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Rani J.,Government Medical College and Hospital | Sharma D.,Patna Medical College and Hospital | Sehgal A.,Government Medical College and Hospital
Archives of Gynecology and Obstetrics | Year: 2014

Background Cervical dilatation documented on partogram indicates expected rate of progress of labour and deviations from alert line indicates abnormal progress of labour. Its early detection and timely intervention can reduce fetomaternal morbidity. Purpose To study the role of partogram in the management of labouring mothers with high risk pregnancies at a tertiary care centre. Method Four hundred primigravidas with high risk pregnancies in active labour (with cervical dilatation ≥ 4 cm) were studied, divided into two groups as Partogram and no Partogram group and each group consisted of 200 patients. In Partogram group, progress of labour was documented on modified WHO partograph along with the notes on progress sheet of case record file while by standard notes only in no Partogram group. Cases included were pregnancy-induced hypertension, gestational diabetes mellitus, cholestasis, hypothyroidism, history of previous one LSCS for trial of labour, postdated pregnancy. Management of labour was standardised using set protocols of intrapartum care followed by analysis of duration of labour, rate of intervention, maternal and perinatal outcomes in both group. Result Though percentage of normal vaginal delivery was higher in Partogram group (71.5 %) than no Partogram group (68 %), no statistically significant difference was found between two groups regarding mean duration of active phase of first and second stage of labour, rate of operative vaginal deliveries (partogram 12 % and no partogram 12.5 %) and of caesarean section (Partogram 16.5 %, no Partogram 18.5 %) and perinatal outcome. Conclusion In this study, partogram had no significant impact on duration of labour, rate of operative interventions and perinatal outcome following its use in the labour management of high risk pregnancies. © 2014 Springer-Verlag Berlin Heidelberg.

Priyadarshi R.N.,Indira Gandhi Institute of Medical science | Anand U.,Indira Gandhi Institute of Medical science | Kumar B.,Indira Gandhi Institute of Medical science | Prakash V.,Patna Medical College and Hospital
Abdominal Imaging | Year: 2013

Wandering spleen is a rare occurrence. Torsion of the splenic pedicle is the major life-threatening complication of this entity. Preoperative diagnosis is based on radiological investigation. We report two consecutive cases, one adult and one child, in whom torsion in a wandering spleen was diagnosed based on a typical whirled appearance of the splenic vessels on computed tomography. We present a review of computed tomographic appearance of splenic torsion, and emphasize the "whirled appearance" as a specific sign for splenic torsion in wandering spleen. © 2012 Springer Science+Business Media, LLC.

Kumar M.,SGRR Institute of Medical and Health science | Kumari R.,SGRR Institute of Medical and Health science | Nigam P.N.,Patna Medical College and Hospital
Journal of Clinical and Diagnostic Research | Year: 2014

Background: Status epilepticus (SE) is a common, life threatening neurologic disorder that is essentially an acute, prolonged epileptic crisis. SE can represent an exacerbation of a pre-existing seizure disorder, the initial manifestation of a seizure disorder, or an insult other than a seizure disorder. Objectives: To study the aetiology, clinical profile, and outcome of SE in pediatric age group. Setting and study design: Prospective study at a tertiary care medical college hospital in Bihar, India. Materials and methods: Study was carried out for a period of one year (from April 2008 to March 2009). Seventy patients of SE in the age group of 6 month to 12 years were included in the study. Clinical history, general and systemic examination and relevant investigations along with pretested questionnaire were used to categorise different variables. Independent t-test was used for continuous variables and chi-square test for categorical variables. Results: Mean age for the study population was found to be 5.94 years (SD=3.152). Preponderance of male (60%) over female (40%) was observed. Aetiology included Idiopathic (27.14%), remote symptomatic (20%), acute symptomatic (47.14%), febrile (2.86%) and progressive encephalopathy (2.86%) groups. Generalised tonic clonic convulsion (GTC) convulsion was observed in 91.4% of SE patients while 8.6% had partial SE. Eighteen patients (25.7%) had prior history of convulsion whereas 52 patients (74.3%) presented with SE as first episode of convulsion. In our study, mortality rate was found to be 31.4% and acute symptomatic causes were responsible for most of the deaths. Conclusion: SE is a severe life threatening emergency with substantial morbidity and mortality. Patients with younger age and male sex are slightly more vulnerable to develop SE. Longer duration of SE and acute symptomatic aetiologies are independent predictors for poor outcome.

Kumar N.,Patna Medical College and Hospital | Kshitiz K.K.,Hospital and Research Institute | Patra S.K.,Lady Hardinge Medical College
International Journal of Pharma and Bio Sciences | Year: 2010

Diabetes mellitus is a group of metabolic disorder characterized by chronic hyperglycemia and disturbances of carbohydrate, fat and protein metabolism associated with absolute or relative insulin deficiency. The present study was carried out to establish a correlationship between hyperglycemia of varying intensity with hyperlipidemia in NIDDM patients taking oral hypoglycemic drugs. The objective of the work was to find out whether hyperlipidemia was affected due to administration of a particular group of hypoglycemic drug. The total numbers of patients under study were 36 and control group consisted of 15 persons. All the 36 cases were divided according to age groups, sex, socio-economic status and dietary habits. Patients were divided into three groups i) patients taking Sulfonylurea ii) patients taking Biguanides and iii) patients taking Thiazolidinedione group of oral hypoglycemic. A morning blood sample after overnight fast was collected and serum total cholesterol, HDL and LDL cholesterol, triglycerides and plasma glucose were estimated. From the present study it is clear that Biguanides are more effective than Sulphonylureas in improving lipid profile in NIDDM cases. Also, the study suggests that NIDDM patients on oral hypoglycemic drugs are not susceptible to develop coronary artery disease.

Arundhati,Mahavir Cancer Sansthan and Research Institute | Kumar A.,Indira Gandhi Institute of Medical science | Kumar R.,Patna Medical College and Hospital
Indian Journal of Hematology and Blood Transfusion | Year: 2011

Microfilariae in bone marrow aspirates have been reported occasionally, but until now no case has been reported in association with acute leukaemia. This is a unique finding, not mentioned in literature. Microfilariae are seen mainly in peripheral blood smears (PBS) and rarely in bone marrow aspirate, but this surprisingly did not show any parasite in PBS. Meticulous examination of bone marrow smears revealed acute lymphoblastic leukaemia and a few interspersed microfilariae. This rare combination, reported for the first time, definitely needs a space in literature. © Indian Society of Haematology & Transfusion Medicine 2011.

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