The study of maternal and fetal outcome in pregnant women with thyroid disorders

Background: Thyroid disorders are among the common endocrine disorders in pregnant women after diabetes mellitus. Several changes are observed in maternal thyroid function during pregnancy and failure to adapt to these physiological changes results in thyroid dysfunction. It is well established that not only overt, but subclinical thyroid dysfunction also has adverse effect on mother and the fetus, like miscarriages, preterm delivery, preeclampsia, eclampsia, polihydromnios, placental abruption, post-partum haemorrhage, low birth weight, neonatal hypothyroidism. Decreased availability of thyroid hormones may also impair neurological and intellectual development of foetus. With this background, we are conducting a study to know the effect of thyroid disorders on pregnancy and its maternal and the fetal outcome.Methods: The present study was conducted in ESI Hospital Rajaji Nagar, Bangalore. It is a prospective study which involved 100 patients diagnosed to have thyroid disorder during their antenatal checkup in the first trimister. It also includes known cases of thyroid disorder. TSH level was estimated. If it is deranged, then FT3 and FT4 levels estimated. Patients were managed accordingly and followed till delivery. Their obstetric and perinatal outcomes were noted.Results: In our study out of 100 cases, 96 cases are subclinical hypohyroid and 4 cases are subclinical hyperthyroid. Subclinical hypothyroidism in pregnancy are associated with abortions (2.1%), Anaemia (4.20%), PIH (14.7%), GDM (4.2%), Preterm labour (3.1%), oligohydromnios (16.67%), Lscs (22.9%), PPH (6.3%), LBW (21.9%), Hyperbilirubinemia (9.4%), NICU admission (14.6%), Which are co-relatine with other studies and hyperthyroid cases in our study were not sufficient for outcome analysis.Conclusions: Thyroid disorders in pregnancy have adverse effects on maternal and fetal outcome emphasizing the importance of routine antenatal thyroid screening

A comparative study of different route of administration of misoprostol in the management of third stage of labour

Background: Post partum haemorrhage is the most common cause of maternal morbidity and mortality.  Misoprostol is a prostaglandin analogue, used for management of post partum haemorrhage. It can be used by various routes with minimal side effects. This study is done to compare the different routes of administration of Misoprostol for the third stage management and their side effects. Objectives of present study were to estimate the amount of blood loss, to assess the maternal side effects of drug, to know the haemoglobin deficit, to know the duration of third stage of labour.Methods: This was a prospective hospital base study of 150 women delivery at obstetrics and gynaecology department at ESICMC Model Hospital, Rajajinagar. They were randomized into 3 groups of 50 patients each. They received 400 µg of misoprostol either orally or rectally or sublingually immediately after delivery of the fetus. The primary outcomes analysed were amount of blood loss duration of third stage of labour haemoglobin deficit and their side effectsResults: The amount of blood loss and haemoglobin deficit was least in sublingual group which was statistically significant. Need of additional oxytocics was less in sublingual and oral group, though it was not statistically significant.Conclusions: In the present study, sublingual Misoprostol was found to be more effective in reducing blood loss during third stage of labour

Social Security Code 2020: An Analysis

The Indian labour market has beencontinuously and predominantly unorganised. In theyear 2018-19,the nature of employment for around 90 percent workers in India’s labour market was unorganised. These workers are either inadequately covered or are not at all covered under  existing labour legislations, social protection schemes, and other employment benefits. Due to the lack of governmental oversight, a large proportion of these workers work in exploitative and precarious conditions. According to International Trade Union Confederation, India is amongst the Ten worst countries in the world in terms of the worker rights in 2020 (ITUC, 2020). The first Sustainable Development Goal, seeks to end the poverty, and among its targets isformulation of national social protection floors, and the implementation of comprehensive social welfare programmes.Similarly, the ILO Recommendation 204 suggests the implementation of minimum social security guarantees to facilitate the transition from an informal to a formal economy. In the context of the widespread chronic poverty and the unrelenting wealth inequality, the social security can offer resilience against socio-economic shocks, such as the one we are faced with today because of the Coronavirus (COVID-19) pandemic. In this context, it is attempted to analyse the provisions of  the Social Security Code,2020 to verify the extent and scope of the Code and to understand its limitationsof the Code in providing comprehensive social security measures to ameliorate the conditions of poor and needy. &nbsp

Professional negligence in dental practice: Potential for civil and criminal liability in India

The doctor/dentist-patient relationship has transformed over the last two decades. Health professionals are increasingly viewed as providers of service for consideration. The Consumer Protection Act (CPA) was enacted in 1986 for better protection of the interests of consumers as well as to provide a simple and quick mechanism for redressing consumer grievances. Since 1995, health professionals have been included within the ambit of the CPA, empowering the patient to file lawsuits (in case of perceived negligence) in consumer courts. This review explores the definitions of 'consumer', 'services', and 'negligence', discussing their implications with respect to civil and criminal liability of dentists, while providing relevant case examples and court guidelines in landmark judgments. It is concluded that the potential for civil lawsuits against dentists for negligent actions is existent, although the prospect of a dentist being held liable for criminal negligence is low