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.

Histopathological evaluation of endometrium and its clinical correlation in patients of abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) is a very common, challenging gynaecological problem in all age group women. Neoplastic lesions are responsible for very less number of cases but they should be diagnosed early. Endometrial biopsy is necessary for histopathological diagnosis of endometrial lesions and to rule out any malignancy. In present study, we evaluated histopathological pattern of endometrium and different clinical parameters in AUB patients.Methods: A retrospective observational study done in Obstetrics and Gynecology department of SSMC Rewa, Madhya Pradesh in 2 year from 1st October 2017 to 30th September 2019. AUB patients who fulfilled inclusion criteria were included in study. All data were collected from department records in predesigned proforma and statistically analyzed by statistical package for the Social sciences (SPSS) version 20.Results: Total 366 AUB patients were included in study; most frequent clinical presentation was HMB (56%). Mostly patient’s age ranged from 24-84 years, belonged to 41-50 years age group (44%), multiparous (78%), and premenopausal (53%). On histopathological evaluation of endometrium most commonly nonneoplastic lesions (75%) were seen, out of which proliferative phase endometrium was most frequent. Neoplastic lesions were seen in 25% cases. Out of which benign lesions were noted in 7%, premalignant in 17.3% and malignant in 1% (all in >45 year patients).Conclusions: Endometrial biopsy should be done in all AUB patients >45 years and in selected premenopausal in order to get early diagnosis, to rule out malignancy and to help in management. Endometrial biopsy should be considered as first diagnostic modality

A PILOT STUDY ON ROLE OF NIMBA PATRA POTTALI SWEDAN IN DADRU

Life style modulated diseases have overpowered the human over a decade. Sedentary life, Virudhaaahar, over sweating. Due to this life style factors reduction in skin based immunity takes place which leads to Kustharoga. Dadru which comes under Kshudraroga. Dadru has classical symptoms mainly of itching (Kandu), reddish patches with prominent edges (Mugdagatam, Mandalaakruti). Materials & Method: Nimba has Tikta rasa katuvipak and Shitavirya. It leaves have properties like Krumighna, Vranashodhan, Putihar, Dahaprashaman and Kandughna. It is included under Kandughnagana. Patrapottaliswedan is consider under Sankarsweda told by Acharya charaka. Hence Nimbapatrapottali swedan has significant result in Dadru. There is a significant relief in itching (Kandu), redness and the prominent edges of the patches are reduced. To prove the efficacy of Nimbapatrapottali swedan in Dadruroga 4 patients were selected with classical symptoms of Dadru from Panchakarma OPD and IPD of Y.M.T. medical college. Result: A course of Nimba patrapottali swedan for 11 days and orally Nimbachala Ghana vati for 3 month was done on the subjective parameter. Significant changes were observed in subjective parameter

A comparative study of the effectiveness of placental blood drainage versus no placental blood drainage in active management of third stage of labor at a tertiary care hospital

Background: WHO defines postpartum haemorrhage (PPH) as when blood loss is greater than or equal to 500 ml within 24 hours after birth. When blood loss is greater than or equal to 1000 ml within 24 hourrs, it is called as severe primary postpartum haemorrhage. Placental blood drainage is done by clamping and cutting of umbilical cord after birth of baby followed by unclamping the maternal side of cord so the blood can drain freely into a container.Methods: 200 patients were studied in current research finding. Study group had 100 patients whose placental blood drainage was done and control group had 100 patients whose placental blood drainage was not done. This study was done to analyze the effectiveness of placental blood drainage in reducing blood loss.Results: The duration of third stage of labor was 295.70 seconds in study group and 475.20 seconds in control group. The amount of blood loss in study group was 273.76 ml and 294.92 ml in control group. p value was found to be significant. Incidence of PPH in study group was 1% and 8% in control group.Conclusions: Placenta blood drainage was safe and simple. It is a non invasive method very useful to prevent PPH. It reduces the duration of third stage of labor and reduces amount of blood loss

A retrospective analysis of maternal deaths over a period of five years at a tertiary care hospital of central India

Background: Maternal mortality is one of the important indicators used for the measurement of maternal health. The present study was conducted to analyse the maternal deaths over a period of five years in a tertiary care centre, GMH Rewa, Madhya Pradesh.Methods: A retrospective observational   study was conducted in department of Obstetrics and Gynaecology, Shyam Shah Medical College and associated Gandhi Memorial Hospital, Rewa. The case records of all maternal deaths between January 3013 to December 2017 were collected from hospital medical records and studied. Data were analyzed statistically.Results: There were 214 maternal deaths from January 3013 to December 2017.The average maternal mortality ratio over a period of five years was 471.5 per one lac live births. Majority of maternal deaths were from toxaemia 33.2%, haemorrhage 26.2%, anaemia 16.3% and sepsis 12.6%.Conclusions: The present study highlights the importance of early antenatal registration of all pregnancies and regular follow up of cases by trained staff. Active management of high-risk groups by frequent antenatal visits, fluid and component transfusions, aggressive management of infection and closer monitoring of women in labor. Higher fertility and unwanted pregnancies should be reduced through family welfare services and easy availability of Medical termination of pregnancy services to be ensured. Analysis of every maternal death through maternal death audit should be carried out.

A review of potential pharmacological treatments of COVID-19: an evidence-based perspective

Coronaviruses (CoVs) typically manifest as mild to severe respiratory tract infections. No drug is approved by US food and drug administration (FDA) for the treatment of patients with coronaviruses infection. With growing COVID-19 pandemic globally, need of hour is to work on potential prophylactic and therapeutic drugs to prevent local and community transmission. A literature search for eligible studies published till March 2020 was conducted in the PubMed, Medline, EMBASE, OVID, and Google Scholar databases by two reviewers. Therapeutic efficacy and safety of different drug regimens targeting treatment pathway acting against corona virus-2019 (COVID-19) were reviewed. Possible mechanism of actions of these potential repurposed drugs against COVID-19 were reviewed to develop effective prevention and treatment strategies. Many potential pharmacological therapies are being studied in various clinical trials. No FDA-approved repurposed drugs have shown safety and efficacy in randomized controlled trials for patients with COVID-19. Vaccines are under development and only few vaccines are under clinical evaluation. This review highlights potential drug actions against COVID-19 and their safety issues. It could help researchers and physicians to use these potential agents judiciously in clinical trials as well as in treatment protocols

Assessment of maternal and fetal outcome in trial of labor after cesarean

Background: Nowadays, cesarean sections are increasing consistently. Repeat cesarean sections are performed for a large percentage and associated with a higher rate of surgical complications and Long-term morbidities. The trial of labor after cesarean offers an alternative choice. This study carried out to assess the maternal and fetal outcome and to evaluate various parameters as a predictor of success of TOLAC.Methods: This prospective observational study conducted on 150 pregnant women with one previous LSCS who delivered at Mahatma Gandhi hospital, from January 2017 to July 2018. Patient having a singleton pregnancy, cephalic presentation, adequate pelvis size with spontaneous onset of labor were included. Cases were monitored carefully during the labor. Emergency LSCS was done if any indication appeared.Results: 78% of cases delivered safely by the vaginal birth and 22% of cases had an emergency repeat cesarean section (EmRCS). Favorable Bishop Score, active stage of labor and prior vaginal delivery were associated with higher success rate. One (0.66%) case of uterine scar rupture and 2 (1.33%) cases of scar dehiscence noted. No maternal mortality observed. Perinatal mortality occurred in 2 cases (1.33%).Conclusions: Present study shows that appropriate clinical settings and the properly selected group of patients can make the TOLAC safe and effective