Twin-twin transfusion syndrome: revisited

Twin to twin transfusion syndrome is a very rare disorder complicating monozygotic monochorionic pregnancy. Here we are reporting a case of Twin to twin transfusion syndrome in 20 year old primigravida woman. Amnioreduction was planned as a treatment option. However patient underwent premature labor and deliver male twins both of which died later on

A randomized study comparing rectally administered misoprostol after spinal anesthesia versus intramuscular oxytocin for prevention of postpartum hemorrhage in caesarean section

Background: Post-Partum Hemorrhage (PPH) is the commonest cause of maternal death worldwide. Studies suggest that the use of Misoprostol may be beneficial in clinical settings where oxytocin is unavailable. However studies are limited that show its use in prevention of PPH in high risk pregnancy involving elective caesarean section. Therefore our aim of study is to compare the effectiveness of rectal misoprostol with intramuscular oxytocin in the prevention of postpartum hemorrhage in cesarean sections.Methods: In a double-blind randomized controlled trial, 200 pregnant women who had cesarean sections were assigned into two groups: to receive either oxytocin intramuscularly or misoprostol rectally after spinal anesthesia.Results: There was no significant difference between the two groups about change in postpartum hemoglobin, need for blood transfusion and incidence of PPH. We also did not observe any significant difference in any side effects.  Conclusions: Misoprostol may be considered as an alternative for oxytocin in low resource clinical settings.

Study of maternal and prenatal outcome in pregnant women with acute hepatitis E viral infection

Background: Hepatitis E Virus (HEV) is a major aspect of hepatitis and death in the developing countries and asymmetrical source of deaths in among of pregnant women. The objective of this study was to determine the maternal and prenatal outcome in pregnant women with acute hepatitis E viral infection in Malwa, India.Methods: Observational, cross-sectional study. The study population was pregnant women with acute hepatitis E infection confirmed by ELISA technique. Pregnant women with other hepatic viral infections were excluded. All medical and obstetric conditions and mortality were noted on the predesigned proforma.Results: Out of the total 105 admitted pregnant women with hepatitis E viral infection, 21.90% women had severe morbidity, 24.17% perinatal death and 14 (13.3%) expired before delivery. The yellowish discoloration of urine or sclera was observed in 91.42% with abdominal pain in 76.19%. Maternal mortality was higher in patients with primi (47.82%) and patients presented in second trimester (56.50%).Conclusions: The acute viral hepatitis E infection in pregnant women is associated with maternal morbidities and high mortality rate

Comparison of serum calcium and magnesium levels between preeclamptic and normotensive healthy pregnant women

Background: Preeclampsia is idiopathic multisystem disorder specific to human pregnancy. Its incidence is 8-10% of total pregnancies in India. It is one of the leading causes of maternal and fetal morbidity and mortality worldwide. Alterations in serum calcium and magnesium levels have been suggested as effective factors in causing preeclampsia. The aim of this study was to compare serum calcium and magnesium levels in preeclamptic and normal pregnant women in third trimester of pregnancy.Methods: The study was conducted in the department of biochemistry in collaboration with department of obstetrics and gynaecology, Sri Aurobindo medical college & P. G. institute, Indore during the period January 2012 to January 2013. Subjects were divided into two groups: group-I included 100 preeclamptic women group-II included 100 age matched, healthy pregnant women. Serum calcium and magnesium was estimated by Arsenazo III method and by Calmagite method in ERBA CHEM-5 respectively (Enzymatic kit method).Results: Serum levels of calcium (8.27 ± 0.37 mg/dL vs. 9.06 ± 0.27 mg/dL) and magnesium (1.99 ± 0.13 mEq/L vs. 2.03 ± 0.13 mEq/L) were significantly lower in preeclamptic women than the control group (i.e. healthy pregnant women).Conclusions: Hypocalcaemia and hypomagnesaemia are seen in the preeclamptic women may be responsible for the vascular pathology associated with onset of preeclampsia. Hence it can be concluded that adjuvant supplementation of calcium and magnesium may prevent further progression of preeclampsia.

Study on prevalence of hepatitis B in pregnant women and its effect on maternal and fetal outcome at tertiary care centre

Background: Hepatitis-B is caused by double stranded DNA virus. Prevalence of hepatitis B in pregnant woman worldwide is 2.5 to 1.5% whereas in India it is 2 to 7.7%.Methods: This is a retrospective study conducted at SAMC and PGI, Indore between January 2016 to December 2016. Hepatitis- B prevalence and outcome was assessed by doing routine screening of hepatitis B antigen in our indoor patients and finding out their maternal and fetal outcome.Results: Total 3567 deliveries were conducted during study period, out of them 39 were diagnosed as HbsAg positive pregnant patient; so, prevalence was found to be 1.09%. out of these, 84.6% were booked cases, mode of delivery was vaginal in 66.67% cases, preterm Delivery was in 10.26% of cases, meconium stained liquor was found in 5.13% cases, maternal mortality was nil, perinatal mortality was found in 2.56% cases and 5.13% cases were admitted in NICU.Conclusions: Screening of all pregnant women for HbsAg irrespective of risk factors will definitely help to know the correct prevalence and reduce the transmission of hepatitis B infection. Hepatitis B is a major public health problem in India and will continue to be until appropriate nationwide vaccination programs and other control measures are established

Novel surgical approach: compare the efficacy of vaginal hysterectomy with abdominal hysterectomy in non-descent uterus

Background: The aim of the study was to compare the efficacy of vaginal hysterectomy with that of abdominal hysterectomy in non-descent uterus for safety and feasibility of advancing gynaecological practice.Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Sri Aurobindo Medical College and Postgraduate Institute, Indore (M.P.) from October 2013 to April 2015. A total of 170 cases were enrolled in this study. Subjects were equally divided into two groups of equal size and assigned to a specified group i.e. study and control group. Each group consists of 85 cases.Results: The two techniques of intervention measured a highly significant mean difference for parameters such as ambulation (1.75), need of analgesic doses post-operative (2.80), resumption of bowel/bladder activity (8.62) and hospital stay (4.44) were less in study group when compared to control group where in ambulation (2.25), need of analgesic doses post-operative (5.11), resumption of bowel/bladder activity (18.75) and hospital stay (6.96). It was also observed that vaginal discharge (4.7%), UTI (4.7%) and re-hospitalization (2.4%) were less in study group when compared to control group which showed vaginal discharge (4%), UTI (0%) and re-hospitalization (5%). Vaginal hysterectomy in women with non-descent and moderately enlarged uteri is safe. A combination of debulking techniques is often needed and the surgeon needs to be familiar with them. With experience larger uterus can be removed. Thus this scar less approach should be chosen as a preferred method for hysterectomy.Conclusions: This study showed UA-S/D ratio and UA-RI>2SD are significant predictors of perinatal deaths and immediate neonatal resuscitation in preeclampsia. Acute fetal distress in labour or neonatal nursery admission could not be predicted

A 54 Mb 11qter duplication and 0.9 Mb 1q44 deletion in a child with laryngomalacia and agenesis of corpus callosum

<p>Abstract</p> <p>Background</p> <p>Partial Trisomy 11q syndrome (or Duplication 11q) has defined clinical features and is documented as a rare syndrome by National Organization of Rare Disorders (NORD). Deletion 1q44 (or Monosomy 1q44) is a well-defined syndrome, but there is controversy about the genes lying in 1q44 region, responsible for agenesis of the corpus callosum. We report a female child with the rare Partial Trisomy 11q syndrome and Deletion 1q44 syndrome. The genomic imbalance in the proband was used for molecular characterization of the critical genes in 1q44 region for agenesis of corpus callosum. Some genes in 11q14q25 may be responsible for laryngomalacia.</p> <p>Results</p> <p>We report a female child with dysmorphic features, microcephaly, growth retardation, seizures, acyanotic heart disease, and hand and foot deformities. She had agenesis of corpus callosum, laryngomalacia, anterior ectopic anus, esophageal reflux and respiratory distress. Chromosome analysis revealed a derivative chromosome 1. Her karyotype was 46,XX,der(1)t(1;11)(q44;q14)pat. The mother had a normal karyotype and the karyotype of the father was 46,XY,t(1;11)(q44;q14). SNP array analysis showed that the proband had a 54 Mb duplication of 11q14q25 and a 0.9 Mb deletion of the submicroscopic subtelomeric 1q44 region. Fluorescence Insitu Hybridisation confirmed the duplication of 11qter and deletion of 1qter.</p> <p>Conclusion</p> <p>Laryngomalacia or obstruction of the upper airway is the outcome of increased dosage of some genes due to Partial Trisomy 11q Syndrome. In association with other phenotypic features, agenesis of corpus callosum appears to be a landmark phenotype for Deletion 1q44 syndrome, the critical genes lying proximal to <it>SMYD3 </it>in 1q44 region.</p

Disorder effects on infrared reflection spectra of InN films

The effect of plasmon and LO-phonon damping on the optical measurements of InN films is discussed. Phonon and plasmon damping dramatically modifies the spectral features of the optical spectra and destabilizes the coupled modes of the system. Phonon damping affects the optical properties in a qualitatively different way from plasmon damping. Increased phonon damping leads to a merging of the coupled modes for a certain range of carrier density. Plasmon damping broadens the spectral linewidths of both of the coupled modes when plasmon energies are of the order of LO-phonon energies. However, when plasmon energies are larger than LO-phonon energies, increasing plasmon damping makes the higher-energy mode completely degenerate with plasmon, and may even have lower energies than plasmon. In weakly damped situations, we also discuss the low-energy optical transmission region that forms in between the coupled modes. Finally, the effect of plasmon and LO-phonon coupling on the analyses of the experimental infrared reflection data of InN films (for different electron densities) is discussed. © 2004 American Institute of Physics.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71000/2/JAPIAU-95-9-4795-1.pd

Raman spectral signatures of mouse mammary tissue and associated lymph nodes: normal, tumor and mastitis

Raman spectroscopy involves the interaction of light with the molecular vibrations and therefore can provide information about molecular structure, tissue composition and changes in its environment. We explored whether Raman spectroscopy can reliably distinguish mammary tumors from normal mammary tissues and other pathological states in mice. We analyzed a large number of Raman spectra from the tumor and normal mammary glands of mice injected with 4T1 tumor cells, which were collected using a high-resolution (less than 4 cm −1 ) Raman spectrometer at a fixed (785 nm) laser excitation wavelength and with 60 mW of laser power. The spectra of normal and tumor mammary glands showed consistent differences in the intensity of certain Raman bands and loss of some bands in the tumor spectra. Multivariate statistical methods—principal component analysis (PCA) and discriminant functional analysis (DFA)—were used to separate the data into different groups of mammary tumors, mastitis, lymph nodes contralateral and tumor-cell-injected sides, and normal contralateral and tumor-cell-injected sides. We demonstrate that this spectroscopic technique has the feasibility of discriminating tumor and mastitis from normal tissues and other pathological states in a short period of time and may detect tumor transformation earlier than the standard histological examination stage. Copyright © 2006 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55947/1/1565_ftp.pd