A study of efficacy of intramuscular injection tramadol as labour analgesic and labour accelerator in 400 primigravida patients in latent phase of first stage of labour

Background: Labour pain is among the most severe pain experienced by women. Most women like to experience labour birth with active involvement and as naturally as possible. Hence, the need for analgesia to overcome labour pains is highly requested by women today. In developing nations where availability of facilities is the main limiting factor, intra muscular opioids can be used. The aim was to know the effect of Tramadol in labour analgesia and reduction in the duration of labour and to know the maternal and neonatal outcome after administration of TramadolMethods: This study was conducted in tertiary teaching care hospital in 400 low risk primigravidae who fulfilled selection criteria with full-term pregnancy with vertex presentation in late latent phase of labour were selected and given 100 mg tramadol hydrochloride intramuscularly.Results: The degree of pain relief in 1 st and 2 nd stage of labour, duration of labour, Apgar score of neonates and side effect of drugs were studied. In this study 23.5% of patients had grade II pain, 38.5% of patients had grade III pain and 38% of patients had no pain relief after Tramadol administration. Before drug, the mean pain score is 3.86 in stage I. After drug administration the mean pain score is 3.14 in stage I and 3.81 in stage II. The duration of first and second stage of labour also shortened.Conclusions: In low risk Primigravidae, IM Tramadol hydrochloride appears to be effective without side effects. Hence, in developing nations, where availability of facilities is the main limiting factor, IM opioids can be considered as suitable alternatives

A Study on the Validation of paediatric index of mortality 2 (PIM2) score in the Paediatric Intensive Care Unit of CMC, Vellore

INTRODUCTION: Paediatric intensive care is a rapidly developing super specialty especially in the later half of the 20th century. While these developments happened much later in developing countries, over the past 10 years there has been a tremendous growth in Paediatric intensive care in India. Paediatric Intensive Care Units (PICU) constantly aim at promoting care to critically ill children which often involves huge amounts of technology that comes at exorbitant cost, often unreachable to many families. Even though the underlying condition is potentially treatable, the outcome is often uncertain. The question of how best to utilize critical care resources is one that challenges intensive care unit (ICU) directors on a daily basis. Shortages in space, human and economic resources especially in developing countries limit the ability to provide complete care. As costs of health care in ICU have gone up dramatically, correctly identifying those children who are salvageable from moribund group of children becomes necessary for implementation of effective and rational medical therapy. The Paediatric Intensive care unit (PICU) at Christian Medical College and Hospital, Vellore is a multispecialty unit that provides services to a heterogeneous group of sick children from various paediatric specialties including General Paediatrics, Paediatric oncology, Paediatric Nephrology, Paediatric Endocrinology, Developmental Paediatrics, Paediatric surgery, Hematology, Urology, Plastic surgery and Cardiology. The annual admission is approximately 1200 children per year from various parts of India mainly comprising population from in and around Vellore including adjacent parts of Andhra Pradesh. Since this is a major tertiary center, most admissions are referred from various nursing homes as well as medical college hospitals for further management in view of disease severity. About one-fourth of PICU admissions are post- operative patients from surgical specialties. Thus our patient population represents a good amount of case mix and disease severity requiring intensive care. AIMS AND OBJECTIVES: 1. To validate the Paediatric Index of Mortality 2 (PIM 2) score in the Paediatric Intensive Care Unit of CMC, Vellore 2. To compare the performance of our PICU with the other Intensive Care Units in the world. MATERIALS AND METHODS: Study design: The design of the study was an observational prospective cohort study Study population All children admitted into the Paediatric Intensive Care Unit (PICU) from 1st February 2007 to 31st September 2007 were included in the study. There was no intervention in this study. All consecutive children were included in the study and none were excluded due to any reason. Study setting: This study was performed in Paediatric Intensive Care Unit (PICU) of Department of Child Health, Christian Medical College and Hospital, Vellore which is a multispecialty tertiary care hospital in South India. The paediatric wards have 133 general beds and cater services to General Paediatrics, Paediatric Oncology, Paediatric Nephrology, Paediatric Endocrinology, Developmental Paediatrics and Paediatric Surgery. Sample size: As per the statisticians advice a defined period of study was chosen before the onset of the study. This period was chosen as minimum of eight months. All children admitted under PICU for treatment during the period were included in the study. Statistical Analysis: PIM 2 SCORE was calculated for each patient using the software published in the website of www_sfar_org-scores-pim2.htm which is a free website available online. All the above collected DATA and the PIM 2 score were entered into the Statistical Package for the Social Sciences (Windows version 15.0; SPSS Inc, Chicago [IL], United States) and the DATA was analyzed. CONCLUSIONS: PIM 2 score performed well in predicting deaths well among the children admitted to the Paediatric Intensive Care Unit. • The Standardized Mortality Ratio of the study population was 1.077 (95% CI 1.060 – 1.093) showing the performance of the PICU to be comparable to the Australian PICUs where PIM2 was developed. • PIM2 model calibrated poorly in our study population as tested by Hosmer Lemeshow goodness of fit test. • Further studies evaluating a modified and adapted PIM2 model that incorporates the different high risk diagnoses seen in our population are needed for better calibration

Clinical and bacteriological profile in lymph node and bone tuberculosis

To study the clinical data and histopathological and microbiological correlates in clinical suspects of lymph node and bone tuberculosis. To study the pattern of drug resistance in microbiologically confirmed cases of lymph node and bone tuberculosis. In our study we observed the culture yield to be low due to paucibacillary nature of the disease in concordance with earlier studies. In immune compromised state like HIV and diabetes nongranulomatous histology in lymph node and spine TB were noted. Lymph node and bone tuberculosis have a higher degree of drug resistance in previously treated patients and HIV seropositive patients. These groups can be considered as risk factors for drug resistance in lymph node and bone tuberculosis and can be targeted for drug susceptibility testing(DST)

A study of efficacy of intramuscular injection tramadol as labour analgesic and labour accelerator in 400 primigravida patients in latent phase of first stage of labour

BACKGROUND: Labour pain is among the most severe pain experienced by women. Most women like to experience to labour birth with active involvement and as naturally as possible. Hence, the need for analgesia to overcome labour pains is highly requested by women today. In developing nations where availability of facilities is the main limiting factor, intra muscular opioids can be used. OBJECTIVES: Our aim was to know the effect of Tramadol in labour analgesia and reduction in the duration of labour and to know the maternal and neonatal outcome after administration of Tramadol. METHODS: This study was conducted in teaching hospital attached to Stanley medical college, Chennai. 400 low risk primigravidae who fulfilled selection criteria with full-term pregnancy with vertex presentation in late latent phase of labour (i.e., with 2-3centimeter cervical dilatation) were selected and given 100 mg tramadol hydrochloride intramuscularly. MAIN OUTCOME MEASURES: The degree of pain relief in 1 st and 2 nd stage of labour, duration of labour, Apgar score of neonates and side effect of drugs were studied. RESULTS: In this study 23.5% of patients had grade II pain, 38.5% of patients had grade III pain and 38% of patients had no pain relief after Tramadol administration. Before drug, the mean pain score is 3.86 in stage I. After drug administration the mean pain score is 3.14 in stage I and 3.81 in stage II. The duration of first and second stage of labour also shortened. CONCLUSION: In low risk Primigravidae, IM Tramadol hydrochloride appears to be effective without side effects. Hence, in developing nations, where availability of facilities is the main limiting factor, IM opioids can be considered as suitable alternatives

Management of coriander wilt using biocontrol agents

A replicated field trial on biocontrol of coriander wilt caused by Fusarium oxysporum f., sp. coriander; was conducted in kharif season during 1995-96, 1996-97 and 1997-98 in the Department of Spices and Plantation Crops, Horticultural College and Research Institute, TNAU, Coimbatore. Seed treatment with Trichoderma viride at 4 g kg-1 of seed was found to be more effective in reducing the wilt incidence to 5.3 per cent as against 28.3 per cent recorded in untreated, control plots in all the three years. The mean yield (387.5 kg ha-1) for all the three years was also significantly higher in seed treatment with T. viride as against very low yield (162 kg ha-1) obtained in untreated plots. The cost benefit ratio was also enhanced with the same treatment. &nbsp

A novel Ag/Carrageenan-gelatin hybrid hydrogel nanocomposite and its biological applications : preparation and characterization

A novel biohybrid hydrogel nanocomposite made of natural polymer carrageenan and gelatin protein were developed. The silver nanoparticles were prepared using the carrageenan polymer as reduction and capping agent. Here, the Ag/Carrageenan was combined with gelatin hydrogel using glutaraldehyde having a cross-link role in order to create the biohybrid hydrogel nanocomposite. The manufactured composite performances were anaylised by UV-visible spectroscopy, Fourier Transform infrared (FTIR) spectroscopy, Scanning Electron Microscopy (SEM), Energy dispersive X-ray (EDX) spectroscopy and Transmission Electron Microscopy (TEM) methods. The swelling behaviour of the Ag/Carrageenan-gelatin hybrid hydrogel nanocomposite was also analyzed. The antibacterial activity was tested against human pathogens viz. S.agalactiae 1661, S. pyogenes 1210 and E. coli. The bacterial cell wall damage of S.agalactiae 1661 was analyzed by scanning electron microscopy. The cytotoxic assay was performed against the A549 lung cancer cells

A Comparative Study on the Sorption Characteristics of Pb(II) and Hg(II) onto Activated Carbon

Biosorption equilibrium and kinetics of Pb(II) and Hg(II) on coconut shell carbon (CSC) were investigated by batch equilibration method. The effects of pH, adsorbent dosage, contact time, temperature and initial concentration of Pb(II) and Hg(II) on the activated carbon of coconut shell wastes were studied. Maximum adsorption of Pb(II) occurred at pH 4.5 and Hg(II) at pH 6. The sorptive mechanism followed the pseudo second order kinetics. The equilibrium data were analysed by Langmuir, Freundlich and Dubinin-Radushkevich isotherm models. The equilibration data fitted well with both Langmuir and Freundlich isotherm model. The Langmuir adsorption capacity for Pb(II) was greater than Hg(II). The mean free energy of adsorption calculated from Dubinin-Radushkevich (D-R) isotherm model indicated that the adsorption of metal ions was found to be by chemical ion exchange. Thermodynamic parameter showed that the sorption process of Pb(II) onto SDC was feasible, spontaneous and endothermic under studied conditions. A comparison was evaluated for the two metals

Women in the IT sector: Is there an English language premium?

Consistent with Human Capital Theory we show that observed earnings differentials are higher, based on the type of education. We track women employees in the Information Technology (IT) sector in Chennai, in the state of Tamil Nadu, India, and, estimate the source of earnings differential, and demonstrate the existence of an English language premium. That is, additional schooling generates higher returns, especially if the medium of instruction is in English. These findings have relevance for enrolment rates, poverty and women empowerment.wage differentials; language premiums; castes; schooling choices; education; women employees; gender; English language; ICT; information technology; communications technology; human capital theory; earnings differentials; Chennai; Tamil Nadu; India; additional schooling; teaching methods; enrolment rates; poverty; female empowerment; economic policies; emerging economies; international development.