A study of obstetric and fetal outcome of placenta previa in scarred and unscarred uterus

Background: This study was conducted to study the maternal and fetal outcome in case of placenta previa in a scarred and unscarred uterus.Methods: This was 10 months’ prospective study conducted in Sree Mookambika Institute of Medical Science, Kulasekharam in the year between January 2021 to October 2021, among the cases of placenta previa with scarred and unscarred uterus. During the study period out of 1882 deliveries 20 cases of placenta previa beyond 28 weeks of gestation were reported. These cases were divided into two groups, scarred uterus (group A) and unscarred uterus (group B).Results: Incidence of placenta previa in scarred uterus (A) was higher than in unscarred uterus (B). Postpartum haemorrhage was seen in 25% of cases malpresentation was found in 55% of cases among which 5 cases in scarred group and in 6 cases in unscarred. Caesarean hysterectomy was performed in 1 case in scarred uterus. Neonatal intensive care unit was required for 15% of babies born to mother with placenta previa.Conclusions: The risk of placenta previa increases with increase in number of previous caesarean section, increased parity and advanced maternal age. Postpartum hemorrhage and blood transfusion are not uncommon in both group. Planned management at a tertiary care centre is obligatory. Mode of delivery is by emergency LSCS in case of bleeding per vaginum or elective LSCS

Correlation of 25-Hydroxycholecalciferol and Glycaemic Status in Recent Onset Type 2 Diabetes Mellitus

Introduction: Type 2 Diabetes Mellitus (T2DM) is a non communicable disease caused by increased insulin resistance and beta cells dysfunction. Recently vitamin D has sparked wide spread interest in pathogenesis of diabetes by playing a role in insulin resistance. As a major regulator of homeostasis of calcium, vitamin D directly and/or indirectly improves insulin exocytosis and glucose tolerance. Aim: To estimate the serum 25 hydroxy cholecalciferol level and also to correlate with fasting, two hour postprandial blood glucose and Glycated Haemoglobin (HbA1c) values in recent onset T2DM patients. Materials and Methods: This cross-sectional study was conducted at Government Kilpauk Medical College, Tamil Nadu, India from November 2017-April 2018. One hundred and thirty nine recently diagnosed T2DM patients aged between 30-60 years of both sex, who were on oral hypoglycemic drugs for less than three months duration were included in the study. The patients were grouped into three groups according to their vitamin D levels, Group 1 Vitamin D deficient- 52 patients (≤20 ng/mL), Group 2- Insufficient Vitamin D -33 patients (>20-30 ng/mL), Group 3- Vitamin D sufficient-54 patients (>30 ng/mL). Fasting and 2 hour postprandial glucose, 25 hydroxy cholecalciferol and HbA1c were estimated. Statistical analysis was performed using analysis of variance (ANOVA) and Pearson’s correlation. Results: Out of 139 participants, 64 were males and 75 were females. The mean age of the study population was 50.64±5.343 years. The mean fasting blood glucose values among the three groups were 168.13, 129.61, and 125.33 mg/dL respectively. The mean two hour postprandial blood glucose values among the three groups were 269.44, 212.45, and 194.11 mg/dL respectively. The mean HbA1c among the three groups were 7.481±1.16, 6.027±0.31, and 5.86±0.19, respectively. Decreased 25 hydroxy cholecalciferol level in patients of T2DM showed a statistically significant inverse correlation with fasting and two hour postprandial blood glucose and HbA1c with p-value <0.001. Conclusion: The study suggested that hypovitaminosis D was prevalent in T2DM. The study showed that decreased vitamin D level in T2DM patients was associated with increased fasting, postprandial blood sugar, and HbA1c. So, vitamin D screening in diabetics and supplementation can improve the glycemic status

Abrasion resistance and compressive strength of unprocessed rice husk ash concrete

This paper investigates the effects of adding natural rice husk ash collected from uncontrolled burning and without previous grinding (NRHA) as cement replacement in concrete. To obtain an adequate particle size, NRHA was mixed with coarse aggregate for a convenient period of time before adding the other components. Compressive strength, water absorption, porosity, and abrasion resistance expressed as weight loss were examined. Test results show that decreasing the particle size through mixing with coarse aggregate improved the compressive strength, reduced the permeability, and increased the abrasion resistance of concrete. By mixing NRHA with aggregate for 8 min, abrasion resistance improved by 10.35 and 23.62% over the control concrete at 28 and 91 days, respectively. Incorporating NRHA in concrete by grinding with coarse aggregate during the mixing process could be suitable for making normal-strength concrete and for applications where abrasion resistance is an important parameter. In addition, using NRHA as a partial replacement cement contributes to the reduction of CO2 emissions due to the production of cement

Durability investigations of micro and nano silica blended cementitious systems in self-compacting concrete under adverse conditions

The colossal magnification of industrialization in recent years led to the snags of squandering materials that harm the environment. To employ the industrial debris into the concrete, can contribute to lower the carbon footprint to some extent. For this purpose, the M60 grade of self-compacting concrete was designed with industrial waste products. Fly ash was used as a constant cement substitute product of 20% of the cementitious systems. Further, silica of micro and nano-sized particles are used as a cementitious replacement in varying percentages from 5% to 15% and 1% to 3% respectively. A total of eight mixes including the reference mix and the combined mix of micro and nano silica were prepared and examined for the fresh state property. The slump flow test, J-ring test, and Orimet test were performed in the fresh state of concrete. Concrete specimens in the hardened state were tested for compression strength and durability characteristics like water absorption, acid attack, and sulphate attack at 7, 28, and 90 days respectively. Further, investigations were carried out on the microstructural behavior when exposed to acid and sulphate attack using a scanning electron microscope (SEM). The hardened state properties of SCC showed positive durability results for the combined mix of 10% micro and 2% nano silica, where better hiking of calcium silicate hydrate gel was observed by the inclusion of binary and ternary blending materials