Universal screening for hypothyroidism in pregnancy: is it necessary?

Background: Thyroid diseases are one of the commonest endocrine disorders affecting women of reproductive age group, and hence constitute one important disorders complicating pregnancy. The objective of this study was to determine the importance of universal screening for hypothyroidism in pregnancy at the first antenatal visit and to formulate whether this routine screening is mandatory in our country.Methods: This retrospective study was conducted in the year 2018 at PSG IMSR Hospital for all pregnant women who attended the first antenatal visit between Jan 2012 to Dec 2012 after obtaining ethical clearance. Pregnant women who were already taking treatment for hypothyroidism, diabetes mellitus, hypertension and those pregnant women who lost their follow up were excluded from the study.Results: The incidence of subclinical hypothyroidism among antenatal women were 7.06%. In our study the maternal complications like anemia 12 (8%), preeclampsia 26 (17.3%), gestational diabetes 25 (16.7%), fetal growth restriction 8 (5.3%), Oligohydramnios 13 (8.7%), pre mature rupture of membranes 25 (16.7%), placental abruption in 2 (1.33%), APLA syndrome 2 (1.33%), low birth weight 26 (17.3%) were observed.Conclusions: Universal screening for hypothyroidism is recommended for all antenatal women especially in iodine depleted country like India

Surveillance of surgical site infections to determine incidence, risk factors and microbiologic spectrum following obstetric and gynaecological surgeries

Background: Surgical site infections (SSI) are one of the major health problems throughout the world with an incidence of 3%-16%. Hospital acquired surgical site infection is further complicated by the emergence of multi drug resistant strains. SSI surveillance is an established monitoring tool and has been shown to reduce infection rates. The importance of preventing surgical site infections is well recognized since they lead to increased morbidity, prolonged hospital stay, need for readmission, high end antibiotic treatment and re-surgery. This study was undertaken to determine the incidence, risk factors, and microbiological spectrum of surgical site infections and to identify the multidrug resistant strains.  Analysis of the effectiveness of the existing surveillance methods was also done.Methods: This retrospective study was done for a period of 1-year form Jan 2016 to Dec 2016. All patients with infection following caesarean section and abdominal and vaginal hysterectomy were included. Laparoscopic surgery and patients with preexisting infection were excluded.Results: Incidence of SSI in present study is 5.27%. The major risk factors identified were obesity, diabetes and prolonged operating time.  The commonest infective organism was Klebsiella Pneumoniae in 37% of which 19% were ESBL producing and 3.8% were carbapenemase producing. E. coli was identified in 20% of isolates. The incidence of ESBL in both isolates was higher.Conclusions: Regular audit of SSIs is a very effective tool to analyse risk factors, identify causes and plan strategies to prevent infection

Is obstetric triage necessary?

Background: The aim was to determine the number and type of patients admitted in the labour and delivery unit and whether a formal triage would improve efficiency.Methods: All patients entering the unit were analyzed for a period of two months: July and August 2013.Results: The 990 patients during the study period were from three areas, the OPD, the ward and emergency visits to the labour unit. The reason for the visit and the number of cases seen was analyzed. This was correlated with the number of deliveries. Most patients were generally seen within 5 to 10 minutes, however in a few cases there was a delay of up to half an hour when the nurses were held up by a delivery or another emergency.Conclusions: Obstetric triage would improve efficiency of care and reduce waiting time. The suggestions for improvement were also discussed. There should be clear guidelines and protocols for the initial assessment and action for each level of severity

Outcome of emergency cerclage for advanced cervical dilatation: a retrospective analysis

Background: The objective was to evaluate the outcome of late second trimester emergency cerclage in patients with advanced cervical dilatation with bulging membranes.Methods: Setting: department of obstetrics and gynaecology, PSG Institute of medical sciences & research, Coimbatore, Tamil Nadu, India. This is a retrospective study of case files of patients who underwent emergency late second trimester cerclage for advanced cervical dilatation with bulging membranes between January 2009 to January 2014. McDonald’s technique was used in all the cases.Results:Altogether, 7 patients (100%) underwent late second trimester  emergency cerclage between 20-28 weeks of gestational age, out of which three  patients (42.86%) had term deliveries (>37w), and 3 patients (42.86 %) carried on their pregnancies to more than 32 weeks resulting in healthy live born babies. Two of them delivered by normal vaginal delivery, 4 underwent LSCS, and one patient had severe abdominal pain with bleeding and draining per vaginum after 3 days of cerclage, in view of which the stitch was removed. Subsequently, the patient expelled a live foetus weighing 620gms, which died in the Neonatal Intensive Care Unit (NICU) after 3 hours. This procedure prolonged the duration of pregnancy in all patients with a mean duration of 70.4 days. The mean gestational age at the time of delivery was 34.33 weeks. The mean birth weight was 2.18 kg and ranged between 1.97 to 2.64 kg. The mean APGAR at one minute was 8/10 and the mean duration of stay in NICU was 1.66 days. All the new-born babies were healthy at the time of discharge. The live birth rate following emergency late second trimester cerclage in this series was 85.75%.  Conclusion:Favourable neonatal outcome can be accomplished in patients with cervical incompetence in the second trimester of pregnancy following emergency cervical suturing, even if performed when the membranes are bulging through the cervix.

Microsomal prostaglandin E synthase-1: the inducible synthase for prostaglandin E(2)

Microsomal prostaglandin E synthase-1 (mPGES-1) is an inducible enzyme that catalyzes the conversion of prostaglandin (PG)H(2 )to PGE(2). Proinflammatory stimuli markedly increase levels of mPGES-1 expression both in vivo and in vitro. mPGES-1 knockout studies and animal models of inflammatory arthritis also provide a strong basis for the contribution of mPGES-1 in the increased local production of PGE(2 )observed in inflammatory arthritis. The focus of this article is to review some recent advances in our understanding of mechanisms specific to the regulation of inducible mPGES-1 in inflammatory arthritis

ANTIPYRETIC ACTIVITY OF ANNONA PLANTS LEAVES ON BREWER'S YEAST INDUCED FEBRILE RATS

Objective: To evaluate and compare the in vivo antipyretic activity of the methanolic extracts of selected three Annona plant leaves.Methods: The acute oral toxicity determined by OECD class method and the in vivo antipyretic activity was determined by brewer's yeast inducedpyrexia method.Results: The results showed that the methanolic extract of leaves of Annona plants are non-toxic and possessed significant antipyretic effect whichmay be attributed to the presence of flavonoids and saponins in the extracts.Conclusion: This study provides evidences for the antipyretic activity of Annona squamosa, Annona reticulata and Annona muricata possess antipyreticactivity at the tested doses 100 and 200 mg/kg body weight without any side effects, which could partly contribute to its ethno medical use.Keywords: Annona squamosa L, Annona reticulata L, Annona muricata L, Antipyretic activity, Brewer's yeast

Search for optical bursts from the gamma ray burst source GBS 0526-66

Attempts were made to detect optical bursts from the gamma-ray burst source GBS 0526-66 during Dec. 31, 1984 to Jan. 2, 1985 and Feb. 23 to Feb. 24, 1985, using the one meter reflector of the Kavalur Observatory. Jan. 1, 1985 coincided with the zero phase of the predicted 164 day period of burst activity from the source (Rothschild and Lingenfelter, 1984). A new optical burst photon counting system with adjustable trigger threshold was used in parallel with a high speed photometer for the observations. The best time resolution was 1 ms and maximum count rate capability was 255,000 counts s(-1). Details of the instrumentation and observational results are presented