Ohvira syndrome with left radial hemimelia: a rare association

Ohvira syndrome is rare complex anomaly consisting of uterus didelphys, unilateral ipsilateral obstructed hemivagina and ipsilateral renal agenesis. It typically presents with dysmenorrhea or pelvic pain shortly after menarche due to collection of secretions in the uterus. Reporting a case of 32 years unmarried nulligravida lady with complaints of pain abdomen since 20 days with history of similar complaints 15 years bac. Patient was on Inj. DMPA 2 years back. On examination upper limb skeletal deformity-left radial hemimelia present with a mass of 14-16 weeks gravid uterus on per abdomen examination. USG (February 2020), was suggestive of uterus didelphys bicollis with collection of 108 cc noted in the right uterine cavity with right kidney agenesis with obscured right ovary. Total abdominal hysterectomy with left salphingo-oopherectomy was done. Specimen features were suggestive of uterus didelphys bicornis bicollis with right uterus hematometra with right cervix blind with right sided blind vagina with features suggestive of Ohvira syndrome

Efficacy of an alginate versus proton pump inhibitor in the symptomatic relief of gastroesophageal reflux symptoms in pregnant women

Background: Gastroesophageal reflux disease (GERD) is frequently seen during pregnancy with prevalence of 80%. Proton pump inhibitors (PPI) are the most effective drugs used in the treatment of reflux symptoms. Alginates are natural polysaccharide polymer which builds a non-systemic barrier against acid and food reflux in the oesophagus. Aims and objectives were to compare the efficacy of alginate versus PPIs in pregnant women, and to determine the time to onset of decrease in the pain intensity of alginate to PPIs. Methods: This is a prospective randomised study conducted in pregnant women with symptoms of heartburn comparing the efficacy of alginates to PPIs in Kempegowda Institute of Medical Sciences. After subjects have signed the consent, two sachets of 10 ml liquid preparation alginate were given to the alginate group while 40 mg intravenous pantoprazole to the PPI group. Results: Among 40 patients studied, 20 were given alginates and 20 were given PPIs. 7 presented in the 1st trimester and 33 in 2nd trimester. Onset of action is faster with alginates when compared to PPIs, it was 30 min to 1 hour in patients taking alginates and 6-12 hours in patients taking PPIs, duration of action was longer for PPIs than alginates, with alginates it’s observed that it attains 24-hour symptom free interval in shorter time when compared to PPIs. Conclusions: ¬Alginates to be used for rapid symptom relief in patients with acute symptoms as an induction agent, PPIs to be used for longer duration of action as maintenance.

Comparative study of efficacy and safety of intravenous ferric carboxymaltose versus iron sucrose in treatment of post-partum anemia

Background: Ferric carboxymaltose has been recently introduced for the treatment of anaemia. The present study was planned to compare the efficacy, tolerability and safety of intravenous ferric carboxymaltose with intravenous iron sucrose in the treatment of iron deficiency anaemia among postpartum women.Methods: A total of 60 postpartum women with haemoglobin levels between 7-10 g/dl were randomized into two groups: 30 in group A (received iron carboxymaltose) and 30 in group B (Received iron sucrose). Haemoglobin and serum ferritin levels were done on day 0 and after 6 weeks.Results: The post treatment haemoglobin levels were found to be 10-10.9 g/dl in 66.7% of women in group A and 63.3% in group B. The mean post treatment haemoglobin levels in group A was 9.97±0.3 g/dl and in group B was 10.9 g/dl (p<0.001). The mean increase in haemoglobin levels post treatment were significantly high in group B (2.1±0.5 gm%) compared to group A (1.3±0.5 gm%). The mean post treatment S. Ferritin levels in group A was 91.2±25.8 and in group B was 126.5±23.2 gm%. The mean increase in S. Ferritin levels post treatment were significantly high in group B (96.9±23.3) compared to group A (62.7±22.6) (p<0.001).Conclusions: Intravenous iron carboxymaltose is more effective and better tolerated in the treatment of iron deficiency anaemia among postpartum women compared to intravenous iron sucrose

Short term effects of antenatal maternal betamethasone administration on CTG

Background: Antenatal administration of corticosteroids to pregnant women has proven to enhance lung maturation, prevent respiratory distress syndrome and provide neuroprotection to the foetus. When betamethasone is given antenatally, it has been observed to transiently reduce fetal movements and fetal heart rate variability; which are often used as indicators of fetal wellbeing. Aim and objectives of the present study was planned to assess the short-term effects of antenatal betamethasone administration on fetal heart rate and its variability by visual interpretation of CTGMethods: A total of 30 women between gestational age of 28 weeks to 36 weeks 6 days with singleton pregnancy requiring maternal betamethasone administration were enrolled and the first CTG was taken. First dose of injection betamethasone 12 mg i.v. was administered and second CTG was taken 6 hours later and both the CTGs were compared.Results: After 1st dose of antenatal betamethasone, 90% of the cases had changes in fetal heart rate on CTG. In 53.3% cases, the baseline fetal heart rate was reduced while in 46.7% there was no change. There was reduced fetal heart rate variability in 56.7% cases while 23.3% cases had increased variability and rest 20% had no observable change. 73.3% study patients delivered and 26.6% study patients continued pregnancy. Among those who delivered, 20% neonates required neonatal ventilator support and 10% required oxygen support. All neonates were eventually discharged.Conclusions: Maternal betamethasone administration can cause changes in fetal heart rate and variability on CTG. Hence, other fetal parameters have to be considered before concluding fetal distress as these changes maybe transient. In our study, though CTG changes were seen in 90% cases, only 20% cases required neonatal ventilator support

A retrospective study on various methods used in second trimester MTP at KIMS hospital and research centre, Bangalore

Background: Despite the fact that majority of abortions are performed in the first trimester, 10-15% of abortions have taken place in the second trimester period globally because of delayed diagnosis of fetal anomalies and failure to recognize an undesired pregnancy in the first trimester. This study aims to describe the various methods used in inducing second trimester abortions and to analyse the efficacy and safety profile of these methods.Methods: Retrospective observational study. This study analysed case records of 30 patients who underwent second trimester abortion between the gestations of 12 and 28 weeks. All case records of patients who underwent second trimester abortion between the gestation 12 and 28 weeks from 1st January 2021 to 1st August 2021 at the department of obstetrics and Gynaecology, KIMS hospital and Research Centre, Bangalore was analysed. Dilapan-s (hygroscopic mechanical dilator), Foley’s and mifepristone for cervical ripening followed by varying doses of misoprostol are the different methods studied in this study population.Results: Most of the patients in study population belonged to the age group of 28-32 years. 60% patients underwent MTP between the gestational ages of 16-20weeks.The commonest indication for MTP was fetal anomaly.Conclusions: Mifepristone group had short induction to abortion interval but was associated with higher rates of retained placenta bits. Foleys group had the longest induction to abortion interval but reported no complications

[In Press] Onion and garlic polysaccharides : a review on extraction, characterization, bioactivity, and modifications

Allium cepa (onion) and Allium sativum (garlic) are important members of the Amaryllidaceae (Alliaceae) family and are being used both as food and medicine for centuries in different parts of the world. Polysaccharides have been extracted from different parts of onion and garlic such as bulb, straw and cell wall. The current literature portrays several studies on the extraction of polysaccharides from onion and garlic, their modification and determination of their structural (molecular weight, monosaccharide unit and their arrangement, type and position of glycosidic bond or linkage, degree of polymerization, chain conformation) and functional properties (emulsifying property, moisture retention, hygroscopicity, thermal stability, foaming ability, fat binding capacity). In this line, this review, summarizes the various extraction techniques used for polysaccharides from onion and garlic, involving methods like solvent extraction method. Furthermore, the antioxidant, antitumor, anticancer, immunomodulatory, antimicrobial, anti-inflammatory, and antidiabetic properties of onion and garlic polysaccharides as reported in in vivo and in vitro studies is also critically assessed in this review. Different studies have proved onion and garlic polysaccharides as potential antioxidant and immunomodulatory agent. Studies have implemented to improve the functionality of onion and garlic polysaccharides through various modification approaches. Further studies are warranted for utilizing onion and garlic polysaccharides in the food, nutraceutical, pharmaceutical and cosmetic industries