MANJARI HOTA - Academia.edu (original) (raw)
Papers by MANJARI HOTA
International journal of reproduction, contraception, obstetrics and gynecology, Apr 26, 2024
De Novo late postpartum preeclampsia is defined by many authors as new onset postpartum hypertens... more De Novo late postpartum preeclampsia is defined by many authors as new onset postpartum hypertension of ≥140/90 mmHg with features of organ system malfunctioning during 48 hours to six weeks of delivery following a normotensive pregnancy and labor. Though a lesser studied condition it is responsible for more number and increased severity of maternal morbidity, mortality, and cause of post-delivery hospital admission. Its exact cause is not yet clearly defined. The incidence is 0.3-27% as noted by many authors. Patients usually present on day 7-10 with severe headaches, neurological symptoms like visual disturbances; symptoms of other organ involvement, and high blood pressure. High suspicion leads to diagnosis. Primary investigations include that for preeclampsia. The principle of management is the reduction of blood pressure, prophylactic anticonvulsants, and diuretic is considered if there are features of fluid overload. She needs constant monitoring. Post delivery women, after discharge, do not avail of home blood pressure monitoring and even the symptoms, to start with are treated with over-the-counter medication. This leads to worsening of the condition. Our patient, a primipara reported to this hospital on the 38 th day of normal vaginal delivery following a normotensive pregnancy and delivery, with features of preeclampsia. The aim of publishing this case is for statistical records and create awareness of the condition. Every postpartum woman on discharge from the hospital following a normotensive pregnancy and delivery must be counseled on the significance of home BP monitoring and must consult an obstetrician on developing any new symptoms.
Folia Medica Indonesiana, Mar 10, 2024
Bleeding from the genital organ after a year of menopause is called postmenopausal bleeding. The ... more Bleeding from the genital organ after a year of menopause is called postmenopausal bleeding. The causes may be either benign or malignant, originating from genital (uterine or extrauterine) and extragenital sites. About 3% of postmenopausal women suffer from uterine cancer. This present study aimed to analyze the clinical significance of postmenopausal bleeding concerning the source, associated risk factors, and various endometrial pathologies, including malignant and premalignant conditions. This retrospective study was conducted over four years and featured postmenopausal bleeding patients who met the inclusion criteria. Different causes of bleeding were noted and managed. Data collection on the history, clinical examination, blood test, and endometrial biopsy was performed on women with endometrial bleeding. The collected data were analyzed using standard descriptive statistics and presented using frequency tables. A total of 88 women were admitted, of whom 73 (82.95%) had endometrial bleeding and 15 (17.05%) experienced bleeding from other sites. The endometrial bleeding group mostly consisted of women aged >50-60 years (45.20%). Hypertension (26.03%), diabetes (21.91%), obesity (43.83%), and nulliparous (5.48%) were the risk factors present among the patients. The majority of the patients (41.10%) were within five years of menopause. The transvaginal ultrasound findings indicated that 56.16% of the women had an endometrial thickness of >10 mm, while 9.59% had an endometrial thickness of ≤4 mm. Upon histological investigation, endometrial hyperplasia (34.24%), atrophy (38.36%), and cancer (4.11%) were detected. Furthermore, a prevalence of 16.44% was identified as proliferative endometrium, whereas polyps were found in 6.84% of cases. In conclusion, postmenopausal bleeding is mostly benign, but it may raise concerns about the possibility of malignancy, which can be distressing for women. Disregarding the amount and frequency, postmenopausal bleeding requires a thorough evaluation, primarily because adequate management can prevent the progression of many premalignant cases to be endometrial cancer.
Nepal Journal of Obstetrics and Gynaecology
Aims: To find the incidence, risk factors, morbidity and mortality in ectopic pregnancy in a tert... more Aims: To find the incidence, risk factors, morbidity and mortality in ectopic pregnancy in a tertiary center in rural Telangana. Methods: This retrospective observational study was conducted in the Department of Obstetrics and Gynecology, Mamata Medical College, Khammam, Telangana State, India, over 5 years from 2017 to 2021. Detailed informative data of all admitted and treated cases of ectopic pregnancy were collected, analyzed and discussed. Result: The incidence of ectopic pregnancy was 1.3 per 100 pregnancies and 2.5% case fatality. The majority of cases were in the 20-30 years of age group (82.5%); multipara (50%) and gestational age of ≤ 8 weeks (62.5%). History of abortion was the most common risk factor (67.5%). The classical triad of amenorrhoea, pain abdomen and bleeding per vagina was present in 45% of cases; and amenorrhea (97.5%), pain abdomen (87.5%) and vaginal bleeding (42.5%), abdominal tenderness (85%) and unstable hemodynamic (22.5%) were reported. The fallopian ...
Abdominal Scar Endometriosis as a Rare and Late Complication of Cesarean Section- Case Reports with Review of Literature
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH
Abdominal scar endometriosis is the commonest extra pelvic site of the pathology, which follows t... more Abdominal scar endometriosis is the commonest extra pelvic site of the pathology, which follows the surgery on the uterus and fallopian tubes. Cesarean section is the commonest such procedure. Very low incidence may be explained by the recently found pathogenesis of genetic, epigenetic, molecular, and immunological changes. Reporting is important for statistical records and varied presentations. The usual presentation of this chronic gynecological pathology is pain and swelling at the abdominal scar site. Its diagnosis is clinical, complimented with Ultrasound and management is surgical excision. We present two post-cesarean cases with localized swelling and pain in the abdominal scar. Both were treated with wide excision of the lesion; the diagnosis was conrmed and malignancy was excluded by histopathology. No recurrence was noted on follow up. This chronic, progressive pain full condition needs prompt diagnosis and management. Patient counseling is mandatory as recurrence and the...
Journal of South Asian Federation of Obstetrics and Gynaecology
Background: Increasing the cesarean section rate with its complications is a global concern now. ... more Background: Increasing the cesarean section rate with its complications is a global concern now. High economical background, education, limited family size, comfort of both; the patient and the care provider as well as the availability of facility and advanced technology are the responsible factors for the high rate of the surgery. In an attempt to reduce the rate, World Health Organization (WHO) has introduced Robson's Ten-group Classification System (RTGCS) for auditing, analyzing, and finding the largest contributor to the surgery so that steps can be taken to limit it. Aims: (i) Finding out the group contributing more to the total cesarean section. (ii) Discussing the possible remedial measures to reduce the rate of the surgery. Materials and methods: This retrospective study was conducted in the Obstetrics and Gynaecology Department of Mamata Medical College, Khammam, Telangana State, India, over 5 years period, which included all the cesarean deliveries at and beyond 28 completed weeks of gestation. Results: Total cesarean deliveries were 778 and the rate of cesarean section was 31.39% of total deliveries. Group X of RTGCS had a maximum contribution (31.10%) followed by group V (29.43%), group II (20.95%), and group I (06.68%) to the total cesarean deliveries. Conclusion: Robson's ten-group classification system, as the preliminary step in reducing the rate of cesarean delivery, is good to find the maximum contributors to the surgery. Detailed auditing and analysis will help to limit the rate of surgery by taking necessary steps, without affecting the mother and the baby. The role of the institution and care provider is important in the success of the mission. Clinical significance: Attempt to reduce the rate of the cesarean section without compromising pregnancy outcome.
Sickle cell disease complicating pregnancy: A retrospective study
Journal of Dr. NTR University of Health Sciences, 2017
Introduction: Sickle cell disease is an uncommon cause of anemia and jaundice during pregnancy. S... more Introduction: Sickle cell disease is an uncommon cause of anemia and jaundice during pregnancy. Sickle cell crisis may lead to several maternal and fetal complications. Aims: To study maternal and fetal complications in pregnant patients with sickle cell disease. Settings and Design: Retrospective study was carried out from case records at Mamata Medical College over a period of five years from July 2011 to June 2016. Patients and Methods: Among 17 pregnancies in 12 cases, we studied the baseline characteristics of study population, frequency of sickle hemoglobin variants, and complications to mother and baby. Statistical Analysis Used: Compiled data was analyzed by simple descriptive statistics and frequency tables. Results: Most cases were primigravida (58.3%). Most common presenting features were anemia and jaundice (hemolytic crisis, 70.58%) and bone and joint pains (painful crises, 41.17%). Acute chest syndrome was seen in 5.88% of the patients. Pregnancies were complicated by severe anemia (Hb Discussion: Because of hematological changes, extra demands, and sickle crisis, complications to both mother and fetus are more common in sickle cell anemia during pregnancy than in non-pregnant state. Conclusions: Although sickle cell anemia during pregnancy is usually associated with complications, prompt recognition and careful management reduces morbidity and mortality associated with them.
Scholars International Journal of Obstetrics and Gynecology, 2020
Background: Pre-eclampsia affects up to 10% pregnancies worldwide and is one of the foremost caus... more Background: Pre-eclampsia affects up to 10% pregnancies worldwide and is one of the foremost causes of poor maternal and foetal outcome. The situation in India is even grave with high rate of maternal mortality due to pre-eclampsia. Though multiple risk factors are associated with pre-eclampsia, it is known that first pregnancy itself is a significant preeclamptic risk factor. Therefore, in this study we intent to gauge the effects of low dose Acetyl salicylic acid (Aspirin) among pregnant women in prevention of pre-eclampsia. Materials and Methods: This randomized controlled study was conducted in Department of Obstetrics and Gynaecology of Mamata Medical College and General Hospital. Total 100 patients were enrolled in this study. Pregnant women with and without any other pre-eclamptic risk factor consulting before the 16th week of amenorrhea were selected in the study. One group i.e. Treatment group (n=50) was given 75mg/day aspirin orally after breakfast to one week before estimated date of delivery while the other group received no aspirin. Both groups were followed for regular antenatal checkup. Results: The treatment group who received acetyl salicylic acid (aspirin), the age ranged from 20-35 years with a mean age of 24.81±3.12 years. Maximum number of cases belonged wot age group of 26-30 years. The treatment group who received acetyl salicylic acid (aspirin), the age ranged from 20-35 years with a mean age of 25.21±4.29 years. Moreover, we found pre-eclampsia in aspirin group was of lesser severity as compared to those in control group. Further, proportion wise the risk of pregnancy induced hypertension and eclampsia were also reduced with aspirin, however, these were not found statistically significant. Conclusion: Our study highlights the beneficial effect of low-dose acetyl salicylic acid in decreasing hypertension and proteinuria. This study also confirms the efficacy of acetyl salicylic acid in decreasing caesarean section, maternal mortality and morbidity.
Newborn birth weight in normal pregnancy in rural Telangana
Journal of Dr. NTR University of Health Sciences, 2017
Introduction: Newborn birth weight is a major indicator of health. Although it is influenced by m... more Introduction: Newborn birth weight is a major indicator of health. Although it is influenced by many conditions that affect maternal and feto-placental units, several sociocultural, religious, and geographical factors cannot be ignored. Considering this, the present study was conducted in a tertiary hospital in Khammam, Telangana to determine the average birth weight in normal pregnancy at term. Materials and Methods: All the babies, born following normal pregnancy from January 2013 to June 2015, were included in this study to establish their birth weight. Babies born without being affected by any factor influencing fetal weight were considered for the study. Some exclusion criteria such as short maternal height and teenage pregnancy were considered in this study. Results: There were 633 cases in the study group, out of which 226 were primipara and 407 were multipara. Average birth weight for all cases was 2790 g. Average birth weight for the first born babies was 2770 g, whereas in later born, it was 2800 g. Average birth weight of male newborn babies was 2860 g, whereas it was 2710 g for female newborn babies. Conclusion: Abnormal birth weight leads to many complications, both immediate and remote. However, to predict and manage such complications, one must know the average newborn birth weight. This study is the first of its kind in rural Telangana.
Bali Medical Journal, 2015
Ovarian cyst in pregnancy may have a poor feto-maternal outcome. A 25 year old multi gravida, pos... more Ovarian cyst in pregnancy may have a poor feto-maternal outcome. A 25 year old multi gravida, post caesarean pregnancy at term reported with antenatal ultrasonography (USG) diagnosis of giant unilocular ovarian cyst and normal obstetrics findings. Elective lower segment caesarean section (LSCS) with left salpingo-oophorectomy and right partial salpingectomy was done. Left ovarian cyst was 29x20 cm in size with smooth surface, no adhesion, no free fluid in peritoneal cavity and a normal right ovary. Histopathological examination revealed mucinous cystadenoma of ovary. Post-operative period was uneventful. The rarity of the case and its successful management prompted us for reporting along with review of literatures.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Benign multicystic mesothelioma is a rare pathology that is usually diagnosed on laparotomy for o... more Benign multicystic mesothelioma is a rare pathology that is usually diagnosed on laparotomy for other abdominal diseases. It is more common in females of reproductive age group than in males. The commonest presentation is chronic pain abdomen. Ultrasound is the usual diagnostic tool and the ovarian cyst is the commonest differential diagnosis. Both, reactive and neoplastic hypotheses are considered in the etiopathogenesis of this condition. Management of the disease constitutes complete surgical excision and follow up of the patient. Our patient, a 33 years old parous lady, reported with chronic pain abdomen and right adnexal multiloculated cystic mass. She underwent laparotomy with a provisional diagnosis of ovarian cyst. Histopathology of the excised specimen was benign multicystic mesothelioma with ovarian endometriosis. This case was presented for its rare occurrence, mimicking malignancy, the chance of local recurrence and malignant transformation requiring long term follow up.
Bali Medical Journal, 2015
Background: Trauma to urinary bladder is the commonest cause of haematuria in repeat lower segmen... more Background: Trauma to urinary bladder is the commonest cause of haematuria in repeat lower segment caesarean section. However, recurrent post op haematuria draws the attention to other aetiologies. Case: A 27 year old lady, G2P1L1, post caesarean pregnancy at term gestation, underwent elective caesarean section and tubectomy. She developed haematuria in perioperative period in episodic manner. Abdominal and pelvic ultrasound revealed a solid mass lesion in the upper pole of right kidney of size 5.8x4.6mm, which was confirmed by CECT of abdomen to be renal cell carcinoma. She was managed with radical nephrectomy in the urology centre without any adverse event. This rare presentation of the case and its successful management, prompted us to present this case with available literatures review.
Clinical study of placenta previa in scarred and unscarred uterus
Journal of Dr. NTR University of Health Sciences, 2018
Background: Placenta previa complicates 0.3–0.5% of all pregnancies and is a major cause of third... more Background: Placenta previa complicates 0.3–0.5% of all pregnancies and is a major cause of third-trimester hemorrhage which is on the rise due to rise in incidence of cesarean sections. Significant maternal morbidity in form of increased incidence of fetal malpresentation, cesarean delivery, increased blood loss, and peripartum hysterectomy have been noted in cases of placenta previa and can lead to prolonged hospitalization in these women. Premature deliveries can occur which lead to higher admission to neonatal intensive care unit and stillbirths. Aim: To study all cases of placenta previa in scarred and unscarred uterus clinically. Materials and Methods: A retrospective study of 80 cases derived from case records, divided into two groups — A (scarred uterus) and B (unscarred uterus), was conducted in Department of Obstetrics and Gynecology at Mamata General Hospital, Khammam, over a period of 5 years from June 2011 to May 2016. Results: Incidence of placenta previa in scarred uterus (A) was 2.75% which was much higher than in unscarred uterus (B) - 1.4% [P value 0.001]. Anterior placenta was seen in 63.8% in group-A and 47.7% in group-B. P value for Type IIIA placenta previa was statistically significant [0.02]. Placenta was adherent in 13.9% of group-A and 4.5% of group-B. Obstetric hysterectomy was performed in 19.4% of group-A and 4.5% of group-B [P-value 0.01]. Conclusions: Incidence of placenta previa and its associated complications is definitely more in scarred group when compared to unscarred group although statistically significant values were obtained only in incidence of placenta previa, especially type III anterior and rate of hysterectomy.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Xanthomatous oophoritis is a rare chronic inflammation of ovary characterized histologically with... more Xanthomatous oophoritis is a rare chronic inflammation of ovary characterized histologically with infiltration of lipid laden foamy macrophages, lymphocytes, plasma cells leading to tissue destruction. Though exact cause is not known, uterine artery embolization, gloves dusting powder and altered lipid metabolism are hypothesized to cause the pathology. A 28-year-old parous lady with history of multiple laparotomies, known case of hypothyroidism under treatment and history of adequately treated pulmonary tuberculosis was diagnosed to have right ovarian dermoid cyst, while undergoing investigation for secondary infertility. On examination she had pallor, healthy abdominal scar, and small tender fixed mass in right fornix on internal examination. She was subjected to laparotomy and right salpingo oophorectomy with left salpingectomy was performed. Histopathological examination of the resected specimen revealed to be xanthomatous oophoritis of right ovary. As this condition mimics tube...
Bali Medical Journal, 2015
Background: The population of Iran is rapidly aging, and there is no specific housing policy and ... more Background: The population of Iran is rapidly aging, and there is no specific housing policy and urban space planning for the elderly. It is vital and necessary to consider urban space and residential environment in order to meet elderly' s different needs, preferences, desires, and aspirations to maintain and improve their quality of life (QOL). Aim: This study aims to evaluate the aging urban space and residential preference because urban space situation influences the residential satisfaction that leads to the quality of life. Methods: In this study, 400 old adults residing in Karaj, Iran were surveyed. Independent sample t-test was used to examine the relationship between socio-demographic factors and urban space preferences. Results: There are no differences among genders for urban space preferences, but there are differences in marital status for urban space preferences among elderlies in Karaj, Iran. The results also showed that most participants emphasized Convenience, Accessibility followed by Safety, and Citizen Participation. Conclusion: Marital status was found to play a significant role in urban space preferences.
International journal of reproduction, contraception, obstetrics and gynecology, Apr 26, 2024
De Novo late postpartum preeclampsia is defined by many authors as new onset postpartum hypertens... more De Novo late postpartum preeclampsia is defined by many authors as new onset postpartum hypertension of ≥140/90 mmHg with features of organ system malfunctioning during 48 hours to six weeks of delivery following a normotensive pregnancy and labor. Though a lesser studied condition it is responsible for more number and increased severity of maternal morbidity, mortality, and cause of post-delivery hospital admission. Its exact cause is not yet clearly defined. The incidence is 0.3-27% as noted by many authors. Patients usually present on day 7-10 with severe headaches, neurological symptoms like visual disturbances; symptoms of other organ involvement, and high blood pressure. High suspicion leads to diagnosis. Primary investigations include that for preeclampsia. The principle of management is the reduction of blood pressure, prophylactic anticonvulsants, and diuretic is considered if there are features of fluid overload. She needs constant monitoring. Post delivery women, after discharge, do not avail of home blood pressure monitoring and even the symptoms, to start with are treated with over-the-counter medication. This leads to worsening of the condition. Our patient, a primipara reported to this hospital on the 38 th day of normal vaginal delivery following a normotensive pregnancy and delivery, with features of preeclampsia. The aim of publishing this case is for statistical records and create awareness of the condition. Every postpartum woman on discharge from the hospital following a normotensive pregnancy and delivery must be counseled on the significance of home BP monitoring and must consult an obstetrician on developing any new symptoms.
Folia Medica Indonesiana, Mar 10, 2024
Bleeding from the genital organ after a year of menopause is called postmenopausal bleeding. The ... more Bleeding from the genital organ after a year of menopause is called postmenopausal bleeding. The causes may be either benign or malignant, originating from genital (uterine or extrauterine) and extragenital sites. About 3% of postmenopausal women suffer from uterine cancer. This present study aimed to analyze the clinical significance of postmenopausal bleeding concerning the source, associated risk factors, and various endometrial pathologies, including malignant and premalignant conditions. This retrospective study was conducted over four years and featured postmenopausal bleeding patients who met the inclusion criteria. Different causes of bleeding were noted and managed. Data collection on the history, clinical examination, blood test, and endometrial biopsy was performed on women with endometrial bleeding. The collected data were analyzed using standard descriptive statistics and presented using frequency tables. A total of 88 women were admitted, of whom 73 (82.95%) had endometrial bleeding and 15 (17.05%) experienced bleeding from other sites. The endometrial bleeding group mostly consisted of women aged >50-60 years (45.20%). Hypertension (26.03%), diabetes (21.91%), obesity (43.83%), and nulliparous (5.48%) were the risk factors present among the patients. The majority of the patients (41.10%) were within five years of menopause. The transvaginal ultrasound findings indicated that 56.16% of the women had an endometrial thickness of >10 mm, while 9.59% had an endometrial thickness of ≤4 mm. Upon histological investigation, endometrial hyperplasia (34.24%), atrophy (38.36%), and cancer (4.11%) were detected. Furthermore, a prevalence of 16.44% was identified as proliferative endometrium, whereas polyps were found in 6.84% of cases. In conclusion, postmenopausal bleeding is mostly benign, but it may raise concerns about the possibility of malignancy, which can be distressing for women. Disregarding the amount and frequency, postmenopausal bleeding requires a thorough evaluation, primarily because adequate management can prevent the progression of many premalignant cases to be endometrial cancer.
Nepal Journal of Obstetrics and Gynaecology
Aims: To find the incidence, risk factors, morbidity and mortality in ectopic pregnancy in a tert... more Aims: To find the incidence, risk factors, morbidity and mortality in ectopic pregnancy in a tertiary center in rural Telangana. Methods: This retrospective observational study was conducted in the Department of Obstetrics and Gynecology, Mamata Medical College, Khammam, Telangana State, India, over 5 years from 2017 to 2021. Detailed informative data of all admitted and treated cases of ectopic pregnancy were collected, analyzed and discussed. Result: The incidence of ectopic pregnancy was 1.3 per 100 pregnancies and 2.5% case fatality. The majority of cases were in the 20-30 years of age group (82.5%); multipara (50%) and gestational age of ≤ 8 weeks (62.5%). History of abortion was the most common risk factor (67.5%). The classical triad of amenorrhoea, pain abdomen and bleeding per vagina was present in 45% of cases; and amenorrhea (97.5%), pain abdomen (87.5%) and vaginal bleeding (42.5%), abdominal tenderness (85%) and unstable hemodynamic (22.5%) were reported. The fallopian ...
Abdominal Scar Endometriosis as a Rare and Late Complication of Cesarean Section- Case Reports with Review of Literature
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH
Abdominal scar endometriosis is the commonest extra pelvic site of the pathology, which follows t... more Abdominal scar endometriosis is the commonest extra pelvic site of the pathology, which follows the surgery on the uterus and fallopian tubes. Cesarean section is the commonest such procedure. Very low incidence may be explained by the recently found pathogenesis of genetic, epigenetic, molecular, and immunological changes. Reporting is important for statistical records and varied presentations. The usual presentation of this chronic gynecological pathology is pain and swelling at the abdominal scar site. Its diagnosis is clinical, complimented with Ultrasound and management is surgical excision. We present two post-cesarean cases with localized swelling and pain in the abdominal scar. Both were treated with wide excision of the lesion; the diagnosis was conrmed and malignancy was excluded by histopathology. No recurrence was noted on follow up. This chronic, progressive pain full condition needs prompt diagnosis and management. Patient counseling is mandatory as recurrence and the...
Journal of South Asian Federation of Obstetrics and Gynaecology
Background: Increasing the cesarean section rate with its complications is a global concern now. ... more Background: Increasing the cesarean section rate with its complications is a global concern now. High economical background, education, limited family size, comfort of both; the patient and the care provider as well as the availability of facility and advanced technology are the responsible factors for the high rate of the surgery. In an attempt to reduce the rate, World Health Organization (WHO) has introduced Robson's Ten-group Classification System (RTGCS) for auditing, analyzing, and finding the largest contributor to the surgery so that steps can be taken to limit it. Aims: (i) Finding out the group contributing more to the total cesarean section. (ii) Discussing the possible remedial measures to reduce the rate of the surgery. Materials and methods: This retrospective study was conducted in the Obstetrics and Gynaecology Department of Mamata Medical College, Khammam, Telangana State, India, over 5 years period, which included all the cesarean deliveries at and beyond 28 completed weeks of gestation. Results: Total cesarean deliveries were 778 and the rate of cesarean section was 31.39% of total deliveries. Group X of RTGCS had a maximum contribution (31.10%) followed by group V (29.43%), group II (20.95%), and group I (06.68%) to the total cesarean deliveries. Conclusion: Robson's ten-group classification system, as the preliminary step in reducing the rate of cesarean delivery, is good to find the maximum contributors to the surgery. Detailed auditing and analysis will help to limit the rate of surgery by taking necessary steps, without affecting the mother and the baby. The role of the institution and care provider is important in the success of the mission. Clinical significance: Attempt to reduce the rate of the cesarean section without compromising pregnancy outcome.
Sickle cell disease complicating pregnancy: A retrospective study
Journal of Dr. NTR University of Health Sciences, 2017
Introduction: Sickle cell disease is an uncommon cause of anemia and jaundice during pregnancy. S... more Introduction: Sickle cell disease is an uncommon cause of anemia and jaundice during pregnancy. Sickle cell crisis may lead to several maternal and fetal complications. Aims: To study maternal and fetal complications in pregnant patients with sickle cell disease. Settings and Design: Retrospective study was carried out from case records at Mamata Medical College over a period of five years from July 2011 to June 2016. Patients and Methods: Among 17 pregnancies in 12 cases, we studied the baseline characteristics of study population, frequency of sickle hemoglobin variants, and complications to mother and baby. Statistical Analysis Used: Compiled data was analyzed by simple descriptive statistics and frequency tables. Results: Most cases were primigravida (58.3%). Most common presenting features were anemia and jaundice (hemolytic crisis, 70.58%) and bone and joint pains (painful crises, 41.17%). Acute chest syndrome was seen in 5.88% of the patients. Pregnancies were complicated by severe anemia (Hb Discussion: Because of hematological changes, extra demands, and sickle crisis, complications to both mother and fetus are more common in sickle cell anemia during pregnancy than in non-pregnant state. Conclusions: Although sickle cell anemia during pregnancy is usually associated with complications, prompt recognition and careful management reduces morbidity and mortality associated with them.
Scholars International Journal of Obstetrics and Gynecology, 2020
Background: Pre-eclampsia affects up to 10% pregnancies worldwide and is one of the foremost caus... more Background: Pre-eclampsia affects up to 10% pregnancies worldwide and is one of the foremost causes of poor maternal and foetal outcome. The situation in India is even grave with high rate of maternal mortality due to pre-eclampsia. Though multiple risk factors are associated with pre-eclampsia, it is known that first pregnancy itself is a significant preeclamptic risk factor. Therefore, in this study we intent to gauge the effects of low dose Acetyl salicylic acid (Aspirin) among pregnant women in prevention of pre-eclampsia. Materials and Methods: This randomized controlled study was conducted in Department of Obstetrics and Gynaecology of Mamata Medical College and General Hospital. Total 100 patients were enrolled in this study. Pregnant women with and without any other pre-eclamptic risk factor consulting before the 16th week of amenorrhea were selected in the study. One group i.e. Treatment group (n=50) was given 75mg/day aspirin orally after breakfast to one week before estimated date of delivery while the other group received no aspirin. Both groups were followed for regular antenatal checkup. Results: The treatment group who received acetyl salicylic acid (aspirin), the age ranged from 20-35 years with a mean age of 24.81±3.12 years. Maximum number of cases belonged wot age group of 26-30 years. The treatment group who received acetyl salicylic acid (aspirin), the age ranged from 20-35 years with a mean age of 25.21±4.29 years. Moreover, we found pre-eclampsia in aspirin group was of lesser severity as compared to those in control group. Further, proportion wise the risk of pregnancy induced hypertension and eclampsia were also reduced with aspirin, however, these were not found statistically significant. Conclusion: Our study highlights the beneficial effect of low-dose acetyl salicylic acid in decreasing hypertension and proteinuria. This study also confirms the efficacy of acetyl salicylic acid in decreasing caesarean section, maternal mortality and morbidity.
Newborn birth weight in normal pregnancy in rural Telangana
Journal of Dr. NTR University of Health Sciences, 2017
Introduction: Newborn birth weight is a major indicator of health. Although it is influenced by m... more Introduction: Newborn birth weight is a major indicator of health. Although it is influenced by many conditions that affect maternal and feto-placental units, several sociocultural, religious, and geographical factors cannot be ignored. Considering this, the present study was conducted in a tertiary hospital in Khammam, Telangana to determine the average birth weight in normal pregnancy at term. Materials and Methods: All the babies, born following normal pregnancy from January 2013 to June 2015, were included in this study to establish their birth weight. Babies born without being affected by any factor influencing fetal weight were considered for the study. Some exclusion criteria such as short maternal height and teenage pregnancy were considered in this study. Results: There were 633 cases in the study group, out of which 226 were primipara and 407 were multipara. Average birth weight for all cases was 2790 g. Average birth weight for the first born babies was 2770 g, whereas in later born, it was 2800 g. Average birth weight of male newborn babies was 2860 g, whereas it was 2710 g for female newborn babies. Conclusion: Abnormal birth weight leads to many complications, both immediate and remote. However, to predict and manage such complications, one must know the average newborn birth weight. This study is the first of its kind in rural Telangana.
Bali Medical Journal, 2015
Ovarian cyst in pregnancy may have a poor feto-maternal outcome. A 25 year old multi gravida, pos... more Ovarian cyst in pregnancy may have a poor feto-maternal outcome. A 25 year old multi gravida, post caesarean pregnancy at term reported with antenatal ultrasonography (USG) diagnosis of giant unilocular ovarian cyst and normal obstetrics findings. Elective lower segment caesarean section (LSCS) with left salpingo-oophorectomy and right partial salpingectomy was done. Left ovarian cyst was 29x20 cm in size with smooth surface, no adhesion, no free fluid in peritoneal cavity and a normal right ovary. Histopathological examination revealed mucinous cystadenoma of ovary. Post-operative period was uneventful. The rarity of the case and its successful management prompted us for reporting along with review of literatures.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Benign multicystic mesothelioma is a rare pathology that is usually diagnosed on laparotomy for o... more Benign multicystic mesothelioma is a rare pathology that is usually diagnosed on laparotomy for other abdominal diseases. It is more common in females of reproductive age group than in males. The commonest presentation is chronic pain abdomen. Ultrasound is the usual diagnostic tool and the ovarian cyst is the commonest differential diagnosis. Both, reactive and neoplastic hypotheses are considered in the etiopathogenesis of this condition. Management of the disease constitutes complete surgical excision and follow up of the patient. Our patient, a 33 years old parous lady, reported with chronic pain abdomen and right adnexal multiloculated cystic mass. She underwent laparotomy with a provisional diagnosis of ovarian cyst. Histopathology of the excised specimen was benign multicystic mesothelioma with ovarian endometriosis. This case was presented for its rare occurrence, mimicking malignancy, the chance of local recurrence and malignant transformation requiring long term follow up.
Bali Medical Journal, 2015
Background: Trauma to urinary bladder is the commonest cause of haematuria in repeat lower segmen... more Background: Trauma to urinary bladder is the commonest cause of haematuria in repeat lower segment caesarean section. However, recurrent post op haematuria draws the attention to other aetiologies. Case: A 27 year old lady, G2P1L1, post caesarean pregnancy at term gestation, underwent elective caesarean section and tubectomy. She developed haematuria in perioperative period in episodic manner. Abdominal and pelvic ultrasound revealed a solid mass lesion in the upper pole of right kidney of size 5.8x4.6mm, which was confirmed by CECT of abdomen to be renal cell carcinoma. She was managed with radical nephrectomy in the urology centre without any adverse event. This rare presentation of the case and its successful management, prompted us to present this case with available literatures review.
Clinical study of placenta previa in scarred and unscarred uterus
Journal of Dr. NTR University of Health Sciences, 2018
Background: Placenta previa complicates 0.3–0.5% of all pregnancies and is a major cause of third... more Background: Placenta previa complicates 0.3–0.5% of all pregnancies and is a major cause of third-trimester hemorrhage which is on the rise due to rise in incidence of cesarean sections. Significant maternal morbidity in form of increased incidence of fetal malpresentation, cesarean delivery, increased blood loss, and peripartum hysterectomy have been noted in cases of placenta previa and can lead to prolonged hospitalization in these women. Premature deliveries can occur which lead to higher admission to neonatal intensive care unit and stillbirths. Aim: To study all cases of placenta previa in scarred and unscarred uterus clinically. Materials and Methods: A retrospective study of 80 cases derived from case records, divided into two groups — A (scarred uterus) and B (unscarred uterus), was conducted in Department of Obstetrics and Gynecology at Mamata General Hospital, Khammam, over a period of 5 years from June 2011 to May 2016. Results: Incidence of placenta previa in scarred uterus (A) was 2.75% which was much higher than in unscarred uterus (B) - 1.4% [P value 0.001]. Anterior placenta was seen in 63.8% in group-A and 47.7% in group-B. P value for Type IIIA placenta previa was statistically significant [0.02]. Placenta was adherent in 13.9% of group-A and 4.5% of group-B. Obstetric hysterectomy was performed in 19.4% of group-A and 4.5% of group-B [P-value 0.01]. Conclusions: Incidence of placenta previa and its associated complications is definitely more in scarred group when compared to unscarred group although statistically significant values were obtained only in incidence of placenta previa, especially type III anterior and rate of hysterectomy.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Xanthomatous oophoritis is a rare chronic inflammation of ovary characterized histologically with... more Xanthomatous oophoritis is a rare chronic inflammation of ovary characterized histologically with infiltration of lipid laden foamy macrophages, lymphocytes, plasma cells leading to tissue destruction. Though exact cause is not known, uterine artery embolization, gloves dusting powder and altered lipid metabolism are hypothesized to cause the pathology. A 28-year-old parous lady with history of multiple laparotomies, known case of hypothyroidism under treatment and history of adequately treated pulmonary tuberculosis was diagnosed to have right ovarian dermoid cyst, while undergoing investigation for secondary infertility. On examination she had pallor, healthy abdominal scar, and small tender fixed mass in right fornix on internal examination. She was subjected to laparotomy and right salpingo oophorectomy with left salpingectomy was performed. Histopathological examination of the resected specimen revealed to be xanthomatous oophoritis of right ovary. As this condition mimics tube...
Bali Medical Journal, 2015
Background: The population of Iran is rapidly aging, and there is no specific housing policy and ... more Background: The population of Iran is rapidly aging, and there is no specific housing policy and urban space planning for the elderly. It is vital and necessary to consider urban space and residential environment in order to meet elderly' s different needs, preferences, desires, and aspirations to maintain and improve their quality of life (QOL). Aim: This study aims to evaluate the aging urban space and residential preference because urban space situation influences the residential satisfaction that leads to the quality of life. Methods: In this study, 400 old adults residing in Karaj, Iran were surveyed. Independent sample t-test was used to examine the relationship between socio-demographic factors and urban space preferences. Results: There are no differences among genders for urban space preferences, but there are differences in marital status for urban space preferences among elderlies in Karaj, Iran. The results also showed that most participants emphasized Convenience, Accessibility followed by Safety, and Citizen Participation. Conclusion: Marital status was found to play a significant role in urban space preferences.