Study of partogram in relation to labour outcome and significance of alert line in partogram

Background: The partogram is a simple, inexpensive tool to provide a continuous pictorial overview of labor. The goal of this study is to use partograph to monitor labor, initiate uterine activity that is sufficient to produce cervical changes, fetal descent while avoiding uterine hyperstimulation, hypostimulation and fetal distress and provide timely surgical intervention where required.Methods: Total 200 term patients, both primigravida and multigravida were selected for study and partograph recording were commenced at 4 cm dilation close maternal and fetal monitoring was done throughout the labour and partogram was plotted to detect any deviation from normal course.Results: Patients were grouped into primigravida and multigravida and based on partogram finding divided into delivered “before alert line” and “between alert and action line” and after action line.175 women delivered vaginally, out of this 106 delivered before alert line ,83 between alert line and action line and 11 after crossing action line.Conclusions: Partographic management of labour is a time honored and evidence based scientific way of managing labour. Partograph improves the quality of delivery care, since it permits to identify dystocia and make logical and effective interventions. It reduces unnecessary strain on mothers by reducing total duration of labour, without any increased foetal morbidity and mortality

Biophysical studies on novel metallo-systems and their interactions with DNA and small molecules

The DNA binding interactions of five novel bis(2,2':6'2"- terpyridine)ruthenium(II) complexes functionalised with an aryl tail group (i) biphenylene (biphen), (ii) P-napthyl (napth), (iii) phenanthrene (phen), (iv) anthracene (anth) and (v) pyrene (pyr) in the 4' position on each terpyridine ligand were investigated with calf thymus DNA (ct-DNA), poly [d(A-T)]2 and poly [d(G-C)]2 DNA using the spectroscopic techniques of absorbance, circular dichroism (CD) and linear dichroism (LD). All five complexes bind non-covalently to DNA. At low complex concentrations, the anth, phen and pyr complexes were found to intercalate their aryl tail groups between DNA bases. The napth complex exhibits both an intercalative and a non-intercalative mode. The biphen complex exhibits groove binding with no significant tail intercalation. At high metal complex concentrations, aggregation of the complexes on the DNA is observed, resonance light scattering indicate aggregates of low nuclearity along the groove. The DNA binding interactions of a novel series of structurally similar eighteen platinum(H) square planar complexes with subtle ligand variations of the formula [Pt(L)Cl(DMSO)] where L denotes an acylthiourea ligand system were investigated with ct-DNA, poly [d(A-T)]2 and poly [d(G-C)]2 DNA, 5'-mononucleotides and 9- methylguanine. Absorbance, CD and LD studies indicate ligand variation affects DNA binding interaction. Mass spectrometric studies suggest these complexes bind covalently to DNA via the loss of the chloride or possibly the DMSO groups on the platinum. Supramolecular copper(l) and silver(l) metal lo-cyclophanes and their interactions with the isomers of di- and tri-methoxybenzenes and chiral anionic compounds were investigated. The metallo-cyclophanes can adopt two conformations, a helical and a bridging non-helical structure. CD, NMR and X-ray crystallography show the dianion sodium antimonyl-L-tartrate can resolve this mixture. Absorbance and fluorescence studies suggest the metallo-cyclophanes bind methoxybenzenes. The design and synthesis of novel longer asymmetric ligands capable of assembly into a larger suprarnolecular metallo-cyclophanesis included

Study of clinical profile and outcome in pregnancy related acute kidney injury

Background: Acute kidney injury (AKI) is a clinical syndrome characterized by a sudden decrease in glomerular filtration rate leading to decreased excretion of nitrogenous waste like urea, creatinine and other uremic toxin. Even minor changes in serum creatinine are associated with increased in-patient mortality. To study various etiological factors responsible for AKI to do better management of condition for prevention of adverse effects on maternal and fatal outcome. To study outcome of disease in form of recovery, morbidity and mortality. To record maternal and foetal outcome. Methods: A prospective, observational study of 50 patients conducted at department of obstetrics and gynaecology, Medical College Baroda and Sir Sayajirao General Hospital from the time period of 1 year. Results: There was no significant association of initial serum creatinine with maternal outcome. However, there was significant association of last serum creatinine and Percentage Improvement in serum creatinine with maternal outcome as last serum creatinine was significantly lowest in completely recovered patients as compared to dead and discharged on request patients and percentage Improvement in serum creatinine was significantly high in completely recovered patients as compared to dead and discharged on request patients. There was no significant association of initial and last serum creatinine with fetal outcome; however, percentage improvement in serum creatinine was significantly high in alive fetuses as compared to aborted, dead and undelivered fetuses. Conclusions: Pregnancy-related AKI is a common medical problem and understanding its association with various etiopathologies has significant impacts on maternal and fetal outcome

Prevalence of dysmenorrhoea and its effect on quality of life among nursing students

Background: Painful menstruation, is common gynaecologic problem, significantly affects the routine life of most of affected girls. Most of them experience some degree of pain and discomfort during menstrual period, which can affect their daily activities, disturb their productivity at their work place. This also appears to be a leading cause of absenteeism from college. Hence arises a need to evaluate the, prevalence of dysmenorrhoea and its effect on daily routine activities and quality of life of nursing students.Methods: This is a cross sectional study conducted among 100 nursing students (1st year, 2nd year and 3rd year) of NSCB Medical College with the objectives to evaluate prevalence and severity of dysmenorrhea and its effects on the quality of life, particularly absenteeism from college/work place. Students chosen for study and each student was given questionnaire to complete background information, question related to menstrual cycle, severity of dysmenorrhoea, PMS, and work /study /daily activities affected due to dysmenorrhoea, elucidated and data collected and analysed.Results: Prevalence of dysmenorrhoea was 79% of these 3% severe, 18% moderate and 58% were mild grade. Out of 79/100 participants of dysmenorrhoea 63.29% missed individual classes or their study affected, 31.64% had to take leave from work place and 51.89% reported social withdrawal during menstruation due to dysmenorrhoea.7.59% take medicines for pain relief.Conclusions: Dysmenorrhoea is a very common problem among girls and it affects their quality of life and their productivity at work place. It is important to spread awareness about the causes and treatment of dysmenorrhoea to avoid undue sufferings causing absenteeism from work and studies

Clinical spectrum of dengue in pediatric age group: A study at tertiary care hospital

Background: Dengue is a mosquito-borne human viral disease, which has become a major public health problem recently. The clinical manifestation of dengue infection varies from asymptomatic to severe fatal condition in the form of dengue hemorrhagic fever/dengue shock syndrome. Objectives: The objectives of this study were to study the clinical profile and hematological changes in dengue fever. Materials and Methods: This prospective observational study was carried out at a tertiary care hospital from March 2017 to August 2018. The study population included dengue positive patients admitted to the pediatric ward. All the children age up to 12 years with positive dengue test either NS1 antigen or IgM/IgG antibodies by rapid serological test kit or ELISA were included in the study. Results: Of 105 cases, the most common clinical feature was fever (100%) with raised hematocrit value (45.8%), leukopenia (38.1%), and thrombocytopenia (74%). Conclusion: Hematological profile with thrombocytopenia, raised hematocrit, and leukopenia with raised serum glutamic-pyruvic transaminase gives enough clues to test for dengue serology to reduce the morbidity and mortality by early diagnosis and management of dengue illness

Dopaminergic Influence on Habitual Consumption of Sugar Sweetened Beverages

Obesity is the leading cause of the top health conditions in the United States including diabetes, heart disease, stroke, and cancer. Here we explored one of the established genetic links to obesity, the DRD2 Taq1A allele. The DRD2 Taq A1 allele (A2/A1) polymorphism results in a 30-40% reduction in dopamine D2 receptor density compared to the normal (A2/A2) polymorphism.1 In an observational study, researchers found that within a population 67% of obese and overweight individuals had the DRD2 Taq A1 allele present compared to only 3.3% in the normal BMI individuals.2 The Taq A1 allele has been linked to increased risk of engaging in addictive behaviors including overeating which can result in obesity.3-4 In this study, 157 participants completed a pre- and post-intervention behavioral assessment to determine the impact of 3 weeks of regular consumption of either a sugar-sweetened beverage or a similarly flavored unsweetened beverage. We expected to see an interaction between BMI and Taq1A status and the pre- to post-intervention wanting of the beverage which we didn’t find. We did find that both groups, regardless of sweetness assignment, had an increase in beverage wanting post-intervention (p < 0.05).Bachelor of Science in Public Healt

A perceptional analysis of online and offline mode of lectures in second year undergraduate medical students at SMIMER medical college, Surat

Background: The COVID-19 pandemic demanded lockdown to control the spread of disease, inevitably medical colleges are also affected and online mode of teaching has become a solution for continuity of teaching in medical colleges. The main purpose of study to identify perception of medical students towards online and offline mode of lectures by parameters as follows: knowledge, understanding, skills and methodology.Methods: This was a prospective, cross-sectional study with duration of three months. A well- articulated set of questionnaires based on knowledge, understanding, skills and methodology parameters will be circulated among the second-year undergraduate medical students from SMIMER, Surat.Results: About 82% of the students perceived that offline mode of lectures provide more information of subject and helps with better retention of knowledge. Only 21.5% students were in favour of online mode for being able to understand lecture content. For the development of the practical skills and clinical training, 97% of the participants favoured offline mode. However, 67% of the participants believe online mode of lectures save their time and work well with their schedule.Conclusions: Majority of students perceived that offline mode of lectures provide more information of subjects and better retention of knowledge. According to them offline mode of lectures is easy to understand and improved conceptual thinking. For development of clinical and practical skills offline mode of lectures is mandatory. But, majority of students perceived that online learning provide flexibility in participation of lectures and time saving method

Comparative study of bupivacaine alone and bupivacaine along with buprenorphine in axillary brachial plexus block: a prospective, randomized, single blind study

Background: Different additives have been used to prolong brachial plexus block. We performed a prospective, randomized single-blind study to compare Bupivacaine alone and Bupivacaine along with Buprenorphine for onset, quality, and duration of block as well as post-operative analgesia and any complication in axillary brachial- plexus block.Methods: Randomized controlled study was carried out among 60 patients of either sex, aged 20-60 years. ASA grade I or II undergoing elective hand, forearm, elbow surgery under axillary brachial plexus block. Patients were randomly divided into two groups.Group-l received 30 ml of 0.35% Bupivacaine alone in axillary block.Group-II received 30 ml of 0.35% Bupivacaine with 3µg/kg Buprenorphine in axillary block. Time taken for onset and completion of motor and sensory block as well as complete duration of block were noted in both groups. Any complication during procedure, during surgery as well as post-operatively were noted and treated.Results: Addition of Buprenorphine (3µg/kg) to Bupivacaine mixture in peripheral nerve block did not affected the onset time for motor as well as sensory block. Mean duration of motor block was 284.33±78.94 mins. in group I and in group II 307.33±60.26 mins. Mean duration of sensory block 305.066±83.64 mins. in group I while 580.166±111.45 mins. in group II. It suggests duration of sensory block was prolonged in group II then group I.Conclusions: Addition of Buprenorphine to local anesthetic drug provides good post-operative analgesia. Buprenorphine significantly prolongs sensory block and lengthens duration of analgesia without prolonging duration of motor block

Evaluation of intersystem agreement between standard pelvic organ prolapse quantification system and simplified pelvic organ prolapse scoring system

Background: Pelvic organ prolapse (POP) is one of the most common gynaecological problem encountered worldwide. The POPQ has become the most commonly used prolapse staging system since its introduction (1996). In spite of having merits to it, POP-Q has not acquired a widespread acceptance. International Urogynaecological Association (IUGA) Standardization of Terminology Committee has devised a simplified version S-POP classification system based on the ordinal stages of the POPQ. The objectives of present study are to determine the intersystem agreement between the standard POPQ and S-POP classification system of pelvic organ prolapse and to propose a user-friendly classification system.Methods: This prospective observational blinded study was conducted in the department of Obstetrics and Gynaecology, NSCB Medical College and Hospital, Jabalpur (M.P.) from March 2015-August 2016. 125 women underwent two separate pelvic examinations POPQ and S-POP, by two groups of gynaecologists at each site. Results were compared and analysed using appropriate statistics.Results: Out of 125 women 54 (43.2%) were in age group 41-50 years. 79 (63.2%) were post-menopausal. 102 (81.4%) were more than third parity. 107 (85.6%) had home delivery. 119 (95.2%) had symptom of something coming out of vagina. The weighted Kappa statistics for the intersystem agreement of S-POP system with POPQ system for overall stage was 0.82, 0.61 for both anterior and posterior vaginal wall, 0.9 for cervix and 0.87 for posterior fornix/cuff.Conclusions: There is significant agreement between the POPQ and S-POP classification systems of POP

Hypoplasia of left pulmonary artery: A rare congenital heart disease

Unilateral hypoplasia or absence of pulmonary artery is a rare pulmonary vascular anomaly that is usually associated with other cardiacanomalies like Tetralogy of Fallot or cardiac septal defects, but can also occur as an isolated anomaly. We present a case of 6-montholdinfant who presented with recurrent respiratory tract infection. On work up, chest X-ray showed ipsilateral small hemithorax withhyperluscency in the left lung field. Findings were confirmed with 2D echocardiography and pulmonary angiography which weresuggestive of hypoplasia of left pulmonary artery