Introduction: The ability of a person to phonate a sound gets affected in different laryngeal and respiratory pathology which can be measured by the help of two measure called as Maximum Phonation Duration (MPD) and S/Z ratio that helps to assess the efficiency of respiratory and phonatory system. The aim of this study is to measure the MPD and S/Z ratio in Normal, Tuberculosis and Asthma group patient. Methods: The participant included Normal, Asthma and Tuberculosis patient where the recording was made in a quiet room with the help of PRAAT software and the participant were asked to sustain phonation of sound on single breath. Analysis was done with helps of SPSS version 25.0. Results: There was a significant difference noted in MPD of /a/, /i/, /u/ sound between control and experimental group. MPD were significantly shorter in Asthma and Tuberculosis group compared to Normal group with no significant difference in S/Z ratio. Conclusions: Maximum Phonation Duration is more reduced in Asthma and Tuberculosis patient compared to Normal group which indicate Asthma and Tuberculosis patient has to put more effort to phonate a sound.
Introduction: The study of lower genital tract trauma has become important in gynaecological practice. There is paucity of reports on this clinical entity from our settings. The main aim of this study is to document injuries in female lower genital tract in Mid-Western Nepal. Methods: Sixty female patients admitted to the hospital with genital tract injuries caused by coitus or accidents were included in the study. Details of the causes of trauma clinical presentations and management were recorded. Results: These injuries were grouped according to etiological factors. This study included 33 (55%) coital injuries and 27 (45%) non- coital injuries. Out of coital injury, 12 cases were criminal assault (rape) in age group of 4 to 18 years. Four unmarried girls had consensual sex. Non-coital injuries were due to fall from height, cattle horn injuries, straddle type of trauma, vulvar haematoma and anorectal injuries. Conclusions: Appropriate surgical intervention can avert morbidity and mortality. Keywords: accident; lower genital tract; Nepal; trauma.
Background: Thrombophilia complicates the pregnancy by interfering the physiology of utero-placental circulation which in turn leads to IUGR, IUD, PIH, RPL, abruption placentae. This study is to find out the prevalence and significance of different thrombophilia markers in cases of adverse pregnancy outcome in eastern part of Uttar Pradesh, India.Methods: 54 antenatal women are selected from the cases presented with or previous history of PIH, IUGR, IUD, Abruption or early/late abortion. A thorough family history, history of risk factors, clinical examination were noted. Platelet count, prothrombin time(PT), activated partial thromboplastin time (APTT), plasma fibrinogen, factor-VIII assay, LA, ACLA, protein- C, protein- S, TORCH, thyroid profile, blood sugar, USG is done in all patients at the time of first registration. 50 antenatal females without any bad obstetric history was taken as controls.Results: Among 54 cases, 64.8% cases were positive for thrombophilia markers, whereas 6% control had presence of thrombophilia markers. 6.5% thrombophilia positive cases had ≥3 markers present and had ≥2 manifestations of adverse pregnancy outcome in 100% cases. Prevalence of different thrombophilia markers are studied in individual case and association to various outcomes were noted.Conclusions: There was high prevalence of thrombophilia markers in the cases with adverse pregnancy outcome. As treatment was found significantly effective in literature, screening of these markers should be done in patients with bad obstetric history.
Background: Thrombophilia is a potentially treatable cause of adverse pregnancy outcome. The objective was to compare the fetomaternal outcome in thrombophilia patients with adverse pregnancy outcome after treating with lowmolecular-weight (LMW)/ unfractionated heparin and aspirin. Methods: 54 antenatal women studied who had an earlier or presenting pregnancy complicated by adverse pregnancy outcome were included in this study. In the present pregnancy, therapy consisting of LMW heparin and aspirin was administered who were found to be thrombophilia positive. Patients also received folic acid supplementation throughout their pregnancy. The fetomaternal outcome is compared according to the time of initiation of treatment. Results: Low-molecular-weight heparin and aspirin was well tolerated and none of the women or the newborns developed any hemorrhagic complications.3 thrombophilia negative cases with history of recurrent pregnancy loss aborted even getting treatment from 1 trimester. 1 thrombophilia positive case with history of recurrent pregnancy loss aborted when received treatment from 2nd trimester. There is 25.8% increase in birth weight of neonate if thrombophilia positive cases were treated from 1st trimester. Whereas there was only 10.23% increase in birth weight in thrombophilia negative cases when treated from first trimester. We found, our treatment was significantly effective in preventing IUD, IUGR, abruption, abortion, eclampsia. Though prevention of PIH had no significant correlation with antithrombotic treatment, only 2 cases booked from 1st trimester developed PIH among thrombophilia positive cases. But neither of cases had suffered from any severe complication as compared to 81% of eclampsia cases, 16.67% of DVT cases, 1 case of mortality in cases treated after third trimester. Conclusions: This case control trial suggests that patients with adverse pregnancy outcome and thrombophilia may get benefit from treatment with combined LMW heparin and aspirin in subsequent pregnancies. We suggest all patients with adverse pregnancy outcome should be investigated for thrombophilia markers.
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