Study of psychosocial aspects of unmarried pregnancy in a tertiary care hospital

Background: Unmarried pregnancy is a major health and social problem in many developed as well as developing countries with unique medical and psychosocial consequences for the patient and society. The objective of this study was study the psychosocial aspects of unmarried pregnancy.Methods: Study was done over a period of one year. Data collected from 31 unmarried abortion seekers in a tertiary care Medical College hospital of Tamilnadu.Results: showed a strong association between unmarried adolescent pregnancy and lack of parental supervision and control , poor intra-family relationship , family problem , lack of knowledge on sexual and reproductive health ), and nonengagement of adolescent in any productive activity.Conclusions: Ignorance regarding sexuality and reproduction along with adventurous nature and poor negotiation skills predisposes unmarried girls for early sexual activity that may lead to various problems like unwanted pregnancy and STIs that may cause psycho-social-economic problems for the unmarried girl

Retrospective study factors related to preterm birth in Government Raja Mirasudar hospital and obstetric and perinatal outcome

Background: Preterm birth is a leading cause of perinatal mortality and long-term morbidity as well as the long-term health consequences and cognitive outcomes. Present study was conducted to determine prevalence and risk factors and obstetric & perinatal outcome associated with preterm birth in Rajamirasudar Hospital, Thanjavur.Methods: A case control study was conducted between Mar 2015 - Sep 2015 in Rajamirasudar Hospital, Thanjavur. All the live new-borns during the study period were investigated. Of 6805 live births during the study period 356 births occurred in <37 weeks were taken as a case and 579 term neonates were taken as a control group. Data were obtained through review of prenatal and hospital delivery records. Univariate and multivariate logistic regression analysis were applied to obtain magnitude of association between independent variables and preterm birth.Results: The prevalence rate of preterm birth was 5.6%. History of previous preterm birth (OR=12.7,CI: 3.9-40.4, p<0.001), hypertension (OR=7.3, CI: 2.1-25.4, p=0.002), oligohydramnios (OR=3.9, CI:1.6-9.5, p=0.002), diabetics (OR=3.7, CI: 1.1-11.8, p=0.024),  premature rupture of membrane (OR=3.1, CI:1.9-4.9, p=0.000), hypothyroid (OR=2.0, CI: 1.0-3.8, p=0.037), prepregnancy low BMI (OR=2.0, CI: 1.1-3.8, p=0.015), urinary tract infection in 26-30 weeks , (OR=1. 8 CI:1.0-3.2, p=0.04) were determined as significant risk factors for preterm birth.Conclusions: Early detection and treatment of diseases or disorders among pregnant women especially hypertension, Oligohydramnios, diabetics, hypothyroid, urinary tract infection, pre pregnancy low BMI as well as the improving health care quality delivered to pregnant women may reduce preterm prevalence rate and also reduce neonatal morbidity and mortality

Serum beta human chorionic gonadotropin and lipid profile in early second trimester (14-20 weeks) is a predictor of pregnancy-induced hypertension

Background: A variety of biological, biochemical, and biophysical markers implicated in the pathophysiology of pre-eclampsia during the last two decades have instigated the growing interest in this study to include both βhCG and lipid profile studies in the early second trimester as early predictors of pregnancy-induced hypertension. Early identification of at-risk women may help in taking timely preventive and curative management to prevent or delay complications associated with pregnancy-induced hypertension.Methods: A prospective study was performed on 100 patients attending the outpatient department of the Obstetrics and Gynaecology of the Raja Mirasudar hospital. All the patients were screened for serum βhCG and serum lipid profile in their early second trimester (14-20 weeks) and followed up till their delivery. Comparative studies of serum βhCG and serum lipid profile were performed between those who remain normotensive (group I) and those who developed pregnancy-induced hypertension (group II).Results: TG, HDL, VLDL, and LDL and BETA HCG values for those women who developed PIH (group II) were significantly higher than those who remain normotensive (group I), with p value of &lt;0.01 which is statistically significant. HDL and βhCG values for group II were not higher than those in group I with p value &gt;0.05 which is statistically insignificant.Conclusions: Maternal lipid profile and BETA HCG in second trimester is very good noninvasive test which can be used for prediction of pregnancy-induced hypertension before its clinical onset

Apolipoprotein A-I gene transfer exerts immunomodulatory effects and reduces vascular inflammation and fibrosis in ob/ob mice

Background Obesity is associated with vascular inflammation, fibrosis and reduced high-density lipoproteins (HDL)-cholesterol. We aimed to investigate whether adenoviral gene transfer with human apolipoprotein (apo) A-I (Ad.A-I), the main apo of HDL, could exert immunomodulatory effects and counteract vascular inflammation and fibrosis in ob/ob mice. Methods Ad.A-I transfer was performed in 8 weeks (w) old ob/ob mice, which were sacrificed 7 w later. The aorta was excised for mRNA analysis and the spleen for splenocyte isolation for subsequent flow cytometry and co-culture with murine fibroblasts. HDL was added to mononuclear cells (MNC) and fibroblasts to assess their impact on adhesion capacity and collagen deposition, respectively. Results Ad.A-I led to a 1.8-fold (p < 0.05) increase in HDL-cholesterol versus control ob/ob mice at the day of sacrifice, which was paralleled by a decrease in aortic TNF-α and VCAM-1 mRNA expression. Pre-culture of MNC with HDL decreased their adhesion to TNF-α-activated HAEC. Ad.A-I exerted immunomodulatory effects as evidenced by a downregulation of aortic NOD2 and NLRP3 mRNA expression and by a 12 %, 6.9 %, and 15 % decrease of the induced proliferation/activity of total splenic MNC, CD4+, and CD8+ cells in ob/ob Ad.A-I versus control ob/ob mice, respectively (p < 0.05). Ad.A-I further reduced aortic collagen I and III mRNA expression by 62 % and 66 %, respectively (p < 0.0005), and abrogated the potential of ob/ob splenocytes to induce the collagen content in murine fibroblasts upon co-culture. Finally, HDL decreased the TGF-ß1-induced collagen deposition of murine fibroblasts in vitro

Homocysteine, hyperhomocysteinemia and vascular contributions to cognitive impairment and dementia (VCID).

Homocysteine is produced physiologically in all cells, and is present in plasma of healthy individuals (plasma [HCy]: 3-10μM). While rare genetic mutations (CBS, MTHFR) cause severe hyperhomocysteinemia ([HCy]: 100-200μM), mild-moderate hyperhomocysteinemia ([HCy]: 10-100μM) is common in older people, and is an independent risk factor for stroke and cognitive impairment. As B-vitamin supplementation (B6, B12 and folate) has well-validated homocysteine-lowering efficacy, this may be a readily-modifiable risk factor in vascular contributions to cognitive impairment and dementia (VCID). Here we review the biochemical and cellular actions of HCy related to VCID. Neuronal actions of HCy were at concentrations above the clinically-relevant range. Effects of HCy <100μM were primarily vascular, including myocyte proliferation, vessel wall fibrosis, impaired nitric oxide signalling, superoxide generation and pro-coagulant actions. HCy-lowering clinical trials relevant to VCID are discussed. Extensive clinical and preclinical data support HCy as a mediator for VCID. In our view further trials of combined B-vitamin supplementation are called for, incorporating lessons from previous trials and from recent experimental work. To maximise likelihood of treatment effect, a future trial should: supply a high-dose, combination supplement (B6, B12 and folate); target the at-risk age range; and target cohorts with low baseline B-vitamin status. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock