HIV and pregnancy: fact sheet of a tertiary care hospital in Ajmer, Rajasthan, India

Background: As HIV infection in women occurs primarily during reproductive years, hence incidence of HIV infection especially in sexually active women is more sensitive marker to track course of HIV epidemics. Pregnant women represent low risk population, so prevalence in pregnant women is proxy to HIV in general population.Methods: A prospective study was conducted in the Department of Obstetrics and Gynecology in JLN Medical College, Ajmer from April 2015 to August 2018. It included women attending antenatal clinic and emergency ward of labor room of our hospital.Results: Total 71 women were found positive for HIV out of 36,006 pregnant women who attended antenatal clinic, giving the prevalence of 0.197%. Out of these 71 cases, 1 case was positive for both HIV1 and HIV2. The prevalence of HIV positive women delivering in our hospital was 0.269%. 40.84% women belonged to age group 25-29.9 years and 39.43% to 19-24.9 years. Among 71 antenatal seropositive women, primigravida and second gravid accounted for equal fraction of the study population i.e. 33.80% each. 19.72% came from urban areas while 80.28% were from rural areas. 22.53% (16/71) had sero-discordant spouses. All seropositive women had singleton pregnancy and were housewives. 94.61% were registered for Anti-Retroviral Treatment (ART) and 5.39% went loss to follow up.Conclusions: The serodiscordance rate in our region is quite high (22.53%). Increased awareness in society leading to increase in number of pregnant women attending ICTC will help in reducing transmission of HIV by safer sex practices

All multipartite entanglements are quantum coherences in locally distinguishable bases

We find that the m-separability and k-partite entanglement of a multipartite quantum system is correlated with quantum coherence of the same with respect to complete orthonormal bases, distinguishable under local operations and classical communication in certain partitions. In particular, we show that the geometric measure of m-inseparable entanglement of a multipartite quantum state is equal to the square of minimum fidelity-based quantum coherence of the state with respect to complete orthonormal bases, that are locally distinguishable in a partition into m-parties.Comment: 8 page

Legal and Ethical Aspects of Surrogacy in India - A Critical Analysis

Surrogacy has been the subject of heated discussions across the world that have centred on its complex ethical and legal ramifications. This research thoroughly analyses the effects of the 2021’s Act of Surrogacy, beginning with a thorough dive into the core ideas that support surrogacy. This paper analyses the requirements and restrictions of surrogacy and outlines the ethical, moral, and legal conundrums that surround it, revealing the challenges that all parties involved must deal with. The comparative examination of surrogacy legislation in various nations is another feature of this article, which reveals the disparate worldwide perspectives. Examining the judicial viewpoints on surrogacy helps to clarify the changing legal environment and to highlight important rulings that have had a big impact on surrogacy practices. This study offers a nuanced view on the complex ethical and legal issues surrounding surrogacy in India by combining various approaches. These observations provide a thorough grasp of the difficulties and potential present in the field of surrogacy

Study of BMI in pregnancy and its correlation with maternal and perinatal outcome

Background: Maternal nutrition plays an important role in maternal and fetal outcome. The low maternal BMI or Obesity is associated with adverse outcome.Methods: A total 148 primigravida included. BMI was calculated on first visit and in each trimester, all booked patient was followed throughout pregnancy and delivery for any maternal and fetal complications.Results: (66.2%) of patients were with normal BMI, (17.56%) were underweight, (10.13%) were overweight and (6.08%) patients were obese. APH was seen in (11.1%) and (6.7%) cases in BMI grades ‘IV and III’ respectively. PIH was present in total 10 cases, (33.3%) cases belonged to BMI grades IV. Anemia was present in total 51 cases (53.8%) belonged to BMI grade I. Preterm delivery was present in total 5 cases and out of them (7.7%), (2%) and (11.1%) belonged to BMI grades I, II and IV respectively. GDM was present in 11 cases and out of them (26.7%) and (44.4%) cases belonged to BMI grade III and IV respectively. PPH was present in total 5 cases and out of them (7.7%), (2%) and (11.1%) belonged to BMI grades I, II and IV respectively. In BMI grade I group, (96.2%) babies had birth weight 2.5 (22.2%) cases of fetal macrosomia belonged to BMI grade IV.Conclusions: There is importance of pr-pregnancy counseling in maintaining weight of women during pregnancy to avoid pregnancy maternal and fetal outcomes.

A Study on The Pivotal Role of Indian Judiciary in Upholding the Notion of Sustainable Development

As the huge degree urbanization, industrialization and related regular change furthermore, its effect on biodiversity addresses a danger to human life and subsequently there is a need to seek after modern improvement with a feeling of obligation. It is conceivable through manageable turn of events. Maintainable advancement proposes balance among natural and formative worries. The Indian Apex Court has been proactive in bringing in maintainable advancement standards from global natural regulation into the Indian regulation through various legal devices and systems. This paper breaks down the idea of practical turn of events and commitment of Indian High Court in laying out the standards of manageability for the public authority and the advancement advocates

Comparison of thoracic segmental spinal anaesthesia and lumbar spinal anaesthesia for percutaneous nephrolithotomy

Background: Randomised controlled study aimed to compare low thoracic segmental spinal anesthesia (TSSA) and conventional lumbar spinal anesthesia (LSA) in percutaneous nephrolithotomy (PCNL). Methods: Sixty adult patients undergoing elective PCNL were randomly assigned to two groups: T (TSSA) and L (LSA). Group T received TSSA (isobaric ropivacaine 0.75% 2.5 ml with dexmedetomidine 6mcg) at T10-T12, while Group L received LSA (hyperbaric ropivacaine 0.75% 4 ml with dexmedetomidine 6mcg) at L2-L4. Primary objectives of our study was to evaluate the feasibility and safety of TSSA for PCNL and to compare hemodynamic changes, block onset, and duration, and adverse effects. Secondary objectives were time to rescue analgesia, patient, and surgeon satisfaction. Data was analyzed using SPSS. Results: All patients underwent surgery successfully under neuraxial anesthesia. Group T exhibited more stable hemodynamics with a significantly lower hypotension incidence compared to Group L (3.33% vs. 26.66%, p=0.03). Onset of sensory and motor block was quicker in the TSSA group (p<0.001) upper. Sensory block levels were T6 for both groups, but lower level in TSSA was levels L2 and L3, while LSA impacted all segments below T6. No neurological complications occurred, particularly in Group T, which had higher satisfaction scores from surgeons and patients. Conclusions: TSSA is a safe and effective option for PCNL, providing better hemodynamic stability with lesser incidence of and reducing intra-operative hypotension compared to conventional LSA

To compare trans-vaginal ultrasound colour doppler (TUCD) with hysteroscopy and guided endometrial biopsy in diagnosing abnormal uterine bleeding

Background: To compare trans-vaginal ultrasound Colour Doppler (TUCD) with hysteroscopy and guided endometrial biopsy in diagnosing abnormal uterine bleeding.Methods: A total of 50 consecutive and haemodynamically stable patients aged more than 40 years with abnormal uterine bleeding (AUB) were included in the study. Patients with pregnancy and probable cervical malignancy were excluded. All the patients were subjected to TUCD followed by hysteroscopic directed endometrial biopsy during the follicular phase of the menstrual cycle between 7th and 11th day to diagnose the underlying pathology. In postmenopausal female both TUCD and hysteroscopy were performed on any day. Results of both the procedures were compared.Results: The sensitivity and specificity of TUCD as compared to hysteroscopy in diagnosing polyp was found out to be 27.78% and 100%; for fibroid 100% and 84.4%; for endometrial hyperplasia 86.36% and 96.43%; for endometrial carcinoma 71.43% and 100%; and for endometrial atrophy 100% and 100%, respectively. After application of kappa statistics, the degree of agreement between the two diagnostic procedures was found to be 0.599 which was considered to be good.Conclusions: Conditions like fibroid, endometrial atrophy and cases of A-V malformation are better diagnosed with TUCD, while others like endometrial polyps, endometrial carcinoma are better detected on hysteroscopy. TUCD can diagnose most of the pathologies but not all, so it can be used as an adjunct to hysteroscopy to diagnose endometrial pathology, but can surely not replace hysteroscopy

Pre and post conception risk factors in PROM

Background: The objective of the study was to evaluate the pre conception and post conception risk factors in cases of premature rupture of membranes (PROM).Methods: Two hundred pregnant women that were hospitalized at Mahatma Gandhi Medical College and Hospital from 1st January 2013 to 31st December 2013 with PROM (>28 Weeks) were evaluated for various risk factors of PROM.Results: Low socio-economic status, cervical manipulation, urogenital infections, malpresentation, coitus, hydraminos, multifetal gestation and smoking significantly increase the risk of PROM.Conclusions: Pre and post conception identification of various factors causing PROM can prevent premature deliveries and it’s complications to some extent

Comparison of vitrification and slow freezing for cryopreservation of cleavage stage embryos (Day 3) and its impact on clinical outcome

Background: The objective of this retrospective study was to compare the efficacy of slow freezing and Vitrification for the cryopreservation of supernumerary cleavage stage embryos on day 3 after IVF and its impact on clinical outcome.Methods: 485 supernumerary embryos of IVF cycles (from Oct 2011 to Dec 2012) were cryopreserved by slow freezing method while 502 embryos (from Jan 2013 to April 2014) by Vitrification method. 362/485 and 230/502 embryos were thawed for FET cycles (65 patients in each group).After warming the survival rate, post warmed embryo morphology, clinical pregnancy and implantation rates were evaluated and compared between the two   groups.Results: There were 65 frozen thawed cycles in each group. The percentage of excellent and good morphology embryos before cryopreservation  were same in both the groups, but after thawing the results were significantly in favour of Vitrification as compared to Slow freezing. In Vitrification group versus Slow freezing group, the different outcomes were survival rate (96.95% vs. 69.06%, p-0.000), post warmed excellent morphology embryos (94.17% vs. 60.8%, p-0.000) clinical pregnancy rate (41.53% vs. 21.53%, p-0.043) and the implantation rate (14.41% vs. 7.01%, p-0.024).Conclusions: Vitrification is a promising alternate to the conventional slow freezing method in terms of not only excellent survival and post warmed excellent morphology embryo rate but also higher clinical pregnancy and implantation rate.

Evaluating condom catheter balloon tamponade in non-traumatic postpartum haemorrhage resistant to medical management

Background: Obstetric haemorrhage remains the most important cause of maternal mortality worldwide accounting for 25% of maternal deaths annually. The aim of the study was to evaluate efficacy of a condom catheter assembly for uterine tamponade in the management of non-traumatic postpartum haemorrhage (PPH).Methods: It was a prospective interventional study done in a tertiary care hospital in New Delhi, India. Thirty three women with intractable PPH unresponsive to medical management were managed by uterine balloon tamponade using a condom-catheter assembly prior to surgical intervention.Results: The catheter successfully controlled haemorrhage in 31 out of 33 patients. In both the failed cases, hysterectomy was required. Among the failed cases there was one maternal death due to sepsis and multi-organ dysfunction syndrome (MODS). In cases where the balloon was successful, it was removed around 24 hours later and no further bleeding or complication was observed.Conclusions: Placement of a condom catheter balloon can successfully treat non-traumatic PPH refractory to medical management. It is simple, inexpensive, easily, available and in those with successful placement no procedure related morbidity was observed. The potential for it to be used by inexperienced operators in areas with limited resources makes it a useful tool in management of PPH