Study of estimation of serum LDH and uric acid in preeclampsia and it’s clinical correlation

Background: Preeclampsia occurs in 2-8% of pregnancies and a leading cause of maternal and perinatal mortality and morbidity. The objective of this study was to compare serum lactate dehydrogenase (LDH) and uric acid levels in normotensive pregnant women and in women with preeclampsia and to correlate the maternal and perinatal outcomes and severity of the disease with serum LDH and uric acid levelsMethods: A prospective case control study conducted during the period of 18 months involving 100 normotensive pregnant women and an equal no. of patients with preeclampsia admitted under OBG department, Vani Vilas Hospital and Bowring and Lady Curzon hospital, which are affiliated to BMCRI, Bangalore. They were followed up till delivery and early post-partum period. Serum LDH and uric acid levels were sent and maternal and foetal outcomes studied.Results: There was statistically significant increase in levels of serum LDH and uric acid among cases compared to control group. Higher levels were also associated with significant maternal and foetal complications.Conclusions: We conclude from this study that the serum LDH and Uric acid are the inexpensive and reliable markers to predict severity and maternal and foetal outcomes in patients with preeclampsia

Single dose metronidazole, tinidazole and ornidazole in the treatment of bacterial vaginosis - a comparative study

Background: Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge. There is a lack of consensus on the etiologic agents or agents associated with BV, due to polymicrobial nature. There is high recurrence rate of BV and it is difficult to treat. Metronidazole is the drug of choice but newer nitroimidazoles are better alternatives with long half-lives and better tolerability.Methods: This was a prospective, comparative, randomized, single blinded study on 120 diagnosed cases of bacterial vaginosis, with symptomatic or asymptomatic abnormal vaginal discharge. Amsel’s criteria were used to diagnose bacterial vaginosis as well as to assess the response and classify the patients as cured, partially cured and not cured. Statistical analysis was done by Chi square test. The cure rate was compared considering metronidazole cure rate as gold standard.Results: At 1 week, the cure rate of tinidazole and ornidazole was 89.5% in both the groups, and at 4 weeks, it was 84.5% for both drugs (P <0.001). Metronidazole showed a cure rate of 65.7% at 4 weeks.Conclusions: Tinidazole and ornidazole have better cure rate as compared to metronidazole in cases of bacterial vaginosis

Obstetric and new born outcome in HIV infected pregnant women: a prospective cohort study in Bangalore Medical College Hospitals, India

Background: The effect of HIV on obstetric complications is known to vary across regions of world. The variation may be due to HIV infection per se or it may be due to complex interaction of related medical and social conditions that affect pregnancy. Incidence of these obstetric complications in HIV infected pregnant women is not well reported in India. So, this prospective cohort study was carried to observe the demographics and incidence of obstetrics complications like abortions, still birth, premature rupture of membranes, preterm delivery, opportunistic infections in HIV infected pregnant women.Methods: All pregnant women who were screened positive for HIV test, irrespective of their gestational age were included in the study. Apart from routine obstetric care, CD4 cell count was carried out. The patients were followed up till term, delivery and up to 6-week postpartum period. Obstetric outcomes like incidence of abortion, intrauterine death, preterm delivery and premature rupture of membrane were noted. Baby`s birth weight and the incidence of maternal opportunistic infection were noted and correlated with maternal CD4 cell count.Results: Maternal HIV infection is associated pre-term labour in 34.5%, PROM in 30%, low birth weight in 52.3%. Increased incidences of these adverse outcomes have an inverse relationship with CD4 count.Conclusions: Maternal HIV infection is associated with increased incidence of adverse obstetric outcome and opportunistic infection, and their incidences increase with lower CD4 count

A prospective study to assess the efficacy and safety of iron sucrose in pregnant women with iron deficiency anemia in a tertiary care hospital

Background: Prevalence of iron deficiency anemia (IDA) is 58% among pregnant women in India. Oral iron therapy is recommended as first-line therapy in mild anemia. Moderate anemia in pregnancy results in high maternal morbidity and mortality. In India, women become pregnant with low iron stores, where oral iron therapy cannot meet the requirement and need parenteral iron therapy. This study was undertaken to evaluate the efficacy and safety of iron sucrose complex (ISC) in pregnant women with IDA.Methods: A prospective study was conducted between June 2014 and June 2015 in the Department of Obstetrics and Gynaecology, Bangalore medical college and research institute. 60 pregnant women having hemoglobin (Hb) between 7 and 9 g/dl with diagnosed IDA were given intravenous ISC in a dose of 200 mg on alternate days after calculating the dose requirement. The efficacy of the therapy was assessed by hematological parameters measured at 4 weeks and 8 weeks of treatment. To assess the safety, adverse drug effects were recorded.Results: The mean Hb increased from 8.02±0.56 to 11.38±0.5 g% (p<0.0001) after eight weeks of therapy. There was a significant rise in serum ferritin levels (from 15.12±1.8 to 31.4±4.9 µg/l) (p<0.0001) at the end of the study. Other parameters including mean corpuscular volume, mean corpuscular Hb, mean corpuscular Hb concentration, and serum reticulocyte count were also improved significantly. There were no allergic reactions.Conclusion: Parenteral iron therapy was effective in increasing Hb, serum ferritin, and other hematological parameters in pregnant women with moderate anemia. Intravenous iron sucrose complex can be used in tertiary care hospitals where it can replace conventional parenteral iron therapy due to injection-related side effects

Ultrasonographic evaluation of abnormal uterine bleeding in postmenopausal women

Background: Objectives of current study were to diagnose causes of Abnormal Uterine Bleeding (AUB) in postmenopausal women (PMW) and to correlate it with curettage and histopathological findings, hysteroscopy and thereby minimizing unnecessary interventions in the form of operations and hysteroscopy where sonography depicts normal findings.Methods: After obtaining ethical clearance present prospective observational study was conducted from November 2010 to November 2012, to evaluate the endometrium in 50 postmenopausal women (PMW) with bleeding per vagina referred to the department of Radio diagnosis by the department of gynaecology in Bangalore medical college and research institute. After applying inclusion and exclusion criterias the cases were evaluated with ultrasonography both transabdominal (TAS) and transvaginal scan (TVS where ever necessary). Histopathological and hysteroscopic correlation was done in all cases.Results: 58% of the PMW with bleed were in the age group of 51-60 years. Most common cause of PMB was atrophic endometrium (44%), endometrial polyp (22%), followed by malignancy (14%), and hyperplastic endometrium (6%). At Endometrium thickness less than 4 mm there were nil chances of carcinoma.Conclusions: In women with AUB in postmenopausal age ultrasonography (USG) can be considered as an initial imaging modality for diagnosing endometrial diseases. The sensitivity and specificity of USG for Atrophic endometrium is 100% &amp; 84% respectively with accuracy of 100%, endometrial polyp the specificity is 100% with accuracy of 88%. For malignancy USG showed 100% specificity &amp; accuracy of 100%. Hence USG is highly accurate for evaluating endometrial pathologies. Being noninvasive, less costly &amp; good patient compliance USG should be considered as an initial imaging modality over invasive investigations like D&amp;C, hysteroscopy in evaluating endometrial disorders

EFFICACY OF SUPPLEMENTATION OF PROBIOTICS ALONG WITH ANTIMICROBIAL AGENTS IN VULVOVAGINAL INFECTIONS IN A TERTIARY CARE HOSPITAL

Objectives: The objectives of the study were to ascertain the efficacy of probiotics along with antimicrobials in the treatment of vulvovaginitis and to evaluate the rate of recurrence. Methods: The study was done on 60 patients who were randomly selected and divided into two groups of 30 each. Prior permission from the Institutional Ethics Committee and higher authorities was obtained before conducting the study. One group received standard treatment including antibacterial, antiviral, and antifungal as per the gynecologist discretion and in other group along with standard treatment, probiotic capsules containing combination of Saccharomyces boulardii, Lactobacillus sporogenes (50 million), Streptococcus faecalis (30 million), Clostridium butyricum (2 million), and Bacillus mesentericus (1 million) given orally twice daily and followed up for a period of 3 months. The drugs were started on the 5th day after menstruation taking starting of the bleeding as day 1. Results: The parameters compared were symptoms and signs (significantly reduced – p-value), clue cells (significantly reduced in number), and recurrence rates (significantly reduced), in 80% of patients smears which were not consistent with BV. Maximum number of patients showed negative KOH mount (71.5%), saline wet mount was negative in 80% of patients in antimicrobial agents + probiotics group. Conclusion: From the present interventional study, probiotics along with antimicrobial agents showed better improvement than antimicrobial agents alone. Hence, supplementation of probiotics along with antimicrobial agents provides better efficacy than antimicrobial agents alone in treating vulvovaginal infections

Myxoid Dermatofibrosarcoma Protuberans of the vulva with myoid nodules: Clinicopathologic and Immunohistochemical study of a case

Dermatofibrosarcoma protuberans is a slow growing dermal spindle cell tumor seldom seen in the vulva and its myxoid variant, a rare type of dermatofibrosarcoma protuberans is characterised by extensive myxoid degeneration. We present the case of a 62 year old woman with an enlarging vulval swelling. Mass was excised surgically. Histopathologically the tumor consisted of uniform spindle-shaped cells showing strong positivity with CD34. In addition to the typical storiform pattern and lace like infiltration, prominent myxoid stromal changes were seen. Herein we report an interesting case of myxoid dermatofibrosarcoma protuberans, uncommonly reported in the dermatopathology literature

Single dose metronidazole, tinidazole and ornidazole in the treatment of bacterial vaginosis - a comparative study

Background: Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge. There is a lack of consensus on the etiologic agents or agents associated with BV, due to polymicrobial nature. There is high recurrence rate of BV and it is difficult to treat. Metronidazole is the drug of choice but newer nitroimidazoles are better alternatives with long half-lives and better tolerability.Methods: This was a prospective, comparative, randomized, single blinded study on 120 diagnosed cases of bacterial vaginosis, with symptomatic or asymptomatic abnormal vaginal discharge. Amsel’s criteria were used to diagnose bacterial vaginosis as well as to assess the response and classify the patients as cured, partially cured and not cured. Statistical analysis was done by Chi square test. The cure rate was compared considering metronidazole cure rate as gold standard.Results: At 1 week, the cure rate of tinidazole and ornidazole was 89.5% in both the groups, and at 4 weeks, it was 84.5% for both drugs (P &lt;0.001). Metronidazole showed a cure rate of 65.7% at 4 weeks.Conclusions: Tinidazole and ornidazole have better cure rate as compared to metronidazole in cases of bacterial vaginosis