Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in reproductive age women. Some of the PCOS women show presence of hypothyroidism.Methods: This study was conducted at tertiary care centre Indira Gandhi Government Medical College and Hospital (IGGMC), Nagpur, Maharashtra, India. The study group had 50 diagnosed patients of PCOS and 50 age matched normal regular menstruating women were taken as controls.Results: In this study, PCOS patients showed higher mean TSH level than control group (4.024±1.09 and 2.84±0.83 respectively). And more women were diagnosed with overt hypothyroidism in the PCOS group (6%) than in the control group (2%).Conclusions: The findings of the study showed that PCOS is associated with hypothyroidism as compared to normal population.
Introduction: Varying degrees of renal insufficiency is associated with renal stone disease. The incidence of Chronic Kidney Disease (CKD) in renal stone is around 0.8 to 17.5%. There is limited data on the outcomes of Percutaneous Nephrolithotomy (PCNL) in CKD patients like improvement in Glomerular Filtration Rate (GFR), Effective Renal Plasma Flow (ERPF), postoperative complications, morbidity like dialysis dependence and mortality and various other factors. Aim: To study the impact of PCNL in patients of urolithiasis with CKD. Materials and Methods: A prospective observational study was conducted on 100 patients of chronic kidney disease seeking operative treatment during June 2017 to September 2019 in the Department of Urology, Superspeciality Hospital and Government Medical College (GMC), Nagpur, Maharashtra, India. All suspected patients underwent a plain Computed Tomography (CT) scan. Patients were classified into three groups; group 1 included stage III, group 2 included stage IV and group 3 included stage V CKD patient. Patients with Acute Kidney Injury (AKI) underwent urine diversion first. Both short term impact like hospital stay, need for blood transfusion, AKI, sepsis, fever and long term impact like change in renal function, stage migration were studied. Statistical analysis was done using Kruskal Wallis Test (age distribution); Chi-squared test (gender and AKI); Fisher’s exact test (stone Composition and transfusion); Kruskal Wallis Test {Body Mass Index (BMI), hospital stay, Effective Renal Plasma Flow (ERPF) and Estimated Glomerular Filtration Rate (eGFR)}. Results: A total of 55 patients were of Grade III CKD, 31 were of Grade IV CKD and 14 patients were of stage V CKD and classified into groups 1, 2 and 3, respectively. Age and gender distribution were not significantly different among various groups. There was no significant difference in BMI (Kg/m2) or diabetes in the groups. The most common stone composition was calcium oxalate dihydrate (53%). Among 100 patients, urine culture was sterile in 77 patients. No significant difference was found in the incidence of urinary tract infection (p-value=0.629). Group 3 presented with significantly higher incidence of AKI (p-value=0.001). Stone free rate was not significantly different among groups (p-value=0.252). Blood transfusion rates was not statistically different in these groups (p-value=0.066). Mean hospital stay was significantly higher with higher stages of CKD (p-value <0.001). Change in renal function was evaluated by change ERPF and eGFR. ERPF significantly increased by 1.96±4.87 (p-value=0.001) after surgery. Similarly, there was significant increase in eGFR over time (p-value=0.037). Conclusion: PCNL in patients of chronic kidney disease has a minor but significant improvement in GFR with good clearance rates.
Background: To compare the efficacy and safety of sublingual route of misoprostol with vaginal route of administration.Methods: This study was conducted at Department of Obstetrics and Gynecology, Medical College, Baroda, Gujarat, India. 50 cases each with a singleton term pregnancy and a live fetus requiring induction of labor were allocated to sublingual and vaginal administration of misoprostol. Outcome measures related to labor and maternal and fetal side effects were compared between the 2 groups and evaluated using Chi square test and relative risk (RR) with 95% confidence intervals (CI).Results: The sublingual route of misoprostol was associated with a reduced risk of failed induction, reduced time from initiation to induction, reduced induction to delivery interval and a higher incidence of maternal and fetal side effects. However, the differences were not statistically significant.Conclusions: The sublingual route of administration of misoprostol is comparable in efficacy and safety to the vaginal route for induction.
BACKGROUNDThanatophoric Dysplasia (TD) is a lethal skeletal dysplasia. Prenatal diagnosis of TD is usually accomplished by Ultrasonography (USG). However, it is not always possible to distinguish TD from other skeletal dysplasias by USG. Chromosomal analysis and DNA molecular testing can be done in suspected cases of TD. Differentiating known lethal disorders from nonlethal disorders before delivery and determining post-delivery management plans improves patient care. We report a case of TD undiagnosed till term and the dilemma faced due to difficulty in differentiating the lethal and non-lethal forms on ultrasonography.
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