine is able to perform multiclass classification. This paper shows the performance of MSVM (1-versus-1, 1-versusmany and Error Correcting Output Coding (ECOC)) and it’s variants for statistical NBIDS. This paper explores the performance of MSVM for various categories of attack

Study of consumption of blood and blood components in emergency obstetrics patients

Background: Most of the emergencies in the labour room, which require blood and blood product transfusion includes, complications of abortion, placenta previa, ruptured ectopic pregnancy and haemorrhage in labouring patients. Patients may come with severe anaemia and may develop post-partum haemorrhage or any other complications resulting in massive blood loss and rapid deterioration in well-being of the mother. Blood transfusion has become life-saving in management of haemorrhage in obstetric patients. However, like all treatments, it may result in acute or delayed complications. Methods: This retrospective study has included the patients who came with obstetric emergencies requiring blood and blood products during antepartum, intrapartum and postpartum period at the obstetrics and gynaecology department, at tertiary care hospital between December 2022 to December 2023. Results: Multigravida patients required more blood transfusion (69.23%) compared to primigravida (30.76%). Anaemia (38.46%) was the commonest indication for blood transfusion followed by post-partum haemorrhage (21.53%). Fever and shivering (3.07%) were seen to be the commonest adverse reactions. This study observed 92.3% live birth and 7.7% intrauterine foetal demise. Wound gap developed in 3(4.61%) patients following blood and blood products transfusion. Conclusions: Transfusing blood or its components holds utmost importance in comprehensive obstetric care, as emphasised by the current study. Haemorrhage in labouring patients and anaemia are leading causes of maternal morbidities and mortalities. The most effective outcomes in management are achieved through a carefully planned multidisciplinary protocol. Prompt availability of blood and blood components helps to avert mortality in a considerable number of cases

Study of medical methods of abortion and self-attempted abortion

Background: Medical abortion in the early stages of pregnancy is considered safe, but it relies on having accurate information and support from a qualified healthcare professional. Despite this, many women opt to use medical abortion pills independently or with the assistance of unqualified practitioners, or pharmacists, as these drugs are readily available over-the-counter without requiring a medical prescription. Methods: This retrospective analytical study was undertaken at the department of obstetrics and gynaecology, at Smt. SCL municipal general hospital, Ahmedabad between December, 2022 to December, 2023. Results: The present study clearly suggests 50% cases of self-attempted medical abortion with drug purchased ‘over the counter’ needs surgical evacuation, 30% managed with further medical intervention and blood transfusion, while comparing with cases which were prescribed MTP Pills in tertiary health care centre need surgical intervention in only 10% cases and the complete abortion rate was 90%. Conclusions: In India the drugs for medical abortion are easily available and accessible without prescription, so most women feel it can be carried out in privacy and they only come to hospital when they develop complications. When MTP pills are prescribed under care of properly trained healthcare personnel with proper guidelines, they have a high success rate and fewer complications

Study of feto-maternal outcome in patients of jaundice in third trimester of pregnancy

Background: Jaundice in pregnancy is an important medical disorder, more commonly seen in developing countries than developed ones. It comprises of a formidable list of complications that may adversely affect the pregnant woman and her fetus. Objective of current study was to study causes and feto-maternal outcome in pregnancies with jaundice in 3rd trimester.Methods: This was a retrospective study of 49 patients admitted in department of Obstetrics & Gynaecology at a tertiary care hospital with jaundice in 3rd trimester of pregnancy during the period from September 2008 to September 2010.Results: Out of 9972 deliveries, 49 patients were admitted with jaundice in 3rd trimester of pregnancy. Out of them 91.1% patients delivered. Vaginal delivery occurred in 82.2% and Cesarean section done in 17.7%. Preterm delivery occurred in 68.8%, low birth weight (LBW) was found in 82.2%, perinatal mortality occurred in 34.6% and maternal mortality occurred in 16.3% of patients.Conclusions: Jaundice in 3rd trimester of pregnancy leads to preterm delivery, fetal distress, intra uterine fetal death (IUFD) and high perinatal & maternal morbidity and mortality. Early diagnosis & aggressive management at tertiary care center help in reducing maternal & perinatal morbiditiy and mortality

Self-medication of abortion pills and its complications: an observational study

Background: Medical termination of pregnancy has been legalized in India since 1971. Medical abortion pill is well effective in early weeks of pregnancy. It is safe only when it is used under medical supervision. This study was carried out to analyse the complications following self-medication of abortion pills and to suggest measures to prevent such practice.Methods: This was a retrospective observational study conducted at our hospital from March 2017 to July 2017.Results: In present study 30 (75%) patients were in age group of 20-30 years. Illiterate patients were 22 (55%). Half of the patients, 20 (50%) were having three or more than three children. Majority of women 30 (75%) had consumed the abortion pills 1-10 days before coming to the hospital and 14 (35%) of patients had come with complain of excessive bleeding per vagina. Incomplete abortion was present in 32 (80%) of patients. Instrumental evacuation was required in 28 (87.5%) patients. Laparotomy for ruptured ectopic and rupture uterus was performed in 1 (2.5%) of each patient. 6 (15%) patients were severely anaemic. Transfusion of blood was required in 9 (22.5%) of patients.Conclusions: Medical abortion is effective and safe when carried out under medical supervision. Unsupervised use of medical abortion pills was associated with many complications like incomplete abortion, rupture ectopic and ruptured uterus. So, over the counter sale of medical abortion pill should be restricted

Evaluation of physico-chemical and microbial parameters on water quality of Narmada River, India

The present study was carried out to ascertain the quality of water at western zone of Narmada River of Madhya Pradesh (India). Due to heavy discharge of harmful and deleterious substances in river, the biological, chemical and physical characteristics of water have changed to a considerable extent. The objectives of this study were to find out the changes in physico-chemical nature as well as biological health of Narmada River. A thorough study was done on the basis of prevailing seasons. The deterioration of water quality was noticed at lower site of water body in a particular season as low temperature, dissolved oxygen and higher concentration of content of chlorine, etc., all pointing towards the nutrient enrichment. This evaluation will be immensely helpful to estimate the effect of impoundments on the quality of water, fisheries development and reservoir management policy. The microbial analysis was also conducted in terms of most probable number (MPN) of total coliforms in water sample and its highest value (1239) was reported from downstream of Omkareshwar dam site of Narmada River. Water quality index of all sites of Narmada River was calculated for three seasons, viz. summer, monsoon and winter and it was found to be highest (123) at Koteshwar dam site of river in monsoon season and the lowest (70) was observed in water of upstream of Omkareshwar dam during winter. The suitable correlation coefficients were calculated for 7 pairs of variables and correlation matrices were then established seasonally.Key words: Impoundments, water quality index, dissolved oxygen, most probable numbe

Effect of Long-Term Exposure to Lower Low-Density Lipoprotein Cholesterol Beginning Early in Life on the Risk of Coronary Heart Disease A Mendelian Randomization Analysis

ObjectivesThe purpose of this study was to estimate the effect of long-term exposure to lower plasma low-density lipoprotein cholesterol (LDL-C) on the risk of coronary heart disease (CHD).BackgroundLDL-C is causally related to the risk of CHD. However, the association between long-term exposure to lower LDL-C beginning early in life and the risk of CHD has not been reliably quantified.MethodsWe conducted a series of meta-analyses to estimate the effect of long-term exposure to lower LDL-C on the risk of CHD mediated by 9 polymorphisms in 6 different genes. We then combined these Mendelian randomization studies in a meta-analysis to obtain a more precise estimate of the effect of long-term exposure to lower LDL-C and compared it with the clinical benefit associated with the same magnitude of LDL-C reduction during treatment with a statin.ResultsAll 9 polymorphisms were associated with a highly consistent reduction in the risk of CHD per unit lower LDL-C, with no evidence of heterogeneity of effect (I2 = 0.0%). In a meta-analysis combining nonoverlapping data from 312,321 participants, naturally random allocation to long-term exposure to lower LDL-C was associated with a 54.5% (95% confidence interval: 48.8% to 59.5%) reduction in the risk of CHD for each mmol/l (38.7 mg/dl) lower LDL-C. This represents a 3-fold greater reduction in the risk of CHD per unit lower LDL-C than that observed during treatment with a statin started later in life (p = 8.43 × 10−19).ConclusionsProlonged exposure to lower LDL-C beginning early in life is associated with a substantially greater reduction in the risk of CHD than the current practice of lowering LDL-C beginning later in life

Cell Nucleus-Targeting Zwitterionic Carbon Dots

An innovative nucleus-targeting zwitterionic carbon dot (CD) vehicle has been developed for anticancer drug delivery and optical monitoring. The zwitterionic functional groups of the CDs introduced by a simple one-step synthesis using beta-alanine as a passivating and zwitterionic ligand allow cytoplasmic uptake and subsequent nuclear translocation of the CDs. Moreover, multicolor fluorescence improves the accuracy of the CDs as an optical code. The CD-based drug delivery system constructed by non-covalent grafting of doxorubicin, exhibits superior antitumor efficacy owing to enhanced nuclear delivery in vitro and tumor accumulation in vivo, resulting in highly effective tumor growth inhibition. Since the zwitterionic CDs are highly biocompatible and effectively translocated into the nucleus, it provides a compelling solution to a multifunctional nanoparticle for substantially enhanced nuclear uptake of drugs and optical monitoring of translocation.open

A comparative study between PGE1 and PGE2 for induction of labour in premature rupture of membrane at term

Background: Premature rupture of membranes at term can be managed expectantly with good results. However, low bishop score may lead to undue latency. It can lead to complications if no intervention done. So, timely intervention by labour induction in selected cases can improve maternal and fetal outcome. Prostaglandins has very vital role for induction of labour. This study is to compare the effectiveness between the two molecules of prostaglandins PGE1 and PGE2 for induction of labour in term premature rupture of membrane (PROM).Methods: It is a prospective interventional study performed at a tertiary hospital attached to a medical college. It was conducted upon randomly selected 100 women of term PROM from April 2011 to April 2015. They were divided into two comparable groups each containing 50 women. Both the groups were comparable in age, parity and bishop score. One group was induced with PGE1 (Tab Misoprostol) and the other with PGE2 (Dinoprostone gel).Results: Among 100 women, a good number of women were primigravida (76%). Majority of women were induced in between 6 to 12 hours after PROM (69%). Vaginal deliveries were 68% in tab. Misoprostol group while 80% in dinoprostone gel group which are comparable in both the groups. The significant difference observed was average induction delivery interval, which was 11.26 hours in tab. misoprostol group and 14.72 hours in dinoprostone gel group (P=0.004). The other women (26%) underwent cesarean section. Among them 46.15% were done for fetal distress and 43.84% for induction failure.Conclusions: Both the molecules of prostaglandins are efficient for labour induction in term PROM.  Though, PGE1 (tab. Misoprostol) is faster acting as compare to PGE2 (dinoprostone gel) even with low bishop score. But it can lead to complications like hyperstimulation, fetal distress and postpartum hemorrhage if not used properly. So, tab misoprostol is not a safe drug where continuous monitoring of women is not available