deepa kanagal - Academia.edu (original) (raw)

Papers by deepa kanagal

Journal of South Asian Federation of Obstetrics and Gynaecology, 2022

Aim: Intrapartum fetal hypoxia leads to neonatal morbidity and mortality. Though cardiotocography... more Aim: Intrapartum fetal hypoxia leads to neonatal morbidity and mortality. Though cardiotocography (CTG) plays an important role in detecting fetal hypoxia, it has high false-positive rate and is a poor predictor of acidosis. Umbilical artery pH identifies infants at risk for hypoxia and better predicts neonatal outcome. Hence the study was done to correlate nonreassuring CTG findings with umbilical artery pH and neonatal outcome. Materials and methods: The study included 255 pregnant women in labor with nonreassuring CTG. The findings were categorized as suspicious and pathological. Umbilical arterial cord blood analysis was done in all newborns. The umbilical arterial cord blood pH of <7.2 was defined as fetal acidosis. The correlation between CTG findings, cord blood pH, and neonatal outcome was recorded. Results: In the study, among 255 women, 54.9% had suspicious and 45.1% had pathological CTG. The rate of cesarean section, Apgar score, was similar in both the groups. Subjects with pathological CTG had more babies with low cord pH compared to suspicious CTG (62.6 vs 26.4%). 55% of babies with pH <7.2 needed neonatal intensive care unit (NICU) admission compared to 11.6% with normal pH. Babies born with pathological CTG and low cord pH were more likely to have NICU admission and other morbidities. Conclusion: Detection and management of fetal compromise at the earliest is of utmost importance. Though cardiotocography is a simple test to analyze fetal condition, it is a good practice to analyze umbilical cord blood pH to find neonates with acidosis and prevent complications. Clinical significance: The umbilical artery pH is a good predictor of adverse neonatal outcome and is a useful tool for screening newborns at risk. Also an umbilical cord pH less than 7.2 can be used as a prognostic factor for prediction of neonatal outcome. Our study is one of the very few studies that compare CTG findings based on National Institute for Health and Care Excellence (NICE) guidelines with umbilical artery pH and neonatal outcome.

Journal of Evolution of medical and Dental Sciences, 2014

INTRODUCTION: Reconstruction of lower 3rd of extremity poses great challenge to reconstructive su... more INTRODUCTION: Reconstruction of lower 3rd of extremity poses great challenge to reconstructive surgeon. Free flap coverage brings a striking difference in lower limb salvage. Lower extremity defects can be managed by direct closure, skin grafting, local flaps, cross leg flap and free flap. The versatility of free flaps in covering a defect of any size irrespective of their locality keeps them in the top rung of the reconstructive ladder. MATERIALS AND METHODS: We present a retrospective study of 12 patients who underwent free flap reconstruction for lower extremity defects between august 2012 to June 2014. Different flaps were chosen based on the size and location of the defect. Radial forearm flap was done in 6 patients, anterolateral thigh flap in 4, latissimus dorsi flap in 1 and free fibula flap in 1 patient with a success rate of 91.6%. CONCLUSION: Free flap is the most cost effective and stable solution for lower extremity reconstruction. It is the best solution to manage larg...

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2021

Background: Prediction of fetal weight is one of the methods towards effective management of preg... more Background: Prediction of fetal weight is one of the methods towards effective management of pregnancy and delivery. To assess and compare the accuracy of clinical and sonographic fetal weight estimation in predicting birth weight at term pregnancy, patients who were in latent or in active phase of labour. In the present study, an effort is made to compare two different clinical methods and USG and relate to the actual weight of the baby at birth.Methods: It is a prospective observational study of one hundred pregnant women satisfying the criteria, consenting for the study was recruited. Both USG and clinical methods will be done and compared with estimated the fetal weight. Weight of the baby at birth will be measured.Results: All the three methods had significant relationship with the baby weight. Percentage error was least with USG and the standard deviation of error was lower with Dare’s formula. The standard deviation was minimal for Dare`s formula EFW followed closely by USG.C...

Archives of Gynecology and Obstetrics, 2021

To assess the effectiveness of colposcopy in detecting cervical lesions and to grade them accordi... more To assess the effectiveness of colposcopy in detecting cervical lesions and to grade them according to Reid score and Swede score, and compare it with histopathology results. This study was conducted on 130 patients in a tertiary care centre, who were subjected to pap smear and colposcopy. The cervical lesions were graded according to Reid score and Swede score, and a biopsy was obtained from the lesion. Histopathology results were correlated with colposcopy findings, and the scores were compared. The colposcopic findings using Reid score and Swede score correlated with histopathology results in the study population. The association between colposcopic impression and histopathology result was highly significant (p < 0.001), using both Reid score and Swede score. The sensitivity, specificity, PPV and NPV of Reid score (overall) was 86.2%, 80.20%, 55.56% and 95.3%, respectively. The diagnostic accuracy was 81.54%. At score > 5, specificity increased to 99% and diagnostic accuracy was 92.31%. The overall sensitivity, specificity, PPV, NPV and diagnostic accuracy of Swede score was 89.7%, 49.5%, 33.8%, 94.3% and 48.46%, respectively. As the cut off value increased, the sensitivity decreased. But the specificity, PPV, NPV and diagnostic accuracy increased and was statistically significant. The specificity and PPV was 100% at score > 8. As the cut off value increased, the diagnostic accuracy of both the Scores increased, and was more accurate in detecting high-grade lesions.

Journal of Health and Allied Sciences NU, 2012

Meigs' syndrome is a rare but well known syndrome defined as the association of ascites, pleu... more Meigs' syndrome is a rare but well known syndrome defined as the association of ascites, pleural effusion and a benign solid ovarian tumor usually a fibroma in which tumor removal leads to complete resolution of pleural and peritoneal effusions. We report a case of Meigs' syndrome in a post menopausal woman which mimicked ovarian malignancy creating a diagnostic dilemma where the lady had complete recovery after surgery. Considering the good prognosis of Meigs' syndrome, prompt and accurate diagnosis is necessary to differentiate the syndrome from other ovarian malignancies.

Journal of Medical Science And clinical Research, 2015

Swyer syndrome, which is pure XY gonadal dysgenesis, is an extremely rare condition, presents wit... more Swyer syndrome, which is pure XY gonadal dysgenesis, is an extremely rare condition, presents with primary amenorrhea, female phenotype and male genotype with fibrous streak gonads. We report a case of Swyer syndrome in a 20 year old girl who presented with primary amenorrhoea and poorly developed secondary sexual characters. Investigations revealed normal thyroid and prolactin levels, high levels of gonadotropins and low levels of estrogen and testosterone. Karyotyping revealed 46 XY. After counseling, the girl underwent diagnostic laparoscopy and bilateralgonadectomy in view of high chance of malignancy in the streak gonads. Histopathology of the streak gonads showed bilateral gonadoblastoma with dysgerminoma. The girl was put on hormone replacement therapy and is on regular follow up. The importance of this condition is its rarity leading to delay in diagnosis, the high risk of malignancy in streak gonads necessitating gonadectomy, the need for hormone replacement therapy for life and the chance of conception by in vitro fertilization as the uterus is retained.

Free Flap Important Tool For Lower Extremity Reconstruction, Oct 14, 2014

Journal of Women’s Health, Issues & Care, 2014

Prevalence of Vaginal Candidiasis in Pregnancy among Coastal South Indian Women Vulvovaginal cand... more Prevalence of Vaginal Candidiasis in Pregnancy among Coastal South Indian Women Vulvovaginal candidiasis is characterized by curd like vaginal discharge and itching. It is associated with considerable distress to the patient. The incidence is increased in pregnancy and may lead to complications like abortions, preterm delivery, candida chorioamnionitis and others. This study was done to determine the prevalence of vaginal candidiasis in pregnant women in Mangalore, a coastal city in South India

Preeclampsia is one of the major causes of maternal and fetal morbidity and mortality. Though the... more Preeclampsia is one of the major causes of maternal and fetal morbidity and mortality. Though the etiology is obscure, studies indicate the role of increased oxidative stress due to endothelial dysfunction in preeclampsia. The aim of this study was to find out iron status parameters in preeclamptics and their comparison to normotensive pregnancies. This study was done in a medical college hospital in South India. 60 women with preeclampsia and 60 normotensive pregnant women were analyzed for serum iron, ferritin and hemoglobin levels. Pregnancy outcome in both groups were compared. Data were expressed as Mean ± Standard Deviation. Comparison of serum levels of the elements was performed by Independent t test and Chi square test and P value of < 0.05 was considered as statistically significant. Mean serum iron and ferrtin levels in preeclamptics were significantly higher compared to normotensives whereas hemoglobin levels did not show much difference. Also preeclamptic women were ...

International Journal of Case Reports and Images, 2013

Introduction: Acardiac twin is a rare anomaly occurring in 1 in 35,000 pregnancies. the outcome i... more Introduction: Acardiac twin is a rare anomaly occurring in 1 in 35,000 pregnancies. the outcome is fatal for the acardiac twin with a 50-75% mortality of the normal pump twin. Management options include conservative management, medical therapy, occlusion of connecting vessels and selective termination of the acardiac twin. the Management of a twin pregnancy complicated by an acardiac twin is a challenge because the continuous growth of the acardiac fetus is deleterious to the healthy pump twin leading to cardiac insufficiency, polyhydramnios, prematurity and even death of the normal twin. case report: We report three cases of acardiac twinning which presented with different manifestations, acardius acephalus, acardius myelocephalus and acardius amorphous. All the three cases were managed conservatively with

Case reports in obstetrics and gynecology, 2012

Unicornuate uterus with rudimentary horn occurs due to failure of complete development of one of ... more 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 a noncommunicating rudimentary horn is extremely rare and usually terminates in rupture during first or second trimester of pregnancy. Diagnosis of rudimentary horn pregnancy and its rupture in a woman with prior vaginal delivery is difficult. It can be missed in routine ultrasound scan and in majority of cases it is detected after rupture. It requires a high index of suspicion. We report a case of G2PlL1 with rupture rudimentary horn pregnancy at 25 weeks of gestation which was misdiagnosed as intrauterine pregnancy with fetal demise by ultrasound, and termination was attempted and the case was later referred to our hospital after the patient developed hemoperitoneum and shock with a diagnosis of rupture uterus. Laparotomy revealed rupture of right rudimentary horn pregnancy with massive hemoperitoneum. ...

Journal of clinical and diagnostic research : JCDR, 2014

Pre-eclampsia is one of the major causes of maternal and fetal morbidity and mortality. Though th... more Pre-eclampsia is one of the major causes of maternal and fetal morbidity and mortality. Though the aetiology is obscure, recent studies indicate that serum levels of calcium and magnesium may have a role in pre-eclampsia. The aim of this study was to find out the relationship of serum levels of calcium and magnesium in pre-eclamptic pregnancies compared to normal pregnancies in women from southern coastal India. This study was done in a medical college hospital in southern coastal India. The blood samples from 60 pre-eclamptic women and an equal number of controls were analysed for calcium and magnesium levels. Data on Body Mass Index, maternal and gestational ages, serum calcium and magnesium were compared between the two groups. Outcome of pregnancy was analysed in both the groups and compared. Data was expressed as Mean ± Standard Deviation. Data analysis was done by SPSS version 20. Comparison of serum levels of the elements between the two groups was performed by Independent t-...

Journal of clinical and diagnostic research : JCDR, 2013

Gonadoblastoma is a rare gonadal tumour consisting of a mixture of germ cells and sex cord stroma... more Gonadoblastoma is a rare gonadal tumour consisting of a mixture of germ cells and sex cord stromal derivatives resembling immature granulosa and Sertoli cells. It usually arises in various types of gonadal dysgenesis containing Y chromosome like pure or mixed gonadal dysgenesis. Occurrence in phenotypically and chromosomally normal women is very rare. We report here a case of gonadoblastoma with dysgerminoma in a 14-years-old girl who presented with a huge tumour, virilisation and normal 46XX karyotype. Association of dysgerminoma is seen in 50% cases of gonadoblastomas. Elevated tumour markers like hCG and alpha Fetoprotein may make the diagnosis challenging.

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2014

Background: Preeclampsia is one of the major causes of maternal and fetal morbidity and mortality... more Background: Preeclampsia is one of the major causes of maternal and fetal morbidity and mortality. Though the etiology is obscure, studies indicate the role of oxidative stress and antioxidants may have a role in the prevention of preeclampsia. Micronutrients such as copper and zinc are involved in the antioxidant defense mechanism. Methods: The present study was undertaken in a medical college hospital in coastal South India to assess the serum levels of zinc and copper in women with preeclampsia and to compare them with normal pregnant women. The blood samples from 60 preeclamptic women and an equal number of controls were analyzed for zinc and copper levels. Outcome of pregnancy was analyzed and compared. Data were expressed as mean ± standard deviation. Comparison of levels of the elements between the two groups was performed by independent t test and Chi square test and P value of <0.05 was considered as statistically significant. Results: The serum zinc and copper levels were significantly lower in the preeclamptic group compared to the normotensives. Also preeclamptic women were older, their BMI was higher and birth weight of babies lower compared to normotensives. Conclusions: Increased knowledge about the importance of specific antioxidant micronutrients and their part in successful pregnancy outcome should be the focus for future health strategies. Low levels of maternal copper and zinc are related to preeclampsia and might have a causal role in this disease. Further investigation is needed to establish the role of these elements in this dangerous condition of pregnancy.

Archives of Gynecology and Obstetrics, 2010

Echinococcosis or hydatid disease which is caused by Echinococcus group of cestodes is very rare ... more Echinococcosis or hydatid disease which is caused by Echinococcus group of cestodes is very rare in pregnancy. While liver and lungs are commonly involved, other sites can be rarely aVected. The management of hydatid disease in pregnancy is challenging in view of varied presentation and manifestation. We report a case of hydatid cyst arising from the bladder associated with pregnancy and presenting with abdominal pain. The cyst was surgically removed and the bladder wash was given with povidoneiodine. The postoperative recovery was uneventful with ongoing pregnancy. This is to our knowledge, the Wrst case of hydatid cyst arising from the bladder associated with pregnancy to be reported.