Serrated Sickle for Reducing the Drudgery of Farm Women in Mehsana District, North Gujarat

Most of the works performed by farm women are tedious as well as time consuming. Also many of these operations are traditionally done in varying body, which if done for long duration cause inconvenience and body pain. Hence, a study was conducted on testing and evaluation of serrated sickle made by CIAE, Bhopal. Farm woman is participatory mode of reduce their drudgery. It was observed during the course of investigation that farm women were using desi sickle while harvesting their crops. The labour requirment by using serrated sickle was 16 labour/ha as against the harvesting by lockle sickle 18 labour/ha

Study of role of blood transfusion in obstetric emergencies

Background: Blood Transfusion is recognized as one of the eight essential component of comprehensive emergency obstetric care which has been shown to reduce the maternal mortality.1,2 In developing country like India, efforts should be done to make blood and transfusion services well maintained and quickly available to reduce maternal morbidity from haemorrhage and thus decrease the incidence of maternal mortality. Aims & objectives: (1) To study clinical status of the patients at time of admission. (2) To study the role of antenatal visits in all patients required blood transfusion. (3) To study the effect of blood components on the patients’ health. (4) To screen out the patients of high risk pregnancy and treat them safely. (5) To study causes of maternal mortality.Methods: Retrospective study of requirement of blood transfusion in antenatal and postnatal patients who came in labour room during last 3 month period at tertiary care Centre, Ahmedabad.Results: during the whole study out of 2200 patients 440 patients required blood transfusion among which 70% required due to obstetric hemorrhage and 30% due to severe anemia (less than 7 gm/dl). Major associated complications in the transfused patients were anemia (34%) and PPH (36%). 4 patients expired among them 2 were due to development of DIC and septicemia, 1 due to severe anemia and 1 due to severe PPH.Conclusions: Ensuring a safe supply of blood and blood products and the appropriate and rational clinical use of blood. Strategies made to maximize the haemoglobin (Hb) level at the time of delivery as well as to minimize blood loss. Active management of the third stage of labour is required to prevent avoidable morbidities, such as PPH, Retained product of conception, and vaginal lacerations.

Equivalent Mid-Term Results of Open vs Endoscopic Gluteal Tendon Tear Repair Using Suture Anchors in Forty-Five Patients.

BackgroundLittle is known about the relative efficacy of open (OGR) vs endoscopic (EGR) gluteal tendon repair of gluteal tendon tears in minimizing pain and restoring function. Our aim is to compare these 2 surgical techniques and quantify their impact on clinical outcomes.MethodsAll patients undergoing gluteal tendon tear repair at our institution between 2015 and 2018 were retrospectively reviewed. Pain scores, limp, hip abduction strength, and the use of analgesics were recorded preoperatively and at last follow-up. The Hip disability and Osteoarthritis Outcome Score Junior and Harris Hip Score Section1 were obtained at last follow-up. Fatty degeneration was quantified using the Goutallier-Fuchs Classification (GFC). Statistical analysis was conducted using one-way analysis of variance and t-tests.ResultsForty-five patients (mean age 66, 87% females) met inclusion criteria. Average follow-up was 20.3 months. None of the 10 patients (22%) undergoing EGR had prior surgery. Of 35 patients (78%) undergoing OGR, 12 (27%) had prior hip replacement (75% via lateral approach). The OGRs had more patients with GFC ≥2 (50% vs 11%, P = .02) and used more anchors (P = .03). Both groups showed statistical improvement (P ≤ .01) for all outcomes measured. GFC >2 was independently associated with a worst limp and Harris Hip Score Section 1 score (P = .05). EGR had a statistically higher opioid use reduction (P < .05) than OGR. Other comparisons between EGR and OGR did not reach statistical significance.ConclusionIn this series, open vs endoscopic operative approach did not impact clinical outcomes. More complex tears were treated open and with more anchors. Fatty degeneration adversely impacted outcomes. Although further evaluation of the efficacy of EGR in complex tears is indicated, both approaches can be used successfully

Importance of parenteral iron sucrose therapy in correction of iron deficiency anemia during pregnancy

Background: Iron deficiency anemia (IDA) is described as decrease in the hemoglobin and/or the amount of red blood cells in the blood due to iron insufficiency in the body. The aim of the study was to measure the efficacy and tolerability of iron sucrose   in iron deficiency anemia in pregnant women.Methods: This was the prospective study of 50 pregnant women with iron deficiency anemia (Hb- 5 g/dl to 8 g/dl) between 20-34 weeks of gestation, who were given intravenous iron sucrose as per their requirements and follow up measurement of Hb was done.Results: Mean rise in Hb was seen by 2.2 g/dl. Minor side effects were seen in 6 out of 50 participants.        Conclusions: Parenteral iron sucrose therapy can be used effectively and safely in pregnant women with iron deficiency anemi

A study of role of doppler in gestational hypertension and perinatal outcome

Background: Hypertensive disorder of pregnancy is one of the most common complications that affect the human pregnancy. Hence it is important to identify women at risk of developing gestational hypertension or preeclampsia, its early diagnosis and subsequent consequences due to uteroplacental insufficiency with help of Doppler ultrasound, to improve perinatal outcome. The objective of this study was to study the application of Doppler ultrasound with analysis of blood flow velocity waveform in gestational hypertension and to examine and study the perinatal outcome in pregnancy with altered Doppler indices.Methods: A prospective study was carried out in 50 antenatal patients diagnosed to have gestational hypertension during a period of 12 months to evaluate the role of color Doppler imaging in gestational hypertension in patients more than 28 weeks of gestation, the initial scan was performed immediately after the diagnosis. This study analyzed the blood flow in umbilical artery, maternal uterine artery and fetal middle cerebral artery using Doppler ultrasound.Results: In this study approximately 76% of cases were found in 20-30 years group. 58% showed abnormal umbilical artery Doppler while 42% women had normal umbilical artery Doppler. In this study 23 cases had cerebro-placental index 1. Cases with cerebro-placental index <1 had various complications like preterm delivery, low birth weight, increased chances of still birth, intra uterine death (IUD), increased NICU admission. In this study 31 cases had abnormal uterine artery Doppler which accounts for 62% of total cases, while 38% had normal uterine artery Doppler.Conclusions: Doppler ultrasound can reliably predict any adverse fetal outcome in hypertensive pregnancies and can be a useful tool for decision making in appropriate timing of intervention for delivery

Role of doppler in fetal growth restriction

Background: Fetal growth restriction is an important and particularly challenging problem for modern obstetricians and paediatricians. The present study is to correlate the importance of Doppler velocimetry and perinatal outcome in cases of growth restricted foetuses by comparing perinatal outcome of control & study groups with normal and abnormal Doppler waveforms.Methods: A study and a control group comprising of 50 pregnant women having growth restricted foetuses in each group was matched for all other confounding factors except for Doppler changes. These patients were followed up and the perinatal outcomes of FGR foetuses having Doppler changes was compared with those having normal Doppler studies.Results: In our study, alteration in both MCA and UmbA Doppler was associated with perinatal morbidity and NICU admissions in 64% and mortality in 28%. Doppler changes showing altered CPR less than 1 had adverse outcome with NICU admission in 61% and mortality in 34%. Alteration in DV Doppler was associated with perinatal morbidity and NICU admissions in 17% cases and mortality in 83% cases, with no pregnancies having a healthy outcome. Among high-risk pregnancies with suspected IUGR, the use of Doppler assessment significantly decreases the likelihood of labor induction, caesarean delivery, and perinatal deaths.Conclusions: Abnormal Doppler waveform changes indicate adverse perinatal outcome of pregnancies with FGR. Doppler study helps to reduce perinatal mortality and morbidity by timely and appropriate interventions

Caesarean section in a tertiary care centre

Background: Caesarean section constitutes a major surgical procedure characterized with morbidity even if it is performed a planned procedure. Postoperative infection in obstetrics continues to affect the practice of every surgeon. Infection can cause an increase in patient’s stay in the hospital, create discomfort, cause disfigurement and lead to morbidities to the patient. Thus, preventive measures need to be constantly evaluated and updated and hence authors have to study and analyse prevalence of postoperative infectious morbidities.Methods: The study was conducted in an Urban Based Medical College Hospital in Ahmedabad. It was a retrospective cross-sectional study of 50 cases of patients who suffered infectious complications post caesarean from 1st March 2019 to 31st March 2020.Results: The prevalence rate of surgical site infection in my study is 5.9% whereas of post-operative puerperal sepsis is 0.6%, of post-operative urinary tract infection is 1.09%, of post-operative breast abnormalities is 0.16%. The most common infectious morbidity amongst all was surgical site infection (surgical site) infection and its prevalence was 5.9%.Conclusions: The development of post-operative infection is an important event that can be prevented by taking proper precautions and following prescribed guidelines. There should be specific use of antibiotics in the post-operative period. In the event of early signs of sepsis antibiotics should be administered properly as per culture sensitivity report. The decrease in infection rate also indirectly reduce the health costs involved in treating them post operatively

Fetomaternal outcome in pregnancy with oligohydramnios

Background: Oligohydramnios has been correlated with increased risk of FGR, meconium aspiration, birth asphyxia, low APGAR scores and congenital anomalies. Early detection of oligohydramnios and its management may help in reduction of perinatal morbidity and mortality. The aim and objectives of the study was to study the effect of oligohydramnios on fetal outcome in form of FGR, fetal distress, altered APGAR scores, NICU admission and early neonatal morbidity and mortality and to study maternal morbidity in the form of operative delivery and induced labour.Methods: 100 patients in third trimester of pregnancy with oligohydramnios confirmed by ultrasound measurement of AFI were selected randomly after satisfying inclusion and exclusion criteria.Results: Incidence of oligohydramnios and operative intervention for the same was seen more in primipara (52%). Most common causes of oligohydramnios were idiopathic (52%) followed by PIH (25%). Operative morbidity was highest in PIH (60%). Most common indication of caesarean section was fetal distress due to cord compression or FGR. 7% patients had fetoplacental insufficiency on Doppler study.Conclusions: Oligohydramnios demands intensive fetal surveillance and proper antepartum and intrapartum care. Due to high rates of intrapartum complications, perinatal morbidity and mortality, rates of caesarean section are rising, but decision between vaginal delivery and caesarean section should be well balanced so that unnecessary operative morbidity is prevented without jeopardizing the fetal well-being

Role of iron sucrose infusion in correction of iron deficiency anemia during pregnancy

Background: Iron deficiency anemia (IDA), is defined as decrease in the amount of red blood cells (RBCs) or hemoglobin in the blood due to insufficient iron in the body. We carried out this study to measure the efficacy of iron sucrose in iron deficiency anemia in pregnant women.Methods: In our prospective study 100 patients were included. All of them were having USG maturity between 15-34 weeks. All of them were given iron sucrose IV according to their requirements and follow-up was taken after 4 weeks by measuring Hb level.Results: Hb level improved significantly (2.1 grams) within a short duration of interval. 14% patients suffered from minor side effects.Conclusions: Iron sucrose has been found very useful for correction of iron deficiency anemia in antenatal patients