A retrospective analysis on placenta previa in a tertiary care center of Jharkhand

Background: When the placenta is implanted partially or completely in the lower uterine segment, it is called placenta previa. Previa is a Latin word means going before. About one-third of APH belongs to placenta previa and now a day’s incidence is increasing in primigravida patients. The objective of this study was to analyze the incidence, risk factors, maternal morbidity, mortality and perinatal outcome in women with placenta previa in a tertiary care center of Jharkhand.Methods: Total 193 cases of placenta previa were studied between September 2018 to August 2019 in the department of obstetrics and gynecology, RIMS, Ranchi with respect to their age, parity, gestational age, clinical presentation, previous history of curettage/hysterotomy/caesarean, ICU admission, need for NICU admission, maternal morbidity and mortality and perinatal outcome.Results: In this study, 1.94% of the deliveries were complicated with placenta previa. 31.6% were above 30 years, 87% were multigravida, 122, i.e.; 62.7% were having history of curettage or previous caesarean or hysterotomy. 49.7% had prior caesarean deliveries, 21.5% had prior abortion with history of D and C. 49.2% had true placenta previa. 68.4% had preterm delivery. 11.9% patients presented in shock and maximum i.e.; 184 (95.3%) out of 193 presented with painless bleeding per vaginum and 9 cases with no complaints. Malpresentation seen in 16.6% cases and 8.3% had adherent placenta previa. There were 45.6% ICU admission and 54.9% NICU admission, 2.5% maternal mortality and 32.6% perinatal mortality.Conclusions: Advanced maternal age, multiparty, scarred uterus as in prior CS or D and C are independent risk factors for placenta previa. Also, it remains a risk factor for adverse maternal and perinatal outcome. The detection of placenta previa and associated adherent placenta should encourage a careful evaluation, timely diagnosis and delivery to reduce associated maternal and perinatal complications

Feto-maternal outcome in previous one cesarean section: a retrospective observational study at a district hospital of Jharkhand

Background: Cesarean section is one of the most common surgery done in department of obstetrics and gynecology. It becomes more complicated in cases of high risk pregnancy like PIH, APH etc. Its rate is increasing day by day. Once a CS, always a CS, is questionable but being followed up at various set up due to various reasons. Today, one of the important indications of repeat CS is previous CS which increases the rate of CS in a particular set up and morbidities associated with multiple CS. According to ACOG guidelines, VBAC should be attempted to decrease the incidence of repeat CS and morbidity among them. This study was conducted to analyze the incidence of subsequent CS in previous one CS cases, demographic variables and feto-maternal outcome in previous CS patients.Methods: This was a retrospective observational study on previous CS patients, carried out in District hospital, Dumka, Jharkhand. The rates, demography and feto-maternal outcome among previous one CS patients were studied during 1 year duration and data was obtained from labor room and medical record department.Results: Out of 2947 deliveries, 63 patients had previous one cesarean section, the incidence being 2.13%. 39.7% deliver vaginally while 60.3% needed repeat cesarean section. Majority (95.2%) were in 21-30yrs age group, 76.2% were unbooked and 25.4% were tribal population. Maximum (79.4%) were gravid 2 and 93.7% were term. 93.7% had birth space >18 months. Out of 38 repeat cesarean section, 78.9% underwent emergency cesarean section. The most common indication being scar tenderness (39.5%) followed by CPD (15.8%). Intraoperatively, severe adhesions found in 15.8% cases, bladder adherence in 18.4% cases and 2.6% had adherent placenta. PPH occurred in 4.8% cases and blood transfusion or injectable iron therapy required in 25.4% cases. 4.7% had wound infection, 7.9% had prolong hospital stay and 22.2% cases required prolong foley’s catheterization. There was no maternal mortality. 95% babies born alive, 3.2% was stillbirth, 1.5% was IUD and the neonatal death rate was 3.2%.Conclusions: Previous cesarean section is one of the most important causes of CS in subsequent pregnancies, hence increase in the rates of CS and the morbidities associated with multiple CS among mothers. Thus the decision of CS in primigravida should be taken wisely and practice of CS on demand should be discouraged.

Exploring determinants of birth weight of the baby delivered in a tertiary hospital of Delhi

Introduction: Low birth weight (LBW) is a global public health challenge. In India, the prevalence is 22%. Objective: The aim of this study is to assess the major determinants of birth weight of the newborns delivered in a tertiary hospital of Delhi. Methodology: A total of 140 newborns were included in the study. The newborns were selected from the ICU. Results: There were 80 male and 60 female newborns. In the current study, 68% of the newborns were LBW, 5% were very LBW, and <1% extremely LBW. All the individual variables with a significant effect on birth weight (p<0.10) were analyzed together using multivariate analysis for combined effect on birth weight. Among all, mainly parity, pre-pregnancy weight, hemoglobin of mother, exposureto smoking tobacco, and residence (p<0.05) were found to be significantly associated with the birth weight of the newborn. Conclusion: Most of the data were concurrent with the previous study results along with no effect of supplementation programs such as the Integrated Child Development Service Scheme or conditional maternity benefit schemes on improving birth weight. More detailed community-based research with bigger sample size needs to be done to develop a clear understanding of some of these unaddressed or partially addressed determinants

Densimetric, acoustic and viscometric behaviour of sucrose solutions in aqueous 1-butyl-3-methylimidazolium hexafluorophosphate at different temperatures and ambient pressure

31-42The thermophysical properties like density, speed of sound and viscosity have been measured for different molalities of sucrose in aqueous and different concentrations of aqueous solutions of an ionic liquid, 1-butyl-3-methylimidazolium hexafluorophosphate, at different temperatures and atmospheric pressure. The results are explained in terms of acoustic parameters like apparent molar volume, apparent molar isentropic compressibility, limiting apparent molar volume, limiting apparent molar isentropic compressibility, limiting apparent molar transfer volume, limiting apparent molar transfer compressibility, hydration number, etc. Further, pair and triplet interaction coefficients, solvation number, viscosity B-coefficients and activation parameters have also been evaluated. The results demonstrate that solute-solvent interactions exist in the ternary system which increases with an increase in ionic liquid concentration

Effect of concentration and temperature variations on interactions in (L-serine/L-valine + aqueous glucose/sucrose/lactose) systems: Viscometric and activation parametric study

Viscosities of (L-serine/L-valine + 0.1 mol dm-3 aqueous glucose/sucrose/lactose) systems have been measured as a function of molal concentration of amino acids at different temperatures; 293.15 K, 298.15 K, 303.15 K, 308.15 K and 313.15 K. The viscosity data has been utilized to determine viscosity B-coefficients employing Jones-Dole equation. The viscosity B-coefficients of transfer (ΔtrB), variation of B with temperature (dB/dT) and solvation number (Sn) of L-serine/L-valine have been obtained using the experimental viscosity values. Further, Gibbs free energy of activation of viscous flow per mole of solvent (Δµ°) as well as per mole of solute (Δµ°) along with activation enthalpy (ΔH°) and entropy (ΔS°) have been computed using Feakin’s transition state theory to throw light on the mechanism of viscous flow. The results have been discussed in terms of solute-solvent interactions; and structure making tendency of amino acid molecules in aqueous saccharides solutions

Effect of thermal annealing on optical properties of CR-39 polymeric track detector

The samples of CR-39 polymer (TASTRAK, Bristol, England) were annealled thermally at various temperatures ranging from 100oC to 180oC for 1 hour, in air. FTIR spectroscopy reveals the structural degradation of CR-39 polymer due to thermal annealing above its glass transition temperature. Optical band gap of pristine and thermally annealed samples has been determined using UV-Visible absorption spectra. It has been observed that the optical band gap decreases continuously as a result of annealing.Department of Physics, Kurukshetra University,Kurukshetra-136 119, Haryana, Indi

Personal Hygiene and Self-Reported Handwashing Practices among Food Handlers of a Medical College in Delhi

Introduction: Food handlers play a major role in ensuring food safety as mishandling and disregard for personal hygiene on their part may result in food borne- illness outbreaks.Methodology: Cross sectional observational study involving about 44 food handlers presently working were included. With structured proforma, details of socio- demographic data and self reported personal hygiene and handwashing practices were carried out. Results: Majority of the study subjects had satisfactory or good personal hygiene. Significantly greater number of study subjects working as servers or helpers had a better status of hygiene as compared to the cooks. Personal income was significantly associated with the status of personal hygiene of the study subjects. Although majority of them were using soap for handwashing after defecation and micturition but only few were using it at the workplace. Although all of them were brushing/ cleaning their teeth, 50% were doing it only once in a day. Majority of them were taking bath in summers while 9% were not taking bath in winters. Majority of them were trimming their nails on a regular basis while 2.3% didn’t cut their nails at all. Majority of them used to take medicine during diarrhea while only 2.3% used to take leave from work during illness. Most of them reported using towel to wipe the sweat. Most of them either covered their mouth or turned their face away from food while coughing/ sneezing. While 56.8% reported that they chased the stray animal, 20.4% said that animals never entered the premises, 2.3% had the habit of offering food to them.Conclusion: There is a lot of scope for improving the standards of personal hygiene practices of food handlers. Important personal hygiene habits that help in prevention of contamination of food should be included in the content of health education sessions

Confessional Poetry in the Light of Psychoanalytic Theory with Special Reference to Sylvia Plath

Confessional poetry is an expression of personality and never escape from it. The personal life of the poet under the stress of psychological crisis, sex, family life, private humiliation and psychological state of mind are the major concerns in this kind of poetry. The expression of personal pain has been regarded as the hallmark of confessional poetry. It chiefly deals with personal experiences, trauma, depression, psychological break-down and the relationships articulated through a new kind of rhythm and mode of expression. Psychoanalysis acts both as a means of self-analysis and as a literacy device. It enables consideration of the poet not only in terms of the straightforward narration of his/her life, but also in relation to his/her poetic language and the process of creativity. Hence, in order to study the confessional poetry psychoanalytic literary approach objectively plays a significant role

Puerperal sub-acute uterine inversion: a rare case report

Puerperal uterine inversion is a complication of third stage of labour, which can lead to maternal morbidity and mortality due to haemorrhage shock and infection. Early cases can be managed by manual reposition of uterus but neglected or late cases of uterine inversion are managed by Haultain`s repair. Here we are presenting a case of subacute uterine inversion referred from peripheral hospital managed by Haultain’s technique