ScopeMed - RSShttp://www.scopemed.orgScopeMed RSSen-us Copyright © 2011 ScopeMed All rights reserved. ScopeMedhttp://www.scopemed.org/img/logo-scopemed-ttk.gifhttp://www.scopemed.org 2016-08-28T18-51-08Z FOOD AND FEEDING HABITS OF CHRYSICHTHYS NIGRODIGITATUS (LACEPEDE, 1803) AND EVALUATION OF PHYSICO-CHEMICAL PARAMETERS IN THE LAGOS LAGOON, NIGERIA http://www.scopemed.org/?mno=240813 2016-08-28T18-51-09Z
Source: THE EGYPTIAN JOURNAL OF EXPERIMENTAL BIOLOGY (Zoology)
Kuton M.P., Akinsanya B..
Four hundred specimens of Chrysicthtys nigrodigitatus from Lagos Lagoon were examined for food and feeding habits. Duration and water samples were collected and analysed for four months. The total length of fish ranged from 11.0 cm to 39.0 cm while the standard length ranged from 8.0 cm to 31.9 cm, with a corresponding weight range from 17.0 g to 668.0 g. The length-frequency distribution followed the expected normal distribution with the small, medium, and large specimen being the lowest size range of (1.25%). The length-weight relationship showed the usual increase of weight with increasing length, and the species exhibit a positive allometric growth pattern. There was high correlation between the length and weight of the fish with regression coefficient (r) ranging between 0.87 and 0.94. The mean K-values were 1.86, 1.50 and 1.86 for males, females and combined sexes, respectively. The result of physico-chemical parameter showed that DO value ranged from 2.45 to 6.7 mg/L, BOD value ranged from 10.6 to 150.1 ml/L, COD value ranged from 65.1 to 256 mg/L, TDS value ranged from 156-545 mg/L, Nitrate value ranged from 1.02 to 4.11 mg/L, Phosphate value ranged from 0.51 to 2.11 mg/L, Copper value ranged from 0.1 to 1.71, Zinc value ranged from 0.01 to 0.71, Lead value ranged from 0.001 to 0.04, pH value ranged from 6.8 to 8.22, Conductivity value ranged from 8.72 to 71.4, Salinity value ranged from10.1 to 19.52. Physico-chemical parameter varies for different months and this is influence by rain fall, run off from the surrounding land and other factors in the Lagos lagoon. Physicochemical parameters however do not influence the food and feeding of C. nigrodigitatus in the Lagos lagoon.
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Sat, 27 Aug 2016 17:18:08 GMT -08:00 http://www.scopemed.org/?mno=240813
Persistent Compromised Hemodynamic Function, due to single ventricular epicardial pacing, after aortic valve replacement surgery: A Case Report http://www.scopemed.org/?mno=238186 2016-08-28T18-51-09Z
Source: International Journal of Surgery and Medicine
Konstantinos Giakoumidakis, Christos Charitos.
We report the case of a 69-year old woman, who was admitted to the cardiac surgery intensive care unit (ICU) of a tertiary hospital, after surgical aortic valve replacement, due to severe aortic stenosis. During the early postoperative period, the patient was hemodynamically stable and her cardiac rhythm was supported by temporary epicardial ventricular pacing. One hour after her ICU admission, the woman presented compromised hemodynamics, characterized by severe hypotension with poor response to aggressive inotropic, vasopressor and fluid therapy. After 15 minutes of her significant clinical worsening, the change of the pacing mode from single ventricular to single atrial effected immediate hemodynamic stabilization, improved arterial blood pressure and optimum patient cardiovascular function. This could be explained by the significantly reduced cardiac output in the absence of atrial contraction to assist ventricular preloading, which characterized some patients with impaired ventricular function, as those with severe aortic stenosis.
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Sat, 27 Aug 2016 14:10:52 GMT -08:00 http://www.scopemed.org/?mno=238186
Phyllodes tumor of the breast : A clinicopathological analysis from a single institution http://www.scopemed.org/?mno=235566 2016-08-28T18-51-09Z
Source: International Journal of Surgery and Medicine
Naoual Benhmidou, Fadoua Rais, Fadila Kouhen, Abdelhak Maghous, Hasna Loughlimi, Khadija Bellahammou, Hanan Elkacemi, Tayeb Kebdani, Sanaa Elmajjaoui, Noureddine Benjaafar.
The aim of our study is to examine the clinical and pathological features of patients with breast phyllodes tumors and to determine features that are correlated to outcome. Forty four phyllodes tumors were assessed. There were 11 benign, 11 borderline and 22 malignant tumors. 10 of 44 patients (22.72 %) relapsed at any site. Seven patients (15.9 %) had a local recurrence and 3 patients experienced local and metastatic relapse. The 5-year and 10-year survival rates are 97% and 95 % respectively. The 5 years and 10 years DFS are 81% and 77% respectively. Grade, histological size, margin involvement impacted disease free survival. Adjuvant radiation therapy improved local control in high grade tumors although it didn’t reach significance.
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Sat, 27 Aug 2016 14:10:30 GMT -08:00 http://www.scopemed.org/?mno=235566
Writing a Case Report: The Opening Challenge http://www.scopemed.org/?mno=238122 2016-08-28T18-51-09Z
Source: Journal of Behavioral Health
S.M. Yasir Arafat.

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Sat, 27 Aug 2016 04:57:12 GMT -08:00 http://www.scopemed.org/?mno=238122
Study of Complementary and Alternative Medicine Usage of Cancer Patients Receiving Medical Oncology Clinic Medicine and Its Relationship with Their Quality of Life http://www.scopemed.org/?mno=216097 2016-08-28T18-51-09Z
Source: Journal of Behavioral Health
Elif Temucin, Tulay Ortabag.
Background: This study has been implemented with the aim of examining the situation and the quality of life of cancer patients receiving treatment at an oncology clinic and using complementary and alternative medicine (CAM). Methods: Research has been carried out with 85 colorectal and lung cancer patients and was conducted from March 23 to May 1, 2011. The “Introductory Information Form”, “Question Form for the Status of Using CAM” and "Rotterdam Symptom Checklist" have been used as data collection tools. Results: It has been found in this study that the rate of cancer patients using CAM was 51,8%. The most popular CAM method was herbal cures. In our research, we found that CAM was used in the young age groups with a high level of education, in patients in the third phase of the disease and in the women. It has also been found that patients were informed by their close environment, and they were reluctant to disclose the CAM method they use to a health care professional. Most of the patients using CAM intended to increase their body strength. When assessed the quality of life of cancer patients using and not using CAM was not statistically different as determined by their physical, psychological, and daily life activities. Conclusion: It is of the utmost important for the nurses providing primary care for the cancer patients in the implementation of conventional treatment, to be able to make assessments about the usage of CAM by patients and provide appropriate advice.
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Sat, 27 Aug 2016 04:54:45 GMT -08:00 http://www.scopemed.org/?mno=216097
The United States National Physical Activity Plan: Is it Being Integrated into Exercise Science Curriculum http://www.scopemed.org/?mno=236458 2016-08-28T18-51-09Z
Source: Journal of Behavioral Health
Allison Nooe, Paul D. Loprinzi.
Purpose: No research has evaluated the extent to which exercise science graduate curriculum incorporates content from the National Physical Activity Plan (NPAP). The purpose of this study was to examine awareness and utilization of the NPAP among university faculty. Methods: A population-based cross-sectional study design was employed that surveyed University exercise science faculty; 60 Universities granting a doctoral degree in Kinesiology were sampled, with 13 ultimately providing data for this study. Three sectors within the NPAP were evaluated, which included: health care; education; and transportation, land use and community design. Results: One-hundred percent of evaluated faculty reported awareness of the U.S. NPAP. With regard to the Health Care and Education strategies, 100% included at least one strategy and 85% included at least one Transportation, Land Use, and Community Design strategy. The percentages indicating use of all strategies in each sector was much lower with 39% of institutions reporting use of all Health Care strategies, 23% reported use of all Education strategies, and 38% reporting use of all Transportation, Land Use, and Community Design strategies. Conclusion: Our findings demonstrate that while awareness of the NPAP among faculty is high, implementation is much lower.
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Sat, 27 Aug 2016 04:53:25 GMT -08:00 http://www.scopemed.org/?mno=236458
Atypical leiomyoma: unusual locations and findings coupled with uncommon presentation http://www.scopemed.org/?mno=231732 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Rekha Agrawal, Hemant Shintre, Krishna Agrawal, Aniruddh Agrawal.
Extrauterine leiomyomas are a rare phenomenon, and they present a great diagnostic challenge. Retroperitoneal leiomyomas remain asymptomatic for a variable period and usually present with wide variety of signs and symptoms. A 51 years old female was multiparous and had undergone a total laparoscopic hysterectomy along with a bilateral salpingo-oophorectomy about four years ago. She visited the outpatient department of a tertiary care hospital complaining of something coming out per vaginum and expressed difficulty in passing urine and also complained of stress urinary incontinence. Bimanual pelvic examination, ultrasonography (USG) and Magnetic resonance imaging (MRI) revealed a large oval shaped well defined solid mass completely filling the vaginal canal while compressing urinary bladder. Tumor marker levels were normal. Laparotomy with adhesiolysis and complete excision of retroperitoneal mass was performed. Frozen section followed by histopathology and immunohistochemistry confirmed that the mass was a leiomyoma. After surgical intervention and removal of mass, the symptoms dissipated and patient had a complete recovery. Despite hysterectomy the manifestation of leiomyoma appears to be apparent. Surgical excision of the mass appeared to be the correct move forward after the leiomyoma was diagnosed with the help of the MRI and the USG.
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Sat, 27 Aug 2016 04:25:34 GMT -08:00 http://www.scopemed.org/?mno=231732
Two interesting cases of gestational trophoblastic disease with methotrexate failure http://www.scopemed.org/?mno=236672 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Poonam Laul, Pinkee Saxena, Vijay K. Kadam, Urvashi Miglani.
Gestational trophoblastic disease is group tumours that are more sensitive and respond well to a wide variety of chemotherapeutic regimes. Presented here are two interesting cases one with life threatening bleeding requiring hysterectomy and other with persistent disease post evacuation. Both being low risk were treated with single agent methotrexate, but failed to respond. They responded to alternative chemotherapy. Methotrexate resistant is seen even in low risk group.
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Sat, 27 Aug 2016 04:22:23 GMT -08:00 http://www.scopemed.org/?mno=236672
Vulvar schwannoma: a case report http://www.scopemed.org/?mno=236009 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Barkha Bafna, Amit Bafna, Ashalata Bafna.
Schwannoma is a benign, slow growing nerve sheath neoplasm that is rarely found in female genital system. Only a few cases of vulvar schwannomas have been reported. We report a case of vulvar Schwannoma arising in labium minus in a patient without neurofibromatosis. A 26 year old woman had two 1cm x 1cm and 1.5cm x 2cm sized oval nodules at the right labium minus. Complete excision was done and the histological report confirmed to be vulvar Schwannoma. Although it has a very low incidence, Schwannoma should be considered as a differential diagnosis of a vulvar mass.
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Sat, 27 Aug 2016 04:18:38 GMT -08:00 http://www.scopemed.org/?mno=236009
Abnormal vulval lesions: diagnosis and management http://www.scopemed.org/?mno=235671 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Aarti Kothari, Usha Parekh, Rashmi Mahajan.
Vulval symptoms are commonly found and cause considerable distress for women. Symptoms are often chronic and can significantly affect the quality of women's lives including sexual function and wellbeing. Despite the frequency of vulval symptoms, women often find it difficult to seek medical advice due to multiple reasons, mostly cultural and emotional. This part is not easily self-observable neither are women aware of the fact that a vulvar lesion could also be a manifestation of a systemic disease. The idea behind this study was to identify whether presenting vulval lesion is dermatological or non-dermatological and to control the symptoms, to identify nature of the various vulvar lesions (inflammatory or neoplastic) and to identify those skin lesions not responding to treatment which require biopsy and further management. It was a clinical descriptive study. Cases included women with vulvar lesions who attended Gynaec OPD at Dhiraj General Hospital affiliated to S.B.K.S. Medical Institute and Research Centre of Vadodara. After taking their informed consent ,all the women who had symptoms like vaginal discharge, itching or discomfort associated a with vulvar lesion, visible lesion or growth over vulva were thoroughly investigated to rule out any systemic illness causing vulvar lesion following which biopsy was taken if solid growth or a non-healing lesion was present. Treatment was done according to the lesions. In the presence of vulvar complains, a diagnostic pathway including systematic physical examination is always mandatory to detect SCC early. A non-healing lesion must be subjected to biopsy mandatorily. Women should be educated to avoid ODC drugs or creams when they face vulval lesions.
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Sat, 27 Aug 2016 04:14:51 GMT -08:00 http://www.scopemed.org/?mno=235671
Primary ovarian pregnancy: early diagnosis still a myth http://www.scopemed.org/?mno=235401 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Suman Lata Mendiratta, Smriti Anand, Rajni Mittal, Farheen Khan, Namrata Nargotra.
Primary ovarian pregnancy occurs quite rarely accounting for 1 to 3%. And that too usually in young highly fertile multiparous women using intra uterine device and is associated with rupture very early in the gestation. We present a case where a young primigravida presented with abdominal pain and was diagnosed as ectopic pregnancy and was confirmed intra-operatively and histopathologically as primary ovarian pregnancy, managed with partial ovariectomy.
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Sat, 27 Aug 2016 04:12:23 GMT -08:00 http://www.scopemed.org/?mno=235401
Report of the 7th international workshop on colposcopy, screening and prevention of cervical cancer, Douala, Cameroon, March 30 - 31 and April 1st 2016 http://www.scopemed.org/?mno=235891 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Jovanny Tsuala Fouogue, Zacharie Sando, Florent Ymele Fouelifack, Jeanne Hortence Fouedjio, Pierre Marie Tebeu, Jacques Tsingaing Kamgaing, Pierre Vassilakos, Patrick Petignat.
Background: Authors herein report the proceedings of the 7th international workshop on colposcopy, screening and prevention of cervical cancer held in Douala (Cameroon) on March 30 - 31 and April 1, 2016. Methods: As with previous conferences of this series, the 2016 edition provided an excellent forum for exchange of information and opinions between the researchers, clinicians, laboratory scientists and regulatory bodies. It also stood as an opportunity for further training of health staff on prevention and screening of cervical cancer. Results: The workshop covered both accepted and emerging methods of preventing and screening cervical cancer with emphasis on current clinical and public health practice in low and middle-income countries. The topic was covered by complementary sessions: cervical principles, cervical cancer epidemiology and prevention strategy; cervical cancer management and treatment; cervical cancer screening programs in Cameroon; innovations in cervical cancer screening and perspectives in cervical cancer screening. This report also summarizes the presentations done during the workshop. This 7th edition set up the record of attendance with more than 150 participants of several backgrounds (specialist physicians and nurses, laboratory technicians, socio-anthropologists, university lecturers and managers of health systems) from more than 19 local and international institutions. Conclusions: Master’s classes, free communications and discussions were fruitful and appointment was taken for March 30-31, 2017 in Yaounde, Cameroon.
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Sat, 27 Aug 2016 04:10:23 GMT -08:00 http://www.scopemed.org/?mno=235891
Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analgesic http://www.scopemed.org/?mno=232984 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Rashmi Patil, Vivek Rayadurg.
We read with interest the article “Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analgesic” by Mohan H et al published in November - December 2015, volume 4 issue 6 of International Journal of Reproduction, Contraception, Obstetrics and Gynecology.1 As we read it, we realized that the article is quite similar to another article “Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analgesic” by Lallar M et al.2 Although the authors quote this article as their reference, the degree of similarity between the two articles is beyond our acceptance. Hence we would like to bring it to your notice. We know that any original research should be encouraged to be published, but the authenticity in style of writing the same should be maintained and plagiarism to such a high extent is not acceptable.
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Sat, 27 Aug 2016 04:10:13 GMT -08:00 http://www.scopemed.org/?mno=232984
Uterine myomatosis and portal vein thrombosis: a rare association http://www.scopemed.org/?mno=237067 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Elamurugan Sujindra, Sai Chandran Sabita, Arounassalame Bupathy.
Uterine leiomyomas are the most common pelvic tumors in women and occur in 20–30% of women over 30 years of age. Many complications are seen with fibroid. We report a rare case of a large uterine leiomyoma associated with portal vein thrombosis. 50-year patient presented lower abdomen swelling associated with pain and breathlessness, diagnosed as multiple fibroids. She had massive splenomegaly. Abdomen Doppler revealed splenomegaly with thrombosis of portal, splenic and superior mesenteric vein. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was done. Iron deficiency anaemia with thrombocytosis caused by fibroid was the identified cause for portal vein thrombosis.
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Sat, 27 Aug 2016 04:10:02 GMT -08:00 http://www.scopemed.org/?mno=237067
Placenta percreta - an audacious experience http://www.scopemed.org/?mno=237006 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Shrinivas Gadappa, Sonali Deshpande, Kalyani Rajpurohit, Bhakti Kalyankar.
Maternal and fetal morbidity and mortality from placenta accreta are considerable and are associated with high demands on health resources. There is abnormally firm attachment of placenta to the uterine wall with the absence of deciduas basalis and incomplete development of Nitabuch’s layer. The reported incidence of placenta accreta has increased from approximately 0.8% in 1980s to 3 per 1000 in the last decade, occurring more frequently in future deliveries after caesarean section. Management of patients with a morbidly adherent placenta (placenta accreta, increta, or percreta) varies widely. Although the impact of a morbidly adherent placenta on pregnancy outcomes is well-described, no randomized trials have examined the management of pregnancies complicated by this disorder. As a result, recommendations for its management are based on case series and reports, personal experience, expert opinion, and good clinical judgement. We report a case of placenta percreta that was successfully managed by planned caesarean hysterectomy with prophylactic ligation of bilateral anterior division of internal iliac artery.
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Sat, 27 Aug 2016 04:09:53 GMT -08:00 http://www.scopemed.org/?mno=237006
A rare case of omental torsion - a surprise diagnosis of acute pelvic pain http://www.scopemed.org/?mno=236518 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Naimah Raza, Prema Kania, Prashant Bhamare.
Omental torsion is a rare cause of acute abdominal or pelvic pain. It is rarely diagnosed pre-operatively. It poses a great challenge as it closely mimics the other conditions causing acute surgical abdomen, such as appendicitis, ovarian torsion, ruptured ovarian cyst or ectopic pregnancy etc. Hence, often it presents as a surprise intra-operative diagnosis. Though exploratory laparotomy represents the diagnostic and definitive therapeutic procedure, presently Laparoscopy is the first choice procedure.
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Sat, 27 Aug 2016 04:09:43 GMT -08:00 http://www.scopemed.org/?mno=236518
Successful outcome of pregnancy in uncorrected tetralogy of fallot with pulmonary atresia http://www.scopemed.org/?mno=235443 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Mugdha Laxmanrao Jungari, Vilas N. Kurude.
Tetralogy of fallot (TOF) is one of the commonest congenital anomalies. TOF is mostly diagnosed early in the life and to reach adulthood, such patients usually require some sort of surgical correction. Management of pregnancy in uncorrected TOF cases poses a significant challenge for obstetrician and team. Most of the time, it ends with significant fetomaternal morbidity or mortality. Here is a case of pregnancy with uncorrected TOF, which was successfully managed with multidisciplinary approach.
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Sat, 27 Aug 2016 04:07:22 GMT -08:00 http://www.scopemed.org/?mno=235443
Intravenous leiomyomatosis http://www.scopemed.org/?mno=233120 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Rita Mittal, Bishan Dhiman, Himani Sharma, Aleeza Pal.
Intravenous leiomyomatosis is a rare benign smooth muscle tumour arising from a venous wall or a uterine leiomyoma. This case highlights that intra-cardiac leiomyomatosis should be considered as a differential diagnosis in addition to extended cancer or thrombus, in female patients, diagnosed with a right sided cardiac mass extending from the IVC. To prevent pulmonary embolism or sudden death in patients with intra-cardiac extension, complete surgical resection is necessary. One stage surgical removal has been recommended for complete resection.
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Sat, 27 Aug 2016 04:05:05 GMT -08:00 http://www.scopemed.org/?mno=233120
Severe morbidity with sublingual misoprostol in a post-partum patient: a case report http://www.scopemed.org/?mno=234895 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
SunitaVerma, Binni Makkar, Netra Singh, Poonam Singh, Shefali Bansal.
Misoprostol is highly useful in preventing and treating postpartum hemorrhage. However, it may be associated with side effects like fever, chills and vomiting. Rarely may it cause severe morbidity and even death. We witnessed a case of 30 year old female, who developed postpartum hemorrhage immediately after her delivery. Patient was administered various uterotonics including 800 mcg sublingual misoprostol, with which her PPH was finally controlled. However, she developed hyperthermia, hypotension, tachycardia and fall in saturation of O2, after few hours of misoprostol administration. Patient was managed by strict monitoring in ICU setting and mechanical ventilation. She gradually recovered over a period of 48 hours and was discharged in stable condition. Misoprostol should be carefully used as it has a potential to cause serious adverse effects in pregnant and postpartum phase.
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Sat, 27 Aug 2016 04:02:12 GMT -08:00 http://www.scopemed.org/?mno=234895
Rare case of broad ligament fibroid with cystic degeneration http://www.scopemed.org/?mno=234886 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Anupama Hada, Sangeeta Sen.
Giant fibroids are known to arise from the uterus, although very rarely from extra-uterine sites. Among extra-uterine fibroids, broad ligament fibroids generally achieve enormous size and generally present with pressure symptom like bladder and bowel dysfunction. Cystic degeneration is a rare complication of benign fibroid, where presence of cystic changes mimics the ovarian tumor. We report a case of false broad ligament fibroid. This case is reported for its rarity and the diagnostic difficulties in differentiating ovarian tumor and benign fibroid with cystic degeneration.
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Sat, 27 Aug 2016 03:51:08 GMT -08:00 http://www.scopemed.org/?mno=234886
A case of extra hepatic portal vein obstruction in pregnancy with superimposed pre-eclampsia http://www.scopemed.org/?mno=233159 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Bindu Nambisan, Sreekumary Radha, Mayadevi Brahmanandan, Libu Gnanaseelan Kanakamma.
Extra hepatic portal vein obstruction in pregnancy poses a clinical challenge by itself. We present here a case of a 19 year old primigravida with EHPVO who developed superimposed preeclampsia. She had a successful maternal and fetal outcome in a tertiary care centre owing to the team effort involving specialists from medical gastroenterology, nephrology, anesthesiology, and neonatology apart from senior obstetrician. EHPVO is an important cause of non-cirrhotic portal hypertension in third world countries. In pregnancy, the increased blood volume and cardiac output and mesenteric vasodilatation will increase portal flow and aggravate portal hypertension in these patients. The resultant hematemesis in such patients, can compromise the perinatal outcome. Endoscopic variceal ligation (EVL) reduces the risk of variceal bleeding, and can improve the pregnancy outcome in these women. Thrombocytopenia due to splenomegaly is one of the major complications in these patients and has to be corrected before pregnancy. Platelet transfusion is required intrapartum if the count is less than 50,000/mm3 caesarean delivery is reserved only for obstetric indications.
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Sat, 27 Aug 2016 03:44:55 GMT -08:00 http://www.scopemed.org/?mno=233159
Successful pregnancy outcome in a case of Takayasu’s arteritis with recurrent pregnancy loss with low dose heparin http://www.scopemed.org/?mno=232979 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Richi Khandelwal, Sudha Gandhi.
Takayasu's arteritis (TA) is a well-known yet rare form of large vessel vasculitis. TA commonly effect women in childbearing age of Asian origin. The etiology remains speculative but current literature supports autoimmune basis for TA. Suppression of inflammation and preservation of vascular competence form the basis of the treatment. The basic disease appears to be unaffected by pregnancy, inflammatory activity and haemodynamic status improves with pregnancy, but the high arterial pressure and the pre-eclampsia constitute main maternal complications. The fetal complication is intrauterine growth. Therefore, obstetricians are faced with the dilemma of optimal management in pregnancy. The optimum management of these women involves conception during the remission period, antenatal care provided by multidisciplinary team, early detection, treatment of hypertension and curtailing the second stage of labour for better maternal and fetal outcome. In our case, the patient was managed with low dose heparin which was started as soon as the patient visited us (14 weeks) and continued till one day before surgery. No steroids were given at any time during the course of pregnancy and post - one year follow - up the patient is doing fine.
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Sat, 27 Aug 2016 03:44:36 GMT -08:00 http://www.scopemed.org/?mno=232979
Equity focused health impact assessment: social determinants of health http://www.scopemed.org/?mno=237322 2016-08-28T18-51-09Z
Source: International Journal of Community Medicine and Public Health
Hassan N. Ayyoub.
Addressing health disparities during planning and delivery of services in health care requires an understanding of the health requirements of the disadvantaged population as well as key barriers to equitable quality care. To gain knowledge in social determinant of health it is important to have effective planning tools. Over the past two decades there has been continuous use of health impact assessment (HIA) to assess the health impacts of proposals, programs, policies, projects and even plans. The major problem affecting the implementation of HIA is the identification of the health issues in a policy since it depends on the judgment and the interpretation of the policy aspects by policy makers. The equity focused HIA has an opportunity to make important contributions to policy making processes. The main purpose of EFHIA (Equity Focused Health Impact Assessment) is to ensure that policies, plans, and programs being developed or proposed have observed health equity in order to promote social health.
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Sat, 27 Aug 2016 03:44:36 GMT -08:00 http://www.scopemed.org/?mno=237322
Recurrent spontaneous multiple pregnancy: a case report http://www.scopemed.org/?mno=230135 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Shazia Parveen, Noor Afshan Sabzposh, Amina Kuraishy.
Multiple gestations are usually iatrogenic like use of assisted reproductive techniques (ART), infertility treatment but it is rare in spontaneous conception. High order multiple pregnancies (HOMPs) are major cause of maternal, fetal and neonatal morbidity. Multiple gestations carries 2 complications either abortion in early gestation or a preterm delivery in late pregnancy (more common). Preterm delivery is common (50%) and patient usually delivers by 30-32 weeks. Discordance of fetal growth is very common and even more than in twins. Perinatal loss is inversely related to birth weight. The mothers should be counseled about regular ante natal care (ANC) check-ups for early identification of multiple pregnancies so that proper care can be given to prolong the gestational age and reduce the complications associated with multiple pregnancies.
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Sat, 27 Aug 2016 03:44:26 GMT -08:00 http://www.scopemed.org/?mno=230135
An atypical manifestation of inguinal endometriosis in the extra pelvic part of the round ligament: a case report http://www.scopemed.org/?mno=234016 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Vito Chiantera, Elene Abesadze, Mohamed Gamal Ibrahim, Anna Maria Dückelmann, Sylvia Mechsner.
Establishing the diagnostic and surgical management of the inguinal Endometriosis, with further investigation of the biological character. The imaging findings of CT and PET-CT, biopsy, ultrasound, open surgery of the inguinal region with intraoperative cryosection, confirmation and evaluation of tissue infiltration by endometriosis, laparoscopic removal of all endometriotic lesions, reconstruction of the groin. Based on the history of the 29-year-old patient, suffering from a painful growing induration of the inguinal region. Immunohistochemistry performed, in order to analyze the character of the inguinal endometriosis. CT, PET-CT and biopsy did not confirm the diagnosis of endometriosis. Considering, the progressive symptoms of the patient, was performed the surgical intervention. Open surgery of the inguinal region, with a preparation and separation of the groin fibrotic mass lead to the finding of an affected extra-peritoneal portion of the round ligament. Intraoperative cryosection confirmed endometriosis. Simultaneous laparoscopy showed peritoneal endometriosis (rASRM I) and an alteration of the inner round ligament, involving the inner inguinal channel in this process. All endometriotic lesions were removed and the inguinal region reconstructed. The immunohistochemical staining gave evidence of the endometriotic tissue, surrounded by smooth muscle metaplasia. We consider that, reporting this rare case of endometriosis, based on a case report and a literature review, affecting intra and extra peritoneal portion of the round ligament, is an important aid to avoid a wrong diagnosis and method of therapy in future. Our data demonstrated the fully recovery of the patient, after surgical treatment, reporting symptom-free status.
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Sat, 27 Aug 2016 03:44:03 GMT -08:00 http://www.scopemed.org/?mno=234016
Bowel injury: a rare but dreaded complication of unsafe abortion http://www.scopemed.org/?mno=234571 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Monika Ramola, Priyanka Chaudhari, Parul Singh, Mahesh Ramola.
Unsafe abortions represent a preventable yet major cause of maternal mortality and morbidity in India. Intestinal perforation is a rare dreaded complication of unsafe abortion. It is commonly seen in countries in which abortions are performed by people without proper training and proper instruments. Bowel perforation occurs when the posterior vaginal wall or the uterine wall is perforated. The ileum and the sigmoid colon are the most commonly injured portion of the bowel. Here, we report a case of ileal perforation following induced unsafe abortion which was managed successfully.
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Sat, 27 Aug 2016 03:35:44 GMT -08:00 http://www.scopemed.org/?mno=234571
Sheehan’s syndrome: a case report http://www.scopemed.org/?mno=233505 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Shazia Ashraf Khan, Prabha Lala, Wansalan Shullai, Abha Singh.
Sheehans syndrome or necrosis of pituitary gland is a rare complication of postpartum haemorrhage, initially described in 1937. Sheehans syndrome though rare is still one of the commonest causes of hypopituitarism in developing countries like ours. We present a case of young lady with this syndrome who presented with classical symptoms of hypopituitarism within 1 year of her delivery which was complicated by postpartum haemorrhage.
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Sat, 27 Aug 2016 03:32:58 GMT -08:00 http://www.scopemed.org/?mno=233505
Placental site trophoblastic tumor presented with unusual presentation http://www.scopemed.org/?mno=234385 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Rajdeep Meena, Santosh Meena.
Placental site trophoblastic tumor (PSTT) is a rarest type of gestational trophoblastic tumor. It is rising from the abnormal proliferation of intermediate trophoblastic cells with occasional multinuclear giant cells, with the potential for local invasion and metastasis. A 28 year old G4P3 woman presented with 4 months Amenorrhea, large uterine mass and plateau low level of serum human chorionic gonadotropin (hCG) which raised the possibility of PSTT. Since whole myometrium has been substituted with the large tumoral mass, hysterectomy was considered despite the young age of the patient. The patient has been in remission 12 months postoperatively without receiving any adjuvant treatment. It seems that plateau low levels of hCG in the presence of amenorrhea should prompt the possibility of PSTT.
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Sat, 27 Aug 2016 03:27:40 GMT -08:00 http://www.scopemed.org/?mno=234385
Comparative study of the efficacy and safety of olopatadine eyedrops and sodium cromoglycate in clinical practice: a prospective study http://www.scopemed.org/?mno=239690 2016-08-28T18-51-09Z
Source: International Journal of Basic & Clinical Pharmacology
Scandashree K, Meghana Patil, Padmaja Udaykumar.
Background: Allergic eye diseases are the commonest causes of ocular morbidity worldwide. To choose the best therapy in allergic conjunctivitis, understanding of underlying mechanisms implicated in triggering the allergy is very important. Olopatadine with a wide spectrum has proven to be very effective in allergic conjunctivitis. The objective of the study was to compare the efficacy and safety of ophthalmic solutions of olopatadine 0.2% once daily, olopatadine 0.1% twice daily and sodium cromoglycate 2% four times daily in allergic conjunctivitis for 3 weeks. Methods: This was a prospective, single centre study enrolling 304 patients with allergic conjunctivitis attending ophthalmology clinics. Subjects were assessed for ocular signs and symptoms at 3 visits-baseline, week 2, week 3. The change from baseline in the mean scores of itching and redness at 3 weeks was primary outcome variable. Results: The reduction in signs and symptoms were statistically significant in all the three groups (p
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Sat, 27 Aug 2016 03:06:14 GMT -08:00 http://www.scopemed.org/?mno=239690
A prospective study to assess the safety and expulsion rate of copper T380A in immediate post-partum period during caesarean section http://www.scopemed.org/?mno=234035 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Preet Kamal Bedi, Manjit Singh Guliani, Suman Bala.
Background: Immediate post-partum IUCD insertion deserves great attention as it can provide immediate contraception and prevents repeated unintended pregnancies. Increasing number of women undergoing elective cesarean section due to repeat cesarean section need effective long term contraception to allow them recuperate from surgery and for reliable means of child spacing. The postpartum insertion of an IUCD provides a convenient opportunity for the woman to receive IUCD services. This is particularly important for women who have limited access to medical care. The objective of this study was to assess the safety in terms of perforation, pain, bleeding, foul smelling vaginal discharge and expulsion rates at 6 weeks follow up and reasons for removal/discontinuation willingness to continue when CuT380A is inserted immediately after C-section deliveries. Methods: The present study was conducted at Bebe Nanaki Mother and Child Care Hospital, Govt. Medical College, Amritsar, between period February 2014 to June 2015, on 200 cases undergoing caesarean section delivery willing for IUCD insertion and who fulfilled the medical eligibility criteria and had no contraindications for PPIUCD and patients were followed up at 6 weeks. Results: A total of 200 women underwent postpartum intracaesarean insertion of copper T 380A. And 16 women lost to follow up. Acceptance was more in the multigravida. The mean age of women included in the study was 25.65±2.42 years. Most common post-insertion complication observed in the immediate postoperative period was excessive bleeding. The common adverse events observed during follow-up of 6 weeks were menstrual complaints, excessive vaginal discharge and persistent pelvic pain. At the end 6 weeks, there were 6 expulsions, 4 removals, and gross cumulative expulsion, removal, failure and continuation rates of 3.2%, 2.2% and 5.4%, respectively. Conclusions: Inserting CuT380A after placental delivery during cesarean section is safe and effective, has high retention rate. The expulsion rate was not high, and can be further reduced with practice. The method may be particularly beneficial in our setting where women do not come for post natal contraception counseling and usage. The government needs to develop strategies to promote PPIUCD by increasing awareness, by arranging trainings among healthcare providers.
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Sat, 27 Aug 2016 03:03:45 GMT -08:00 http://www.scopemed.org/?mno=234035
Study of preoperative GnRh agonist in cutaneous scar endometriosis http://www.scopemed.org/?mno=233559 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Nitin Naresh Kulkarni, Alka Bhaurao Patil, Richa Patel.
Background: Cutaneous scar endometriosis is an uncommon pathology, it is rare and difficult to diagnose, mostly follows obstetrical and gynaecological surgeries. Surgical wide excision is the mainstay of treatment. The objective of this study was to evaluate efficacy of preoperative GnRh agonist in scar endometriosis. Methods: This is prospective randomized case control study performed on all cutaneous scar endometriosis cases reporting to our institute as well as consultants from Dhule obstetrics and gynaecology society. All cases were operated and follow up in our institute by same surgeon. Results: Surgical excision accompanied by preoperative GnRh agonist therapy is helpful for easy excision and reduce recurrence of scar endometriosis. Conclusions: Abdominal scar endometriosis is rare gynecological pathology, should be suspected in any women of child bearing age group complaining of cyclical painful nodule in scar following a previous obstetric and gynaecological procedure.
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Sat, 27 Aug 2016 03:03:34 GMT -08:00 http://www.scopemed.org/?mno=233559
A study of cytological pattern of cervical papanicolaou smears in western Rajasthan, India http://www.scopemed.org/?mno=237074 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Kiran Rawat, Narendra Rawat, Navgeet Mathur, Medha Mathur, Nitesh Chauhan, Rajat Tinna, Rahul Kakkar.
Background: Cervical cancer is one of the most common cancers of Indian females. Western Rajasthan differs a lot from rest of India in respect of geographical conditions, environment, culture, population density etc. and it also has relatively lower literacy rate which is one of the risk factor for many diseases. The objective of this study was to estimate the prevalence of cervical cytological pattern in females of western Rajasthan by using conventional Papanicolaou (Pap) smears for the screening of inflammatory, premalignant and malignant lesions of the cervix. Methods: This cross sectional study was conducted at tertiary care institute of western Rajasthan for 1.5 year duration, on 1768 females who were screened by Pap smear examination. After staining with conventional Papanicolaou technique, all smears were classified as per Bethesda nomenclature. Results: Out of 1768 smears 1039 (58.7%) were abnormal Pap smears, 445 (25.1%) were normal Pap smears while 284 (16.1%) smears had inadequate sample material to be examined. Out of 1039 abnormal smears, 956 (92.01%) smears reported to have inflammatory/reactive changes whereas 26 (2.50%) had atrophic changes in Pap smear and abnormality in epithelial cell was reported in 57(5.49%) smears. Conclusions: Pap smear examination is an effective screening procedure to detect cervical cytological abnormalities. Routine cytological screening by Pap smear should be offered to all women above 19 years or within 3 years of sexual activity. It is recommended to improve the awareness about the disease amongst females and skills of health care personal about proper preparation of Pap smear.
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Sat, 27 Aug 2016 03:03:25 GMT -08:00 http://www.scopemed.org/?mno=237074
Hypothyroidism in polycystic ovarian syndrome: a comparative study of clinical characteristics, metabolic and hormonal parameters in euthyroid and hypothyroid polycystic ovarian syndrome women http://www.scopemed.org/?mno=236920 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Ramanand SJ, Raparti GT, Halasawadekar NR, Ramanand JB, Kumbhar AV, Shah RD.
Background: This study was conducted to examine influence of hypothyroidism on pathophysiology and features of PCOS with respect to clinical characteristics of polycystic ovarian syndrome (PCOS), hormonal and metabolic profile. Methods: 102 euthyroid PCOS and 18 hypothyroid PCOS women were included in this cross-sectional study after considering inclusion and exclusion criteria. The study subjects were assessed for various signs and symptoms like recent weight gain, obesity, abnormal hair growth, hirsutism, hair loss, acne, acanthosis nigricans and infertility. Various hormonal and metabolic parameters were evaluated viz. Luteinizing hormone, Follicle stimulating hormone, LH:FSH ratio, testosterone, prolactin, dehydroepiandrosterone, fasting insulin and fasting blood glucose. BMI and HOMA values were calculated. Results: Association of hirsutism, excessive hair growth, hair loss, acanthosis nigricans, acne, infertility was not significant between the two groups. Majority of patients in both the groups were overweight/obese. BMI and number of patients complaining weight gain was significantly more in hypothyroid PCOS women. While no statistical difference in LH, FSH, LH:FSH ratio, prolactin, and testosterone levels was found, serum DHEA level was significantly less in hypothyroid PCOS group. No statistical difference in fasting blood glucose and insulin levels was found between the two groups. Though both the groups show insulin resistance, HOMA values were significantly more in hypothyroid PCOS women. Conclusions: Presence of hypothyroidism significantly increased severity of insulin resistance as well as obesity in PCOS. This could have adverse metabolic consequences in them. Concurrent occurrence of both these disorder could also possibly affect other features of the PCOS viz. hair loss and infertility.
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Sat, 27 Aug 2016 03:03:16 GMT -08:00 http://www.scopemed.org/?mno=236920
Association between helicobacter pylori infection and hyperemesis gravidarum http://www.scopemed.org/?mno=236680 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
M. Elmahdy, A. Elmarsafawy, D. Elkafash.
Background: Hyperemesis gravidarum is one of the serious problem affecting pregnant females. The main etiology is still unknown. Different theories were assumed. The objective of this study was to study the relationship between Helicobacter pylori infection and hyperemesis gravidarum. Methods: case control study of 80 cases (40 case of HEG) and (40 case of normal pregnant females. assessment of helicobacter pylori antibodies in serum and stool were done for both groups. Results: Helicobacter pylori in stool samples were positive in 75% of cases of HEG and positive in 37.50% of normal pregnant females. These results were statistically significant (p = 0.001). The prevalence of Hp IgG AB and HpSAB was 77.5% in the patients with HEG, and 55.0% in controls (P = 0.05). Conclusions: helicobacter pylori infection may be one of the risk factors for HEG. The prevalence of helicobacter pylori AB in both serum and stool is more in HEG cases than in normal pregnant females.
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Sat, 27 Aug 2016 03:02:54 GMT -08:00 http://www.scopemed.org/?mno=236680
A prospective study to evaluate the role of serum vascular endothelial growth factor levels and color Doppler indices in prediction of malignancy in adnexal masses http://www.scopemed.org/?mno=236555 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
S. Tahmina.
Background: Several markers have been used for predicting malignancy in adnexal masses. Objectives were to measure preoperative serum vascular endothelial growth factor (VEGF) and to determine its value in predicting risk of malignancy in adnexal masses, in combination with colour Doppler indices (resistance index, RI; pulsatility index, PI). Methods: A hospital based prospective observational study was conducted in 79 women with 102 adnexal masses, who underwent a preoperative colour doppler ultrasound and CA-125 and VEGF levels were estimated. Cut-off levels for suspicion of malignancy were taken at CA-125>35IU/ml, RI
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Sat, 27 Aug 2016 03:02:41 GMT -08:00 http://www.scopemed.org/?mno=236555
Medical versus surgical termination of early pregnancy: satisfaction with care, emotional impact and acceptability of the procedure http://www.scopemed.org/?mno=236508 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Prasanna L. Akkenapally, Vasundhara Kamineni.
Background: Aim of the study was to compare the satisfaction with care and acceptability of the procedure next time between medical and surgical termination of pregnancy (TOP) and the factors affecting it. Methods: This is a prospective observational study conducted at Jyothi Maternity Centre, a project of population health services of India (PHSI). Total 213 women were included in the study, of these 108 women received medical termination of pregnancy (MTOP) and 105 received surgical termination of pregnancy (STOP). Questionnaires regarding satisfaction with care, experience of care, psychological rating scales and acceptability were given at the follow- up visit at two weeks. The data was collected and computed for statistical analysis. Results: Women in both the groups were similar with respect to age, marital status, socioeconomic status, educational status and parity. The mean age was 24 years. The success rate with STOP (100%) was more than MTOP (79.6%), with p -value of 0.001. The experience of care comparing the semantic variables showed MTOP to be less painful and safer, while STOP was good and faster. The total mean impact scores and depression scores of MTOP were higher than STOP and it was statistically significant with p- values of 0.010 and < 0.001 respectively. The acceptability rate with MTOP was 79.6% and with STOP 95.2%. Conclusions: Satisfaction with both the methods of medical and surgical abortion is high. Acceptability of the procedure next time was more with surgical abortion. MTOP had higher emotional impact.
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Sat, 27 Aug 2016 03:02:32 GMT -08:00 http://www.scopemed.org/?mno=236508
Analysis of caesarean delivery rates using the ten group classification system in a tertiary care hospital http://www.scopemed.org/?mno=236467 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Seetha Panicker, Chitra T. V..
Background: With the increasing safety of operative delivery the caesarean section rates have been increasing steadily over the last 60 years both in the developing countries and the developed world. However efforts to analyse the rates and identify preventable causes are difficult as most units report only the overall caesarean section rates. This retrospective study was undertaken to analyse the indications for caesarean delivery in a one year period from January 1st to December 31st 2014 using the Robson’s ten group classification system to identify CS rates in each of the separate groups. Methods: All patients who delivered between 1st January 2014 to 31st December 2014 were identified based on the parturition register and their case records were analysed for risk factors, intra-partum events, mode of delivery and the indications for caesarean section. These were classified according to the ten group classification system. Results: Caesarean section rate was 41.5% in this period. The CS rate was lowest in Group 3 - 11.97% and 100% in Group 9 (Transverse lie). Group 5 (Previous CS) made the greatest contribution (42.77%) to the total number of CS. Analysing these rates could make comparisons over time and from different centers. Conclusions: Strategies to reduce the CS rate should be concentrated on Group 1 and Group 2. These include a relook at definition of abnormal first stage, standardization of abnormal FHR tracings, strict policy on induction of labour and protocols for trial of labour in previous CS.
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Sat, 27 Aug 2016 03:02:20 GMT -08:00 http://www.scopemed.org/?mno=236467
A study on contraceptive use among married women of reproductive age group in a rural area of Tamilnadu, India http://www.scopemed.org/?mno=236440 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Rema V. Nair, Vishnu G. Ashok, Prashant V. Solanke.
Background: India was the first country in the world to formulate the national family planning programme in the year 1952 with the objective of “reducing the birth rate to the extent necessary to stabilize the population at a level consistent with requirement of national economy. The objective of this study was to study contraceptive use among married women of reproductive age group in a rural area of Tamilnadu. Methods: A cross sectional study was conducted from December 2014 to January 2015 in Sree Mookambika institute of medical Sciences, Kulasekharam among the married women in eligible couples group attending the hospital. Sample size was calculated to be 84. Inclusion criteria: married couple with female in age group of 15 - 45 years and sexually active and having the ability to communicate in local language. Results: The mean age was 30.95 years (SD = 6.421). Formal education was received by 100% women. Majority are Christians (48.8%) followed by Hindu (46.4%) and Muslim (4.8%). Among the respondents (n = 84), 33.7%, 41.7%, 2.4% and 22.6% had parity of 1, 2, 3 or more and none respectively Most of the women (71.4%) belonged to middle class group. 94% of women were aware of sterilization. This study shows a significant association between number of children and contraception usage (p
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Sat, 27 Aug 2016 03:02:09 GMT -08:00 http://www.scopemed.org/?mno=236440
Comparison of unilateral spinal anaesthesia using low dose bupivacaine with or without fentanyl in lower limb surgery http://www.scopemed.org/?mno=240327 2016-08-28T18-51-09Z
Source: International Journal of Basic & Clinical Pharmacology
Vinod S. Jaiswal, Devendra W. Thakare.
Background: Intrathecal opioids are synergistic with local anesthetics and intensifies sensory block without increasing motor block. This combination makes it possible to achieve spinal anesthesia without hemodynamic instability and adverse effects that are associated with higher doses of bupivacaine. Hence we conducted this comparative study using 5 mg of hyperbaric bupivacaine with or without fentanyl (25 µg) in unilateral spinal anaesthesia for lower limb surgery. Methods: Sixty patients were randomized into two groups with Group B receiving 0.5% bupivacaine and Group BF receiving 0.5% bupivacaine + 25 µg fentanyl intrathecal. Sensory and motor block quality and duration, post anesthesia care unit stay (PACU) and adverse effects were compared. Results: The onset of sensory block (6.17±1.44) was faster in Group B compared Group BF (6.73±1.52) and duration of sensory blockade was intensified by addition of intrathecal fentanyl in Group BF. The onset and duration of motor blockade was similar in both the groups and was not affected by addition of fentanyl in Group BF. The number and mean duration stay in PACU was found to be significantly higher in patients 24 [80%]; 30 minutes receiving fentanyl suggesting it prolonged duration of recovery. No patient in either group had hypotension, respiratory depression, sedation, nausea, vomiting, PDPH and TNS. Only 1 patient in each group experienced bradycardia and 4 patients in Group BF had mild pruritus. Conclusions: Unilateral spinal anaesthesia with 5 mg hyperbaric bupivacaine with 25 µg fentanyl is a better choice than 5 mg hyperbaric bupivacaine alone in short procedure of lower limb in orthopaedic surgery.
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Sat, 27 Aug 2016 02:50:38 GMT -08:00 http://www.scopemed.org/?mno=240327
Obstetric and perinatal outcome in previous one cesarean section http://www.scopemed.org/?mno=236420 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Seema Patel, Vijay Kansara, Riddhi Patel, Nikhil Anand.
Background: Women with previous cesarean sections constitute a high risk group in obstetrics, with associated complications. The cesarean section carries 3 fold risk of mortality compared with vaginal deliveries. The study was conducted to determine the mode of deliveries after previous one cesarean section, maternal and fetal complication. Methods: This is a prospective observation study. Total 150 patients of previous one caesarean with gestational weeks between 37 to 40 weeks admitted in labour room of Obstetrics and Gynecology Department in Sola Civil Hospital with spontaneous onset of labour, over a period of one year from April 2014 to April 2015 or till the desired sample will reached. Results: In the present study, out of 150 pregnant women with history of previous one LSCS who were subjected to this study, 39(26%) underwent elective LSCS, commonest indication being previous pregnancy bad experience (38.46%). 111(74%) underwent trial of labour after cesarean section out of it 77(69.36%) had successful VBAC and 34(30.63%) underwent repeat emergency LSCS. Maternal complications were higher in Emergency LSCS group than in those had a successful VBAC (17.64% vs.3.89%)). Neonatal complications were also higher in Emergency LSCS group than in those had a successful VBAC (2.95% vs. 0%). Conclusions: With proper case selection, appropriate timing and close supervision trial of labour after prior LSCS is safe and often successful.
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Sat, 27 Aug 2016 02:22:50 GMT -08:00 http://www.scopemed.org/?mno=236420
Effectiveness of structured teaching programme on knowledge regarding menstrual blood stem cells banking among nursing students http://www.scopemed.org/?mno=236376 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Neelam Hans, Sandeep Kaur.
Background: Menstrual blood banking enables women to store their menstrual blood under required conditions and preserve it for future. Stem cells present in the menstrual blood have the remarkable potential to develop into many different cell types in the body. The objective of the study was to assess the effectiveness of structured teaching programme on knowledge regarding menstrual blood stem cells banking among nursing students studying in selected nursing college of Amritsar, Punjab. Methods: Current study is an evaluative study carried out on 96 nursing student’s data for the study was collected in the month of November 2016. Purposive sampling technique was used to select the sample. Socio-demographic profile was used to assess the personal information of the subjects and self-structured questionnaire to assess the knowledge of nursing students regarding menstrual blood stem cells banking. Results: Results of the study revealed that according to pre-test knowledge, majority (92.7%) of nursing students had average knowledge regarding menstrual blood stem cells banking and according to post-test knowledge, majority (88.5%) of nursing students had good knowledge. On comparing, mean post-test knowledge score was more than pre-test knowledge score which was calculated by t-test (t=19.197) at p
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Sat, 27 Aug 2016 02:22:47 GMT -08:00 http://www.scopemed.org/?mno=236376
A study of predisposing factors and microbial flora in puerperal sepsis http://www.scopemed.org/?mno=236373 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Tajinder Kaur, Sunita Mor, Meenu Puri, Ruchika Sood, Jayati Nath.
Background: Puerperal sepsis is the third or fourth leading cause of maternal death worldwide with maternal mortality due to infections being as high as 15%6 with maternal morbidity being 8.1%7. Meticulous aseptic techniques, modern investigative tools and use of prophylactic antibiotics have reduced the incidence of puerperal sepsis in the developed countries however it still continues as a major cause of maternal morbidity and mortality in the developing countries. Methods: This was a retrospective study over a period of 18 months from July 2010 to December 2011 which included all the post natal patients admitted in the obstetrics ward of our hospital. All the patients who fulfilled the ICD 10 criteria of puerperal pyrexia were studied for the booking status, parity, mode of delivery, maternal anemia, number of PV examinations and duration of rupture of membranes. In addition vaginal swab culture and sensitivity of these cases was analysed. The results were calculated by statistical analysis and odds ratio calculated with 95% confidence interval. Results: The incidence of puerperal sepsis was 8.68% and was responsible for 60.29% of cases of puerperal pyrexia. The common predisposing factors were unbooked status, primiparity, caesarean section, anaemia, frequent PV examination and prolonged rupture of membranes. The most common microorganisms in vaginal swab culture and sensitivity were S. aureus (36%) and E. coli (29.8%). Conclusions: Puerperal sepsis is by and large a preventable cause of maternal morbidity and mortality. From our study and review of literature we conclude that early booking of all the antenatal cases, correction of maternal anemia, better aseptic conditions, deferring undue PV examinations, recognition of all the high risk cases and prophylactic administration of ampicillin and gentamycin can go a long way in preventing puerperal sepsis.
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Sat, 27 Aug 2016 02:22:24 GMT -08:00 http://www.scopemed.org/?mno=236373
Association of follicle-stimulating hormone receptor gene ser680 asn (rs6166) polymorphism with polycystic ovarian syndrome http://www.scopemed.org/?mno=236369 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Thathapudi Sujatha, Erukkambattu Jayashankar, Uma Addepally, Kodati Vijayalakshmi, Qurratulain Annie Hasan.
Background: Polycystic Ovarian Syndrome (PCOS) is the most common cause of female anovulatory infertility, with a prevalence of 6-10% among women of reproductive age, characterized by clinical and / or biochemical androgen excess, ovulatory dysfunction and polycystic ovaries. Sex hormones and hormone receptors play a fundamental role in folliculogenesis. Aim of the study was to study the association of follicle-stimulating hormone receptor (FSHR) Ser680Asn; rs6166 gene polymorphism with PCOS in our study population. Methods: Genetic case-control study, involving 204 women with PCOS and 204 healthy, sex and age matched controls. Anthropometric and biochemical profile were taken in a well-designed proforma. Isolation of deoxyribonucleic acid (DNA) by salting out method and genotype analysis was done for all the study population using Polymerase chain reaction – Restriction fragment length polymorphism (PCR-RFLP). Results: We have demonstrated an association between FSHR gene, Ser680SAsn (rs6166) polymorphism and PCOS. Frequency of A allele was 0.61 in PCOS and 0.44 in controls (OR 1.98, CI 1.5-2.6, and P value
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Sat, 27 Aug 2016 02:22:23 GMT -08:00 http://www.scopemed.org/?mno=236369
Is it time to move up? Feasibility of medical abortion between 9-13 weeks of gestation http://www.scopemed.org/?mno=236313 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Vandana Jha, Ayesha, Subrat Panda, Rina Sharma.
Background: Medical termination of pregnancy act helps to reduce incidence of illegal abortion its dreaded complication like maternal mortality to analyze the safety, efficacy and acceptability of medical regimen in 9-13 weeks of pregnancy. Methods: A prospective study was carried out for a period of two and half years. All patients between 9-13 weeks of pregnancy seeking medical termination of pregnancy were given either medical regimen or surgical abortion depending on patients’ preference. Medical regimen consisted of 200 mg of mifepristone followed by 600 mcg of misoprostol after 48 hours. If required 2nd and 3rd dose of misoprostol was repeated. Surgical abortion was done under sedation after cervical priming with misoprostol. Results: Out of 353 cases of medical termination of pregnancy, 92 cases (26.1%) were between 9-13 weeks of pregnancy. Two cases were excluded as surgical abortion was indicated in them. Out of 90 cases, only 30 cases (33.3%) were willing to participate in randomized controlled trial if needed. Out of 90 cases, 50 (55.6%) preferred surgical abortion, while 40 (44.4%) cases preferred medical abortion. Out of 40 cases of medical abortion, 5% cases required surgical curettage, while 3.8% cases required repeat curettage in surgical group. Minor complication rate was comparable in both groups except for prolonged bleeding, which was significantly higher in medical abortion group. Major complication in the surgical group was uterine perforation (1.9%). After completion of procedure, both group satisfied with same procedure, 92% in medical abortion group and 89% in surgical abortion group. Conclusions: Medical abortion is a safe and effective alternative to surgical abortion between 9-13 weeks of gestation. It should be included routinely at these gestations, thus increasing women's choice. However randomized controlled trial for medical versus surgical abortion between 9-13 weeks will be difficult to initiate.
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Sat, 27 Aug 2016 02:22:13 GMT -08:00 http://www.scopemed.org/?mno=236313
Comparative study of vaginal hysterectomy and abdominal hysterectomy for enlarged uterus http://www.scopemed.org/?mno=236081 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Chandrika S., Kasinath Kosti.
Background: Hysterectomy is the second most common gynecological surgeries performed. Maximum (70% to 80%) hysterectomies are done by abdominal route. Abdominal route provides good visibility and easy access to pelvic organs. Methods: Randomized prospective comparative study was carried out to know the feasibility of vaginal hysterectomy in moderately enlarged uterus due to benign conditions and to compare operative complications and morbidity of vaginal and abdominal hysterectomy in moderately enlarged uterus due to benign conditions at Department of Obstetrics and Gynecology, at tertiary health care hospital during the period from October 2009 to September 2011. Results: Out of 50 cases, 25 cases were subjected for abdominal hysterectomy and 25 for vaginal hysterectomy. Cases with moderately enlarged uterus up to 16 weeks due to benign condition were included in the study. Cases with uterus more than 16 weeks, previous pelvic surgeries, adnexal mass, prolapse and restricted mobility were excluded from our study Conclusions: Bulk reducing techniques were used to remove the moderately enlarged uterus through vaginal route. Vaginal hysterectomy is invasive route, safe and feasible in cases with enlarged uteri up to 14 weeks due to benign causes.
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Sat, 27 Aug 2016 02:21:47 GMT -08:00 http://www.scopemed.org/?mno=236081
Emergency peripartum hysterectomy: a retrospective study of 7 years http://www.scopemed.org/?mno=236249 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Suchith Hoblidar, Sunil Kumar K. S., Ratnamala M. Desai.
Background: Emergency peripartum hysterectomy (EPH) is a rare but a lifesaving procedure done as a last resort to save life of mother. We conducted this study to know the incidence, leading causes, risk factors and complications of EPH. Methods: We conducted a retrospective analysis of all the patients who underwent EPH from January 2008 to December 2015 at SDMCM and H. All patients who underwent EPH from 22 weeks of gestation to 6 weeks postpartum were included in the study. Results: There were 21 emergency peripartum hysterectomies, with deliveries during the same period being 27271 and the rate of EPH was 0.7 per 1000 deliveries. Most common indication for EPH was uterine atony (38%), followed by uterine rupture (23.8%) and morbidly adherent placenta (19%). Most of the patients (47.6%) had previous cesarean deliveries. EPH was done following cesarean in 66.6%. Subtotal hysterectomy was done in 61.9%. Intra-operative urinary bladder injury was seen in 14.2% of the patients. Conclusions: Uterine atony and uterine rupture continues to be the most common causes for EPH in our population. Multiparity is an important risk factor among patients with rupture uterus. Cesarean delivery and repeat cesarean deliveries are the likely risk factors for EPH.
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Sat, 27 Aug 2016 02:21:44 GMT -08:00 http://www.scopemed.org/?mno=236249
Role of thalassemia screening in prevention and control of thalassemia - a 5 year experience http://www.scopemed.org/?mno=235975 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Suman Lata Mendiratta, Meenakshi Mittal, Farha Naaz, Sompal Singh, Smriti Anand.
Background: Thalassemia is a commonest genetic blood disorder in India which can be prevented by antenatal screening and prenatal diagnosis. Aim of the study was to screen antenatal women and their spouses to detect “couples at risk” of thalassemia major births and offering them genetic counseling and option of prenatal diagnosis thereby preventing the birth of thalassemia major babies. Methods: Thalassemia screening for antenatal women was done by NESTROFT test and RBC Indices (MCV, MCH, and RBC count). Confirmation of diagnosis was done by HPLC test. Husbands of women testing positive on HPLC were also tested and couples at risk detected. They were counseled and referred for prenatal genetic diagnosis. Women carrying thalassemia major fetus were advised termination and those with normal and thalassemia minor fetus were advised to continue pregnancy. Results: A total of 93871 patients were screened and HPLC was done on 10983 patients. 7.07% had one or the other hemoglobinopathies and 5.8% had beta thalassemia trait. Among antenatal beta thalassemia trait was found in 5.02%, HbD in 0.36%, HbE in 0.58% and HbS 0.05%. Forty two “at risk couples” (both husband and wife thalassemia trait) were identified, 16 of these underwent prenatal diagnosis and 3 thalassemia major births were terminated. Conclusions: Lack of awareness, late registration, husbands not coming/turning up for their test and “at risk couples” opting out of prenatal diagnosis are the cause of thalassemia major births which can be prevented if awareness is generated amongst masses, screening and prenatal genetic diagnosis services are made widely available.
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Sat, 27 Aug 2016 02:21:21 GMT -08:00 http://www.scopemed.org/?mno=235975
Urinary tract infections at first antenatal check-up: a single centre prospective study http://www.scopemed.org/?mno=235754 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Saubhagya Kumar Jena, Rajashree Panigrahy, Lipsa Mishra, Suren Kumar Das, Soumya Samal.
Background: Pregnant women with asymptomatic bacteriuria (ASB) are more likely to develop acute pyelonephritis, postpartum UTI, hypertensive disease, anemia, prematurity, low birth weight babies and prenatal death if untreated. Methods: Total 780 pregnant women attending for first antenatal check-up in a medical college were enrolled for the study. Those with any symptoms of UTI, like burning micturition, frequency, urgency, dysuria or fever were excluded from the study. All were subjected to undergo urine culture and sensitivity to the commonly used antibiotics in that area, irrespective of period of gestation, age and parity. Prevalence of ASB, most common infecting organism and antibiotic sensitivity pattern were analyzed. Results: The prevalence of ASB in 25 years age group (26.06% versus 18.80%; p = 0.020). Out of the 780 culture samples, 52 had more than 3 type colonies indicating contamination and 22 had budding yeast colonies, thus excluded from the study. No growth was found in 551 samples (78.05%). The prevalence of ASB was 21.95%. The most common organism isolated was ESBL-ve E coli (32.25%), followed by ESBL +ve E coli (21.29%) and Enterococcus (15.48%) respectively. E coli were mostly sensitive to nitrofurantoin, amikacin and cotrimoxazole whereas enteroccocus was sensitive to vancomycin. Conclusions: ASB is more common during pregnancy even in first antenatal check-up. We suggest routine urine culture and sensitivity during first antenatal check-up to detect ASB and treat with proper antibiotic to prevent the complications and development of resistance.
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Sat, 27 Aug 2016 02:21:18 GMT -08:00 http://www.scopemed.org/?mno=235754
Pregnancy outcome in cases of rupture uterus: a clinical study http://www.scopemed.org/?mno=235904 2016-08-28T18-51-09Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Pallavi S. Kalewad, Amarjeet Bava, Y. S. Nandanwar.
Background: The aim of the study was to evaluate and analyze the risk factors, maternal and perinatal outcome in cases of ruptured uterus. Methods: It is retrospective observational study was designed from January 2015 to December 2015. A total of 69 patients diagnosed with ruptured uterus during the study period were included. Results: The incidence of uterine rupture was 0.64%. The uterine rupture in scarred uterus seen in 66 (95.6%) cases and unscarred uterus 3 (4.4%) cases. Forty five (65.3%) patients did not receive any antenatal care. Sixty six (49.1%) of the cases underwent previous uterine surgery due to cesarean. Other observed predisposing factors were induced/augmented labor seen in 39 cases (29.1%), prolonged labor in 8 (6%), macrosomic fetus 8 (11.6%), grand multiparous 10 (7.5%), multiple pregnancies 4 (3%) and malformed baby 2 (1.5%), cephalopelvic disproportion 2 (1.5%), instrumental deliveries 1 (0.7%) respectively. Primary repair of uterus was performed in 52 (75.2%) of the patients. Subtotal abdominal hysterectomy was performed in 10 patients (15.2%). There were seven fetal deaths and two maternal deaths recorded during the study period. Conclusions: Uterine rupture is a major contributing factor for maternal and perinatal morbidity and mortality. Proper antenatal care and early referral of women at risk to tertiary center will significantly improve maternal and perinatal outcome. Uterine rupture is amongst the preventable obstetric complication that carries severe risks both to the mother as well as the baby. Health education of people, training and supervision of health personal will reduce incidence especially in remote areas.
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Sat, 27 Aug 2016 02:21:03 GMT -08:00 http://www.scopemed.org/?mno=235904
Mixed connective tissue disease presenting with isolated pulmonary hypertension, and limited cutaneous sclerosis http://www.scopemed.org/?mno=231831 2016-08-28T18-51-09Z
Source: International Journal of Research in Medical Sciences
Vaishal Kamlesh Shah, Dhaval Dave, Rushabh Parikh, Divya Lala, S.T. Nabar, Archana Bhate.
Mixed connective tissue disease (MCTD) was first recognized by Sharp and Colleagues in 1972 among a group of patients with overlapping clinical features of systemic lupus erythematosis (SLE), scleroderma and myositis, with the presence of distinctive antibodies against, what now is known to be U1ribonucleoprotein (RNP). We report an unusual case of a 29-year old female with MCTD characterized by the coexistence of signs, symptoms and immunological features of 3 defined autoimmune diseases isolated PHT, cutaneous sclerosis (SSc), hypothyroidism
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Sat, 27 Aug 2016 02:11:47 GMT -08:00 http://www.scopemed.org/?mno=231831