Cord blood parameters and fetal outcome in neonates with fetal distress due to meconium staining liquor- an observational study

Background: Meconium staining liquor (MSL) results from passage of meconium during labour and is used to diagnose fetal distress. Thick and granular meconium has been found to have a significant association with an abnormal cord pH and lactate and worst neonatal outcome. The aim of this study was to analyse and compare the mode of delivery, cord blood parameters and fetal outcomes in cases diagnosed with different degrees of meconium staining liquor.Methods: An observational study was carried out on 76 labouring patients presenting in the active stage of labour with term, singleton pregnancy with cephalic presentation diagnosed with either thin or thick MSL. The cases were followed up and compared in thin or thick MSL group for the mode of delivery (normal vaginal delivery, instrumental delivery or caesarean section), fetal cord blood parameter after birth (cord blood pH and lactate) and the neonatal outcome.Results: 39 cases were diagnosed with thin MSL. Of these, 74.4% delivered by a normal vaginal delivery. Maximum cases had normal cord blood parameters with a favourable neonatal outcome. 37 cases had thick MSL. Lower segment caesarean section (LSCS) rate was highest in this group (i.e. 48.6%). The neonatal outcomes were as follows- 24.3% had an APGAR score <7, 43.2% required assisted ventilation, 43.2% required NICU admission and 13.5% had an early neonatal death.Conclusions: Thin MSL should be closely monitored and can be followed up for normal vaginal delivery

Diagnostic accuracy of neutrophil to lymphocyte ratio in comparison with liver function tests for the diagnosis of intrahepatic cholestasis of pregnancy

Background: In this study, we aimed to find diagnostic accuracy of neutrophil to lymphocyte ratio in comparison with liver function tests for the diagnosis of intrahepatic cholestasis of pregnancy and adverse fetal-maternal outcomes.Methods: NLR and aminotransferase (AST/ALT) levels in the blood samples of pregnant women with complaint of pruritus. 90 women with elevated transaminase were taken as cases and same number of women with normal aminotransferase levels taken as control. All were examined in this prospective case-control study.Results: Not only was the mean NLR elevated in the pregnant women with cholestasis when compared to the controls, but it also predicted the severity of the cholestasis. The correlation between transaminase levels and NLR was significant.Conclusions: Although TBA is still the diagnostic standard, NLR can be used as an initial screening tool due to its high specificity

Sigmoid volvulus complicating pregnancy: a case report

Sigmoid volvulus in pregnancy is a rare, but devastating pathology owing to its adverse effects on the mother as well as the foetus. It can lead to maternal mortality in 5-50% cases and foetal mortality in up to 30% cases. A high index of suspicion is necessary and timely surgical intervention is the key to improving feto-maternal outcomes. We present a case of a 32-year-old pregnant woman who presented with sigmoid volvulus at 28 weeks of gestation. The patient was taken up for an emergency laparotomy, where the sigmoid colon was found to be extremely dilated and twisted. Bowel resection and primary anastomosis was done. An anastamotic leak occurred postoperatively, due to which re-exploration and colostomy was done. The patient had a spontaneous abortion after the surgery. She was discharged after five days with a functional stoma and elective colostomy closure was done after six weeks

A REVIEW OF THE COMBINATION OF XANTHINE AND BRONCHODILATOR DRUG IN MOUTH‑DISSOLVING FILM FOR ASTHMA TREATMENT”

There has been an increase in demand for caregiver dosage forms over the past two decades. In the oral cavity, mouth dissolving film dissolves swiftly. Oral films that dissolve in your mouth function best when combined with medications that act quickly, such as Xanthine category drugs (Salbutamol Sulphate) and Xanthene Derivative Theophylline. According to the World Health Organization (WHO), asthma affects one in six adults and a quarter of all children, according to the WHO. A child’s admission to the hospital is often due to asthma, which is one of the most prevalent reasons for admission. During an asthma attack, quick-relief or rescue drugs are used to relax and open the airways, as well as ease symptoms. If prescribed, these medications can also be administered prior to exercise. To treat asthma, a combination of Salbutamol Sulfate and Theophylline is available in tablet form under the brand name “Theo-Asthalin.” Oral films seem to be the most efficacious formulation. As a consequence, children with asthma should receive support from drugs given in the form of mouth-dissolving films, since they provide better patient compliance and an appropriate treatment method

Correlation of lipid profile of infertile men with abnormal semen parameters

Background: Male’s inability to impregnate a fertile female is referred as male factor infertility. It accounts for 40-50% of infertile couples and affects almost 7% of all men. Male comorbidities and conditions, which negatively affect men’s health, have been repeatedly associated with impaired reproductive functioning. Cholesterol is the main substrate for steroid synthesis and it plays crucial role in formation of sperm plasma membrane and thus in spermatogenesis, highlighting the role of serum lipids in male fecundity. Purpose of the study is to evaluate correlation lipid profile of male partners with abnormal semen parameters in infertile couples. Methods: A cross sectional study was carried out in the infertility clinic of a tertiary care hospital for over 18 months and 151 infertile men with abnormal semen parameters (as per WHO 2010 criteria) were enrolled. Evaluation of lipid profile was done and its relationship with abnormal semen parameters was analyzed. Results: Significant positive correlation was seen between LDL and Triglyceride with sperm concentration and total sperm count. However, significant negative correlation was seen between Triglyceride and sperm motility and TMSC. Total and progressive motility was found to be significantly associated with total cholesterol (p&lt;0.05). Infertile men having higher total cholesterol were found to have better total and progressive motility compared to men with less total cholesterol. Conclusions: Our findings demonstrated that lipid profile has significant correlation with semen parameters, specifically sperm concentration, count and motility

A rare case of paraneoplastic neurological syndrome with ovarian teratoma

Paraneoplastic neurological syndrome (PNS) is a neuropathological disorder of central nervous system, in this the patient presents with a tumor anywhere in the body with diverse neuropsychiatric symptoms. The clinical manifestation of the tumor may be preceded by PNS. We are reporting a case of a 23-year-old married nulliparous female who came to the gynaecology outpatient department (OPD) with the history of mass per abdomen for the past four months and also undergoing treatment for acute psychosis, memory loss and cognitive impairment for the past five months. Her symptoms were not relieved on treatment. After clinical, laboratory and radiological evaluation possibility of paraneoplastic neurological syndrome associated with ovarian teratoma was made. Patient was taken up for staging laparotomy with U/L salpingoophrectomy. After surgical treatment her psychiatric symptoms rapidly improved and her psychiatric medications doses was reduced. PNS should be suspected in female patients presenting with an acute history of neuropsychiatric symptoms. Tumor resection should be performed at the earliest to improve patient outcomes

Effect of antenatal corticosteroids on neonatal outcome in term elective caesarean section: a randomised controlled trial

Background: Infants born at term by elective caesarean section are more likely to develop respiratory morbidity than infants born vaginally. Prophylactic corticosteroids in singleton preterm pregnancies accelerate lung maturation and reduce the incidence of respiratory complications. Thus, the aim of this randomized controlled trial was to assess the effect of antenatal corticosteroids on neonatal outcome among term pregnant women undergoing elective caesarean section.Methods: It was an open labelled randomized controlled trial conducted among women with term pregnancy of 37-38+6 weeks and planned for caesarean section at term and who were willing to participate in the study. We randomized 50 pregnant women into intervention group which received antenatal corticosteroids in the form of injection dexamethasone 12 mg IM, 4 doses at 12 hourly intervals before term elective caesarean section and 50 pregnant women into control group which did not receive antenatal corticosteroid. Fetal outcomes were compared in both groups after caesarean section. Data were analysed using SPSS vs.20.Results: Nearly half (54%) of pregnant women belonged age group of 21-25 years and majority (58%) of pregnant women belonged to 38-39 weeks of gestation. Out of 50 pregnant women in intervention group, only two percent neonates developed RDS, four percent neonates developed transient tachypnea of neonate (TTN) and six percent neonates required NICU admission which was lower than control group. However, difference between fetal outcomes in intervention and control group was not statistically significant (p>0.05).Conclusions: Administration of prophylactic antenatal corticosteroids before 48 hours of elective term caesarean section does not have impact on fetal outcome in our study