134 research outputs found

    Outcome of expectantly managed small-for-gestational-age pregnancies with normal Doppler parameters- a prospective cohort study

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    Background: SGA foetuses with normal Dopplers are not at risk of IUD. However, there is lack of consensus about timing of delivery of SGA foetuses. Clinicians commonly induce all SGA pregnancies at 37 weeks. Expectant management of SGA foetuses beyond 37 weeks is not well studied.Methods: We followed up women with clinically suspected growth restriction with foetal biometry, Doppler and biophysical profile. Pregnancies with foetal AC between 10th to 3rd centile with normal Dopplers were recruited in the study group. The women were allowed to go in spontaneous labor till 39+6/7 weeks or were induced at 39+6/7 weeks. The outcome of such cases was compared with controls who were induced at 37+0/7 weeks.Results: Spontaneous labor occurred in 42% subjects in study group whereas in control group all were induced. Mean gestation at delivery in the study group was increased (39.57┬▒0.71 versus 37.0┬▒0.0, p value <0.001). Almost 81% of the subjects in study group delivered after 39 weeks. The rate of caesarean section was significantly lower in study group (3% versus 22%, p value-0.024). Also, the risk of intrapartum foetal distress was lower in study group (3/36 versus 1/36).The mean birth weight in the study group was higher (2426.5┬▒154.1 gm versus 2297.9┬▒101.4 gm, p value <0.001.Conclusions: Expectant management of SGA pregnancies with normal Doppler parameters leads to a significant increase in gestational age at birth and the mean birth weight and a significant reduction in caesarean section rate.

    Retrospective Conversion of Ancient Knowledge, Issues and Challenges: A Case Study of Central Library, Banaras Hindu University, India

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    The paper outlines the efforts of Sayaji Rao Gaekwad Library, which belongs to Asia \u27s largest university system, Banaras Hindu University (BHU), to make their rich collection of manuscripts available to the world of scholars. It also includes an elaboration of the National Mission for Manuscripts of India and the affiliation of Central Library, BHU with it. A detailed account of the Central Library, BHU as Manuscript Conservation Centre is provided. The issues and future targets for the library pertaining to preservation of manuscripts are described. The paper is first to report the gradual evolution of Central Library, BHU as an essential part of the National Mission for Manuscripts, a National initiative by Ministry of Culture, Government of India

    Pregnancy outcomes in the in vitro fertilization conceived polycystic ovary syndrome patients: a prospective study

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    Background: In vitro fertilization (IVF) is the need of modern era which was first developed to overcome the infertility resulting from irreparable tubal disease but now is applied more broadly for treatment of all causes of infertility including polycystic ovary syndrome (PCOS) and is associated with obstetric complications as well. This study aimed to whether pregnancy-related outcomes and complications are differed between patients with polycystic ovary syndrome (PCOS) and those with other causes of infertility who had undergone IVF. Objective were to compare maternal and fetal outcome in IVF conceived women with PCOS v/s without PCOS. Prospective comparative study at a tertiary care hospital.Methods: After getting approval from institutional ethical and scientific research committee, 108 IVF conceived women are studied, where IVF is done using controlled ovarian stimulation with GnRH antagonist protocol followed by freeze all strategy and preparation of endometrial lining. Frozen embryo transfer done in subsequent cycle over a period of one year. Study group includes women with PCOS and control group includes women without PCOS. The entire data is statistically analysed using statistical package for social sciences (SPSS ver 22.0, IBM Corporation, USA) for MS Windows.Results: Out of 108 IVF conceived pregnant women studied, 50% were PCOS (study group) and 50% non PCOS (control group). We have compared maternal and neonatal outcome in both the groups which shows patient in PCOS group has higher incidence of GDM, severe pre-eclampsia, preterm labour, LBW babies, SGA babies and babies admitted to NICU.Conclusions: Women with PCOS should be given notice of additional adverse pregnancy outcomes as well receiving early diagnosis and treatment for these complications during pregnancy and postpartum period

    M├╝llerian duct cyst misdiagnosed as ovarian cyst: a rare case report

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    The M├╝llerian duct cyst is a remnant of the caudal ends of the fused embryologic paramesonephric ducts (or M├╝llerian ducts). Preoperative distinction of ovarian cyst from a M├╝llerian duct cyst is important and is based on visualization of the ipsilateral ovary separate from the mass. M├╝llerian duct cysts may also be mistaken as paratubal, paraovarian or peritoneal inclusion cysts and hydrosalpinx. Thus, preoperative diagnosis of M├╝llerian cyst of the uterus can be very challenging. However, with increased awareness, preoperative diagnosis of this condition should be possible by sonography. Laparoscopy is useful as a minimally invasive treatment to diagnose as well as resect the cyst at the same time. We present a rare case of M├╝llerian duct cyst misdiagnosed as ovarian cyst pre-operatively and managed laparoscopically. A 32 year old multiparous female presented with the complaint of lump and dull aching pain in lower abdomen since three months. A cystic mobile mass measuring 6X7 cm with smooth surface which corresponded to 16 weeks gravid uterus size was palpated arising from pelvis. Her pelvic ultrasonography revealed a 7X7 cm unilocular thin walled simple cyst in right ovary suggestive of serous cystadenoma. Her CA-125 was 5.3 IU/ml. She was taken up for laparoscopic ovarian cystectomy. Intra-operatively, a 7X7 cm cyst was seen arising from right lateral wall of uterus. Histopathology showed the cyst wall features consistent with a M├╝llerian duct cyst

    Antibiotic prophylaxis in cesarean sections: a tertiary care hospital based survey

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    Background: The objective of the study was to study the pattern of prophylactic antibiotics usage in caesarean sections in Indian settings.Methods: A cross-sectional observational study was done on women undergoing elective and emergency caesarean sections in the Department of obstetrics and gynecology who were given antibiotics according to the existing trends in the hospital.Results: Almost 72% women received prophylactic antibiotics within 30-60 minutes of skin incision while rest 28% received it before 60 minutes. In post-operative period around 80% of the women received injectable antibiotics for 48 hours, 12% for 72 hours and rest 8% received antibiotics for more than 72 hours. 90% of the patients received injections ceftriaxone 1 gm IV BD, gentamycin 80 mg IV BD metronidazole 400 mg iv TDS while 10% received injection Ampicillin 500 mg QID along with Injection Metronidazole 400 mg iv TDS and injection gentamycin 80 mg IV BD. Two percent of the cases developed wound sepsis and required change to higher antibiotics.Conclusions: In spite of recommendations by International Guidelines for single dose of prophylactic antibiotics, multiple doses are being given. There are no Indian guidelines for antibiotic prophylaxis in cesarean sections and as a result, various combinations of antibiotics are being given for variable duration leading to antibiotic resistance and increased cost of treatment

    Prevalence and clinical utility of sperm DNA fragmentation index in couples with unexplained infertility

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    Background: Worldwide increased burden of infertility has built up stress in reproductive age group couples. Female factor evaluation and┬ásemen analysis are carried out routinely in infertility work up. As per the recent observations, males with normal semen analysis may have abnormal sperm DNA fragmentation index (DFI). Thus, rendering semen analysis with poor diagnostic value in unexplained infertility cases. There is lack of adequate literature on prevalence of abnormal DFI in unexplained infertility. This study is directed to contribute to the literature by assessing┬áprevalence of┬ácouples with ÔÇśunexplained infertilityÔÇÖ having DFI&gt;15% in male partners.┬áMethods: After getting approval from institutional ethical and scientific research committee, 200 couples with unexplained infertility were recruited for the study and┬ásperm DFI using sperm chromatin dispersion (SCD) test (Halo test) was done.┬áResults: Out of┬á200 subjects,┬á54%┬áwere having low DFI,┬á32% were having moderate DFI┬áand 14% were having high DFI.Conclusions: Many couples diagnosed as unexplained infertility according to traditional diagnostic methods has remarkably high degrees of fragmented sperm DNA. Identification of such couples provide vital information and better therapeutic options can be offered to them to achieve best reproductive outcomes

    Influence of a magnetic field on the flow of a micropolar fluid sandwiched between two Newtonian fluid layers through a porous medium.

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    The present problem is concerned with the flow of micropolar/Eringen fluid sandwiched between two Newtonian fluid layers through the horizontal porous channel. The flow in both the regions is steady, incompressible and the fluids are immiscible. The flow is driven by a constant pressure gradient and a magnetic field of uniform strength is being applied in the direction perpendicular to the flow. The flow of electrically conducting fluids, in the three regions, is governed by the Brinkman equation with the assumption that the effective viscosity of each fluid is the same as the viscosity of the fluid. No-slip conditions at the end of the plates, continuity of velocity, continuity of shearing stress and constant rotational velocity at the interface have been used as the boundary conditions to get the solution of the problem considered. The numerical values of the solution obtained are used to analyse the effect of various transport parameters, such as permeability of porous region, magnetic number, viscosity ratio etc. on the velocity profile and micro rotational velocity profile graphically. Also, the variations in the flow rate and the wall shear stress, with respect to the governing parameters, are presented in tabular form

    A rare case of primary infertility with bilateral agenesis of medial part of fimbrial end with hypoplasia of fimbria and absence of fimbria ovarica with septate uterus with bilateral normal ovaries

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    Patients with infertility frequently present with associated congenital genital anomalies affecting around 5-6% of patients. Most of these patients have anomalies associated with uterus, cervix and vagina which have been extensively studied through time. The exact association of abnormalities of fallopian tube to infertility is still unknown due to the limited data available. The true incidence of congenital fallopian tube anomalies is unknown because abnormalities may be subtle and are often overlooked or thought to be due to acquired or iatrogenic causes. While reviewing the literature, we observed that partial or complete agenesis of the fallopian tube is rarely reported. They are usually incidental diagnosis on laparoscopy done for some other purposes. Due to rarity of such cases, their effect on fertility and its management is still a challenge. Here, we present a case report of septate uterus with bilateral fimbrial agenesis and normal ovaries in a patient of primary infertility. 

    Zrównoważone źródła utrzymania Fundacji Rozwoju Obszarów Wiejskich jako droga do zrównoważonego rozwoju

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    The primary objective of this study is to evaluate and analyse the significance of the Sustainable Livelihoods Approach (SLA) and its application to rural development projects and policies. A literature review is conducted, with the primary focus being on the primary components of the SLA. The researchers noted that the SLA effectively interrogates the livelihoods of the poor and the various mechanisms in the approach. These mechanisms include all forms of capital, the vulnerability aspect, livelihood strategies, and outcomes, as well as the different laws and regulations governing the access and use of resources. The research also noted that the SLA effectively addresses the poorÔÇÖs vulnerabilities. Scholarly heavy hitters like Chambers and Scoones (1992) have pointed out that this method is all-encompassing and hierarchical. The methodology has demonstrated in a theoretical sense that it is beneficial in understanding the livelihoods problem of the less fortunate in rural communities. It is strongly suggested that the government and its development partners adopt and incorporate the SLA into their policies to ensure sustainable livelihoods leading to sustainable development.G┼é├│wnym celem tego badania jest ocena i analiza znaczenia zr├│wnowa┼╝onych ┼║r├│de┼é utrzymania (SLA) i ich zastosowania w projektach i politykach rozwoju obszar├│w wiejskich. Przegl─ůd literatury skupia si─Ö przede wszystkim na g┼é├│wnych sk┼éadnikach umowy SLA. Zauwa┼╝ono, ┼╝e SLA skutecznie bada ┼║r├│d┼éa utrzymania ubogich i r├│┼╝ne mechanizmy w tym podej┼Ťciu. Mechanizmy te obejmuj─ů wszystkie formy kapita┼éu, aspekt podatno┼Ťci na zagro┼╝enia, strategie utrzymania i wyniki, a tak┼╝e r├│┼╝ne prawa i regulacje reguluj─ůce dost─Öp do zasob├│w i korzystanie z nich. W badaniu zauwa┼╝ono r├│wnie┼╝, ┼╝e umowa SLA skutecznie eliminuje s┼éabe punkty biednych. Badacze, tacy jak Chambers i Scoones (1992), zwr├│cili uwag─Ö, ┼╝e ta metoda obejmuje ca┼éo┼Ť─ç problematyki i jest hierarchiczna. Od strony teoretycznej wykazano, ┼╝e jest ona korzystna dla zrozumienia problemu ┼Ťrodk├│w do ┼╝ycia os├│b mniej szcz─Ö┼Ťliwych w spo┼éeczno┼Ťciach wiejskich. Stanowczo zaleca si─Ö, aby rz─ůd i jego partnerzy rozwojowi przyj─Öli i w┼é─ůczyli umow─Ö SLA do swoich polityk w celu zapewnienia zr├│wnowa┼╝onych ┼║r├│de┼é utrzymania prowadz─ůcych do zr├│wnowa┼╝onego rozwoju

    PHARMACOVIGILANCE IN THE ERA OF COVID-19: A CONCISE REVIEW OF THE CURRENT SCENARIO, IMPLICATIONS, AND CHALLENGES

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    The pandemic of Coronavirus Disease 2019 (COVID-19) has now affected the entire globe which was first surfaced in China in December 2019. In absence of effective therapy to manage COVID-19, repurposed therapies were being used to manage the condition. In view of an urgent need for definitive therapy, multiple repurposed drugs, and investigational drug candidates are being tried in clinical trials which may lead to the emergence of unknown short term and long term adverse drug reactions (ADRs), and hence it is crucial to assess the safety of the tried therapeutic interventions. The lag in the pharmacovigilance activities in the midst of this pandemic fosters under-reporting of ADRs. Difficulty in causality assessment due to factors like wide variations in clinical presentation, concomitant use of multiple drugs, associated comorbidities, drug-drug and drug-disease interaction which forestalls the appropriate causality assessment. Hydroxychloroquine, a repurposed antimalarial drug has been a part of hue and cry at present because of its in-question safety in patients with cardiac disorders. National and International Drug monitoring centers have stressed upon reporting of ADRs and to boost up the process and come up with various recommendations. We can overcome these issues by working cohesively, motivating HCPs and patients to report ADRs electronically, and by setting up dedicated pharmacovigilance rapid response team to tackle the issues at the earliest
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