Diagnostic and therapeutic hysterolaparoscopy in evaluation and treatment of female infertility in a tertiary hospital

Background: To corroborate the findings of hystero-laparoscopy for evaluation of female infertility in a tertiary hospital over a period of 18 months. This study is intended to review the effectiveness of combining diagnostic hysteroscopy and laparoscopy in predicting the prevalence of different lesions with accuracy and taking appropriate therapeutic measures.Methods: This is a prospective study conducted at the Dept of O and GSCB Medical College, Cuttack, Odisha over a period of 18 months (April 2014 to October 2015). Those infertile women where the period of infertility was more than 2 years with optimum male factor were subjected to diagnostic hysteroscopy and laparoscopy under general anaesthesia.Results: Of 235 cases recruited 64% were having primary infertility and 36% were having secondary infertility.46% had hysteroscopic abnormality and 39.5%had laparoscopic abnormality. Among the abnormal hysteroscopy cases septate uterus was highest and among laparoscopic finding peritoneal adhesions was highest. All the cases undergoing DTHL were discharged on the next day with no major complication except 2 cases which were managed at the same time.Conclusions: DTHL is an effective and safe procedure for female infertility evaluation. This can be taken as a gold standard method in those whose infertility is more than 2 years

Admission cardiotocography as a screening test in high risk pregnancies and its co-relation with peri-natal outcome

Background: Birth asphyxia which results due to deprivation of oxygen to the foetus during the birth process is still the leading cause of perinatal death. So the labour should be monitored by an effective method. Electronic foetal monitoring is quite promising in this regard. The present study was done to project the effectiveness of cardiotocography (CTG) at admission to labour room in high risk pregnancies as a predictor of perinatal outcome.Methods: This is a randomized prospective study conducted in the labour room of SCB Medical College, over a period of 1 year (April 2013 to April 2014) at Cuttack, Odisha, India. All women randomized for the study were subjected to initial admission CTG in the 1st stage of labour. Those with a normal/reassuring admission test, monitored by intermittent auscultation method and those with abnormal test were monitored by continuous CTG. Foetal and perinatal outcome were co-related with admission CTG.Results: Foetal distress during labour developed in 29 % of patients with a normal test and in 64% of patients with an abnormal test. The admission test had a sensitivity of 44% specificity 95% of and a positive predictive value of 50% for predicting an APGAR score 5 min after birth. Neonatal admission to SNCU was required in 29% of patients with a normal test and 45% of patients with an abnormal test.Conclusions: Labour admission CTG should be used for screening but not a sole diagnostic test of compromised foetus. It is found to be valuable in high risk pregnancy

Prediction of Factors Influencing Social Performance of Indian MFIs using Machine Learning Approach

The aim of the current work is to predict the impact of MFI specific internal factors on the social performance of Indian microfinance institutions (MFIs) by using machine learning techniques. Social performance index (SPI) is designed by taking data of 73 Indian MFIs for 10 years with the help of an indexing technique where six different factors (operational self sufficiency, number of women borrowers, number of rural borrowers, gross loan portfolio, average loan balance per borrower / GNI per capita and cost per borrower) representing different dimensions of functioning of MFIs are considered. The data is taken from MIX data repository. Pooled OLS regression model is used for analyzing impact of various MFI specific factors on SPI. For predicting the SPI, Artificial Neural Networks (ANN) machine learning model is considered that takes all independent variables as input. The results of regression model indicate that size, legal status, outreach and service provisions significantly affect SPI. ANN analysis result indicates that social performance of MFIs gets determined by MFI specific internal factors. The experimental result indicates that the proposed ANN prediction model is providing better result for predicting the SPI. The findings suggest that MFIs can contribute for development of the society by adopting suitable policies keeping in view certain internal factors

A comparative study of maternal outcome between low dose and standard dose magnesium sulphate as regimen for the treatment of eclampsia in a tertiary centre

Background: Eclampsia is an obstetric emergency complicating the maternal outcome in all developing countries. Various regimen of magnesium sulphate have been tried to treat the condition with varied results. A few studies have been done to compare between various types of regimen in this part of India. Magnesium sulphate is a double edged sword. Aim of the study was to compare the maternal morbidity and mortality after administering two different regimen of magnesium sulphate in eclampsia patients in a tertiary care hospital in Odisha.Methods: This is a randomized prospective study conducted at the Labour room, Dept of O and GSCB Medical College, Cuttack, Odisha over a period of 18 months (January 2015 to June 2016). 228 eclampsia patients were randomly selected out of which 114 were administered low dose (Dhaka) regimen and the other 114 subjects were given high dose (Pritchard) regimen. The findings were analysed using SPSS version 21.Results: In low dose regimen group convulsion was controlled in 96% of eclampsia patients and in only few cases recurrence of seizure occurred and was shifted to standard dose regimen.Conclusions: The toxicity profile also seems to be less so low dose regimen (Dhaka) can be adopted with less toxicity in peripheral hospitals with low resource setting

DETERMINATION OF SENSITIVITY AND SPECIFICITY OF ULTRASONOGRAPHY IN ACUTE APPENDICITIS: COMPARISON WITH PER-OPERATIVE FINDINGS AND HISTOPATHOLOGICAL REPORT

  Objective: This study was under taken to compare the ultrasonographic findings with pre-operative findings and histo-pathological report and to evaluate the sensitivity, specificity, positive and negative predictive values and accuracy of ultrasonography in the diagnosis of acute appendicitis.Methods: It was a prospective study done in the department of radio-diagnosis, SCBMCH, Cuttack. Patients with provisional diagnosis of acute appendicitis were subjected to ultrasound of abdomen and pelvis. Patients with positive USG findings were followed up for pre-operative findings and histo-pathological results. All the obtained data were tabulated and subjected to statistical analysis.Results: Among the 100 cases studied, 77 cases were proved as acute appendicitis based on surgical and histopathological results. Male to female ratio was 1.5:1. The disease was found to be more prevalent in second and third decade of life. Location of affected appendix was most commonly retro caecal. Mean diameter of the appendix was 8.56 mm. Target sign and non-compressible bowel loop was the most commonly detected ultrasonographic sign and the ultrasonographic sensitivity was 96.1% and specificity was 95.65% in our study.Conclusion: High resolution sonography with graded compression is a very useful diagnostic tool for diagnosis of appendicitis in problematic cases and in women in their reproductive period. It is also helpful in detecting complications of appendicitis and other abdominal diseases that mimic acute appendicitis

Study of maternal mortality in a tertiary care hospital in a tribal KBK area of Odisha, India

Background: Pregnancy, although being considered a physiological state, carries risk of serious maternal morbidity and at times death. This is due to various complications that may occur during pregnancy, labor, or thereafter. The major causes of maternal mortality are mostly preventable through regular antenatal check-up, proper diagnosis, and management of labor complications. Therefore, the factors at different levels affecting the use of these services need to be clearly understood. The aim is to study the incidence of MMR, assess the epidemiological aspects, causes of maternal mortality and avoidable factors that can prevent maternal deaths.Methods: A retrospective hospital-based study was conducted in obstetrics and gynecology department, SLN MCH, a tertiary care referral hospital in a tribal area of southern Odisha over a period of 2 years from April 2017 to March 2019.Results: A total of 108 deaths were analyzed over 2 years period and MMR was calculated to be 1124/1 lakh live births. Most of the maternal deaths occurred in the age group of 20-24 years (35.1%), majority of maternal deaths were observed in multipara (46.3%), 70.3% deaths occurred within 24 hours of admission. Hypertensive disorders in pregnancy (37%) were the leading direct cause followed by hemorrhage (14.8%) and sepsis (11.1%). Among the indirect causes jaundice (7.4%) and anaemia (3.7%) were the leading cause.Conclusions: MMR in our study was very high as compared to national average of 167/1,00,000 live births, being a tertiary care hospital as most of the patients were referred from peripheral centers. Most maternal deaths are preventable by intensive health education, basic obstetric care for all, strengthening referral and communication system and emphasizing on overall safe motherhood

CD14 Modulates PI3K/AKT/p38-MAPK Licensing of Negative Regulators of TLR Signaling to Restrain Chronic Inflammation

Current thinking emphasizes the primacy of CD14 in facilitating TLR recognition of microbes to initiate proinflammatory signaling events and the importance of p38-MAPK in augmenting such responses. Herein, this paradigm is challenged by demonstrating that recognition of _Borrelia burgdorferi_ not only triggers an inflammatory response in the absence of CD14, but one that is uncontrolled as a consequence of impaired PI3K/AKT/p38-MAPK signaling and negative regulation of TLR2. CD14 deficiency results in hyperphosphorylation of AKT and reduced activation of p38. Such aberrant signaling leads to decreased negative regulation by SOCS1, SOCS3, and CIS thereby engendering a more severe and persistent inflammatory response to _B. burgdorferi_. Perturbation of this CD14/p38-MAPK-dependent mechanism of immune regulation may underlie development of infectious chronic inflammatory syndromes

Successful treatment of ureteric calculi with constitutional homoeopathic medicine Lycopodium clavatum: A Case report

Introduction Formation of stone in the urinary tract, kidney, ureter and bladder is called as Urolithiasis. Formation of urinary stones is very common. About 5-15% population are affected with urinary stone, and, therefore, causes high morbidity in comparison to the above types of stone formation. Shock wave lithotripsy and ureteroscopy along with conservative treatments are the most common approaches for the treatment of calculi, although considered as expressive in one hand, and on the other hand, such interventions may lead to complications. Therefore, alternative medicines give a second thought for the treatment of urolithiasis because it avoids surgical interventions. Here we present a case study for the successful treatment of urolithiasis by a homoeopathic medicine Lycopodium clavatum in a 43 years old male. Case Profile A 43-year-old male patient with intense pain in the right loin for 5-6 days, increased frequency of urination, ineffectual urination, severe pain during urination, and finally with the pain score was 9, was considered for treatment in the present study. Based on his complete case history, Lycopodium clavatum at potencies of 0/1 to 0/6 was prescribed to him. Conclusion Correct homoeopathic organ specific or constitutional formulation(s) selected based on specific important symptoms can also be efficacious in diseases such as ureteric stone. Constitutional medicine Lycopodium clavatum is usually prescribed when the patient is with right side pain with ureteric stone and it is justified in the present case report. Randomized control trial is suggested to ascertain the results obtained in the present study i.e. successful treatment of urolithiasis with the constitutional homeopathic formulation Lycopodium clavatum

Revealing contrasting genetic variation and study of genetic diversity in urdbean (Vigna mungo (L.) Hepper) using SDS-PAGE of seed storage proteins

Total seed storage protein profiles of 20 urdbean genotypes including the popular variety T9 were analysed by Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE). 14 genotypes could be clearly identified based on genotype-specific seed protein fingerprints while rest of the test genotypes were categorized into three protein types. Dendrogram based on electrophoretic data clustered the genotypes into seven groups at 78.5% phenon level.  TU 95-1 with TU 12-25-4 revealed lowest similarity index value (0.33) followed by TU 95-1 with PU 30 and KU 96-3(SI=0.35). Clustering pattern revealed distinctly divergent group formed by TPU 95-1 and TPU 4. These may serve as a valuable source genotype in recombination breeding.   Key words: Seed storage protein profiling, SDS-PAGE, Genetic variation, urdbean

Identification of seed storage protein markers for drought tolerance in mungbean

A set of 292 mungbean germplasm accessions including 62 popularly adapted local land races and two wild forms (Vigna radiata var. sublobata), important breeding lines and standard ruling varieties were screened for drought stress tolerance at seedling stage.  Eight genotypes e.g., C. No. 35, OUM 14-1, OUM 49-2, Pusa 9072, OM 99-3, Banapur local B, Nipania munga, Kalamunga 1-A) have been identified to possess drought tolerance.  Globulin seed storage protein profiling was carried out in 19 selected mungbean genotypes comprising eight drought tolerant, seven drought sensitive, two wild forms of mungbean (TCR 20 and TCR 213) and two standard checks (LGG 460 and T 2-1) to explore differentially expressed polypeptides. Seed protein profiles revealed 15 scorable polypeptide bands with molecular weights ranging from 10.0 to 102.2kD. A specific 12.8kD polypeptide band was present in all above drought tolerant test genotypes including the wild accession TCR 20. Such a polypeptide band may serve as useful biochemical marker for identification of drought tolerant genotypes in mungbean.             Key words: Genetic diversity, seed storage protein profile, wild and cultivated Vigna radiata