Antibacterial, Antioxidant Activity and Phytochemical Analysis of Euphorbia hirta Linn.

Objective: Crude extracts were prepared from aerial parts of Euphorbia hirta Linn. in four solvents i.e. water, acetone, ethanol and petroleum ether. Extracts were investigated for their phytochemical, antibacterial and antioxidant properties. Methods: Plant extracts were prepared by using Soxhlet apparatus. Antibacterial potential was assessed by disc diffusion method against six bacterial strains viz. Klebsiella pneumoniae (MTCC NO 109), Staphylococcus aureus (MTCC NO 96), Pseudomonas aeruginosa (MTCC NO 2453), Mycobacterium smegmatis (MTCC NO 992), Bacillus subtilis (MTCC NO 2057) and Chromobacterium violaceum (MTCC NO 2656). Minimum inhibitory concentration was determined by microbroth dilution method, only to those bacterial strains which showed a significant zone of inhibition by disc diffusion method. The extracts were also examined for the presence of various phytoconstituents, total phenolic and flavonoid content using standard methods. Free radical scavenging activity was assessed by DPPH method. Results: The plant extracts showed a wide spectrum of inhibition against the test pathogens thus justifying the use of plant in traditional medicine. Acetone, aqueous and ethanol extracts exhibited stronger antibacterial activity as compared to the petroleum ether extract. The maximum activity recorded was 17.6±0.57 mm with 200 mg/ml concentration of ethanol extract against Klebsiella pneumoniae. Petroleum ether extract was found to be least effective as it showed zone of inhibition only against Chromobacterium violaceum. Aqueous extract of the plant showed highest antioxidant activity and minimum IC50 value (105.39 µg/ml) followed by acetone (371.0 µg/ml), ethanol (504.92 µg/ml) and petroleum ether (645.12 µg/ml) extracts. Aqueous extract showed highest TPC value (8.2 mgGAE/g), followed by acetone (6.4 mgGAE/g) and ethanol (5.84 mgGAE/g). Similarly, highest TFC value (4.6 mgQE/g) was also observed against aqueous extract, followed by acetone (2.05 mgQE/g) and ethanol extract (1.82 mgQE/g). Petroleum ether extract exhibited minimum TFC value i.e. 0.79 mgQE/g. Conclusions: The present in vitro study revealed that E. hirta is a rich source of bioactive compounds with significant antibacterial and antioxidant activity. However, further investigation with ethno-pharmacological approach is needed for better understanding of its utility in health care

A retrospective study of maternal and perinatal outcome in patients of postpartum haemorrhage in a tertiary care hospital

Background: Postpartum hemorrhage is one of the most important causes of maternal mortality and morbidity. Maternal Hemorrhage is the commonest cause of maternal mortality in India. Identification of risk factors, early diagnosis and timely intervention can help in reducing significant maternal morbidity and mortality due to post-partum hemorrhage. The aim and objectives of the study was to study socio-demographic profile of patients admitted with the diagnosis of post-partum Haemorrhage, to study the various risk factors and causes of post-partum Haemorrhage, to study maternal and perinatal outcome in patients suffering from post-partum haemorrhage.Methods: It was a record based retrospective study. Files of the patients admitted with diagnosis of postpartum haemorrhage from September 2014 to February 2015 were retrieved and detailed analysis was done regarding patients’ socio demographic characteristics, various risk factors, causes and maternal and perinatal outcome.Results: It was a record based retrospective study. It was found that majority (88%) of the patients belonged to age group of 21-30 years. Majority of them (59%) were from rural background. It was found that the commonest (26%) risk factor associated with postpartum hemorrhage in our study was prolonged labour, followed by ante partum hemorrhage (20%). It was found that the commonest (68%) underlying cause of postpartum hemorrhage was atonicity of uterus, followed by genital tract trauma (24%).Conclusions: Postpartum hemorrhage is one of the biggest menace in today’s times. It adds to significant maternal morbidity and mortality

Impact of increase of caesarean section on postpartum hemorrhage in a tertiary care center of India over 6 years

Background: PPH (postpartum hemorrhage) is the leading cause of maternal mortality. Despite of all the medical advancement, maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Caesarean section is an obstetric intervention where, normal delivery can pose a risk for mother or foetus. The rate of caesarean section has increased worldwide. A survey conducted by WHO found that the worldwide rate of caesarean section increased from 26.4% between 2004 to 2008, to 31.2% between 2010 to 2011.Methods: We collected data of the caesarean sections and patients who developed PPH over 6 years. We studied the association of temporal increase of caesarean section with PPH.Results: Uterine atonicity continues to be the most common etiology of PPH each year, however, there is an increase in tissue abnormality (retained placenta, placenta praevia, accreta, increta, percreta) over years as there is a significant increase in the incidence of caesarean section. Atonic uterus was the most common cause for obstetric hysterectomies and mortality due to PPH every year.Conclusions: Family planning advise is essential in developing country like ours to counsel patients to prevent multiparity, thus reducing PPH. It is also important to train all the health workers in periphery and referral centers to manage the third stage of labor and atonic uterus to save the mothers. Sagacious attitude towards the decision of caesarean section is needed to prevent maternal morbidity and mortality

Antepartum Eclampsia and Partial HELLP Syndrome in a Patient with Bell's Palsy

Bell's palsy affects pregnant women three times more often than nonpregnant women, with majority of cases occurring in the third trimester (71%) and early postpartum period (21%). Bell's palsy during pregnancy has been associated with preeclampsia, with 22% of these women developing preeclampsia. A 26-year-old G3P1 L1A1 diagnosed with Bell's palsy 2 weeks earlier, presented at 33-week period of gestation with a chief complaint of progressive bilateral pedal edema for 1 week, blood pressure (BP) - 150/100 mmHg and dipstick urine - 3+. Laboratory screening of HELLP syndrome was normal. Six days later, she had an episode of generalized tonic–clonic convulsion, magnesium sulfate was given, and emergency laboratory investigations revealed partial HELLP syndrome (platelet - 80,000, serum glutamic oxaloacetic transaminase/serum glutamic pyruvic transaminase - 281/222 U/L) with normal coagulation profile. Lower segment caesarean section was performed with delivery of a 2ks neonate with APGAR of 7/10 and 9/10 at 1 and 5 minute respectively. Postoperative day 3, all laboratory reports including magnetic resonance imaging brain were normal. BP was stabilized and she was discharged on the third postnatal day, with some right-sided residual facial weakness. All obstetricians must be aware of association of Bell's palsy with hypertensive disorders of pregnancy and aggressively screen for the same as soon as diagnosed, to prevent complications such as eclampsia and HELLP. Since Bell's palsy is not associated with adverse perinatal outcomes, it should not prompt obstetricians for hastening deliveries prematurely

A retrospective study of maternal and perinatal outcome in patients of postpartum haemorrhage in a tertiary care hospital

Background: Postpartum hemorrhage is one of the most important causes of maternal mortality and morbidity. Maternal Hemorrhage is the commonest cause of maternal mortality in India. Identification of risk factors, early diagnosis and timely intervention can help in reducing significant maternal morbidity and mortality due to post-partum hemorrhage. The aim and objectives of the study was to study socio-demographic profile of patients admitted with the diagnosis of post-partum Haemorrhage, to study the various risk factors and causes of post-partum Haemorrhage, to study maternal and perinatal outcome in patients suffering from post-partum haemorrhage. Methods: It was a record based retrospective study. Files of the patients admitted with diagnosis of postpartum haemorrhage from September 2014 to February 2015 were retrieved and detailed analysis was done regarding patients' socio demographic characteristics, various risk factors, causes and maternal and perinatal outcome. Results: It was a record based retrospective study. It was found that majority (88%) of the patients belonged to age group of 21-30 years. Majority of them (59%) were from rural background. It was found that the commonest (26%) risk factor associated with postpartum hemorrhage in our study was prolonged labour, followed by ante partum hemorrhage (20%). It was found that the commonest (68%) underlying cause of postpartum hemorrhage was atonicity of uterus, followed by genital tract trauma (24%). Conclusions: Postpartum hemorrhage is one of the biggest menace in today's times. It adds to significant maternal morbidity and mortality. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000): 1897-1901

Comparative study of anatomical landmark-guided versus ultrasound-guided suprascapular nerve block in chronic shoulder pain

Background: Suprascapular nerve block (SSNB) is an effective method for the treatment of shoulder disorders. The present study was conducted to evaluate and compare the effectiveness of SSNB under ultrasonographic guidance with anatomical landmark-guided (LMG) technique in the treatment of chronic shoulder pain. Materials and Methods: A total of fifty patients with shoulder pain were enrolled in the present prospective randomized study. Patients in Group I (n = 25) received SSNB using the anatomical LMG as technique described by Dangoisse, in whom a total of 6 ml of drug (5 ml of 0.25% bupivacaine and 40 mg methylprednisolone) was injected. Group II patients (n = 25) were given SSNB using the ultrasound guidance with the same amount of drug. Pain was measured using visual analog scale (VAS), range of motion and Shoulder Pain and Disability Index (SPADI) were recorded. Observations were recorded before the block, immediately after the block, and 1 and 4 weeks after the block. Results: There was no statistically significant difference between the VAS score, range of motion and SPADI before the procedure (P > 0.05) in both the groups. Both the groups showed statistically similar improvement of VAS, range of motion and SPADI at 4-week (P > 0.05) follow-up. In Group I, VAS decreased from baseline value of 6.64 ± 1.50–2.04 ± 0.94 at 4 weeks (P < 0.001). In Group II, the VAS decreased from 6.92 ± 1.00 to 1.84 ± 1.03 at 4 weeks (P < 0.01). Conclusion: In our study, both the techniques have produced comparable relief of pain, improvement in shoulder movement, and decreased SPADI 4 weeks after the block

Periodontal health status, oral mucosal lesions, and adverse oral habits among rubber factory workers of Bahadurgarh, Haryana, India

Objective: The objective of this study was to assess the prevalence of periodontal disease, oral mucosal lesions, and tobacco usage among rubber factory workers of Bahadurgarh, Haryana, India. Materials and Methods: A descriptive cross-sectional study was conducted on a total sample size of 3290 workers with an age group of 19–60 years old. Tobacco-related habits, periodontal health, and oral mucosal lesions were recorded using the modified World Health Organization pro forma (1997). Descriptive statistics, Pearson Chi-square, and one-way analysis of variance were used. Results: Higher tobacco usage frequency (78.28%) in both forms smoking and smokeless was found. The prevalence of periodontal disease and oral mucosal lesions was 87.4% and 41.24%, respectively, among the study population. The most common oral mucosal lesion found was leukoplakia (10.13%), followed by oral submucous fibrosis (4.67%) among the 50–60 years age group. The most commonly involved site in the present study for the occurrence of oral mucosal lesions is buccal mucosa (30.5%), followed by vestibular region (22.3%), tongue (16.1%), labial mucosa (10.3%), and palate (9.7%), whereas floor of mouth (6.4%) and commissures (4.7%) were the least involved. Conclusions: The findings of this study provided an insight into the periodontal health status, adverse oral habits, and the prevalence of oral mucosal lesions of factory workers, which may be useful in planning oral health programs and free services for tobacco cessation and dental treatment, especially to this industrial sector