bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of intracervical Foley’s in women receiving sublingual misoprostol for induction of labour: a randomized controlled trial
Authors: Yadaraju Salini , Chaturvedula Latha , Rengaraj Sasirekha
Published: September 2020

Background: Induction of labour can be carried out by medical or mechanical methods, used alone or in combination. This study is to evaluate the efficacy and safety of intracervical Foley’s in women receiving sublingual misoprostol for induction of labour.Methods: We randomized 230 primi gravidae at ≥37 weeks of gestation, with singleton pregnancy, cephalic presentation requiring induction, with Bishop score ≤4 using block randomization into study and control groups. Both groups received 50 µg sublingual misoprostol every fourth hourly till active labour was achieved or upto a maximum of 6 doses. The study group was induced simultaneously with intracervical Foley catheter.Results: Mean induction to labour interval in study and control groups was 11.191±7.14 hours and 11.758±6.26 hours while mean induction to delivery interval was 17.502±7.93 hours and 18.275±7.66 hours respectively with no significant difference between the groups (p=0.522 and 0.453). More women in study group than in the control (51.3% versus 33.9%) were in active labour within ten hours of induction (p=0.001). Caesarean section rate was 23.5% and 19.1% in study and control groups (p=0.497), the most common indication being foetal distress. Secondary outcomes like foetal heart rate abnormalities, oxytocin requirement were comparable between the two groups. APGAR scores and NICU admission rate were similar in both groups. There was no significant maternal or neonatal morbidity.Conclusions: Though there was no significant reduction in induction to labour or delivery interval with synchronous use of sublingual misoprostol and Foley’s, there was no increase in the complications encountered.
Comparative evaluation of artificial rupture of membranes and spontaneous rupture of membranes on course of labour and feto-maternal outcomes
Authors: Chauhan Anjali , Sarkar Bani , Tanwar Kritika
Published: September 2020

Background: Present study was undertaken to do a comparative evaluation of artificial rupture of membrane (ARM) and spontaneous rupture of membrane (SRM) on the course of labour and feto-maternal outcome.Methods: It was prospective interventional randomized comparative study including 120 primigravidae (60 in ARM and SRM group each) with cervical dilatation ≥3 cm and intact membranes. Amniotomy was performed in ARM group after enrolment while no intervention in SRM group. Outcomes noted were duration of labor, mode of delivery, APGAR score, NICU stay.Results: Significant reduction seen in duration of labour in ARM group (p=0.0001). Mean duration of labor was 5.24 hours in ARM group while 6.94 hours in SRM group. No significant difference noted in mode of delivery (p=0.082). No significant adverse feto-maternal outcomes were seen with amniotomy. APGAR score and NICU admission had no significant difference among the two groups.Conclusions: ARM can be opted as an intervention with shorter duration of labour without adversely affecting the feto-maternal outcomes. It is safe, reliable and cost effective modality when employed in primigravida and may be considered as a low-cost accessible intervention to reduce prolonged labour and its associated complications.
Maternal and fetal factors associated with non detection of fetal growth restriction at term: a retrospective study
Authors: Aziz Atiya , Tiwari Shyamji , Dey Madhusudan , Singh Suneeta
Published: September 2020

Background: Fetal growth restriction (FGR) is one of the major factors of perinatal morbidity and mortality. Aim was to study the maternal and fetal risk factors associated with non- detection of fetal growth restriction.Methods: A retrospective analysis was done at a tertiary care hospital. 280 term newborn cases weighing <2.5 kg were selected and they were divided into two groups, Group I- FGR detected cases by ultrasound, and group II- FGR non detected cases. Data was collected from the labour room registers.Results: Incidence of FGR found to be 6.8%.The maternal biological factors found to be significantly associated with fetal growth restriction were gestational hypertension, chronic hypertension and anemia. Fewer ANC visits was associated with non-detection of FGR cases. Detection of FGR cases were more if the birth weight found to be <2 kg when compared to non detection of FGR cases.Conclusions: Anaemia and fewer ante natal visits were associated with non detection of FGR at term when compared with antenatally detected FGR patients.
Histopathological evaluation of endometrium and its clinical correlation in patients of abnormal uterine bleeding
Authors: Khatik Neha , Tiwari Arti , Yadav Kalpana
Published: September 2020

Background: Abnormal uterine bleeding (AUB) is a very common, challenging gynaecological problem in all age group women. Neoplastic lesions are responsible for very less number of cases but they should be diagnosed early. Endometrial biopsy is necessary for histopathological diagnosis of endometrial lesions and to rule out any malignancy. In present study, we evaluated histopathological pattern of endometrium and different clinical parameters in AUB patients.Methods: A retrospective observational study done in Obstetrics and Gynecology department of SSMC Rewa, Madhya Pradesh in 2 year from 1st October 2017 to 30th September 2019. AUB patients who fulfilled inclusion criteria were included in study. All data were collected from department records in predesigned proforma and statistically analyzed by statistical package for the Social sciences (SPSS) version 20.Results: Total 366 AUB patients were included in study; most frequent clinical presentation was HMB (56%). Mostly patient’s age ranged from 24-84 years, belonged to 41-50 years age group (44%), multiparous (78%), and premenopausal (53%). On histopathological evaluation of endometrium most commonly nonneoplastic lesions (75%) were seen, out of which proliferative phase endometrium was most frequent. Neoplastic lesions were seen in 25% cases. Out of which benign lesions were noted in 7%, premalignant in 17.3% and malignant in 1% (all in >45 year patients).Conclusions: Endometrial biopsy should be done in all AUB patients >45 years and in selected premenopausal in order to get early diagnosis, to rule out malignancy and to help in management. Endometrial biopsy should be considered as first diagnostic modality.
Association between serum ca-125 levels and severity of pre-eclampsia: a case-control study conducted in a tertiary care centre, West Bengal
Authors: Mukherjee Bijoya , Das Amiya
Published: September 2020

Background: Screening test for pre-eclampsia has been a topic of extensive research in last few decades, and to identify a cost effective and accurate one is of immense importance. This study was conducted to determine an association between serum CA-125 levels and severity of pre-eclampsia, and thus to specify clinical utility of this biochemical marker in prediction, diagnosis and follow-up of pre-eclampsia.Methods: A case-control study involving 40 women with non-severe pre-eclampsia, 40 women with severe pre-eclampsia and 40 healthy pregnant women matched for age, parity and gestational age at enrolment were taken in a tertiary care centre in West Bengal.Results: The CA-125 levels in three categories of participants were: normotensive (15.76±2.95), non-severe pre-eclampsia (26.98±2.28), severe pre-eclampsia (44.99±11.23), p<0.001. CA-125 levels correlated positively with systolic blood pressure (r=0.78, p<0.001), diastolic blood pressure (r=0.79, p<0.001), negatively with platelet levels (r=-0.67, p<0.001) and with birth weight of baby (r=-0.54, p<0.001). When cut-off for serum CA-125 levels was accepted as 35 IU/ml, the sensitivity and specificity of the marker was found to be 92.1% and 97.1% respectively. Positive predictive value 95.5%, Negative predictive value 94.4%.Conclusions: We can infer from this study that maternal serum CA-125 levels are associated with pre-eclampsia and its severity. As it is much more available and less expensive, it seems to be a promising as a screening test.
Risk factor and perinatal outcome of preterm delivery in a tertiary care centre in rural Haryana
Authors: Singla Sunaina , Das Banashree
Published: September 2020

Background: Aim of the study was to identify risk factors and to assess neonatal mortality and morbidity associated with preterm delivery in patient attending a tertiary care centre in rural Haryana.Methods: This retrospective cohort study was conducted in Shree Guru Gobind Singh Tricentenary Medical College, over a period of one year (January to December). All pre-term deliveries were included in the study. They were followed up from admission till delivery and till discharge from hospital. Various, parameters like maternal age, associated medical disorder, obstetric complications, gestational age, neonatal mortality, need of neonatal intensive care and condition of baby at discharge were analyzed.Results: In the present study, incidence of preterm deliveries was 16.1%. The most common risk factor found to be history of previous abortion (23.6%), preterm premature rupture of membrane (17.1%), Intra-uterine growth restriction (IUGR) with oligohydramnios (10.5%), hypertensive disorder during pregnancy (5.9%), and antepartum hemorrhage (4.6%). But majority of the patient (56.5%) no cause could be identify. Out of total 160 preterm births 3 were still born and 157 live preterm births, and out of which total Neonatal intensive care (NICU) admission were 60. Mortality rate was 100% in neonate weighing less than 1000 gm and 18% in babies weighing less than 2000 gm.Conclusions: The commonest risk factor for preterm delivery is previous history of abortion and adverse perinatal outcome is inversely proportionate to the period of gestation at the time of delivery. All efforts should be made to prolong the pregnancy beyond 34 weeks by identifying and actively managing the risk factors for better neonatal outcome.
A study to assess knowledge and attitude of infertile Kashmiri couples
Authors: Pandit Basharat Hussain , Mustafa Asif , Wani Sadia Ali , Nazir Fatima
Published: September 2020

Background: Infertility is defined as the inability to conceive naturally after one year of regular unprotected sexual intercourse. The chance to conceive depends on multiple factors like the length of sexual intercourse, frequency of coitus and age of couples. This could be due to male as well as female factors and deficiencies.Methods: This is a cross sectional observational study conducted on infertility patients. A fertility questionnaire was designed for both the partners with questions covering knowledge and attitude towards infertility.Results: A total 100 couples were selected in which prevalence of primary and secondary infertility was 72% and 28% respectively. The mean duration of infertility was 3 years. On scoring their level of knowledge, 52% had inadequate knowledge, 44% had moderate knowledge and 4% had adequate knowledge. There was no statistically significant difference in the knowledge in relation to their educational qualification and type of infertility among participants.Conclusions: Infertility is common problem affecting 10-15% of the population. The knowledge about infertility and its risk factors is generally limited among the participants, in spite of their educational status.
Classification of caesarean section based on Robson ten group classification system in our hospital
Authors: Sharma Ari , Singh Dipika , Verma Sarika , Sharma Sanjog
Published: September 2020

Background: Recent data indicate that one in five women undergo caesarean section (CS). In the last decade, there has been a dramatic increase in the caesarean section rate worldwide, which now exceeds 30% in some regions. Thus, the increasing rate of caesarean section became a matter of international public health concern. Our study aimed to classify the CS-based on Robson ten group classification system (RTGCS) criteria which will subsequently enable us to standardise the indication of CS and establish protocols to reduce the number of CS in our set up.Method: A retrospective study was conducted in ESI Hospital, New Delhi wherein Robson TGCS was used to classify CS for 15 months (January 2019 to April 2020).Results: Overall CS rate in our hospital over the specified period was 34.5%. All women with one or more previous cesareans (group V) had the maximum number of cesareans, 37%, followed by nulliparous, single, cephalic, term pregnancy (induced) i.e group II, 22.1% and nulliparous women more than 37 weeks in spontaneous labour (group I), 9.5%.Conclusions: RTGCS is easy to comprehend and reproduce. All deliveries and cesareans should be universally categorized by the Robsons TGCS. An attempt should be made to evaluate the group contributing most to the CS rate and interventions should be made accordingly.
A study of neurological disorders in pregnancy and puerperium
Authors: Gupta Megha , Pradeep Yashodhara , Singh Renu , Shrivastava P. K.
Published: September 2020

Background: Neurological diseases contribute to 20% of maternal deaths. The objective of this study was to find the prevalence of primary and secondary neurological disorders in pregnant and postpartum patients, to study their clinical features, feto-maternal outcome and diagnosis using radiological imaging.Methods: This is a prospective cross-sectional study done over a period of 1 year. Pregnant and postpartum women with neurological disorders except eclampsia were enrolled. A total of 100 cases were analysed out of which 92 underwent radiological imaging to confirm diagnosis. Primary outcome in the form of prevalence of neurological disorders and secondary outcome in the form of maternal and foetal outcome was assessed.Results: The prevalence of neurological disorders in pregnancy is 1150/100000 deliveries. 75 cases were classified as primary neurological disorders (prevalence of 862/100000) which included epilepsy, cerebrovascular accidents, CNS infections, neoplasm, neuropathies and miscellaneous. 25 cases were secondary neurological disorders (prevalence of 287/100000) which included hepatic and septic encephalopathy. Among primary disorders the prevalence of cerebrovascular accidents was found to be highest (33.3%) followed by epilepsy (32%) while that among secondary neurological disorder was of Hepatic encephalopathy (92%). Majority (68%) had recovery while 15%of women had residual deficit. There were 17 (17%) cases of maternal mortality.Conclusions: Neurological disorders were significantly associated with poor feto- maternal outcome. Radiological imaging in the form of MRI is an excellent diagnostic tool for confirming diagnosis of neurological disorders.
Menopause rating scale: a simple tool for assessment of climacteric symptoms
Authors: R. Ramya N. , Gadgi Radhika
Published: September 2020

Background: Menopause is a physiological event, a unique stage of a female reproductive system and transition in life that occurs in all women who reach midlife. The clinical consequence of menopause is due to estrogen deficiency. Some of menopausal symptoms experienced by these women can be severe enough to affect their normal lifestyle. Unfortunately, majority of these women are not aware of the changes brought about by menopause. Objective of the study was to assess the prevalence of different menopausal symptoms and their severity according to menopause rating scale and their impact on quality of life.Methods: A cross sectional study was conducted by the department of obstetrics and gynaecology, Yenopaya Medical College, Mangalore between June 2020 to August 2020. A total of 210 women who are between the age of 40 and 65 years who had their last menstrual period of at least 1 year ago and were included in the study.Results: In the study majority of subjects were in the age group 46 to 50 years (42.9%). In the study there was significant association between general health and hot flushes, heart discomfort, depressive mood, irritability, physical and mental exhaustion, bladder problems and joint and muscular pain. There was no significant association between general health and sleep problem, anxiety, sexual problems and dryness of vagina.Conclusion: The menopausal rating scale can be used an effective tool while examining the patients for menopausal symptoms. Regular screening of such women can make a huge difference, and their quality of life can be improved.
Body mass index and gestational weight gain in pregnant women with gestational diabetes and its relation with adverse maternal and fetal outcome
Authors: Singh Abha , Kujur Avinashi , Roy Archana
Published: September 2020

Background: Raised body mass index (BMI) and excessive gestational weight gain (GWG) are important determinants in development of gestational diabetes.Methods: A prospective, observational study carried out on antenatal women since their first trimester. These women were screened for gestational diabetes mellitus (GDM) by diabetes in pregnancy study group of India (DIPSI) criteria. All participants were followed up by measuring their BMI, weight gain, blood sugars in every trimester. Also, data was collected regarding any adverse outcomes.Results: Among all participants, 16.8% were diagnosed as GDM. 44% women of study group had weight gain beyond Institute of Medicine (IOM) recommendations. Higher risk of GDM was observed in women with raised BMI and excessive GWG. Also, odds of preeclampsia, preterm deliveries, caesarean section, macrosomia, intrauterine fetal death, neonatal intensive care unit (NICU) admissions were higher in women with GDM.Conclusions: Compliance of recommended weight gain during pregnancy have a strong impact on the fetal outcome. Amount and timing of weight gain plays a crucial role in GDM.
Tissue trauma and inflammatory response following laparoscopic versus abdominal hysterectomy: a prospective randomized clinical trial
Authors: Abbas Ahmed M. , Swidan Khaled H. , Ali Ahmed M. , Sweed Mohamed S.
Published: September 2020

Background: Laparoscopic surgery is associated with more favorable clinical outcome than conventional open surgery. This might be related to the magnitude of tissue trauma and tissue stress response. This study compares the intensity of tissue injury by assessing plasma C-reactive protein (CRP), lactic dehydrogenase (LDH), and cancer antigen 125 (CA 125) in patients undergoing laparoscopic hysterectomy compared to abdominal hysterectomy.Methods: This study was conducted at Ain Shams University Maternity Hospital from May 2018 to February 2020. 74 women candidate for hysterectomy were recruited and randomized into two groups: group A included 37 cases who underwent abdominal hysterectomy, and group B included 37 cases that underwent laparoscopic hysterectomy.Results: CRP, LDH and CA125 significantly increased post-operatively in both groups. Postoperative mean serum CRP, LDH and CA125 were significantly higher in the laparotomy group (10.84±2.47, 262.21±76.77, and 13.41±2.6 respectively) compared to laparoscopy group (7.92±2.25, 148.53±43.56, 11.79±2.77 respectively) (p<0.05).Conclusions: Surgery is a significant cause of tissue injury that can be assessed by specific markers. We suggest that laparoscopic surgery causes less tissue damage as assessed by lower postoperative CRP and LDH values, which might account for the earlier recovery and reduced hospital stay in laparoscopic surgery.
Vasa previa: a case report
Authors: Mohapatra Ipsita , Samantaray Subha R. , Sindhuja V. Naga
Published: September 2020

Vasa previa is defined as a condition where fetal vessels traverse the membranes in the lower segment below the presenting part unsupported by placental tissue or umbilical cord. Rupture of the membranes leads to fetal exsanguinations and even neonatal death. The etiology is uncertain, but risk factors include bilobed or succenturiate lobed placenta, velamentous insertion of cord, placenta previa, pregnancies resulting from In vitro fertilization (IVF) and multiple pregnancies. We report here a case of 24 year old woman, G3A2 at 34 weeks of gestation and history of 2 previous spontaneous abortions with vasa previa which was successfully managed. Prenatal sonographic diagnosis has the potential to improve or prevent the poor obstetric and neonatal outcome associated with it.
A rare association of puerperal ovarian venous thrombosis with pseudomembranous colitis
Authors: Kamat Devika J. , Kavlekar Namrata P.
Published: September 2020

Ovarian venous thrombosis is a rare but serious complication associated with early puerperium. The risk of this complication increases with associated puerperal infection or inflammatory condition. The present case report is of a 36-year-old lady who presented after emergency caesarean with puerperal fever and abdominal pain along with diarrhoea post antibiotic cover. Patient presented with moderate ascites and uterine subinvolution on examination. Contrast enhanced computed tomography (CECT) showed evidence of bowel wall edema due of colitis along with ovarian vein thrombosis. Patients had persistent symptoms despite receiving an empirical course of injectable cephalosporins. Stool culture confirmed growth of Clostridium difficile. Patient developed a rare infection after a course of antibiotic i.e. pseudomembranous colitis caused by Clostridium difficile. Patient then received a course of injectable vancomycin after which colitis subsided. This case increases our vigilance on management of puerperal fever which could get complicated with life-threatening events like deep vein thrombosis.
Understanding pelvic floor in women
Authors: Mittal Rajni , Rath Gayatri , Sahai R. N. , Aggarwal Mahima
Published: September 2020

Change from quadruped to erect posture has resulted in changes in the human pelvis. This has resulted in pelvis supporting the abdominal viscera. The bony pelvis is deficient on inferior aspect. Muscles covered by fascia on superior and inferior aspect. A good knowledge of pelvic floor is very basic and mandatory for any gynecologist as pelvic floor is crucial to support the pelvic organs and is required to maintain urinary and fecal continence.
Incidence and management of inguinodynia after inguinal plasty
Authors: Granados-Romero Juan J. , Ceballos-Villalva Jesus C. , García-Olivo Israel , Jonathan E. Cruz Escobar , Corona-Torres María J. , Mondragón-Cordero Alba M. , Lourdes A. Quintero Arías , Henry Ayala García , Juan C. Vázquez González , Contreras-Flores Ericka H.
Published: September 2020

Background: Hernia is defined as a defect of fascial and muscle-aponeurotic structures, allowing the protrusion of elements. The most frequent is inguinal region, prevailing in men 3:1 vs female. The most frequent complications are persistent chronic pain.Methods: A descriptive, prospective and cross-sectional study was performed in postoperative inguinal plasty patients, using a laparoscopic approach and open approach, the presence or absence of inguinodynia was studied using the visual analogue pain scale (VAS) and the Semmes-Weinstein monofilament, in addition to a systematic investigation in the following PubMed, Medline, Clinical Key and Index Medicus databases, with articles from July 2019 to April 2020.Results: Inguinodynia was present in laparoscopic surgery and open approach, 58 patients had inguinodynia at two weeks associated with the inflammatory response of the tissues and the presence of a foreign body (mesh), 77% of the patients with persistence of pain at 3 months reported mild pain (VAS 1-4), 21% moderate pain that did not limit their daily activities (VAS 5-8) and 2% of the patients reported severe pain which limited physical activity and effort   (VAS 9-10).Conclusions: Inguinodynia has an impact on hospital costs and quality life, we consider it is essential to domain the anatomical variants of the region. We propose an extensive follow-up of this group of patients, to make a comparison of diagnostic methods, as well as conservative management vs. modern techniques for pain control.
Antiulcerogenic effect of Capparis cartillaginea decne on indomethacin induced gastric ulcer in wistar rats
Authors: Mugo Nancy W. , Wangia Christine , Kikuvi Gideon , Ngugi Samuel
Published: September 2020

Background: Peptic ulcer disease is a non-malignant, mucosal lesion of the stomach or duodenum. The mucosal defect reaches the muscularis mucosa and sometimes, beyond causing life threatening complications, including haemorrhage, perforations, gastrointestinal obstruction and malignancy.Methods: The animals were pre-treated with omeprazole 20 mg/kg and 300 mg/kg of Capparis cartillaginea decne orally for 14 days. On the 15th day, ulcers were induced using indomethacin 30 mg/kg and 4 hours post ulcer induction, they were sacrificed. Ulcer index, pH, total acidity and volume were determined.Results: Extensive lesions were seen in indomethacin ulcerated rats with mean ulcer score of (1.260±0.18). In comparison, there were minimal areas of erosion on animals pre-treated with omeprazole (0.14±0.025) and plant extracts (0.280±0.097). Indomethacin-induced ulcer treated animals showed the highest volume of gastric juice output (3.14±0.21 ml), whereas the animals pre-treated with omeprazole had lower gastric juice output (2.20±0.2 9ml). This was comparable to animals pre-treated with the plant extract (1.80±0.13 ml). The pH was high in animals pre-treated with omeprazole (5.02±0.53). This was also seen in animals pre-treated with the extract (4.82±0.31). This was in comparison to the low pH seen in indomethacin ulcerated animals (2.20±0.16). Indomethacin-induced ulcer treated animals showed high levels of total acidity (88.64±1.71 mEq/L). Whereas the animals pre-treated with omeprazole had lower total acidity (55.26±3.77 mEq/L), which was also mirrored in animals pre-treated with the plant extracts (61.44±2.42 mEq/L).Conclusions: The extracts of Capparis cartillaginea decne showed anti-ulcer effect on indomethacin induced ulcers in Wistar rats.
Oral versus intravenous maternal hydration in isolated third trimester oligohydramnios
Authors: Zafar Humaira , Naz Mubashra , Fatima Umber , Shahzad Uzma , Fatima Anees , Yasmeen Attiya
Published: September 2020

Background: To study the effect of oral and intravenous maternal hydration in patients with isolated oligohydramnios in terms of mean change in amniotic fluid.Methods: A total number of 38 patients included in the study which fulfill the selection criteria.  Patients were randomly divided in two groups. Amniotic fluid index (AFI) of all patients was measured before the hydration therapy according to the method of Phelan et al.  In maternal oral hydration (Group A), every patient was instructed to drink two liters of water over two hours daily for 1 week. In intravenous hydration (Group B), every woman infused two liters of 0.9% normal saline in two hour daily for 1 week. After 48 hours and 1 week of oral and intravenous hydration, the AFI was reassessed by the same observer. Patients were monitored closely for sign and symptoms of fluid overload. Data was stratified for mean difference in improvement in amniotic fluid index.Results: After oral hydration therapy AFI was 5.926±0.4593 after 48 hours and 8.286±0.6000 after 7 days in Group A. In Group B AFI was 5.784±0.4622 after 48 hours and 7.868±0.2810 after 7 days of intravenous hydration. P value after 48 hours is 0.348 and p=0.014 after 7 days means oral hydration therapy significantly increase amniotic fluid index.Conclusions: Oral maternal hydration significantly increase the amniotic fluid index in patients with isolated oligohydramnios. It is simple, safe and non-invasive method.
In vivo experimental infection of sarcosporidiosis and toxoplasmosis of rabbits in Duhok Province, Kurdistan region, Iraq
Authors: Hussein Shivan N. , Shukur Mohammed S.
Published: September 2020

Background: Sarcocystis species and Toxoplasma gondii are both zoonotic obligatory intracellular protozoan organisms and cyst-forming coccidian parasites that occur in domestic animals and human throughout the world.Methods: Forty local breed rabbits were divided into four groups, each group ten. Group one were infected with Sarcocystis, group two with Toxoplasma and group three with both parasites and last group was non-infected control group. The LAT serological test was used for detection of anti-toxoplasma antibody in serum of Toxoplasma infected rabbits. The direct impression smears stained with Giemsa was prepared from different body organs including; liver, lung, heart, brain and skeletal muscle for detection of tissue cysts (Bradyzoites) of T. gondii and microcysts of Sarcocystis.Results: In group one, 70% of infected rabbits were positive for toxoplasmosis by serological test; both are and by impression smear method 80% of the rabbits were positive for T. gondii with tissue cysts. Fifty percent of rabbits were positive for microcysts of Sarcocystis by direct impression smear method in group two. In group three, the impression smear and latex agglutination method were positive in 40% and 60% of rabbits, respectively. Statistically, there was no significant difference in detection of toxoplasmosis and sarcocystosis by LAT and impression smear method in group one and three.Conclusions: Rabbits could be source of toxoplasmosis and sarcocystosis and have public health implications and hazard as source of food. They might be source of infection for cats and shed environmentally resistant oocysts.
The effect of anaesthesia and antenatal care on feto-maternal outcome after caesarean section in a developing country
Authors: Onyekwulu Fidelis A. , Okonna Friday G. , Okeke Tochukwu C. , Okwor Israel O.
Published: September 2020

Background: The feto-maternal outcome after delivery is precarious in developing country. The anaesthetic technique and antenatal care as it affect this outcome is assessed.Methods: This is a 5-year retrospective study carried out at the University of Nigeria Teaching Hospital Enugu. Obstetric theatre records of patients who had caesarean section between January 1st 2011 and December 31st 2015 were reviewed. Data extracted from the records using a proformer included socio-dermographic characteristics, indications for surgery, maternal and neonatal outcome, and anaesthetic technique. The data were analyzed using SPSS Version 17 [SPSS Inc., Chicago, IL, USA].Results: A total of 1574 patients had caesarean section within the study period and 1158 (73.6%) of the patients were booked, while 416 (26.4%) were unbooked. The total number of deliveries during this period was 6235 giving a caesarean section rate of 39.6%. More deaths on the operating table were recorded in the unbooked patients as compared to booked parturient (x2=20.013, p<0.001). More babies of the unbooked patients died perioperatively (17.3%) when compared to booked paturient (3.4%) p<0.001.Conclusions: The commonest anaesthesia administered was subarachnoid block. Maternal and neonatal mortality was significantly higher in paturient who did not attend antenatal care compared to those who attended.
Effect of coffee consumption on liver enzymes (alanine transaminase, aspartate transaminase and alkaline phosphatase), total and conjugated bilirubin levels among students in Nnewi
Authors: Amah Ubou K. , Analike Adamma R. , Uzodinma Somadina S. , Ogbodo Chukwuemeka E. , Nnamdi Chinonso J. , Njoku Chidiadi M. , Agudi Chibuike C. , Amah Akuma K. , Obi-Ezeani Chikaodili N.
Published: September 2020

Background: Coffee has a number of bioactive compounds that have beneficial effects on human health in general and more importantly is the fact that coffee consumption has positive impact on the liver function. The present study investigated the effect of coffee consumption on liver enzymes: alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase (ALP), total bilirubin (TB) and conjugated bilirubin (CB) levels among student in Nnewi.Methods: A total of twenty-five (25) apparently healthy participants aged between 18 and 30 years which were randomly recruited from College of Health Sciences’ students to serve as both test and control group. Each participant was advised to abstain from coffee and similar beverages for a period of three weeks prior to the commencement of the study. Subsequently, in addition to their normal diet, each of the subjects was given 2 gm of coffee dissolved in 150 ml of hot water in which 50 mg of non-dairy creamer was added before breakfast daily for 28 consecutive days. 6 ml each of baseline and test samples (after an overnight fast) were collected at day 0 and 29 respectively from each participant. Liver enzymes such as ALT, AST, and ALP activity as well as TB and CB levels was determined using standard laboratory methods.Results: This showed significant reductions in the mean serum AST and ALT activity, TB and unconjugated bilirubin (UB) levels with no significant alterations in the mean ALP activity and CB level in participants studied after short-term coffee consumption.Conclusions: This study revealed the hepatoprotective effect of coffee intake at short term basis.
Knowledge and attitude towards mental illness among health and non-health university students in Riyadh
Authors: Mahboub Samira M. , Aleyadhi Rahaf A. , Aldrees Reema I. , Almuhanna Shahad S.
Published: September 2020

Background: Mental illness can affect anyone regardless of age, gender, and residence. Studying the attitude and knowledge about mental illnesses among university students is important, because they are the future decision makers dealing with such problems. The aim of this study was to assess level of knowledge and attitude towards mental illnesses among health and non-health university students in Riyadh.Methods: This study was a cross-sectional study on students of the governmental universities in Riyadh with both health and non-health speciality. The total sample size was 587 students. The questionnaire was designed electronically, and the link was distributed through social media. It included socio-demographic questions, 17 questions to assess knowledge and 22 questions to assess the attitudes. The statistical tests used were chi square, independent sample t-test, spearman’s correlation and multiple linear regression tests.Results: More than half of the participants had a positive attitude toward mental illness (52%). Only 13.46% of university students had good knowledge about mental illness. Significant higher level of good knowledge and positive attitude were reported among health college students compared to non-health (24.7% versus 7.9% for good knowledge and 60.8% versus 48.3 for positive attitude respectively). Attitude towards mental illness can be successfully predicted by using the knowledge score about mental illness and the type of college.Conclusion: Low percentage of university students had good knowledge about mental illness and their attitude towards mental illness was generally positive. Health college students had better attitude and knowledge about mental illness than non-health.
Comparison of mortality rate between bipolar hemiarthroplasty and proximal femoral nail anti-rotation for intertrochanteric fractures in Sanglah hospital, Bali
Authors: Dusak I. Wayan Suryanto , Aryana I. Gusti Ngurah Wien , Dharmayuda Cokorda Gde Oka , Subawa I. Wayan , Nugraha Hans Kristian , Susila I. Made Arya
Published: September 2020

Introduction: Intertrochanteric fractures occur in about 50% of all hip fracture events, with a mortality rate within 1 year after fracture reaching 15 to 20%. The most common treatment nowadays is either the bipolar hemiarthroplasty procedure or proximal femoral nail anti-rotation (PFNA), although there is still no consensus regarding which is better from the two, especially on patient mortality.Method: This study was an observational study using a retrospective cohort design. A total of 102 study subjects who met the inclusion requirements were grouped into 2 groups, one with bipolar hemiarthroplasty fixation treatment and another with PFNA fixation treatment. Mortality rate was recorded by survey 2 years after surgery.Result: Chi-square test showed that 2-year mortality rate after intertrochanteric fracture treated with bipolar hemiarthroplasty (21.4%) was significantly higher than the PFNA group (10.3%) (p=0.028). Bipolar hemiarthroplasty group also had longer length of stay (LoS) (50%) than the PFNA group (32.4%), albeit statistically insignificant (p=0.13). There was no significant difference between the 2-year mortality rate and LoS (p=0.976).Conclusion: Patients with intertrochanteric fractures who underwent bipolar hemiarthroplasty have significantly higher 2-year mortality rate than similar patients underwent fixation with PFNA, while they did not experience higher LoS than the PFNA group. Future prospective, multi-center study with larger sample size will be likely to validate similar fixation choice needed to decrease the mortality rate in intertrochanteric fractures.
Clinicopathological study of premalignant and malignant lesions of cervix along with apoptotic index and Ki-67 expression
Authors: Atla Bhagyalakshmi , Prasad Uma , Samantra Saraswathi , Botta Venkata Satya Kartheek , Dasari Naresh , Changala Glen Christopher
Published: September 2020

Background: Cervical cancer is known to have a good response to radiotherapy. The response and prognosis are dependent on the level of apoptosis. Pap smear and histopathology are cost-effective methods in diagnosing premalignant and malignant lesions of cervix but not accurate in classifying and estimating the progression of the disease, especially in premalignant lesions. Therefore this study was undertaken to know the role of Ki-67 expression and apoptotic index in classifying accurately the premalignant lesions for better management.Methods: The study included 540 cases diagnosed histologically as cervical intraepithelial neoplasia or carcinoma. The apoptotic index is calculated for all the 540 cases using light microscopy on Haematoxylin and Eosin stained sections. Ki-67 immunohistochemical staining was done for 100 cervical biopsies. Ki-67 expression was graded and the Ki-67 labelling index was calculated. Statistical evaluation was done using the unpaired t-test.Results: The Apoptotic index increased with increasing grade of dysplasia. There is a significant difference in the mean apoptotic index between premalignant and malignant lesions of the cervix. The ki-67 index increased with increasing grade of dysplasia. There is a significant difference in the mean Ki-67 index between premalignant and malignant lesions of the cervix.Conclusions: Apoptotic index and proliferative indices have been found useful in distinguishing between premalignant and malignant lesions of the cervix and gives an idea about the proliferative activity of the tumour for better management of the patient and to determine prognosis.
A case control study of serum vitamin D levels in alopecia areata
Authors: Naidu Bobbili Tarun Kesava , Baddireddy Kavya
Published: September 2020

Background: Alopecia areata is an autoimmune disorder of anagen hair follicle leading to distressing and relapsing non-scarring hair loss. Vitamin D is an immunomodulator and plays a role in regulating normal hair cycle. Recent evidence suggests inconsistent association between vitamin D deficiency and alopecia areata.Methods: This case control study included 70 newly diagnosed cases of alopecia areata and 70 healthy controls. Competitive chemiluminescence immunoassay was used to determine and compare the serum vitamin D (25‑hydroxyvitamin D) levels between these groups. Also, the serum vitamin D levels correlation with severity of the disease was studied. ANOVA test and student t test were used for the statistical analysis.Results: Serum Vitamin D levels were significantly decreased in alopecia areata patients than in controls (p<0.05). There was no stastically significant relationship between serum 25-OH Vitamin D levels and severity of the disease (p=0.06).Conclusions: Prevalence of serum 25 (OH) deficiency was significantly higher in alopecia areata group. However no significant relation was found with disease severity.
Cyto-histological correlation in diagnosis of gastrointestinal lesions- a prospective study in a tertiary care institute
Authors: Aggarwal Swati , Mardi Kavita , Sood Shivani , Kaushal Vijay , Sharma Brij , Sood Pranav
Published: September 2020

Background: Gastrointestinal tract is involved by a large number of inflammatory, infectious and neoplastic diseases. There is a worldwide rising incidence of GIT lesions especially neoplasms.Methods: This study was planned to correlate endoscopic and colonoscopic brush cytology with histopathology of gastrointestinal lesions and to determine the spectrum of gastrointestinal lesions in patients subjected to endoscopic brushings and biopsy.Results: Sensitivity of upper GI brush cytology was 95.15% and specificity 90.41%. Sensitivity of colonoscopic brush cytology was 100% and specificity 86.79%. The accuracy of brush cytology came out to be 92.45% in upper GIT and 92.22% in lower GIT.Conclusions: Brush cytology is a non-invasive and cost-effective method to retrieve epithelial cells from a much larger surface area of the mucosa, thus allowing thorough sampling and increasing the diagnostic yield.
Staphylococcus aureus still the commonest culprit
Authors: Kumar Saurabh , Faisal Yousuf , Chaudhary Rajib Ratan , Sarda Mukund Shyam
Published: September 2020

Background: Sepsis is still one of the most leading cause of death in world. 19 million sepsis (formerly severe sepsis) cases and 5 million sepsis-related deaths are estimated to occur annually. Sepsis is also one of the most common cause of patients getting critically ill and getting admission in intensive care unit. The main focus of this study is to identify the culture isolate from the critically ill patients and to check for the antibiotic sensitivity and resistance and identify if the report has changed the course of treatment and outcome of the patients. Critical illness is a life-threatening multisystem process that can result in significant morbidity or mortality. Critically ill patients are those who have dysfunction or failure of one or more organs/system and depend on survival from advanced instruments of monitoring and therapy. The aim of the study was to identify the causative organism causing sepsis in critically ill patients.Methods: It will be multi central retrospective study which included patients of critical illness of Rohilkhand Medical college, Bareilly, Uttar Pradesh and Varun Arjun Medical college, Shahjanpur, A total of 468 patients were taken for the analysis during period of from August 2018 to November 2019 among of which 324 samples came positive. Samples were taken on day one of the patient’s presentation to the hospital and were analysed in BD BACTEC culture medium. Patient’s data were taken from records available at both the hospitals. Sensitivity was performed using disk diffusion method and the results were compared with the records of patients.Results: Among of samples taken that is 324; 194 were male and 130 were female. Maximum patients which were tested positive for Staphylococcus aureus (n=198). Others included Streptococcus pneumococcus (n=25), Escherichia coli (n=50), Klebsiella oxytoca (n=13), Klebsiella pneumoniae (n=15), Pseudomonas aeruginosa (n=20), and Acinetobacter (n=3). In retrospective analysis of the patients of all 324 cases treatment in approximately 148 patients was changed due to change in the sensitivity of antibiotics.Conclusions: Staphylococcus still dominates the sepsis. It is advisable to add an antibiotic with gram negative if patients count does not improve in first 24 hour.
A study on scrape smear cytology in oral leukoplakia in a tertiary health care centre of southern Assam
Authors: Ullah Sania S. , Deka Manoj K. , Khakhlari Nitumani
Published: September 2020

Background: Oral cavity is susceptible to countless changes with advancing, environmental, and lifestyle related habits and factors. Oral mucosal lesions especially related to chewing and smoking of tobacco have led to the increased incidence and prevalence of potentially malignant and malignant disorders worldwide. Oral leukoplakia has been a very frequent finding in patients coming to our department and with an increasing rise of oral squamous cell carcinoma in the region, the study was conducted.Methods: Patients referred to our section from various department with white oral lesion. Scrapping smears were prepared. Stained with MGG and PAP stain. Study period: January 2019 to May 2020.Results: Total number of patients with white oral lesion were 83. Out of these 65 were male and 18 were female. Most of the patients had addiction to betel nut and leaf with tobacco and few had history of intake of bidi for several years.Conclusions: The study reveals that most of the oral leukoplakia cases is attributed to smoking, betel nut and lime intake. Exfoliative cytology of oral mucosa serves to be an easy, convenient and reproducible technique for early diagnosis of premalignant condition. Biopsy can be used as an adjunct in cases showing atypia and mixed type of keratosis.
Impact of coronavirus on pregnant females in India: an observational study
Authors: Garg Megha , Jain Madhu , Jain Shuchi
Published: September 2020

Background: Coronavirus (COVID-19) has emerged as a rampant pandemic and the entire world is struggling against it. The entire nations are trying to device measure like national lockdowns, diverting resources towards fighting coronavirus, extensive media coverage, closing of elective services in hospitals. All this has influences the masses to a deep level. Coronavirus not only is morbid for the sick, but also the healthy pregnant females seeking health care and impacted them more mentally than physically.Methods: In this study 103 pregnant females from the entire nation of India were made to answer a well thought and made questionnaire which aimed at assessing the mental state and impact of coronavirus on the pregnant females.Results: Majority of the females answered that they felt anxious and were undergoing stress due to the coronavirus. They fear impending doom for the child and also are struggling a lot to seek apt healthcare for themselves and their children because of the ongoing pandemic.Conclusions: Coronavirus has not only affected people who are directly affected with the virus, but also who are still not affected but are mentally stressed because of it. National lockdown and alteration in the healthcare services are also stress- inducing for the pregnant females.
Evaluating substance use in an urbanizing town of mid hills of Northern India
Authors: Singh Ajay K , Verma Kushel , Guleria Amit , Puri Shalini , Sharma Ankit , Sharma Vaishali
Published: September 2020

Background: Substance use is emerging as a major cause of morbidity and mortality across the world. Solan, a fast urbanizing town of India has witnessed mushrooming of industries and educational institutes. A surge in the persons booked under the Narcotic Drug and Psychoactive Substance Act 1985 led us to look into the determinants of the substance use in this region.Methods: We undertook a cross sectional study of one year secondary data analysis of 750 substance users screened at the de-addiction centre of Solan Hospital. The data mining was done by the cluster analysis technique. SPSS 16 and STATA 13 software were employed.Results: Mean age of users was 31 years with dominance of males (89.20 %), two third of total users were married, 75% were unemployed, 42% had upper school level education. About 60 and 38% were using cannabis and chitta (a synthetic opioid) respectively. Only 2% were consuming tobacco and alcohol. 62% of substance users had the fear of legal action and 44% had no family history of substance use. 39% had only single parent, 54% had started substance use under peer pressure and duration of use varied between 6 to 24 months.  Alcohol and cannabis were used more in urban and rural areas respectively. 63 and 70% had family history and experience of peer pressure respectively.Conclusions: Cluster analysis has generated substance specific socio-demographic determinants of substance use which would help in planning appropriate substance use alleviation strategies.