Study of fetomaternal outcome in emergency peripartum hysterectomy at pannadhay zanana hospital, Udaipur, India

Background: Peripartum or obstetric hysterectomy is the removal of the corpus uteri alone or with the cervix at the time of a caesarean section or shortly after a vaginal delivery. On one hand, it is the last resort to save a woman's life and on the other hand, her reproductive capability is sacrificed. Many times it is a very difficult decision and requires good clinical judgment. Most of the time the operation is carried out when the condition of patient is too critical to withstand the risks of anesthesia or surgery, but proper timing and meticulous care may reduce or prevent maternal complications. Methods: The study is prospective study and was conducted on cases of peripartum emergency hysterectomy performed at PDZH, Udaipur, during the period from April 2021 to October 2022. Results: Our study depicts following results on the basis of 31498 deliveries during the study period (April 2021 to October 2022), so the overall incidence of peripartum hysterectomy is 1 in 1049 (0.095%). Incidence of hysterectomy following vaginal delivery found to be 0.15%, whereas following caesarean incidence found to be 0.24%. Conclusions: Increase in caesarean section rates may lead to a rise in the number of peripartum hysterectomies required in the future because of increased chances of scar dehiscence and morbidly adherent placenta and Thus, there is a need for institutions to reassess their indication for first caesarean section to decrease the incidence of caesarean sections.

Study of maternal and perinatal outcome in twin pregnancy at a tertiary care hospital

Background: Twin pregnancy refers to the presence of two fetuses in the uterus. The phenomenon of twinning has fascinated mankind throughout its recorded history. The major problems occurring in twin pregnancy are prematurity, Lbw, IUGR, birth trauma, birth asphyxia and congenital anomalies. The most serious risk is preterm delivery, which accounts for most of the increased perinatal mortality, neonatal morbidity, and long-term morbidity of twins. Methods: This prospective observational study included analysis of 250 women with twin pregnancies, over a period from 01st November 2021 to 31st October 2022 with 28 completed weeks of gestation, admitted at PDMC, Udaipur, Rajasthan. Results: In our study 250 twin pregnancies delivered Out of total 15209 deliveries were studied in our institute. incidence of twin pregnancy was 1.64%. The majority of study participants were in the age group 20 to 29 year and delivered between the gestation age 34-37week, multigravida was 51.2% and in primi it was 48.8%. The 4% patients underwent caesarean section and 48% delivered by vaginal delivery. Conclusions: Twin pregnancy is a great challenge to the concerned obstetricians. Complications associated with twin pregnancies cannot be prevented but can be detected early and controlled adequately by proper and prompt management. Timely diagnosis and treatment of nutritional anaemia and pre-eclampsia helps in preventing additional complications. Hence the need for better obstetric care, neonatal care, health services to get a better fruitful outcome

Pedunculated perianal lipoma: a rare presentation

Lipomas are ubiquitous lesions. Most of the lipomas have a fibrous capsule and are divided into lobules by delicate septae. On gross examination and histological analysis, lipomas resemble mature fatty tissue.They are more compact on the cut surface than normal adipose tissue and the lobules are smaller on histological analysis. There is undoubtedly some physiologic difference between fat of lipoma and normal fat. Perianal lipomas are rare and may have deeper or interspincteric extensions. Preoperative evaluation to rule it out is a necessary part of the work up for any perianal lipoma. The case report is of a soft swelling on left side in the perianal region, which was investigated to rule out nature of the lesion or deeper and interspincteric extension. Case was managed by complete enucleation of the lipomatous swelling. Gross and microscopic examination of the surgical specimen revealed a perianal pedunculated lipoma

Insights into salt tolerance of mustard (Brassica juncea L. Czern & Coss): A metabolomics perspective

Salt stress is one of the key abiotic factor which leads to reduced global agricultural productions through negatively impacting the growth and development of crops. Indian mustard (Brassica juncea), the most important cruciferous crop with significant nutritional and medicinal values, is majorly affected by salt stress. In this study, we explored the global metabolomic response of two Indian mustard genotypes, CS 60 and CS 245–2–80–7 grown under salt stress for different time periods to unleash the role of differentially accumulated metabolites and relevant metabolic pathways involved in the salt tolerance mechanism. A total of 608 known compounds were detected from 4119 metabolites using DionexUltiMate® 3000 Ultra High-Performance Liquid Chromatographic System combined with “Q Exactive™ Plus Orbitrap™ Mass Spectrometer (UHPLC-MS/MS) analysis, from which 111 significantly altered metabolites in both genotypes were selected based on t-test and VIP score values. Using MetPa from MetaboAnalyst 5.0 platform, metabolic pathways with significant impact values were considered to be involved in the salt tolerance mechanism. Increased accumulation of metabolites and detected relevant pathways majorly regulating the anti-oxidant defense system gives CS 60, a high yielding variety, an edge against the genotype CS 245–2–80–7, which might be the chief tolerance mechanism to withstand salt stress

Prevalence and prognostic implications of myocardial injury across different waves of COVID-19

IntroductionThe prognostic ability of myocardial injury across different waves of the COVID-19 pandemic is not well established. The purpose of this study was to evaluate the prevalence and prognostic implications of myocardial injury in the first and sixth wave of COVID-19.MethodsWe conducted a retrospective observational study that included patients admitted to the emergency department with COVID-19 with data on concentrations of cardiac troponin during the first and sixth wave. We compared the prevalence of myocardial injury and its predictive capacity for 30-day all-cause death in both waves.Results and discussionA total of 346 patients were included (1st wave 199 and 6th wave 147 patients). The prevalence of myocardial injury was 21% with non-significant differences between waves. Myocardial injury was associated, in both waves, with a higher prevalence of comorbidities and with an increased risk of 30-day all-cause death [1st wave HR: 3.73 (1.84–7.55); p < 0.001 and 6th wave HR: 3.13 (1.23–7.92); p = 0.016], with non-significant differences in predictive capacity between groups after ROC curve analysis [AUC: 1st wave 0.829 (95% CI: 0.764–0.895) and 6th wave 0.794 (95% CI: 0.711–0.876)]. As limitations, this is a retrospective study with a relatively small simple size and troponin assay was performed at the discretion of the emergency physician so selection bias could be present. In conclusion, the prevalence of myocardial injury and its prognostic capacity was similar in both waves despite vaccination programs. Myocardial injury predicts short-term mortality in all COVID-19 patients, so they should be treated intensively

Are clinical outcomes from COVID-19 improving in ethnic minority groups?

No abstract available

A strategic assessment of cervical cancer prevention and treatment services in 3 districts of Uttar Pradesh, India

BACKGROUND: Despite being a preventable disease, cervical cancer claims the lives of almost half a million women worldwide each year. India bears one-fifth of the global burden of the disease, with approximately 130,000 new cases a year. In an effort to assess the need and potential for improving the quality of cervical cancer prevention and treatment services in Uttar Pradesh, a strategic assessment was conducted in three of the state's districts: Agra, Lucknow, and Saharanpur. METHODS: Using an adaptation of stage one of the World Health Organization's Strategic Approach to Improving Reproductive Health Policies and Programmes, an assessment of the quality of cervical cancer services was carried out by a multidisciplinary team of stakeholders. The assessment included a review of the available literature, observations of services, collection of hospital statistics and the conduct of qualitative research (in-depth interviews and focus group discussions) to assess the perspectives of women, providers, policy makers and community members. RESULTS: There were gaps in provider knowledge and practices, potentially attributable to limited provider training and professional development opportunities. In the absence of a state policy on cervical cancer, screening of asymptomatic women was practically absent, except in the military sector. Cytology-based cancer screening tests (i.e. pap smears) were often used to help diagnose women with symptoms of reproductive tract infections but not routinely screen asymptomatic women. Access to appropriate treatment of precancerous lesions was limited and often inappropriately managed by hysterectomy in many urban centers. Cancer treatment facilities were well equipped but mostly inaccessible for women in need. Finally, policy makers, community members and clients were mostly unaware about cervical cancer and its preventable nature, although with information, expressed a strong interest in having services available to women in their communities. CONCLUSION: To address gaps in services and unmet needs, state policies and integrated interventions have the potential to improve the quality of services for prevention of cervical cancer in Uttar Pradesh

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Not AvailableSunburn injury is common on fruits in due to high solar radiation levels and air temperatures, low relative humidity, and high elevations. The incidence and severity of sunburn depends upon climatic factor, cultivars, hormonal, nutritional and soil moisture. Fruit production losses due to sunburn may be 6 to30 per cent depending on seasons and the type of fruit. Grower must follow best management practices to minimise sunburn and grow tolerant cultivars, efficient irrigation, appropriate canopy management, cover or intercropping, over tree sprinkler, shade netting, fruit bagging, suppressants (Kaolin or calcium carbonate) and chemical protectants.Not Availabl

A Review of Preventive Health Care in Geriatrics through Ayurveda

Ayurveda is basically the science of life and longevity. Ageing is a process of physical, psychological and social change in multi dimensional aspects. According to the Ayurveda, ageing is outcome of kala or parinama. Vata dosha is the most important factor in the pathophysiology of ageing obviously because of its natural predominance at that stage of life. Ayurveda advocates an excellent approach for promotion of health, prevention of diseases and delaying the process of ageing with number of measures mentioned in svastha chatushka and rasayanadhyaya of charakasamhita, time to time panchakarma and various herbal drugs. Jarachikitsa or Rasayana in Ayurveda is a unique therapeutic methodology to delay ageing and to minimize the intensity of problems occuring in this degenerative phase of one's life. Prevention and management of health problems could help the elderly to improve quality of life and remain self dependant for their daily activities to maximum possible extent