bluuebunny/crossref_metadata_2025 huggingface dataset:
Study on nephroprotective effect of Ebselen in cisplatin induced renal damage in rats
Authors: Praharsheta A. M. , Samuel Vanitha , Nirmala P.
Published: September 2017

Background: Renal dysfunction arises as a result of exposure to medicines, industrial or environmental chemicals. Cisplatin is a major antineoplastic drug used for the treatment of solid tumors. Its chief dose limiting side effect is nephrotoxicity; 20% of patients receiving high-dose cisplatin have severe renal dysfunction. Ebselen a promising antioxidant, was used to explore the nephroprotective effect.Methods: The rats were divided into five groups; each group consisting of 6 animals. The experimental design included one control group and four experimental groups. The study was carried out for a period of 7 wks. The test drug Ebselen in group 4 and 5 and the reference standard drug Amifostine in group 3 was administered once a week intraperitoneally for 5 weeks. Nephrotoxicity was induced by cisplatin (5mg/kg IP) in the 6th week, following this the drug Amifostine in group 3 and Ebselen in group 4 and 5 will be continued twice a day for 5 consecutive days post induction. Urine samples were collected and sent for determination of urine creatinine and albumin.Results: The Urine creatinine level and albumin level estimation in group II show significant renal damage as compared to control group. The statistical reduction in urine creatinine and urine albumin level in Ebselen treated group I (10mg/kg), Ebselen group V (20mg/kg) as compared to Cisplatin group II show a potential reduction in renal damage. Ebselen treated group V showed a reduction in urine creatinine and urine albumin as same as in group III.Conclusions: This study brings to a close that Ebselen lessens Cisplatin induced renal damage.
Monitoring adverse drug reactions in patients on TDF+3TC+EFV in a tertiary care hospital in Eastern India: a prospective observational study
Authors: Era Nikhil , Mukherjee Shatavisa , Saha Bibhuti , Tripathi Santanu Kumar
Published: September 2017

Background: Recently, the National Aids Control Organisation (NACO) in India advocated and recommended the use of tenofovir, lamivudine and efavirenz as a fixed-dose combination in initiating ART in all future treatment-naïve patients. The present study was thus undertaken to assess the nature and extent of safety concerns with this regime.Methods: A prospective observational study was carried out in the outpatient setting of nodal ART centre of Eastern India. A total of 242 patients on various ART regimens were studied for suspected ADRs over one year. Adverse event history, medication history and other relevant details were captured. Causality and severity of each reported ADR were duly assessed.Results: Out of 242 PLHIV put on this regimen, 75 patients did not encounter any adverse reactions during the entire study period. Out of remaining 167 patients who presented with a total of 451 ADRs, maximum ADRs were attributed to various psychiatric disorders which included insomnia, dizziness, drowsiness etc, which were followed by gastrointestinal disorders including anorexia, flatulence, nausea, vomiting etc. Dermatological complications included rashes, itching, SJS, pigmentation of nails, skin hyper pigmentation respectively.Conclusions: The study enables to obtain information on the pattern of adverse drug reactions associated with treatment naïve PLHIV put on first line antiretroviral regimen comprising of once daily dosing of tenofovir, lamivudine, efavirenz. Need of intensive monitoring for ADRs in ARTs followed with proper patient counselling regarding its nature can lead to better compliance to the therapy.
Drug utilization study in neonatal intensive care unit of a tertiary care teaching hospital
Authors: Vaghela Jayeshkumar P. , Sukhlecha Anupama
Published: September 2017

Background: Sick and pre-term neonates are admitted in neonatal intensive care units (NICU) and treated. A great care needs to be taken to use drugs in neonates due to the immaturity of their body functions. There is a lack of standard drug prescribing guideline in children, especially neonates because; safety and efficacy for a majority of drugs have not been established in them. The objectives of the study were to evaluate the drug utilization pattern in NICU of a teaching hospital and to identify problems in drug utilization and suggest measures, if needed.Methods: A prospective, observational study was carried out in NICU for duration of one year. Demographic details like age, sex, birth weight, duration of hospitalization was recorded from the case files of neonates. The morbid condition, treatment with drugs and other supportive modalities were recorded. The outcome of treatment was also noted. WHO drug utilization core indicators were also evaluated.Results: Out of 623 admissions in NICU, 56% were males. There were 56% of neonates who were born pre-term. The maximum used drugs were Vitamin K (73%) and antibiotics (64%). The antibiotics were mainly from penicillin and aminoglycoside groups. Respiratory distress syndrome (19%) and neonatal sepsis (16%) were the most common causes for admission. Out of total admissions, 64% were discharged following recovery, while, 12% had expired.Conclusions: Drugs usage in neonates should be minimal and should be prescribed from essential drug list. Antibiotic policy needs to be formulated for hospitals to minimize antibiotic usage and prevent development of resistance.
Antibiotic use: evaluating knowledge, attitude and practices among medical students in a sub Himalayan state
Authors: Gupta Rajiv Kumar , Singh Parveen , Rani Renu , Kumari Rashmi , Langer Bhavna , Gupta Riya
Published: September 2017

Background: The growing concern about antibiotic resistance, of late, led World Health Organization to declare it as World Health Day theme in 2011. Knowledge spreads awareness and understanding by melting the barriers of ignorance while attitudes and practices have a bearing on the health related behaviour. The present study aims at evaluating the knowledge, attitudes and practices of medical students towards antibiotic usage.Methods: The present cross-sectional study was conducted among the Pre-final medical students (6th / 7th semester) who participated in the questionnaire survey on knowledge, attitude and practice towards antibiotics usage. The data was analysed and Chi-square was used as test of significance.Results: Overall, 132 students were interviewed. Majority (96.2%) had heard of antibiotic resistance. About 22% of the sample stated that antibiotics can cure viral infections, among them female being in the higher proportion (p<0.05). Majority (>90%) agreed that antibiotic resistance is a serious problem and had positive attitude about population awareness campaign regarding antibiotic resistance. Among practices, higher proportion of male respondents preferred antibiotics in case of cough and sore throat. (p<0.05).Conclusions: Despite being Pre-final MBBS students, the results have revealed that knowledge and attitude of the respondents were not up to the desired levels. The practices regarding use of antibiotics were more or less adequate. For effective curriculum, thorough knowledge and rational prescription of antibiotics needs to be reinforced among medical students both before and during internship.
Role of antihypertensives drugs on proteinuria in patients with chronic kidney disease and hypertension
Authors: Bala Ritu , Singh Harminder , Rupali . , Verma Kuhu
Published: September 2017

Background: Hypertension is the most prevalent cardiovascular disease and the relevant data suggest that the burden, risk factors and co-morbidities associated with the essential hypertension is increasing with every passing day. It is one of the major chronic diseases resulting in high mortality and morbidity in today’s world. Aim: The aim of the study was to compare effects of cilnidipine and amlodipine on the blood pressure (BP), heart rate and proteinuria among patients of hypertension with chronic kidney disease.Methods: 100 patients were included in this study. Patients were randomly assigned into two groups Group A and Group B (50 each). Group A: Patients received Cilnidipine (5-10mg/day). Group B: Patients received amlodipine (5-10mg/day).Results: No significant difference in SBP, DBP, MBP and proteinuria while comparing both the groups of patients taking cilnidipine and amlodipine at baseline i.e. 0 to 12 week, 12 to 24 weeks and 0 to 24 weeks. Cilnidipine caused decrease in HR 0 to 12 week (p value 0.001), 12 to 24 weeks (p value 0.001) and 0 to 24 weeks (p value 0.0001). Amlodipine had increased heart rate from baseline to 12 weeks (p value 0.0001), 12 to 24 weeks (p value 0.051) and 0 to 24 weeks (p value 0.001). No significant difference was seen in any biochemical readings.Conclusions: There was a significant change in all the parameters including BP, heart rate, proteinuria and other biochemical tests when they compared within the group but no significant difference while comparing both the groups.
A new threat to India- Zika! An obstetrician's perspective
Authors: Malik Renuka , Garg Nidhi , Khera Kaveri
Published: September 2017

Since last 2 years, ever since the Zika outbreak in Brazil, there has been a great interest in this infection caused by Aedes aegypti and A. albopictus, though this RNA Flavirus has been in existence since 1947. A large number of children born with microcephly during the outbreak in Brazil attributed to Zika was alarming. Though Brazil in May, 1917 has declared an end to Zika emergency, this virus continues to be detected in parts of America ca and south East Asia, including Thailand, Cambodia, Malaysia and Myanmar. WHO declared Zika as Public Health Emergency of International Concern on 1st February, 2016. Though at present only 4 confirmed cases have been reported in India, Zika is a notifiable disease along with chicken guinea and dengue. A state of awareness and preparedness is required, among treating physicians, obstetricians and pediatricians for this disease. This article deals with history, presentation, diagnosis, pitfalls, management and preventive aspect of Zika in pregnancy.
Comparison of intravaginal and oral metronidazole in patients with bacterial vaginosis
Authors: Han Sang Won , Chung Jae Eun
Published: September 2017

Background: Metronidazole is considered an effective treatment for bacterial vaginosis. Only oral preparations were available until 2014, but an intravaginal gel preparation recently became commercially available in South Korea. In this report, the efficacy and safety of metronidazole intravaginal gel application was compared to that of the conventional oral metronidazole preparation.Methods: Patients who were treated with either intravaginal metronidazole or oral metronidazole after diagnosis of bacterial vaginosis were included in this study. Patient characteristics, mode of treatment, recurrence rate, and complications including gastro-intestinal discomfort and concomitant vulvovaginal candidiasis were analyzed.Results: There were no differences in patient characteristics, except the mean age was older in the intravaginal group. Treatment outcomes were similar in both groups. In the oral metronidazole group, 6.3% of patients reported ongoing symptoms of bacterial vaginosis within one month of treatment and required a refill, while 7.3% of the intravaginal group required a refill. Significantly more patients on oral metronidazole treatment complained about gastro-intestinal discomfort including nausea (13.4%) and diarrhea (9.4%). Patients who took intravaginal metronidazole complained about increased watery vaginal discharge (26.8%). The comparatively high cost of metronidazole intravaginal gel was another factor that could affect patient access to this treatment versus the oral preparation. The incidence of vulvovaginal candidiasis was similar between groups (oral 3.9%, intravaginal 4.9%).Conclusions: Intravaginal metronidazole usage can be considered as an effective alternative treatment for bacterial vaginosis in patients with gastro-intestinal complications. However, the increased incidence of watery vaginal discharge and high cost remain obstacles to widespread use of the intravaginal preparation.
Clients’ perception of antenatal care services in a tertiary hospital in North Eastern Nigeria
Authors: Ibrahim Sanusi M. , Bakari Maisaratu , Abdullahi Hadiza U. , Bukar Mohammed
Published: September 2017

Background: The study determined and documented the level of satisfaction and quality of care of patients attending the antenatal clinic of University of Maiduguri Teaching Hospital. It was a cross sectional study.Methods: Using an interviewer administered questionnaire whose contents were synthesized from validated Patient Satisfaction Questionnaire III (PSQ III), information on clients’ satisfaction was obtained from 274 women attending antenatal care clinic. Data were entered in to the IBM SPSS software, and analysed. Some variables were reduced to binomial scale with two categories in order to ease the process of logistic regression. P value <0.05 at 95% confidence interval was considered significant.Results: The study showed an excellent level of satisfaction of clients with services obtained from our facility. Majority of respondents, 99 (36.1%) were aged of 20-24 years, with most of them having education above primary school level- 99 (36.1%). Although most of the clients, 158 (57.7%) were unskilled, majority of the clients’ husbands, 136 (49.6%) were middle level workers. However, logistic regression of all the significant determinants of patients’ overall satisfaction of quality of ANC services- clients’ occupation, educational status, enjoying full medical services, having enough time with doctors and access to hospital, good registration process and effective ANC laboratory, showed that none of the factors was a predictor of clients’ satisfaction.Conclusions: Periodic patient satisfaction survey should be institutionalized to provide feedback for continuous quality improvement.
Prevalence of hypomagnesemia in patients undergoing gynecological oncology surgery in tertiary care cancer institute of India
Authors: Bhardwaj Bikram , Desai Ava Dipan , Patel Bijal Manish , Parekh Chetna Deepal , Patel Shilpa Mukesh
Published: September 2017

Background: Hypomagnesemia is an important but unknown risk factor for post-operative complications in patients undergoing surgery for presumed gynecological malignancy. This study aims to evaluate the prevalence of hypomagnesemia in patients undergoing surgery for presumed gynecological cancers referred to our tertiary care Cancer Institute.Methods: This is a prospective observational study of 100 patients admitted with provisional diagnosis of malignancy. They underwent surgery in one of the Gynecologic Oncology units at The Gujarat Cancer Research Institute, Ahmedabad from October 2016 to April 2017. Hypomagnesemia was defined a serum magnesium levels less than 1.8mg/dl.Results: The incidence of pre-operative hypomagnesemia in the entire cohort was 35%. Sixty three percent patients had normal pre-operative magnesium levels and hypermagnesemia was seen in 2% of study population. Patients with benign disease had 29.6% pre-operative hypomagnesemia compared with 39.6% in patients with gynecologic malignancy. Pre-operative hypomagnesemia and even falling levels in post-operative period are an important predictive marker for post-operative complications like increased post-operative pain, post-operative ileus, hypertension and even post-operative hypokalemia. Age, body mass index, hematocrit, surgical indication and length of hospital stay were not associated with hypomagnesemia. Patients undergoing neo-adjuvant chemotherapy before surgery had significant incidence of hypomagnesemia both pre-operatively and post-operatively.Conclusions: Hypomagnesemia is quite prevalent in patients of gynecologic-oncology undergoing surgery. Pre-operative hypomagnesemia and even falling levels in post-operative period have a bearing on the final surgical outcome. Hence pre-operative and post-operative magnesium levels may be included as a valuable marker in all patients undergoing surgery for gynecologic malignancy.
Comparative study of induction of labour with dinoprostone gel versus mechanical dilatation in unfavorable cervix (low Bishops Score)
Authors: Mathuriya Gayatri , Kushwaha Sharad Pratap Singh , Pradhan Shweta
Published: September 2017

Background: Induction of labour is a common procedure in obstetrics, occurring in upto 30% of pregnancies. Objective of present study was to compare the efficacy of double balloon transcervical catheter to that of a PG vaginal insert among women undergoing labour induction in terms of singleton pregnancies of both nulliparous and multiparous women with an unfavorable cervix.Methods: Patient admitted for induction of labour were randomized to receive intravaginal dinoprostone or intracervical Foley’s catheter. Patient not entering active labour and having rupture membranes or arrest of dilatation received IV oxytocin.Results: 150 patients received dinoprostone gel (group A) and 150 patients received Foleys catheter no.18 (group B). The mean time until cervix ripening was less in group A group (0.0001-p value). The mean time until vaginal delivery was less in the Group A group (p value-0.010) among vaginal deliveries more patients in the Group A group delivered within 24 hours (0.0001-P value.). There was significant differences in cesarean delivery rates (8% vs 20.66%, P value-0.0001, sig). Oxytocins is required in both groups (73.33% vs. 78.66%).Conclusions: Group A was associated with more rapid cervical ripening, shorten induction to vaginal delivery interval and greater no. of vaginal deliveries within 24 hours.
A study of N-acetyl cysteine, metformin and vitamin D3 with calcium on clinical and metabolic profile in PCOS
Authors: Gupta Veena , Chaurasia Amrita , Khatoon Shazia , Singh Urvashi Barman
Published: September 2017

Background: Polycystic ovarian syndrome (PCOS) is characterized by the combination of hyperandrogenism, chronic anovulation and polycystic ovaries. Objective of present study was to compare the effects of N-acetyl cysteine, metformin and vitamin D3 with calcium on clinical and metabolic profile in PCOS.Methods: 66 women were randomly assigned into three equal treatment groups. Group 1 received N-acetyl cysteine, 600 mg three times a day. Group 2 metformin hydrochloride, 500 mg two times a day for 1 week, then three times a day for rest of the study and Group 3 Vit-D3 60,000 IU weekly with calcium 1500mg daily. Clinical and metabolic assessment was done at baseline and after three months of treatment.Results: After 12 weeks of treatment improvement of symptoms was seen in all the three groups, however better improvement in oligomenorrhea and hirsutism was seen in metformin group than others two groups. The clinical parameters like weight, BMI, waist hip ratio, biochemical markers of insulin resistance, fasting glucose, fasting insulin, fasting glucose/insulin ratio were significantly decreased in N-acetyl cysteine group than others two groups.Conclusions: N-acetyl cysteine had better improvement in clinical, and metabolic profile than metformin and vitamin D3 with Calcium group in PCOS patients. It can be used as a substitute for insulin reducing medications in treatment of PCOS patients, considering its limited adverse effects.
Association of metabolic syndrome and lower urinary tract symptoms amongst South Indian postmenopausal women
Authors: Kamaraj Jeyasheela , Londhe Vaibhav , Shetty Sahana , Kekre Aruna Nitin , Paul Thomas V. , Yadav Bijesh
Published: September 2017

Background: Women spend one third of their life in menopause. The age related anatomical and physiological changes predispose them to MetS and lower urinary tract symptoms (LUTS). The aim was to study the prevalence of metabolic syndrome (MetS) and lower urinary tract symptoms in postmenopausal women attending menopause clinic, to study the correlation of LUTS and body composition among women with MetS.Methods: 154 post-menopausal women who attended menopause clinic at the Christian Medical College Hospital Vellore, were recruited. MetS was diagnosed using IDF criteria. LUTS were assessed BFLUTS questionnaires. Blood was taken to assess serum fasting glucose and lipid proﬁle. DEXA was performed to assess the whole-body composition.Results: Of 154 postmenopausal women, 64% had MetS and 43% of women had a total LUTS score > 5. 90% of women had filling symptoms,57% had incontinence,17% had voiding symptoms,14 % had quality of life issues and 6 % had sexual symptoms. However, there was no statistical significant difference between two groups in correlating the variables of MetS with LUTS (P >0.05). The percentage of total body fat by DEXA scan was significantly greater (P=0.006) in women with MetS (37.32±5.04) when compared to the women without MetS (34.629±3.65).Conclusions: Prevalence of MetS among the study population was 64 %. LUTS were observed in 43% of the patients. There was no significant difference in LUTS in women with MetS and without Mets. However, there was a significant difference in body composition among women with and without MetS.
Progesterone only pills: an effective contraceptive option for lactating women
Authors: Fonseca Michelle , Deshmukh Prasad Yeshwant , Kharat Deepali
Published: September 2017

Background: Progesteone only pills (POP) are the most suitable for breastfeeding women as they have no effect on quality and quantity of breast milk in lactating women or on infant growth as well.Methods: A study was conducted on post partum lactating women over a period of 6 months at a tertiary care hospital in Mumbai. Post partum women were called for follow up in the post natal OPD and were counseled about temporary and permanent spacing methods.Results: Progesterone only pills are an acceptable and convenient means of temporary contraception / spacing during lactation period in motivated patients who do not want IUCDs or Injectables or are undecided about permanent methods of family planning.Conclusions: Low Dose progesterone only minipill is both effective and acceptable to breast feeding women. It may be used as a temporary spacing method in women who do not prefer an IUD but who are motivated to be complaint with its use.
Prevalence of various urogynaecological problems and their subsequent management with outcome amongst women attending a tertiary care hospital of a developing Country
Authors: Arora Manju , Sharma J. B. , Mittal Suneeta
Published: September 2017

Background: The prevalence of urogynaecological problems may be significantly underestimated since the physicians rarely ask women about these problems and women seldom initiate discussion about these symptoms on their own with the physician.Methods: The present study was conducted from March 2006 to August 2008. All the women between 20 to 80 years of age with varying parity attending gynecological outpatient department were evaluated for urogynaecological and bowel problems, based on a questionnaire incorporating demographic and urogynaecological symptoms (IUGA terminology). The frequency of various urinary problems was correlated with the demographic data, urodynamic studies and cystoscopic findings, whenever appropriate and available. Exclusion criteria: The women with disorders of central nervous system, retention urine and pregnancy were excluded from the study.Results: During this period, 15100 women attended outpatient department of gynecology. Out of these, 376 women had urogynaecological and bowel problems. The prevalence of urogynaecological and bowel problems was 24.9 per 1000 women. The incidence of symptoms was dysuria in 38.5 % women, increased frequency of micturition in 38% women; feeling of something coming out per vaginum in 37% women, nocturia in 27.6 % women and pain lower abdomen in 25 % women.Conclusions: Amongst incontinence, 31.3% women had stress incontinence, 25% women had urge incontinence, 14.6% women had urgency, 8.7% women had continuous urinary incontinence and 2.12% women had anal incontinence.
Abusive yet affectionate husbands: Conflicting perceptions of domestic violence experiences of wives living in urban slum communities of Mumbai, India
Authors: Sebastian Ajeesh , Begum Shahina , Donta Balaiah , Naik D. D. , Tapase Prashant
Published: September 2017

Background: The prevalence of intimate partner violence (IPV) contributed to reproductive health problems worldwide. Data on coping mechanism of women within domestic violence (DV) were unexplored.Methods: The objective of the paper was to explore the perceived cause of DV and coping mechanism of women who reported affectionate nature of husband. A community-based intervention study was carried out in urban slums to screen women with an unmet need for family planning. Women reported of DV in the past one year preceding the survey were counselled on marital communication and family planning methods. During these sessions, women shared their views on the cause of DV and their coping mechanism.Results: The narratives of the sessions threw light into the cause of DV, which includes decision-making, the influence of significant others and fewer time couples spent with each other. Affectionate nature and violence by husbands created a conflict of emotions. Fear of loss of the relationship and socio-cultural attitude made them remain in the relationship.Conclusions: The wives develop an emotional attachment with their partners and do not want to leave the relationship. They create a space within the abusive relationship; enjoy limited functionings, a bonus of affections and demoting violence from the partner without taking a chance to lose the relationship.
Surgical and functional outcome of sigmoid colon-vaginoplasty in Mayer-Rokitansky-Kuster-Hauser syndrome
Authors: Pan Pradyumna
Published: September 2017

Background: The objective of this study is to report our experience with sigmoid vaginoplasty in adolescent female patients of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome with emphasis on the effectiveness of surgery, complications, sexual and functional outcomes.Methods: A retrospective study of adolescent females with vaginal atresia and Mayer-Rokitansky-Kuster-Hauser syndrome. The sigmoid segment was used for vaginoplasty in all the case.Results: Eleven females were studied over a period of 15 years. Postoperative complications were perineal rash in 3, ileus in 3, and minor wound infection in 1 patient and urinary tract infection in one patient. Nine patients were on regular follow-up. All the neovaginas were patent and functional. The postoperative mean vaginal length was 12.1 cm (range 11 cm to 14 cm). One of the patients had mild vaginal stenosis which responded to vaginal dilation, one had mucosal prolapse of the neovagina, one had excessive mucus discharge, during follow-up visits. Out of the 11patients, 8 patients are sexually active and 7 reported that they were engaging in satisfactory sexual activity with mild or no pain, and with good mucosal sensitivity. Only one experienced dyspareunia and three patients had not participated in sexual activity.Conclusions: Sigmoid vaginoplasty is a safe and acceptable procedure for vaginal agenesis with good cosmetic results and acceptable complications rate. Sigmoid colon vaginoplasty is the treatment of choice because of its large lumen, thick walls resistant to trauma, adequate secretion allowing lubrication, not demanding prolonged dilatation and short recovery time.
To compare the efficacy and safety of intravaginal misoprostol and intracervica lcervigel for induction of labour
Authors: Malik Nivedita
Published: September 2017

Background: This randomized prospective study was conducted in the department of obstetrics and Gynaecology Batra Hospital and Medical Research centre from 1st March to 30th April 2008 to compare the safety and efficacy of intravaginal misoprostol and intracervical dinoprostone gel (cervigel) for cervical ripening and induction of labour.Methods: 80 women were recruited in the study. 40 women were administered misoprostol tablet 25ug vaginally while the other 40 were given intracervical cervigel.Results: A total of 85.1% (68 patients) delivered vaginally (33 in the misoprostol group and 35 in the cervigel group) i.e. spontaneous vaginal and assisted vaginal deliveries. The mean interval from start of induction to vaginal delivery was 707.63+146.511 minutes in the misoprostol group and 833.13 +144.36 minutes in the cervigel group with p=0.001 which was significant statistically. Though both the groups showed a favourable change in Bishop’s score after induction but this was not statistically significant. However, the number of doses required in both the groups to produce an effect on cervical ripening and dilation was statistically significant p=0.001, cervigel group requiring lesser dose (42.5% in cervigel vesus 7.5% in the misoprostol group after administration of 1st dose).Conclusions: Both 25ug misoprostol intravaginal and dinoprostone gel intracervical are equally effective and safe for cervical ripening and induction of labour.
A study to compare the efficacy of ormeloxifene with norethisterone and conventional oral contraceptive pills
Authors: Chauhan Monica , Gupta Neena , Dwivedi Seema , Agarwal Shaily
Published: September 2017

Background: Dysfunctional uterine bleeding is one of the commonest conditions for which patients seek advice in gynaecological outpatient department. Objective of present study was comparative evaluation of ormeloxifene with norethisterone and conventional oral contraceptive pills in dysfunctional uterine bleeding.Methods: This randomized study was conducted on 300 cases of dysfunctional uterine bleeding and they were distributed into three groups. group I were given ormeloxifene 60 mg biweekly for first 12 weeks followed by 60 mg weekly for next 12 weeks. Group II were given norethisterone 5 mg BD from 5th to 25th day of cycle and group III were given oral contraceptive pills from 5th to 25th day of cycle.Results: Subjective improvement was outstanding in group I in comparison to other two groups. There was also statistically significant increase in Hb g/dl and statistically significant decrease in endometrial thickness.Conclusions: Ormeloxifene was found to be superior to both norethisterone and conventional OCPs.
A study of feto-maternal outcome in cases of pre-labour rupture of membranes
Authors: U. T. Koothan , Kate Nina V. , V. Anuradha
Published: September 2017

Background: Prelabour rupture of membranes is a common obstetric problem and the assessment of women with possible membrane rupture is a management issue faced in every day practice. The diagnosis and treatment of Prelabour rupture of membranes depends upon the facilities available. Unrecognized and inadequately treated conditions can lead to various maternal and neonatal complications.Methods: The present prospective study was conducted on 200 pregnant women satisfying the inclusion criteria after getting consent for participation. Pregnant women between the gestational age of 28 – 40 weeks who presented with Prelabour rupture of membranes to casualty were enrolled into the study.Results: 76.5% of the study participants were between 37-40 weeks of gestation and the remaining 23.5% belonged to the preterm population. Maternal morbidity was found to be 68% among the study participants with latency period more than 24 hrs. 37.5% of the neonates developed morbidity and the neonatal mortality was 2%.Conclusions: Prelabour rupture of membranes contributes significantly to maternal morbidity, neonatal morbidity and perinatal mortality.
Prevalence of metabolic syndrome in preeclampsia
Authors: Beigh Mehbooba , Naik Muzafar , Tali Irshad , Ara Rifat , Malik Anjum
Published: September 2017

Background: Preeclampsia is associated with increased morbidity and mortality and it increases with severity of preeclampsia. Preeclampsia shares many characteristics of metabolic syndrome (MeS) which has led many investigators to elucidate this relationship. The aim and objective of this study was to assess the prevalence of MS in preeclampsia and its relation with its severity.Methods: The study included 130 cases (41 gestational hypertension (GHTN), 27 mild pre-eclampsia (Mild PET), 47 severe preeclampsia (Severe PET), 13 pre-eclampsia superimposed on chronic hypertension (PSHTN) and 2 eclampsia) based on pre-specified maternal characteristics according to ACOG criteria after 20 th week of gestation. Two hundred normotensive pregnant females served as controls. The frequency of MS was assessed using pregnancy adaptation of MeS definition of the NCEP-ATP III criteria in cases and controls.Results: Metabolic syndrome was found in 37.7% of preeclampsia group and 12% of control group (p<0.00). Among the components of MeS, preeclampsia group was having significantly higher sugars (30% Vs 20%) and body mass index (BMI) (23.8% Vs 7.5%) than controls. GHTN was seen in 31.5%, mild PET in 20.8%, severe PET in 36.2%, PSHTN in 10% and eclampsia in 1.5% of cases. MeS was seen in 57.4% of severe PET, 50% of eclampsia, 26.8% of GHTN, 25.9% of mild PET and 23.1% of PSHTN. The clinical course in preeclampsia with MeS was complicated by IUD (intrauterine death), IUGR (intrauterine growth retardation), preterm delivery, APH and pulmonary edema. Oligohydromnios was less common in preeclampsia with MeS.Conclusions: The frequency of MeS was higher in preeclampsia group as compared to normotensive group. MeS was more significantly higher in patients with severe preeclampsia. In our study there were no demographic, clinical and laboratory predictors of MeS in preeclampsia. On the other hand, preeclampsia patients with MeS had significant maternofoetal complications. There is a need to screen for MeS in pregnant females from the first antenatal visit in order to predict severe preeclampsia.
Addressing family planning needs among low-literate population in peri-urban areas of Delhi, India: a qualitative inquiry
Authors: Atre Sachin R. , Kudale Abhay M. , Howard Heather M. B.
Published: September 2017

Background: Since several decades, population control has remained one of the major challenges for India. Understanding family planning (FP) related knowledge and practices, especially among low-literate population groups is important for increasing the reach of FP services nearer to them, which is an essential step for population control as well as to prevent unwanted pregnancies.Methods: We conducted a cross-sectional, qualitative research study among low literate population in peri-urban areas of New Delhi, bordered with Uttar Pradesh (U.P.) state. We selected and interviewed 27 participants including married men and women in the age range 18-34 years using semi-structured interview schedules. The focus of inquiry was on fertility awareness; beliefs and practices related to menstruation, pregnancy and FP methods etc. and decision making about FP. The data were processed for thematic analysis.Results: The study revealed lack of basic scientific knowledge about fertility in this community which often resulted into unwanted pregnancies. This finding has major implications especially when the Government’s FP program is geared mainly towards sterilization and conventional spacing methods. The study further confirmed that traditional beliefs and practices like separating women during menstruation still prevail in many joint families, but less likely in the nuclear ones. There were mixed opinions about spacing methods. Husband was reported to be main decision maker in FP process in this male dominated society. Regarding sources of information on FP, women reported elder women, lady clinicians and peers whereas men reported only peers.Conclusions: This study points out various barriers for FP around which basic FP education for both men and women in this community need to be provided. The study will have implications for other parts of India which share the same socio-cultural milieu as this community.
Quality of life assessment in women with stress urinary incontinence following Trans Obturator Tape (TOT) insertion: a prospective study
Authors: Jacob K. J. , Jayaprakash Megha , Cherian Anu
Published: September 2017

Background: Stress urinary incontinence is a symptom or sign indicating that the woman has involuntary loss of urine associated with exertion in the absence of detrusor contraction. It has a significant impact on quality of life. TOT insertion is a popular procedure being done now. Studies related to quality of life assessment following Trans obturator tape (TOT) insertion is sparingly reported. Objectives of present study were to evaluate the quality of life following TOT insertion in patients with stress urinary incontinence and to assess the post operative complications.Methods: This is a prospective study done in the Department of Obstetrics and Gynecology, Government Medical College, Thrissur from January 2015 to December 2016. 48 women with Stress urinary incontinence who underwent TOT insertion were included in the study, out of which 30 patients were followed up. The King’s Health Questionnaire was used for assessment. Data was analyzed using Epi Info 7 and Microsoft Excel. The statistical analysis was done using student t-test.Results: At 6 months follow up 86.66% (26) of patients had significant improvement in quality of life. 2 patients (6.66%) had postoperative voiding dysfunction, required recatheterisation, discharged after relief of symptoms. 2 patients (6.66%) had urge incontinence, advised medical management and was sent home, showed no improvement even after 6 months. 2 patients (6.66%) had continuous incontinence, fistula ruled out. Now they were lost to our follow up. Most common late post operative complication was groin pain. None had mesh erosion, bladder and bowel injuries.Conclusions: TOT is a safe and effective procedure for the treatment of stress urinary incontinence (SUI) which significantly improves the quality of life.
A five-year study of postpartum exploratory laparotomy in a tertiary care teaching hospital
Authors: Tasneem Fasiha , Shanbhag Vijayalakshmi , Sirsam Shyam
Published: September 2017

Background: Emergency postpartum exploratory laparotomy is a major surgical venture invariably performed in the setting of life threatening conditions during or immediately after abdominal and vaginal deliveries. Tertiary health care centers play a prime role in such cases to avoid any mishap. In spite of that sometimes sudden such incidences in the form of maternal morbidity or mortality occur which makes us think upon.Methods: A retrospective study was conducted in Dr. SCGMC, Nanded, a tertiary health care centre in Nanded Maharashtra, over a period of 5 years in the Department of OBGY i.e. between January 2012 to December 2016 of the cases who required postpartum exploratory laparotomy.Results: Out of the total deliveries in our hospital and cases referred from outside hospital from January 2012 to December 2016 i.e a span of 5 years including 62525 cases under study, 39 cases required postpartum exploratory laparotomy. We found that postpartum hemorrhage is the most common cause requiring postpartum exploratory laparotomy. Other causes requiring postpartum exploratory laparotomy are burst abdomen, puerperal sepsis, rectus muscle hematoma etc.Conclusions: In the era of modern obstetrics, to fulfill the main objective of obstetrics of having healthy mother and healthy baby at the end of pregnancy, postpartum exploratory laparotomy is a procedure done as an extreme measure to reduce maternal mortality and morbidity. We observed that majority of the patients who required exploratory laparotomy in postpartum period suffered morbidity in the form of prolonged hospital stay or transfusion of blood or blood products, need of ventilator support or ICU care. Though the patients suffered morbidity, mortality could be prevented by timely intervention in majority of the patients.
Evaluation of effectiveness of intermittent inhalational entonox in comparison with opioid tramadol for labour analgesia
Authors: Kumar Amit , Chandel Y. S.
Published: September 2017

Background: Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation. Entonox, opioids as well as epidural analgesia are effective means for pain relief in labour, notwithstanding their shortcomings. The objectives of study are to compare the effectiveness of intermittent inhalational Entonox for labour analgesia with intramuscular opioid (Tramadol) and to compare the effects of Entonox and Tramadol as labour analgesia on the maternal and fetal outcome of labour.Methods: The study was a prospective randomized, comparative study of two established techniques of labour analgesia. The study was carried out in 100 subjects. These subjects are divided into two groups. Group A - Tramadol Group: 50 women in active labour who received 100 mg tramadol intramuscularly with repeat dose of 50mg tramadol 4 hourly. Group B - Entonox Group: 50 women in active labour who received entonox for labour analgesia.Results: The mean VAS (visual analogue score) i.e. the pain score in group I (Tramadol) was 4.58±1.54 and Group II (Entonox) was 4.02±1.99 which is significantly low when compared to Group I (Tramadol) p<0.001. Study also showed that both the analgesics Entonox as well as Tramadol does not cause any significant change when compared for duration of labor. The rate of instrumental assisted vaginal deliveries and normal vaginal deliveries were almost equal in both the groups. In our study, the mean overall satisfaction level of the parturients in group II (Entonox) at 1 hr post delivery was (5.06±1.42) and 24 hr post delivery was (6.64±1.66) which was more when compared with tramadol group. The difference was statistically significant (p value was <0.001). This indicates that overall satisfaction level of the parturients is more with the use of Entonox when compared with Tramadol.Conclusions: Therefore, it is concluded that intermittent inhalational Entonox provides better labour analgesia then intramuscular opioid Tramadol.
Efficacy of methyldopa versus nifedipine in mild and severe pregnancy induced hypertension
Authors: Togarikar Sopanrao Malharrao
Published: September 2017

Background: Hypertension and its associated disorders are major health concerns during pregnancy. Antihypertensive therapy prescribes, when blood pressure is >140/90 mm of Hg, to minimize elevated blood pressure. The present study aimed to assess the efficacy of nifedipine and methyldopa in the antihypertensive treatment of mild and severe pregnancy induced hypertension (PIH).Methods: A total one hundred Patients attending antenatal clinic of the department between 26-37 weeks of gestation suffering from PIH were recruited. Participants were divided in to two groups i.e. group-I consists of 50 patients medicated with oral methyldopa and group-II consists of 50 patients treated with Nifedipine 10mg.Results: Methyldopa reduced systolic blood pressure (SBP) from 162±19.6 to 140.3±10.01 and diastolic blood pressure (DBP) from 99.6±8.8 to 96.17±6.4. Nifedipine reduced SBP from 99.6±8.8 to 96.17±6.4 and DBP from 99.2± 7.4 to 93.45±12.3. Response to methyldopa and nifedipine was almost similar in mild PIH but in severe PIH, 65.5% of patients required additional drug atenolol for adequate control of PIH.Conclusions: Methyldopa and nifedipine are effective drugs for lowering blood pressure when given orally, Methyldopa was found to have a higher incidence of Intra uterine growth restriction while nifedipine was found to have an increased incidence of perinatal mortality.
Efficacy of low dose aspirin on maternal and foetal outcome in preeclampsia
Authors: Togarikar Sopanrao Malharrao
Published: September 2017

Background: Low dose aspirin administration can reduce vasoconstriction and decreases thrombosis of the vessels related to placenta, thereby increases blood flow and protects against to pregnancy related complication like preeclampsia, IUGR or FGR. This study was undertaken to assess the efficacy of low dose aspirin (75 mg/day) on foetal and maternal outcome in preeclampsia patients.Methods: A total 100 preeclampsia patients were elected and were divided in to two groups i.e. control group includes age and parity matched preeclampsia cases under regular conventional treatment without aspirin administration and cases group receiving conventional treatment with aspirin 75 mg/ day after breakfast from recruitment upto one week before pregnancy.Results: There was a significant decrease in caesarean sections in cases (22%) and control groups (30%). Blood pressure, proteinuria was significantly reduced and platelets count was increased at time of presentation to after delivery in cases and controls. There was a less intra uterine deaths (8% in cases and 14% in controls) and neonatal deaths (2% in cases and 6% in controls) in cases than in controls. Neonatal haemorrhage was not accounted in both groups.Conclusions: Beginning of low dose aspirin administration in the early second trimester of pregnancy may reduce incidence of adverse health outcomes like IUGR, preeclampsia and preterm birth.
Therapeutic amnioinfusion in oligohydramnios during pregnancy (excluding labor)
Authors: Qazi Mahvish , Saqib Najmus , Ahmad Abida , Wagay Imran
Published: September 2017

Background: Oligohydramnios is a serious complication of pregnancy that is associated with a poor perinatal outcome and complicates 1-5% of pregnancies. The purpose of this study was to evaluate the role of antepartum transabdominal amnioinfusion on amniotic fluid volume/latency period in pregnancies with oligohydramnios.Methods: This study was conducted in the Department of Obstetrics and Gynaecology at Sher-i-Kashmir Institute of Medical Sciences Soura Srinagar. In this study, a total of 54 pregnant women with ultrasonographically diagnosed oligohydramnios i.e. AFI < 5 cm and gestational age of >24 weeks were taken for therapeutic amnioinfusion and its effects on amniotic fluid volume were studied. Statistical Software SPSS (Version 20.0) and Microsoft excel were used to carry out the statistical analysis of data. P-value less than 0.05 was considered statistically significant.Results: Mean age of patients in our study was 27.5±3.19 years and gestational age group of 28-34 weeks. The mean AFI pre and post amnioinfusion was found to be 3.3 cm and 8.8 cm respectively. The difference was found to be statistically significant with a p value of <0.001. There was increase in the latency period in the studied patients with a mean latency period of 42.8±14.94 days. Mean number of transabdominal amnioinfusions in our study was 1.48±0.64. In our study, majority of patients i.e. 33 (61.1%) delivered at 38-40 weeks with a mean age at delivery 37.4±1.92 weeks. In our study, maximum number of patients i.e. 32 (59.3%) were delivered by full term normal delivery and only 15 (27.8%) required caesarean section. 78% of newborns weighed >2.5kg. The mean weight of newborn was 2.9±0.59 kgs. The incidence of newborn admissions to NICU was 20.4%. Number of neonatal deaths in our study was 5.6%. There was reduction of neonatal admission to NICU and neonatal deaths after transabdominal amnioinfusion.Conclusions: Antepartum transabdominal amnioinfusion is a useful procedure to reduce complications resulting from decreased intra-amniotic volume. It significantly raises the amniotic fluid especially useful in preterm pregnancies, where the procedure allows for a better perinatal outcome by significantly prolonging the duration of pregnancy, increasing birth weight, preventing fetal distress and thereby reducing operative intervention. Optimizing the selection of patients who are good candidates for the procedure is a prerequisite.