Serum uric acid in first trimester as a predictor for the diagnosis of gestational diabetes mellitus-a prospective study

Background: Gestational diabetes mellitus (GDM) is common worldwide. It is a disorder of carbohydrate metabolism. Indian women have increased risk of developing GDM, and leads to adverse Maternal and neonatal outcomes. Women with raised uric acid in pregnancy are interlinked with more incidence of unfavorable outcomes in pregnancy such as GDM. Hence this study is done to prove the utility of uric acid in early diagnosis of GDM by starting early treatment so as to reduce the complications in pregnant women.Methods: The antenatal women are screened for GDM by serum uric acid levels with gestational age <12 weeks. These antenatal women are followed up around 24-28 weeks and oral glucose tolerance test is done and evaluated for GDM using ADA criteria.Results: In our study, serum uric acid cut–off of 4.2 mg/dl had a positive association with the GTT values with p value less than 0.05 (p=0.018). In this study, in the raised serum uric acid category, 8 (19%) were positive for GTT and among the normal serum uric acid category, 3 (4.7%) were positive for GTT. Thus, we observe from our study that elevated levels of uric acid during the first trimester is interlinked with prediction of gestational diabetes.Conclusions: The diagnosis of serum uric acid level in first trimester as a predictor of GDM is easy and economical and it can be used as a screening test for prediction of GDM

Efficacy of ormeloxifene in comparison to norethisterone in the management of abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) is the most common complaint worldwide. In India, most of the women present with menorrhagia and majority of them are anemic and require medical management to avoid its consequences. Hence this study is done to compare the efficacy of ormeloxifene with norethisterone in women presenting with AUB.Methods: In this study 61 women suffering from AUB were included. This prospective randomized double blinded study was done on women between the age group of 19-45 years and were allocated randomly into two groups, one group was given ormeloxifene and the other was given norethisterone for a period of 3 months. Haemoglobin levels, endometrial morphology on ultrasound were assessed before and after the treatment in both the groups.Results: It is observed in our study, that both ormeloxifene and norethisterone reduced menorrhagia. The rise in hemoglobin concentration was significantly more with ormeloxifene than norethisterone (8.3 g/dl to 10.3 g/dl versus 9.0 g/dl to 10.4 g/dl). In our study, the significant reduction in the endometrial morphology was more with ormeloxifene than norethisterone (9.3 mm to 7.8 mm versus 8.3 mm to 7.2 mm).Conclusions: Ormeloxifene is a new modality drug and is found to be a better option in reducing menorrhagia compared with norethisterone in respect to a greater success rate, better compliance and cost effectiveness. Hence our study concludes ormeloxifene as a better choice over norethisterone in the treatment of AUB

Correlation of endometrial morphology by transvaginal sonography with histopathological examination in patients with abnormal uterine bleeding

 Background: Abnormal uterine bleeding (AUB) is the most common complaint worldwide. Among Indian women, AUB not only affects the quality of life but also leads to serious consequences such as anemia. prolonged and frequent periods lead to morbidity, diminished quality of life and social embarrassment. Hence this study is undertaken to correlate the endometrial morphology by transvaginal ultrasound with histopathological findings of endometrium in women with AUB.Methods: In this study 173 women suffering from AUB were included. This cross-sectional study was conducted by Transvaginal ultrasound using a 7.5 Mhz Philips Transvaginal sonography (TVS) probe to study endometrial morphology (ET). It is measured at the thickest part in the longitudinal plane and included both endometrial layers. Endometrial sampling and histopathological examination were done.Results: It is observed in our study, AUB is more common among the perimenopausal women (50.9%) and also in multiparous women (86.7%). The commonest problem in our study population is heavy menstrual bleeding (HMB) (45.7%). In our study, the endometrial morphology assessed by TVS correlated statistically with the histopathology of endometrium (p<0.001). Hence, TVS, which is affordable and non–invasive can be used as the first line investigation of AUB, but histopathology of the endometrium always gives the confirmatory result.Conclusions: TVS can be used as the initial investigation for AUB, as it is affordable, non–invasive and has good acceptability by the patients. The endometrial morphology assessed by TVS correlated statistically with histopathological examination

Screening for gestational diabetes mellitus by two step method and the pregnancy outcome: a study in Indian women

Background: In recent times, gestational diabetes is becoming more common Worldwide and complications are seen in fetal development, growth, labour and delivery due to maternal hyperglycemia. Gestational Diabetes Mellitus(GDM) is associated with adverse maternal and fetal outcomes. Among South Asian Population, Indian Women are at high risk of developing carbohydrate intolerance during pregnancy. Hence this study is undertaken to screen for gestational diabetes mellitus by two step method in Indian Women.Methods: This study was done in 153 nondiabetic pregnant women of gestational age 24-28 weeks, excluding diabetes mellitus diagnosed prior to pregnancy. Two step method was followed in the present study and GDM was diagnosed and the pregnancy outcomes were noted.Results: In our study the prevalence of GDM is 8.1% by two step method. Most of the women diagnosed with GDM were of age 26-30 yrs (41.66%). Among the women who were diagnosed as GDM, (58.33%) cases required Insulin along with diet control. In our study 33.33% had vaginal delivery, 8.33% had Emergency LSCS and 58.33% had Elective LSCS.Conclusion: Indian Women have high prevalence of GDM, hence universal screening is essential to diagnose GDM, which will improve the pregnancy outcome

Screening for gestational diabetes mellitus by two step method and the neonatal outcome

Background: As Indian women has increased risk of developing GDM, screening for GDM is essential for early diagnosis and treatment and hence to reduce the adverse neonatal outcomes.Methods: The antenatal women are screened for GDM by administering 50g GCT and the screening test value of >130mg/dl measured at 1 hours were considered screening test positive and subjected to standard 2 hour 75gm OGTT and the neonatal outcome were observed in relation to neonatal birth weight, Apgar, and the occurrence of complications like hypoglycemia, hypocalcemia, hyperbilirubenemia.Results: The average neonatal birth weight in the study population was 3kg. The women with GDM who required diet alone had average neonatal birth weight of 2.9kgs and the GDM women who were on diet and insulin therapy had average neonatal birth weight of 3.4kg. There was increased incidence of hyperbilirubinemia 33.3% .There was only 1 preterm birth.Conclusions: There is association with neonatal Complications like hyperbilirubenemia and hypoglycemia with women who had screening positive for GDM

Comparison of vaginal hysterectomy and laparoscopically assisted vaginal hysterectomy in women with benign uterine disease: a retrospective study

Background: Nowadays, there is a trend in favour of (laparoscopically assisted vaginal hysterectomy) LAVH even for patients in whom (vaginal hysterectomy) VH is feasible. Hence, this study is undertaken to compare the efficacy of LAVH and the traditional vaginal hysterectomy for the treatment of benign uterine disease and also to find out the advantage of LAVH over VH.Methods: The study population consists of patients who had undergone hysterectomy for benign uterine disease excluding prolapse of uterus. Medical records of patients who had undergone vaginal hysterectomy (50) and LAVH (50) without any medical illness and without previous surgical history (except sterilisation) were collected. Age, parity, indication for hysterectomy, operative time, intra operative and postoperative complications and duration of hospital stay were noted and compared between the two groups.Results: The mean operative time was significantly shorter in the VH group (83.7min) than in the LAVH group (128.7 min) and the difference was statistically significant (p<0.000). Total hospital stay was significantly longer in the VH group (7.1days) when compared to the LAVH group (4.9days) and the difference was found to be statistically significant (p<0.000). There were no intraoperative complications noted in both the groups. There was no significant difference in the minor postoperative complications (fever and spotting per vaginum) between the two groups.Conclusions: This study shows lesser operative time in VH group when compared to LAVH group and there is no added advantage in performing LAVH other than shorter hospital stay. Hence it is concluded that whenever feasible VH should be the preferred route of hysterectomy

ACCESSORY BREAST TISSUE IN THE AXILLA IN A PUERPERAL WOMAN- CASE STUDY

Ectopic or accessory breast tissue (EBT) is an uncommon residual tissue that persists from normal embryonic development, found in 2-6% of the female population. EBT may occur anywhere along the embryonic mammary streak, but is most commonly located in the axillary region. EBT can consist of any or all components of the breast and may be functional or non-functional. The development of this tissue is hormone- dependent, similar to normal breast tissue. EBT presents as asymptomatic mass and may prove to be a diagnostic challenge in the absence of areola and nipple. The identification and distinction of EBT from other breast pathologies occurring in the area, both benign and malignant, is essential for proper management. In most of the cases, these lesions are asymptomatic and do not warrant any intervention unless they produce discomfort. In this report, we present a case of an ectopic breast tissue in the left axilla of an 24-year-old Asian Indian primipara patient. The importance of FNAC as diagnostic tool in suspected cases of polymastia without nipple/areola and the conservative approach through regular follow-up for management of proven benign ectopic breast tissue are highlighted

Novel cyclic tetraselenides of mannose: synthesis and mechanistic studies

In this Letter, we disclose the synthesis of novel cyclic tetraselenides starting from mannose which are very unusual and rare and have been synthesised for the first time. The structures are confirmed by X-ray analysis. The reactivity of the reagent tetraethylammonium tetraselenotungstate, $(Et_4N)_2WSe_4$ has been compared with the well-known selenium transfer reagents $Li_2Se_2$ and $Na_2Se_2$. A tentative reaction mechanism has been proposed

Perceptions on Oral Ulcers From Facebook Page Categories: Observational Study

BackgroundOral ulcers are a common condition affecting a considerable proportion of the population, and they are often associated with trauma and stress. They are very painful, and interfere with eating. As they are usually considered an annoyance, people may turn to social media for potential management options. Facebook is one of the most commonly accessed social media platforms and is the primary source of news information, including health information, for a significant percentage of American adults. Given the increasing importance of social media as a source of health information, potential remedies, and prevention strategies, it is essential to understand the type and quality of information available on Facebook regarding oral ulcers. ObjectiveThe goal of our study was to evaluate information on recurrent oral ulcers that can be accessed via the most popular social media network—Facebook. MethodsWe performed a keyword search of Facebook pages on 2 consecutive days in March 2022, using duplicate, newly created accounts, and then anonymized all posts. The collected pages were filtered, using predefined criteria to include only English-language pages wherein oral ulcer information was posted by the general public and to exclude pages created by professional dentists, associated professionals, organizations, and academic researchers. The selected pages were then screened for page origin and Facebook categories. ResultsOur initial keyword search yielded 517 pages; interestingly however, only 112 (22%) of pages had information relevant to oral ulcers, and 405 (78%) had irrelevant information, with ulcers being mentioned in relation to other parts of the human body. Excluding professional pages and pages without relevant posts resulted in 30 pages, of which 9 (30%) were categorized as “health/beauty” pages or as “product/service” pages, 3 (10%) were categorized as “medical & health” pages, and 5 (17%) were categorized as “community” pages. Majority of the pages (22/30, 73%) originated from 6 countries; most originated from the United States (7 pages), followed by India (6 pages). There was little information on oral ulcer prevention, long-term treatment, and complications. ConclusionsFacebook, in oral ulcer information dissemination, appears to be primarily used as an adjunct to business enterprises for marketing or for enhancing access to a product. Consequently, it was unsurprising that there was little information on oral ulcer prevention, long-term treatment, and complications. Although we made efforts to identify and select Facebook pages related to oral ulcers, we did not manually verify the authenticity or accuracy of the pages included in our analysis, potentially limiting the reliability of our findings or resulting in bias toward specific products or services. Although this work forms something of a pilot project, we plan to expand the project to encompass text mining for content analysis and include multiple social media platforms in the future