Study of serum lipid profile and magnesium in preeclampsia

Background: A comparative study of serum lipid profile and magnesium levels in normal pregnancy versus preeclampsia (PE).Methods: A prospective study done for 2 years (October 2014 to October 2016) in the Department of Obstetrics and Gynecology, Narayana medical college and hospital, a tertiary care centre, Nellore, Andhra Pradesh, India. A sample size of 200 pregnant women, recruited and divided into group A and B. group A being women with PE and group B is normal pregnant women.A10ml of venous blood was collected in the fasting state and serum collected from clotted blood to measure lipid profile, magnesium, Apo lipoprotein A-I and Apo lipoprotein B 100.Serum Lipid profile  measured by enzymatic method using commercially available kit Human (GmbH Germany) using humastar 600 chemistry analyzer (Human GmbH Germany). Serum magnesium measured by dye binding method using commercially available kit Human (GmbH Germany) using Humastar 600 chemistry analyzer (Human GmbH Germany). Serum ApoA-I and ApoB were measured by immune-turbidometry using commercial kits from Spinreact Spain. Urine albumin done by dipstick method.Results: Serum total cholesterol (TC), Triglyceride (TG), low density lipoprotein (LDL), very low-density lipoprotein (VLDL), Apo lipoprotein B 100 (Apo B100) were high and serum Magnesium, high density lipoprotein (HDL) and Apo lipoprotein A1(Apo A1) were low in the study group (group A) compared to controls (group B).Conclusions: Abnormal lipid profile (low HDL and increased TG concentration) and serum hypomagnesaemia may be contributing etiologies of preeclampsia, having good predictive value as a screening procedure for PE in high risk pregnant population

Pregnancy related acute kidney injury: nondialytic management

Acute Kidney Injury (AKI) is associated with increased mortality and morbidity unless timely diagnosed & promptly managed. An understanding of the renal physiologic changes that occur during pregnancy is essential for Proper evaluation, diagnosis, and management of Pregnancy Related AKI (PRAKI). In the general population, AKI can occur from prerenal, intrinsic/renal, and post-renal causes. Major causes of pre-renal azotemia include hyperemesis gravidarum and uterine hemorrhage in the setting of placental abruption. Intrinsic etiologies include infections from acute pyelonephritis and septic abortion, bilateral cortical necrosis, and acute tubular necrosis. Particular attention should be paid to specific conditions that lead to AKI during the second and third trimesters, such as preeclampsia, HELLP syndrome, acute fatty liver of pregnancy, and TTP-HUS. An understanding of the various etiologies of AKI in the pregnant patient is key to the appropriate clinical management & prevention of adverse maternal/fetal outcomes. Sometimes PRAKI may require intensive management and even dialysis adding additional economical burden to the patient. We here, with report an interesting case of PRAKI diagnosed & managed in time by simple medical measures thus delivering an effective treatment at a much lesser cost

Seroma: an interesting case report

A seroma is defined as a sterile accumulation of serum in a circumscribed location in the tissue. Seromas can occur after surgeries, especially those that are extensive or involve significant tissue disruption viz. hernia repairs, plastic surgeries such as breast augmentation or reconstruction, abdominoplasties (tummy tucks)and removal of large intra-abdominal space occupying lesions like huge fibroids/ovarian masses. The literature citing the exact incidence of seromas following removal of large intra-abdominal masses is scant. Seromas at times become severely symptomatic. The best way to prevent a seroma is not to give it any place to form. It's easier said than done. Here is an interesting case report of postoperative seroma following removal of a large broad ligament fibroid