Correlation of body mass index and age of menopause in women attending medicine and gynaecology department of a tertiary care centre

Background: Menopause is a physiological change that every woman experiences in her life. Some find it extremely troublesome and for some it is a gradual change .Multiple factors determine the age at which menopause occurs, also deciding the course of menopause. How do height, weight and body mass index affect the same is the basis of this research.Methods: 500 women who underwent natural menopause were examined to assess their height and weight. The body mass index was henceforth calculated. The results were statistically analysed using Pearson correlation.Results: The age of menopause varied with the increasing height, weight and BMI. Though no statistical significance was found in between height and age of menopause, there was a definite correlation between weight and BMI of the women.Conclusions: Time long obesity and higher BMI is known for being associated with many diseases like hypertension, diabetes, metabolic syndrome etc. This study indicates how it affects the physiologic change i.e. menopause also. Women with higher BMI tend to have higher age of attaining menopause

A comparative study of misoprostol versus surgical management of incomplete and missed miscarriage

Background: The aim of this study is to assess the effectiveness and acceptability of using vaginal Misoprostol for management of spontaneous incomplete and missed miscarriage as an alternative to direct vaginal surgical evacuation in our setting and also to compare the efficacy and patient satisfaction of the medical method with surgical method in same.Methods: this is a prospective comparative study performed on randomly divided 200 patients in two groups. Each group of patients are case of missed or incomplete abortion in first trimester.(5-12 weeks). Group one received Misoprostol tablet 600 mcg single dose per vaginally, and second group underwent surgical vaginal evacuation directly under local anesthesia (para-cervical block . both groups were compared in terms of success, complications, pain and patient satisfaction.Results: 97% success rates were obtained in the medical treatment group. Surgical group had 95% success rates. 3 patients underwent repeat surgical evacuation in the medical group. Bleeding was more and prolonged in the patients managed by Misoprostol, 27% patients had moderate bleeding. Though bleeding was less in the surgical group but there was excruciating pain and weakness as the procedure being done under local anesthesia, 98% patients experienced pain in surgical group. Satisfaction rates in the misoprostol group were 100%.Conclusions: Misoprostol is effective in complete evacuation of uterus in incomplete and missed miscarriage. Patients are highly satisfied with the misoprostol treatment as they didn’t have to get hospitalized. The bleeding was more or less like menstrual bleeding which did not affect the daily chores of the women. It is as effective as surgical evacuation and patient satisfaction is much more than the surgical evacuation.

A prospective randomized comparative study of rapidly absorbing polyglactin 910 versus chromic catgut for episiotomy repair at tertiary care hospital Bikaner, Rajasthan

Background: The aim of our study was to compare rapidly absorbing polyglactin 910 with chromic catgut as a suture material for episiotomy repair, in relation to post episiotomy complications and maternal morbidity.Methods: This prospective, randomized, comparative study of rapidly absorbing polyglactin 910 versus chromic catgut for episiotomy repair was conducted in the department of obstetrics and gynaecology, PBM hospital, associated with Sardar Patel medical college Bikaner, Rajasthan.Results: RAPG-910 was associated with significantly lesser analgesic dose requirement for pain relief than chromic catgut. Use of chromic catgut was associated with a higher incidence of hematoma formation, wound gaping, need of re-suturing of wound and need of re-admissions for management of post-episiotomy complications than RAPG-910 although, the difference was statistically insignificant. RAPG-910 was associated with better wound condition & healing as compared to chromic catgut.Conclusions:To conclude, rapidly absorbing polyglactin 910 was better than chromic catgut in relation to post episiotomy complications and maternal morbidity with a significantly lesser incidence and severity of post episiotomy pain, lesser dose of analgesia required, lesser wound gaping and infection, better wound healing, faster suture reabsorption. 

Reinforcing the vast difference between the outcomes of spontaneous versus induced miscarriages

Background: Information on incidence of spontaneous and induced abortion is crucial for identifying policy and programmatic needs aimed at reducing unintended pregnancies. In this study, we analyzed in detail the presentation, complications of abortions and procedure associated complications of spontaneous and induced miscarriages.Methods: The study was prospectively conducted on 200 patients from IPD of MGM Medical College, Indore over a period of two years and under the guidance of population council of India. The patients were divided into 2 groups of 100 patients each under spontaneous and induced miscarriages.Results: After matching the parity, age of mothers, gestational age at presentation and socioeconomic status the results were analyzed.  45% women presented with incomplete abortion followed by inevitable (20), missed (12) and complete abortion (19) in the spontaneous abortion group. In induced abortion group majority of women presented with failure of contraception, natural method use being the most common method of contraception. Young women preferred medical abortion while multiparous women went for surgical evacuation.  Minor and tolerable side effects like mild bleeding pain nausea etc. were seen in medically supervised group of induced miscarriage. Major and life threatening complications were seen in the spontaneous abortion group like heavy bleeding, hypovolumic shock, septic abortion, foul smelling vaginal discharge, bowel injury and also one mortality was seen in the spontaneous abortion group.Conclusions: While appreciable progress has been made in legalizing and improving MTP services, the unmet needs continue to grow. Efforts should be made to make safe abortion facilities available to majority of population. At the same time awareness should be spread so that seeking abortion does not become an alternative to contraception

Study of effect of intra-umbilical oxytocin along with active management in third stage of labor

Background: The aim of the study was to determine effect of intra-umbilical oxytocin along with active management on duration and amount of blood loss in 3rd of stage of labor.Methods: This was a hospital based prospective, randomized, case-control study conducted in the department of OBG between 1st September 2019 to 31st December 2020. After obtaining permission from ethical committee, screening of inclusion and exclusion criteria and informed consent of participants, 300 cases were enrolled. In group A (control) 20 ml normal saline and in group B (case) 20 IU oxytocin diluted in normal saline to make a 20 ml solution was given intra-umbilically along with standard active management of third stage labor. The data was systematically recorded and analysed.Results: Both the groups were comparable in terms of demographic data.  A statistically significant reduction in the duration of third stage of  labor (1.83±0.64  min in group B vs 2.92±0.79 min in group A), amount of blood loss (203.73±62.11 ml in group B vs 328.83±87.18 ml  group A) and fall in haemoglobin (9.28±1.03 g/dl in the study group A vs 9.97±1.28 g/dl in group B) and haematocrit (31.20±3.05% in  study group A vs 33.60±3.31%  in study group B)  were noted, taking p value  significant <0.05.Conclusions: Intra-umbilical oxytocin was associated with a significant reduction in duration and amount blood loss in third stage of labor

A study of vitamin D levels and associated deficiency in pregnancy and its effect on maternal and fetal outcome

Background: From conception the embryo is dependent on the mother for all nutritional requirements until birth. Vitamin D deficiencies have adverse effect on pregnancy outcome result in poor growth, prematurity, NTD, even congenital anomalies. The aim and objectives of the study was to assess the prevalence of deficiencies among pregnant woman attending M.Y. Hospital and assess the correlation with the pregnancy complications.Methods: Total 110 patients were studied for vitamin d levels and associated obstetrical complications and risk factors over a period of six months. 53 pregnant women were found to be deficient with vitamin D.Results: 53 pregnant women out of total of 110 were deficient in vitamin D levels. Maximum patients belonged to group (21-30yr) of age. Vitamin D deficiency was more in housewives (65.3%) and in urban(86.8%). Low birth weight&lt;2.5kg were born 50(45.5%) and 2 IUD. 2 were diagnosed NTD in USG reports. 80% low birth weight babies were born in vitamin D deficient women.Conclusions: Our study fails to show a causal relation between low vitamin D level and adverse maternal and fetal outcome in terms of preeclampsia, cesarean delivery, oligo and diabetes. There was a relation between vitamin D deficiency and low birth weight babies

Interpretation of Biochemical Tests for Iron Metabolism in Hyperthyroidism

Objective: Several studies suggest that thyroid hormones may affect erythropoiesis. However the mechanism by which thyroid hormones alter the ferritin concentration is not well known. Therefore, the present case-control study was designed to determine the changes due to hyperthyroidism in serum ferritin, iron and transferrin levels and to investigate the inter-relationship between these parameters.Material: This study was conducted on 50 newly diagnosed hyperthyroid patients and the results were compared with 50 age and sex matched healthy controls. Serum ferritin was assessed by two site sandwich immunoassay using direct chemiluminometric technology. TIBC and serum iron were estimated by colorimetric method.Results: Serum ferritin (314.43 ± 68.7 ng/mL) and iron concentration (159.88 ± 36.28 µg/dL) were found to be increased in hyperthyroid patients as compared to healthy controls (255.23 ± 45.5 ng/mL and 110.52 ± 20.52 µg/dL respectively). There was a significant difference between hyperthyroid patients and healthy controls in serum levels of ferritin and iron (p0.05 for both). Serum ferritin and iron were correlated significantly positive with thyroid parameters while a significant negative correlation was found with transferrin.Conclusion: Our data suggest that alterations in thyroid status in a given individual produce significant changes in serum ferritin, iron and transferrin levels. Increased ferritin levels seem to be protective against increased oxidative stress seen in hyperthyroidism but these also increase atherosclerotic risk. However, a large scale study is recommended to establish the fact

A prospective study of fetomaternal outcome in patients of pregnancy with jaundice in tertiary care centre

Background: The objective of the study was to study the incidence of jaundice, biochemical alterations, Fetomaternal outcome and various liver pathologies of pregnant patients with jaundice.Methods: This was a prospective observational study conducted in Dr S N Medical College Jodhpur, Rajasthan, India from June 2014 to February 2016. Total fifty pregnant patients with clinical jaundice and prodromal symptoms of hepatitis were included in study.Results: Out of 40,398 deliveries in our hospital, 50 cases of jaundice were identified giving an incidence of 1 in 808 (0.12%). Most common cause of jaundice in pregnancy in our set up was viral hepatitis i.e. 13 cases (26%) were HEV+ and 1 case (2%) came out to be HAV+. Serum LDH levels were raised in 36% of patients. Maximum no. of patients had their serum AST/ALT levels in the range of 100-1000 IU/ml (54%). Out of 52 births (2 twins) 34 were live births (65.38%) and rest were either SB or IUFDs. Most common causes of mortality in patients were Septicemia, MODS, DIC (25%) followed by HELLP syndrome and HEV+ viral hepatitis equally (16.67%). Maximum no. of patients with jaundice suffered from postpartum haemorrage and septicemia (60%).Conclusions: Most common cause of jaundice in pregnancy in our study was viral hepatitis. Public awareness about the various routs of transmission of different types of infective hepatitis, improving sanitary conditions and habits, health education of preventive measures can help in reducing the burden of jaundice in pregnancy

Coenzyme Q10 therapy in current clinical practice

Coenzyme Q10 (CoQ10) is a naturally occurring, lipid soluble, essential compound and is also known as ubiquinone. CoQ10 acts as an intermediate of the electron transport chain situated in membrane of mitochondria and vital for ATP production and cellular respiration. CoQ10 also serves as an intercellular antioxidant. All the clinical use of CoQ10 are based upon these two functions. CoQ10 levels are altered in a number of oncological as well as non-oncological diseases. Furthermore, recent data indicate that CoQ10 has an impact on the expression of many genes involved in metabolism, cellular transport, transcription control, and cell signaling, making CoQ10 a potent gene regulator. CoQ10 supplementation is useful in diseases associated with CoQ10 deficiency which includes primary and secondary CoQ10 deficiencies, fibromyalgia, diabetes mellitus, mitochondrial diseases, neurodegenerative diseases, cardiovascular disease, cancer, male infertility and periodontal disease. Clinical presentations of severe CoQ10 deficiency include severe infantile multisystemic disease, encephalomyopathy, isolated myopathy cerebellar ataxia and Leigh syndrome with growth retardation. Oral CoQ10 administration can correct CoQ10 deficiency since it increases CoQ10 tissue levels. CoQ10 therapy has no serious side effects in humans and new formulations have been developed that increase CoQ10 absorption and tissue distribution. Future trends involving CoQ10 in many diseases needs more clinical trials for better understanding of CoQ10 efficacy

Polo-like kinase 4 controls centriole duplication but does not directly regulate cytokinesis.

Centrioles organize the centrosome, and accurate control of their number is critical for the maintenance of genomic integrity. Centrioles duplicate once per cell cycle, and duplication is coordinated by Polo-like kinase 4 (Plk4). We previously demonstrated that Plk4 accumulation is autoregulated by its own kinase activity. However, loss of heterozygosity of Plk4 in mouse embryonic fibroblasts has been proposed to cause cytokinesis failure as a primary event, leading to centrosome amplification and gross chromosomal abnormalities. Using targeted gene disruption, we show that human epithelial cells with one inactivated Plk4 allele undergo neither cytokinesis failure nor increase in centrosome amplification. Plk4 is shown to localize exclusively at the centrosome, with none in the spindle midbody. Substantial depletion of Plk4 by small interfering RNA leads to loss of centrioles and subsequent spindle defects that lead to a modest increase in the rate of cytokinesis failure. Therefore, Plk4 is a centriole-localized kinase that does not directly regulate cytokinesis