Seroprevalence of human immunodeficiency virus and various risk factors responsible for spread of human immunodeficiency virus in pregnant women in Jammu, India

Background: Human immunodeficiency virus (HIV) is increasing at an alarming rate among pregnant women in various parts of India. Purpose of present study is to investigate the seroprevalence of HIV infection in Jammu region of India and to trace various risk factors responsible for its spread. Another objective is to look for strategies which can be adapted to curtail transmission of this dreadful infection.Methods: Pregnant women attending the antenatal clinic of Government Medical College and Hospital, Jammu (India) from October 2013 to September 2014, were counseled and those who agreed to undergo testing, were subjected to HIV testing by ELISA method. Pre-designed and post-testing questionnaire was used for collecting the data. In addition, all the unbooked HIV positive patients, who were directly admitted in labor ward and delivered in this hospital during this period, were also included in the present study.Results: Out of 17918 women attending the antenatal clinic, 5695 agreed for HIV testing at ICTC (integrated counseling and testing center), SMGS hospital and only 5 cases were confirmed positive. Prevalence rate of HIV positivity was found to be 0.088%. Majority of women were between 21-25 years of age, primigravidas, from rural background, lower middle class and spouses of laborers/drivers.Conclusions: Seroprevalence of HIV in Jammu region is relatively low when compared to the national figures. More attention is to be focused on the risk factors to control the transmission of HIV infection

Thrombocytopenia in pregnancy in a tertiary care hospital: a retrospective study

Background: To investigate the etiology, obstetrical risk factors, complications and outcomes of pregnancies affected by thrombocytopenia.Methods: A retrospective surveillance study was conducted on the basis of hospital records of 1532 women who delivered during a period of one year, in Christian Medical College and Hospital, Ludhiana, India. Clinical data including basic history, physical examination and investigations of those women who had thrombocytopenia, was evaluated and compiled into three groups depending upon the etiological factors.Results: Sixty four of 1532 women (4.2%) had thrombocytopenia of varying severity. 77.8% of these women had gestational thrombocytopenia (GT) as the commonest cause. Pregnancy specific hypertension and HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) accounted for 20.6% cases whereas in 3.2% of pregnant women, idiopathic thrombocytopenic purpura (ITP) was the causative factor. A higher rate of IUGR (Intrauterine growth restriction), placental abruption and labor induction was noted among those gravidas who had moderate to severe thrombocytopenia. Maternal mortality, bleeding complications and adverse perinatal outcomes were not seen in this study.Conclusions: Commonest cause of thrombocytopenia in pregnancy is GT, followed by preeclampsia, eclampsia and HELLP syndrome. ITP is a rare cause of this disorder in pregnancy. Early detection and treatment of expected complications is the key focus in management of such cases

Outcome of transforaminal nerve root block using posterolateral approach in patients with low back ache due to PIVD in a tertiary care centre of North India

Background: Back ache has become a common phenomenon in our society, reason being our sedentary and unhealthy lifestyle. Transforaminal administration of steroid and analgesia is an important modality in the conservative management of prolapsed lumbar disc. The aim of this study is to assess functional outcome of transforaminal epidural analgesic injection in cases of chronic back pain due to prolapsed intervertebral disc.Methods: 152 patients who fulfilled the inclusion and exclusion criterias were given the block and were compared pre and post injection using ODI score.Results: Most patients in study were in fourth or fifth decade and had complained of pain for more than a year. L4-L5 was found to be the most common level involved. Post injection 129 patients out of 152 reported minimal pain and most of the patients reported improvement in pain post block.Conclusions: We concluded that tranforaminal block is an effective method of achieving pain relief in most patients for some duration and can help in delaying and in some cases avoiding the need for surgery

MANAGEMENT OF GRAHANI ROGA WITH TAKRA AND ASHVAGOLA: A REVIEW

Diseases emanating from GIT form a considerable part of medical practice in India and abroad. Starting from ancient time to the modern era, Grahani Dosha has remained a fore runner but has also behaved like the fountain head of many GIT ailments. The faulty lifestyle, wrong food habits and busy schedules with abnormal-stressed lifestyle, changed eating habits and their patterns, inadequate sleep and non-observance of daily regime, seasonal regime, night regime and Sadvritta are the reasons for growing metabolic diseases in society. Due to improper digestion of food, there is vitiation of the Dosha and Agni and symptoms like alternate Constipation and Diarrhoea, with associated symptoms are seen, which can be collectively called as Grahani Roga. All the renowned physician of Ayurveda has given an account of treatment modalities for Grahani Roga. Among the different food habits and medicinal preparations, Takrasevan and Ashvabgola have been taken in this study. Takra having Ushna Veerya, Kashaya Rasa, Madhura Vipaka & Ruksha Guna pacifies Vata, Pitta, potentiates the Agni and digests as well as absorbs the food articles, and Ashvagola having Madhura Rasa, Sheeta Veerya and Madhura Vipaka is Vata Pittashamak and give bulk to the stool, relieving the symptoms and treating the disease in a generous way. This study is an attempt of the author to explain the effect of Butter milk and Ashvagola in Grahanidosha with the help of Ayurvedic Pharmaco-dynamics and other experimental studies.

Abnormal umbilical artery Doppler in third trimester and perinatal outcome: a retrospective study

Background: Umbilical artery Doppler (UAD) has the greatest impact in modern obstetric assessment in high risk pregnancies. The objective of this study was to evaluate the maternal characteristics and perinatal outcome in pregnancies complicated by abnormal umbilical artery Doppler.Methods: A retrospective study was designed to analyze the medical records of 50 singleton pregnant women who delivered in the labour ward of our institution from 1st July 2014 to 30th June 2015. The study population had abnormal umbilical artery Doppler velocimetry with varying degree of reduction in placental circulation. These patients were assessed for maternal complications and foetal outcome.Results: Results of present study revealed that majority of women who had abnormal placental Doppler flow were under 37 weeks of gestation (82%). Absent end diastolic flow was seen more in pre-eclampsia/ eclampsia (38%), gestational diabetes (19%) and oligohydramnios (52%) as compared to high systolic/diastolic (S/D) ratio. Higher incidence of abruption (25%), operative deliveries (50%), intrauterine deaths (25%) and still births (25%) was seen with increase in the severity of placental insufficiency. High frequency of pre-maturity (76%) was noticed in this study as a result of abnormal Doppler. Neonatal complications like jaundice, RDS (Respiratory distress syndrome), IVH (Intra-ventricular haemorrhage) and NEC (Necrotizing enterocolitis) were recorded in increasing trends in present study.Conclusions: Umbilical artery Doppler helps in the prediction of possible maternal and foetal complications in cases of compromised placental flow. Monitoring of antenatal parameters, availability of emergency facility for early surgical intervention and neonatal care pave a long way in curtailing perinatal morbidity and mortality

Knowledge, attitude and preferences of pregnant women towards mode of delivery in a tertiary care center

Background: Delivery mechanism is a spontaneous process and requires no intervention. Advances in medical technology in maternity care have drastically reduced maternal and infant mortality. Aim of the study was to determine maternal knowledge, attitude and preferences of pregnant women towards mode of delivery in a tertiary care center.Methods: This was a prospective study conducted on 100 antenatal women in third trimester who attended the antenatal clinic in Christian Medical College and Hospital, Ludhiana, Punjab from September 2015 to January 2016.The information regarding socio-demographic profile, obstetric history, knowledge and attitude statements towards vaginal and cesarean delivery was collected.Results: Total of 100 women was enrolled in the study. Out of these, majority (47%) had secondary education. Majority of the women (89%) interviewed had positive attitude towards vaginal delivery. High rate of cesarean section was seen in patients with primary and secondary infertility as they thought that babies born by cesarean section are healthier than those delivered by vaginal delivery. The most frequently mentioned source of information about mode of delivery was family and friends. Almost half of women agreed to the statement that vaginal delivery creates a more affectionate mother and baby relationship. Economic factors play an important role in deciding cesarean birth.Conclusions: Majority of pregnant women interviewed in our institution were keen to deliver vaginally, while the remaining women due to lack of knowledge or phobia of vaginal delivery wanted to undergo a cesarean section. Improving women’s knowledge about the risks and benefits of different modes of delivery can lead to a positive maternal attitude towards vaginal delivery

Evaluation of Expulsion and Continuation Rate of Immediate Postpartum Intrauterine Contraceptive Devices: A Prospective Hospital-based Study

Introduction: Family planning can avert nearly one-third of maternal deaths and 10% of child mortality when couples space their pregnancies more than two years apart. With increased institutional deliveries, Postpartum Intrauterine Contraceptive Devices (PPIUCD) can play an important role in addressing the unmet needs of spacing methods in India. Moreover, in this digital age, generalised awareness of the female population about contraception has increased considerably, so the acceptance and continuation rate might be high. Aim: To evaluate expulsion and continuation rate of immediate PPIUCDs at a tertiary care hospital in Haryana, India. Materials and Methods: The prospective, hospital-based study was conducted from October 2020 to September 2021 in the Department of Obstetrics and Gynaecology at Kalpana Chawla Government Medical College, Karnal, Haryana, India. Ninety women who underwent IUCD insertion within 10 minutes of delivery of the placenta were enrolled, irrespective of the mode of delivery. Patients were followed-up at six weeks, three months, and six months. The expulsion and continuation rate of immediate PPIUCD and reasons for removal were studied. Descriptive variables were expressed in percentages. The Chi-square test was used to determine the continuation rate and expulsion/removal rates in vaginal versus cesarean deliveries and a p-value less than 0.05 was taken as statistically significant. Results: A continuation rate of 84.4% was observed at six months. A statistically significant difference was observed in the continuation rate of participants of vaginal delivery versus caesarean section (82.67% vs 93.33%, p-value <0.01). Overall, the expulsion rate was 6.66%. Conclusion: Immediate PPIUCD insertion has high continuation rates and can play an important role in family planning

ATIVISA (ACONITUM HETEROPHYLLUM WALL EX. ROYLE): A COMPREHENSIVE REVIEW ON PROPAGATION, TRADITIONAL USES AND PHARMACOLOGY

Aconitum heterophyllum Wall ex. Royle is considered an important medicinal plant in traditional system of medicine as the tuberous roots are used for curing different ailments. But over grazing, prolong seed dormancy and many other reasons have led to the exploitation of this plant, so conservation through various modes is the need of the hour. Aims: The present review aims for accounting extensive information on different methods of propagation, traditional uses and pharmacological activities of Aconitum heterophyllum. Review Methods: A literature search was done on Aconitum heterophyllum using relevant Ayurvedic and contemporary texts. Different scientific databases such as Pubmed, Scopus, EBSCO, Google Scholar Information were used to collect all information regarding propagation and pharmacology of this plant. Results: Available data has reported that this endangered plant can be propagated through various methods such as raising propagules from seeds and daughter tubers, and other plant tissue culture techniques. Plant has reported to have 0.79% of total alkaloids in roots, out of which Atisine (0.4%), Heteratisine (0.3%), histisine, heterophyllisine, heterophylline, heterophyllidine are some major alkaloids. It also possesses important pharmacological activities like anti-bacterial activity, anti-diarrhoeal activity, enzyme-inhibition activity, anti-inflammatory activity, hepato-protective activity and anti-spasmodic activity. Conclusion: The results of this review clearly suggests about the valuable traditional use of Aconitum heterophyllum in curing various ailments like diarrhoea, dysentery, bilious complaints, intermittent fever and diseases of children. Further research: Different traditional uses mentioned in Āyurveda texts need further validation through different experimental and clinical studies which is a recommendation of this review

Bilateral ruptured tubal pregnancy: a case report

The infrequency with which Bilateral Tubal Pregnancy (BTP) occurs makes it a rare entity with an estimated incidence of 1 in 2,00,000 of all pregnancies and about 0.1 percent of all ectopic pregnancies. In the last few decades enhancement in the rate of occurrence has been reported in literature which has been attributed to Assisted Reproductive Technology (ART), Intra-Uterine Devices (IUD) and Pelvic Inflammatory Diseases (PID). We report a case of ruptured BTP where rupture of one tube preceded the rupture of contralateral side by approximately 3 weeks. 30 years old G4P2L1A1 presented with complaints of nausea and vomiting, vaginal bleeding and pain lower abdomen. There was no history of ART, IUCD or PID. A presumptive diagnosis of ruptured tubal pregnancy was made on the basis of clinical examination and ultrasound findings and patient was taken up for laparotomy. There was a right tubo-ovarian mass with bleeding from ruptured tube. Right salpingo-oophrectomy was done. Left tube on examination revealed a mass with a bleeding rent. Left salpingectomy was done because of extensive damage. Bilateral ruptured tubal ectopic pregnancy was confirmed on histopathological examination. BTP is likely to be missed even during USG as was in this case. This emphasizes the need to thoroughly examine pelvis for any other ectopic gestation during laparotomy

A CRITICAL REVIEW ON GUDUCHI (TINOSPORA CORDIFOLIA (WILLD.) MIERS) AND ITS MEDICINAL PROPERTIES

All edible things which are used in our food are full of free radicals. So there develops a need to free our body from these free radicals and the things which can help are the natural antioxidants. Guduchi (Amrita, Giloy) is the best of them which is abundantly available in all over India. Though almost all of its parts are used in traditional systems of medicines, leaves, stem and roots are the most important parts which are used medicinally. Guduchi (Tinospora cordifolia (Wild.) Miers ex Hook.F. &amp; Thoms.) is a versatile resource for all forms of life. It belongs to family Menispermaceae. It contains many different chemicals that affect the body. Some of these chemicals have an antioxidant effect. While other might increases the ability of bodys immune system and some chemicals have activity against cancer cells also. The Rasayana&nbsp;accords longevity, enhance the memory, improve the health, bestows youth, better complexion, voice, energy and lustre the skin. So it is one of the most effective Rasayana and rejuvenative. It works well on all the seven Dhatus (tissues) and keeps the system in balance. This review gives a birds eye view on the therapeutic uses of various parts and extract of T. cordifolia to enrich our knowledge about this plant