Celiac disease and pregnancy in Indian scenario

Celiac disease is a chronic lifelong inflammatory condition of gastrointestinal tract specifically the small intestine. We report a case of pregnancy outcome in a patient with celiac disease (gluten sensitive enteropathy) diagnosed during the investigations of recurrent abortions and intermittent diarrhoea since childhood.  A 32 years old patient who had four abortions and loss of a premature baby was diagnosed as celiac disease during investigations of recurrent abortions and diarrhoea since childhood. After stabilisation of disease she conceived spontaneously. Patient had regular follow up in some private institute. She was referred to our hospital as a case of IUGR with color Doppler changes with breech presentation with sluggish fetal movements at 37 weeks and emergency caesarean section was performed. A male fetus with 2.25 kg AS 7, 9 at birth was delivered. The cause of her recurrent pregnancy losses and previous preterm birth was celiac disease. Celiac disease (CD) is an immune-mediated enteropathy caused by a permanent sensitivity to gluten in genetically susceptible individual. It may also lead to serious maternal and fetal complications because of systemic effects of disease however a successful pregnancy outcome is possible when pre-gestational diagnosis is made and proper management of disease during pregnancy is achieved

Incidence of bone tumors and tumor like lesions at a tertiary centre - a study of 64 cases

Background: Primary bone tumors are uncommon lesions constituting less than 1% of all cancers. Although open biopsy has high accuracy, it increases risk of tumor dissemination in patients with highly malignant tumors. FNAC eliminates the complications that may occur in surgical procedures and also gives quick results. This study was conducted to determine the spectrum and demographic characteristics of bone tumors and tumor like lesions at a tertiary care centre in western Uttar Pradesh and also to assess the role of FNAC in their diagnosis.Methods: This is a three-year, retrospective as well as a prospective study done on a total of 64 cases. All the cases were subjected to detailed history, physical examination and radiological investigations. FNAC smears were stained with Giemsa and Papanicolaou stain. H and E staining was done for histopathology.Results: Mean age affected was 26 years. Male-female ratio was 2.8:1. Out of total 64 cases of bone tumors and tumor like lesions, maximum was chondrogenic tumors (17; 26.56%), followed by osteogenic tumors (15; 23.44%). Osteochondroma (08; 47.06%), Osteosarcoma (07; 46.66%) and Aneurysmal bone cyst (04; 50.0%) were the most common chondrogenic tumor, osteogenic tumor and tumor like lesion respectively. The most common bone affected was tibia (16; 25.0%), followed by femur (15; 23.4%). Sensitivity and specificity of FNAC as a diagnostic modality were 90.0% and 91.67% respectively.Conclusions: A good correlation is observed between cytological and histological diagnoses which implies that FNAC can be used as a preliminary diagnostic approach to bone tumors, although histopathology remains the gold standard

Anterior cervico-vaginal tear along with posterior bladder wall rupture: a rare case report

A 25 year old female presented to our emergency as a case of G3P2+0 (2A and H), full term pregnancy with intrauterine foetal demise with obstructed labour with severe anaemia. In view of obstructed labour with severe anaemia suspicion of rupture uterus was raised. Abnormal contour of abdomen also raised suspicion of bladder tumour. Here emergency caesarean section was done, peroperatively she was diagnosed as a case of anterior cervico-vaginal rupture along with posterior bladder wall rupture which is a rare entity. Uterine closure was done along with anterior cervico-vaginal wall with posterior bladder wall repair. This repair was done through trans- bladder route. Unique finding of this case was tear of anterior cervico-vaginal region with associated posterior bladder wall tear without rupture of uterus despite of obstructed labour in multiparous women. Most probable cause behind this type of injury is impacted head in neglected or obstructed labour responsible for ischemia and necrosis

A comparative study of efficacy and side effects of nifedipine with nifedipine along with dydrogesterone in management of preterm labor

Background: Preterm labor remains one of the major cause of neonatal morbidity and mortality. Different tocolytics have been studied for prolongation of pregnancy, role of progesterone in increasing latency period remains controversial. Aim of the study was to compare efficacy of nifedipine with nifedipine along with dydrogesterone as a tocolytic agent in case of preterm labor and find its impact on maternal and neonatal outcome. Methods: This study was conducted in 100 women who presented with  symptoms of   preterm labor,  patients were then randomized to nifedipine plus dydrogesterone therapy  or nifedipine  treatment. Group I received Nifedipine plus dydrogesterone 10 mg and group II received only nifedipine. Results: There was significant difference in latency period between group I and group II polongation beyond 1 week was observed in 58% in group I and 32% in group II. There is significant difference in APGAR score at 1 minute and 5 minute between patients of group I and group II. In group I, 57.4% neonates have APGAR >7 whereas in group II 31.9% neonates have APGAR >7 at 1 minute. In Group I, 89.4 % neonates have APGAR >7 whereas in group II 68.1% neonates have APGAR >7 at 5 minutes. The mean birth weight in group I was 1.86 with SD 0.35 whereas in group II it was 1.72 with SD 0.34 which is statistically significant. However, no significant difference was found between admission in neonatal intensive care unit or neonatal complications and adverse effects between 2 groups. Conclusions: This study found dydrogesterone along with nifedipine is more effective as tocolytic in comparison to nifedipine alone

Impact of COVID 19 in antenatal patient with gestational diabetes mellitus and vice a versa: a retrospective study

Background: The objective of this study is to compare the incidence, severity and feto-maternal outcome of antenatal Coronavirus disease 2019 (COVID-19) positive patients with GDM vs non GDM patients.Methods: This is a retrospective observational study. The study was carried out in department of Obstetrics and Gynecology, GSVM Medical College, Kanpur from March 2020 to December 2020. All the antenatal women with COVID 19 positive status who were admitted during this period were enrolled in the study. Analysis were made on the basis of observation regarding the severity of symptoms COVID 19 disease, oxygen requirements, mode of delivery and neonatal outcome in GDM vs non GDM COVID positive antenatal patient.Results: A total of 421 COVID positive antenatal patients were enrolled of which 21 patients were having GDM and 400 were non GDM. Of these 21 patients, 14 (66.7%) were diagnosed with GDM after admission while 7 patients i.e., 33.3% were already diagnosed GDM before admission in current pregnancy. Of these 21 (42.9%) antenatal COVID pt with GDM majority shows mild symptoms of COVID 19, however the severity of fever, myalgia and cough was increased in GDM compared to Non GDM Group. While in non GDM Group, majority of patients were asymptomatic (44.3%) and severity was also less.Conclusions: It is also evident that patients with GDM had longer duration of hospital stay, higher incidence of caesarean delivery and oxygen requirements

Respiratory viral infections detected by multiplex PCR among pediatric patients with lower respiratory tract infections seen at an urban hospital in Delhi from 2005 to 2007

<p>Abstract</p> <p>Background</p> <p>Acute lower respiratory tract infections (ALRI) are the major cause of morbidity and mortality in young children worldwide. Information on viral etiology in ALRI from India is limited. The aim of the present study was to develop a simple, sensitive, specific and cost effective multiplex PCR (mPCR) assay without post PCR hybridization or nested PCR steps for the detection of respiratory syncytial virus (RSV), influenza viruses, parainfluenza viruses (PIV1–3) and human metapneumovirus (hMPV). Nasopharyngeal aspirates (NPAs) were collected from children with ALRI ≤ 5 years of age. The sensitivity and specificity of mPCR was compared to virus isolation by centrifugation enhanced culture (CEC) followed by indirect immunofluorescence (IIF).</p> <p>Results</p> <p>From April 2005–March 2007, 301 NPAs were collected from children attending the outpatient department or admitted to the ward of All India Institute of Medical Sciences hospital at New Delhi, India. Multiplex PCR detected respiratory viruses in 106 (35.2%) of 301 samples with 130 viruses of which RSV was detected in 61, PIV3 in 22, PIV2 in 17, hMPV in 11, PIV1 in 10 and influenza A in 9 children. CEC-IIF detected 79 viruses only. The sensitivity of mPCR was 0.1TCID₅₀for RSV and influenza A and 1TCID₅₀for hMPV, PIV1, PIV2, PIV3 and Influenza B. Mixed infections were detected in 18.8% of the children with viral infections, none detected by CEC-IIF. Bronchiolitis was significantly associated with both total viral infections and RSV infection (p < 0.05). History of ARI in family predisposed children to acquire viral infection (p > 0.05).</p> <p>Conclusion</p> <p>Multiplex PCR offers a rapid, sensitive and reasonably priced diagnostic method for common respiratory viruses.</p

Comparative Evaluation of Two Different Marketed Brands of Enalapril maleate

Efficacy of pharmaceuticals dosage form generally depends on their formulation properties and manufacturing methods, hence it is likely that the quality of dosage form may vary. Renin acts on angiotensinogen to form angiotensin I, which is converted to angiotensin II by angiotensin-converting enzyme (ACE). Angiotensin II, a potent vasoconstrictor increases blood pressure by increasing vasopressin&nbsp;production and aldosterone secretion. Enalaprilat, the active metabolite of enalapril, inhibits ACE, hence decreases levels of angiotensin II resulting in less vasoconstriction and decreased blood pressure. The study was exclusively experimental that used IP and other standard books to check in vitro quality of enalapril maleate tablet using different analytical techniques and procedure. Test for weight variation, hardness, friability, disintegration time, and dissolution were conducted. The dissolution test was performed at pH 6.8 for both the brands of the tablet. Further all the tablets passed weight variation, hardness, friability and disintegration test as per the pharmacopoeial standard. Hence we can conclude that both the brands of tablets are equal and both the brands contain equal quantity of active pharmaceutical ingredient (API). Both the brands having higher and lower costs exert similar action. Keywords: Enalapril maleate, In Vitro, Dissolution test, Enalapri

Celiac disease and pregnancy in Indian scenario

Celiac disease is a chronic lifelong inflammatory condition of gastrointestinal tract specifically the small intestine. We report a case of pregnancy outcome in a patient with celiac disease (gluten sensitive enteropathy) diagnosed during the investigations of recurrent abortions and intermittent diarrhoea since childhood.  A 32 years old patient who had four abortions and loss of a premature baby was diagnosed as celiac disease during investigations of recurrent abortions and diarrhoea since childhood. After stabilisation of disease she conceived spontaneously. Patient had regular follow up in some private institute. She was referred to our hospital as a case of IUGR with color Doppler changes with breech presentation with sluggish fetal movements at 37 weeks and emergency caesarean section was performed. A male fetus with 2.25 kg AS 7, 9 at birth was delivered. The cause of her recurrent pregnancy losses and previous preterm birth was celiac disease. Celiac disease (CD) is an immune-mediated enteropathy caused by a permanent sensitivity to gluten in genetically susceptible individual. It may also lead to serious maternal and fetal complications because of systemic effects of disease however a successful pregnancy outcome is possible when pre-gestational diagnosis is made and proper management of disease during pregnancy is achieved

Relative performance of academic departments using DEA with sensitivity analysis

The process of liberalization and globalization of Indian economy has brought new opportunities and challenges in all areas of human endeavor including education. Educational institutions have to adopt new strategies to make best use of the opportunities and counter the challenges. One of these challenges is how to assess the performance of academic programs based on multiple criteria. Keeping this in view, this paper attempts to evaluate the performance efficiencies of 19 academic departments of IIT Roorkee (India) through data envelopment analysis (DEA) technique. The technique has been used to assess the performance of academic institutions in a number of countries like USA, UK, Australia, etc. But we are using it first time in Indian context to the best of our knowledge. Applying DEA models, we calculate technical, pure technical and scale efficiencies and identify the reference sets for inefficient departments. Input and output projections are also suggested for inefficient departments to reach the frontier. Overall performance, research performance and teaching performance are assessed separately using sensitivity analysis.DEA Performance assessment Efficiency India

Anterior cervico-vaginal tear along with posterior bladder wall rupture: a rare case report

A 25 year old female presented to our emergency as a case of G3P2+0 (2A and H), full term pregnancy with intrauterine foetal demise with obstructed labour with severe anaemia. In view of obstructed labour with severe anaemia suspicion of rupture uterus was raised. Abnormal contour of abdomen also raised suspicion of bladder tumour. Here emergency caesarean section was done, peroperatively she was diagnosed as a case of anterior cervico-vaginal rupture along with posterior bladder wall rupture which is a rare entity. Uterine closure was done along with anterior cervico-vaginal wall with posterior bladder wall repair. This repair was done through trans- bladder route. Unique finding of this case was tear of anterior cervico-vaginal region with associated posterior bladder wall tear without rupture of uterus despite of obstructed labour in multiparous women. Most probable cause behind this type of injury is impacted head in neglected or obstructed labour responsible for ischemia and necrosis