A Critical Study Of Right To Equality Under Indian Constitution With Judicial Decision

For writing this research paper null hypothecation are taken and critical approach and study done. In this present scenario Right to Equality under Indian Constitution are given Art. 14 to 18.Every person is equal under Indian Constitution and he should be treated equally and non-discrimination on the basis of religion, caste, race, place of birth. But state government can make special provision for women and children, scheduled caste, scheduled tribes and backward classes. In Indian constitution there is some provision for upliftment for Scheduled tribe, scheduled caste, backward classes, women and children so there is flexibility in Right to Equality provision. This is very important articles of Indian Constitution

Perinatal lethal skeletal dysplasia: a case report

The word dysplasia originates from ancient Greek words dys (anomalous) and plasia (formation). Skeltal dysplasia (SD) is a heterogeneous group of congenital anomalies characterized by abnormalities in the development of the bone and cartilage tissue. This results in mark disproportion of the long bones, the spine and fetal head relation to the trunk. Perinatal lethal skeletal dysplasia leads to still birth or early neonatal death due to pulmonary hypoplasia. 30 yrs old G3P3L2 at 32 weeks presented with leaking per vaginum. Her serial scan was done as she had previous stillborn male child with short limbs. Her antenatal scan revealed short limbs from 24 weeks. From18 weeks to 24 weeks she did not underwent any sonography. She went into spontaneous labor and delivered still born male baby with clinical and radiological features suggestive of skeletal dysplasia. Skeletal dysplasia can be diagnosed on antenatal 2 D ultrasound from 14 - 16 weeks onwards. Prenatal genetic testing should be done to diagnose the genetic anomaly and patient should be referred to higher institute for this test. Even if genetic test not done even then termination of pregnancy should be considered based on ultrasound diagnosis especially with family history because of poor fetal prognosis and long term morbidity if survived

Direct and indirect impact of COVID-19 pandemic on maternal mortality at tertiary care institute of north India

Background: During COVID-19 pandemic, healthcare services and infrastructures have been utilized primarily in screening and management of COVID-19 infected patients that might have compromised routine antenatal health care services especially in low- and middle-income countries. This study was planned to know impact of COVID-19 pandemic on antenatal care and maternal mortality at our institute. Methods: This retrospective cohort study compared labour room and maternal mortality statistics before (group ‘A’) and after declaration of COVID-19 pandemic in our country (group ‘B’). One year data (from 1st April, 2019 to 31st March, 2020) before declaration of lockdown in India on 24th March, 2020 was compared with (group ‘B’) data of 1 year after first nation wise lockdown (from 1st April, 2020 to 31st March 2021). Outcomes which were studied included impact on Institutional delivery, cesarean section and still birth rate along with maternal mortality ratio and its causes in both the groups. Modifiable factors such as level-I, level-II, and level-III delay were also considered. Results: There was 66% decline (fall from 5867 before to 1985 during pandemic) observed in institutional delivery, statistically significant rise observed in still birth (p=0.0030) and cesarean section rate (p=0.0007) during pandemic. Maternal mortality ratio (MMR) increased from 649 to 1786 per one lac live birth (64% rise, p=0.0001) during COVID-19 pandemic. Demographic profiles of deceased women were comparable between both the groups. Hypertensive disorder of pregnancy remained the leading direct cause of maternal mortality. COVID-19 associated maternal mortality observed during second wave of pandemic. Delay in seeking care remains the leading indirect cause of maternal mortality like before (23/38,61% versus 21/35,60%, p=1 before and during pandemic). Conclusions: COVID-19 pandemic resulted in fall in institutional delivery and rise still birth rate and maternal mortality ratio. Gestational hypertension remained the leading cause of maternal mortality during COVID-19 pandemic. Type 1 delay was the leading modifiable factor of maternal mortality before and during pandemic. Hence, it is recommended to strengthen health care services at primary health centers and redeployment of staff involved in obstetrical care should be strictly abandoned for timely care and referrals of complicated cases from peripheral health center

Is it safe to use intravenous iron sucrose during pregnancy? A randomized controlled trial

Background: To compare the efficacy and safety of intravenous iron sucrose to oral iron in the treatment of iron deficiency anemia in pregnancy.Methods: In this randomized trial 200 pregnant women with hemoglobin between 7g/dl and 9g/dl and serum ferritin <15 ng/ml received either iron sucrose or oral iron sulphate. The iron sucrose dose was calculated from the following formula: weight (kg) x (110 g/l – actual hemoglobin (g/l) x 0.24 + 500mg. Treatment efficacy was assessed by clinical and laboratory response on 2nd week, 4th week of therapy, after that 4th weekly till delivery.Statistical analysis was done with paired and independent samples “t” test applied. Hemoglobin measurements were analyzed by repeated- measures of analysis of variance with Huynh and Feldt corrections. Serum ferritin measurement across the time within each group was analyzed by two sample test with equal variance .Adverse drug reactions, fetal weight, blood transfusions were also recorded.Results: The significant rise in hemoglobin from 8.0 ± 0.79gm/dl to10.80± 0.61gm/dl in intravenous group as compared to oral iron group from 8.19 ± 0.60gm/dl to 9.86± 0.61 gm/dl was seen at 4th week of treatment (P = 0.000).After 2 week of treatment rise in serum ferritin values were higher in intravenous group from 6.25± 1.05 ng/ml; to 155.33± 57.4 ng/ml and in oral group from5.71± 1.71ng/ml to20.8 ±9.5 ng/ml ( p=.000 ).No serious adverse drug reactions were observed in intravenousgroup. Conclusion: Iron sucrose is safe to use during pregnancy. It raises hemoglobin and restores iron stores faster than oral iron

Pseudo-Meigs syndrome: a rare presentation of pedunculated fibroid

Serosal fibroid of uterus are usually asymptomatic but rarely; it may present with atypical symptoms to simulate malignancy and needs extensive evaluation. Authors are reporting a case of 26 years old P1L1 female with history of asymptomatic multiple intramural fibroids since 6 years came with complained of progressively increasing abdominal distension and mild pain abdomen from 2-3 months. On evaluation, she had ascites, pleural effusion and raised Ca-125. MR imaging of pelvis revealed moderate ascites and pedunculated serosal fibroid in addition to intramural fibroids with normal bilateral ovaries. She was evaluated to rule out uterine sarcoma and tuberculosis but diagnosis of them could not be established. Finally, conclusion of Pseudo-Meigs syndrome was made. Myomectomy of single pedunculated fibroid relieved her symptoms. Though, subserosal fibroids are benign in pathology, timely surgery is must to avoid morbidity and mortality owing to massive ascites and pleural effusion

Maternal complications in twin pregnancy; recent trends: a study at a tertiary care referral institute in Northern India

Background: This study aims to determine the maternal complications in twin pregnancy in North Indian population at tertiary institute.Methods: This was a retrospective cohort review of multiple pregnancies after 20 weeks gestation at a tertiary teaching hospital (2011-2015). Maternal data was collected from the labor room delivery data entry register and patient’s admission file. Patients with diabetes mellitus and chronic hypertension were excluded from the study.Results: Out of 19539 births during this period, 432 were twin pregnancies with an incidence of 22/1000 birth. Most of them were 282 (65.4%) were referred patients. Eighty seven percent patients were in the age group of 21-30 years and primigravida contributed to 45.7% of total patients. Maternal complications noticed were as preterm deliveries in 304 (70%), anaemia in 259(60%) patients, preterm rupture of membranes in 120 (39.4%) patients, hypertensive disorders of pregnancy in 122(28.3%) patients, cholestasis of pregnancy in 24(5.5%) of patients, hypothyroidism in 22(5.1%) of patients, antepartum hemorrhage (APH) in 20(4.6%) and gestational diabetes mallitus (GDM) in 08(1.8%) of patients. Among postpartum complications, atonic postpartum haemorrhage (PPH) was observed in 44 (10.2%) and maternal mortality happened in 02(0.46%) cases.Conclusions: This study reveals higher percentage of, preterm labor, anaemia, and gestational hypertension than other studies. More number of intensive care unit should be established in high prevalence areas to prevent perinatal mortality due to prematurity. Treatment of anaemia requires more aggressive approach by considering intravenous iron whenever compliance is in doubt. Frequent antenatal care is required for early diagnosis of these complications to prevent maternal and fetal morbidity

Chronic non-puerperal incomplete uterine inversion

Chronic non-puerperal uterine inversion is an extremely rare diagnosis especially in younger women. The diagnosis commands high level of clinical suspicion supplemented with imaging. An emergency admission of a 35-year-old para 1 with submucosal fundal fibroid presenting with excessive menstrual flow with hemodynamic instability requiring multiple blood transfusions is presented. On abdominal examination slight suprapubic tenderness was made out with no palpable mass. Bimanual examination revealed a non-pediculated mass in upper vagina with a circular constriction around it. On ultrasound, cupping of fundus suggested uterine inversion. Pelvic MRI reaffirmed the findings of a highly vascularized intracavitary leiomyoma protruding through the cervix. After optimization patient underwent myomectomy and Haultain’s procedure followed by total abdominal hysterectomy with bilateral salpingectomy. Post-operative period was uneventful. Inversion is generally associated with fundal fibroid polyp but can rarely follow submucosal leiomyoma. Imaging helps preoperative planning of management

Umbilical cord cyst: a diagnostic dilemma

Umbilical cord cyst refers to any cystic lesion associated with the umbilical cord. Cord cysts can be defined as true or false cysts and may occur in any location along the cord. They are irregular in shape and are located between the cord vessels. Authors are reporting the case of an infant with an umbilical cord tumor which had twice been misdiagnosed previously as a hemangioma, based on ultrasound image of its cystic and solid component with good vascular supply. The ultrasound image most likely suggestive of a hemangioma as a differential diagnosis led to caesarean section in our patient (based on large size of the lesion and fear of rupture of same during process of labour). The definitive diagnosis was made only after birth of the baby. Final diagnosis of true umbilical cord cyst was made after histopathological examination. Thus, there can be confusion in the diagnosis between umbilical cord hemangiomas and umbilical cord cysts based on ultrasound

A Study to Assess the Effectiveness of Abdominal Breathing Exercise in Reduction of Blood Pressure Among Hypertensive Patients in Selected Hospitals at Bhopal

Background: Abdominal breathing exercise is one among these. It reduces blood pressure by increasing baroreflex sensitivity and reducing sympathetic activity and chemo reflex activation. In India, it is reported that there are around 42% people are with pre hypertension, 15% are newly diagnose to have Hypertension and 31% are with known case of hypertension, and it kills nearly 8 million people every year worldwide. The noncompliance with treatment, stress and life style are found to be major reason for this doubling of disease within a decade, there “arises need for new therapies ‘and’ remedies. Objectives: The study aimed to assess the effectiveness of abdominal breathing exercise in reducing mean blood pressure among hypertensive patients. Methods: Pre-experimental one group pre-test – post-test design was adopted for the study. 60 hypertensive patients from male and female medical general ward had been selected by convenient sampling. Tool comprised of Demographic proforma contained 9 items and sphygmomanometer, stethoscope and blood pressure monitoring table contained 3 items to record the readings. The reliability of the tool was tested by inter-rater method and it was found to be r = 0.99. Abdominal breathing exercise was administered to the samples after pre-assessment of mean blood pressure for ten minutes and post assessment of mean blood pressure is done at the gap of 5 minutes which is repeated 3 times a day and monitored for minimum of 3 days. ‘t’ test was used for finding the effectiveness, and Chi square test was used for finding out the association between mean blood pressure and selected demographic variables. Results: It revealed that the mean differences in pre and post assessment was5.61 and ‘t’ value was 19.39 which is more than the ‘t’ table value. The overall findings of the study revealed that the Conclusion: the study concluded that abdominal breathing exercise is found to be very effective in reducing the mean blood pressure

Perinatal lethal skeletal dysplasia: a case report

The word dysplasia originates from ancient Greek words dys (anomalous) and plasia (formation). Skeltal dysplasia (SD) is a heterogeneous group of congenital anomalies characterized by abnormalities in the development of the bone and cartilage tissue. This results in mark disproportion of the long bones, the spine and fetal head relation to the trunk. Perinatal lethal skeletal dysplasia leads to still birth or early neonatal death due to pulmonary hypoplasia. 30 yrs old G3P3L2 at 32 weeks presented with leaking per vaginum. Her serial scan was done as she had previous stillborn male child with short limbs. Her antenatal scan revealed short limbs from 24 weeks. From18 weeks to 24 weeks she did not underwent any sonography. She went into spontaneous labor and delivered still born male baby with clinical and radiological features suggestive of skeletal dysplasia. Skeletal dysplasia can be diagnosed on antenatal 2 D ultrasound from 14 - 16 weeks onwards. Prenatal genetic testing should be done to diagnose the genetic anomaly and patient should be referred to higher institute for this test. Even if genetic test not done even then termination of pregnancy should be considered based on ultrasound diagnosis especially with family history because of poor fetal prognosis and long term morbidity if survived