Pregnancy outcome in women with polycystic ovary syndrome

Background: To compare the pregnancy outcome in polycystic ovary syndrome (PCOS) women with normal women and to study the incidence of pregnancy complications like spontaneous abortions, preterm labour, gestational diabetes, gestational hypertension, preeclampsia, pregnancy and neonatal outcome in women with PCOS.Methods: Prospective comparative study done on 160 pregnant women to compare the pregnancy outcome in PCOS and normal women. All patients were subjected to detailed history, general and obstetric examination, antenatal investigations, routine dating scan, glucose challenge test at 24 to 28 weeks in study and control groups, blood pressure recording and urine for proteinuria after 20 weeks to evaluate preeclampsia. After delivery, birth weight and apgar score at 1 and 5 minutes are recorded. Body mass index is calculated and pregnancy outcome studied and compared.Results: Out of 80 pregnancies with PCOS, 8 had spontaneous abortions, 11 Gestational diabetes mellitus (GDM), 9 gestational hypertension, 5 preeclampsia and 3 had preterm labour. GDM is 3 times, Spontaneous Abortion is 4.33 times, gestational hypertension is 3.25 times and neonatal intensive care unit (NICU) admission is 3.25 times more in PCOD women.Conclusions: Pregnancy complications like spontaneous abortions, gestational diabetes, gestational hypertension and neonatal complications requiring NICU admissions are significantly higher in pregnant women with PCOD. Pregnant women with PCOD may become a high risk pregnancy at any time. Hence proper antenatal care is mandatory to prevent and treat the complications.

Histopathological features of endometrium in those with symptoms suggestive of female genital tuberculosis

Background: Genital tuberculosis is an important cause of female infertility. It is estimated that 5-13 percent of females presenting themselves in infertility clinics in India have genital tuberculosis. Objective of present study was to compare the prevalence of symptoms suggestive of genital tuberculosis between the patients suffering from infertility and the patients with normal fertility.Methods: A random of 200 female OPD patients who were proved to be negative for genital TB (FGTB) by Microscopy, AFB culture, AFB-PCR and histopathology were retrospectively analyzed for presence of symptoms suggestive of FGTB. A comparative study was done to find any specific association of symptoms suggestive of FGTB with infertility.Results: Oligomenorrhoea was the only symptom significantly (p=0.02) associated with those suffering from infertility [n= 64 (32%)]. The rest of the symptoms suggestive of FGTB were not significantly associated with infertility.Conclusions: Symptoms suggestive of FGTB are present even in those who are proved Negative for FGTB and non-significantly associated with those with infertility in whom FGTB is expected to be an important cause. This paradox questions the specificity of these symptoms in developing a symptomatic diagnostic algorithm for FGTB

Histopathological features of endometrium in those with symptoms suggestive of female genital tuberculosis

Background: Histological characteristics of endometrial biopsy material as assessed by light microscopy remain the diagnostic standard for the clinical diagnosis of endometrial pathology. Management of female genital TB is not complete without tissue diagnosis. The aim of the present study was to find out the histopathological pattern of theendometrium in those with symptoms suggestive of genital tuberculosis.Methods: A random sample of 200 female OPD patients with symptoms suggestive of FGTB attending to the Obstetrics and Gynaecology OPD in a tertiary care hospital at Ariyur, Puducherry were subjected to endometrial curettage and histological characteristics of endometrial biopsy material was assessed.Results: Endometrial histopathology revealed proliferative endometrium (60.5%, n=121), secretary endometrium (25.5%, n=51) and menstrual endometrium (9%, n=18) in majority. Chronic endometritis (3%, n=6), Simple hyperplasia without atypia (1%, n=2), atrophic (0.5%, n=1) and inert endometrium (0.5%, n=1) were other abnormalities reported.Conclusions: Histopathological features of endometrium in those with suggestive symptoms of female genital TB are variable and non-specific

Iatrogenic bladder injuries during obstetric and gynecological surgeries-does it demand prophylactic presence of an urologist?

Background: Iatrogenic bladder injuries (IBI) are more common during obstetric and gynaecological procedures averaging 2.6 IBIs per 1000 surgeries. The objective of the study was to estimate the incidence of IBIs during OBG procedures in a tertiary care hospital at Puducherry. To study the proportion and clinical profile of the IBIs where the management of an urologist was indicated intra-operatively.Methods: This cross-sectional study was conducted in a tertiary care hospital in Puducherry by analysis of records of OBG surgeries conducted during the 5 years’ period from 2011 to 2015. The occurrence of IBIs during obstetric and gynaecological surgeries was estimated and the records of those with injuries were analysed retrospectively.Results: The overall incidence of Iatrogenic Bladder Injuries (IBI) among the OBG surgeries was 1.33% (n=19). Iatrogenic Bladder Injuries (IBI) frequently happened during Gynaecological procedures (73.7%, n=14) than during Obstetric procedures (26.3%, n=5). The incidence of bladder injuries intra-operatively was more frequent during dissection of bladder (57.9%, n=11) and opening the abdomen (36.8%, n=7). The requirement of urologist was more felt during posterior bladder wall injuries (26.3%, n=5).Conclusions: The occurrence of IBIs was more common during Gynaecological procedures than during obstetric procedures. Most of the gynaecological procedures especially hysterectomies require the expertise presence of an urologist

Influence of Cu concentration on the structural, morphological, optical and catalytic properties of TiO2 thin films

Pristine titanium oxide (TiO2) and Cu doped TiO2 thin films of ~2.0 µm thicknesses have been deposited on glass substrates by sol-gel dip coating technique. The deposited films are even and more adherent to the substrate. The consequences of incorporation of Cu ions of different concentration in TiO2 lattice towards the structural, morphological and optical characteristics of prepared thin films have been investigated. Cu doping alters crystallite size and morphology of doped TiO2 films marginally. Gradual increase in concentration of Cu atoms into TiO2 matrix expands the absorption window of prepared films to visible region. The decrease in excitonic energy upon Cu doping promotes the charge separation in TiO2 semiconductor. Depending upon Cu concentration, exciton life time is extended fairly which leads to improved electron-hole separation and enhanced oxidation-reduction reactions at the surface of TiO2 semiconductors. The advantage of thin film catalyst over the other catalyst structures has been exhibited by the reusability nature of Cu-TiO2 films. This study reveals that an ideal amount of Cu doping can increase the photocatalytic performance of TiO2 thin films efficiently

Menstrual disorders associated with thyroid dysfunction

Background: Present study was done to evaluate the thyroid function in patients presenting with varying menstrual patterns of reproductive age group from 15 to 45 years of age.Methods: This prospective study was carried out in obstetrics and gynecology Department of Sri Venkateshwaraa Medical College, Pondicherry, India on 155 women, clinically given the provisional diagnosis of dysfunctional uterine bleeding (DUB). All these patients were investigated for T3, T4, TSH (Thyroid stimulating hormone) levels and grouped according to that.Results: Among the 155 women (58.7%) were normal thyroid function, (41.3%) had hypothyroid and (1.3%) had subclinical hypothyroidism.Conclusions: There is a high prevalence of thyroid disorders in cases which are clinically diagnosed as DUB. Evaluating for thyroid and treating it medically which was most accurate and cost effective and unnecessary surgery was avoided. Hence the thyroid function evaluation should be mandatory in cases of DUB to detect thyroid dysfunction and these cases should be referred to physician for further medical treatment

Comparison of prophylactic versus regular use of antibiotics in elective major obstetrical and gynecological surgeries

Background: Surgical site infections better prevented by parenteral antibiotic in sufficient doses generally should be given before the operation which helps to achieve the therapeutic drug level both in the blood and related tissue during the operation. Ceftriaxone, when administered together as a prophylaxis can fulfil the above criteria of a good antibiotic. Thus, this study was planned to assess the efficacy of prophylactic antibiotic usage to that of regular antibiotics usage in patients undergoing elective surgeries.Methods: This randomized controlled study was conducted in a tertiary care teaching hospital during the study period of June 2017 to April 2018 with 140 cases. Group A received a single dose of Injection Ceftriaxone 1g. Group B, received Injection Ceftriaxone 1 gm and Injection Metronidazole 500 mg for five days. The data was entered in excel sheet and analyzed using SPSS (Version 16).Results: The mean age group in Group A and Group B was found to be 34.24±10.5 and 35.97±11.89, respectively. There was no statistical significance between group A and B for incidence of infection in the post-operative period and duration of hospital stay. The mean value in group A for duration of surgery was found to be 67.5±13.5 and in group B mean value was 72.1±14.9. (p value <0.05).Conclusions: This study demonstrated that administration of prophylactic antibiotic rather than conventional antibiotic at caesarean and gynecological surgeries are not associated with significant difference in post-operative morbidities

Characterization of New Bacterial Leaf Blight of Rice Caused by Pantoea stewartii subsp. indologenes in Southern Districts of Tamil Nadu

A survey was conducted in the rice fields of Tirunelveli, Tuticorin, Kanyakumari and Madurai districts of Tamil Nadu during 2016to assess the importance of bacterial leaf blight (BLB) of rice caused by Xanthomonas oryzae pv. oryzae. Bacterial Leaf Blight affected leaf samples showing yellowing symptoms or orange to brown stripes on one or both halves of the leaf blade were collected from seventeen places and maintained as isolates. Upon isolation, symptomatic leaf pieces were surface sterilized and placed in wakimoto semi-synthetic medium. The yellow pigmented, raised and translucent colonies with smooth margin were obtained after incubation at 28°C for 2 days. The biochemical characterization revealed that the bacteria belong to gramnegativefacultative anaerobes with small rods either arranged singly or in chains. Thirteen isolates show positive results in biochemical tests viz.,Gram staining, KOH test, starch hydrolysis, anaerobic growth test, tween 80 hydrolysis test, catalase test, citrate utilizationtest and production of yellow pigment on Yeast Dextrose Chalk agar medium. In virulence test, Isolate 1, Isolate 3 and Isolate 4 were considered virulent as they have caused severe blight symptoms both in TN1 and ADT 43, the susceptible check varieties. Based on 16S rRNA sequence analysis, the causal agent was identified as Pantoea stewartii subsp. indolegenes (Accession No. SUB2733370: MF163273; MF163274; MF16327). The biochemical and molecular analysis revealed that the causal agent was not Xanthomonas oryzae pv oryzae, but a new species of bacteriumnamely Pantoea stewartii subsp. indolegenes. This is the first report of new bacterial leaf blight disease of rice caused by Pantoea stewartii subsp.indologenesin southern districts of Tamil Nadu

Study of effectiveness of combined test Pap smear, visual inspection with acetic acid and Lugols iodine for mass screening of premalignant and malignant lesions of cervix

Background: Cancer cervix is the leading cause of morbidity and mortality in developing nations. This study aims to evaluate the usefulness of visual inspection with acetic acid (VIA) and Lugols iodine (VILI) as adjunct to improve the sensitivity of cervical cytology with Pap smear and to enhance the test performance.Methods: Study was conducted in Gynaec OPD clinic in SVMCH & RC, Ariyur, Pondicherry during the period of January 2015 to June 2015. 350 patients enrolled in the study, 10 patients (2.8%) had positive Pap smear, 96 patients (27.4%) had inflammatory smears and 244 (69.7%) had normal smear. VIA was positive in 29 patients (8.2%). VILI was positive in 50 patients (14.2%).Results: Sensitivity of Pap smear = 40% (CI 19.82-64.25%), sensitivity of VIA=40% (CI 19.82-64.25%), sensitivity of VILI = 86.66% (CI 62.12-92.26%), sensitivity of VIA+VILI tests = 86.66% (CI 62.12-96.26), sensitivity of combination tests (Pap + VIA + VILI) = 100% (CI 79.60-100.00). As shown by our study, VILI picked up the maximum premalignant lesions confirmed by cervical biopsy (15 premalignant lesions on cervical biopsy, and VILI is positive in 13 cases) and 6 were picked up by VIA, whereas Pap was positive in 6 patients.Conclusions: This study concludes that the effectiveness of cervical cancer screening can be improved by a combination test of Pap, VILI and VIA, even in tertiary centers in India

Study of effectiveness of combined test Pap smear, visual inspection with acetic acid and Lugols iodine for mass screening of premalignant and malignant lesions of cervix

Background: Cancer cervix is the leading cause of morbidity and mortality in developing nations. This study aims to evaluate the usefulness of visual inspection with acetic acid (VIA) and Lugols iodine (VILI) as adjunct to improve the sensitivity of cervical cytology with Pap smear and to enhance the test performance.Methods: Study was conducted in Gynaec OPD clinic in SVMCH &amp; RC, Ariyur, Pondicherry during the period of January 2015 to June 2015. 350 patients enrolled in the study, 10 patients (2.8%) had positive Pap smear, 96 patients (27.4%) had inflammatory smears and 244 (69.7%) had normal smear. VIA was positive in 29 patients (8.2%). VILI was positive in 50 patients (14.2%).Results: Sensitivity of Pap smear = 40% (CI 19.82-64.25%), sensitivity of VIA=40% (CI 19.82-64.25%), sensitivity of VILI = 86.66% (CI 62.12-92.26%), sensitivity of VIA+VILI tests = 86.66% (CI 62.12-96.26), sensitivity of combination tests (Pap + VIA + VILI) = 100% (CI 79.60-100.00). As shown by our study, VILI picked up the maximum premalignant lesions confirmed by cervical biopsy (15 premalignant lesions on cervical biopsy, and VILI is positive in 13 cases) and 6 were picked up by VIA, whereas Pap was positive in 6 patients.Conclusions: This study concludes that the effectiveness of cervical cancer screening can be improved by a combination test of Pap, VILI and VIA, even in tertiary centers in India