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 2015-01-29T02-16-31Z Exploring the Utility of Social Marketing Techniques in Motivating People to Adopt Healthy Behavior http://www.scopemed.org/?mno=176452 2015-01-29T02-16-32Z
Source: Medicine Science | International Medical Journal
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy.
Over the years across the globe, the lives of people have been significantly influenced by a wide range of diseases and morbidities. The approach of social marketing has been developed to encourage acceptance and voluntary uptake by the target population by assigning more responsibility to the health professionals. In the health sector, social marketing consists of four key components - product, place, price and promotion. However, utility of social marketing is not universal owing to the presence of multiple challenges and constraints. In conclusion, the approach of social marketing can play a significant role in motivating people to adopt healthy behavior, provided both policy makers and community stakeholders are involved in the planning & implementation phase.
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Thu, 29 Jan 2015 01:52:58 GMT -08:00 http://www.scopemed.org/?mno=176452
DPPH FREE RADICAL SCAVENGING ACTIVITY OF SOME MEDICINAL PLANTS USED IN THE TREATMENT OF MALARIA IN SOUTH-WESTERN NIGERIA. http://www.scopemed.org/?mno=152682 2015-01-29T02-16-32Z
Source: Spatula DD - Peer Reviewed Journal on Complementary Medicine and Drug Discovery
PASS IYAMAH, TAIYE FASOLA, MacDonald Idu.
Aim: The Antioxidant activities of the leaf, root and stem bark of 16 selected Nigerian medicinal plants frequently used in the treatment of malaria in South-Western Nigeria were investigated. Method: The radical scavenging activities of the plant extracts against 2,2 Diphenyl -1-picryl hydrazyl, were determined by UV spectrophotometry at 570nm. Results: Quantitative analysis showed that the different plant parts demonstrated antioxidant activity in various degrees. However, DPPH radical scavenging activity was significantly highest (P
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Wed, 28 Jan 2015 05:17:05 GMT -08:00 http://www.scopemed.org/?mno=152682
TRADIONAL PRACTICES IN PAINFUL CONDITION AT ELDERLY INDIVIDUALS IN LIVING TUNCELI http://www.scopemed.org/?mno=162610 2015-01-29T02-16-32Z
Source: Spatula DD - Peer Reviewed Journal on Complementary Medicine and Drug Discovery
Ezgi Karadağ, Sibel Sevinç.
AIM: The aim of the study was to determine the tradional practices in painful condition at elderly individuals in living Tunceli. METHODS: A cross sectional study was conducted on 180 elderly people treatment at internal medicine clinic in Tunceli State Hopital from September 2013 to February 2014. RESULTS: Most of this elderly were female (51.1%). 67.2 % of elderly 65-74 years old. As results of research most of elderly prefer to use tradional practice for their pain. CONCLUSION: We suggest, the future research should be regarding whether benefit or not harmful of tradional practices at painly in elderly individuals.
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Wed, 28 Jan 2015 05:17:05 GMT -08:00 http://www.scopemed.org/?mno=162610
Studies on the Samples Sold as Mint in Aktars of Ankara http://www.scopemed.org/?mno=162924 2015-01-29T02-16-32Z
Source: Spatula DD - Peer Reviewed Journal on Complementary Medicine and Drug Discovery
Mürüvet Demirez, Nilüfer Orhan, Fatma Ergun.
Aim: Since ancient times, mint is used for nausea, respiratory and urinary tract infections, bronchitis, diarrhea, and jaundice in folk medicine. In addition, it is also an important plant as spice, medicine, food, perfumery and cosmetic industry. In this study, it is aimed to compare mint samples purchased from aktars of Ankara with the culture samples of Mentha x piperita L., M. spicata L. and M. rotundifolia as comparison materials, to determine which species they belong, and to conduct their pharmacopoeia analysis. Methods: Samples and comparison materials were investigated morphological, and anatomically; total ash, water, foreign matter percentage, and volatile oil content of the samples were calculated. Extracts and volatile oils obtained from samples and comparison materials were compared by thin layer chromatography. Menthae piperitae folium monograph in European Pharmacopoeia is used for the limit values and methods. Results: According to obtained data, most of the leaves sold as mint is identified as M. rotundifolia.
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Wed, 28 Jan 2015 05:17:05 GMT -08:00 http://www.scopemed.org/?mno=162924
SALT RESTRICTION OR USING A DIFFERENT FORM OF SALT? http://www.scopemed.org/?mno=163419 2015-01-29T02-16-32Z
Source: Spatula DD - Peer Reviewed Journal on Complementary Medicine and Drug Discovery
Kubranur Unal , Fatma Meric Yilmaz , .
AIM: This study was performed in the aim of comparing boiled salt and its alternative rock salt . MATERIAL AND METHOD: Two solutions prepared from boiled salt and rock salt were analyzed to determine sodium (Na), chloride (Cl), potassium (K), magnesium (Mg) and calcium (Ca). Statistical evaluation was performed using Statistical Package for the Social Sciences (SPSS, version 16.0, Chicago, IL, USA). RESULTS: Na percent was 25% in rock salt and 33% in boiled salt. The except for Na and Cl mineral content was 37% in rock salt and 20% in boiled salt. CONCLUSION: The findings of the study confirm the elimination of various minerals during raffination. Using rock salt instead of boiled salt might be useful for hypertension patients .
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Wed, 28 Jan 2015 05:17:05 GMT -08:00 http://www.scopemed.org/?mno=163419
Concept and Management of Fatty Liver Disease in Unani Medicine Vis - A - Vis Conventional Medicine – A Review http://www.scopemed.org/?mno=163586 2015-01-29T02-16-32Z
Source: Spatula DD - Peer Reviewed Journal on Complementary Medicine and Drug Discovery
NOOR ZAHEER AHMED, mohd anzar alam, mohd sheeraz.
Fatty liver refers to a varied range of liver injury, ranging from simple steatosis to steatohepatitis, fibrosis, and cirrhosis. It appears to have become significant medical condition and this importance is mainly caused due to its ability to advance to cirrhosis and hepatic failure and its common occurrence in overall population. Up to 10% of cirrhotic alcoholic fatty liver may develop hepatocellular carcinoma. Ancient Unani scholars were well aware about the significance of liver and considered it to be one of the dynamic organs responsible for the metabolic functions chiefly the production of Akhlat (humors). The Mizaj (temperament) of liver is hot and moist; due to erratic dietary habits, excessive consumption of fatty food, drugs notably alcohol etc, its mizaj is altered to barid (cold) or haar (hot), which is antagonistic to the liver, thereby allowing the accretion of morbid matter in the form of fat (Tashhamul kabid) which affects the normal functioning of liver resulting in Su’ mizaj barid / haar kabid. Despite the incredible advancement of conventional medicine, the role of pharmacotherapy remains investigational and is not recommended for routine clinical practice. Lifestyle changes are the first line and mainstay of management of fatty liver. The present review was envisaged to unveil the vast Unani classical literature lying dormant and bring it to medical domain for the better understanding and management of fatty liver disease.
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Wed, 28 Jan 2015 05:17:05 GMT -08:00 http://www.scopemed.org/?mno=163586
Spectrophotometric Analysis of Heavy Metal in Two Miraculous Medicinal herbs belonging to Family Piperaceae http://www.scopemed.org/?mno=163841 2015-01-29T02-16-32Z
Source: Spatula DD - Peer Reviewed Journal on Complementary Medicine and Drug Discovery
Bushra Hina, Ghazala H Rizwani.
Aim The present study aims to analyze the heavy metal in Piper nigrum L. and Piper longum L. that are widely utilized as medicinal herbs as well as food condiments. Furthermore a comparative study of these plants collected from south, east, and west zones of Karachi city was also performed. Method Qualitative and quantitative analysis of Pb, Cd, Cu, Zn, Cr, Ni, Co, and Fe in P. nigrum and P.longum were performed using the technique of atomic absorption spectroscopy following wet digestion sample preparation method. Results Average concentration of metals in P .nigrum (mg/kg) was found as: 13.08 for Pb, 0.2 for Cu, 27.07 for Ni, 19.63 for Co, 54.5 for Zn, and 69.72 for Fe. Similarly for P.longum (mg/kg) 2.13 for Cd, 17.96 for Pb, 2.6 for Cu, 2.16 for Cr, 19.43 for Ni, 11.5 for Co, 102.96 for Zn, and 88.86 for Fe. Conclusion It is very important to monitor the heavy metal profile of medicinal plants. Both of plants were found rich source of essential metals. However Pb was found as common toxic metal detected in both plants, while Cd was present in P. longum only.
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Wed, 28 Jan 2015 05:17:05 GMT -08:00 http://www.scopemed.org/?mno=163841
Protective effects of Hippophae salicifolia D. Don fruit pulp extract in Aluminium toxicity http://www.scopemed.org/?mno=166477 2015-01-29T02-16-32Z
Source: Spatula DD - Peer Reviewed Journal on Complementary Medicine and Drug Discovery
Sathiya Ramu a*, Kaliaperumal Krishnaraj b, Abarna Devika c, Anita Murali a aDepartment of Pharmacology, Faculty of Pharmacy, M. S. Ramaiah University of Applied Sciences, Bangalore, Karnataka, India. bResearch Scientist, Formulation and Development (Pharma), Research and Development, The Himalaya Drug Company, Bangalore, Karnataka, India. cInstitute of Pharmacology, Madras Medical College, Chennai, Tamil Nadu, India..
There is an increasing interest in the measurement and use of plant antioxidants for scientific research since Reactive Oxygen Species (ROS) contributes to the initiation of many major diseases. This study deals with the evaluation of antioxidant property, and the effect on learning and memory of hydroalcoholic pulp extract of Hippophae salicifolia D. Don (HAHS) in aluminium induced toxicity in Wistar rats. Objective: The present study is to investigate the effect of hydroalcoholic fruit pulp extract of HAHS in combating the oxidative stress and memory impairment induced by the administration of aluminium chloride (300 mg/kg p.o). Methods: Albino rats were grouped into four (n=6) and were administered vehicle, aluminium chloride 300 mg/kg, HAHS 400 mg/kg, aluminium chloride 300 mg/kg + HAHS 400 mg/kg respectively for 21 days. Blood samples were collected on the 0th, 7th, 14th and 21st day of treatment and subjected to the estimation of serum antioxidant parameters such as lipid peroxidation (LPO), catalase (CAT), glutathione-S-transferase (GST) and reduced glutathione (GSH). The animals were also evaluated for their learning and memory ability using Jumping box and Hebb William maze apparatus. Results: Aluminium chloride treated animals showed impaired antioxidant defense and memory but results were not significant. However, it showed the possibility of being a major factor of oxidative stress. The hydroalcoholic pulp extract of H. salicifolia D.Don significantly improved the antioxidant defense and memory. Conclusion: The extract taken for investigation was found to suppress free radical formation, as well as aluminium induced memory deficits.
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Wed, 28 Jan 2015 05:17:05 GMT -08:00 http://www.scopemed.org/?mno=166477
USE OF COMPLEMENTARY ALTERNATIVE THERAPİES FOR DYSMENORRHEA MANAGEMENT http://www.scopemed.org/?mno=167276 2015-01-29T02-16-32Z
Source: Spatula DD - Peer Reviewed Journal on Complementary Medicine and Drug Discovery
Çiğdem Gün, Nurdan Demirci, Mustafa Otrar.
SUMMARY OBJECTIVE: This study was planned for detecting the use cases of complementary alternative medicine (CAM) methods by people having dysmenorrhea. METHOD: It was planned as a descriptive cross-sectional study between February-June 2014. The research population consisted of students studying at a public university. Without going to the sample selection, the entire universe is intended to achieve. Eventually, 660 female participants who are 18 years old and over, having primer dysmenorrhea and suit to be diagnosed with primer dysmenorrhea were got involved in the research. Data were collected on the basis of participants' self-report. Before the study, approval was obtained from the institutions and participants. SPSS program was used to evaluate the data. In collecting the data, a questionnaire including demographic characterictics and features related to dysmenorrhea are used. FINDINGS: The mean age of participants 20,40 ± 1,54 and the average duration of participants’ menstruation 5,81 ± 1,26 days. In the majority of the participants, it is seen that the dysmenorrhea started with menstruation (%39,9); dysmenorrhea pain lasted only the first day (%52,6) and not consulted a doctor due to dysmenorrhea (%83). It is determined that %51,7 of participants use the analgesic drugs, the majority (%80,9) apply to any CAM therapies. The most commonly used CAM therapies are detected as application of heat to the abdomen (%67,2) and massage (%42,6). Participants who use herbal methods prefer chamomile tea (%15%), black tea and sage (%11,8). Analgesic usage rate, usually 1-2 times per day (%87,9); %39,6 of participants were using drugs with the suggestion of a friend. RESULT: It has been observed on participants having primary dysmenorrhea, complementary therapy methods are used more compared to the use of analgesic drugs and most preferred method is the application of heat to the abdomen. In addition, the majority of participants use the drugs accoarding to friend suggestions ,without physician recommendation. Accoarding to these findings women see the dysmenorrhea as a condition they can handle themselves.
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Wed, 28 Jan 2015 05:17:05 GMT -08:00 http://www.scopemed.org/?mno=167276
Twin reversed arterial perfusion syndrome: a rare but critical event of twin pregnancy http://www.scopemed.org/?mno=174924 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Urvashi Barman Singh, Akanksha Mishra, Kahkashan Bano.
Twin-Reversed Arterial Perfusion (TRAP) sequence is also known as acardiac twin gestation or chorioangiopagus parasiticus, it is a rare and unique complication of monozygotic monochorionic twin pregnancies. 35 year old 8 gravida four alive issues and one spontaneous abortion. Patient came with complaint of pain in abdomen since 8 hours. She was having an ultrasonography report of twin pregnancy of 28 weeks gestation with one fetus alive and normal while other fetus was anomalous fetus FHS of first fetus was localised while FHS of other fetus was not localised. Twin-Reversed Arterial Perfusion (TRAP) sequence is a rare complication of monochorionic multiple gestation. Accurate antenatal diagnosis is essential to improve the prognosis of this rare entity.
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Wed, 28 Jan 2015 05:16:36 GMT -08:00 http://www.scopemed.org/?mno=174924
Use of oxidized regenerated cellulose (Surgicel Nu-Knit) as a hemostat in laparoscopic endometriotic cystectomy: a case report http://www.scopemed.org/?mno=175009 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
J. B. Sharma, Rinchen Zangmo, Sunesh Kumar, K. K. Roy.
Ovary is one of the common sites for occurrence of endometriosis. Endometriosis contributes to a major cause of infertility in young women. Apart from infertility, endometriosis is one of the important causes of severe secondary dysmenorrhea and chronic pelvic pain. Endometriotic cystectomy is often required in endometriotic cysts more than 3 cm in size. A 33 year old patient married for 4 years with primary infertility was diagnosed to have an endometriotic cyst of the ovary measuring 4x3 centimeters. Patient underwent laparoscopic endometriotic cystectomy under general anesthesia. Intraoperatively, the right ovary was enlarged and was adherent to the posterior surface of uterus and the uterosacral ligament of the same side. Adhesiolysis was done followed by removal of the ovarian endometriotic cyst. Post cystectomy oozing was controlled by application of Oxidized regenerated cellulose (Surgicel Nu-Knit) on the bleeding points. Postoperative course of the patient was uneventful and she was discharged after 7 hours in stable condition.
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Wed, 28 Jan 2015 05:16:04 GMT -08:00 http://www.scopemed.org/?mno=175009
A rare case of rectovaginal fistula caused by coital injury in a patient of MRKH http://www.scopemed.org/?mno=175229 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Kumkum Srivastava, Mona Asnani, Maryam Ali, Shipra Kunwar.
Rectovaginal fistula is defined as an epithelized communication between the rectum and vagina with involuntary escape of flatus and/or faeces into the vagina. Rectovaginal fistula is a very distressing problem for women. The successful management of this problem depends on the etiology, size and location of both fistula, as well as assessing the competence of the continence mechanism. It may be acquired and congenital, the most common causes are obstetrical injury. Coital injury is very rare cause of recto vaginal fistula. Here we are reporting a rare case of MRKH along with recto vaginal fistula resulting from coital trauma.
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Wed, 28 Jan 2015 05:15:19 GMT -08:00 http://www.scopemed.org/?mno=175229
A ‘never before’ presentation of a common Mullerian abnormality http://www.scopemed.org/?mno=174506 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Bindu Bajaj, Sunil Kumar Bajaj, Harsha S. Gaekwad, Ritu Misra.
Transvaginal septum is one of uncommon Mullerian anomalies which may lead to infertility. We all depend so often on HSG and MRI for investigating these infecund patients. Here we bring out how a distended vaginal cavity with contrast mimicked the uterine cavity on HSG misleading the clinician. The septum was missed on MRI too initially. A simple surgical correction and the patient was able to conceive in her very first cycle.
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Wed, 28 Jan 2015 05:14:31 GMT -08:00 http://www.scopemed.org/?mno=174506
A rare case of uterus didelphys with full term pregnancy in left horn http://www.scopemed.org/?mno=174902 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Tanvi Vijay Tuteja, Kirti Rajesh Bendre, Geeta Niyogi.
Uterus didelphys, also known as a duplicated uterus, is an embryological abnormality resulting from complete failure of fusion of Mullerian ducts causing full uterine development to erroneously occur bilaterally. It is associated with many obstetrical complications and thus has clinical importance. We present a case of an elderly patient with history of infertility diagnosed with uterus didelphys with a pregnancy in left horn. She carried pregnancy to term and delivered by caesarean section at 37 weeks of gestation. She had an uncomplicated intraoperative and postoperative period.
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Wed, 28 Jan 2015 05:13:51 GMT -08:00 http://www.scopemed.org/?mno=174902
Combined oral contraceptives and cerebral venous sinus thrombosis: 2 cases and review http://www.scopemed.org/?mno=174089 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Anshuja Singla, Garima Yadav, Sneha Shree.
The incidence of venous thromboembolism with combined oral contraceptive is 20-30 per 1 lakh women years. Studies have shown that there is an increasing risk of VTE in current users and risk decreases with both time of use and decreasing estrogen dose. We report two cases in which both women had CVST triggered by combined oral contraceptive use. Before prescribing COCs, a complete personal and family history along with evaluation of risk factors for VTE and cardiovascular diseases is mandatory to ensure safe use of COCs.
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Wed, 28 Jan 2015 05:13:14 GMT -08:00 http://www.scopemed.org/?mno=174089
A case of viable fetus co-existing with a complete hydatidiform mole in a twin pregnancy with successful outcome http://www.scopemed.org/?mno=173656 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Seneesh Kumar Vikraman, Vipin Chandra, Bijoy Balakrishanan, Meenu Batra, Rekha Kuriakose, Gopinathan Kannoli.
Twin pregnancies with a viable fetus and co-existing complete hydatidiform mole (CHMF) are being increasingly reported in literature. It is now evident that with proper obstetric care live births can be reasonably expected. We present here such a case successfully managed at our centre with one year follow up of mother and the baby. The case highlights the role of prompt diagnosis, rational prenatal counselling, evidence based management and role of high risk obstetric and neonatal care in providing solutions to seemingly difficult situations.
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Wed, 28 Jan 2015 05:12:39 GMT -08:00 http://www.scopemed.org/?mno=173656
Pregnancy outcome in a rare case of complex cyanotic congenital heart disease http://www.scopemed.org/?mno=176271 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Amitha V. Kamat, Sahaja S. Kittur, Mallikarjun G. Hiremath, S. R. Chandana Murthy.
A 28 year old primigravida with the very rare congenital heart condition of single ventricle with single atrium presented with 34 weeks gestation, and underwent caesarean section with minimal morbidity. As the condition is not known for survival into adulthood, the carrying of a pregnancy successfully to near term makes this an even rarer case.
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Wed, 28 Jan 2015 05:11:39 GMT -08:00 http://www.scopemed.org/?mno=176271
Rare metastasis of carcinoma ovary http://www.scopemed.org/?mno=176269 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Amitha Kamat, Sahaja Kittur, Mallikarjun G. Hiremath, Swetha Dama.
This is a case report of a 64 year old para 5 operated 2 years back for ovarian papillary adenocarcinoma presenting 2 years later with cutaneous metastases over anterior abdominal wall.
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Wed, 28 Jan 2015 05:10:38 GMT -08:00 http://www.scopemed.org/?mno=176269
A study of changing trends of maternal mortality at the tertiary care centre, MMC and RI Mysore, India http://www.scopemed.org/?mno=176989 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Ashraf Ali M, Babitha MC, Lokeshchandra HC, Kavya D. Sharma, Maheen Zehra, Madhuri S. Reddy.
Background: Maternal mortality is a reflection of the care given to women by the society. It is tragic that deaths occur during the natural process of child birth and most of them are preventable. Aims and objectives: To study the maternal mortality and the causes resulting in maternal death over 5 years in a tertiary care centre, Cheluvamba hospital, MMC & RI, Mysore. To find out avoidable factors and use information thus generated to reduce maternal mortality. Methods: A retrospective study of all maternal deaths from June 2008 to June 2013. All maternal deaths were reviewed and studied in detail including admission death interval and cause of death. Results: Maternal mortality ratio ranged between 262 to 109/100000 births. The causes of death were hypertensive disorders (30.4%), haemorrhage (24.8%), anaemia (14.8%), sepsis (6.8%) and others (23.2%). Maximum deaths (70.6%) occurred in women between 20-29 years of age, multigravida contributed to 54.96% of maternal mortality. 42 % were unbooked, 97% were referred cases. Conclusions: Overall maternal mortality was 215/100000 live births. Maternal deaths due to direct obstetric causes were 87% and indirect were 13 %. The causes of potentially preventable deaths include haemorrhage, anaemia, sepsis, disseminated intravascular coagulation and its complications. Hypertensive disorders were the leading cause of death, followed by haemorrhage. Anaemia was an important indirect cause of death. Most maternal deaths are preventable by optimum utilization of existing MCH facilities, identifying the bottlenecks in health delivery system, early identification of high risk pregnancies and their timely referral to tertiary care centre.
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Wed, 28 Jan 2015 05:09:29 GMT -08:00 http://www.scopemed.org/?mno=176989
Age at menarche as a predictor of diminished ovarian reserve: a new approach http://www.scopemed.org/?mno=175352 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Ramona Perhar, Rita Shukla, Akanksha Mishra.
Background: Objective of current study was to investigate whether age at menarche is associated with Functional Ovarian Reserve (FOR) later in life. Methods: Design: Retrospective cohort study. Setting: Gayatri Hospital, Allahabad, Uttar Pradesh, India. Patient(s): One hundred fifty one. Intervention(s): None. Results: The mean age of the patients was 38.9 ± 4.9 years, and their mean level of AMH was 1.4 ± 2.0 ng/ml and of FSH was 10.7 ± 6.1 mIU/ml. Their current age-specific Diminished Functional Ovarian Reserve (DFOR) was statistically significantly associated with early menarche, defined as age
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Wed, 28 Jan 2015 05:08:30 GMT -08:00 http://www.scopemed.org/?mno=175352
Ultrasonographic evaluation of abnormal uterine bleeding in postmenopausal women http://www.scopemed.org/?mno=176232 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Bindushree Kadakola, G. Gurushankar, Geetha Shivamurthy, M. N. Rashmi.
Background: Objectives of current study were to diagnose causes of Abnormal Uterine Bleeding (AUB) in postmenopausal women (PMW) and to correlate it with curettage and histopathological findings, hysteroscopy and thereby minimizing unnecessary interventions in the form of operations and hysteroscopy where sonography depicts normal findings. Methods: After obtaining ethical clearance present prospective observational study was conducted from November 2010 to November 2012, to evaluate the endometrium in 50 postmenopausal women (PMW) with bleeding per vagina referred to the department of Radio diagnosis by the department of gynaecology in Bangalore medical college and research institute. After applying inclusion and exclusion criterias the cases were evaluated with ultrasonography both transabdominal (TAS) and transvaginal scan (TVS where ever necessary). Histopathological and hysteroscopic correlation was done in all cases. Results: 58% of the PMW with bleed were in the age group of 51-60 years. Most common cause of PMB was atrophic endometrium (44%), endometrial polyp (22%), followed by malignancy (14%), and hyperplastic endometrium (6%). At Endometrium thickness less than 4 mm there were nil chances of carcinoma. Conclusions: In women with AUB in postmenopausal age ultrasonography (USG) can be considered as an initial imaging modality for diagnosing endometrial diseases. The sensitivity and specificity of USG for Atrophic endometrium is 100% & 84% respectively with accuracy of 100%, endometrial polyp the specificity is 100% with accuracy of 88%. For malignancy USG showed 100% specificity & accuracy of 100%. Hence USG is highly accurate for evaluating endometrial pathologies. Being noninvasive, less costly & good patient compliance USG should be considered as an initial imaging modality over invasive investigations like D&C, hysteroscopy in evaluating endometrial disorders.
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Wed, 28 Jan 2015 05:07:47 GMT -08:00 http://www.scopemed.org/?mno=176232
Role of preoperative sublingual misoprostol in reducing need of analgesia and anaesthesia for gynaecological procedures in rural hospital http://www.scopemed.org/?mno=176213 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Shaveta Gupta, Neema Acharya, C. Hariharan, Sunaina Batra.
Background: Many of gynaecological procedures require dilatation of cervix which may cause complications like excessive pain, cervical damage, creation of false tract and uterine perforation. Most of these may be done as outpatient procedures, which may reduce anaesthetic complications and decrease hospital stay. Misoprostol is a prostaglandin E1 which is proven to be effective in cervical priming hence reducing the fore mentioned complications. Methods: The study was randomized control trial followed a single bind style for two parallel groups. There were two groups, study group (n=100) and control group (n=100). The patients were recruited from the indoor as well as OPD requiring intrauterine procedure (viz D&C, hysteroscopy, HSG). The women of misoprostol group received, 200 microgram of misoprostol sublingualy and the women of placebo group received l mg folic acid 2 hours prior to the intrauterine procedure. Cervical dilatation, time required for the dilatation, cervical resistance, general experience of the patient, side effects, need of anaesthesia and complications were studied. Results: In present study mean post drug cervical dilatation was 4.08 ± 0.88 in study group which was more than control group 2.08 ± 0.27. It was statistically significant by using student‘t’ test as p value
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Wed, 28 Jan 2015 05:06:37 GMT -08:00 http://www.scopemed.org/?mno=176213
Autoimmune diseases in pregnancy: maternal and fetal outcomes http://www.scopemed.org/?mno=176237 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Pavithra M. Vengetesh, Shripad Hebbar, Lavanya Rai.
Background: The aim of this study was to assess the impact of autoimmune connective tissue disorders on the outcomes of pregnancy and the influence of treatment on pregnancy. Methods: Thirty-seven antenatal patients with autoimmune connective tissue diseases, comprising of Systemic Lupus Erythematosus (SLE), primary antiphospholipid antibody syndrome (APS), Mixed Connective Tissue Diseases (MCTD), ankylosing spondylitis and Takayasu arteritis were analysed. Results: Multigravidas constituted 89.4% and were associated with bad obstetric history. Before diagnosis and treatment, serious maternal complications of eclampsia and thromboembolism were observed in patients with SLE and APS. The live birth rates were 9% and 2.4% respectively in patients with SLE and APS. With appropriate treatment- aspirin, heparin and immunosuppressant, the live birth rates were raised to 70% in SLE and 100% in APS patients. Investigation for autoimmune disease in recurrent pregnancy loss is important. A rare association between MCTD and congenital anomaly - Rhizomelic chondrodysplasia punctata was observed. Preeclampsia, gestational diabetes, fetal growth restriction and preterm labour were the common complications noted. Conclusions: Active disease at onset of pregnancy, presence of Anti-ds DNA antibodies and secondary APS were strong predictors of poor pregnancy outcomes among patients with SLE. Vigilant monitoring during pregnancy is required for favourable outcomes.
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Wed, 28 Jan 2015 05:06:32 GMT -08:00 http://www.scopemed.org/?mno=176237
A descriptive study: maternal and fetal outcome of grand multipara http://www.scopemed.org/?mno=176191 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Sunder Pal Singh, Jyoti Chawan, Divya Mangla.
Background: Pregnancies in grand multipara have been considered risky for many decades as there are higher chances of complications during pregnancy, labour and puerperium in these women. This study aims to find out various maternal and fetal complications associated with grand multiparty during pregnancy and labour. Methods: A descriptive observational study was conducted in the department of obstetrics and gynecology of S.K.H.M Medical College Nalhar, Mewat, from Jan, 2014 till Oct, 2014. It included 100 cases of grand multipara women. All the women who delivered at S.K.H.M and had five or more previous viable pregnancies were included in the study. Results: In the total 100 cases that were included in the study, the common medical illness found in grand multipara were anemia (92%), hypertension (13%), preeclampsia (9%) eclampsia (4%) and diabetics mellitus (2%). Other complications observed were mal-presentations (18%), intra-uterine deaths (18%), preterm labor (15%), placental abruption (8%), shoulder dystocia (6%), placenta previa (5%), obstructed labour (4%), and ruptured uterus (2%). Caesarian section was required in 28% of the cases. Third stage complications were also high in grand multi para e.g. PPH (14%), retained placenta (5%), uterine inversion (3%) and maternal mortality (4%). In perinatal outcomes the observations were lbw babies (15%), macrosomies (10%), and APGAR score (8-10) in 70% of the babies. Conclusions: Grand multiparity is still a major obstetric hazard which needs strict supervision and good antenatal care and active intervention at appropriate time. Extreme parity should be treated with extra care especially in populations with high rates of unbooked deliveries.
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Wed, 28 Jan 2015 05:05:32 GMT -08:00 http://www.scopemed.org/?mno=176191
Study of obstetric and fetal outcome of post caesarean pregnancy http://www.scopemed.org/?mno=175958 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Akanksha Nigam, Rakesh Anand, Niyati Jain.
Background: With the sky rocketing caesarean section rates an increasing number of women face the issue of mode of delivery in their current pregnancy. There are conflicting reports regarding the safety of a trial for Vaginal Birth After Caesarean delivery (VBAC) in terms of uterine rupture and concern about, maternal and perinatal morbidity. The purpose of this study was to evaluate the obstetric and fetal outcomes of patients presenting at term with a history of previous LSCS. Methods: A one year prospective observational study was conducted where in all patients who had a term pregnancy with a history of prior LSCS were included in the study after obtaining their consent for participation. The obstetric and fetal outcomes of these patients in the present pregnancy were noted and tabulated. A descriptive analysis of these outcomes was carried out. Results: 100 patients at term, with a history of previous LSCS were studied. Of these, trial for a VBAC was attempted by 50 patients of these 46% (23) had a successful VBAC. And remaining 54% went for emergency LSCS. 50% patients underwent an elective repeat caesarean deliver. Scar dehiscence was seen in 2.72% of the patients who opted for a trial for VBAC. Perinatal morbidity was higher in cases of repeat caesarean delivery than in those who had a successful VBAC (12.12% vs. 0 percent). Maternal complications were also higher in patients who had a repeat LSCS compared to those who had a successful VBAC. Conclusions: With an increase in the proportion of patients with a history of previous LSCS, it is essential for health care institutions to have proper antenatal counseling regarding VBAC and a well-defined management protocol in place in an effort to increase the number of VBACs and bring down the overall caesarean rates. Patients with a history of prior vaginal delivery have an increased likelihood for a successful VBAC. A successful VBAC is associated with a lower perinatal and maternal morbidity than repeat caesarean delivery, and this is relevant for counseling women about their choices after a caesarean delivery.
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Wed, 28 Jan 2015 05:04:26 GMT -08:00 http://www.scopemed.org/?mno=175958
Low molecular weight heparin prophylaxis: a boon for women with history of placental mediated complications http://www.scopemed.org/?mno=176035 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Shweta Singh, Renuka Sinha, Mayank Kaushik.
Background: Prevention of placental mediated pregnancy complication is likely the best approach to decrease maternal mortality and morbidity. Anticoagulation therapy represents a good preventive option. Methods: A prospective randomized case control study was conducted at Safdarjang hospital. Patients were recruited from Sept. 2011 till May 2012 and followed till delivery. Thirty cases & controls were enrolled which comprised of non- thrombophilic patients with previous history of severe preeclampsia, Fetal Growth Restriction (FGR), severe placental abruption, stillbirth after 20 weeks. Study group received LMWH according to weight subcutaneously, once daily started at < 15 weeks till 36 weeks of gestation. Maternal outcomes were observed in both groups. Results: Incidence of stillbirth and abruption were significantly lower in study group (0 versus 3.3%, P = 0.05; and 0 versus 20%, P = 0.01). The respective incidence of severe preeclampsia and FGR were 6.6% versus 40% (P = 0.04) and 6.6% versus 30 % (P = 0.02). There was reduction of 72.7% of total adverse outcome. Conclusions: Prophylactic LMWH before 15 weeks of gestation decreases the incidence of placental mediated complications in non thrombophilic pregnant women who had previously suffered with these complications.
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Wed, 28 Jan 2015 05:03:22 GMT -08:00 http://www.scopemed.org/?mno=176035
Application of Robotic Surgery in the treatment of endometriosis: View point of an Indian OBGYN fellow in USA http://www.scopemed.org/?mno=175870 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Krishna Kavita Ramavath, Manuel A. Penalver, Luis E. Mendez, Olyai Roza.
Background: This article is an observational experience of robotic surgery in USA by an Indian Obgyn fellow. Primary objective is to analyze retrospectively peri operative outcomes in stage 2 and 3 Endometriosis treated with robot assisted laparoscopy. Secondary objective is to report an Indian Obgyn, Physician observer fellows experience in USA with Robotic surgery. Methods: 29 women underwent robotic surgery at in the department of gynecology at Doctor’s hospital, Baptist health, Miami. Pre-op time, console time, total operative time, blood loss, peri-operative complications noted. Results: Mean age is 42 ± 8 years with BMI of 26.2 ± 8 kg/m2. Eighteen patients (62%) were age 40 and above. Twenty patients (69%) presented with chronic pelvic pain. Dyspareunia in 16 (55.2%), bloating in five (17.2%) and pelvic mass in thirteen (44.8%) Unilateral pelvic mass in nine patients (31 %) and bilateral in four patients (13.8%). CA 125 levels are elevated in nine patients (31%) and significantly higher with endometriomas (76.1 ± 49.2 U/ml). 38% underwent robot assisted laparoscopic hysterectomy and BSO. 14.8% underwent robot assisted laparoscopic hysterectomy with Robot (LSO/RSO). Mean operative time 64.7 min. Mean blood loss 40 ml. Conclusions: Robotic surgery is safe, with minimal blood loss and shorter hospital stay. Alike in the surgical techniques, though diverse in the work infrastructure and technology, East and West have common scenarios which can be tackled with exchange of training opportunities. This interchange of knowledge and skills will benefit patients with increased surgeon’s efficiency.
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Wed, 28 Jan 2015 05:02:40 GMT -08:00 http://www.scopemed.org/?mno=175870
Comparison between intramuscular and intravenous regimen of magnesium sulfate in management of severe preeclampsia and eclampsia http://www.scopemed.org/?mno=175343 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Vaibhav Kanti, Abhilasha Gupta, Shikha Seth, Mona Bajaj, Sunil Kumar, Mukeshvir Singh.
ABSTRACT: Objective:To compare between intramuscular and intravenous magnesium sulfate regimen in terms of efficacy, incidence of side effects ,maternal and fetal outcome. Method:A prospective study was performed over a period of 1 years on 82 patients and comparision was made between intravenous and intramuscular group ,each group consisting of 17 patients of eclampsia and 24 patients of severe pre-eclampsia.Intravenous group received continuous intravenous magnesium sulfate (IV MgSO4) consisting of 4gm of loading dose administered over 15 minutes followed by maintainence dose of 2gm/hour.The intramuscular group(IM MgSO4) received magnesium sulfate according to pritchard regimen . Result:recurrence of convulsion in eclamptic patients was found in 1/17( 5.88%) of patients of intravenous(IV) and 1/17( 5.88% )of intramuscular (IM) group which is statistically not significant(p=1).There was no occurance of convulsion in any of the svere eclamptic patients in either group. There was statistically no significant difference in maternal death between the two groups ( IM= 1/41(2.43%) and no mortality in IV group,P=0.314) . Statistically higher incidence (p=0.034) of sign of impending toxicity such as loss of patellar reflex was seen in intramuscular group as compared to intravenous group.Other signs of toxicity such as oliguria,respiratory rate depression though more in intramuscular group , were statistically insignificant. There were no significant differences in other measures of serious maternal morbidity, in perinatal morbidity or mortality Conclusion:Intramuscular magnesium sulfate regimen is as safe as intravenous magnesium sulfate . Intra muscular magnesium sulfate should be given without any fear and delay in those low resource setups where monitoring only by clinical signs can be done and where patient and institute cannot bear the extra burden of monitoring serum magnesium levels at frequent intervals.
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Wed, 28 Jan 2015 05:02:06 GMT -08:00 http://www.scopemed.org/?mno=175343
A comparative study of metabolic and hormonal effects of myoinositol vs. metformin in women with polycystic ovary syndrome: a randomised controlled trial http://www.scopemed.org/?mno=175421 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Riju Angik, Shubhada S. Jajoo, C. Hariharan, Amogh Chimote.
Background: The purpose of the study was to find out which drug is more effective in treatment and improvement of metabolic and hormonal parameters in women with polycystic ovary syndrome (PCOS); Myoinositol or Metformin. This study was conducted since there are very limited studies on the same. Methods: Patients between 15-40 years of age with signs and symptoms of PCOS who attended the outpatient department of obstetrics and gynaecolgy at AVBRH between study period of September, 2012 to August 2014, were subjected to specific investigations to diagnose PCOS. Patients who were diagnosed with PCOS according to the Rotterdam criteria were included in the study group. Patients were randomly allocated to treatment with either myoinositol or metformin. Myoinositol group received 1 g twice daily while Metformin group received 500 mg twice daily for 6 months .The findings and investigations were repeated after 6 months and was compared with the baseline values. Results: Treatment with myoinositol and metformin both decreased body mass index, androgenic features, improved menstrual abnormalities and polycystic ovaries but the Level of insulin resistance as measured by fasting insulin and homeostatic model assessment (HOMA) decreased only on treatment with myoinositol. Conclusions: Myoinositol acts at the level of insulin receptors and is effective in treatment of hyperinsulinemia and insulin resistance, which is the underlying factor leading to the development of polycystic ovary syndrome.
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Wed, 28 Jan 2015 04:58:02 GMT -08:00 http://www.scopemed.org/?mno=175421
Study on the reproductive behavior among women of rural areas of Pondicherry http://www.scopemed.org/?mno=175290 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
K. N. Prasad, Basavaraj M. Ingalgeri, R. Poovitha, E. Sujitha, K. Sukanya, Thongam BK. Singh, D. Suganya, M. Suganya, V. Viswanath.
Background: The fertility rate in India is declining and it is necessary to know the factors responsible for such decline in different states. It was decided to study reproductive behavior of women contributing to decline in fertility in Pondicherry. The aim and objective of this study is known the reproductive behavior of women in the rural areas on Pondicherry. Methods: Sample of 300 married women aged between 30 and 60 years were selected randomly from village belonging to Katerikuppam PHC and the data collected using the pre tested semi open ended questionnaires by interviewing the subjects at their doorsteps during September to November 2014. Results: The mean age of the subjects was 41.5 ± 9.5 years. There were 793 total pregnancies and live births were 701 and abortions accounted for ten percent and still births were 9 in number. The mean number of pregnancies and live births were 2.6 ± 1.1 and 2.3 ± 1.0 per women respectively. The mean age at menarche, marriage and first pregnancy were 14.3 ± 1.4, 19.6 ± 3.1 and 21.1 ± 3.1 years respectively. The mean number of pregnancies were declined from currently older age to the lower age of the subjects and found to be statistically significant. Conclusions: The mean age at marriage and first pregnancy is increasing and the differences in the mean number of pregnancies and live births are showing declining trend.
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Wed, 28 Jan 2015 04:57:26 GMT -08:00 http://www.scopemed.org/?mno=175290
Acceptability and feasibility of immediate postpartum IUCD insertion in a tertiary care centre in Central India http://www.scopemed.org/?mno=175278 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Anjali Vivek Kanhere, Prachi Pateriya, Manisha Jain.
Background: This study was conducted to assess the acceptability and feasibility of immediate postpartum intrauterine contraception device insertion after vaginal deliveries in a tertiary care centre in Central India. Aims: To study acceptability, feasibility & complications of immediate PPIUCD. Methods: This is a prospective analytical study conducted at Department of Obstetrics and Gynecology, PCMS & RC Bhopal. 200 eligible postpartum women were counselled for IUCD insertion. After consent, Cu-T 380 A insertion was done. These women were also interviewed for their reasons for accepting and rejecting PPIUCD and their preference for other forms of contraception. Follow-up was done at 6 week or when they reported with any complaint. Results: Out of 200 eligible postpartum patient counselled, 72 (36%) women underwent PPIUCD insertion which was significantly low as compared to preference to use of other methods of contraception at a later date (66%). Acceptance of PPIUCD was higher in the age group of 21-29 years (35%), para-1 (48%), and educated (60%) clients. Expulsion rate was 22%. There was no case of perforation or any other major complication. 52 cases (72%) reported for follow up. 43% of cases were comfortable with PPIUCD at 6 weeks. There was no case of perforation, PID reported in our study. Only one patient reported with intrauterine pregnancy at 6months with IUCD in place. Conclusions: PPIUCD was not very acceptable in our set up but it is a safe, highly effective, long acting, cost effective method of contraception with very few side effects and no major complication and contraindication. The feasibility of accepting PPIUCD insertion can increase with antenatal counselling and institutional deliveries.
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Wed, 28 Jan 2015 04:56:47 GMT -08:00 http://www.scopemed.org/?mno=175278
Laparoscopic and bacteriologic evidence of bacterial vaginosis in unexplained infertility http://www.scopemed.org/?mno=175164 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Atef M. Darwish, Mahmoud A. AbdelAleem, Micheal N. Agban, Mostafa A. Mohamed.
Background: Aim of current study was to estimate the prevalence of Bacterial Vaginosis (BV) among women with Unexplained Infertility (UI) and to describe laparoscopic appearances in positive cases. Methods: Design: Prospective randomized comparative diagnostic trial. Setting: Tertiary care referral facility and University hospital. Patients: One hundred and fifty women divided into UI study group A (120 cases) and a control group B (30 cases). Intervention(s): Vaginal and endouterine swabs form two subgroups of the UI group (60 cases each) and vaginal swabs from control group (30 cases). All swabs were tested using Amsel's criteria then cultured. Thereafter, UI group (60 cases) was subjected to diagnostic laparoscopy. Main outcome measure(s): the prevalence of BV among women with UI and laparoscopic findings among positive cases. Results: In the study group, the number of positive cases of BV confirmed by culture was 51 cases (42.5%) while it was diagnosed in three cases (10%) in group B (P = 0.0001). In group A, BV was diagnosed in 24 and 27 infertile cases with periods of infertility less than and more than 3 years respectively and in 39 patients (32.5%) with recurrent vaginitis without statistically significant difference. There was an insignificant difference in diagnosis of BV whether the site of sample was the posterior fornix of the vagina or the endometrial cavity. Positive laparoscopic findings were reported in 77 patients (64.2%). The most common laparoscopic abnormalities were hyperemic uterus and chronic salpingitis. Conclusions: BV is frequently implicated in female infertility and it is probably an underestimated cause of UI. There is no extra benefit from using culture instead of Amsel’s criteria for the diagnosis of BV. No difference in the site of sample taking in diagnosis of BV from posterior vaginal fornix or endometrial cavity. Laparoscopy is very beneficial in explaining the effect of BV on the upper genital tract.
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Wed, 28 Jan 2015 04:56:20 GMT -08:00 http://www.scopemed.org/?mno=175164
Correlation between leukocytospermia and oxidative stress in male partners of infertile couples with leukocytospermia http://www.scopemed.org/?mno=173750 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Richa Aggarwal, Manju Puri, Rima Dada, Gyan Saurabh.
Background: The last century has seen rapid advances in the diagnosis and management of male infertility but still the cause eludes us in a majority of cases. The World Health Organization (WHO) has defined leukocytospermia as >1 million WBC/mL of semen. However, the clinical significance of increased leukocyte infiltration in semen, that is, leukocytospermia, is currently a subject of controversy. Evidence from several recent studies indicates that leukocytospermia could significantly contribute to male infertility. Of the many causes of male infertility, oxidative stress has been identified as one factor that affects fertility status and thus, has been extensively studied in recent years. A study was conducted to evaluate the relationship between leukocytospermia and oxidative stress. Methods: 88 men with leukocytospermia were included in the study. Semen parameters, no. of pus cells present and oxidative stress were noted. The correlation between leukocytospermia and ROS level was found using Pearson correlation coefficient. Results: Significant positive correlation (r = 0.882, P
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Wed, 28 Jan 2015 04:55:47 GMT -08:00 http://www.scopemed.org/?mno=173750
Sonographic assessment of lower uterine segment at term with previous caesarean section http://www.scopemed.org/?mno=175052 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Sandip Lahiri, Suresh Chandra Mondal, Sudip Ranjan Pal.
Background: The present study is an attempt to evaluate the efficacy of trans abdominal sonography to measure the thickness of scarred lower uterine segment at term and to detect anatomical defect if there is any to predict the risk of scar rupture. Methods: This study assessed the usefulness of sonographic measurement of lower uterine segment thickness in 100 patients with previous Caesarean patients. Lower uterine segment thickness was compared by antenatal sonography caliper measurements and observations during caesarean section. Results: Lower uterine segment thickness measured by ultrasonography correlated well with the thickness measured by vernier calipers at Caesarean section. Sensitivity of 92.86%, specificity of 77.27%, positive predictive value of 83.87% and negative predictive value of 89.47% suggested that if the thickness of lower uterine segment was 2.6 mm or more, chances of vaginal delivery following trial of labour was high. Conclusions: Antenatal ultrasonographic assessment of lower uterine segment thickness can result a successful trial of labour in women with previous caesarean section.
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Wed, 28 Jan 2015 04:51:10 GMT -08:00 http://www.scopemed.org/?mno=175052
Effect of GnRH antagonist on follicular development and uterine biophysical profile in controlled ovarian stimulation http://www.scopemed.org/?mno=174935 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Bhawana Tiwary, Lakhbir Dhaliwal, Shalini Gainder.
Background: Objective of current study was to assess the effect of GnRH antagonist on follicular development, premature luteinization, uterine biophysical profile and pregnancy rate in controlled ovarian stimulation with clomiphene and gonadotropins for intrauterine insemination in women with unexplained infertility. Methods: Randomised controlled trial. Minimal stimulation protocol with or without GnRH antagonist was compared. Setting: Infertility clinic, PGIMER, Chandigarh. Patients: Couples with unexplained infertility, age of female partner between 20-39 years. Intervention: GnRH antagonist 0.25 mg since follicle size 14 mm till hCG administration. Main outcome measures: Follicle characteristics, premature luteinisation, uterine biophysical profile and pregnancy rate. Results: The mean number of follicles recruited in group A was 2.32 ± 1.01 while that in group B (receiving GnRH antagonist) it was 4.10 ± 1.69. Statistically significant increase in total biophysical profile score was observed in periovulatory phase in the antagonist group. 40% women in group A had premature luteinization whereas only 4% women in group B suffered from premature luteinization. 20% women who received GnRH antagonist conceived against only 6% in group A, this difference however was not statistically significant Conclusions: GnRH antagonist has a role in increasing the number of follicles recruited. Furthermore, GnRH antagonist can improve the total uterine biophysical profile score by improving the endometrial thickness, endometrial pattern, blood flow and decreasing the impedance to the blood flow in uterine artery. The drug can potentially help in improving pregnancy rates by decreasing the rate of premature luteinisation.
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Wed, 28 Jan 2015 04:50:39 GMT -08:00 http://www.scopemed.org/?mno=174935
Fetomaternal outcome in cases of oligohydramnios after 28 weeks of pregnancy http://www.scopemed.org/?mno=174797 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Veena Vidyasagar, Nimmi Chutani.
Background: Aim of current study was to study the fetomaternal outcome in cases of oligohydramnios admitted in the labour room for delivery. Methods: A prospective hospital based study was conducted at Sharda hospital, school of medical sciences and research, Sharda University, Greater Noida. The study was undertaken over a period of two years from April 2012 to March 2014. Cases of oligohydramnios (AFI ≤5 cm) detected ultrasonographically at the time of admission in labour room were included in the study. The inclusion criteria for the purpose were: 28 completed weeks of gestation with singleton live pregnancy, intact membranes and no foetal anomalies. Data regarding bio-social characteristics, maternal and perinatal outcome were collected and results were analysed. 40 cases (with similar age and parity profile, as study cases) were taken as control. Results: There were 1342 deliveries during the study period. 41 cases were detected to have oligohydramnios. Majority of the cases (80.49%) in the study group belonged to the age group of 20-30 years. Incidence of associated maternal and foetal complications was higher in cases with oligohydramnios. Perinatal mortality was 9.76%. Fetal heart rate abnormalities were observed in 19.51% cases at the time of admission. Low Apgar score was seen in 19.51% neonates and 36.59% neonates were admitted in NICU. Conclusions: Oligohydramnios is being detected more often these days, due to routinely performed obstetric ultrasonography. In the present study, cases with AFI of ≤5 presenting for delivery (after 28 weeks of gestation), were studied. Babies were relatively more prone for complications.
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Wed, 28 Jan 2015 04:50:12 GMT -08:00 http://www.scopemed.org/?mno=174797
An audit of obstetric admissions to intensive care unit in a medical college hospital of central India: lessons in preventing maternal morbidity and mortality http://www.scopemed.org/?mno=174411 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Manisha Jain, Jyoti Nath Modi.
Background: The spectrum of causes leading to maternal morbidity and mortality may be well reflected in the clinical profile of obstetric patients admitted to the Intensive Care Unit (ICU). An audit of these patients may help in devising intervention strategies and implementing preventive measures. This is expected to contribute to the ongoing concerted multipronged efforts towards reducing maternal mortality as a step towards the millennium development goals. The aim was to study the clinical and demographic profile of antenatal and postpartum women requiring admission to the ICU, the interventions required in these women and the final outcome. The overall goal is to identify the contributing factors towards maternal morbidity and mortality. Methods: A retrospective analysis of hospital records of all antenatal, post-abortal and postpartum women admitted to the ICU at People’s hospital, Bhopal over a period of 3 years (June 2011 to May 2014). Results: A total of 157 records were identified and analyzed: 22 (14%) antenatal, seven (4%) post-abortion, 114 (73%) postpartum, and 14(9%) post-laparotomy women. The mean age was 25 years (Range 18-38 years; SD 4.49), two thirds being from rural areas. Majority (78%) had no earlier visit. The gestational age at admission to ICU ranged from 6-43 weeks (Mean 31 weeks; SD 9.06). One third (24%) of patients had severe anemia, 18 patients needed ventilation, 25 required inotropic support, 4 required dialysis and 17 underwent surgical intervention. Blood or blood component therapy was needed in 60% cases with total blood units transfused being 225. The average duration of stay in intensive care unit was 79 hours. Analyzing as organ-system dysfunctions: Cardiovascular dysfunction (22%), hematological (20%), hepatic (16%), neurological (11%), septicemia (11%), renal (9%). There were 19 maternal deaths. Conclusions: Maternal anemia and consequences still contribute significantly to maternal morbidity. Non-utilization of antenatal care services especially in rural area compounds the problem. Multidisciplinary care is essential in intensive care setting.
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Wed, 28 Jan 2015 04:49:19 GMT -08:00 http://www.scopemed.org/?mno=174411
Importance of estimation of follicular output rate (FORT) in females assisted by intracytoplasmic sperm injection http://www.scopemed.org/?mno=174316 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Rehana Rehman, Rozina Mustafa, Talea Hoor, Rakhshaan Khan, Hina Gul.
Background: We aimed to estimate pregnancy outcome after ICSI in terms of oocyte parameters, embryo quality, endometrial thickness, hormone and cytokine levels in women stratified on the basis of follicular output rate (FORT). Methods: Quasi experimental design was carried out after approval from “Ethical review board of Islamabad clinic serving infertile couples” from July 2010 to August 2013. One thousand and fifty females were selected with the criteria of age between 21-40 years, infertility of more than 2 years, body mass index of 18-35 kg/m2, menstrual cycle of 25 ± 7 days, both ovaries present with normal uterine cavity, serum FSH levels less than 8 IU/ml and normal thyroid-stimulating hormone levels. Females on short agonist or antagonist protocol with diagnosis of polycystic ovarian syndrome, fibroids or in their male partner sperms retrieved by testicular biopsy were excluded from the study. Down regulation of ovaries was followed by controlled ovarian stimulation, Ovulation Induction (OI), oocyte pick up, in vitro fertilization, Embryo Transfer (ET) and confirmation of pregnancy was done by serum beta hCG of more than 25 mIU/ml and cardiac activity on trans vaginal scan. Enzyme linked immuno sorbent assay was used for peak and mid luteal estradiol (E2), progesterone (P) and interleukin I-β estimation on OI and ET days respectively. FORT (ratio of preovulatory follicle count to antral follicle count × 100 on OI day) stratified females into low under the 33rd percentile, medium between the 33rd and the 67th percentile and high above the 67th percentile. Characteristics of groups were compared by one way analysis of variance. Results: Females 276 (33%), 288 (34%) and 282 (33%) comprised of low, medium and high FORT groups respectively. The number of retrieved, mature and fertilized oocytes, cleaved embryos, endometrial thickness and number of gestational sacs in the high FORT group was significantly high (P
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Wed, 28 Jan 2015 04:48:42 GMT -08:00 http://www.scopemed.org/?mno=174316
Doppler prediction of adverse perinatal outcome in intrauterine growth restriction http://www.scopemed.org/?mno=173932 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Nina Mahale, Bandana Khanal, Ajit Mahale, Merwyn Fernandes, Pallavi Rao, Chanabasappa Chavadi.
Background: Objective of current study was to determine and compare the diagnostic performance of Doppler ultrasonography of the fetal Middle Cerebral Artery (MCA) and Umbilical Artery (UA) for prediction of adverse perinatal outcome in suspected intrauterine growth restriction (IUGR). Methods: Fifty singleton pregnancies in third trimester of pregnancy with suspected intrauterine growth restriction were examined with Doppler ultrasonography of fetal MCA and UA. Results: Twenty patients of the fifty included patients had at least one major or minor adverse outcome. Major adverse outcome included perinatal deaths which included both intrauterine deaths and early neonatal deaths, hypoxic ischemic encephalopathy, intraventricular hemorrhage, periventricular leukomalacia, pulmonary hemorrhage, necrotizing enterocolitis and septicemia. Minor outcomes included cesarean section for fetal distress, Apgar score below 7 at 5 minutes and admission to Neonatal Intensive Care Unit (NICU) for treatment. MCA PI is the most sensitive(90%) index in predicting any adverse perinatal outcome i.e. including both major and minor outcomes, Positive Predictive Value (PPV) and specificity being greatest for MCA/UA PI (96.6%, 93.7%). For the major adverse outcome most sensitive (86.6%) most specific (91.4%) and with highest PPV (81.2%) and NPV (94.1%), is MCA/UA PI. Ratio of MCA/UAPI is more sensitive (90%) than PI of both the arteries alone for overall prediction of adverse perinatal outcome. Conclusions: Thus we conclude that the Doppler studies of the multiple vessels in the fetoplacental unit can help in the monitoring of the compromised fetus and can help us predicting neonatal morbidity. This may be helpful in determining the optimal time of deliveries in pregnancies complicated by IUGR.
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Wed, 28 Jan 2015 04:48:14 GMT -08:00 http://www.scopemed.org/?mno=173932
Perceptual analysis of women on tubectomy and other family planning services: a qualitative study http://www.scopemed.org/?mno=173506 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Ruchi Kalra, Sameer Phadnis, Ankur Joshi.
Background: In our country India, Population explosion has become a major concern to all. As per NHFS 3 report, in MP 44.3%, adopted the female sterilization other methods like male sterilization 1.3%, Intrauterine devices 0.7% and pills users were 1.7%, condom 4.8%. The study probed into the reasons of female sterilization as the method of choice and to know ideas of other temporary contraceptives and male sterilization. Methods: In the study qualitative technique was adopted to understand the perception of participants. FGD’s and in-depth interviews were conducted with residents of Ratua village between Nov 2011 - April 2012 to explore the gaps. 52 women participated in the study. They were between 20-40 years, married and had children. Results: The interview transcripts were thematically analysed. All the participants knew tubectomy operation either through health care workers, friends, relatives or media. They thought it as a better and safer way to prevent unwanted pregnancy as compared to temporary ways and male sterilization. Economic incentives were looked up as insufficient motivation for undergoing the procedure. The decision was combined and women had less freedom in decision making. All felt strongly need of having at least one son for the family progression and care provider to them during the old age. They were hesitant to use temporary methods as they had misconceptions about the adverse effects. The male sterilization was unacceptable to all the participant as they thought it causes weakness and would adversely affect the physical work performance of their husband Conclusions: Participants in the study were hesitant to use temporary contraceptive methods for the fear of adverse effects. Multiple approaches to educate and transform their misconceptions of contraceptive methods and male sterilization should be adopted.
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Wed, 28 Jan 2015 04:47:45 GMT -08:00 http://www.scopemed.org/?mno=173506
Role of intrauterine insemination in infertile couple seeking care at Acharya Vinobha Bhave rural tertiary care hospital http://www.scopemed.org/?mno=173361 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Sanjana Sunil Khemka, Deepti Shrivastava, C. Hariharan, Arpita Jaiswal.
Background: Fibroids Infertility affects between 60 million to 68 million people worldwide; generally one in ten couples experience primary or secondary infertility. The majority of those who suffer, live in the developing world. Universally, the prevalence rises significantly with a woman’s age. The WHO estimates the overall prevalence of infertility in India to be between 3.9 and 16.8 per cent. Objective: To assess the outcome of intrauterine insemination (IUI) amongst infertile couples seeking care at AVBRH. And to correlate the outcome of IUI with various parameters associated with infertility. Methods: 50 patients undergoing 72 stimulated IUI cycles between September 2012 and august 2014. It was a prospective interventional study. Interventions: Ovarian stimulation with clomifene citrate & gonadotrophins was initiated and a single IUI was performed 36 h after triggering ovulation. Main outcome: Pregnancy rates by urine pregnancy test per couple. Pregnancy rates by urine pregnancy test per cycle. Secondary outcome: livebirth, on-going PR, abortion rate. Results: The pregnancy rate per couple and per cycle were 22% and 15.27% respectively. Live birth were 8%, on-going pregnancy was 4%, abortions were 10%. Conclusions: On the basis of analysis of successful outcome of IUI it can be said that the patients with best prognosis are the one with age
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Wed, 28 Jan 2015 04:46:42 GMT -08:00 http://www.scopemed.org/?mno=173361
Impact of placenta praevia on obstetric outcome http://www.scopemed.org/?mno=173210 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Neelam Meena, Anupama Dave, Shivraj Meena, Asha Meena, Ankita Shrivastava.
Background: Placenta praevia is the implantation of the placenta partially or totally in the lesser segment of the uterus. The blood loss is generally mild and frequent but at times can be enormous and life threatening. The frequency of placenta praevia is 3-5 per 1000 pregnancies thought out the world and is still increasing for the reason that of growing caesarean section rates.2 The present study was carried out to asses impact of placenta praevia on obstetric outcome at our setup. Methods: This was case control study that was conducted at department of gynaecology and obstetrics, M Y hospital, M G M medical college, Indore from Sep 2011 to Feb 2013. A predesigned proforma was used to collect the study variables. Results: The incidence of placenta previa was 0.76 %. Maximum patients belonged to age group of 21-30 years (70.43%) and in gravidae >2 (35.65%). In this study 22.6% patients of PPH, 36.52% of perpueral sepsis, 1.75% of UTI, 4.35% of ARF, 5.22% of wound infection, 1.74% of DIC and 5.22% patients of placenta accrete. Caesarean hysterectomy and uterine artery ligation were done in 6.08% and 13.04% patients respectively. Hysterectomy was done in 4 patients belonging to anterior PP and 3 patients in posterior PP group. Major placenta praevia was present in 47.82% patients. 6% patients present in hospital with gestational age
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Wed, 28 Jan 2015 04:45:48 GMT -08:00 http://www.scopemed.org/?mno=173210
Comparison of diagnostic accuracy of two one step procedures for screening of gestational diabetes mellitus http://www.scopemed.org/?mno=173247 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Amita Sharma, Manisha Gupta, Alpana Agrawal.
Background: Single test procedures for screening GDM in Indian women will help in its management.This study was aimed to compare the accuracy measures of the random glucose test and the Diabetes In Pregnancy Study group India (DIPSI) recommended glucose challenge test as screening tests for Gestational Diabetes Mellitus (GDM) between 24 and 28 weeks of pregnancy and to study the prevalence of GDM and associated risk factors. Methods: In this prospective cohort study, all pregnant women without pre-existing diabetes underwent a random glucose test first followed by DIPSI recommended method (2 hours after a 75 g oral glucose load, without regard to the time of the last meal). All the pregnant women were subjected to 2-h 75-g oral glucose tolerance test for diagnosis of GDM within one week. Receiver Operating Characteristic (ROC) analysis was used to evaluate the discriminatory power of the two screening tests. Results: The OGTT was performed in 576 women. The area under the ROC curve was larger for the DIPSI test [0.97 (95% CI 0.95-0.98)] than for the random glucose test [0.76 (95% CI 0.72-0.79)]. There was a significant difference in the areas under the curve of the two tests of 0.21 (0.14 to 0.28) (P
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Wed, 28 Jan 2015 04:44:28 GMT -08:00 http://www.scopemed.org/?mno=173247
Abnormalities in semen analysis among male partners of infertile couples: a study in a tertiary care level hospital of West Bengal, India http://www.scopemed.org/?mno=173507 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Nandini Bhaduri (Bhattacharyya), Aditya Prasad Sarkar, Nikhilesh Dewasi, Tapan Kumar Ghosh.
Background: The prevalence of infertility in the general population is 15%-20%. Of this, the male factor is responsible for 20%-40%. Analysis of semen is the most important diagnostic tool for evaluation of role of males in infertility. The study was conducted to determine the abnormalities in semen among male partners in infertile couples. Methods: A descriptive study with cross-sectional design among male partners of infertile couples was conducted in the laboratory of the Department of Pathology at Burdwan Medical College, Burdwan in West Bengal during August 2011 to July 2012. Analysis of semen was done for semen volume, sperm number, sperm motility and presence of other cells. Results: 7.45% samples were of inadequate quantity. 19.87 % of cases had oligozoospermia, 12.42% had azoospermia and 4.35% of males had asthenozoospermia. Pus cells were found in 12.42% cases. Conclusions: Majority of the cases of infertility in males is due to oligozoospermia followed by azoospermia while less sperm motility or less amount of semen are also responsible in some cases.
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Wed, 28 Jan 2015 04:43:23 GMT -08:00 http://www.scopemed.org/?mno=173507
Impairments in testicular function indices in male wistar rats: a possible mechanism for infertility induction by Xylopia aethiopica fruit extract http://www.scopemed.org/?mno=173188 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Ologhaguo Macstephen Adienbo, Arthur Nwafor, Datonye Victor Dapper.
Background: The accumulating evidence about alterations in male fertility necessitates the need to screen more medicinal plants for their effect on male reproductive functions. This study is aimed at evaluating the effects of fruit extract of Xylopia aethiopica on testicular functions in males using wistar rats as models. Methods: Forty eight adult male rats, randomly divided into four groups of 12 each, were used for the study. Group 1 (control), while groups 2, 3 and 4 (test groups). Daily oral doses of 0.5, 2.0 and 10.0 mg/kg b.w. of hydro-methanol extract were given to the test groups for 30 days followed by 30 days withdrawal. From each group, 6 animals were sacrificed on days 31 and 61 of the study and samples collected: Testes and epididymis were each weighed; blood was assayed for serum testosterone; testes processed for tissue biochemical studies. Results: Results show significant (P
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Wed, 28 Jan 2015 04:42:20 GMT -08:00 http://www.scopemed.org/?mno=173188
Prevalence and predictors of metabolic syndrome in women with polycystic ovarian syndrome: a study from Southern India http://www.scopemed.org/?mno=173846 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Jisha Varghese, Supriya Kantharaju, Suchitra Thunga, Nitin Joseph, Prakhar Kumar Singh.
Background: Metabolic syndrome (MBS) is a common disorder and is thought to be highly prevalent in polycystic ovarian syndrome (PCOS). The objectives were to find out the prevalence and predictors of metabolic syndrome in women with PCOS. Methods: Forty five women diagnosed with PCOS, underwent clinical and laboratory assessments for the diagnosis of metabolic syndrome, as per modified National Cholesterol Education Program’s Adult Treatment Panel III (NCEP ATP III criteria). Results: Twenty four (53.3%) subjects had metabolic syndrome. The prevalence of individual components of the metabolic syndrome among PCOS patients were: waist circumference ≥80 cm in 36 (86.6%), High Density Lipoprotein (HDL-C) less than 50 mg/dl in 42 (93.3%), triglycerides ≥150 mg/dl in 17 (37.8%), blood pressure ≥130/85 mmHg in 7 (15.6%), and fasting plasma glucose ≥100 mg/dl in 13 (28.8%). Subjects with MBS had significantly higher BMI compared to those without (P = 0.039). However, fasting insulin and free testosterone levels did not differ significantly between subjects with and without MBS. Conclusions: The metabolic syndrome and its individual components, waist circumference ≥80 cm in particular were found to be common among PCOS patients in this study. This along with high BMI being significantly associated with MBS suggests immediate need of interventions like lifestyle changes for prevention of MBS and other cardiovascular diseases. Also, as dyslipidemia was more common than impaired fasting glucose among PCOS patients, finding of one risk factor should prompt the clinician to search for other risk factors.
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Wed, 28 Jan 2015 04:41:13 GMT -08:00 http://www.scopemed.org/?mno=173846
To study the efficacy of digital and transvaginal ultrasonographic measurement of cervical length in asymptomatic high risk women at POG 16-24 weeks as a predictor of preterm delivery and progesterone and cerclage vs. progesterone alone for short cervical length in prevention of preterm labour http://www.scopemed.org/?mno=173002 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Richa Sharma, Santosh Minhas, Rajeev Sood.
Background: Objectives of current study were (i) To correlate the Cervical Length (CL) measured digitally and by transvaginal sonography (TVS) at 16 to 24 weeks with outcome of pregnancy (ii) Estimate risk of spontaneous preterm labour (PTL) based on CL measurements and (iii) study intervention in short CL and their effect on maternal and neonatal outcome. Methods: Women with singleton pregnancy at POG 16-24 weeks with history of previous preterm birth or mid trimester abortions were included in the study and subjected to digital assessment of CL followed by TVS measurement. In patients with TVS CL ≤25 mm, intervention in the form of progesterone or cerclage with progesterone was done. The outcome of the pregnancy in the form of delivery before completed 37 weeks or at and after 37 weeks was noted. Results: Twenty two subjects out of total 153 subjects (14.4%) had preterm delivery. The incidence of preterm delivery in study was 14.4%. Using Receiver Operating Characteristics (ROC) Curve, cut off value of digital CL was found to be 1.5 cm. The sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy of digital CL ≤1.5 cm in prediction of PTL were 72.7 %, 37.4%, 16.3%, 89.1% and 42.5% respectively. Cut off value of TVS CL by ROC curve was found to be 2.85 cm. The sensitivity, specificity, PPV, NPV and accuracy of CL (TVS) of ≤2.85 cm in prediction of PTL is 81.8%, 68.7%, 30.5%, 95.7%, 70.6% respectively. The outcome in form of PTL in 30 subjects, who had TVS CL ≤2.5 cm in both the intervention groups (McDonald stitch with progesterone and progesterone alone) was comparable (P value 0.60 not significant). Conclusions: The CL, both digitally and by TVS, was inversely correlated with the probability of preterm delivery so that the shorter the cervix, the greater the likelihood of preterm delivery. TVS CL is more predictive of preterm delivery than digital CL when performed between 16-24 weeks in asymptomatic high risk women. Intervention in short CL in form of McDonald’s stitch application with progesterone and progesterone alone have similar efficacy for prevention of PTL.
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Wed, 28 Jan 2015 04:40:27 GMT -08:00 http://www.scopemed.org/?mno=173002
Ruptured rudimentary horn pregnancy of unicornuate uterus: a case report http://www.scopemed.org/?mno=172872 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Lopamudra Jena, Rabi Narayan Satapathy, Sujata Swain, Purna Chandra Mahapatra.
Unicornuate uterus with rudimentary horn occurs due to failure of complete development of one of the Mullerian ducts and incomplete fusion with the contralateral side. Pregnancy in the noncommunicating rudimentary horn is extremely rare and usually terminates in rupture during first or second trimester of pregnancy. Pregnancy occurs via transperitoneal migration of sperm or zygote. Variable thickness of rudimentary horn musculature, poor distensibility of myometrium lead to rupture. This complication is usually seen in 2nd trimester resulting in shock and haemoperitoneum. Diagnosis of rudimentary horn pregnancy is difficult and can be missed in ultrasound. It requires a high risk of suspicion. We report a case of G2A1 with pregnancy of 20 weeks gestation which was suspected as intraabdominal pregnancy on ultrasound and on laparotomy a live fetus of 19 weeks in intact gestational sac was found in ruptured left noncommunication horn of unicornuate uterus with haemoperitoneum. Timely laparotomy, excision of the horn and blood transfusion saved the patient.
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Wed, 28 Jan 2015 04:39:37 GMT -08:00 http://www.scopemed.org/?mno=172872
Term live secondary abdominal pregnancy: a case report http://www.scopemed.org/?mno=172902 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Sujata Swain, Sasmita Behuria, Rabi Narayan Satpathy, Abarajda Venkatachalapathy, Purna Chandra Mahapatra.
An abdominal pregnancy is defined as an ectopic pregnancy that implants in the peritoneal cavity. Abdominal pregnancy is a rare form of ectopic pregnancy and is frequently misdiagnosed. Advanced abdominal pregnancy is a rare event, with high fetal and maternal morbidity and mortality. We report a case of abdominal pregnancy leading to a delivery of a healthy baby girl weighing 1.75 kg. A 35 year old woman, gravida 2 para 1 was referred from a private hospital as a case of term pregnancy with transverse lie, placenta praevia and severe oligohydraminos (AFI-3) with complaints of severe abdominal pain for one day. The patient suffered from recurrent abdominal pain with painful fetal movements throughout her pregnancy. Diagnosis was missed inspite of ultrasound examination. Intraoperatively it was diagnosed to be a case of abdominal pregnancy, where we delivered a healthy baby without any difficulty. Deattached placenta was removed in piecemeal. There occurred severe torrential bleeding was managed by peritoneal packing. Both mother & foetus survived due to timely management & quick surgical decision. Patient was followed regularly with serum β HCG level.
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Wed, 28 Jan 2015 04:39:01 GMT -08:00 http://www.scopemed.org/?mno=172902
Non decent vaginal hysterectomy: personal experience of 105 cases http://www.scopemed.org/?mno=172559 2015-01-29T02-16-32Z
Source: International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Suman Mehla, Nimmi Chutani, Monika Gupta.
Background: Objective of current study was to evaluate the feasibility of performing vaginal hysterectomy for non-prolapsed uterus as a primary route. Methods: A hospital based prospective study was conducted at department of obstetrics and gynaecology of SMS & R from 1st January 2011 to 31st August 2014. All the patients undergoing non-descent vaginal hysterectomy for benign indication, without suspected adnexal pathology were included in the study. Vaginal hysterectomy was done in usual manner. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing, or combination of these were used to remove the uterus. Data regarding age, parity, uterine size, estimated blood loss, length of operation, complication and hospital stay were recorded. Results: A total of 105 cases were selected for non-descent vaginal hysterectomy. All 105 cases successfully underwent non-descent vaginal hysterectomy. Commonest age group was (41-45 years) i.e. 48.6%. All patients were parous. Uterus size was 8 weeks in 33 cases. Commonest indication was AUB (45.7%). Mean duration of surgery was 90 minutes. Mean blood loss was 205 ml. The most common complication was post –operative pain in 21.9% of cases. Febrile morbidity was present in 9.5% of cases. Blood transfusion was required in 4 cases. Average duration of hospital stay was four days. Conclusions: Vaginal hysterectomy for benign gynecological causes other than prolapse is safe and feasible, more economical and effective. For successful outcome size of uterus, size in all dimensions and location of fibroid should be taken into consideration. Today in the era of minimally invasive surgery, non-descent vaginal hysterectomy needs to be considered and seems to be a safe option.
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Wed, 28 Jan 2015 04:38:28 GMT -08:00 http://www.scopemed.org/?mno=172559