Analysis of indications of induction of labor and feto-maternal outcome in a tertiary care hospital

Background: Induction of labor (IOL) is an intervention that artificially initiates uterine contractions leading to progressive dilatation and effacement of cervix and expulsion of fetus prior to spontaneous onset of labor. Aim of study was to study the indications of induction of labor and the feto-maternal outcome. Methods: Women who underwent IOL beyond 28 weeks gestation with single cephalic presentation were included in the study over a period of one year. Results: A total of 3887 women delivered in the hospital during the study period. 1107 (28.47%) pregnant women underwent induction of labor. Most common indication of induction of labor was post-date pregnancy 682 (61.60%). About 64.52% had vaginal delivery, 30.71% had caesarean section and 4.6% had instrumental delivery, 1.80% PPH, 0.45% puerperal sepsis and 2.16% wound sepsis.  97% neonates with APGAR score more than 7and 1.08% neonates were admitted to NICU. There were 0.27% fresh still births and 0.45% birth asphyxia. Conclusions: Careful analysis of indication of induction of labor, selection of the patients, proper monitoring at the time of induction and strict partographic management of labor results in a healthy baby and mother.

Clinical profile, maternal and fetal outcome in pregnant women with COVID-19 infection: a retrospective observational study in a tertiary care hospital of Himachal Pradesh

Background: The aim of this study was to evaluate the clinical characteristics and outcomes of pregnant women confirmed with COVID-19 infections and their neonates to provide more reference to contribute in managing this noval viral disease.Methods: We conducted a retrospective study over a period of six months; 20 March, 2020 to 8 October, 2020 at SLBSGMC Nerchowk (Himachal Pradesh). Total number of pregnant women who delivered in our hospital during the defined study period was recorded and analysed.Results: The total number of women were delivered over the study period was 13, out of which caesarean sections (CS) were 7 and NVDs were 6 in number. All of them were diagnosed mild COVID-19, and none one of the patients developed severe COVID-19 or died. Their all newborns were recorded healthy except one was COVID positive and one neonate had birth asphyxia.Conclusions: Apparently no difference was observed in relation to onset of disease, symptoms, cure rates or severity in pregnant women when compared to non-pregnant women and healthy men of similar age groups. Pregnancy does not seem to deteriorate the course and prognosis of the disease. Maternal and fetal outcomes are apparently favourable in these patients. Lastly COVID-19 is not an indication of cesarean section. More multicentre studies are the need of the hour to formulate the authentic management guidelines for this novel disease

Maternal and foetal outcome in second stage caesarean section: a prospective study

Background: Caesarean section is the most commonly performed abdominal operation in women all over the world. Caesarean sections during the second stage labour accounts for approximately one fourth of all primary caesareans.  Caesarean section at full cervical dilatation is technically difficult and is associated with increased trauma to the lower uterine segment and adjacent structures, as well as increased haemorrhage and infection. Aims and objectives were to determine the indications, maternal and foetal morbidity associated with caesarean section in the second stage of labour.Methods: This prospective study included consecutive 50 cases of caesarean section deliveries conducted in second stage of labor for singleton live pregnancies at term. The data collected in the study was analyzed in terms of maternal demographics, indications of caesarean section, intra-operative and postoperative complications and neonatal outcomes.Results: In our series of 50 deliveries, arrest of descent of fetal head due to malposition was the most common indication of caesarean section accounting for 74% and average procedure time was 45-70 minutes. PPH (62%) was the most common complication. Bladder injury was found in 14% cases. Neonatal outcome variables like APGAR<3 at 5 minutes, respiratory distress and neonatal death were observed in 7, 26 and 2 deliveries respectively.Conclusions: Women undergoing cesarean section in second stage of labour are associated with increased maternal and fetal morbidity. They require special care and hence operation should ideally be performed and supervised by an experienced obstetrician. A proper judgement is required to take a decision for caesarean section at full cervical dilatation

High grade endometrial stromal sarcoma: a clinician dilemma

Uterine sarcomas are relatively rare tumors of mesodermal origin. ESS occurs primarily in perimenopausal women in 4th and 5th decade of their life; about one third occurs in postmenopausal women. Here in we describe a case of 44 years old patient presented with one month history of foul smelling discharge per vagina and a pelvic mass. Ultrasound and MRI gave possibility of a large anterior wall and fundal fibroid with degeneration versus neoplastic endometrial thickening. The patient underwent exploratory laparotomy with total abdominal hysterectomy with bilateral salpingoophorectomy with pelvic lymphadenectomy. Histopathology showed tumor cells with round to oval nuclei with high mitotic activity, blood vessel proliferation between the tumor cells and extensive lymphovascular invasion. The pathological diagnosis was HG-ESS stage IB. The patient was referred to radiotherapy department for adjuvant therapy. HG-ESS is a rare clinical entity and considered as important differential diagnosis

PHYSICO-CHEMICAL ANALYSIS AND IMPACT OF DIFFERENT SHODHANA METHODS ON GUGGULU

Objective:&nbsp;Guggulu is one of the important Dravya (drug) used in Ayurvedic formulations since ancient time which means “Protection against diseases”. Ashuddhaguggulu has physical and chemical impurities which need to be eliminated before using in formulation by Shodhana. The present study was conducted to evaluate and compare the effect of different Shodhana methods&nbsp;i.e., Dolayantra Shodhana and dissolving Shodhana on properties of Guggulu by employing various physic-chemical and chromatographic methods. Method: Physicochemical screening was done by evaluating ash, Acid Insoluble Ash, Loss on Drying, Water Soluble Extractive and Alcohol Soluble Extractive. Chromatographic analysis was performed to estimate guggulsterone (E and Z) content, using High Performance Liquid Chromatography (HPLC).&nbsp;Result:&nbsp;The Physico-chemical studies showed decrease in LOD, Ash and Acid Insoluble Ash content and increase in extractive values such as Alcohol Soluble Extractive of Guggulu after Shodhana process. The HPTLC analysis showed significant change in guggulsterone (E and Z) content in Guggulu after Shodhana process&nbsp;Conclusion:&nbsp;This study helps to understand the effect of different Shodhana methods on the efficacy of drug. In this study, we established qualitative profile of Shodhit Guggulu in terms of physicochemical parameters and phytochemical content by HPLC

A study on delayed cord clamping and early skin-to-skin contact and its effects on neonatal outcome

Background: Previous study conducted against immediate tying and cutting of the umbilical cord and suggested waiting until the child had taken repeated breaths and the pulsation in the cord had ceased to prevent potential weakness in the child.  A comparative study between delayed cord clamping (DCC) and early cord clamping (ECC) was carried out on a select group of primigravida without any high-risk factor and delivering at term. The objective of the study was to identify the effects of delayed cord clamping and early skin to skin contact on new born infant’s physiological parameters (temperature, weight, SpO2= saturation of peripheral oxygen, Apgar score= appearance, pulse, grimace, activity, and respiration, Hb=haemoglobin level). Methods: Study sample consisted of 300 mothers and their new born after gaining mother’s acceptance. They were divided into 2 groups of 150 each. Group A underwent delayed cord clamping and early skin to skin contact and group B early cord clamping. Newborns monitored 24 hours for hypothermia, apnoea, oxygen needs. Results: The findings of the present study were equivalent among both groups regards the mean neonatal haematological parameters were comparable and slightly elevated hemoglobin level and weight status among late cord clamping compared to early cord clamping group with significant difference was observed at 24 hour later. Conclusions: This study was found that DCC does have a beneficial effect on temperature, Apgar score, SpO2, Hb level and weight status of new born. Therefore, it is believed that DCC and early skin to skin contact (ESSC) provides effective thermal control with a reduced risk of hypothermia

Effective Antimicrobial Activity of Green ZnO Nano Particles of Catharanthus roseus

In the present study, zinc oxide nanoparticles (ZnO NPs) were synthesized using leaf extract of Catharanthus roseus (C. roseus) under different physical parameters. Biosynthesis of ZnO NPs was confirmed by UV-Visible spectrophotometer and further, characterized by X-Ray Diffraction (XRD), Fourier Transform Infrared spectroscopy (FTIR), Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), Energy-Dispersive X-ray spectroscopy (EDX), Atomic Force Microscopy (AFM), Photoluminescence study and Dynamic Light Scattering (DLS). We have also confirmed that several physical parameters such as pH, temperature, concentration of metal ions and reaction time were able to regulate shape and size of synthesized ZnO NPs. XRD and TEM analysis provided the information about the average size and hexagonal morphology of ZnO NPs. FTIR spectra analysis suggested that phenolic compounds played crucial role in the biosynthesis of ZnO NPs. The significant antibacterial activity of ZnO NPs was observed against Staphylococcus aureus MTCC 9760 (S. aureus), Streptococcus pyogenes MTCC 1926 (S. pyogenes), Bacillus cereus MTCC 430 (B. cereus), Pseudomonas aeruginosa MTCC 424 (P. aeruginosa), Proteus mirabilis MTCC 3310 (P. mirabilis) and Escherichia coli MTCC 40 (E. coli). The synthesized ZnO NPs have shown antibacterial efficacy against both Gram-positive and Gram-negative pathogens. Synergistic effects of ZnO NPs and streptomycin showed increased efficacy as indicated by the increased zone of clearance in comparison to their individual effects (either ZnO NPs or streptomycin). Overall, the results elucidated a rapid, cost-effective, environmentally friendly and convenient method for ZnO NPs synthesis, which could be used as a potential antimicrobial agent against drug resistant microbes

Tubercular Retropharyngeal Abscess in Association with Aberrant Retropharyngeal Internal Carotid Arteries - A Rare Entity: Imaging Diagnosis and a Word of Caution

Retropharyngeal (RP) abscess is rarely encountered in adults. Still rare is an abscess of tubercular etiology especially without involvement of the underlying cervical spine. We present a case of an immunocompetent woman with a tubercular RP abscess diagnosed on contrast-enhanced cervical computed tomography and confirmed on cytology. Another interesting feature was an aberrant RP course of the internal carotid arteries in this patient. This case report stresses the importance of imaging in establishing an unexpected diagnosis of an RP abscess, suggesting its likely cause, and also in demonstrating the aberration in regional vascular anatomy, and warns the clinician of life-threatening hemorrhagic complication in the event of any diagnostic or therapeutic intervention

Steganographic Techniques of Data Hiding Using Digital Images (Review Paper)

Steganography is an art that involves communication of secret data in an appropriate carrier, e.g., image, audio, video or TCP/IP header file. Steganography’s goal is to hide the very existence of embedded data so as not to arouse an eavesdropper’s suspicion. For hiding secret data in digital images, large varieties of steganographic techniques are available, some are more complex than others, and all of them have their respective pros and cons. Steganography has various useful applications and the technique employed depends on the requirements of the application to be designed for. For instance. applications may require absolute invisibility of the secret data, larger secret data to be hidden or high degree of robustness of the carrier. This paper intends to give thorough understanding and evolution of different existing digital image steganography techniques of data hiding in spatial, transform and compression domains. It covers and integrates recent research work without going in to much detail of steganalysis, which is the art and science of defeating steganography.Defence Science Journal, 2012, 62(1), pp.11-18, DOI:http://dx.doi.org/10.14429/dsj.62.143