Diagnostic efficacy of Striae Gravidarum in predicting intraperitoneal adhesions and uterine scar thickness in women undergoing repeat caesarean section

Background: Striae gravidarum (SG) are stretch marks on the skin which develop during pregnancy. Cesarean section is one of the most common operation performed worldwide which carries a potential risk of complications due to the intra-peritoneal adhesions and thickness of previous uterine scar. The aim of this study was to find the diagnostic efficacy of striae gravidarum in predicting intra-peritoneal adhesions (IPA) and uterine scar thickness in women undergoing repeated caesarean delivery.Methods: It was a cross-sectional study done over a period of 18 months duration. One hundred women with previous cesarean section scheduled for elective LSCS were enrolled for the study. Striae gravidarum was calculated according to the Atwal numerical scoring system. Presence of intra-peritoneal adhesions were graded intraoperatively according to modified Nair scoring system. After extraction of baby, the thickness of lower uterine segment at midpoint of lower flap of uterine incision was measured by metallic screw gauge.Results: Significant positive correlation was seen between striae gravidarum and intra-peritoneal adhesions. A negative association was established between striae gravidarum severity and thickness of LUS. Owing to its moderately high sensitivity and low specificity in predicting IPA Grade 3 or 4 and LUS scar thickness<3.74mm, striae gravidarum cannot be used as a diagnostic indicator, but can be a useful mass screening method.Conclusions: Striae gravidarum is a zero-cost simple quick and easy technique which can be universally used with minimal intra-observer variation to predict perioperative complications in low resource settings

Comparison of centchroman and PPIUCD in terms of efficacy, safety and continuation rate in immediate postpartum period

Background: Study was done to assess the efficacy, safety and continuation rate of Centchroman and IUCD administered in immediate postpartum period (within 48 hours).Methods: An interventional study was conducted in Obstetrics and Gynecology department of Safdarjung Hospital, New Delhi, at a tertiary care hospital after approval from ethical committee. 280 women were enrolled in the study and divided into 2 groups centchroman group and PPIUCD group, 140 in each group after excluding the exclusion criteria and satisfying inclusion criteria. These women were followed up at 6 week, 3 month and 6 months to study efficacy, safety and continuation rate.Results: Centchroman as contraception is safe with fewer side effects, better satisfaction rate and better continuation rate in comparison to PPIUCD.Conclusions: Centchroman is a newer contraceptive which is recently added in basket of family planning in our country to give wider choices to women. It is an indigenous product developed by central drug research institute (CDRI), Lucknow available free of cost in government hospitals. Centchroman needs more popularity and education for its widespread use

Ultrasonographic evaluation of cervical length and amniotic fluid index as predictor of pregnancy outcome in case of preterm premature rupture of membrane

Background: Preterm premature rupture of membrane (PPROM) is among the most important cause of the perinatal morbidity and mortality. We sought to determine whether cervical length and amniotic fluid index individually or in combination can predict the pregnancy outcome in cases of PPROM.Methods: The prospective observational study was done on 170 women complicated by PPROM with gestational age between 24-36+6 weeks. They were categorized into three groups Group I.24-28 weeks, Group II.28+1 to 32 weeks and Group III. 32+1 to 36+6 weeks. Cervical length and amniotic fluid index were measured using trans abdominal ultrasound within 24 hr of admission. Maternal outcomes were recorded in terms of latency period, chorioamnionitis, and abruption , and neonatal outcomes were recorded in terms of birth weight, first minute APGAR score 5 cm had a greater mean latency period (8.32±1.25 days) which increased their risk of developing chorioamnionitis as compared to women with PPROM having AFI ≤5 cm, who had a shorter mean latency period (7.63±1.07 days) and a lower risk of developing chorioamnionitis (p value <0.0001).Conclusions: Latency is inversely related to period of gestation. A long cervical length and increased amount of AFI correlates with increased latency, increased risk of chorioamnionitis and increased neonatal complications

Comparison of modified biophysical profile and Doppler ultrasound in prediction of perinatal outcome in high-risk pregnancies

Background: The objective of this present study was to compare MBPP and umbilical artery Doppler flow in high-risk pregnant women in prediction of perinatal outcome.Methods: A cohort study was done on 150 high-risk pregnant women over 16 months. Antenatal women with singleton pregnancy who delivered within 48 hours of performing MBPP and Doppler USG, with presence of ≥1 high-risk factor like pre-eclampsia/gestational HTN, BOH, post-dated pregnancy, FGR, GDM, maternal heart disease, anaemia, hypothyroidism and IHCP were included in the study. MBPP (NST and AFI) and umbilical artery Doppler was performed. Perinatal outcome was measured in terms of stillbirth/IUD, LBW, Apgar &lt;7 at 5 minutes, admission to NICU, neonatal death within 48 hours of delivery, MSL and neonatal seizures within 24-48 hours. Quantitative variables were compared using independent t-test/Mann Whitney test. Qualitative variables were correlated using Chi square test/Fisher exact test. Sensitivity, specificity, NPV, PPV were calculated and p-value &lt;0.05 was considered statistically significant. Data analysis was done using social sciences (SPSS) licensed version 21.0.Results: Majority belonged to the age group 21-25 years and were between 37-40 weeks of gestation. It was found that highest perinatal complications occurred in those with both abnormal MBPP and Doppler followed by those with only abnormal MBPP (p-value&lt;0.0001).Conclusions: MBPP is a better predictor of perinatal outcome compared to umbilical artery Doppler USG in high-risk pregnant women. MBPP should be done in all high-risk pregnancies even if Doppler is normal. Both the tests must be performed in all high-risk pregnancies to improve perinatal outcome

The Apollo Virtual Microscope Collection: Lunar Mineralogy and Petrology of Apollo 11, 12, 14, 15 and 16 Rocks

We report on the new Virtual Microscopes on Apollo 16 lunar samples in our Apollo Virtual Microscope collection

Single intra-articular steroid injection of the glenohumeral joint in management of adhesive capsulitis: a comparison between approaches

Background: Adhesive capsulitis is a common, painful musculoskeletal condition of the shoulder associated with loss of range of motion in the glenohumeral joint resulting from contraction of the glenohumeral joint capsule and adherence to the humeral head. Earlier stages of adhesive capsulitis can be treated by intra-articular steroid injections into the glenohumeral joint. This study was designed to study the role of long acting intra-articular corticosteroid injections in combination with simple therapeutic exercises while comparing the outcome of blinded anterior and posterior injection approaches in the management of adhesive capsulitis.Methods: The study comprised of 60 subjects aged 18 years and above who were diagnosed with primary adhesive capsulitis. They were randomly divided into 2 groups i.e., Group A who received blind intra-articular steroid injections via standard anterior approach and group B who received blind intra-articular steroid injection via standard posterior approach. Both groups followed up with a simple home based exercise program. Outcome measures assessed were visual analog scale (VAS) score, shoulder pain assessment disability index (SPADI) and passive shoulder range of motion (ROM).Results: At last follow up, both groups showed statistically significant improvements in all outcome measures i.e., VAS score, SPADI, shoulder ROM. However, comparison between groups did not reveal any statistically significant differences between the two groups.Conclusions: Intra-articular steroid injections into the glenohumeral joint in conjunction with simple physiotherapy are effective in improving pain, function and shoulder ROM in adhesive capsulitis. Both the anterior and posterior injection approaches provide good results

Synthesis of SmFeAsO by an Easy and Versatile Route and its Physical Property Characterization

We report synthesis, structure, electrical transport and heat capacity of SmFeAsO. The title compound is synthesized by one-step encapsulation of stoichiometric FeAs, Sm, and Sm2O3 in an evacuated (10-5 Torr) quartz tube by prolong (72 hours) annealing at 1100oC. The as synthesized compound is crystallized in tetragonal structure with P4/nmm space group having lattice parameters a = 3.93726(33) A and c = 8.49802(07) A. The resistance (R-T) measurements on the compound exhibited ground state spin-density-wave (SDW)-like metallic steps below 140 K. Heat capacity CP(T) measurements on the title compound, showed an anomaly at around 140 K, which is reminiscent of the SDW ordering of the compound. At lower temperatures the CP(T) shows a clear peak at around 4.5 K. At lower temperature below 20 K, Cp(T) is also measured under an applied field of 7 Tesla. It is concluded that the CP(T) peak at 4.5 K is due to the anti-ferromagnetic(AFM) ordering of Sm3+ spins. These results are in confirmation with ordering of Sm in Sm2-xCexCuO4.Comment: 9 pages Text + Figs Contact Author ([email protected]