Comparison of laparoscopic-assisted vaginal hysterectomy, total abdominal hysterectomy and vaginal hysterectomy: A four years retrospective study in tertiary care centre

Background: Hysterectomy is one of the commonest gynaecological operations performed in India. Traditional surgical treatments performed are abdominal hysterectomy and vaginal hysterectomy. Vaginal and laparoscopic procedures are considered “minimally invasive” surgical approaches because they do not require a large abdominal incision and, thus, typically are associated with shortened hospitalization and postoperative recovery times compared with open abdominal hysterectomy. With the aid of laparoscopic procedure, a potential abdominal hysterectomy can be converted to a vaginal one and a difficult vaginal hysterectomy can be converted into a fairly simple vaginal hysterectomy. Aim of the present study is to compare above methods of hysterectomy in terms of operating time, estimated blood loss, and postoperative hospital stay and complication, so as to provide best course of treatment to patient.Methods: A retrospective observational study was conducted in tertiary care centre. Four-year data was collected from January 2012 to December 2016. Cases of LAVH with benign gynaecological condition and up to 12 weeks size uterus, without any associated medical condition were selected in study randomly, and compare with cases of NDVH, TAH in terms of duration of operative procedure, blood loss during surgery, and postoperative hospital stay.Results: In present study we found that average duration of procedure in LAVH was 84.35 minute, which was maximum compare to other method. Estimated blood loss in LAVH was least as compare to NDVH and TAH it was maximum. The average hospital stays in LAVH and NDVH was less as compared to TAH.Conclusions: LAVH should be considered a better approach in view of the relatively less blood loss and intraoperative complication. Due to lack of large randomized controlled trials, the role of Laparoscopic hysterectomy is difficult to define

Assessment of maternal deaths using three delay model at a tertiary care centre in rural Maharashtra, India: retrospective six years study

Background: Maternal deaths are the social indicators of the human development and hence their place in MDGs and now in SDGs. Even though India has made a great stride in reducing maternal deaths, the differentials in the states are huge ranging from 46 to 237 maternal deaths per 100000 live births. The three delay model assesses the issues in the emergency obstetric care and upon which the interventions can be based to improve maternal health indicators.Methods: Retrospective record based observational study was carried out at an obstetrics and gynecology department of a tertiary care hospital located at Northern Maharashtra region. The records of deliveries, maternal deaths, age of the mothers, their time of presentation with obstetric complication, level of delay and the reason for delay were extracted for the period of 2011 to 2016. Three delays being, level I - delay in decision to seek care, level II - delay in identifying and reaching medical facility, level III - delay in receipt of adequate and appropriate treatment at facility.Results: Out of 54335 deliveries, there were 128 maternal deaths. 80% women died due to complication in their ANC, 55% being in the third trimester of ANC. Major causes of death were preventable, including Eclampsia (21%), Anaemia (17%), PIH (15%), Sepsis, Other infections and haemorrhage. 27% women had delay of level I, 21% had level III and 15% had a mix of two or three level of delays. The reasons for level I delay being Lack of ANC visits, no ANC registration, level II delay being lack of timely transport facility, level III delay being lack of adequate manpower, training, and lack of efficient intensive care facilities.Conclusions: A good quality emergency obstetric care equals good maternal health. It can be achieved by strengthening the health infrastructure, tackling manpower shortages, having better referral linkages

Interventional study to find out effect of human chorionic gonadotropin and antioxidants on idiopathic male infertility

Background: Male contributes about 50% for cases with combined male and female infertility. When the cause is not known, it is term as idiopathic infertility. It affects 25% of men. Many advances have been made in reproductive medicine which provides great opportunities, couples which were considered untreatable now have got chance to have their own babies. Various ART procedures like ICSI have been proven as an efficient therapy in severe male factor infertility. However, the cost per cycle and complications such as multiple gestations cannot be ignored. Medical management of infertility can be specific or empirical depending on etiology. Specific medical management is use when certain etiology is identified. However, in absence of specific etiology use of empirical medical treatment can be attempted in order to improve treatment results. In this study our aim is to evaluate the effect of human chorionic gonadotropin (hCG) and antioxidants on semen parameters in men with idiopathic male infertility.Methods: Thirty men with abnormal semen parameters were included in study. Patients were treated with injection hCG-2000 IU three times a week for three months along with the antioxidants. After 3 months of treatment repeat semen analysis were performed and results were compared with pre-treated seminal parameters.Results: Results showed significant increase in sperm count (p value ≤ 0.001), total motility (p value=<0.001), and progressive forward motility (p value = <0.001), while no significant difference is seen in rest of the parameters.Conclusions: Use of hCG and antioxidants in idiopathic male infertility can significantly improve seminal parameters in idiopathic male infertility

Knowing a cross-talk between embryo and endometrium can help to achieve successful pregnancy outcome in recurrent implantation failure

Recurrent implantation failure is most distressing condition to both couple as well as doctor in the field of reproductive medicine. Patients have already undergone various ART treatments with no favourable outcome and are drained emotionally as well as economically. To overcome this obstacle a comprehensive approach is needed. In this case report, we are addressing a couple who came to us with primary infertility of 15 yrs, with recurrent IVF failures (four cycles of IUI, seven cycles of ICSI both fresh and frozen and with ovum donation in last two cycle), with poor ovarian reserve and male factor infertility for surrogacy as a last option. After complete evaluation of couple, recurrent Implantation failure is thought to be due to poor endometrium and bad embryo quality, and we counselled couple to go for ovum donation and ICSI before considering surrogacy. To improve endometrial receptivity we performed local endometrial injury, oral estradiol therapy, intrauterine G-CSF instillation and IVIG etc. Simultaneously for better quality of embryo we decided to choose ovum donation due to poor ovarian reserve and advance age of the patient and ICSI was done with husband sperm after treatment of male factor infertility and ET was performed. Patient conceived in first cycle with single live intrauterine pregnancy, her antenatal course was uneventful and delivered a healthy baby at term without any complication

Prolactin level in umbilical cord blood of newborn and its relation to respiratory distress syndrome

Background: Production of lower concentrations of prolactin in fetus is considered as one of the major contributor for the development of respiratory distress syndrome (RDS) in newborns considerably in pregnants with maternal complications. Hence the present study was conducted with the objective to measure the serum level of cord blood prolactin in normal pregnancy and in pregnancy with maternal complications and its association with development of RDS in newborn.Methods: In this prospective study of 100 women, 28 with normal pregnancy (Group A) and 72 with abnormal pregnancies (Group B) were included in the study. Umbilical cord blood was collected and serum prolactin level was estimated using radio-immuno assay. The obtained values were correlated with prevalence of RDS in neonates and maternal complications.Results: The average age of pregnant women participated in Group A was 26 years and Group B was 27 years. In Group A 2 babies with birth weight of 2001-3000 gm had a cord serum prolactin level of 216±137.8 ng/mL developed RDS. In Group B the level of prolactin was 285±276 and 326±132 ng/mL in 4 RDS babies with birth weight of <1000 gm and 1000-2000 gm respectively. It was observed that cord serum prolactin levels had no correlation with the mode of delivery, sex of newborn, steroid therapy. In Group A, 2 neonates developed RDS which were of gestational age between 32-35 weeks with mean prolactin level of 216 ng/ml, while in Group B, 1 neonate with gestational age less than 32 weeks and mean prolactin level of 480 and 4 neonates of 32-35 weeks with mean prolactin level of 266 ng/mL developed RDS. Out of 27 mothers with complications of PIH, 3 developed RDS. 1 case each from IUGR and twins developed RDS respectively.Conclusions: The risk of RDS is less in newborn with high prolactin level than in newborns with low prolactin levels. So prolactin might have a role in fetal lung maturation

A RANDOMISED SINGLE BLIND ACTIVE CONTROLLED, PARALLEL GROUP STUDY COMPARING THE EFFICACY & SAFETY OF THE KARNIM PLUS® CAPSULES IN PATIENTS WITH MILD OR MODERATE DIABETES MELLITUS TYPE. II

Diabetes is the most prevalent disease in the world affecting middle and old aged persons of the world directly impacting their life style and other metabolic hazards. Karnim plus is a remedy of Unijules Life Sciences ltd. And current multicentric, randomized, single blind, active controlled and parallel group with metformin capsule clinical study is conducted in two centres of Dr. D.Y. Patil College and Ashwin Ayurved college respectively. Total 121 patients were treated according to the previously approved protocol from institutional ethics committee for the treatment period of 24 weeks in a dose of 2 capsules BID before meal and primary efficacy parameters set to HbA1c, fasting and post meal blood sugar. From the study it was concluded that Karnim plus capsule and Metformin capsule are equally effective in controlling hyperglycemia with slightly more time to achieve significance result in Karnim plus. In case of HbA1c highly significant results were observed in Karnim plus capsule and also highly significance is observed in symptom score of clinical parameters. Cholesterol levels are significantly decreased in Karnim plus group than metformin group. This indicated that Karnim plus is effective remedy in controlling diabetes type II with no any adverse effects and controlling metabolism in a effective way than other OHA

PAPEL DAS PEQUENAS CULTURAS DE MILLETE NA SEGURANÇA ALIMENTAR DE SATPURA OCIDENTAL NO DISTRITO DE NANDURBAR (MS), ÍNDIA.

ABSTRACT The term millet includes many small-grain cereals. Grain-based on size, millet is classified as the major and minor grain millet. In the study area cultivated proso millet (Mor), Foxtail millet (padi and rala) and Barnyard millet (banti), etc small millets. These crops occupied 31.35 percent of the total cultivated area and are mostly grown on the hill slope. Small millets cultivated during the rainy season and also unmanured and unfertilized conditions. Small millets are highly nutritious and are better in protein, oil, mineral, calcium content than rice and wheat. These small millets are usually cooked as rice after dehulling in the study area. Small millets are used as a substitute for rice flour in various snack foods. They were primarily stored in larger quantities in Kothi for up to fifteen years for food security and used as animal feed. Regular consumption of small millets reduces lifestyle (diabetes), cardiovascular, gastrointestinal diseases. KEYWORDS: Cropping System, Food Security, Nutritional Value, Small Millet, Wooden Plough.RESUMEN El término mijo incluye muchos cereales de grano pequeño. Según el tamaño del grano, el mijo se clasifica como el mijo de grano mayor y menor. En la zona de estudio se cultivaron mijo proso (Mor), mijo cola de zorra (padi y rala) y mijo de corral (banti), etc. mijo pequeño. Estos cultivos ocuparon el 31,35 por ciento del área total cultivada y se cultivan principalmente en la ladera de la colina. Mijo pequeño cultivado durante la temporada de lluvias y también en condiciones no abonadas y no fertilizadas. Los mijos pequeños son muy nutritivos y son mejores en proteínas, aceite, minerales y contenido de calcio que el arroz y el trigo. Estos pequeños mijos se suelen cocinar como arroz después de descascararlos en el área de estudio. Los mijos pequeños se utilizan como sustituto de la harina de arroz en varios bocadillos. Se almacenaron principalmente en grandes cantidades en Kothi durante un máximo de quince años para la seguridad alimentaria y se utilizaron como alimento para animales. El consumo regular de mijo pequeño reduce el estilo de vida (diabetes), enfermedades cardiovasculares y gastrointestinales. PALABRAS CLAVE: Sistema de cultivo, Seguridad alimentaria, Valor nutricional, Mijo pequeño, Arado de madera.ABSTRATO O termo painço inclui muitos cereais de grãos pequenos. Com base no tamanho do grão, o painço é classificado como o painço do grão maior e menor. Na área de estudo cultivou-se proso milheto (Mor), milheto Foxtail (padi e rala) e milheto Barnyard (banti), etc. painço pequeno. Essas safras ocuparam 31,35 por cento da área total cultivada e são principalmente cultivadas na encosta do morro. Painço pequeno cultivado durante a estação chuvosa e também em condições não adubadas e não fertilizadas. O painço pequeno é altamente nutritivo e tem melhor teor de proteína, óleo, mineral e cálcio do que o arroz e o trigo. Esses pequenos painços são geralmente cozidos como arroz após o descasque na área de estudo. O painço pequeno é usado como substituto da farinha de arroz em vários salgadinhos. Eles foram armazenados em grandes quantidades em Kothi por até quinze anos para segurança alimentar e usados ​​como ração animal. O consumo regular de milho pequeno reduz o estilo de vida (diabetes), doenças cardiovasculares e gastrointestinais. PALAVRAS-CHAVE: Sistema de cultivo, Segurança alimentar, Valor nutricional, Painço pequeno, Arado de madeira

An investigation into applying open-source technologies for healthcare solutions in remote and underprivileged areas: an action-based applied research

This thesis aimed to develop electrocardiography (ECG) interpretation and remote monitoring applications to address healthcare challenges in remote areas, particularly low-to-middle-income regions. The intention was to demonstrate how open-source technology can provide healthcare solutions to the client organisation, the Busi-ness Centre of Savonia University of Health Sciences. The core objective of this thesis was to evaluate the ne-cessity of such technology in underserved areas, consider legal aspects of medical software, and explore open-source technologies for application development. The thesis employed a combined action-based and applied research methodology, focusing on cardiovascular healthcare and open-source technology. It involved developing ECG interpretation and remote monitoring prototypes using open-source tools and collaborating with an IT engineer for coding and implementation. The experimentation with open-source technology in this thesis yielded promising results. The developed prototypes are functional but still in their early developmental stages, needing further refinement and expert collaboration. The study highlights the potential of open-source technology in improving healthcare in remote areas. It suggests ongoing evaluation and development for enhanced functionality and efficiency, opening avenues for future research in technology-driven healthcare solutions