bluuebunny/crossref_metadata_2025 huggingface dataset:
Intrauterine instillation of granulocyte colony stimulating factor for infertile women with thin endometrium in intrauterine insemination cycle: a non-randomized clinical trial
Authors: Ghosh Tandra , Banu Jesmine , Anwary Shaheen Ara , Roy Abhijit , Al Tarique Mostafa M. , Begum Nurjahan , Lasker Nastaran
Published: November 2022

Background: Endometrial thickness is one of the major factors for a receptive endometrium and successful implantation. Thin endometrium, generally measuring <7 mm are thought to be less able to support implantation and pregnancy. Several adjuvants have been investigated for their efficacy on thin endometrium in assisted reproductive technology. Granulocyte colony stimulating factor (G-CSF) is a glycoprotein that promotes endometrial stromal cell decidualization via cyclic adenosine monophosphate mediator and induces endometrial proliferation and differentiation. This study was done to evaluate the effect of G-CSF in improving endometrial thickness and pregnancy rate in infertile patients undergoing stimulated IUI (intrauterine instillation) having thin endometrium.Methods: This was a non-randomized clinical trial done among 40 infertile patients with thin endometrium (<7 mm) on the day of ovulation trigger in stimulated IUI patients. Study subjects were non randomly allocated into 2 groups. In group A 20 patients received intrauterine instillation of G-CSF (300 mcg/0.5 ml) via intrauterine catheter on triggering day and in group B another 20 patients received intrauterine instillation of 0.5 ml normal saline in the same procedure. After 48 hours endometrial thickness was measured in both groups. IUI was done on the same day. Pregnancy was detected by serum beta hCG level after 14 days of IUI.Results: In both groups most of the respondents were aged between 30-34 years, 14 (70%) in group A and 11 (55%) in group B. The mean±SD of age 32.4±3.1 in group A, 32.2±3.4 in group B and P value was 0.9. In group A the minimum endometrial thickness on day of ovulation trigger was 4.4 mm and after 48 hours of treatment with G-CSF, it was found 6.3 mm. The maximum endometrial thickness recorded in group A was 6.9 mm and it also increased to 8.7 mm after G-CSF treatment and followed by in group B min thickness 4.8 mm increase to 5.2 mm and max thickness 6.8 mm increased to 8.7 mm. The mean±SD of ET (mm) on the day of ovarian trigger was 5.8±0.8 which increased to 7.4±0.8 in group A and followed by 5.9±0.6 to 7.1±0.9 in group B. ET mean change (mean±SD) for group A was 1.6±0.7 which was greater than the group B 1.3±0.8. Pregnancy rate was 2 (10%) in group A and 1(5%) in group B.Conclusions: Mean increase in endometrial thickness and pregnancy rate was higher in G-CSF group than normal saline group, but the difference was not statistically significant.
Comparative study between cases of previous one cesarean section delivered at Kafr El-Sheikh hospitals, versus those delivered at Tanta Uniersity Hospital
Authors: Mostafa Asmaa A. , El-Khiat Ahmed M. , El-Gergawey Adel E. , Ismail Mohammed M.
Published: November 2022

Background: Many factors have contributed to the increasing rates of CSs, including increases in maternal age, BMI, and changes in obstetric practices and technologies. CSs requested by the mother and fear of litigation among caregivers have now become one of the most common indications of CS. Aim of this study was to compare between conditions of previous one caesarean section subjects delivered at Kafr El-Sheikh general hospitals, versus those delivered at Tanta University hospital as regard integrity of the uterine scars, presence of adhesions, time of termination, and fetal outcomes.Methods: This study was an observational study that was carried out on 100 pregnant ladies with history of previous one caesarean section. Participants were divided into two groups: group I included 50 pregnant women selected from Tanta University hospitals, group II included 50 pregnant women selected from Kafr El-Sheikh General hospital.Results: The estimated blood loss was significantly higher in cases selected from Kafr El-Sheikh hospitals compared to that lost from cases selected from Tanta University hospitals. Furthermore, operation time was significantly longer in patients selected from Kafr El-Sheikh hospitals than those selected from Tanta University hospitals. Additionally, omental adhesion was observed in 5 cases (5%); 3 (6%) from those selected from Kafr El-sheikh hospitals and 2 (4%) from those selected from Tanta University hospitals. As regard post-operative blood transfusion, there were increase in the incidence of post-operative blood transfusion in pregnant women selected from Kafr El-Sheikh hospitals (8%) compared to those selected from Tanta University hospitals (4%), but without statistically significant difference (p=0.678).Conclusions: There is high rate of caesarean section in our country. But satisfactory results were present in both Tanta university hospitals and Kafr El-Sheikh general hospital with few complication rates found special in cases priory delivered at Tanta University hospitals including less adhesion finding and thus less intra and post-operative complications.
Assessment of gestational diabetes mellitus development in correlation with elevated first trimester serum uric acid levels
Authors: M. Anushaktha Reddy , S. Shridevi A. , Patil Gayatri L.
Published: November 2022

Background: More than 10% of pregnancies in the world are affected with gestational diabetes mellitus (GDM), making it a prevalent pregnancy complication. The goal of this research was to examine whether or not higher serum uric acid levels in the first trimester of pregnancy are associated with an increased risk of developing GDM.Methods: The study was conducted on 56 first-trimester pregnant females at risk of GDM attending the outpatient clinic of the S. S. institute of medical sciences, Davanagere. All cases underwent estimation of uric acid levels <15 weeks, 24 to 28 weeks, and oral glucose challenge test (OGCT) at 24 to 28 weeks.Results: In our study, among 56 pregnant women, 17 (30.3%) developed GDM. Of these 12 women (70.6%) with GDM had higher uric acid levels and 5 women (29.4%) with GDM had normal uric acid levels. Uric acid levels were higher in women with a higher BMI.Conclusions: GDM development is significantly correlated with elevated serum uric acid levels in the first trimester. Early interventions by dietary and exercise regimes in these patients can reduce the maternal and neonatal complications.
Utility of first trimester ultrasound before 12 weeks of gestation at tertiary care centre in western India
Authors: Mehta Shital T. , Yadava Pushpa A. , Jani Shashwat K. , Solanki Tejas V. , Patel Aastha H. , Mehta Sweta D. , Shyara Ashish J. , Rawal Dhwani R. , Patel Dhruvi R.
Published: November 2022

Background: The first trimester begins on the first day of the last menstrual period (LMP) and lasts until the end of 12 weeks of gestation. Transvaginal ultrasound is modality of choice for establishing the presence of an intrauterine pregnancy in the first trimester. The focus of our study is routine early pregnancy ultrasound. The purpose of this study was to diagnose various conditions of pregnancy at an early stage by using ultrasound.Methods: We conducted retrospective data analysis of random 250 pregnant patients who had undergone first-trimester ultrasonography USG) (transvaginal/abdominal) in their first antenatal visit at S.V.P. Hospital, Ahmedabad, Gujarat, India from March 2021 to February 2022. The patient was selected by a simple randomized method. Maternal age, parity, gestational age, and special features regarding maternal gestational history were compared with USG findings. Patients were divided into 13 groups on the basis of ultrasonographic diagnosis.Results: We noted 76.8% of patients had single, viable, intrauterine pregnancies, while 23.2% had complicated pregnancies with uterine anomalies, ovarian cysts, leiomyoma, caesarean scar pregnancy or subchorionic hematomas.Conclusions: Ultrasound measurement of fetus in first trimester is most accurate method to confirm gestational age. It is less expensive and easily available modality. First-trimester ultrasound is useful to define embryonic landmarks in developmental stages with reference to gestational age, early diagnosis of miscarriage, ectopic pregnancy, molar pregnancy, multifetal pregnancy, major fetal malformation. And also, to diagnose pregnancy with leiomyoma, caesarean scar pregnancy, uterine anomaly and pre-eclampsia with the help of uterine artery PI.
Diosmin versus tranexamic acid in heavy menstrual bleeding: a randomized controlled trial
Authors: Gupta Vinita , Das Anirban , Dalai Sujata , Mistri Pallab Kumar
Published: November 2022

Background: Heavy menstrual bleeding (HMB) is defined as cyclical bleeding at regular intervals but excessive in amount which affect the physical, social and mental aspects of life of a woman. The prevalence is 10-30% in reproductive age women and 50% in perimenopausal women. HMB is not just a clinical burden but also a huge social and economic burden. The aims and objective of my study is to compare the efficacy of diosmin and tranexamic acid in acute HMB in terms of average duration of menstrual cycle, PBAC/PABC score, endometrial thickness, hemoglobin concentration and finally need for other modes of treatment.Methods: The study was a randomized control trial in which the patients (sample size-72) were divided into two groups- group D (n=36) and group T (n=36). Group D was treated with tab diosmin 500 mg thrice daily from day 1 to day 5 of menstrual cycle. Similarly group T was treated with tab tranexamic acid 500 mg thrice daily from day 1 to day 5 of menstrual cycle. The PBAC score was taken at the end of three months along with endometrial thickness and hemoglobin concentration. The results were compared with values obtained before initiating treatment.Results: In this study after 3 months of treatment; the patients in group D had an initial PBAC score of 423.52 and at the end of treatment it was decreased to 149.89 (p<0.0001). Reduction was 60.5%. Group T patients had an initial PBAC score of 441which was reduced to 177.94 (p<0.0001) after treatment. The reduction in this group was 59.6%.Conclusions: In this study it was found that both tranexamic acid and diosmin were effective in reduction of HMB, in terms of PBAC score, average duration of menstrual cycle and endometrial thickness. But the in reduction in PBAC score was similar in both the groups. The failure rates were also similar in both the groups, but improvements in hemoglobin concentration were only marginal
Comparison of single dose versus multiple doses of antibiotic prophylaxis in elective caesarean section
Authors: Mishra Vidhi
Published: November 2022

Background: Infectious complications after caesarean delivery (CD) are a substantial cause of maternal morbidity, increase in hospital stay and treatment cost. The spectrum of these complications’ spreads from fever, wound infection, endometritis, urinary tract infection, and some serious complications like pelvic abscess, septic shock and septic pelvic vein thrombophlebitis. To prevent these prophylactic antibiotics have been used however the use of antibiotics should be judicious. Aim was to compare the efficacy of single dose versus multiple doses of antibiotics in elective caesarean section.Methods: This study was conducted in a tertiary care hospital from December 2017 to May 2020. It was a prospective case control study. Sample size was 600, patients were randomly allocated in two groups A and B by card method. Pregnancy category B drug “cefuroxime” was given.Results: Incidence of SSI was 2.7% (n=8) in single dose group and 3% (n=9) in multi-dose group, this difference was not statistically significant. Incidence of fever for more than 48 hours was 1.3% (n=4) in the single dose group and 0.6% (n=2) in multi-dose group, this difference was not statistically significant. Urine R/M for all patients on 3rd post-operative day, in single dose group 2.3% (n=7) patients and in multi-dose group 2.0 % (n=6) patients had more than 5 pus cells. Patients, who had more than 5 pus cells in urine R/M, were subjected to urine culture and sensitivity. Four (1.40%) patients in single dose group had positive cultures (E. coli was detected in three patients and Klebsiella pneumoniae in one) and three (1.0%) patients, in multi dose group, (all the three patients had E. coli in growth). These results were statistically not significant.Conclusions: Single dose antibiotic prophylaxis was found to be comparable to multi-dose antibiotics in our study. Hence it is advocated that single dose antibiotic can be given in elective caesarean section as it is cost effective and as efficient as multi-dose regimen, ensures complete compliance and minimizes side effects and cut-down nursing work-load.
Correlation of levels of early second trimester beta-human chorionic gonadotropin levels with severity of preeclampsia
Authors: Kumari Shilpa , Chaudhary Gunjan
Published: November 2022

Background: Hypertensive disorders in pregnancy remains a leading cause of maternal morbidity and mortality all over the world as per World Health Organization (WHO), affecting 5-10% of all pregnant women. Screening women at an early stage and preventing complications are corner stone in the management of pre-eclampsia. Several studies have proven the reliability of beta-human chorionic gonadotropin (β-hCG) as predictor of preeclampsia. In this study we aim to find the correlation of increasing levels of β-hCG with severity of preeclampsia.Methods: In this study serum β-hCG estimation was done in 200 pregnant women between 13 and 20 weeks of gestation, selected randomly over a period of 1 year attending antenatal clinic by quantitative determination of β-hCG by electro-chemiluminescence immunoassay. Multiple of median (MOM) is calculated from charts of norms available. They were followed till delivery for development of pre-eclampsia. The following patients were followed up till delivery. Blood parameters, blood pressure readings, were done at 34 weeks for every patient and maternal complications were noted and results were analysed statistically.Results: The incidence of preeclampsia in this study population was 8% (16 out of 200). This study found a significant correlation between increasing levels of MOM’s of β-hCG with the severity of preeclampsia.Conclusions: In this study, there was significant association between MOM values of β-hCG with the parameters defining severity of preeclampsia. The results of our study show β-hCG to be not only a reliable marker for prediction of preeclampsia, but also its severity.
Understanding, acknowledging and accepting the knowledge regarding the complication of post-placental intrauterine contraceptive device insertion
Authors: Agrawal Rushabh H. , Shah Krima V. , Patwa Khusboo N. , Anand Rakesh
Published: November 2022

Background: Intrauterine devices are an effective and increasingly popular from of reversible contraception and are most effective method of long-term contraception. Post placental intrauterine contraceptive devices insertion is done within 48 hours of birth which is ideal period ass women are strongly motivated to do so at this time. Aim was to understand knowledge, acceptance and complication of post placental intrauterine contractive device insertion.Methods: This was a prospective observational study conducted in obstetrics and gynecology department of a tertiary care centre from 1st September 2021 to 28th February 2022.Results: Total 84 patient were counselled out which 50 were willing for PPIUCD out of which 48 (58%) patients PPIUCD was inserted and 2 patients were deferred.Conclusions: PPIUCD was accepted in 50 (60%) of counselled total patients out which most of the patient were 20-29 years having graduate degrees and were mutipara most common cause of acceptance was that it is long term method of contraception most of the patient were counselled intrapartum and had vaginal method of delivery patient were minimum complications with most common complication of missing threads and expulsion.
Correlation of non-stress test with fetal outcome in term of Apgar score- a prospective observation study
Authors: Choudhary Neeraj , Verma Savitri , Gandhi Sudha , Gour Yukti , Kumari Asha
Published: November 2022

Background: Non-stress test (NST) is a graphical recording of changes in fetal heart activity and uterine contraction along with fetal movement when uterus is quiescent. The objectives of antepartum fetal surveillance are to prevent fetal death and avoidance of unnecessary intervention. This study using NST as a tool for routine antepartum fetal surveillance was trying to catch up those fetuses who might be at risk in womb and provide prompt intervention in otherwise considered normal pregnancies without any obvious high risk factor thus giving the best outcome in mothers.Methods: The objective of this study was to evaluate the correlation of the non-stress test with fetal outcome in pregnancies from 37-42 weeks of gestation.  This was a prospective observational study at Pannadhaya Rajkiya Mahila Chikitsalya Udaipur (Rajasthan) from February 2022 to July 2022. This study included 100 normal pregnant mothers from 37 weeks to 42 weeks who were subjected to NST.Results: The parameters of poor fetal outcome like Apgar score <7 at 5 minutes had increased incidences in the non reactive group.Conclusions: NST tells about acute fetal hypoxia and decision to delivery time can be made for those patients with fetal distress so that a major improvement in the outcome among parturient can be achieved with abnormal NST results. So This study suggested that the NST was found to be a good predictor of the healthy foetus even in normal pregnancies between 37-42 weeks of gestation and the probability of an adverse outcome such as poor Apgar score increases with a non reactive strip.
An observational case control study: study of preterm labour- risk factors and its outcome
Authors: Shah Krima V. , Agrawal Rushabh H. , Parmar Radhika
Published: November 2022

Background: Preterm birth is considered as the most significant risk in infant morbidity and mortality. The number of preterm births can be reduced significantly if all of the risk factors for predicting preterm births were eliminated to maximum extent. The aim of this study was analysis of risk factors of preterm labour and its outcome through case control study.Methods: It was an observational case control study of 200 pregnant women divided into study group of 100 pregnant women who were admitted with signs and symptoms of preterm labour with gestational age between 28-36 weeks. Control group of 100 pregnant women having gestational age above 36 weeks and with spontaneous onset of active labour. Risk factors and other parameters of both the groups were analyzed along with their neonatal outcome.Results: It was found that premature rupture of membrane, previous abortion, previous preterm delivery, anemia and impaired body mass index (BMI) are significantly higher in cases with preterm labour (p value <0.05). Hyperbilirubinemia, birth asphyxia and respiratory distress syndrome are significantly higher in cases with preterm labour (p value <0.05).Conclusions: Preterm labour is a multifactorial problem. Preterm labour and delivery require early and prolonged hospitalization causing great financial and psychological burden on the society and the number of preterm births can be reduced significantly if all of the risk factors for predicting preterm births were eliminated to maximum extent.
Factors leading to surgical evacuation in first trimester medical termination of pregnancy
Authors: Mooppichathil Rasila , Vaman Jayshree V. , A. Simi
Published: November 2022

Background: Aim of the study was to determine factors leading to surgical evacuation in first trimester medical termination of pregnancy of women attending SAT hospital, medical college, Thiruvananthapuram.Methods: A case control study was conducted at the department of obstetrics and gynaecology, Government Medical college, Thiruvananthapuram. The sample size was calculated to be 58 in each group. Antenatal women attending family planning OPD for termination of pregnancy in first trimester at SAT hospital over a period of one year were recruited for this study. A structured questionnaire was used to record history, examination findings, and investigations including ultrasound. The clinical outcome was defined as successful medical abortion and failed medical abortion which leads to surgical evacuation due to retained products.Results: Previous caesarean, previous induced abortion, previous pregnancy loss or increasing gestational age showed increasing rate of failed medical abortion. Also, in patients with anaemia with haemoglobin <11 gm/dl or diabetes or hypertension showed independent association with failed medical abortion.Conclusions: If patient planning for medical abortion, can do at earlier gestational age as advancing gestation will leads to increasing rate of failed medical abortion and also after correcting anaemia, with proper medication.
The assessment in the awareness regarding nutrition in pregnancy in population attending Dhiraj hospital and effect of taboos, customs and food availability on such population
Authors: Patwa Khushboo N. , Kathrani Sulay R. , Agrawal Rushabh H. , Anand Rakesh
Published: November 2022

Background: Food taboos have great effect on pregnant women through prohibited essential food and/or drinks. It is transferred from generation to generation and has negative effect on pregnant mothers' health. The objective was to assess magnitude of food taboo and associated factors among pregnant women attending antenatal care at Dhiraj hospital, Waghodiya, Vadodara.Methods: Institutional based cross-sectional study was conducted. 180 pregnant women were selected for the study. Multiple logistic regression analysis was conducted to identify independent predictors of food taboo.Results: Twenty-seven percent of pregnant mother encountered food taboos. Avoided food items by pregnant mothers were linseed, coffee, tea, cabbage, meat, wheat bread, banana, groundnut, salty diet, sugarcane, pumpkin, and coca drinks. Reasons mentioned for avoidance of this food items were plastered on the fetal head, making fatty baby which is difficult for delivery, fear of abortion, and fetal abnormality. Age of the mother AOR=2.97 (1.71-5.16), income AOR=0.28 (0.11-0.72), and previous antenatal care AOR=2.33 (1.89-5.47) were significantly associated with food taboo.Conclusions: Our study revealed that considerable proportion of food taboo exists during pregnancy in the study area. This can be improved by strengthening the nutrition counselling components of antenatal care follow-up.
Non-puerperal uterine inversion caused by a leiomyoma
Authors: Soukaina Fekkoul , Inas Rhazi , Hafsa Taheri , Hanane Saadi , Ahmed Mimouni
Published: November 2022

Uterine inversion is characterized by the invagination of the fundus of the uterus through the vagina. It’s a rare postpartum complication leading to massive bleeding and it’s extremely rare in non-puerperal cases. Non-puerperal uterine inversion is caused by tumors exerting force on the fundus of the uterus, turning the uterus inside out. It is most frequently associated with benign tumors such as submucosal leiomyomas however, malignant tumors can also be associated. We reported the case of 43-year-old women, G1P1, who was admitted at the emergency department for a bleeding vaginal prolapsed mass. A pelvic MRI performed revealing a complete uterine inversion probably due to a submucous myoma or a malignant process. She underwent a total abdominal hysterectomy with bilateral salpingectomy by both natural and abdominal way. Pathological study revealed a degenerating leiomyoma. The patient recovered well from the operation with no complications.
Successful outcome of pregnancy in a case of Guillain Barre syndrome-report of a rare case and review of literature
Authors: Aggarwal Sakshi , Sachdeva Poonam , Mala Y. M. , Tyagi Shakun , Shakarwal Shalini
Published: November 2022

Guillain Barre syndrome (GBS) is a rare autoimmune neurological disorder that has been reported to carry a high maternal risk and maternal mortality risk of >10% if occurred during pregnancy. It is characterized by acute onset of symmetrical ascending paralysis with or without respiratory depression and autonomic dysfunction secondary to gastrointestinal or respiratory infection. This is case report of 30 years old multigravida who presented at 19 weeks period of gestation with sudden onset back pain and bilateral lower limb weakness that progressed to involve bilateral upper limbs with respiratory insufficiency.  Based on clinical presentation and relevant investigations like serum electrolyte, arterial blood gas analysis and nerve conduction studies, provisional diagnosis of GBS was made. In collaboration with the physician, she was managed with ventilator support for 12 days, intravenous immunoglobulin and supportive therapy. This was followed by complete and rapid recovery as she was extubated on 12th day and discharged on day 16. Patient was followed by strict maternal and fetal surveillance. She successfully delivered a healthy boy at 38 weeks of period of gestation by caesarean section done in view of meconium-stained liquor grade 3 in early labour and she was discharged on day 3 of LSCS.
A case of post dural puncture headache following labour epidural analgesia, managed by sphenopalatine ganglion block
Authors: Dinesh Aishwarya , Puthenveettil Nitu , Nair Sobha S.
Published: November 2022

Postpartum headache is a common complaint faced by most obstetricians, with over 39% of women having headache in the ﬁrst postpartum week. With the increasing use of labour epidural analgesia, the incidence of postdural puncture headache (PDPH) due to inadvertent dural puncture is 0.5-1%. Most treatment modalities relieve the symptoms of PDPH by minimizing compensatory cerebral vasodilatation, or by sealing the dural puncture site. Treatment options include, conservative, pharmacological, and the gold standard, epidural blood patch (EBP). EBP is invasive and may result in rare however, severe complications. Sphenopalatine ganglion block (SPGB) has been proposed as a non-invasive intervention for PDPH, which has minimal adverse effects, which can be performed bedside. Here we are reporting a case of PDPH, following labour epidural analgesia which was effectively managed by a sphenopalatine block.
Mucinous carcinoma recurrence after fertility preservation surgery
Authors: Saidhandapani Kalyani , Ravichandran Vidhya
Published: November 2022

Benign ovarian tumours occurs in 7% of women in reproductive age group. The average age of onset for borderline ovarian tumours is ten years younger than that of ovarian cancers. Considered the very good prognosis following an adequate surgical staging in early epithelial ovarian cancers (EOCs), the FPS for women of childbearing age group has become an argument of debate in last decades. 25% of the EOCs are diagnosed in early stages, 14% of those early stage patients are under age of 40 at the time of diagnosis. Fertility preservation is widely accepted in early stage epithelial ovarian cancers, germ cell, sex cord stromal tumours. Based on data, fertility sparing surgery in EOCs recommended in stage 1A, grade 1 and 2 and favourable histologic types (endometrioid, mucinous, low grade serous and clear cell carcinomas) ovarian cancer. Above stage 1A, grade 3, high grade serous and clear cell tumours decision process about FPS should be individualised, weighing a slightly higher risk of recurrence with fertility goals. Correct surgical staging is mandatory and oncological safety should be primary importance. Survival rates in oncological patients have been steadily increasing now a days due to the effectiveness of novel oncological treatments like surgery, chemo and radiotherapy. However, these treatments impair the reproductive ability of the patients and may cause premature ovarian failure in females and azoospermia in males. A multidisciplinary approach with oncology, reproductive endocrinology may be of utility to help these patients to achieve their fertility goals in future.
Post‑caesarean vesicouterine fistula: Youssef’s syndrome a case report
Authors: Roy Tuhin S.
Published: November 2022

Vesicouterine fistula is an uncommon urogynecological fistula, typically induced following lower uterine segment cesarean section, especially an emergency one. The classical clinical features of Youssef’s syndrome are cyclical hematuria, amenorrhea, and urinary continence. The index case reported was a 30 year‐old multipara who had two previous lower segment cesarean sections, underwent a third-time cesarean section and developed urinary incontinence and hematuria on the second week of the post-operative period. CECT urography confirmed vesicouterine fistula. The fistula was managed conservatively.
Anatomic variations of the hepatic arterial irrigation in a Mexican population: contrast enhanced computer tomography evaluation: a cross-sectional study
Authors: Castillo-Martinez Daniel Benito , Palacios-Rivera Doris Michelle , Boy-Serratos Jorge
Published: November 2022

Background: Knowledge and mastery of the anatomical variability of the hepatic arteries are essential for surgical disciplines and, given their complexity and importance over time, they have been extensively studied and described.Methods: A retrospective, cross-sectional, analytical study was carried out in which contrast-enhanced computer tomography (CT) studies carried out between January 2021 and December 2021 at the North Central PEMEX hospital were analyzed. A total of 207 contrast-enhanced CT scans were analyzed, and Statistical analysis was performed with the statistical software IBM® SPSS© Statistics.Results: Uflacker type I CT was found in 90.8%, the Michel class I hepatic arterial irrigation in 70.5%, and the origin of CA was documented in the right hepatic arteries (RHA) in 90.3%. Multiple cystic artery (Cas) were identified in 1% and Moynihan's hump in 0.5%. The mean length of the common hepatic artery (CHA) was 53 millimeters.Conclusions: The tomographic study of the anatomical variants of hepatic irrigation is an accessible and non-invasive tool. The nomenclature described in the present work allows a precise and straightforward understanding of clinical-surgical utility.
Evaluation of efficacy and safety of bilastine 20 mg tablets in adult patients with allergic rhinitis
Authors: Bhargava Samir , Padmanabhan Karthikeyan , Ramappa Chidananda
Published: November 2022

Background: Bilastine is a nonsedating, H1-antihistamine used for symptomatic treatment of allergic rhinitis; However, data on its efficacy and safety in Indian patients with allergic rhinitis are lacking.Methods: In this multicenter, single-arm, investigator-initiated study, 90 patients with allergic rhinitis received bilastine 20 mg tablets once daily for 4 weeks. The primary endpoint was change in total symptom score (TSS=nasal symptom score [NSS] + non-nasal symptom score [NNSS]) at day 28 from baseline. Severity of individual nasal and non-nasal symptoms was assessed at baseline, day 7, and day 28 by rating each symptom on a scale of 0-3. Key secondary endpoints were incidence of treatment-emergent adverse events (TEAEs), changes in NSS, NNSS, and rhinoconjunctivitis quality of life questionnaire (RQLQ) score, and from baseline to days 7 and 28, and change in Stanford sleepiness scale (SSS) score from baseline to 2 hours post-first dose.Results: The mean allergic rhinitis symptom scores TSS, NSS and NNSS showed a significant decrease (p˂0.0001) at each visit compared with baseline. A statistically significant decline (p˂0.0001) in the mean RQLQ score was observed at days 7 and 28 versus baseline. Median SSS score was 1.0 (range: 1.0-7.0) before and after the 1st dose of bilastine, indicating that it did not cause sedation. No TEAEs were reported during the study.Conclusions: Bilastine 20 mg once daily was efficacious in reducing nasal and non-nasal allergic symptoms, was well tolerated, and had a good safety profile in patients with allergic rhinitis.
Analysis and establish a correlation between serum ceruloplasmin, serum apelin level and thyroid profile in patients with hypothyroidism and healthy controls
Authors: Sharma Ashish , Verma Mahendra Kumar , Yadav Munmun , Pokra Manish
Published: November 2022

Background: Hypothyroidism is an endocrine disorder resulting from deficiency of thyroid hormone. It is often the primary process in which the thyroid gland produces insufficient amounts of thyroid hormone. It can also be secondary, i.e., lack of thyroid hormone secretion due to the failure of either adequate thyrotropin (TSH) secretion from the pituitary gland or thyrotropin-releasing hormone (TRH) from the hypothalamus (secondary or tertiary hypothyroidism). The patient's appearance may vary from asymptomatic to, rarely, coma with multisystem organ failure (myxoedema coma). Methods: The present observational descriptive, cross sectional study has been conducted on 120 newly diagnosed Subclinical Hypothyroidism patients of 20-50 years age group of both sex attending the OPD of department of medicine, RVRS medical college and associated group of hospitals, Bhilwara from May 2021 to May 2022. Diagnosis of thyroid disorder has been made according to the criteria recommended by the European thyroid association guidelines-2013. The result has been compared with age and gender matched 120 euthyroid subjects acting as controls. Detailed history of participants including age, history of any medications, addictions has been taken. Written consent from all the subjects has been obtained for the study.Results: The mean serum FT3 level was found to be slightly decreased in Subclinical hypothyroid subjects (group I) as compared to healthy controls (group II) but the difference was statistically significant (p<0.0001). The mean serum FT4 level was found to be slightly decreased in Subclinical hypothyroid subjects (group I) as compared to healthy controls (group II) but the difference was statistically significant (p<0.0001). A highly significant increase (p<0.0001) in mean serum TSH level has been observed in subclinical hypothyroid subjects (group-I) when compared to controls (group- II). In subclinical hypothyroid subjects, mean serum ceruloplasmin levels were found to be significantly lower in comparison to healthy subjects (p<0.0001).Conclusions: The overall findings of the present study thus confirm that serum Apelin level is significantly higher in subclinical hypothyroid subjects and serum ceruloplasmin level is significantly lower in the subclinical hypothyroid subjects. However, further experimental and observational studies are needed to illustrate the role of serum ceruloplasmin and serum apelin in subclinical hypothyroidism.
Neuroimaging in paediatric patients with developmental delay
Authors: G. Abhinaya , M. Gautam , M. Y. Gagandeep , A. Parthasarathi
Published: November 2022

Background: Aim and objectives of the study were to radiologically evaluate paediatric patients with developmental delay (DD), assess the relative prevalence of abnormal brain MRI, further categorize them based on the abnormal imaging findings and structures affected. The purpose of this study is to diagnose the underlying etiology that helps in early treatment and amelioration of the condition, parental counselling regarding the outcome of the child, providing an estimate of child’s developmental potential and the recurrence risk in siblings.Methods: 135 paediatric patients of the age 3 months to 15 years with DD referred to department of radiology were investigated with MRI scans of the brain via 1.5T Siemens scanner after making the child sleep or sedated. The sequences used were: axial T1, axial T2, axial FLAIR, axial DWI, axial ADC, axial SWI, axial PHASE, sagittal T1 and coronal FLAIR. CT scan of the brain was done only when indicated on 128 slice Siemens Somatom perspective scanner. Informed consent shall be taken from patient’s parents. Clinical and demographic details of the enrolled patients were noted in the Performa. Data collected was analysed using descriptive and inferential statistics.Results: Out of 135 children with DD, 69.1% (n=92) were male and 31.9% (n=43) were female. Majority of these children belonged to 3 months to 1 year and 2 to 5 years of age group. About 81.4% (n=110) of children with DD had abnormal findings in MRI. Among children with abnormal MRI findings, 42.9% had hypoxic ischemic changes, 6.6% had congenital malformations and non-specific causes, respectively 4.4% had neurodegenerative and occlusive neurovascular conditions, respectively 3.7% had CSF disorders and neoplasms, respectively 2.9% had infection associated changes and non-traumatic intracranial bleed, respectively 2.2% had metabolic disorders and 0.7% had demyelination. Majority of cases had ventricular abnormality, followed by the corpus callosum.Conclusions: DD presents with a wide spectrum of etiologies, clinical findings and MRI features ranging from completely normal to abnormal. The present study could establish the various morphological appearances of DD on MRI and further categorize them into various subgroups be effective in diagnosis, management and prognosis determination processes.
Multidetector computed tomographic urography for evaluation of vascular and ureteric anomalies associated with ectopic kidneys
Authors: M. Y. Gagandeep , M. Gautam , G. Abhinaya , N. Sindhu
Published: November 2022

Background: The purpose of this study is to evaluate the vascular and ureteric anomalies associated with ectopic kidneys with multidetector computed tomography (MDCT). Methods: The 40 patients with pre-diagnosed ectopic kidney undergoing MDCT urography (Contrast study) and KUB (Plain study) were included in this cross-sectional observational study. The location and number of bilateral kidneys were assessed. The number and origin of the renal arteries and renal veins were noted. Their relationship with each other and possible complications in surgical handling analysed. Data collected was analysed using descriptive and inferential statistics.Results: The renal artery originated from suprarenal aorta in 2 cases, normal origin in 10 cases, infrarenal aorta in 12 cases, aortic bifurcation in 19 cases, common iliac artery in 6 cases and iliac artery bifurcation in 2 cases. The renal vein was of normal origin in 8 cases, originated from infrarenal inferior vena cava (IVC) in 16 cases, IVC bifurcation in 14 cases, common iliac vein in 9 cases, internal iliac vein in 2 cases and external iliac vein in 1 case. There was a significant correlation between the level of ectopic kidneys (abdominal, iliac and pelvis) and level of origin of arteries (p<0.001) and veins (p<0.001). In addition, significant correlation was found between the origins of arteries and veins of ectopic kidneys (p<0.001).Conclusions: A knowledge of the possible variations in renal vasculature and ureter associated with ectopic kidneys can play a key role in preventing iatrogenic hemorrhage during surgery.
Awareness, knowledge and practice of contact lens use among medical students
Authors: Thiraviam Mahima , Kumaresan Vinisha , P. Anuradha
Published: November 2022

Background: Contact lens are thin optical lenses that are commonly used for correcting refractive errors. They are available in various materials, types, and colors. The complications associated with contact lens usage are allergic conjunctivitis, keratitis, and neovascularization. These complications arise with a lack of proper practice and knowledge about contact lens. In our study, we assess the awareness, knowledge, and practice of contact lens use among medical students of Saveetha medical college and hospital. Study design was cross-sectional study. Place of study was Saveetha medical college and hospital, Thandalam, Chennai.Methods: A cross-sectional study was conducted on contact lens users among medical students. A total of 100 contact lens users participated in the study of which 70 were females and 30 were males. The study was done using pretested semi-structured questionnaire. The data were collected, tabulated, and analyzed using SPSS version 25 software.Result: There is a female predominance with about 70%. Most of the participants use contact lens for both cosmetic and refractive errors. About 91% of students use soft contact lens. Nearly 70% of students are not aware of overwear syndrome. Problems faced by contact lens wearers include dryness, eye discomfort, pain, watering, and redness.Conclusions: The lack of proper practice, knowledge, and awareness of contact lens use even in those knowledgeable like medical students increases the risk of complications. Thus, there is a need to provide more education to consumers.
Histo-pathological findings in kidneys with polar artery: a demystifying endeavor
Authors: Nallagatla N. Shakuntala , Nannam Kavya , Kugananthan Meera , Rao H. R. Krishna , Kumarguru B. N.
Published: November 2022

Background: The kidneys are supplied by renal arteries which enter the hilum and branch progressively from the pyramids to the cortex into lobar, interlobar, arcuate, interlobar, interlobular, and finally terminate as afferent arterioles that enter the glomeruli. Thus there is a normal pattern of blood flow towards the cortex from the pyramids when the artery enters at the hilum. The aim of the study was to explore the glomeruli pattern in kidneys with polar arteries.Methods: The study was conducted in the department of anatomy at a tertiary care referral institute. Twenty-two kidneys with polar arteries were obtained by conventional method of dissection from cadavers for the study. Sections were taken from the upper pole and lower pole in each kidney. The sections were taken perpendicular and close to the polar arteries. The sections were subjected to routine histological processing and staining as per the standard operating procedure. Histological findings were observed and documented.Results: The study found that the kidneys were histologically different with polar arteries as compared to normal kidneys. The number of glomeruli per high power field was higher nearer to the polar arteries. The glomeruli were viable and not sclerosed. An agglomeration of arterioles were present close to the polar arteries but they were distinct and did not seem to be associated with glomeruli.    Conclusions: The study found an agglomeration of arterioles, increased number of viable glomeruli and cystic changes associated with kidneys having polar artery. Thus this warrants a detailed study with special stains for research to elucidate the mechanisms of the circulation in polar arteries and correlation of the same findings with clinical conditions such as hypertension or any other diseases of the kidney.
Comparative analysis of post-operative analgesic requirements in patients undergoing minor oral surgery using buprenorphine with lignocaine versus lignocaine: a clinical study
Authors: Kamal Neel , Sheikh Alfisha , Alwyn Vaz Ashwin , Kaur Navneet , Shekhar Chandra , Sharma Amit
Published: November 2022

Background: We aimed to inspect the post -operative analgesic requirement in patient undergoing minor oral surgery using buprenorphine versus lignocaine and lignocaine alone. Minor oral surgeries are followed by inflammatory reaction characterized by pain, mild swelling and discomfort. Opioid analgesics have an advantage over non-steroidal anti-inflammatory drugs (NSAIDs) as they do not cause organ damage. Buprenorphine has an antinociceptive potency greater than that of morphine. Hence, in this study, buprenorphine was added to lignocaine in relieving postoperative pain after minor oral surgery.Methods: A total of 100 patients requiring minor oral surgery were included in the study. The patients were randomized by a third party and allocated to one of the two study groups. Hence a total of 50 patients in each group were selected for study, during a period of 24 months. 1 ml of buprenorphine hydrochloride injection I.P which contains an equivalent of 0.3 mg buprenorphine was withdrawn into a syringe and injected into a 30 ml vial of 2% lignocaine with adrenaline 1:200000.Results: The pain was found to be statistically significant at 2-hour, 24 hour and 36 hours postoperatively, thereafter the difference in NRS values between the solutions was not significant. Hence, the analgesic effect of solution A (buprenorphine) was effective at 2-hour, 24 hour and 36 hours postoperatively.Conclusions: Our study indicate that addition of 0.3 mg of buprenorphine to local anesthetic solution provides efficient post-operative analgesia and reduces patient's discomfort.
Social media addiction and its impact among the school students during COVID-19 lockdown in an urban area of Western India: a cross-sectional study
Authors: Engti Raktim , Momin Mohmmedirfan H. , Vyas Shailee N.
Published: November 2022

Background: Reports indicate significant increase in number of social media users. Teenagers are among the most prolific users of social media. Subsequently, questions and controversies emerge about its positive and negative effects, including their safety, academics and inter-personal relationships. This study will help in identifying teenagers at risk and implications of social media addiction on students.Methods: A cross sectional study conducted among school students of randomly selected schools of Surat city. Social media addiction scale-student form was used for data collection. Data entry in Microsoft excel and analysis was done by Epi-info. Univariate analysis was done to calculate mean and standard deviation while bivariate analysis for chi square test.Results: With 434 students of grade 9-12, mean age was 15.70±1.20 years. The prevalence of social media addiction was 23.5%. Girls were significantly associated with social media addiction. Overall, 26% of the students agreed that they were eager to go on social media, 14% of the students agreed that a life without social media becomes meaningless for them and 14.3% of the students agreed that they were unhappy when they are not on social media. Overall, 21.5% agreed that their productivity has decreased due to social media use and 12% had physical problems because of social media use.Conclusions: Risk factors for addiction were younger age group (13-15 years), female gender and students of standard 9. The academics was hampered for all the students irrespective of their age. There was a negative effect on their inter-personal relationships, mental and physical health.
Evaluation of validity and reliability of multiple-choice questions in second MBBS competency-based medical education-based pharmacology examination of medical institute of India
Authors: Patil Rushikesh P. , Bahekar Satish E. , Kulkarni Madhuri D. , Baig Mirza S.
Published: November 2022

Background: Multiple choice questions (MCQs) are most commonly used assessment tool in undergraduate medical examination. Assessment method must be reliable and valid. To improve quality of MCQs, item analysis was carried out by determining their validity and reliability using parameters like difficulty index, discrimination index, distractor efficiency and Cronbach’s alpha value.Methods: Study was carried out among 193 second year medical students. Each student was given 40 MCQs of 1 mark each. After assessment of MCQs, validity of test was analyzed by using difficulty index, discrimination index and distractor efficiency while reliability was analyzed by using Cronbach’s alpha.Results: Mean ± SD of difficulty index, discrimination index, functioning and non-functioning distractors were 59.80±23.38, 0.25±0.12, 1.98±0.92 and 13.25±13.05 respectively with reliability value of 0.7. About 47.5% items had moderate difficulty index, 22.5% items have excellent discrimination index with 35% items having 100% distractor efficiency. Reliability of test as measured by Cronbach’s alpha value was 0.7. There was weak correlation between difficulty index and discrimination index.Conclusions: It is concluded from study that given MCQs test have reliability but not validity and needs to improve quality of MCQs. Validity of test is improved by improving difficulty index, discrimination index, distractor efficiency of items.