Trends in maternal mortality in a tertiary care hospital

Background: To analyze the trends in maternal mortality in a tertiary hospital in Salem, Tamil Nadu.Methods: Design of the study was retrospective. Records of all maternal deaths occurring for the past 3 years from January 2013-December 2015 were studied and various factors analyzed and compared.Results: The maternal mortality rate ranged between 559-802/ 1,00,000 live births in our study. The majority of deaths were in the age group between 21-25 yrs. The majority of deaths in 2013 were due to hemorrhage (19.5%) followed by cortical venous thrombosis (17.6%), hypertensive disorders (14.6%). But in 2014 and 2015 hypertensive disorders were the common cause of death, [2014 (23%), 2015 (26.78%)] followed by hemorrhage (2014-12.8%, 2015 -17.5%) and sepsis (2014-20.5%, 2015-12.5%).Conclusions: Majority of maternal deaths can be prevented by adopting improved standards in early identification of preeclampsia, anemia and its management and early referral. Routine iron and folic acid supplementation to be done in an effective way. Proper antenatal care, emergency obstetrics care and routine audits are very much essential to decrease the maternal mortality as well as to know the trends of maternal deaths to develop subsequent management protocols

Perspectives on the Pathogenesis and Complications of PE

Preeclampsia is a multisystem disorder characterized by hypertension and proteinuria after 20 weeks of gestation. Globally, it is the leading cause of fetal and maternal morbidity and mortality. Nearly 8–10% of women develop hypertension during pregnancy worldwide. Although the actual pathogenesis of PE has not been fully understood, the only cure for the disease is delivery. So, the growing evidence suggests that improper spiral artery remodeling creates placental hypoxia and leads to altered immune response followed by endothelial dysfunction, the release of angiogenic and antiangiogenic factors, and various other vasoactive factors into the maternal circulation. Reliable biochemical markers are needed for the diagnosis of PE at the earliest. MMPs are differentially expressed as a result of the trophoblast invasion’s distinct temporal features. Early in the gestational period, MMPs create the conditions for the ensuing incursion to the placental bed. Endothelial dysfunction is the cause of the clinical sign of the mother such as impairment of the hepatic endothelium causing the HELLP syndrome to develop, impairment of the cerebral endothelium causing refractory neurological problems, or even eclampsia. Also, this chapter reveals the various maternal consequences like HELLP syndrome, Seizure, future cardiovascular events, and end-organ dysfunction; fetal complications include premature delivery, respiratory distress, IUGR, etc

Greatness of leader in Thirukural

International audienc

Greatness of leader in Thirukural

International audienc

Trends in maternal mortality in a tertiary care hospital

Background: To analyze the trends in maternal mortality in a tertiary hospital in Salem, Tamil Nadu.Methods: Design of the study was retrospective. Records of all maternal deaths occurring for the past 3 years from January 2013-December 2015 were studied and various factors analyzed and compared.Results: The maternal mortality rate ranged between 559-802/ 1,00,000 live births in our study. The majority of deaths were in the age group between 21-25 yrs. The majority of deaths in 2013 were due to hemorrhage (19.5%) followed by cortical venous thrombosis (17.6%), hypertensive disorders (14.6%). But in 2014 and 2015 hypertensive disorders were the common cause of death, [2014 (23%), 2015 (26.78%)] followed by hemorrhage (2014-12.8%, 2015 -17.5%) and sepsis (2014-20.5%, 2015-12.5%).Conclusions: Majority of maternal deaths can be prevented by adopting improved standards in early identification of preeclampsia, anemia and its management and early referral. Routine iron and folic acid supplementation to be done in an effective way. Proper antenatal care, emergency obstetrics care and routine audits are very much essential to decrease the maternal mortality as well as to know the trends of maternal deaths to develop subsequent management protocols

TYG-BMI AS A SURROGATE MARKER IN HYPERTENSIVE PATIENTS - AN OBSERVATIONAL STUDY IN TERTIARY CARE HOSPITAL

Background: Previous epidemiological studies have shown that the triglyceride-glucose index (Ty-G) was well- known predictor for the development of diabetes mellitus. A study proposed that traditional lipid ratios, particularly the TGHDL- C ratio based on the proportion between pro atherogenic and anti-atherogenic fractions are more effective than single lipids measure in identifying IR. Ty-G index predicted the subsequent occurrence of HTN in a positive and dose-dependent manner. Therefore, early detection of the Ty-G index may be beneficial for early interventions to prevent HTN among the Chinese population Methodology: The present study was an observational study and the results of total 128 hypertensive patients and healthy volunteers aged between 35 to 60 years was collected from a Tertiary care hospital. Body mass index (BMI), Waist Circumference (WC), blood pressure, fasting blood glucose and Triglyceride levels were measured. Receiver Operating Characteristic (ROC) Curve was used to check association between the study groups. Results: ROC curve based on sensitivity and specificity with reference to TyG-BMI as dependent variable among the groups. Area under curve for Waist/Hip ratio(W/H) was 0.543, HbA1c was 0.766, albumin/creatinine was 0.512, aspartate aminotransferase/alanine aminotransferase was 0.528, triacylglycerol/high density lipoprotein was 0.681 with cut-off value of W/H is 0.81, HbA1c is 5.05, albumin/creatinine is 2.56, AST/ALT is 0.41, TAG/HDL is 0.71 respectively. TyG-WC as dependent variable in normotensive and hypertensive subjects, area under curve for W/H was 0.626, HbA1c was 0.671, albumin/creatinine was 0.527, AST/ALT was 0.528, TAG/HDL was 0.681 with cut-off value of W/H ratio is 0.80, HbA1c is 5.05, albumin/creatinine is 2.56, AST/ALT is 0.55, TAG/HDL is 1.64 respectively. Conclusion: Our observational study suggests that higher Ty-G index was associated with higher probabilities of hypertension in general adult population. Large-scale prospective cohort studies are looked-for to elucidate the latent pathophysiological mechanisms underlying the association among Ty-G index and hypertensive subjects

Assessment of factors related to poly cystic ovarian syndrome – A comparative and correlational study

AbstractPolycystic ovarian syndrome (PCOS) is a common endocrine disorder that primarily affects women of reproductive age. It is particularly prevalent among adolescent females who receive an insufficient diagnosis despite having potentially adverse consequences. The use of PCOS screening questionnaires has the potential to aid in the early detection of symptoms. The goal of this study is to observe if a self-administered questionnaire may be useful for a clear cognizance of the associated conditions like mental stress and menstrual characteristics correlated to polycystic ovary syndrome. In this study, we selected women within an age group of 17–40 with and without PCOS based on the modified Rotterdam criteria to fill out a self-administrated questionnaire based on the signs and symptoms of PCOS majorly focusing on mental stress and menstrual characteristics. SPSS software, univariate analyses were employed to elucidate the associations among the components of PCOS, demographic factors, and lifestyle characteristics, hence providing insights into the interrelationships among those variables. 64 women with PCOS and 141 women without PCOS participated in the present study. The present study revealed PCOS is greatly influenced by age at menarche (p-value= .043), typical cycle length (p-value = .000) mental health problems during menstruation (p-value = .032), and body mass index (p-value = .001). Multivariate hierarchical logistic regression analysis showed only 2 variables BMI (a-OR 1.156,95% CI (1.067–1.242), p-value = .000), and typical cycle length (a-OR 2.278, 95% CI (1.079–4.809), p-value = .003) were significant. The present study showed that BMI and menstrual cycle length were most closely associated with the incidence of PCOS, which is important in diagnosing and treating the condition. Considering the high incidence of PCOS among women of reproductive age and its potential for significant health implications, it would be prudent to incorporate inquiries regarding mental health concerns and menstrual patterns into routine medical assessments for this demographic analysis. This approach aims to ascertain whether additional diagnostic evaluations and screenings for PCOS are warranted

Induction of ROS-Dependent Mitochondria-Mediated Intrinsic Apoptosis in MDA-MB-231 Cells by Glycoprotein from Codium decorticatum

Marine macroalgae consist of a range of bioactive molecules exhibiting different biological activities, and many of these properties are attributed to sulfated polysaccharides, fucoxanthin, phycobiliproteins, and halogenated compounds. In this study, a glycoprotein (GLP) with a molecular mass of ∼48 kDa was extracted and purified from Codium decorticatum and investigated for its cytotoxic properties against human MDA-MB-231 breast cancer cells. The IC₅₀ values of GLP against MDA-MB-231 and normal breast HBL-100 cells (control) were 75 ± 0.23 μg/mL (IC₂₅), 55 ± 0.32 μg/mL (IC₅₀), and 30 ± 0.43 μg/mL (IC₇₅) and 90 ± 0.57 μg/mL (IC₂₅), 80 ± 0.48 μg/mL (IC₅₀), and 60 ± 0.26 μg/mL (IC₇₅), respectively. Chromatin condensation and poly­(ADP-ribose) polymerase (PARP) cleavage studies showed that the GLP inhibited cell viability by inducing apoptosis in MDA-MB-231 cells. Induction of mitochondria-mediated intrinsic apoptotic pathway by GLP was evidenced by the events of loss of mitochondrial membrane potential (ΔΨ_m), bax/bcl-2 dysregulation, cytochrome <i>c</i> release, and activation of caspases 3 and 9. Apoptosis-associated factors such as reactive oxygen species (ROS) formation and loss of ΔΨ_m were evaluated by DCFH-DA staining and flow cytometry, respectively. Cell cycle arrest of G₂/M phase and expression of apoptosis associated proteins were determined using flow cytometry and Western blotting, respectively