A study of predisposing factors and microbial flora in puerperal sepsis

Background: Puerperal sepsis is the third or fourth leading cause of maternal death worldwide with maternal mortality due to infections being as high as 15%6 with maternal morbidity being 8.1%7. Meticulous aseptic techniques, modern investigative tools and use of prophylactic antibiotics have reduced the incidence of puerperal sepsis in the developed countries however it still continues as a major cause of maternal morbidity and mortality in the developing countries.Methods: This was a retrospective study over a period of 18 months from July 2010 to December 2011 which included all the post natal patients admitted in the obstetrics ward of our hospital. All the patients who fulfilled the ICD 10 criteria of puerperal pyrexia were studied for the booking status, parity, mode of delivery, maternal anemia, number of PV examinations and duration of rupture of membranes. In addition vaginal swab culture and sensitivity of these cases was analysed. The results were calculated by statistical analysis and odds ratio calculated with 95% confidence interval.Results: The incidence of puerperal sepsis was 8.68% and was responsible for 60.29% of cases of puerperal pyrexia. The common predisposing factors were unbooked status, primiparity, caesarean section, anaemia, frequent PV examination and prolonged rupture of membranes. The most common microorganisms in vaginal swab culture and sensitivity were S. aureus (36%) and E. coli (29.8%).Conclusions: Puerperal sepsis is by and large a preventable cause of maternal morbidity and mortality. From our study and review of literature we conclude that early booking of all the antenatal cases, correction of maternal anemia, better aseptic conditions, deferring undue PV examinations, recognition of all the high risk cases and prophylactic administration of ampicillin and gentamycin can go a long way in preventing puerperal sepsis

Economic potential of Angelica glauca Edgew: an endangered plant of western Himalaya

The present study was carried out to assess the economic viability of Angelica glauca. Cost benefit ratio tool was used to assess the net benefit that could lure the local farm community to bring this important species in farm cultivation and thus promote the ex-situ conservation of species. To observe the economic yield of plants, underground parts of the plant from treatments were uprooted at the end of growing season. Cost benefit analysis was calculated on the basis of total output in the form of cash and total investment on various development activities. The cost of cultivation including all the inputs among different treatments varied from Rs. 76606.47 (F0) to Rs. 114544.28 (F6). Similarly, while calculating the return, the total dry plant biomass obtained was multiplied by the average of prevailing market rate of Angelica glauca. The Benefit Cost Ratio (BCR) among the various treatments varied from 1.91 (F2) to 2.49 (F7) and the highest benefit-cost ratio of 2.49 was observed when FYM @ 10t/ha along with Azotobacter @ 5 kg/ha and PSB @ 5 kg/ha were applied

A study of predisposing factors and microbial flora in puerperal sepsis

Background: Puerperal sepsis is the third or fourth leading cause of maternal death worldwide with maternal mortality due to infections being as high as 15%6 with maternal morbidity being 8.1%7. Meticulous aseptic techniques, modern investigative tools and use of prophylactic antibiotics have reduced the incidence of puerperal sepsis in the developed countries however it still continues as a major cause of maternal morbidity and mortality in the developing countries.Methods: This was a retrospective study over a period of 18 months from July 2010 to December 2011 which included all the post natal patients admitted in the obstetrics ward of our hospital. All the patients who fulfilled the ICD 10 criteria of puerperal pyrexia were studied for the booking status, parity, mode of delivery, maternal anemia, number of PV examinations and duration of rupture of membranes. In addition vaginal swab culture and sensitivity of these cases was analysed. The results were calculated by statistical analysis and odds ratio calculated with 95% confidence interval.Results: The incidence of puerperal sepsis was 8.68% and was responsible for 60.29% of cases of puerperal pyrexia. The common predisposing factors were unbooked status, primiparity, caesarean section, anaemia, frequent PV examination and prolonged rupture of membranes. The most common microorganisms in vaginal swab culture and sensitivity were S. aureus (36%) and E. coli (29.8%).Conclusions: Puerperal sepsis is by and large a preventable cause of maternal morbidity and mortality. From our study and review of literature we conclude that early booking of all the antenatal cases, correction of maternal anemia, better aseptic conditions, deferring undue PV examinations, recognition of all the high risk cases and prophylactic administration of ampicillin and gentamycin can go a long way in preventing puerperal sepsis

A comparative evaluation of efficacy of commercially available bleaching agents in non-vital teeth: An in vitro study

Aim : The aim of the study was to evaluate and compare the efficacy of commercially available three bleaching agents when used internally or by internal-external method in non-vital teeth. Materials and Methods: Seventy extracted single-rooted premolars were artificially stained with whole blood in centrifugal machine. Teeth were divided into six experimental groups (Group I-VI) and one control group (Group VII). Bleaching was carried out in all the experimental groups using either of three commercially available bleaching agents: In Group I and group IV, 35% carbamide peroxide was used. In group II and V, 21% carbamide peroxide was used. Teeth in Group III and VI were bleached using 35% hydrogen peroxide (H 2 O 2 ). In the first three experimental groups (Group I, II, III), internal bleaching was done and in other three groups (Group IV, V, VI), both internal and external application was done. The evaluation was done at 0, 7, and 14 days using VITA shade guide. Statistical Analysis: The results obtained were statistically analyzed using ANOVA, Paired t-test, and ANOVA with post hoc Tukey′s modification to evaluate the significant change and efficacy of the groups tested. Results: All bleaching agents showed effective shade reduction. The effects of 35% H 2 O 2 and 35% carbamide peroxide were statistically similar. The least reduction was seen with 21% carbamide peroxide groups. There was no difference between internal bleaching and internal-external methods. Conclusions: Within the limitation of the study, it could be concluded that 35% carbamide peroxide is an effective intracoronal bleaching agent similar to that of 35% H 2 O 2

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update (vol 13, pg 353, 2019)

10.1007/s12072-019-09980-1HEPATOLOGY INTERNATIONAL136826-82

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update

10.1007/s12072-019-09946-3HEPATOLOGY INTERNATIONAL134353-39