BACKGROUND We wanted to compare the effectiveness of the treatment and the adverse effects of ulipristal acetate and leuprolide acetate in the medical management of symptomatic uterine fibroids. METHODS This is a randomised controlled study conducted in the the Department of Obstetrics and Gynaecology in Chalmeda Anand Rao Institute of Medical Sciences from January 2019 to January 2020. 60 patients with symptomatic fibroids and excessive uterine bleeding were randomly divided. They were given daily therapy of ulipristal acetate 10 mg orally for 3 months or monthly injection leuprolide acetate 3.75 mg intramuscularly for 3 months. RESULTS Controlled uterine bleeding was observed in 98 % of patients who received oral therapy of ulipristal acetate of 10 mg, and 89 % of patients who received injections of leuprolide acetate, for differences in comparison with leuprolide acetate of 8.8 % points (95 % CI, 0.4 to 18.3) for ulipristal acetate of 10 mg. Median time of amenorrhea for those taking ulipristal acetate of 10 mg was 5 days, and 21 days for leuprolide acetate. 10 % of patients receiving ulipristal acetate reported moderateto-severe hot flashes and 40 % of patients receiving leuprolide acetate reported moderate to severe hot flashes (P < 0.0010 for each dose of leuprolide acetate vs. ulipristal acetate). CONCLUSIONS Daily therapy of 10-mg ulipristal acetate was considered non inferior when compared to monthly injections of leuprolide acetate in control of uterine bleeding, moreover ulipristal acetate therapy was also significantly less likely to cause hot flashes. KEY WORDS Ulipristal Acetate; Leuprolide acetate; Abnormal Uterine Bleeding; Leiomyoma
BACKGROUND Heart disease complicating pregnancy is considered as a high-risk condition. Increased cardiac demands during the course of pregnancy potentially increase morbidity and mortality in women with underlying heart disease. Fifty percent increase in volume of plasma and increase in the risk of thrombosis by 6 times strikes a challenge to pregnant woman with heart disease. Pregnancy state is more prone to risk of infection as it is an immunocompromised condition which can result in increased heart rate eventually deteriorating the cardiac function. We wanted to determine maternal and foetal outcome in pregnant women with heart diseases in terms of foetal complications, maternal complications, and mode of delivery. METHODS A prospective clinical study conducted in Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar for delivery was carried to find out the maternal and foetal outcomes in about 30 cases of pregnancy complicated heart disease. Taking prevalence to be 4 % (P) with confidence interval of 95 % (Z = 1.96) and allowable error (d) 7 %, sample size was calculated using formula ๐ 2๐๐/๐2 RESULTS Present study revealed heart disease in pregnancy as about 0.48 %. Rheumatic heart lesions constituted 56.6 % of the cases. Eleven (36.7 %) women delivered spontaneously vaginally at term. Caesarean section was performed in 12 cases (41.2 %). There were 2 maternal deaths. No perinatal deaths were reported. CONCLUSIONS Pregnancy and cardiac lesions affect mutually. Compliance of patient and her family to regular follow up will ensure a safe outcome for mother and foetus and avoid complications by regular checkups with obstetrician and cardiologist. KEY WORDS Cardiomyopathy, Pregnancy, Rheumatic Heart Disease, Maternal Morbidity, Maternal Mortality
Aim of the study:To Evaluate the usefulness and reliability of cell free DNA as a screening method to identify the mothers at risk of fetus with trisomy 21, 18, 13, sex chromosomal anomalies and other chromosomal abnormalities. Method: This is a prospective observational study conducted at Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar from a period of October 2020 to October 2022. Patients were included with at least one atypical biochemical marker of first trimester screening test or with abnormal NT scan. The cell free DNA was analysed by VeriSeq NIPT Solution v2 method. The accuracy of cell free DNA assay was evaluated by calculation of sensitivity and specificity. Screen positive cases were validated by comparing with karyotyping analysis. Results: Among the 250 patients with atypical biochemical markers who underwent a cell free DNA analysis, fourteen (5.6%) were excluded because of loss to follow-up, mis-carriage and affordability constraints. Out of 236, Cell free DNA was positive for Trisomy 21 in 3 pregnant women (n = 3), Trisomy 18 in 1 pregnant woman (n = 1) and Sex Chromosomal Aneuploidy in 1 pregnant woman (n = 1) and negative in 227 pregnant women. Test failure occurred for two pregnant women (0.8%). Conclusion:Cell free DNA assay is an effective and reliable tool in screening for fetal chromosomal anomalies.
A 39-year-old, married man was diagnosed with hepatic cirrhosis with portal hypertension and ascites in February 2016. His symptoms as described by him began with generalized body weakness, breathlessness and sudden weight gain of 16โkg within 3 weeks. History of regular intake of alcohol since 7 years and tremendous family stress were present. Patient underwent conventional medication for 6 months and ayurvedic medications for 4 months. In January 2017, he visited our hospital with the same complaints and underwent integrated naturopathy and yoga therapies (INYTs) for 4 weeks along with Ayurveda and conventional medications. The results of this study showed a better reduction in body weight, body mass index, abdominal girth, systolic blood pressure and diastolic blood pressure along with improvement in breath holding time, hemoglobin level, liver function test and renal function test. It suggests that 4 weeks of INYT with Ayurveda and conventional medications was effective in patients with hepatic cirrhosis with portal hypertension and ascites. Further studies are required to warrant these results.
-Accidents and traumas are the most frequent causes of health impairments among firemen, determined by the nature of their occupation. A firefighter who was left paralyzed in a freak accident will not have secure system to protect him. Their work is directly related with the exposure to harmful fire and physical factors. Thus, the accident rate was 70.3. These accidents were responsible for the period of work disability three times higher (293.5 days/100 workers) than eight times higher (770.2 days/100 workers) in the 50-59 age groups. According to recent survey about 40% people in that job are died due to accident and sudden paralysis. Here, we implement the system to rescue the fireman. In fired building, the fireman will have the wearable device embedded with heart rate monitoring system. The heart rate of the fireman is monitored and it is alerted. The location can be mapped and the fireman location can be detected. The wireless voice communication is enhanced between the fireman and rescue crew. Here, the heart rate is monitored and it will updated on the mobile, so that crew can view the heart rate and the crew team will have the mobile Application in which they can communicate with the fireman through voice using wireless technology. The system is advanced and both monitoring and alerted can be done.
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