bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of selective reporting: protocol for a review and content analysis of a random selection of the literature v1
Authors: T. van der Steen Jenny , C. van Soest-Poortvliet Mirjam , A. van den Bogert Cornelis , H.J. Otten René , ter Riet Gerben , M. Bouter Lex
Published: September 2017

Background: Selective reporting distorts the aggregate body of scientific evidence, wastes resources and can harm patients’ health and the credibility of science. Selective reporting may result from a focus on preferred findings by researchers and others stakeholders. However, it is unclear if some persons or environments are at greater risk of selective reporting than others. Our review assesses what is known and what is postulated about determinants of selective reporting in the scientific domain. Methods/design: Using search terms for bias and selection combined with terms for reporting and publication, we systematically search the PubMed, Embase, PsycINFO and Web of Science databases. A 25 percent random selection of records is reviewed for inclusion by at least two reviewers based on title and abstract if available and, if needed, the full text. Inter-rater agreement is calculated. Examining the content of the entire article, including, for example the discussion section, we extract phrases mentioning determinants. From this, we compile a structured list of possible determinants. The results are also categorized by type of source (empirical result or view, study design, and academic discipline if variability suffices). We follow the PRISMA-P and PRISMA reporting guidelines for systematic reviews where applicable. Discussion: We use principles of the systematic review along with principles of qualitative content analysis to focus on the nature of possible determinants of selective reporting. Our review includes both empirical findings and theoretical considerations. It will identify priority questions for further research on mechanisms of selective reporting. Furthermore, it will help in assessing risk of selective reporting. Such “risk profiling” may inform effective policy development on responsible conduct of research. The approach of combining quantitative and qualitative assessment techniques is expected to optimally inform well-targeted intervention studies and inspire policy development.
Drugs acting on mitochondrial pathways
Authors: Srinivasan Akila , Selvarajan Sandhiya , Dkhar Steven Aibor , Gunaseelan Vikneswaran
Published: September 2017

Mitochondrion, “the power house” of the cell plays a vital role in generating energy for the intricate functions of the cells. Mitochondria also play important roles in various apoptotic pathways. Around 80-90% of the ATP generated in cells is contributed by these organelles through the process of oxidative phosphorylation. Though this process is essential for the functioning of cells it also generates various Reactive Oxygen Species (ROS), which are toxic to cells. Hence mitochondrial dysfunction is hypothesized to be an important factor in the occurrence of disorders related to aging such as neurodegeneration and malignancies. Several commonly used drugs in clinical practice exert their action by interacting with mitochondrial pathways. This review attempts to focus on the various groups of drugs which act on mitochondria and are utilized for therapy of conditions like cancer, diabetes mellitus, neurodegeneration and so on.
Assessment of drug use pattern for lower respiratory tract infection in outpatient department of paediatric at central referral hospital: a cross-sectional study
Authors: Sharma Chandrakala , Endow Arkojit , Dutta Sudip
Published: September 2017

Background: Prescription audit is an important tool to analyse rational use of drug at different health sectors. The aim of the study was to evaluate the prescribing pattern using World Health Organization prescribing indicators for lower respiratory tract infection in children below five years of age.Methods: A cross-sectional study was conducted in the outpatient department of Paediatrics at Central Referral Hospital, Gangtok, Sikkim, India for a period of 18 months. Study involved children between 1-5 years of age with fever/cough with or without respiratory distress. The data were collected from the out patient department prescription slips as well as interviewing the parents/guardians after finishing the physician consultation. The data were processed using statistical software SPSS 20.Results: The study was conducted with 57 prescriptions comprising 210 drugs from both male (54.38%) and female (45.61%) patients. The average number of drugs per prescription was found to be 3.68. negligible (0.013%) prescription containing generic name of drug was found, 96.66% of medicines were prescribed from National Essential List of Medicine (NELM). No prescriptions were found to have injectables, 8.57% of the prescriptions were found to contain fixed dose combination. Amongst the drug categories, salbutamol accounted for 23.33% in total prescription followed by paracetamol (22.85%) and amoxicillin (7.14%). While accounting for the formulations used, the maximum prescriptions were containing syrup followed by nebulization.Conclusions: The use of generic names was minimal, only few of the prescriptions had vitamins and tonics with no use of injectable preparations. Maximum numbers of drugs were prescribed from NELM.
Prescription pattern of antibiotics in paediatric inpatients at a tertiary care hospital in North East India
Authors: Dutta Sayeri , Bhattacharjee Abhishek , Meena Devi N.
Published: September 2017

Background: Paediatric antibiotic prescription is a major concern in terms of public health since infections are the most frequent cause of childhood disease. The aim of this hospital-based cross sectional study was to assess the pattern of antibiotic use in the paediatric ward of RIMS hospital, Manipur, India.Methods: A retrospective study of six months duration was carried out for the month of October 2016 to March 2017. A total number of 200 patients case sheets were utilized for our study from paediatric in-patients department of RIMS hospital, Manipur. The data collected was then analysed for various prescribing indicators as laid down by world health organisation (WHO) for analysis of drug use parameters.Results: The mean age of paediatric patient was 2.1 years. The average number of drugs per encounter was 5.14. The average number of antibiotic per patient was 2.11. In present study antibiotic were 41% of total drugs prescribed. Most common prevalence of disease among study patients sample was acute gastroenteritis. The most commonly prescribed antibiotic was Ceftriaxone followed by Amikacin. In present study 8.2% of antibiotics were prescribed in generic name. Polypharmacy was evident from the study.Conclusions: Antibiotic prescribing in children is relatively high in RIMS, Imphal, Manipur. Prescription of broad-spectrum antibiotics though has increased demonstrably which   h may result in development of bacterial resistance; however, development of guidelines for antibiotic prescription and use of appropriate drugs for the disease can result in minimizing the unfavourable use of antibiotics in children.
Adverse drug reactions monitoring of newer oral hypoglycemic drugs in a tertiary care hospital of North India: a prospective study
Authors: Singh Shephali , Nigam Nilam , Gupta Shalini , Kumar Shravan
Published: September 2017

Background: Diabetes Mellitus (DM) is a metabolic disorder characterized by hyperglycemia. In majority of patients oral hypoglycemic drugs remain the primary agents in management of DM. Currently there are variety of new drugs are approved in management of DM of which safety is established in clinical trials but there surveillance is needed for reporting newer adverse effects which are not documented yet.Methods: 112 patients were screened with the help of a predefined inclusion and exclusion criteria for the study and followed up for three months. The drugs which are relatively new and have been in the market for around 5-7 years were taken as new drug. These include specifically the following drugs: DPP-IV Inhibitors, PPAR α/γ agonist, SGLT-2 inhibitors. They were screened and investigated suitably for any ADRs. The severity of the adverse drug reactions was graded according to the Hartwig’s Severity Assessment Scale and Naranjo Scale was used for causality assessment between the drug and suspected reaction.Results: Maximum ADRs reported belonged to gastro intestinal system (53%). DPP-IV inhibitors showed maximum number of ADRs i.e. 70.6%. Majority of ADRs reported were mild i.e. 52.9%. Overall 15.2% patients reported ADRs. Majority of ADRs reported (70.6%) belonged to category ‘possible’.Conclusions: All three class of newer oral hypoglycemics seems reasonably safe to be used in general practice. As the number of patients were small, we need larger study to substantiate the findings.
Comparative clinical profile of patients of Benign Prostatic Hyperplasia (BPH) with and without Metabolic Syndrome: a prospective observational study
Authors: Panwar Vikrant , Pandey B. L. , Dwivedi U. S. , Singh Alok
Published: September 2017

Background: Benign Prostatic Hyperplasia (BPH) is one of common disorder in men of old age group. The pathogenesis of BPH is multi-factorial and still not been fully elucidated. There are numerous reports which suggest possible link between several metabolic alterations known as Metabolic Syndrome. In the present study, the aim was to establish relation between Benign Prostatic Hyperplasia and Metabolic Syndrome and to find out effects of therapeutic intervention of Metabolic Syndrome on prostatic parameters.Methods: 93 patients of Benign Prostatic Hyperplasia enrolled who met qualifying criteria for inclusion in study and divided into three groups on the basis of Metabolic Syndrome and its treatment administered. Administration of alpha adrenergic blocker was common to all patients of all groups. Metabolic parameters including Fasting blood glucose, High-density lipoprotein (HDL), Triglycerides (TGs), waist circumference and prostatic parameters that is prostate volume, prostate specific antigen (PSA), uroflometry, International prostate symptom score (IPSS) were assessed at baseline, after 3 and 6 months follow-up. Further appropriate statistical tests were applied for comparison of parameters among groups.Results: Patients receiving no treatment for Metabolic Syndrome were having most deranged prostatic parameters as compared to patients without Metabolic Syndrome or patients with Metabolic Syndrome receiving treatment for same. Further patients receiving treatment for Metabolic Syndrome and alpha adrenergic blocker were having better clinical profile than patients of alpha adrenergic blocker alone.Conclusions: These findings show probable link between Metabolic Syndrome and worse prostatic profile. Metabolic Syndrome must be looked for and treated in patients of Benign Prostatic Hyperplasia. Metabolic derangements must not be overlooked and must be treated accordingly.
Study of the oral hypoglycemic activity of Moringaoleifera leaves alone and in combination with Glibenclamide in streptozotocin induced diabetic albino rats
Authors: Naidu Sushma V. , R. N. Suresha , M. K. Jayanthi , A. M. Satish , H. L. Kalabharathi , V. H. Pushpa
Published: September 2017

Background: Oringaoleifera is a widely used plant with high medicinal value, well known for its pharmacological actions and is used in various conditions. It has been reported to have many biological properties like anti-inflammatory, antimicrobial, antispasmodic, antitumour including antidiabetic activity.Methods: The study was carried out in Wistar albino rats with body weight 150-250gms. Diabetes was induced by injecting Streptozotocin intraperitoneally- dose 55 mg/kg BW. Animals were divided into 5 groups with 6 animals in each group. First group (Control) was given 2% gum acacia. Other 4 groups were induced diabetes by giving Streptozotocin. Diabetic control group received gum acacia (0.5 ml), Standard group received Glibenclamide (0.5mg/kg BW), Test group received Moringaoleifera extract (300mg/kg) and Test+ Standard group receiving combination of Moringaoleifera and glibenclamide at half the above doses. All drugs were given orally for 28 days and blood glucose levels analyzed using Glucometer on Day 0 before drug and on D1, D3, D7, D14, D21, and D28. Data were statistically analyzed by ANOVA and Tukey‘s Post Hoc test.Results: Hypoglycemia produced by Moringaoleifera extract was significant (p<0.001) when compared to diabetic control group from day 7 to day 28. The percent reduction of blood glucose level was 52.9% as compared to Glibenclamide group 61.3%. The combination group also showed significant hypoglycemic activity the percentage reduction being 56.44%.Conclusions: Thus, Moringaoleifera decreased blood glucose level efficaciously as compared to diabetic control group and similar to standard group at p<0.001.
Analysis of the pattern of ADR’s reported to an ADR monitoring center in South India: a prospective study
Authors: Khot Anant , Thomas Thresiamma K. , P. Savithri , N. Rajalakshmi A.
Published: September 2017

Background: All medicines with an ability to produce a desired therapeutic effect will also have the potential to cause unwanted adverse effects. It has been established that ~ 2.9%-5.6% of all hospital admissions are caused by Adverse drug reactions (ADRs) & as many as 35% of the hospitalized patients experience an ADR during their hospital stay. An incidence of fatal ADRs is 0.23%-0.41%. In some countries, ADRs rank among the top 10 leading causes of mortality. In order to increase awareness, observe the pattern of ADRs and communicate scientific data to prevent ADRs, this study was undertaken.Methods: It was a prospective observational study conducted at a tertiary hospital in Kochi. All the spontaneously reported ADRs were assessed and analyzed for type, severity and causality.Results: A total of 120 ADRs were reported during the study period. Most of the ADRs were seen in females in the age group of 61-70 years. Skin and appendage disorders were the most common manifestation of different type of ADRs (49.2%). Antineoplastic and immunomodulating agents (30.8%), followed by anti-infectives for systemic use (29.2%) were mostly implicated in the causation of ADRs. Majority of the ADRs were of mild to moderate in severity (89.2%).Conclusions: Although small, but significant number of patients had severe ADRs. Hence, we require a robust system for monitoring the medication use process. So that we can prevent and reduce the morbidity and mortality due to therapeutic agents.
Evaluation of antioxidant activity of ormeloxifene: in vitro study
Authors: M. Vinay , S. Seethalakshmi , Kumar Vijay
Published: September 2017

Background: Ormeloxifene (Centchroman) is a Selective Estrogen Receptor Modulator (SERM) which acts as estrogen antagonist and having anti progestogenic activity also. It is being used in the management of dysfunctional uterine bleeding and as nonhormonal oral contraceptive. It is also being investigated for the indications such as osteoporosis, breast and endometrial carcinoma. In this study, we have evaluated the Antioxidant potential of drug by using DPPH and NO synthase Assay. It was found that ormeloxifene has significant antioxidant activity which could be cause for its use in various gynaecological and other conditions.Methods: In this study, we have demonstrated in vitro antioxidant activity of ormeloxifene. DPPH and NO synthase assay tests were done for different concentrations of ormeloxifene.Results: In our study, it showed that the free radical scavenging activity of ormeloxifene was less in lower concentration and increased in the higher concentration in DPPH assay. The free radical scavenging activity of drug ormeloxifene was 22% at 100µg/ml and 27% for the concentrations of 1000µg/ml in DPPH assay. No scavenging activity was 3% at 100µg/ml and 11% at 1000µg/ml.Conclusions: The invitro antioxidant analysis of ormeloxifene, was proved to be a potent antioxidant.
A comparative evaluation of intravenous dexmedetomidine and oral clonidine in attenuating the rise in intra ocular pressure
Authors: K. Yadhuraj M. , P. Somasekharam , M. Vinay D. , U. K. Akhil Rao
Published: September 2017

Background: Administration of Suxamethonium, laryngoscopy and intubation is associated with rise in intraocular pressure (IOP). The need to attenuate rise in IOP is of utmost importance, especially in patients with perforating injury of the eyeball. The present study was undertaken to compare the effectiveness of intravenous Dexmedetomidine 0.4μg/kg and oral Clonidine 3μg/kg in attenuating the rise in IOP following administration of suxamethonium, laryngoscopy and intubation.Methods: 150 patients of ASA I or II, aged between 18-60 years, who were posted for elective non-ophthalmic surgery requiring general anaesthesia were included in this study. Patients were randomly divided into 3 groups with 50 patients in each group. Group-D: Received 0.4μg/kg IV dexmed in 10ml sterile water, over 10 min before induction. Group-C: Received 3μg/kg oral clonidine two hours prior to surgery. Group-S: Control group.Results: IOP, MAP, and HR were recorded at baseline, before induction, after induction, 1 min, 3 min and 5 min after administration of suxamethonium. Although Suxamethonium laryngoscopy and intubation increased IOP in all the 3 groups there was significant reduced rise in IOP noted in dexmed group and clonidine group compared to study group (p= <0.001). Furthermore, patients in dexmed group had lesser rise in IOP compared to clonidine group (p= <0.001).Conclusions: We concluded that both intravenous dexmedetomidine 0.4μg/kg and oral clonidine 3μg/kg, significantly attenuated the rise in IOP associated with administration of suxamethonium, laryngoscopy and intubation. However intravenous dexmedetomidine proved better than oral clonidine in attenuating the rise in IOP.
Unscheduled bleeding on HRT - do we always need to investigate for endometrial pathology?
Authors: Lou Ying Yiing , Kannappar Jeyanthan , Sathiyathasan Sahathevan
Published: September 2017

Hormone replacement therapy (HRT) is the most effective method for relieving the effects of hypoestrogenism following menopause. Despite the benefit of the HRT, unscheduled/breakthrough bleeding decreases patients’ compliance with long-term use. The underlying mechanisms for this unpredictable breakthrough bleeding are less well understood. In the event of unscheduled bleeding, investigation may be necessary according to local protocol. Whilst the incidence of underlying benign pathology may be quite high, the likelihood of malignancy is low and unless there is particular clinical concern, these women do not need fast track referral which should be reserved for women with true postmenopausal bleeding.
Adolescent pregnancy: an overview
Authors: Ghose Seetesh , John Lopamudra B.
Published: September 2017

A pregnancy can take place at any time before or after puberty. Adolescent pregnancy is defined as pregnancy under the age of 20 years. It is a problem in both developed and developing country. It raises various human right issues i.e. an adolescent pregnant girl is forced to leave school, depriving her right to education; she is prevented from using any contraception or reproductive health related information, so she is also denied her right to health. As many adolescents are neither physically nor psychologically ready for pregnancy or childbirth, this reproductive event makes them more vulnerable to complications resulting in devastating health consequences for them. Early drop out from the school and health problem jeopardize their income-earning potential.
A comparative study between the efficacy of local intra-myometrial injection of vasopressin and octreotide acetate, in reducing blood loss during myomectomy
Authors: Badawy Amira Mohammed
Published: September 2017

Background: Symptomatic Uterine leiomyomata may lead to many symptoms including abnormal uterine bleeding, mass pressure effects and infertility. Myomectomy is an option for conservative management, however, it is associated with some disadvantages, mainly increased intra-operative blood loss. Intra-myometrial vasopressin injection during myomectomy is an effective method to decrease the intraoperative bleeding due to its vasoconstrictor effect. Octreotide Acetate (OA) is another vasoconstrictor agent that have not been tested for gynaecologic indications. The current study was conducted to assess the efficacy of local injection of OA in reducing blood loss during conventional abdominal myomectomy, and to compare it with local instillation of vasopressin.Methods: 60 cases with symptomatic leiomyomata were recruited and planned for abdominal myomectomy, they were divided randomly into 3 groups, 20 cases in each. Group I, where local vasopressin was used, group II, where OA was used, and group III (the control group), where no specific medication was used and only free Saline was injected locally.Results: The overall results showed that OA group had significantly less operative time and less blood loss compared to control group. However, when compared to cases in group I, operative time and blood loss were significantly higher. Postoperative haemoglobin levels were significantly lower in group III compared to groups I (P = 0.039) and II (P = 0.044). Blood transfusion was indicated in 9 cases among group III, while only one case needed blood transfusion in group II, and no cases in group I.Conclusions: The use of local intra-myometrial OA is an option for reducing blood loss during myomectomy, but still efficacy is less than local vasopressin. This may be attributed to the low concentrations used, and to the less potency of OA as a vasoconstrictor agent.
Clinical audit of neonatal care in Assiut Women's Health Hospital, Egypt
Authors: Shehata Walaa S. , Refat Nafisa H. , El Saman Ali , Kandeel Mansour Y. , Ismail Alaa M. , Abbas Ahmed M.
Published: September 2017

Background: The current study aims to auditing the current care of healthy full term newborns in the delivery room and identify the gap between the current practice and ideal practice in Assiut Women's Health Hospital, Egypt.Methods: The current study was a clinical audit carried out in Assiut Woman Health Hospital, in the period from 1 September 2016 to 28 February 2017.The study included all newborns delivered in the delivery word of gestational age after 37 week. We excluded all Preterm babies, those with congenital anomalies, pregnant women with medical disorders and multiple pregnancies. In the present work all data was collected prospectively through direct personal patient contact, direct observation of care givers, patient interactions and attitudes, from the clinical records and then recording the data in special check sheet. All basic criteria of the study participants as age, parity, gestational age at delivery and type of delivery were obtained. The neonatal gender, weight, heart rate and respiratory rate were checked. Audit criteria were selected according to the WHO 2015 and AAP 2010-2015 guidelines.Results: The study included 800 women; the mean age of the women was 26.52±5.70 years. The mean parity was 1.78±1.85. The mean gestational age at delivery was 38.81±0.96 weeks. As regard the type of delivery, 54.1% of women were delivered by cesarean section. Calling neonatologists occurred in 67.9% of deliveries. The mean birth weight was 3.17±0.39 kilograms. Nearly half of them (52%) were males.Conclusions: Application of the guidelines of the neonatal handling is important for optimum care to the neonates. Re-audit the steps of the handling is important to discuss whether practice has improved or not in our tertiary hospital.
Efficacy of colour doppler imaging in prediction of placenta accrete
Authors: Agarwal Rachna , Bhaskaran Sruthi , Gupta Esha , Dutta Dipanvita , Tandon Anupama
Published: September 2017

Background: In present scenario of increasing cases of previous caesarean section the diagnosis of Placenta accreta preoperatively is of great value to the attending obstetrician. This helps in preparing, counselling the patient and also in assembling a multidisciplinary team for effective peripartum clinical management of these patients to prevent maternal morbidity and mortality.Methods: One hundred patient with persistent placenta previa after 28 weeks gestation were screened by grey scale B mode sonography. In suspicious cases of placenta accreta, further assessment by colour Doppler ultrasound was done. The color doppler imaging (CDI) criteria used were - diffuse intra parenchymal placental lacunar flow, focal intra parenchymal placental lacunar flow, bladder-uterine serosa interphase hypervascularity, prominent sub-placental venous complex and loss of sub-placental vascular signal in areas lacking peripheral sub-placental hypoechoic zone. Patients were prospectively followed up till delivery and the CDI findings were analysed with reference to final diagnosis made during caesarean section.Results: Six of hundred patients exhibited characteristic CDI patterns highly specific for placenta accreta according to the criteria used. In all 6 patients, morbidly adherent placenta was present intraoperatively. The sensitivity and specificity of CDI in the diagnosis of placenta accreta in presentstudy was 100%. Caesarean hysterectomy was required in five patients. Patients with CDI features of lacunar flow had higher incidence of blood loss, transfusion requirements and need for caesarean hysterectomy compared to patients with nonlacunar flow. The remaining 94 patients with placenta previa, not suspicious for placenta accreta on sonography underwent uncomplicated caesarean section.Conclusions: The use of CDI along with conventional grey-scale sonography improves the diagnostic accuracy for prediction of placenta accreta in patients with persistent placenta previa.
Role of umbilical artery Doppler velocimetry in predicting the adverse perinatal outcomes in hypertensive disorder of pregnancy
Authors: Yadav Jyoti , Shukla Mala , Jain P. K. , Kumar Devender
Published: September 2017

Background: Early detection of fetoplacental compromise with Umbilical Artery Doppler indices and to know the predictive value of each indices in predicting perinatal outcome and interventional strategies in these patients.Methods: The present prospective study was conducted on 200 women with hypertensive disorder of pregnancy. Umbilical artery doppler evaluation done in all the patients at (28-32) weeks, (33-36) weeks and (37-40) weeks of gestation and more frequently in those patients having deranged Doppler. Patients divided into two groups women with abnormal Umbilical artery indices (group B) and normal indices (group A). Perinatal outcome of both the groups were compared, analyzed statistically using Chi-square test. Multiple pregnancy, chronic hypertension, fetal congenital anomalies, systemic disease and those lost to follow up till delivery were excluded from study.Results: A total of 200 pregnant women with hypertensive disorder, 64% were primgravida. Abnormal umbilical artery indices seen in 36%. Adverse outcome was seen in 88.88% patients of group B. Statistically significantly higher rate of caeserian section, induction of labour, Preterm delivery, fetal growth restriction, NICU admission, NICU stay >48hrs were seen in group B. In all indices Umbilical artery PI had highest Sensitivity (84.21%), positive predictive value (88.88%) and accuracy (90%).Conclusions: Umbilical artery PI is the most reliable to predict adverse perinatal outcomes and help in appropriate timing of intervention to improve perinatal outcome.
Correlation of serum biomarkers in prediction of gestational diabetes mellitus
Authors: Menon Maya , Alaganandha M. , Mohan Jayanthi
Published: September 2017

Background: Adiponectin and Leptin are adipokines produced by adipocytes. TNF-alpha and IL-6 are inflammatory cytokines which increases insulin resistance. Decreased adiponectin, increased leptin, TNF-alpha and IL-6 is associated with risk of Gestational Diabetes Mellitus, characterised by glucose intolerance that begins or first recognised in pregnancy leading to maternal and foetal complications. India has a high prevalence of GDM upto 16.55% by (2hr plasma glucose of more than 140mg/dl). We aimed to evaluate whether ‘First trimester serum biomarkers predict gestational diabetes mellitus’. The objective of the study was to study the serum biomarkers levels in early pregnancy and predict the risk of developing gestational diabetes mellitus. To study the correlation of serum biomarkers levels in gestational diabetes mellitus.Methods: The study was conducted between October 2014 to March 2016 in healthy pregnant women aged 20-35 yrs attending the antenatal OPD in ESIC Hospital. Study design: Prospective observational study with three study groups 1. NGT, 2. GDM1, 3. GDM2 with two-time points one at first trimester and other second trimester. Sample size: 125 pregnant women. Work plan: Demographics, baseline characteristics and other clinical risk factors of pregnant women in 1st trimester who consented for the study, meeting the inclusion criteria are noted. 75 gm OGCT (oral glucose challenge test) done at two-time points first and second trimester in the study groups will be analysed using the DIPSI criteria with a cut-off value ≥140mg/dl and divided into 3 groups. Serum biomarkers were measured by DRG ELISA method at one-time point in first trimester in all the 3 groups.Results: The serum levels of adiponectin are comparatively reduced in first trimester GDM1 group. As the difference was not significant with p-value of 0.33 there was no correlation between adiponectin and GDM in our study. Serum leptin is increased in second trimester GDM group but the difference is insignificant with a p value of 0.11 showing no correlation.Conclusions: Among the cytokines IL-6 also shows an increasing tendency in both GDM1 (5.9±0.57) and GDM2 (6.04±1.04) groups compared to the NGT (5.82±0.38) group. Serum TNFα is increased in GDM1 (17.29±17.14) and NGT (17.03±24.03) compared to GDM2 (13.54±17.29) group.
A pilot study evaluating the feasibility of non-descent vaginal hysterectomy for benign gynecological indications in women in rural India
Authors: Soni Anjali , Soni Pawan Kumar , Sharma Chanderdeep , Verma Suresh , Vashasit Shivani
Published: September 2017

Background: Hysterectomy for benign indications is one of the common surgical procedures performed on women worldwide. Despite the available evidence favouring vaginal surgery still abdominal route is preferred in majority of women in rural India. Hence, this pilot study was done to determine the feasibility of Non-descent vaginal hysterectomy (NDVH) in rural India.Methods: All women planned for hysterectomy for benign indications (with no or minimal pelvic organ prolapse) during a period of six months were enrolled after taking informed consent and subsequently, underwent NDVH. Data was analyzed retrospectively with respect to duration of surgery, average blood loss, complications of surgery and duration of stay in the hospital.Results: All except one woman out of 37 women enrolled for the study had an un-eventful surgery with median duration of surgery [median 30 minutes; (range 30-55 minutes)], median hospital stay [(median 2 days) range 2-7 days], and minimal blood loss [median 50 ml (range 50-200 ml)]. There was one case of inadvertent cystotomy (diagnosed and repaired intra-operatively), and discharged in healthy condition on seventh post-operative day.Conclusions: NDVH is a safe option for hysterectomy (in women without pelvic organ prolapse) for benign indications even in rural India. It has been found to be associated with short hospital stay, minimal blood loss and short recovery time.
A retrospective study on surgical management of ovarian tumours in a teritary care semiurban hospital
Authors: Ranjitha S. Divya , Karthikeyan Kavitha , Nalini Amrita Priscilla
Published: September 2017

Background: The prevalance of ovarian tumors is around 1-3%. The accurate diagnosis and appropriate management of ovarian tumors is a real challenge to gynaecologists. The aim of the study was to analyse the risk factors, clinical presentation, surgical procedure and histopathological report in patients with surgically managed ovarian tumours.Methods: We conducted a retrospective study by collecting the data of patients operated in the department of Obstetrics and Gynecology at Chettinad Hospital and Research Institute, Kelambakkam. A total of 118 case records were studied.Results: 20.3% were nulliparous. 79.7% were multiparous. 10.2% were <20 years, 47.2% were 20-40 years, 39.2% were 40-60 years, 3.4% were >60 years. 72.9% were premenopausal. 27.1% were postmenopausal. 25.4% presented with acute abdominal pain, 11.9% with mass abdomen, 30.5% with chronic pain abdomen and 32.2% were incidentally diagnosed. 20.4% underwent ovarian cystectomy, 18.6% ovariotomy, 30.5% salpingoophorectomy and 30.5% total abdominal hystrectomy with bilateral salpingoophorectomy. Most common histopathology report was simple cyst in 44.%. 31.3% had serous cystadenoma, 9.3% had mucinous cystadenoma, 9.3% had teratoma, 2.5% had brenner tumour, 1.7% borderline tumours and 1.7% malignancy (Serous cystadenocarcinoma).Conclusions: Elective surgical management of ovarian tumours is better option for reducing emergency laparotomies for torsion and rupture and also for obtaining a conclusive histopathological diagnosis in suspicious cases. The choice between laparoscopy and laparotomy should made after making appropriate preoperative evaluation.
Transvaginal sonography versus saline contrast sonohysterography in evaluation of abnormal uterine bleeding
Authors: Vohra Rashmi , Mittal Rita , Sood Anupa
Published: September 2017

Background: To evaluate TVS and SCSH as a screening method in case of AUB and to correlate he findings of TVS and SCSH with hysterectomy specimen.Methods: Present study was conducted in department of obstetrics and gynaecology, Kamla Nehru Hospital for mother and child, IGMC, Shimla for a period of one year. A total of 150 patients with AUB were subjected to TVS and SCSH in same sitting irrespective of their phase of menstrual cycle. All the cases were subjected to hysterectomy within 2 weeks and operative findings were noted. Data was collected and findings analysed.Results: Overall sensitivity of SCSH was found to be 97.6% while that of TVS was 95.1%. The overall specificity of SCSH was found to be 99.6% and that of TVS was 98.2%. PPV, NPV and DA for SCSH was more than that of TVS i.e., 98.9% vs 97.4%, 99.7% vs 99.3% and 99.4% vs 98.7%.Conclusions: SCSH represents a new and promising technique for investigation of the uterine cavity. It is safe, minimally invasive, easy, cost effective and reliable method to diagnose the cause of AUB.
Menopausal dyslipoproteinemia in breast carcinoma patients: a laboratory analysis
Authors: Narkhede Harshal P. , Muddeshwar Manohar G.
Published: September 2017

Background: Seldom any precedent work has aimed to study the influence of age and menopausal status towards serum lipoproteins levels in breast cancer. Owing to influence of sex-steroids over lipid handling by oestrogen-dependent breast cells, their serum levels might reveal insinuating facts, if menopausal status-wise analysis is attempted. Ascertainment of serum lipid/lipoprotein aberrations in breast carcinoma; and substantiation of their behaviour with age and menopause among breast cancer and healthy subjects.Methods: Laboratory analyses of serum total cholesterol (TC), high density lipoprotein cholesterol (HDL-c), low and very low density lipoproteins (LDL-c, VLDL-c) and triglycerides (TG) were done among breast cancer subjects (n=50) and healthy women (n=50) with respect to their age (3 sub-groups viz. 25-40, 41-55 and 56-75 years) and menopausal status. Grouped numerical data were subjected to intra- and inter-group comparisons using Student’s unpaired-‘t’-test and ANOVA with Post-Hoc comparisons using Tukey-HSD (Honestly-Significant-Difference) Test.Results: Higher serum LDL-c and TC with lower HDL-c levels were observed among breast carcinoma subjects than healthy women (P=0.004, 0.003, 0.009 respectively). Serum LDL-c elevation in peri- and post-menopausal age (P=0.009), while lowered HDL-c specifically during post-menopausal age (0.004) were significantly evident in breast cancer subjects.Conclusions: Breast carcinoma has obvious alliance with serum LDL-c, TC and HDL-c aberrations. LDL-c has specific variability during peri-menopausal and post-menopausal ages among breast cancer subjects. HDL-c alteration is mainly concerted for post-menopausal age; while total cholesterol could be a peril throughout. The odds of pooled effect of such aberrations in cancer causation cannot be underrated.
A cross-sectional study on asymptomatic bacteriuria among antenatal women attending an urban tertiary health care center in Southern India
Authors: Paari Priya , T. P. Sindhuja , Dhinakaran Shanthi , Paul Christina Mary P.
Published: September 2017

Background: Asymptomatic bacteriuria (ASB) in pregnancy is a treatable risk factor for preterm delivery. India accounts for the highest preterm birth incidence in the world according to the WHO census released in November 2016. This study was aimed at finding the prevalence of asymptomatic bacteriuria, the spectrum of bacteria involved and the susceptibility pattern for the antimicrobials in the antenatal women attending a tertiary care hospital in urban Southern India.Methods: One hundred and eighty ante-natal patients without symptoms of ongoing urinary tract infection were enrolled to this study. Clean midstream urine sample was collected in a wide mouthed container and sample was analyzed by standardized microbiological testing techniques.Results: Out of the 180 ante-natal women included in the study, 11(6.1%) patients were found to have insignificant bacteriuria and 38(21.1%) had a significant bacteriuria. E. coli was the most frequently isolated organism and about 95% of the organisms were sensitive to Nitrofurantoin.Conclusions: More than a fifth of all pregnant women have ASB and E. coli is the most frequent pathogen encountered.
Comparison of maternal and fetal outcomes in gestational diabetes mellitus diagnosed either by oral glucose tolerance test or diabetes in pregnancy study group India
Authors: Sinha Somya , Mayadeo Niranjan M.
Published: September 2017

Background: The optimal strategy for screening and diagnosis of Gestational Diabetes Mellitus (GDM) is still controversial and elusive. There is possibility of difference in maternal and fetal outcome depending on the diagnostic method used. This study throws light on the efficacy of two screening tests “Oral Glucose Tolerance Test’’ and “Diabetes in Pregnancy Study Group India” and to know maternal and fetal outcome in pregnancy complicated by GDM in Indian setting.Methods: Depending on the diagnostic method used 100 GDM patients were divided in 2 groups: 1. OGTT, 2. DIPSI. Maternal outcomes were measured in terms of pregnancy induced hypertension, polyhydramnios, preterm labour, genital tract injury and methods of termination of pregnancy, gestational age at delivery. Congenital malformation, macrosomia, hypoglycemia, hyperbilirubinimia, respiratory distress, duration of NICU stay was studied in newborns.Results: 22% of DIPSI group and 26% of OGTT group had PIH as comorbidity. Preterm delivery was noted in 22% of DIPSI group and 30% of OGTT group. 50% patients of both the groups underwent LSCS. No intrapartum complications were seen in 82% of patients. Malformations were noted in 18% of DIPSI group and 14% of OGTT group. In DIPSI group 14% of baby had macrosomia compared to 10% and in that of OGTT group.In neonates, hypoglycaemia, respiratory distress syndrome and hyperbilirubinemia seen in 46.8%, 31% and 42.6% respectively in DIPSI group compared to 50%, 45.5% and 47.7% respectively in OGTT group.Conclusions: No statistically significant difference was noted with respect to maternal and fetal outcomes between the two groups.
Pregnancy outcome in Non-cirrhotic portal hypertension
Authors: M. R. Sandya , K. Manjula S. , Ancy Sr.
Published: September 2017

Background: To study the maternal and fetal outcome of non-cirrhotic portal hypertension (NCPH) in pregnancy.Methods: We retrospectively analyzed ten women with the diagnosis of NCPH in pregnancy. The study was done at St John’s Medical College Hospital Bangalore, Karnataka from January 2012 - January 2016. All the necessary data was obtained by record review.Results: The mean age of the pregnant woman was 25.5 years. Among 10 women with the diagnosis of NCPH 4 had Non-cirrhotic portal fibrosis (NCPF) and 6 had Extrahepatic portal venous obstruction (EHPVO). Six patients were diagnosed with NCPH prior to pregnancy; while among the remaining 4 patients, 1 had variceal bleed and the other 3 manifested with splenomegaly during pregnancy which led to the diagnosis of NCPH. All these 4 patients were successfully managed with beta blockers alone without any surgical intervention during pregnancy. Thrombocytopenia and splenomegaly were the most common clinical manifestations which were observed in all 10 patients. Severe thrombocytopenia (platelet <50,000 cells/mm3) was seen in 7 patients who received platelet transfusion. Six (60%) of patients had vaginal delivery, the other 4 underwent cesarean section due to meconium stained liquor and fetal distress in early labor. Hence cesarean delivery was reserved only for obstetric indication. Postpartum hemorrhage was seen in 2 patients managed conservatively, one patient on 3rd postoperative day developed ascites and pleural effusion requiring pleural tapping and diuretics with successful recovery. There was no maternal mortality during the study period. The fetal/neonatal outcome was good in the present study with 90% of babies with good APGAR score, whereas 1 preterm neonate developed HIE stage 2 requiring prolonged NICU stay. The overall pregnancy outcome was good in the present study.Conclusions: Pregnancies can be allowed and managed successfully in patients with NCPH.
Obstetric outcome of phase IV of National AIDS Control Programme at a tertiary care centre
Authors: Kalyankar Vijay Y. , Kalyankar Bhakti V. , Gadappa Shriniwas N. , Rasool Ummehani G.
Published: September 2017

Background: This study was conducted to observe maternal and fetal outcome of sero-positive women delivering at our centre by using the newly introduced National AIDS Control Programme (NACP) phase IV of HARRT (highly active antiretroviral therapy) recommended by National AIDS Control Organisation (GOI) started from 1st January 2014.Methods: Study included all seropositive pregnant women diagnosed during pregnancy and in emergency at labour room of Government Medical College, Aurangabad, Maharashtra, India in 2 years period. The women and their newborns were managed as per recommendations of phase IV of National AIDS Control Programme of Government of India.Results: There was reduction in associated maternal infections, high CD4 counts, increase in vaginal deliveries, promotion of exclusive breast feeding and limitation of vertical transmission of HIV. The adverse impact of HIV on mother and newborn still continues.Conclusions: Phase IV of NACP appears to be promising in the initial phases of its implementation.
External cephalic version at 36 weeks and its outcome
Authors: N. Deepika , Kumar Arun
Published: September 2017

Background: External cephalic version (ECV) is well known non-invasive procedure done for the management of breech presentation but is not routinely practised by obstetricians in many clinical settings. The aim of the study was to assess the success rate of external cephalic version, labour outcome of pregnancy after successful ECV, to study maternal and foetal complications associated with ECV and to explore the reasons for failed ECV.Methods: It was a prospective interventional study to assess the labour outcomes of pregnancies with successful and uncomplicated ECV. All women who had singleton breech presentation at 36+ weeks were included unless contraindications for ECV were present. After obtaining consent, ECV was attempted after giving tocolysis.Results: The total number of deliveries was 6038 in the same period. Out of these 301 were breech presentations thus the incidence of breech presentation was 4.9%. ECV was offered to 81 women (26.9%) and out of these 77 women (95.06%) gave consent for the procedure. The remaining 4 (4.93%) did not give consent due to anxiety about the procedure. The success rate was 54.54%. Out of total 301 women with breech presentation 40 women (13.3%) had assisted breech delivery and 216 women (71.8%) had caesarean section due to obstetric indications. Thus the caesarean section rate for breech presentation at our institute was 71.8%. ECV was successful in 63.82% of the multigravida on which it was attempted as compared to 40% of the primigravida. The success rate of ECV in the present study is maximum when ECV was performed at a gestational age of 38-39 weeks and when fetal weight was less than 3000 grams. Out of the 42 successful ECV cases, 4 babies (9.52%) had neonatal sepsis and 1 was still born (2.3%) which was unrelated to ECV.Conclusions: ECV is a valuable though under used option in the management of breech presentation at term. It is a relatively safe procedure, simple to learn and perform. Vigilance for breech presentation after 36 weeks is important. ECV at term using tocolytics should be part of the routine management of breech presentation.
Clinico-pathological profile of ovarian cysts in a tertiary care hospital
Authors: Chanu Sairem Mangolnganbi , Dey Biswajit , Raphael Vandana , Panda Subrat , Khonglah Yookarin
Published: September 2017

Background: Ovarian cystic neoplasms are common in gynaecological practice. These may pose diagnostic difficulty to the pathologists. This study was conducted to analyse the clinical and histological profile of ovarian cystic neoplasms.Methods: This is a retrospective study done from January 2016 to April 2017 in a tertiary care hospital in North East India. All the patients, who were clinically and radiologically diagnosed as ovarian cysts, which had histopathological confirmation were included in the study. Data including the age, parity, clinical symptoms, laterality and histopathological findings were analysed.Results: A total of 101 patients operated for ovarian cysts in the study period were analysed. The most common clinical presentation was lower abdominal pain. There were 11 (10.9%) malignant cases, 4 (4%) were intermediate grade and borderline in nature, and 85 (84.1%) cases were benign in nature. There was 1 (1%) case of metastasis to ovary. Mature cystic teratoma was most common (20.8%) histopathological diagnosis. The second most common cyst was serous cystadenoma (19.8%).Conclusion: Ovarian cysts are commonly encountered in gynaecological practice and equally encountered by the pathologists. Most commonly found ovarian cysts were mature cystic teratoma followed by serous cystadenoma.