Assessment of maternal serum β hCG level in pregnancy induced hypertension and normotensive patients and to correlate between the level of β hCG with the severity of pre-eclampsia and eclampsia

Background: Hypertensive disorders during pregnancy are one of the most common medical complication seen during pregnancy, affecting around 5-10% of all pregnancies. Spectrum of this disease ranges from mildly elevated blood pressure with minimal clinical significance to severe hypertension with multi organ dysfunction. Pre-eclampsia complicates about 2-8% of all pregnancies. Pre-eclampsia incidence in India is about 8-10%. Various studies have depicted that, there is a strict relationship between PIH and elevated serum β-hCG level.Methods: This one-year prospective case control study toteled 200 pregnant women attending antenatal care and admitted in eclampsia ward fulfiling the inclusion criteria were studied. Serum βhCG levels were estimated by chemiluminescent microparticle immunoassay. Statistical analysis of data was done by student’s t-test and p-value.Results: The mean β hCG level in PIH patients was found to 36851.59 mIU/ml with standard deviation of 22916.58 while the mean β hCG in normotensive patient was 15433.26 mIU/ml with standard deviation of 6861.56. (p <0.001). The mean β hCG level in gestational hypertensive patients was 25206.19 mIU/ml with a standard deviation of 8696.9. The mean β hCG level in pre-eclamptic patients was 61697.67 mIU/ml with standard deviation of 18498.57. The mean β hCG level were 84106.38 mIU/ml with standard deviation of 11295.05 in the eclamptic patient. The above values were statistically significant (p <0.001).Conclusions: We concluded that there was a striking relation between the PIH including pre-eclampsia and eclampsia with the elevated serum βhCG level. Concluding that early detection of altered serum βhCG shell aid in better management of pre-eclampsia and eclampsia cases which would play a pivotal role in improving the maternal and fetal outcome

Comparative study of fetal outcomes in pregestational and gestational diabetes mellitus

Background: Diabetes mellitus is an emerging health problem worldwide and is now seen in increased frequency during pregnancy. Pregestational DM and GDM have an impact on the fetal outcome in terms of the baby weight, hypoglycemia, hyperbilirubinemia, respiratory distress syndrome and other complications in the fetus. This study was designed to study these effects in a comparative way between these two groups so as to equip ourselves better and provide better materno-fetal care. Method: This was a prospective observational study conducted during a period of one year.All pregnant females attending the antenatal OPD were screened for diabetes mellitus. Those fulfilling the ADA criteria belonged to the pregestational diabetes mellitus group and those fulfilling the DIPSI criteria belonged to the GDM group. A proforma containing general information on demographic characteristics and neonatal outcome in terms of the baby status, baby weight, l, hypoglycaemia, hyperbilirubinemia, and respiratory distress syndrome was maintained. The whole data collected was then analyzed. Results: The fetal outcome for Group DM was more adverse in comparison to the Group GDM. There was an increased incidence of macrosomia (27.9% vs. 8.25%), hyperbilirubinemia (87.1% vs. 53.1%), hypoglycemia and fetal wastage. Conclusions: Pregnancy complicated with diabetes mellitus is a high risk pregnancy and the type of diabetes plays a crucial role in the fetal outcome of that pregnancy. An understanding of this can help provide better perinatal care and outcome

Investment, Insurance Myth & Reality: Investors Guide 1.0

Multiple options of investment from Saving Bank Account, Recurring Deposit, Bonds, Mutual funds, Equity &amp; SIP. (Systematic Investment&nbsp; Plan) are prevalent besides age old technique to invest in Gold &amp; Real Estate. If we look at the last 40 years returns since inception of the Sensex in yr. 1980 &amp; the journey of Nifty, CSE index over the years to understand performance of equity &amp; mutual funds besides RD./ FD./ Saving Account. Also the study of the performance of Gold &amp; Real Estate to reach at the consolidated opinion on the available multiple tools of investment

HPMC/CMC BASED FAST DISSOLVABLE ORAL FILMS OF AN ANXIOLYTIC: IN VITRO DRUG RELEASE AND TEXTURE ANALYSIS

Film forming capacity of a polymeric combination consisted of HPMC/CMC was investigated for fast dissolvable oral films (FDOFs) of an anxiolytic agent. Other non-film forming components were cross-povidone as disintegrant, and polyethylene glycol 400/ sorbitol in the ratio (1:1) as plasticizer, citric acid as saliva stimulating agent. Buspirone hydrochloride was selected as low dose anxiolytic agent with less than 5% oral bioavailability. Solvent casted films were physically evaluated for thickness, drug content, surface pH, swelling, disintegration and in vitro drug release. Mechanical properties of film viz. % elongation, tensile strength, Young modulus and elongation at break were determined using TXT texture analyzer. Drug loaded film (2.0×2.0 cm2­­ size, average weight 60-70 mg) had average thickness in the range of 100-300 μm. Higher HPMC/CMC ratios resulted in lower folding endurance in films (100 turnings), shorter disintegration time (10 sec) and simulated swelling time of 15sec whereas films produced at lower HPMC/CMC ratios had affected film characteristics conversely. Mechanical properties of film were found to relate the plasticizer ratio. Folding endurance and tensile strength of the films prepared at higher PEG 400/sorbitol ratios, showed comparatively higher values than film prepared at lower ratio. It had also been determined that higher ratios of PEG400/sorbitol were of shorter disintegration time. No drug-exicipient interaction was observed from characterization studies conducted on films using FTIR and DSC methods. Films were stable at 30±0.5 ºC; 60±5% RH.  In vitro drug release showed that BH was released from film within ten minutes.  It can be inferred that polymeric blend HPMC/CMC can be employed as fast dissolving oral film of BH for immediate release

Results of sagittaly unstable intertrochanteric fractures managed by dual reduction technique

Background: We evaluated the functional and radiological outcome of sagittally unstable intertrochanteric fractures reduced by dual technique consisting of a crutch placed posteriorly over distal fragment and pushing the flexed proximal fragment by ramrod anteriorly over a period of 12 months.Methods: A fracture was defined as sagittally unstable intertrochanteric fracture when posterior sagging of distal fragment and flexion of proximal fragment worsens after routine maneuvers for closed reduction. Out of the 80 intertrochanteric fractures treated from February 2018 to April 2019, 16 hips had sagittal instability and after reduction were treated with proximal femoral nail (Stryker Trauson) in some patients and DePuy Synthes proximal femoral nail PFNA in remaining patients. These 16 patients were followed up for a period of 1 year and functional and radiological outcome was noted.Results: Out of the 16 patients, 10 were males and 6 were females. The mean age was 68.2 years. According to the A.O classification out of the 16 patients, 7, 5 and 4 patients were classified as A1.3, A2.1, and A2.2 or more. The mean time from injury till surgery was 4.6 days. The mean surgical time was 45.8 minutes. The mean time for radiological union was 22.4 weeks. The mean pre injury activity level was 4.2 while the mean final activity level was 3.8 (1-5) according to modified Koval activity index.Conclusions: Anatomical reduction followed by rigid internal fixation is the key to success in intertrochanteric fractures.

Prevalence and associated risk factors of abnormal pap smear in pregnant women

Background: The Papanicolaou test is a method of cervical screening used to detect pre-cancerous and cancerous processes. The incidence of cervical cancer in India is alarmingly high and is the leading cause of cancer in women in India accounting for 147 deaths per lakh women. Cervical cytological abnormalities are found in up to 5% of all pregnancies. In Indian settings, published data on abnormal Pap smear in pregnancy is lacking. The present study was designed to know the prevalence of abnormal Pap smear in pregnant women and its associated risk factors.Methods: This prospective study included 450 pregnant and 450 non-pregnant women who fulfilled the inclusion criteria. After a detailed history, clinical examination and investigations, Pap smear was collected as per conventional method and reported using 2014 Bethesda system.Results: 53.6% pregnant and 44.6% non-pregnant subjects had abnormal Pap smear. Out of the abnormal smears in pregnant women, 31.18% had inflammatory cytology, 15.37% had bacterial vaginosis, 4.01% had Trichomonal and 3.34% Monilial pathology. No epithelial cell abnormality was seen. Rural residence, lower class, age at first intercourse less than 21 years and having more than one sexual partner were important risk factors observed in our study and were statistically significant.Conclusions: Bacterial vaginosis, the most common infection detected on Pap smear is strongly associated with previos preterm labour and delivery. This opportunity for screening of cervical cancer and counselling should not be missed in the antenatal period

STUDY OF PANEL OF DIAGNOSTIC CARDIAC MARKERS FOR ACUTE MYOCARDIAL INFARCTION

Objectives: The aim of this study is to estimate the level of creatine kinase-myocardial band (CK-MB), C-reactive protein (CRP), and lactate dehydrogenase (LDH) biomarker in myocardial infarction (MI) (troponin T-positive) and compare with normal healthy individuals (Troponin-T [TnT] negative). Methods: A cross-sectional study on 172 patients involving 100 patients with nondiabetic MI and 72 apparently healthy controls with no history of diabetes and/or MI was done from December 2017 to May 2018. The diagnosis of MI was established with electrocardiogram findings and TnT estimation. Blood samples were gathered and processed for the estimation of CK-MB, LDH, and CRP. Results: The mean age of the cases was 62.15±7.75 years and in the controls was 61.49±8.35 years (p=0.592). The mean value of CK-MB, LDH, and CRP in the TnT positive group was 111.94±29.59 IU/L, 564.43±110.99 IU/L, and 15.69±4.04 mg/L, whereas in the TnT negative group was 16.36±3.77 IU/L, 223.68±36.23 IU/L, and 6.08±2.02 mg/L, respectively (p&lt;0.0001). CK-MB was deranged in 100% of TnT positive group, and in only 2.78% in TnT negative group (p&lt;0.0001). LDH was deranged in 100% TnT positive group, and in 16.67% in TnT negative group (p&lt;0.0001). CRP was deranged in 4% TnT positive group, and in 0% in TnT negative group (p=0.141). Conclusion: This study indicated that CK-MB and LDH are sensitive cardiac markers for the diagnosis of MI

Vitamin D deficiency and adverse fetal outcome

Background: Vitamin D deficiency is recognized as the most untreated nutritional deficiency in the world. It is plausible that vitamin D deficiency could make the fetal heart more vulnerable to distress/birth asphyxia. Vitamin D deficiency has been hypothesized to be associated with low birth weight, low Apgar score at birth, higher rates of still births and admission to NICU. The aim of present study was to study prevalence of vitamin D deficiency in pregnancy and evaluate perinatal outcome.Methods: The study was conducted in the department of obstetrics and gynecology, Kamla Nehru Hospital, Shimla, India over a period of 12 months. Six hundred women were included in the study.Results: All the mothers who had still births suffered from vitamin D deficiency and the severe vitamin D deficiency was there in 90.91% (30) of these subjects. Severe vitamin D deficiency was seen in 78.95% (75) of the subjects having babies with birth weights <2.5 kg compared to 61.16% (288) subjects of the other group.Conclusions: Adverse fetal outcome are more common in vitamin D deficient group

Vitamin D deficiency and maternal complications

Background: Vitamin D deficiency is prevalent in India, a finding that is unexpected in a tropical country with abundant sunshine. Vitamin D deficiency is recognized as the most untreated nutritional deficiency currently in the world. Several studies reported the relationship between maternal vitamin D deficiency and adverse maternal and fetal outcomes including gestational diabetes, preeclampsia, preterm labour, low birth weight and increased rate of caesarean section.Methods: The study was conducted in the department of obstetrics and gynecology, Kamla Nehru Hospital, Shimla, Himachal Pradesh, India over a period of 12 months. Six hundred women were included in the study.Results: Forty-eight (8%) subjects developed preeclampsia-eclampsia syndrome, of which none had sufficient vitamin D levels, whereas 48 (100%) subjects had vitamin D deficiency.Conclusions: Maternal antenatal complications are more common in vitamin D deficient group