bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of female sex hormones influence on the protein-transporter p-glycoprotein functioning in vitro
Authors: Shchulkin A.V. , Chernykh I.V. , Popova N.M. , Slepnev A.A. , Yakusheva E.N.
Published: December 2020

The effects of female sex hormones estradiol and progesterone on P-glycoprotein (Pgp) functioning have been investigated using Caco-2 cells. Pgp activity was analyzed in a transwell system by the transport of its substrate, fexofenadine. The amount of the transporter protein was analyzed by enzyme immunoassay. Incubation of Caco-2 cells with 10 μM estradiol and incubation for 3 days increased activity and synthesis of Pgp. Moreover, this effect was suppressed by the inhibitor of the constitutive androstane receptor (CAR) CINPA 1. Incubation of these cells with 100 μM progesterone for 3 days increased Pgp synthesis, but its activity remained unchanged due to non-genomic (direct) inhibition of Pgp molecule by gestagen. The pregnan-X receptor inhibitor (PXR), ketoconazole suppressed the inducing effect of progesterone on Pgp synthesis. The combination of 10 μM estradiol and 100 μM progesterone increased Pgp synthesis, but did not increase the transporter protein activity, due to direct inhibition of the Pgp molecule by progestogen. Thus, it was found that estradiol increased activity and synthesis of Pgp by stimulating CAR, and progesterone stimulated transporter protein synthesis by activating PXR.
Comparative study of the human keratinocytes proteome of the HaCaT line: identification of proteins encoded by genes of 18 chromosomes under the influence of detergents
Authors: Kisrieva Y.S. , Samenkova N.F. , Larina O.B. , Zgoda V.G. , Karuzina I.I. , Rusanov A.L. , Luzgina N.G. , Petushkova N.A.
Published: December 2020

Using electrospray ionization tandem mass spectrometry, a comparative analysis of the HaCaT keratinocyte proteins encoded by the 18th chromosome was performed before and after exposure to sodium dodecyl sulfate (25 mg/ml) and to Triton X-100 (12.5 mg/ml) in a subtoxic dose for 48 hours. Proteins were identified using the SearchGUI platform (X!Tandem and MS-GF+ search engines). In total, 1284 proteins were found in immortalized human HaCaT keratinocytes and about 75% of them were identified by two or more peptides. Were identified, that 26 proteins were encoded by genes of chromosome 18. Among these proteins, 17 were common for control cells and HaCaT cells treated with SDS. Proteins MARE2 and CTIF were identified only in control keratinocytes. Seven identified proteins encoded by genes of chromosome 18 were found only in detergent-treated keratinocytes: LMAN1, NDUV2, SPB3, VPS4B, KDSR, ROCK1 and RHG28.
MULTISCALE APPROACH OF THE EQUIVALENT THERMAL CONDUCTIVITY OF MODIFIED FOAM-FILLED AND NON-FILLED HOLLOW BRICK AND A BRICK WALL
Authors: HASHİM Atheer , ALMENSOURY Mushtaq , ALİ Farooq , HAMZAH Hameed , GHALAMBAZ Mohammad
Published: December 2020

The energy loss through building components resulting in higher energy consumption, thus energy saving has become an essential aspect in design and comfort. This study aims to optimize the thermal insulation of red clay bricks used in the walls of buildings by using a multiscale method. The finite element approach in ABAQUS software has been used to simulate the bricks under different configurations and conditions. Due to cost and time challenges and difficulties in simulation and complex calculations, simplified and applicable equations have been derived to calculate thermal insulation properties. The results show that the paper’s brick design has a significant thermal conductivity reduction that could reach more than one-third of the other corresponding studies. The study goes to fill the hollow bricks by the insulation polyurethane foam (PUF) and comparing the results with air hollow bricks. Besides its other advantages, the outcomes reveal that using the PUF has a noticeable desired-influence in thermal insulation when considering the heat transfer by convection and radiation inside the air cavity of bricks.
Epidemiological and diagnostic aspects of spontaneous miscarriage in the department of gynecology-obstetric of the university hospital of Treichville in Abidjan
Authors: Yao Ignace N. , Dia Jean Marc L. , Menin Michelle M. , Oyelade Mouhedeen A. , Saki Corneille T. , Okon Gerard
Published: December 2020

Background: Describe the epidemiological and diagnostic of spontaneous aspects of early miscarriage in the department of the Gynecology Obsteric of Treichville University Teaching Hospital of   Treichville in Abidjan.Methods: A cross-sectional study was performed from January 2016 to March 2017 on patients received for an early miscarriage (gestational age less than 14 weeks of amenorrhea).Results: We recorded 337 cases of miscarriage and it shows that miscarriage was frequently estimated at 58 percent. Our patients had a average age of 32.9 years, 60.4 percent of them with primary education and 48 percent are housewives. The patients were paucigestes in 46 percent and the majority of them were nulliparous (62 percent). 6 percent with history of high blood pressure; diabetes (3 percent) and 31 percent of patients were HIV positive. Patients had pelvic pain at the admission in (55 percent). A miscarriage appears before 10 weeks of amenorrhea (76.1 percent) of cases. Ultrasound showed ovular debris (47 percent) of patients and (55.4 percent) were chromosomal abnormalities on anatomy-pathological examination.Conclusions: Spontaneous abortions are common and pathological examination is essential for diagnosis.
Seroprevalence rates of Toxoplasma gondii, Rubella, Cytomegalovirus among first trimester pregnant women in Istanbul
Authors: Ozer Aysegul , Canday Mujde , Yurtkal Aslihan , Davutoglu Ebru Alici , Akpak Yasam Kemal , Ozmus Dogay Nurtac , Ileri Alper , Budak Adnak , Madazli Riza
Published: December 2020

Background: Toxoplasma Gondii, Rubella, and Cytomegalovirus (CMV) are the most common causes of congenital infections worldwide. There is not a consensus on these infectious agents should be screened during pregnancy. The aim of this study is to determine the prevalence of toxoplasma, rubella, and CMV infections in order to know the need for antenatal screening.Methods: This retrospective cross-sectional study was performed on 1309 ambulatory pregnant patients who applied to the obstetric clinic of a university hospital between October 2016 and April 2018. Documents of patients in the first trimester were reviewed and serologic data of Toxoplasma gondii, CMV, Rubella infections were retrieved from the computer database.Results: Of 1309 pregnant women, positivity for anti-Toxoplasma IgG antibody was 352(26.9%), while 17(1.3%) of the subjects tested were positive for the anti-Toxoplasma IgM antibody. These positivities of the pregnant women for anti-Rubella IgG and IgM were 1147(87.6%) and (0.1%), respectively. These positivities of the pregnant women for anti-CMV IgG and IgM were 1163(88.8%) and 17(1.3%), respectively.Conclusions: We detected high rates of immunity against Rubella and CMV but low rates of immunity against Toxoplasma in this retrospective cohort of pregnant women. Due to high rates of seropositivity against Rubella and CMV, routine nationwide screening may not be necessary.
The impact of chorionicity on maternal and fetal outcomes
Authors: Bivar Leonor , Casteleiro Maria , Vasconcelos Rita , Borges Ana , Abreu Cátia , Reis Isabel , Sousa-Santos Ricardo
Published: December 2020

Background: Women carrying twin pregnancies receive extensive antenatal counselling on fetal risks, but less is known about whether the presence of two placentas confers dissimilar maternal risks. We pretend to determine the impact of chorionicity on the maternal and fetal outcome, evaluating the possibility of finding the association between complications and the presence of two placental masses.Methods: We conducted a retrospective observational cohort study of 550 twin pregnancies monitored at a level-3 hospital, between January 2004 and December 2018.Results: Of the 550 pregnancies, 419 (76.2%) were bichorionic and 131 (23.8%) were monochorionic. Caesarean delivery was more frequent in monochorionic group (70.2% vs. 61.8%, p=0.05). There were no statistically significant differences in the proportion of adverse maternal outcomes between bichorionic and monochorionic pregnancies, despite a trend towards higher proportions in bichorionic group. Regarding fetal outcomes, monochorionic twins were delivered earlier (mean gestational age of 34+4 weeks vs. 35+1 weeks, p=0.04) and the proportion of preterm delivery cases between 32+0 and 36+6 weeks was higher in monochorionic pregnancies (72.5% vs. 54.9%, p=0.002). Stillbirth of one or both twins was more frequent in monochorionic group (3.1% vs. 0.5%, p=0.03).Conclusions: The presence of two placental masses does not seems to confer an increase in maternal risks, despite a trend towards higher proportions of adverse outcomes in bichorionic pregnancies. However, monochorionicity is associated with an increase in fetal risks, particularly prematurity. Counselling and monitoring of bichorionic or monochorionic pregnancies may be identical with respect to maternal risks, but chorionicity should be considered when evaluating fetal risks.
Epidemiology of ectopic pregnancy at Laquintinie Douala hospital (Cameroon): prevalence survey, clinical profile, therapeutic and transfusion issues
Authors: Essome Henri , Egbe Thomas O. , Halle Gregory E. , Nana Théophile N. , Boten Merlin , Tocki Grace T. , Foumane Pascal
Published: December 2020

Background: Pregnancy is a serious pathology of the first trimester of pregnancy and is the leading cause of death. The objective of our work was to determine the hospital prevalence of ectopic pregnancy (EP), to describe the epidemiological, clinical and therapeutic profile given the often-haemorrhagic context at Laquintinie Hospital in Douala.Methods: We carried out a retrospective study over 10 years, from January 1st, 2007 to December 31st, 2016, using the operating theatre registers and the files of patients admitted during this period for ectopic pregnancy in the gynaecology and obstetrics department of the Laquintinie Hospital in Douala.Results: A total of 905 cases of EP for 32,595 deliveries were recorded, for an overall incidence of 2.8%. EP mainly affected the age group of 25 to 35 (60.6%), single people (57.9%) and housewives (46.6%). The risk factors found were similar to those of cervical cancer, namely multiple sexual partners (80.4%), the precocity of sexual intercourse under 18 years (54.1%) and sexually transmitted infections (52.5%). The symptomatic triad (pelvic pain, amenorrhea and metrorrhagia) was found in 46.1% of cases with a respective order of frequency of 96.9%, 77.3% and 63.6% The management was essentially surgical by radical laparotomy (97% of cases). Two of the 07 deaths were due to religious considerations.Conclusions: EP remains a frequent pathology in our environment with a heavy toll of tubal amputations and death.
Drivers of transactional sexual relationships among students in a Nigerian University: implications for elimination of reproductive rights violation
Authors: Ige Oluwatosin Sunday , Solanke Bola Lukman
Published: December 2020

Background: The objective of the study was to assess the prevalence and drivers of transactional sex in a Nigerian University.Methods: Data was collected through Mobile Data Collection platform (Google form). The dependent variable was transactional sex. The independent variables are self-reported household wealth group, gender, current age, marital status, age at sexual debut, family structure, consumption of alcohol, and use of psychoactive drugs. Two binary logistic regression models were fitted.Results: The prevalence of transactional sex was 23.85%. The odds of transactional sex were higher among females (OR=1.642, 95% CI: 1.499-1.799) and older students, but lower among undergraduates who were 18 years or older at the time of first intercourse (OR=0.842, 95% CI: 0.764-0.927). Results further revealed that while being from richest household wealth group (OR=0.587, 95% CI: 0.486-0.710) and being from a nuclear family structure (OR=0.446, 95% CI: 0.213-0.933) lowers the odds of transactional sex, the use of psychoactive drugs and alcoholic consumption increased the likelihood of transactional sex among undergraduates.Conclusions: The drivers of transactional sex in tertiary institutions in Nigeria are age, age at sexual debut, family structure, use of psychoactive drugs and alcoholic consumption. Promoting responsible sexual behaviour of undergraduates is imperative in the country.
Psychological distress and quality of life of Malaysian infertile couples
Authors: Ibrahim Noorfaizah , Mohamed Salina , Ismail Zaliha , Salleh Mohd Razali
Published: December 2020

Background: Infertility is an intense situation experienced by couples that causes emotional discomfort and worsening of their quality of life (QoL). The husband and wives of the infertile couples may reacted differently to stress.Methods: This is a cross-sectional study involving 100 infertile couples attending fertility clinics. Cases were selected by systematic random sampling. The severity of depression, anxiety and stress was measured using the Depression, Anxiety and Stress Scale (DASS-21) and QoL was assessed with the Fertility Quality of Life (FertiQoL) questionnaire.Results: Multivariate analysis revealed that depression, anxiety and stress-related difficulties were reported at a higher level by wives (p<0.001). Total Ferti QoL scores were significantly higher in husbands (p<0.001). The female gender (wives) was the only significant variable associated with the severity of all three DASS-21 sub-scale scores (p <0.001) and considered as a high-risk factor for psychological distress. Poor Qol were significantly associated with wives (p<0.001), male cause of infertility (p=0.004), primary infertility (p=0.022) and previous history of receiving intrauterine insemination (IUI) (p =0.020).Conclusions: The wives of the infertile couples were at higher risk of developing psychological distress and had poor QoL than their husbands. The severity of the anxiety, depression and stress were adversely affected the QoL.
Do women with benign versus malignant ovarian masses demonstrate variable clinical presentation?
Authors: Bagde Nilajkumar D. , Bagde Madhuri , Agrawal Sarita , Lone Zamir A. , Hussain Nighat
Published: December 2020

Background: Early diagnosis of ovarian tumors is a challenge due to variable presentation. Early diagnosis of ovarian cancers aids in timely management and better clinical outcomes. Aim of study was to determine the different clinical presentations of ovarian tumors and compare those in benign tumors versus malignancies.Methods: Clinical data of all women operated for ovarian masses was extracted from case files at a tertiary care centre and evaluated and clinical features compared in women with benign versus malignant tumors.  Results: We found 50 cases of ovarian tumors with 26% malignancies. The mean age was 38.48+14.9 years. Malignancies were significantly common in menopausal than menstruating (χ2=13.57, p=0.001, fishers exact). Pain was the commonest symptom and combined lumbar and iliac pain was reported in 67% cases. The location of pain was not significantly different in women with malignancy compared to those with benign tumors (likelihood ratio χ2=7.93, p=0.24). The odds of reporting a mass in abdomen were significantly greater in women with cancers than benign tumors (OR= 4.9, 95%CI 1.07-24.06, p=0.01). More women with cancer had history of distension of abdomen compared to women with benign tumors (χ2=9.43, p=0.002).Conclusions: Lumbar pain is most frequent complaint in women with ovarian pathology. Symptoms of distension in abdomen or presence of lump in abdomen are a significant guide to alert the physician regarding possibility of malignancy must be evaluated without delay.
Fetomaternal outcome in pregnancy with hepatitis E infection
Authors: Lewis Preeti F. , Prasad Sampada , Bavdekar Nitin B.
Published: December 2020

Background: HEV infection, a major public health concern, is known to cause large-scale epidemic and sporadic cases of acute viral hepatitis in developing countries. The infection occurs primarily in young adults and is generally mild and self-limiting; however, the case fatality rate is reportedly higher among pregnant women.Methods: Our study, a retrospective observational study, was conducted in a tertiary care center for over a period of 3 years (January 2017 to January 2020) to find out the fetal and maternal outcome in pregnant women with HEV infection.Results: A total of 38 antenatal cases with anti-HEV IgM-positive were included, and the maternal-fetal outcome was analyzed. The maternal mortality was 52.63 % especially during 3rd trimester and post-partum period, including 5 antenatal death. The most common maternal complication was acute fulminant hepatitis (39.5 %), DIC (36.8 %) and hepatic encephalopathy (31.6%). Prematurity (33.3% of total live births) and Still births (32.3 %) including 4 freshes still births were the commonest fetal complications noted.Conclusions: Our study shows that pregnant woman with acute viral hepatitis due to hepatitis E virus infection had a high mortality rate especially during 3rd trimester and post-partum period with poor obstetric and fetal outcome.
Clinicomicrobiological spectrum of abnormal discharge from vagina in women in costal Andhra Pradesh
Authors: Singamsetty Jyothi , Sravani G.
Published: December 2020

Background: When there is change in colour, consistency, order and volume of discharge then it is called abnormal vaginal discharge and associated with vulvar pruritus, dyspareunia, dysuria and lower abdominal pain. There is variability in organism isolated and treatment used.Methods: Sexually active women in reproductive age group with complain of abnormal vaginal discharge were included in this study based in following inclusion and exclusion criteria. . A detailed history of patient was taken regarding nature of discharge, colour, smell along with dysuria, dyspareunia, itching of vulva and lower abdominal pain.Results: Out of 160 patients 88 patients have bacterial vaginosis. Trichomonas vaginitis was present in 7.5% patients. Candidiasis was present in 6.25% patients. Some patients were having more than one infection like Bacterial vaginosis and Trichomonas vaginitis was coexisting in 13.75%, Bacterial vaginosis + Candidiasis were present in 8.75% patients. Mixed infection was present in 8.75%.Conclusions: From present study we can conclude that vaginal discharge is more common in married women in young age. Patients commonly presented with curdy white discharge, pruritus vulva and lower abdominal pain. Erythema and excoriation in vulva were common presentation, followed by erythema of vagina. Nature of discharge was mucopurulent in most patients. Bacterial vaginosis was most common followed by Trichomonas vaginitis.
Study of fetomaternal outcome in various modes of breech delivery in a tertiary care hospital- MGM GH, Trichy
Authors: Mohanraj Uma , Adhirai A.
Published: December 2020

Background: Aim of the study was to optimize the fetomaternal outcome using different modes of delivery in breech presentation and objective of the study was to optimize the maternal and perinatal outcome in various modes of breech delivery.Methods: Among 150 mothers with different parity and gestational age having singleton breech were studied during May 2019- October 2019 for the period of 6 months at KAPV government medical college. Fetomaternal outcome was compared in various modes of breech delivery during this study period in our institute. This study was a prospective analytical study.Results: Incidence of breech presentation was 3.3% of total deliveries in this institute. Around 4 (26.6%) cases by emergency LSCS, 48 (32%) cases delivered vaginally, 62 (41.3%) cases by elective LSCS. Comparatively, large number of cases were delivered by planned caesarean section in our institute. The maternal and perinatal morbidity and mortality was found to be less in planned caesarean section compared with other modes of delivery in this study.Conclusions: In view of insignificant difference in the fetomaternal outcome balanced decision about mode of delivery on a case by case basis will go a long way in improving both fetal and maternal outcome. Regular drills and conduct of assisted vaginal breech delivery should be pursued in all maternity hospitals.
A cross sectional observational study to evaluate the maternal and fetal outcome in postdated pregnancies
Authors: Narayan Ritika , R. Sheela S.
Published: December 2020

Background: Post-dated pregnancy is when the gestation is more than 40 weeks or 280 days. They last longer than the estimated date of delivery. Postdated pregnancies are associated with increased perinatal and maternal complications. These risks are greater than it was originally thought. Risks have been underestimated in the past leading to increasing number of complicated postdated pregnancies which appears to be otherwise low risk. The maternal risks are very often underappreciated resulting in increased maternal morbidity.Methods: This cross sectional observational study was done to evaluate maternal and fetal complications associated with Postdated pregnancies was carried out in the department of obstetrics and gynecology in a tertiary care centre, Sir Devraj Urs Medical College and RL Jalappa Hospital, Kolar between July 2018 and July 2019, fulfilling all the inclusion and exclusion criteria.Results: 50 out of 100 patients had full term normal deliveries where as 45% patients required cesarean section. Most common indication for cesarean section was meconium stained liquor with fetal distress (25%). 42% of the babies born needed NICU admission. Most common maternal complication seen was Postpartum Hemorrhage.Conclusions: The present study we conclude that postdated pregnancy was associated with significant risk of perinatal complications such as fetal distress, meconium aspiration syndrome and IUGR. There was increased risk of obstetric complications as well like atonic PPH, oligohydramnios, obstructed labor.
Effects of letrozole alone or letrozole in combination with low-dose intramuscular injection of human menopausal gonadotropin on ovulation and pregnancy of 150 patients with polycystic ovary syndrome
Authors: Ahmad Kaiser , Muzaffar Ufaque , Bashir Sadiya , Jabeen Farhat
Published: December 2020

Background: Objective of the study was to explore the effects of letrozole (LE) in combination with low-dose intramuscular injection of human menopausal gonadotropin (HMG) on the ovulation induction and pregnancy of patients with polycystic ovary syndrome (PCOS).Methods: The study comprised of 150 couples who were randomly divided into two groups of 75 each. Group “A” received letrozole (LE) in a dose of 2.5 mg to 5mg /d. LE was started orally starting on 3rd to 5th day of menstrual cycle for 5 consecutive days. Group “B” received letrozole in a dose of 2.5 to 5 mg/day starting on the 3rd to 5th day of menstrual cycle for 5 consecutive days. Starting from the day of oral administration of letrozole, 75 IU HMG was injected intramuscularly on alternate days for 5 consecutive doses. The ovulation induction parameters and pregnancy outcomes were observed.Results: The Group A (LE group) had the most completed cycle (310 cycles), 157 (52.3%) of which had ovulation. The Group B (LE+HMG) group completed the fewest cycles (258 cycles), with 168 (65.1%) of them ovulating. This difference was statistically significant (P<0.05). On HCG injection day, both the endometrial thickness (11.5±1.2) and number of mature follicles (2.1±1.3) of the Group B were significantly higher than those of Group A (P<0.001), but the follicle diameters were similar (P>0.05) The pregnancy rate of the Group B was 54.7%, which was significantly higher than that of the Group A (29.3 %) (P<0.05) The average medication cycle of the Group B group was significantly shorter than that of the Group A (P<0.05).Conclusions: The regimen using LE in combination with low-dose intramuscular injection of HMG has satisfactory therapeutic effects on ovulation induction, short medication cycle and high clinical pregnancy rate, which is promising for treating patients with PCOS infertility.
Comparative study with or without application of enhanced recovery after surgery protocols in patients undergoing elective cesarean section
Authors: Pravina Pammy , Tewary Khushbu
Published: December 2020

Background: Concept of enhanced recovery after surgery (ERAS) has been applied in various surgical branches. Evidence regarding the necessary components of ERAS for obstetric population is limited. Therefore, objective of this study was to test the application of ERAS in patients undergoing elective caesarean section on the post-operative recovery process.Methods: The study was conducted in the Department of Obstetrics and Gynecology, NMCH, Patna from January 2014 to December 2014. A total of 100 patients (n=100) undergoing elective caesarean section were included in the study. Cases were allocated into two groups a) Study group included 60 patients (n=60) and ERAS protocol was followed b) Control group included 40 patients (n=40) and standard post-operative care protocol was followed. Two groups were compared with respect to recovery parameters, post-operative complications and satisfaction rates.Results: More patients in the ERAS group were discharged on post-operative day 4 than the standard postoperative care group (90% vs 12.5%, p<0.0001). More patient in the ERAS group were significantly satisfied with the protocol compared to standard post-operative care (77% vs 70%, p<0.04). Approximately 77 percent of the patients in the ERAS group rated the satisfication score between 8-10 compared to 70 percent of the patients in control group (p<0.04). There was no difference between two groups with respect to recatheterization rate, readmission rate and post-discharge complaints.Conclusions: In this study with application of ERAS protocol, we reported reduced hospital stay which may reduce financial burden of patients and healthcare facilities.
Study of the clinical spectrum of AUB (FIGO AUB Systems) and women’s attitude towards its management at Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India
Authors: Kumari Ruby , Dwivedy Lata Shukla , Gupta Sweta , . Surabhi , Choudhary Madhuri , Kumari Arti
Published: December 2020

Background: AUB has significant impact on quality of life of women related to health specially in developing countries including India. FIGO AUB systems are universally accepted. Aim was to study the clinical spectrum of AUB according to the FIGO AUB systems and women’s attitude towards its management.Methods: Cross sectional prospective study was carried out in the department of Obstetrics and Gynaecology, ANMMCH, Gaya, a tertiary care center, among women of 15-55 years age groups having complain related to abnormal uterine bleeding, for 1 year from 1st May 2019 to 30th April 2020 on 1000 patients. Data was collected and analyzed by percentage and proportions.Results: Prevalence of AUB was maximum among 15-30 years age group of patients (46.80%). Most of the patients belong to lower (62.5%) class, rural area (68%) and were anaemic (62.5%). Ovulatory dysfunction (55%) was most common cause for AUB, maximum patients choose surgical management (hysterectomy) but after counselling, most of them shifted to medical management.Conclusions: This study suggests more conservative approach for management of AUB and emphasizes the importance of awareness for clinical spectrum of AUB among women so that they can be self-motivated for early treatment and unnecessary hysterectomy can be avoided.
An educational interventional study to compare conventional versus peyton’s method in training medical students on antenatal examination skills
Authors: Sethuraman Dhivya , Revwathy S. , Thangaraj Prabha
Published: December 2020

Background: Introduction of competency based medical education in India has made it imperative to teach and assess clinical skills in a uniform manner. Antenatal Examination is one of the core competency under Obstetrics and Gynaecology. We need to use effective instructional methods to teach skills. In this study, we have compared Peyton’s ‘four step approach’ with the conventional ‘see one, do one’ approach.Methods: A quasi- randomized crossover study with educational intervention was done among 49 medical students. They were divided into two groups (A and B). Students of group A were first trained on Antenatal examination using Conventional method and evaluated. With a gap of one week, they were re-trained on the same skill using Peyton’s method and re-evaluated again; the vice versa was for done in group B. Mann Whitney test was used to compare the difference in score between the two groups of students (A and B) and Wilcoxon Signed Ranks test was used to compare the student’s perception of both teaching methods.Results: The mean score obtained by students after the first training by Peyton’s (24.08±2.31) was greater than Conventional method (20.32±3.59) which was found to be statistically significant (Z=-3.54, p<0.5). Following the second training i.e crossover of the training technique, the marks obtained by both group of students were almost the same. Students perceived Peyton’s methods to be more interesting, interactive, better understanding and recall over conventional.Conclusions: Peyton’s method was found to be superior over conventional method of training medical students in Antenatal examination.
Comparison of centchroman and PPIUCD in terms of efficacy, safety and continuation rate in immediate postpartum period
Authors: Gupta Megha , Bansiwal Reeta , Anand H. P.
Published: December 2020

Background: Study was done to assess the efficacy, safety and continuation rate of Centchroman and IUCD administered in immediate postpartum period (within 48 hours).Methods: An interventional study was conducted in Obstetrics and Gynecology department of Safdarjung Hospital, New Delhi, at a tertiary care hospital after approval from ethical committee. 280 women were enrolled in the study and divided into 2 groups centchroman group and PPIUCD group, 140 in each group after excluding the exclusion criteria and satisfying inclusion criteria. These women were followed up at 6 week, 3 month and 6 months to study efficacy, safety and continuation rate.Results: Centchroman as contraception is safe with fewer side effects, better satisfaction rate and better continuation rate in comparison to PPIUCD.Conclusions: Centchroman is a newer contraceptive which is recently added in basket of family planning in our country to give wider choices to women. It is an indigenous product developed by central drug research institute (CDRI), Lucknow available free of cost in government hospitals. Centchroman needs more popularity and education for its widespread use.
A comparative study on the role of oral mifepristone and endocervical prostaglandin as preinduction cervical ripening agent
Authors: Mohapatra Sanghamitra , . Samarpita
Published: December 2020

Background: Induction of labour is one of the most common interventions practised in modern obstetrics with up to 20% of pregnant women having labour induced in some countries. Induction rates have been influenced by several reports worldwide, which claimed that an active induction policy, led to substantial reduction in perinatal and maternal morbidity and mortality. A ripe or favourable cervix is a pre-requisite for successful vaginal birth. This study is conducted with an aim to compare the efficacy of mifepristone and dinoprostone as a cervical ripening and priming agent for induction of labour and their safety and fetomaternal outcome.Methods: It was a prospective comparative study in the Department of Obstetrics and Gynecology, M.K.C.G. Medical college, Berhampur from October 2017 to October 2019. 100 cases with bishop score less than 6 were subjected for pre induction ripening. These cases were assigned at random either  to study group, who were given single dose oral mifepristone 200 mg and control group with  single dose intracervical E2 gel. All the cases were examined to check the bishop score. In cases of control cases, second dose was given after 6 hours, if there was no improvement in bishop score. At the end of 24 hour if bishop score <6, it was called as failed induction.Results: 90% of mifepristone gr and 56% of dinoprostone gr had improved Bishop score>6 after 6hr.32 cases required oxytocin augmentation in mifepristone gr where as it was 57 in dinoprostone. Drug administration to delivery interval was 19.40 hour in mifepristone gr and 15 hour in dinoprostone gr. More vaginal delivery and less fetal distress in mifepristone gr.Conclusions: Mifepristone is an effective agent for cervical ripening with better fetomaternal outcome compaired to dinoprostone.
Clinical profile, maternal and fetal outcome in pregnant women with COVID-19 infection: a retrospective observational study in a tertiary care hospital of Himachal Pradesh
Authors: Dogra Poojan , Sharma B. R. , Sharma Shuchi , Sharma Reena
Published: December 2020

Background: The aim of this study was to evaluate the clinical characteristics and outcomes of pregnant women confirmed with COVID-19 infections and their neonates to provide more reference to contribute in managing this noval viral disease.Methods: We conducted a retrospective study over a period of six months; 20 March, 2020 to 8 October, 2020 at SLBSGMC Nerchowk (Himachal Pradesh). Total number of pregnant women who delivered in our hospital during the defined study period was recorded and analysed.Results: The total number of women were delivered over the study period was 13, out of which caesarean sections (CS) were 7 and NVDs were 6 in number. All of them were diagnosed mild COVID-19, and none one of the patients developed severe COVID-19 or died. Their all newborns were recorded healthy except one was COVID positive and one neonate had birth asphyxia.Conclusions: Apparently no difference was observed in relation to onset of disease, symptoms, cure rates or severity in pregnant women when compared to non-pregnant women and healthy men of similar age groups. Pregnancy does not seem to deteriorate the course and prognosis of the disease. Maternal and fetal outcomes are apparently favourable in these patients. Lastly COVID-19 is not an indication of cesarean section. More multicentre studies are the need of the hour to formulate the authentic management guidelines for this novel disease.
A prospective study on awareness of postnatal mothers regarding self and newborn care in a tertiary care centre in Mangalore, Karnataka
Authors: Ganiga Pradeep , Shetty Sourabha S.
Published: December 2020

Background: Postnatal care is the important portion of maternal health care as it helps to assess the health status of mother and newborn. It promotes to rectify the defect and to identify the progress of the baby that is essential to solve the health issues.Methods: All 100 postnatal women were assessed regarding awareness of self and newborn care using structured questionnaire.Results: In this study maximum number were in age group of 21-25 years (42%). Majority of respondents were literate (88%). Main source of information regarding postnatal and neonatal care is given by health care personnel (49%). 77% cleaned the perineum after defecation and urination. 39% of postnatal mothers practice postnatal exercise. 54% were aware of spacing between two pregnancies. Majority of mothers agreed that colostrum is first breast milk and are aware on giving it to newborn (68%). 78% are aware of exclusively breast feeding baby for 6 months. 79% of postnatal women were aware vaccines prevent diseases in baby. Postnatal mothers had good awareness about self and newborn care.Conclusions: The first 48 hours after delivery is the time when the mother and baby are most vulnerable to morbidity and mortality associated with childbirth. Postnatal care is one of the most important maternal health care for not only prevention of impairment and disabilities, but also for reduction of maternal and neonatal mortality and morbidity.
Comparative study of the effectiveness of two different dosage of sublingual misoprostal for cervical ripening before hysteroscopy
Authors: Jadon Komal , Chawla Indu , Kumari Kanika
Published: December 2020

Background: Hysteroscopy a minimally invasive approach for evaluating uterine cavity, and has become an indispensable diagnostic and therapeutic procedure. The main limiting factor while performing office hysteroscopy is the level of pain or discomfort encountered during the procedure. The pain is attributed mainly to the difficulty in entering the internal cervical os with the hysteroscope and while distending uterine cavity. It could be reduced if cervix is ripened before the procedure. The purpose of this prospective observational study was to compare the effectiveness, adverse effects and surgery-related complications associated with two different doses of sublingual Misoprostol (100 and 200 µg) given 2-4 hours before hysteroscopy.Methods: A randomised comparative study was conducted in the department of Obstetrics and Gynaecology of ABVIMS and Dr. RML hospital New Delhi, from 1st November, 2018 to 31st March, 2020. One hundred and twenty women, fulfilling inclusion criteria were subjected to hysteroscopy. Women received either 100 µg (Group I) or 200 µg (Group II) of sublingual Misoprostol 2-4 hours prior to hysteroscopy. The primary outcome of the study was cervical dilatation as measured by the largest number of Hegar dilator that could be inserted without resistance at the beginning of procedure. The largest dilator that negotiated cervical canal without resistance at the beginning of procedure was recorded as the baseline cervical width. The secondary outcomes were subjective assessment of the surgeon of the ease of dilatation of cervix and adverse effects of drug (i.e. vaginal bleeding, shivering, fever and pain as measured on visual analog scale).Results: The mean baseline cervical width as measured by first Hegar dilator that could be passed through the cervical canal without resistance was 6.6±0.62 mm in group I and 6.94±1.21 mm in group II respectively                    (p value=0.016). Adverse effects like vaginal bleeding, shivering was more in group II compared to group I. No statistically significant difference was found between group I and II with regards to visual analog scale.Conclusions: 100 µg Misoprostol can be used for cervical ripening prior to hysteroscopy with minimal adverse effects.
Self-medication amongst pregnant women in a tertiary care teaching hospital in India
Authors: Rangwala Pooja P. , Chokshi Anushka S. , Shah Radhe K. , Thakkar Ayush S. , Thakker Yash G. , Dumra Gurusharan H. , Trivedi Yamini N.
Published: December 2020

Background: Self-medication is a popular practice in developing countries where there is no strict regulation of drugs sold in local pharmacies. General public is usually unaware of the adverse effects of drugs used for common illness and continue using them without prescription during pregnancy. This study was carried out to know the extent of self-medication practised by pregnant women and various factors associated with it.Methods: A questionnaire based, cross-sectional study of pregnant women visiting the OB GYN-OPD of a tertiary care teaching hospital was conducted. 303 eligible subjects were questioned and statistical analysis was carried out.Results: Total 16.5% women were found to be self-medicating during pregnancy for common conditions like headache (26%), fever (23%) and common cold (19%). Odds Ratio between the self-medicating and non-self-medicating groups for variables like age (<25 years; ≥25 years), education (illiterate; literate) and gestational age (<20 weeks; ≥20 weeks) are 1.6, 2 and 1.73 respectively. Women with a history of self-medicating before pregnancy were significantly more likely to continue doing so during pregnancy (p value <0.00001).Conclusions: A significant proportion of pregnant women have been found to self-medicate without knowing the adverse effects of the drug used. Thus, spreading awareness against this health-predicament is necessary.
Maternal mortality review by three delay model: a retrospective study from a tertiary care hospital of Chhattisgarh
Authors: Jogi Sangeeta R. , Ekka Anju R.
Published: December 2020

Background: SDG 3 includes an ambitious target of reducing the global MMR to less than 70 per 100 000 births by 2030. In order for effective initiation of measures to reduce maternal mortality it is necessary to assess the levels of delays, causes of death, health seeking behavior during antenatal and postnatal period and obstacles in reception of health services.Methods: Retrospective study of 112 maternal death cases from a tertiary medical centre (Medical College) was done. The details of all the maternal mortalities from January 2018 to July 2020 were collected from the individual case sheets, facility-based maternal death review form and MDR Case Summary.Results: The study reported a very high MMR of 802. Hypertensive disorders (36.61%), Obstetric haemorrhage (25.89%) and Sepsis (14.29%) constituted the major direct cause of maternal deaths whereas anaemia was the most common indirect cause (7.14%). First, second and third delays were present in 95.54%, 70.54% and 47.32% cases respectively.Conclusions: Suboptimal ANC, long distances to reach final hospitals, high number of referrals and admission during complicated stage explains the very high maternal mortality in the present study. Application of Three Delay Model revealed that most of the maternal death occurred due to delays in multiple levels and first delay was the most commonly identified delay. Accelerated efforts should be implemented to minimize all the delays in order to achieve SDG goals.
Induction of labour after 37 weeks of pregnancy using foley’s catheter: traction versus non-traction method
Authors: Bhatu Jaydeep J. , Patel Disha
Published: December 2020

Background: Cervical Foley’s catheter used now a days for induction of labour alone as well as a combined with cerviprim gel. The objective of the study was to assess the effectiveness of 750 cc traction on Foley catheter with no traction for labour induction in >37 weeks pregnancy.Methods: A randomized controlled trial performed on pregnant women at >37 weeks who were admitted for induction of labour with unfavourable cervix. They were randomly assigned into two groups, Foley’s with 750 cc traction and without traction. The primary outcomes were improvement in Bishop Score, number of favourable cervix following induction and the mode of delivery. The secondary outcomes were neonatal outcome, and maternal infection.Results: A total of 80 pregnant women were randomized into traction group (n=46) and non-traction group (n=34). Traction group had significantly (p=0.0462) higher number of vaginal delivery compared to non-traction group. Participants were comfortable using both methods. There was no difference in neonatal outcomes and risk of maternal infections in both groups.Conclusions: Application of traction did result in more vaginal delivery.
Significance of 2 dimensional-echocardiography in hypertensive disorders of pregnancy: a study in tertiary care centre, Ahmedabad, Western India
Authors: Parikh Purvi M. , Goswami Vishwa M. , Shah Sapana R. , Vyas Rupa C. , Damor Hiral
Published: December 2020

Background: Echocardiography is a safe, non-invasive technique to assess cardiac structure and function in pregnancy. Understanding the structure and function of the heart in hypertensive women is important in terms of timely diagnosis, better management and good prognosis. This study will focus on the importance and feasibility of Echocardiography as a routine investigation tool in hypertensive disorders of pregnancy.Methods: This is a retrospective study of 150 cases of hypertension in pregnancy conducted at the Obstetrics and Gynaecology department of a tertiary care centre in the year June 2019-July 2020. Data was analysed in terms of complications seen in women who had structural and functional abnormalities in the echocardiographic scan in comparison to those hypertensive women who had a normal scan.  The important Echocardiographic parameters were compared amongst cases of hypertension and their impact on fetomaternal outcome was discussed.Results: In this study conducted amongst 150 pregnant women suffering from different forms of hypertensive disorders  presenting in our institute for routine workup in the year 2019-2020, 12(8%) had chronic hypertension, 75(50%) had gestational hypertension, whereas 63(42%) had pre- eclampsia. The incidence of structural valvular lesions in these categories as 2%, 3.34% and 4% respectively. Deranged echocardiographic parameters like decreased Left Ventricular Ejection Fraction in 10%, decreased stroke volume in 28.6% and increased Left Ventricular mass in 26.6% are seen more in cases of pre-eclampsia compared to gestational hypertension and chronic hypertension.Conclusions: Echocardiography is a valuable tool to stratify risk and can guide management in gestational hypertension, chronic hypertension and preeclampsia. Changes in cardiac function and morphology are recognizable at an asymptomatic early stage and correlate with disease severity and adverse outcomes. Preeclampsia has a greater impact on the heart than gestational hypertension, and changes are most pronounced in early onset, severe disease. Studying the cardiac structure and function in early trimesters can bring about better maternal and fetal outcome.
Correlation of incontinence impact questionnaire score in overactive bladder syndrome cases with urodynamic findings
Authors: Sharma Jai B. , Chauhan Mukul , Bhatla Neerja , Seth Amlesh , Kumari Rajesh , Uppal Bharti , Singh Janmeeta
Published: December 2020

Background: Overactive bladder syndrome (OAB) is a common condition. The aim of the present study was to correlate the incontinence impact questionnaire (IIQ) score with urodynamic studies in patients of overactive bladder syndrome.Methods: It was a prospective study performed in a tertiary referral centre on 60 women with symptomatology of OAB. IIQ score was calculated and urodynamic studies were performed in all patients in which detrusor overactivity, maximum flow rate of urine per second (Qmax) and voiding time in seconds was calculated in all women.Results: The mean age was 42.3±9.91 years, mean body mass index was 24.7±2.71 kg/m2, mean parity was 2.4 and mean serum creatinine level was 0.84±0.21 mg/dl. Symptoms seen were urgency (100%), frequency (100%), urge incontinence (95.0%) and nocturia (76.6%). IIQ score ranged from 7-20 with mean being 12.27±3.38. OAB was mild in 36.6%, moderate in 41.66% and severe in 21.66% patients. On urodynamic studies, detrusor overactivity was present in 75% cases being 59% in mild, 80% in moderate and 76.92% in severe OAB. Mean Qmax increased with severity of OAB and was 29.55ml/second in mild OAB, 30.36ml/second in moderate OAB and 31.59 ml/second in severe OAB. Mean voiding time decreased with severity of OAB and was 33.44 seconds in mild OAB, 32.14 seconds in moderate OAB and 31.47 seconds in severe OAB.Conclusions: IIQ score and urodynamic studies are useful in diagnosis and quantification of OAB syndrome.