Effect of antenatal retroviral therapy on feto-maternal outcome in human immunodeficiency virus seropositive patients

Background: To study the effect of HIV and duration of ART on term of delivery, newborn birth weight and adverse fetal outcomes.Methods: Prospective comparative study of 40 HIV seropositive pregnant females with varying duration of ART (tenofovir 300 mg + lamivudine 300 mg + efavirenz 600 mg) and HIV seronegative pregnant females attending ANC and delivering in department of obstetrics and gynecology at S. M. S. Medical College, Jaipur, Rajasthan, India.Results: Most HIV seropositive patients were in age group 25 to 30 years and more number were booked in comparison to unbooked. Adverse fetal outcomes were seen more in HIV seropositive patients and they were found to be statistically significant (p=0.029). No relationship could be derived of duration of ART on either the birth weight or term of delivery or adverse fetal outcomes.Conclusions: Maternal HIV infection was significantly found associated with adverse fetal outcome and this was not affected by the use of ART

A rare case report of conjoined twins: Thoraco-omphalopagus with anterior abdominal wall defect

Conjoined twins are a rare deviation of monozygotic monoamniotic twins which results from fusion of the two at any part of their body. The prognosis is not good and associated with high mortality. Here we report a case of conjoined twin which was referred to our tertiary care hospital as twin pregnancy with impacted breech in obstructed labour. Taking mothers condition into account, she was taken for emergency caesarean section, performing which we realised that it was a conjoined twin. The baby were still born and conjoined at thorax and abdomen (thoraco-omphalopagus) with anterior abdominal wall defect in one and unrevealed sex in other. Current report emphasizes on making an early diagnosis of conjoined twin pregnancy, so that it can be managed at the earliest according to the gestational age

A case report of sirenomelia with two umbilical arteries: an unusual finding in a rare case

Sirenomelia also known as Mermaid syndrome is a rarely encountered fusion anomaly of the caudal region of body often associated with Potter’s facies, single umbilical artery and various visceral abnormalities which make it irreconcilable with life. Here we report a case of sirenomelia delivered in our tertiary care hospital by lower segment cesarean section to a 24 year old third gravida with no previous live issues. No high risk factors could be identified with the mother including diabetes mellitus. Baby was born alive with Potter’s facies. Both the lower limbs were merging into each other like a mermaid’s tail (hence called mermaid syndrome). Sex of the baby could not be identified and the urogenital and anal orifices were absent. Umbilical cord stump had two umbilical arteries. The baby died after 20 hours of life. There appears to be no definitive modality for diagnosing sirenomelia in the antenatal period. However, if a patient has consistently low AFI without any history of leaking per vaginum, high resolution USG or colour Doppler should be done at the earliest to look for the cause

Phytochemicals & Pharmacological activity of Xanthium strumarium: An Updated Review

Therapeutic plants are of extraordinary worth in the field of treatment and fix of infections. Throughout the long term, logical examination has extended our insight into the compound constituents of the therapeutic plants, which decide the restorative properties. The purpose of this paper is to summarize the progress of modern research, and provide a systematic review on the traditional usages, phytochemistry, pharmacology of the X. strumarium. Plant parts like leaves, organic product, bark and seed have been accounted for having antidiabetic, antiulcer, calming, invulnerable modulator and pain- relieving movement. This survey tends to the tentatively validated realities and furthermore proposes the requirement for research on substance and pharmacological properties of Xanthium strumarium

Feto-maternal outcome in human immunodeficiency virus seropositive mothers in co-relation with CD4 count

Background: To study the effect of human immunodeficiency virus (HIV) infection on pregnancy outcomes and new born as mother to child transmission of HIV is a major route on new infections in children and compare it with HIV uninfected pregnancies.Methods: Prospective comparative study conducted on 40 HIV seropositive and 40 HIV seronegative pregnant women attending ANC and delivering in the department of obstetrics and gynecology, S. M. S. Medical College, Jaipur, Rajasthan, India.Results: CD4 count had no effect on birth weight of baby or term of delivery. HIV seropositive pregnancies were more prone to IUD, still birth and preterm birth (p=0.029). Mother to child transmission was 2.7%.Conclusions: HIV infection increases the risk of adverse foetal outcome in terms of intrauterine demise, still birth and preterm labour

MeshSOS: An IoT Based Emergency Response System

Due to the limited mobility and technical knowledge, senior and disabled citizens of the society face difficulties during emergencies. Most hardware/software emergency assistance/response systems available in the market have a complex user interface even for the general public. Requesting help using these systems requires sharing information such as type and location of the event, which wastes precious time to respond to the event. Often, citizens end up handling the event themselves instead of waiting for someone to arrive at the event location. Hence, it is necessary to design a simple but incredibly robust system which bypasses the challenges of traditional emergency response systems. In this paper, we propose an Internet of Things (IoT) based mesh-enabled emergency response system called MeshSOS, which enables senior and disabled citizens to get assistance by simply pressing a button. Use of mesh networking along with WiFi made our system robust to network failures. We have also developed a central monitoring application for healthcare and security agencies to handle emergency events proactively. Initial field experiments and simulations show that our system has the potential to improve the robustness and response time in an energy and cost-efficient manner

Absence of Wharton’s jelly: an association with feto-maternal morbidity

Umbilical cord contains two arteries and one vein connecting fetus to the placenta and is responsible for blood flow between the two. It is surrounded by Wharton’s jelly which is a gelatinous substance and functions as adventitia layer of umbilical vessels, thereby providing insulation and protection to the umbilical cord. Umbilical cord abnormalities are associated with poor perinatal outcomes. Very few cases of absent Wharton’s jelly are reported in literature. Ours might be the 8th one in which we did a lower segment caesarean section for meconium stained liquor but the baby died after 12 hours

PART I: OPTIMIZATION OF HYDRALAZINE HYDROCHLORIDE IMMEDIATE RELEASE LAYER IN ANTIHYPERTENSIVE BILAYER TABLET

Objective: Aim of the present study was the optimization of the immediate release (IR) layer containing hydralazine hydrochloride (HHC) 25 mg and compressed with a sustained-release (SR) layer of isosorbide dinitrate (ISDN) 40 mg to decrease the dosing frequency. Methods: In this study, Drug-excipients compatibility study was carried out by FT-IR and a preliminary trial was conducted for screening of super disintegrating agents. The amount of sodium starch glycolate (SSG) (X1) and the amount of ac-di-sol® (X2) was chosen as independent variables in 32 full factorial design while wetting time (WT) (Y1), disintegration time (DT) (Y2) and In vitro drug release at 15 min (Q15) (Y3) were taken as dependent variables. Multiple linear regression analysis, ANOVA, and graphical representation of the influence of factor by 3D plots were performed by using sigma plot 13.0. In the present study, the following constraints were used for the selection of an optimized batch: WT<16 s, DT<25 s, and Q15>90%. To validate the evolved mathematical models, a checkpoint batch was selected from its desirability value. Results: FT-IR spectra show that the drug and excipients were compatible with each other. The calculated F values found for WT, DT, and Q15 were 045.559, 077.100 and 278.760, respectively. All Calculated F values are greater than tabulated values for all dependent variables. Prepared checkpoint was selected from its desirability value 0.935 and it gives a 100% drug release within 30 min. Conclusion: These results confirm that the prepared HHC 25 mg IR layer is used for rapid control of hypertension

Anaesthetic management of giant encephalocele

One of the several challenges to the anaesthesiologists, is management of child with difficult airway. Management of even normal airway in a neonate is different and complex as compared to airway of two year old child and that of adult. Definition of the difficult airway is related solely to tracheal intubation or problems with mask ventilation1.Among the different causes of difficult airway cranio facial and neoplastic anomalies are very common. We present a case report of difficult airway management in encephalocele patient

A prospective clinical study of foetomaternal outcome in relation to oligohydramnios in pregnancies beyond 36 weeks of gestation

Background: Amniotic fluid is contributed by both mother and foetus. It plays a vital role in foetal growth. The main purpose of this study was to evaluate the foetomaternal outcome in pregnant females with oligohydramnios beyond 36 weeks of gestation.Methods: This study was conducted on 230 pregnant females beyond 36 weeks of gestation with decreased liquor clinically and confirmed sonographically. It was conducted from May 2018 to May 2019. Females with leaking per vaginum, patients who did not give consent and with intrauterine foetal death were excluded. Complete labour record was made. Assessment of maternal outcome was done in terms of mode of delivery and foetal outcome was done in terms of birth weight, Apgar score at one and five-minute, respiratory distress, meconium aspiration, seizures in first 24 hours of life, congenital malformations, neonatal intensive care unit admission and death of baby.Results: A total of 230 pregnant females met the inclusion criteria who were having AFI <5. 121 (53%) females were primigravida and 119 (52%) underwent for caesarean section. Most common indication of LSCS was foetal distress. Apgar score at 1 minute was <7 in 97 (42%) babies and after 5 minutes, it was <7 in 93 (40%) babies. Other neonatal outcome results were IUGR in 59 (26%) babies, meconium aspiration syndrome in 52 (23%) babies, respiratory distress in 92 (40%) babies, congenital malformation in 6 (3%) babies, NICU admission of 93 (40%) babies and neonatal death of 11 (5%) babies.Conclusions: Oligohydramnios increases the chances of maternal morbidity and perinatal morbidity and mortality