Medical disorders in pregnancy and pregnancy outcome: a retrospective analysis

Background: Medical disorders, including hypertensive diseases, diabetes, thyroid disorders may exist prior to pregnancy or may manifest themselves for the first time during pregnancy.Methods: This retrospective study was conducted at the Department of Obstetrics and Gynecology of tertiary care hospital by reviewing all medical records of pregnant patients with medical disorders admitted for delivery from January 2016 to December 2016. Data collected was analysed using simple statistical measures like percentage and proportion.Results: Most common medical disorder was pregnancy induced hypertension and its complication seen in 43% of the females; followed by anaemia and hypothyroidism seen in 20% females respectively. Maximum perinatal morbidity was seen in females suffering with hypertensive disorders (53.4%), with 17(41.8%) IUGR and 6 (11.6%) intra uterine demise respectively. Following PIH, higher rate of perinatal morbidity was seen in anaemic females (50% IUGR).Conclusions: A detailed history taking and evaluation of all pregnant females at the first visit, regular antenatal follow-ups, investigations will help us to detect the pre-existing medical disorders or the pregnancy associated medical disorders in time. If the condition is detected early, it is easy to treat with very little detrimental effects to the mother and foetus

Record based analysis of indications and complications of 500 cases of lower segment cesarean sections at a tertiary care hospital

Background: The drastically increasing rate of caesarean section is a topic of constant worry and analysis throughout the world. In order to understand the degree to which caesarean section may be preventable, it is important to know why caesarean section are performed. This study is aimed to find out the rate of caesarean section at our institute, various indications of the procedure and complications related to them.Methods: This study was carried out retrospectively in the department of obstetrics and gynecology at Chirayu Medical College and Hospital, Bhopal. Study period was from January 2017 to December 2017. 500 cases of lower segment cesarean section were studied including both elective and emergency caesarean sections. Statistical analysis of age, parity, period of gestation, indications of LSCS and complications was done.Results: The rate of caesarean section came out to be 47.7%, which is far above recommended. Majority of patients (81.6%) were in 21-30 years age group; while the number of primary and repeat caesarean section were comparable (40.8% and 59.2%respectively). Commonest indication was previous LSCS (31.6%) followed by fetal distress (21.6%). Surgical site infection was present in 4.6% cases whereas, post-partum hemorrhage occurred in 5.8% cases. Three patients underwent obstetric hysterectomy and two cases of maternal mortality were reported among post LSCS patients.Conclusions: Increasing rates of caesarean section has contributed to maternal morbidity along with financial burden. Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit rate of caesarean section

Screening of gestational diabetes mellitus using one-step versus two-step method: a comparative study

Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during the present pregnancy. It affects 7% of all pregnancies worldwide and in India it ranges from 6 to 9% in rural and 12 to 21% in urban area. The aim of this study was to compare the DIPSI criteria with the two-step method (Carpenter and Couston criteria.) and to study merits and demerits of one step and two step tests for GDM.Methods: A total 400 pregnant women of gestational age between 24-28 weeks attending antenatal clinic at this study tertiary care center were enrolled in this study. 200 pregnant women were enrolled in each of the study group (Group I OGTT and Group II DIPSI).Results: In Group I (OGTT) screening 47 (23.5%) were tested positive. In Group II cases, screening test results were found positive among 44 (22%). Out of 95 high-risk pregnant women 38 (40%) were positive for GDM by OGTT and 34 (35.78%) were positive by DIPSI. Out of 305 non high-risk pregnant women, 9 (2.95%) were positive for GDM by OGTT and 10 (3.27%) were positive by DIPSI.Conclusions: Present study concludes that DIPSI is the test which can predict GDM in population comparable to another test like OGTT. Also, India’s major population reside in rural areas, ANC are mostly conducted by ANM, therefore screening test should be easy to perform and interpret

Gestational trophoblastic disease: a profile of 37 cases

Background: Objective of current study was to study the demographic details, pattern of presentation and response to the treatment in the patients presenting with Gestational Trophoblastic Disease (GTD).Methods: The present study was conducted in a tertiary teaching institute as a retrospective plus prospective study over a period of 5 years from August 2004 to August 2009. Total 37 cases were studied out of which 16 were studied retrospectively from the case record and 21 were studied prospectively. Patients were evaluated on the basis of their age, number of deliveries, history of abortion or molar pregnancy and the treatment received.Results: 37 cases of gestational trophoblastic disease were studied in a period of 5 years from August 2004 to August 2009. The incidence of gestational trophoblastic disease was 1in 600 deliveries with the mean age of patients being 26.9 years. Most common chief complaint at presentation was bleeding per vaginum after a period of amenorrhoea seen in 31 patients (84%) followed by hyperemesis seen in 8 (19%) patients. Out of 37 patients 29 (78%) had complete mole & 8 (22%) had partial mole, the ratio of being 3.6:1. Complete cure rate in present study was seen in 31 out of 37 (84%) patients and mortality was seen in 2.7%.Conclusions: Gestational trophoblastic disease is seen most commonly in reproductive age group. This is a highly curable tumor even in the presence of distant metastasis

NANO FORMULATION ANALYSIS: ANALYTICAL METHOD DEVELOPMENT OF ISONIAZID AND SIMULTANEOUS ESTIMATION OF ANTI-TUBERCULAR DRUGS ISONIAZID AND RIFAMPICIN BY RP-HPLC

Objective: The objective of the study was to develop and validate a simple and reproducible reverse phase high pressure liquid chromatography (RPHPLC) method for hydrophilic drug isoniazid (INH) to apply for the analysis of the INH in nanoparticle drug formulations. Furthermore, to estimate simultaneously rifampicin (RIF) and INH in combined form.Methods: Isocratic elution with 10 minutes runtime on a C-18 Luna, 5 μ, 100Ã…, 150 mm column, methanol, and water as mobile phase with detection wavelength at 268 nm was used. INH nanoformulations were prepared by double emulsion solvent evaporation technique. Quantitative analysis of encapsulated drug was estimated via developed RP-HPLC method. Simultaneous estimation for the two drugs was carried out by gradient elution. All chromatographic separation and estimations were obtained on Shimadzu HPLC system.Results: INH eluted with a short retention time (RT) of 4.06 minutes. Method showed good linearity in the range of concentrations 0.01-100 μg/ml. The limit of detection (LOD) and quantification (LOQ) for INH was 0.03 and 0.12 μg/mL, respectively, and developed method has been successfully applied for the analysis of drugs in nanoparticle formulations. Simultaneous estimation of antitubercular drugs INH and RIF showed two separate peaks within specified runtime.Conclusion: Developed method showed good resolved peaks. Since the RT is short, in a shorter duration more samples could be completed and developed method will be easy for analyzing greater number of samples. Analysis of nanoformulation results have shown that this method is simple, reliable, reproducible, hence can be applied for drug delivery analysis.Â

The effect of social skill training among schizophrenic patients on social skill development in selected psychiatric ward of different hospitals in Odisha

Background: Schizophrenia as a severe mental disorder characterized by profound deficits in thinking, perception, affect and social behaviour (World Health Organization [WHO], 2014). Schizophrenia is treatable. Treatment with medicines and psychosocial support is effective. Methods: Quantitative approach with true experimental research design was adopted. Total 60 schizophrenic patients were selected for the study using purposive sampling technique. Subjects were randomly assigned into the experimental (n=30) and control group (n=30). Social skill training was given to experimental group. The training includes discussion, questioning, group activity, role play. The tools used to collect the data were as follows: (1) Demographic questionnaire (2) Standardized tool social adaptive functioning evaluation. Baseline assessment was done on the 1st day, then pre-test was done and the social skill training was implemented in experimental group on the same day. The training includes six sessions of discussion, questioning, group activity, role play etc. given for seven days followed by post-test was done in both the experimental as well as control group. The data analysed using descriptive and inferential statistics with SPSS 21 version. Results: The mean post-test social skill score in experimental group (38.90±11.813) and in control group is (30.97±11.556) which shows the significant difference in social skill score between the groups (t=2.629, P= 0.005472*). There was a significant association found between the education (chi square= 15.890, P= 0.043), social skill training programme (chi square= 6.058, P= 0.048). Conclusions: Thus, the training regarding social skill was effective in improving level of social skill among schizophrenic patient

Indigofera tinctoria Linn (Fabaceae) attenuates cognitive and behavioral deficits in scopolamine-induced amnesic mice

Purpose: To investigate the cognition-enhancing effects of aqueous extract of Indigofera tinctoria Linn (ITE, Fabaceae) in experimental amnesic mice.Methods: Scopolamine (2 mg/kg, i.p.) was used to induce amnesia in mice. The cognitive-enhancing activity of the ITE (5, 10 and 20 μg/mL) was studied by passive avoidance response, elevated plus maze and Y-maze behavioral paradigm in normal and scopolamine-induced amnesic mice. Antioxidant activities were also determined based on the ability of ITE to inhibit lipid peroxide, superoxide and hydroxyl radicals.Results: Scopolamine-induced cognitive deficits were significantly reversed by ITE (p < 0.001 at 20 mg/kg) in a dose-dependent fashion in all the behavioral paradigms tested. Furthermore, ITE dosedependently scavenged lipid peroxide, superoxide and hydroxyl free radicals with 50 % inhibition concentration (IC50) of 7.28 ± 0.37, 5.25 ± 0.28 and 7.62 ± 0.43 μg/mL, respectively.Conclusion: ITE possesses cognitive-enhancing properties in amnesic mice due to its potent antioxidant action.Keywords: Indigofera tinctoria, Scopolamine, Lipid peroxidation, Amnesia, Antioxidant, Cognitio

Cuminum cyminum Linn (Apiaceae) extract attenuates MPTP-induced oxidative stress and behavioral impairments in mouse model of Parkinson’s disease

Purpose: To evaluate the protective effects of Cuminum cyminum Linn (Apiaceae, CCY) against 1- methyl-4 phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP)-induced oxidative stress and behavioral impairments in mouse model of Parkinson’s disease (PD).Methods: MPTP-intoxicated mice model of PD was used for evaluating the effect of CCY extract on behavioral deficits through rota rod, passive avoidance and open field tasks. The effect of CCY extract on oxidative stress levels were assessed by estimating enzyme status, including superoxide dismutase (SOD), catalase (CAT) and lipid peroxidation(LPO) in brain tissues of MPTP-induced mice.Results: MPTP (25 mg/kg, i.p.)-treated mice resulted in a significant (p < 0.001) behavioral deficit in locomotor behavior (from 56.24 ± 1.21 to 27.64 ± 0.94) and cognitive functions (from 298 ± 3.68 s to 207.28 ± 4.12 s) compared with their respective control groups. Administration of CCY extract (100, 200 and 300 mg/kg, p.o.) for three weeks significantly and dose-dependently improved (p < 0.001 at 300 mg/kg) locomotor and cognitive deficits in MPTP-treated mice. CCY treatment also significantly (p < 0.001 at 300 mg/kg) inhibited MPTP-induced decrease in antioxidant enzyme levels (superoxide dismutase and catalase) and lipid peroxides in mice brain tissues.Conclusion: CCY extract exhibits strong protection against MPTP-induced behavioral deficit through enhancement of antioxidant defense mechanisms. Therefore, CCY may be developed as a therapeutic strategy in the treatment of neurodegeneration seen in PD.Keywords: Cuminum cyminum, Neurodegeneration, Catalase, Superoxide dismutase, Oxidative stress, Parkinson’s diseas

Maternal mortality: a retrospective analysis of 6 years in a tertiary care centre

Background: Pregnancy, although being considered a physiological state, carries the risk of serious maternal morbidity and at times death. This is due to various complications that may occur during pregnancy, labour or thereafter. Worldwide 3,03,000 women are dying of pregnancy related complication annually.Methods: The medical records of all maternal death occurred over a period of last five years between August 2011 to August 2017 in the Department of Obstetrics and Gynaecology at our tertiary care hospital were reviewed and analysed.Results: It is observed that out of total 30 patients, 24 (80%) deaths were from 20-30 year of age followed by 5 (16.67%) deaths from above 30 years of age. In the study period, 40% of maternal deaths were due to direct causes, haemorrhage (8/12; 66.67%) was main direct causes of obstetric death.Conclusions: The complications leading to maternal death can occur without warning at any time during pregnancy and childbirth. Most maternal deaths are preventable by optimum utilization of existing maternal and child health care facilities. Complications require prompt access to quality obstetric services equipped with life-saving drugs, intensive care unit, and the ability to provide blood transfusions and to perform surgical interventions as per the need