Study of iatrogenic bladder injury in vaginal hysterectomy: our experience

Background: This study was carried out to calculate the incidence of bladder injury detected during benign gynecologic vaginal hysterectomy. This investigation examined the clinical features of urologic complications during gynecologic surgery and outcome of their management.Methods: It was a retrospective study done at Department of Gynecology, GCS medical college, Ahmedabad from year 2012-2016. All patients undergoing vaginal hysterectomy for benign diseases were included in the study. This study assessed the causative disease and surgical approach type, and treatment method of the bladder injury.Results: Of these 237 patients who underwent vaginal hysterectomies, 3 (1.26%) had bladder perforation. All the 3 cases of bladder injury underwent primary suturing during surgery without complications.Conclusions: Bladder injury was the most common urological injury during obstetric and gynecologic surgery. Early diagnosis and urologic intervention is important for better outcomes

Study of mode of delivery and maternal morbidity in preterm and term COVID-19 positive pregnant women

Background: Pregnant women are likely to represent a high-risk population during current coronavirus 2019 pandemic caused by severe acute respiratory syndrome coronavirus-2. The aim and objective of this study was to evaluate how COVID-19 pandemic has affected the mode of delivery and whether complications of the disease and mortality rate are higher in pregnant women than in non‐pregnant women.Methods: This ambispective observational study was conducted in department of obstetrics and gynaecology of our institute. Pregnant women diagnosed with positive for COVID-19 via the SARS-CoV-2 RT-PCR test in the third trimester and all neonates with complete COVID-19 testing and delivery data. This data was analysed.Results: Out of total 66 cases studied, 48 patients (72.7%) were asymptomatic, while 13 (19.7%) had mild respiratory or gastro intestinal symptoms on initial assessment at admission, including cough, sore throat, fever, weakness or diarrhoea. Cesarean sections were performed in 57.6% of cases. There were no cases of maternal or neonatal mortality.Conclusions: The study revealed that COVID-19 positive pregnant women are usually asymptomatic or mild-moderately symptomatic, similar to COVID-19 positive non-pregnant women. There was a noted rise in the rate of caesarean sections as a mode of delivery.

Maternal and perinatal outcome in instrumental vaginal deliveries over 5 years: a retrospective study

Background: Due to fear of trauma and less skill, use of instrumental vaginal delivery (IVD) is decreasing every year and incidence of caesarean section is increasing. Caesarean section is a major surgery associated with increased morbidity and mortality. This study evaluates the incidence of instrumental vaginal delivery and associated maternal and perinatal outcome. Methods: This observational retrospective study was carried out in full term antenatal patients in labour with vertex presentation who had undergone operative vaginal deliveries during the study period from January 2017 to December 2021 at G.C.S. Hospital. Data were obtained from the hospital records and analysed which included the age, parity, incidence, indication, the APGAR scores of the babies and complications in the patient. Results: Incidence of instrumental deliveries was found to be 1.98%. Most common indications for IVD were prolonged second stage of labour followed by foetal distress and post-dated pregnancy. Most common maternal complication was perineal tears and most common perinatal complication was neonatal intensive care unit (NICU) admission. Conclusions: The decision to proceed with an operative vaginal delivery when a spontaneous vaginal delivery is not possible must be based upon maternal and foetal factors. Most common maternal complications were perineal tears, cervical tears, episiotomy extension, vaginal laceration and atonic postpartum hemorrhage (PPH). Most common neonatal complications were NICU admission most commonly for neonatal hyperbilirubinemia.

To evaluate the correlation between gingival crevicular blood glucose and capillary blood glucose to screen diabetes mellitus in the dental office

Background: Most of the Indian population goes undiagnosed for diabetes due to unawareness. This will lead to more serious and long-term complications of diabetes. Thus, there is a critical need to increase opportunities for diabetes screening and early diabetes detection. Research has explored the dental office as a strategic venue of opportunity for glucose testing, examining the possibility of using gingival crevicular fluid (GCF) for diabetes screening. Aim: The aim of this study is to evaluate the reliability of gingival crevicular blood (GCB) to screen the diabetes. Methodology: Thirty patients were randomly selected based on bleeding on probing and probing depth. GCB and capillary finger blood (CFB) glucose levels were calculated using glucometer from patients. Data for glucose levels were statistically analyzed. Results: The correlation between GCB and CFB was high. Conclusion: GCB can be used as the screening test for diabetes in the dental office. Clinical Significance: GCB blood glucose level detection can be used as chairside screening test for diabetes patients

A study of feto-maternal outcome in case of premature rupture of membrane at a tertiary care center

Background: Premature rupture of membranes is the rupture of the fetal membranes in the absence of uterine contraction or before the onset of labor. When this occurs before 37 weeks of gestation, it is termed as preterm premature rupture of membranes. Management depends upon gestational age and the presence of complicating factors. An accurate assessment of gestational age and knowledge of the maternal, fetal and neonatal risks are essential to appropriate evaluation, counselling, and care of patients with PROM. The purpose of the study is timely diagnosis and appropriate management of the cases of PROM and PPROM to improve maternal and neonatal outcomes. Methods: A Prospective study was performed at the department of obstetrics and gynecology, at a tertiary care center from August 2020 to December 2021. A clinical data sheet was made for recording all information about the pregnant women after taking their consent. And their maternal and neonatal outcomes were recorded. Results: a total of 150 cases of PROM and PPROM were taken during our study out of which 53.33% belong to the younger age group, 43.33% were primi gravida, 66.66% belonged to the lower socioeconomic class, 25.33% had a previous history of abortion followed by dilatation and evacuation, rate of cesarean delivery was 34.66% and rate of NICU admission of neonates was 15.78% and 57.87% babies had low birth weight and rate of stillbirth was 1.97%. whereas 34.66% of cases had various complications related to PROM. Conclusions: Individualized management of PROM cases depending on the gestational age and risk of complications and antibiotic coverage is the best way to achieve a good fetomaternal outcome

Factors influencing the outcome of intrauterine insemination (IUI): age, clinical variables and significant thresholds

The aim was to investigate the influence of various biological factors upon the outcome of intrauterine insemination (IUI). The total IUI history (856 cycles) of 352 couples was studied. Live-birth showed a strong negative correlation with female age but no correlation with male age. Antimullerian hormone (AMH) and antral follicle count (AFC) correlated negatively with female age, and follicle stimulating hormone (FSH) correlated positively. Significant thresholds were found for all three variables, and also for total motile count (TMC) in the prepared sperm. Calculating pregnancy losses per positive pregnancy showed a strong correlation with increasing female age. This was highly significant for biochemical losses but not for fetal heart miscarriages. Male age had no effect on rate of pregnancy loss. In conclusion, female age, FSH, AMH and TMC are good predictive factors for live-birth and therefore relate to essential in vivo steps in the reproductive process

Sprint interval and sprint continuous training increases circulating CD34+ cells and cardio-respiratory fitness in young healthy women

The improvement of vascular health in the exercising limb can be attained by sprint interval training (SIT). However, the effects on systemic vascular function and on circulating angiogenic cells (CACs) which may contribute to endothelial repair have not been investigated. Additionally, a comparison between SIT and sprint continuous training (SCT) which is less time committing has not been made

Neuropeptide signaling regulates the susceptibility of developing C. elegans to anoxia

Inadequate delivery of oxygen to organisms during development can lead to cell dysfunction/death and life-long disabilities. Although the susceptibility of developing cells to low oxygen conditions changes with maturation, the cellular and molecular pathways that govern responses to low oxygen are incompletely understood. Here we show that developing Caenorhabditis elegans are substantially more sensitive to anoxia than adult animals and that this sensitivity is controlled by nervous system generated hormones (e.g., neuropeptides). A screen of neuropeptide genes identified and validated nlp-40 and its receptor aex-2 as a key regulator of anoxic survival in developing worms. The survival-promoting action of impaired neuropeptide signaling does not rely on five known stress resistance pathways and is specific to anoxic insult. Together, these data highlight a novel cell non-autonomous pathway that regulates the susceptibility of developing organisms to anoxia

Allosteric effects in cyclophilin mutants may be explained by changes in nano-microsecond time scale motions

The relationship between molecular motion and catalysis in enzymes is debated. Here, simulations of cyclophilin A and three catalytically-impaired mutants reveal a nanosecond-scale interconversion between active and inactive conformations, orders of magnitude faster than previously suggested