Context: Accurate assessment of thyroid function during pregnancy is critical, for initiation of thyroid hormone therapy, as well as for adjustment of thyroid hormone dose in hypothyroid cases. Aims: ...We evaluated pregnant women who had no past history of thyroid disorders and studied their thyroid function in each trimester. Settings and Design: 86 normal pregnant women in the first trimester of pregnancy were selected for setting reference intervals. All were healthy, euthyroid and negative for thyroid peroxidase antibody (TPOAb). These women were serially followed throughout pregnancy. 124 normal nonpregnant subjects were selected for comparison. Material and methods: Thyrotropin (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and anti-TPO were measured using Roche Elecsys 1010 analyzer. Urinary iodine content was determined by simple microplate method. The 2.5th and 97.5th percentiles were calculated as the reference intervals for thyroid hormone levels during each trimester. Statistical Analysis: SPSS (version 14.0, SPSS Inc., Chicago, IL, USA) was used for data processing and analysis. Results: The reference intervals for the first, second and third trimesters for the following parameters: TSH 0.09-6.65, 0.51-6.66, 0.91-4.86 µ IU/mL, FT4 9.81-18.53, 8.52-19.43, 7.39-18.28 pM/L and FT3 3.1-6.35, 2.39-5.12, 2.57-5.68 pM/L respectively. Thyroid hormone concentrations significantly differed during pregnancy at different stages of gestation. The pregnant women in the study had median urinary iodine concentration of 150-200 µg/l during each trimester. Conclusions: The trimester-specific reference intervals for thyroid tests during pregnancy have been established for pregnant Indian women serially followed during pregnancy using 2.5th and 97.5th percentiles.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The objective of this study was to study the risk factors, management protocols, and the outcome of vulvar cancer cases over a period of 2 years in a tertiary care hospital. This is a case series of ...early-stage vulvar cancer in the Department of Surgical Oncology in BL Kapur Superspeciality Hospital from Jan 2016 to date. Five patients with histologically proven diagnosis of early-stage vulvar cancer were included. The mean age for the diagnosis of vulvar cancer was 58 years and the peak incidence was seen in postmenopausal age group. All of the cases were squamous cell carcinomas in stage IB except one which was a basisquamous variant. All cases were treated primarily with surgery and vulvar flap reconstruction. Adjuvant therapy was not given in any case. Cases were followed from 6 months to date, and no recurrence noted. The limitations of the study were rarity of disease and less number of cases. As all the cases in our study were in early stage of disease (stages I and II), surgical treatment in the form of modified radical vulvectomy with B/L inguinofemoral lymph node dissection and oncoplastic procedure was the treatment modality chosen for all the patients.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
ABSTRACT
Breast cancer related lymphedema (BCRL) is a chronic debilitating condition seen after treatment of breast cancer. The overall incidence varies from 20% to 56% in all patients treated for ...breast cancer. Every patient is at a lifelong risk for BCRL and the risk goes on increasing as the followup period increases. Locoregional treatment including surgery or radiotherapy is the most common risk factor for development of arm lymphedema. There are two phases of arm lymphedema. There is increased fluid accumulation in the fluid phase of lymphedema which later on goes into the solid phase where fat and fibrotic tissue is deposited in the subcutaneous tissue. The treatment of BCRL is a challenge both for the patient and the treating surgeon and it needs multidisciplinary team work to be successful. Non-surgical treatment modalities include complete decongestive therapy (CDT) and pneumatic compression therapy. Surgery for BCRL is usually undertaken as a salvage modality after failure of conservative approaches. The surgical spectrum for BCRL varies from extensive excisional operations which were commonly done in the past to newer methods like suction assisted protein lipectomy, lymphatic reconstruction and vascular lymph node transfer (VLNT) using super-microsurgical techniques. There is no consensus regarding the preference of one procedure over other due to lack of randomised control trials. It is however suggested to do lymphovenous anastomosis and complete decongestive therapy for early cases in fluid phase; while patients in the solid phase may be treated with a combination of liposuction with CDT or VLNT alone.
Background: The objective is to determine the knowledge, attitude and preventive practice of women above 45 years old. Methods: It is a cross-sectional analytical study of 100 women above 45 years of ...upper class women. The interview schedule consisted of 4 parts including questions about knowledge, attitude and practice (KAP) and also demographic questions. Results: A significant relationship between the score of preventive practice and all the following parameters was found: level of education, hearing about osteoporosis, knowledge score, perceived barrier to preventive actions and perceived seriousness of osteoporosis. Conclusions: Inaccurate or insufficient knowledge and their negative attitude to the preventive actions and their weak practice in case of prevention, it is the responsibility of health policymakers and medical associations to plan for osteoporosis education and prevention initiatives. Keywords: Attitude, Knowledge, Osteoporosis
Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy. Aim of this study was to identify thyroid dysfunction as a maternal health problem. Objective of this ...study was to study the maternal outcomes in these patients. Methods: The main source of data are the patients admitted in Sultania Zanana Hospital, GMC Bhopal. The study was an observational prospective study conducted from March 2018 to February 2019. Results: The present study was conducted in department of obstetrics and gynecology, Gandhi Medical College and associated Sultania Zanana Hospital Bhopal for the period of 1 year. The study could enroll 400 females fulfilling the inclusion criteria during the study period. Conclusions: In developing countries like India where there is prominent micronutrient deficiency, iodine deficiency further aggravates the condition and carries a great potential to show deleterious impacts on maternal and fetal outcomes, thus serving a major health problem. Considering the substantial increase in short term as well as long term perinatal morbidity, a felt need for creating awareness not only on adverse outcomes but also detection of the disorder in first trimester is required. The desired perinatal outcome can be achieved by early detection and prompt treatment of the disorder. Henceforth, universal screening of all antenatal women in the first trimester rather than targeted case finding should be recommended at all the health care facilities. Keywords: Antenatal, Hypothyroidism, Maternal, Outcomes, Thyroid dysfunction
Pancreatitis and pseudo-pancreatic cysts are frequently encountered entities; however, intrahepatic pseudocysts presenting as large number of liver cysts with absence of overt signs of pancreatitis ...has never been reported in literature. Here, we report an interesting case of multiple intrahepatic pancreatic pseudocysts (MIHPPs), a challenging diagnosis to be kept in mind while dealing with complex cystic lesions of liver. Pseudocysts are common complication of pancreatitis, often these are located within the vicinity of the pancreas in the lesser sac and the retroperitoneum. Extra pancreatic location of these cysts within the liver is a diagnosis often missed, with only 50 odd cases reported in literature till date. Most of these reported cases are either subcapsular in location or limited in number to one or two lesions. Although rare, possibility of MIHPPs is an important diagnosis that should be kept in mind while considering list of differentials for complex cystic lesions of the liver even in the absence of overt signs of pancreatitis.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Background: Anemia during pregnancy is a global public health challenge facing the world today. Among the South Asian countries, WHO estimate that India has the highest prevalence of anemia in ...pregnancy. Prevalence of anemia in pregnant Indian women is 49.7%, against the global prevalence of 41.8% (WHO 2008). In India, the prevalence of anemia is high because of ignorance, poverty, fewer intakes of iron, folic acid and food sources and gender bias significantly contribute to this high prevalence. Hence, this study aims to identify the risk factors and red cell morphological pattern that contribute to the presence and severity of anemia among pregnant women at the Sultania Zanana hospital, Gandhi Medical College Bhopal. Methods: The present study was conducted in Department of Obstetrics and Gynaecology, Sultania Zanana Hospital, Gandhi Medical College, Bhopal, Madhya Pradesh, India. The study included all pregnant women at third trimester who was admitted at Sultania Zanana hospital, Bhopal from January 2016 to December 2016 having haemoglobin level < 7 gm /dl. This is a Hospital- based Observational study. The sample size was calculated to be 500. Results: The following conclusion were drawn from this study. Poverty, early marriage, multiparity, poor nutrition, parasitic infections and lack of antenatal visits and antenatal care due to illiteracy and ignorance are probably the most important features responsible for severity of anemia. Maximum patients of anemia were in the age group of 21-35 Years. The majority of patients (62.8%) were rural. Majority of cases (65.4) belongs to low-socioeconomic class followed by (29.8%) belongs to middle socio-economic category. Most of the patients were multigravida (68.6%) most of them came from poor and illiterate class of society (74.2%) followed by women less than 20-year-old (18.8%). Majority of patients had education level (43.0%) below 10th standard. Conclusions: This study was undertaken to find out the various risk factors that contribute to the severity of anemia. Keywords: Pica, Pregnancy, Severe anaemia
Background: Anemia during pregnancy is a global public health challenge facing the world today. Among the South Asian countries, WHO estimate that India has the highest prevalence of anemia in ...pregnancy. Prevalence of anemia in pregnant Indian women is 49.7%, against the global prevalence of 41.8% (WHO 2008). In India, the prevalence of anemia is high because of ignorance, poverty, fewer intakes of iron, folic acid and food sources and gender bias significantly contribute to this high prevalence. Hence, this study aims to identify the risk factors and red cell morphological pattern that contribute to the presence and severity of anemia among pregnant women at the Sultania Zanana hospital, Gandhi Medical College Bhopal.Methods: The present study was conducted in Department of Obstetrics and Gynaecology, Sultania Zanana Hospital, Gandhi Medical College, Bhopal, Madhya Pradesh, India. The study included all pregnant women at third trimester who was admitted at Sultania Zanana hospital, Bhopal from January 2016 to December 2016 having haemoglobin level < 7 gm /dl. This is a Hospital- based Observational study. The sample size was calculated to be 500.Results: The following conclusion were drawn from this study. Poverty, early marriage, multiparity, poor nutrition, parasitic infections and lack of antenatal visits and antenatal care due to illiteracy and ignorance are probably the most important features responsible for severity of anemia. Maximum patients of anemia were in the age group of 21-35 Years. The majority of patients (62.8%) were rural. Majority of cases (65.4) belongs to low-socioeconomic class followed by (29.8%) belongs to middle socio-economic category. Most of the patients were multigravida (68.6%) most of them came from poor and illiterate class of society (74.2%) followed by women less than 20-year-old (18.8%). Majority of patients had education level (43.0%) below 10th standard.Conclusions: This study was undertaken to find out the various risk factors that contribute to the severity of anemia.
Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during the present pregnancy. It affects 7% of all ...pregnancies worldwide and in India it ranges from 6 to 9% in rural and 12 to 21% in urban area. The aim of this study was to compare the DIPSI criteria with the two-step method (Carpenter and Couston criteria.) and to study merits and demerits of one step and two step tests for GDM. Methods: A total 400 pregnant women of gestational age between 24-28 weeks attending antenatal clinic at this study tertiary care center were enrolled in this study. 200 pregnant women were enrolled in each of the study group (Group I OGTT and Group II DIPSI). Results: In Group I (OGTT) screening 47 (23.5%) were tested positive. In Group II cases, screening test results were found positive among 44 (22%). Out of 95 high-risk pregnant women 38 (40%) were positive for GDM by OGTT and 34 (35.78%) were positive by DIPSI. Out of 305 non high-risk pregnant women, 9 (2.95%) were positive for GDM by OGTT and 10 (3.27%) were positive by DIPSI. Conclusions: Present study concludes that DIPSI is the test which can predict GDM in population comparable to another test like OGTT. Also, India's major population reside in rural areas, ANC are mostly conducted by ANM, therefore screening test should be easy to perform and interpret. Keywords: Diabetes in pregnancy study group of India, Gestational diabetes mellitus, Oral glucose tolerance test, One step method, Two step method
PDF
