ORIGINAL RESEARCH ARTICLE | Dec. 17, 2019
Vitamin D Status in Pregnant Women of North East India and Impact of Vitamin D Deficiency in Pregnancy on Feto-Maternal Outcome
Dr. Ratna Kanta Talukdar, Dr. Shweta M. Joshi
Page no 298-303
Background: Despite of sufficient and stable sunny conditions across the equatorial countries, there has been a high prevalence of Vitamin D deficiency (VDD) in pregnancy. The reasons for increased prevalence of VDD are increased time spent indoors, dark skin, and adoption of covered clothing due to religious & cultural reasons, low socio-economic status that leads to chronically poor diet. The present study was undertaken to find Vitamin D deficiency in the pregnant women of North East India and to find the adverse feto-maternal outcomes associated with VDD. Methods: This prospective study was conducted in the Department of Obstetrics & Gynaecology, Gauhati Medical College & Hospital, Guwahati, Assam, and India over a period of one year. Sample size was 150 pregnant women attending antenatal clinic. Results: Out of 150 pregnant women 66 (44%) had deficient, 41 (27.3%) had insufficient and 43 (28.7%) had sufficient vitamin D levels. VDD was seen in extremes of age groups i.e. group ≤ 20 years and 31- 35 years. Multiparity and low socio-economic status was associated with vitamin D deficiency and insufficiency, no association was found between VDD and religion (Hindu & Muslim). There was significant association between Vitamin D deficiency and insufficiency and occurrence of gestational hypertensive diseases and low birth weight babies. Rate of primary caesarean section was significantly high in vitamin D deficient women. No association was found between VDD and PROM/PPROM, preterm births, gestational diabetes mellitus and neonatal jaundice.
CASE REPORT | Dec. 17, 2019
Sigmoid Volvulus during Pregnancy: A Diagnostic Trap
Imane Benchiba, Meimouna Mohamed Lemine, Nissrine Mamouni, Sanaa Errarhay, Chahrazed Bouchikhi, Abdelaziz Banani
Page no 304-307
Colonic obstruction due to sigmoid colon volvulus during pregnancy is a rare but complication with significant maternal and fetal mortality. That requires prompt surgical intervention (decompression) to avoid intestinal ischemia and perforation. We report the case of a 38-week pregnant woman with abdominal pain and subsequent development of constipation. Preoperative diagnosis was achieved using ultrasonography: the large bowel distension and a typical whirl sign - near a sigmoid colon transition point - suggested the diagnosis of sigmoid volvulus. The decision to refer the patient for emergency laparotomy was adopted without any ionizing radiation exposure, and the pre-operative diagnosis was confirmed after surgery. Sigmoid volvulus complicating pregnancy is a rare, non-obstetric cause of abdominal pain.
ORIGINAL RESEARCH ARTICLE | Dec. 22, 2019
Gold Nanoparticles Targeting Human Cervical Cancer Cells
Hayat Awadh Merkadh, Fatimah Mezaal Hameed
Page no 308-311
The most disturbing gynecologic malignancies are cervical cancer particularly in the developing world with the same high incidence in Iraqi women. Cervical carcinoma has a high rate of mortality. The high death rate is associated with presence of human papillomavirus (HPV) infection. Cervical carcinoma is hard to treat, and conventional therapies are very aggressive which lead for the need for new approaches of therapy. Nanoparticles is a promising treatment modality to produce non-toxic and efficient cancer therapy. Gold nanoparticles (AuNPs) accumulate in cancer cells selectively. The current work was aimed to study cytotoxicity and cell death induced by AuNPs on cervical carcinoma cells. Methods: Cytotoxicity of AuNPs was assessed by MTT viability assay and analysed using multiple comparison ANOVA tests. Results: AuNPs nanoparticles from 12.5 up to 50 µg/mL for 72 hours showed concentration-dependent killing activity. Conclusion: Gold nanoparticles have anti-cervical carcinoma cells activity by cell death induction.
ORIGINAL RESEARCH ARTICLE | Dec. 30, 2019
Breast Cancer in Young Women under 40 years: Epidemiological, Clinical, Therapeutic and Prognostic Aspects in the Oncology and Radiotherapy Department of Marrakech; About 318 Cases
K. Mazouz, S. Elouarzzazi, Y. Bouchabaka, D. Nimbuna, Z. Kaitoni, A. Elmatlini, M. Laanigri, M. Saadoun, M. Raouah, H. Abourazeq, S. Barkich, H. Eddaoualline, H. Sami, S. Laatitioui, M. Darfaoui, I. L
Page no 312-318
Introduction: Breast cancer in women, and especially in young women, represents a real public health issue given its frequency and severity. The objective of our study is to specify the epidemiological profile; anatomo-clinical; therapy and prognosis of breast cancer in young women. Methods: Descriptive retrospective study spread over a period of 5 years (2013-2017), collecting all the patients followed for breast cancer aged 40 years or less, within the cancer department of CHU Med VI in Marrakech. Results: The average age was 34.2 years (19-40 years). The average age at puberty was 12 years old (9 and 16 years old). Nulliparity was noted in 22% of the cases. Clinically, the T classification in the cases specified was: T1 (n = 48), T2 (n = 128), T3 (n = 52), T4 (n = 42). Clinical lymph node involvement was found in 44% of the cases. Histologically, infiltrating ductal carcinoma was the most common (n = 283). SBR II grade was the most frequent with a rate of 66%, Thirty Fifty percent of all patients had an over-expression of HER2 , Sixty-three percent had lymph node invasion, including 42% with capsular rupture and 31% of patients were metastatic in appearance. Therapeutically, fifty patients had neo-adjuvant chemotherapy. The surgery was conservative in 66% of the cases. Adjuvant chemotherapy was sequential in 61% of the cases. 180 patients had adjuvant radiation therapy. Of the 96 patients with HER2 over expression, 82 received treatment with trastuzumab. Hormone therapy was prescribed in 156 patients or 49% of cases with expression of hormone receptors. In our series, the median follow-up was 8.1 months. The course was marked by a locoregional relapse in fifty-eight patients, and a metastatic relapse in sixty patients. Conclusion: Since screening in our country does not include young women, it would be interesting to reconsider its indications, especially given the growing frequency of this cancer in young women as well as its poor prognosis.
ORIGINAL RESEARCH ARTICLE | Dec. 30, 2019
Characteristics of Pre-gestational and Gestational Diabetes: A Comparison of Maternal and Fetal Outcome
Dr. Kaniz Fatema, Dr. Nigar Sultana, Dr. Farah Noor
Page no 319-326
| DOI: 10.36348/sijog.2019.v02i12.005
Backgroup: Pregnancy is a diabeto-genic condition, which is why pregnancy with diabetes is one of the common medical and endocrinological disorder encountered in obstetrics. Diabetes Mellitus complications during pregnancy has become more common worldwide. About 0-4% of all pregnancies are complicated by diabetes mellitus and 90% of those are GDM. Aim of the study: This study was conducted to find out the maternal and fetal outcome of the pregnancies complicated by pre-gestational and gestational diabetes mellitus. Material & methods: This was a cross-sectional analytical study which was conducted in the Department of Obstetrics and Gynecology Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. In this study, a total of 225 patients were selected using purposive sampling technique. There were three groups of pre-gestational diabetic, gestational diabetic and non-diabetic control, designated as Group A, Group B, Group C accordingly; and each consists of 75 patients. Duration of data collection was one year (July 2016 to June 2017). Information collected from all pregnant women (After 28 weeks of gestation) using a questionnaire made for recoding all relevant parameters under study, after proper counseling and taking written consent of the patient or her legal guardian. Results: History of GDM was significantly more common among patients with pre-GDM (38%) and GDM (18%) compared to controls. History of abortion, IUFD and congenital anomaly were significantly higher among pre-GDM mothers than GDM mothers and controls (p<0.05). History of deliveries with macrosomia and still birth was distributed similarly across the groups (p>0.05). Pre–GDM and GDM patients had significantly higher number of patients with HbA1C >6.5% than controls. Mean FBS and PPBS was significantly higher in pre-GDM & GDM patients than control (p<0.05). APGAR score was <7 in significantly higher number of pre–GDM and GDM babies than controls (p <0.05). Mean Weight of the babies was significantly lower among pre–GDM patients than GDM patients (p <0.05). Among pre–GDM patients and GDM patient’s cases of birth asphyxia, Hypoglycemia, hyperbilirubinemia and congenital anomalies were significantly higher than controls (p< 0.05). Conclusion: Interventions such as preconception care for women with pre-gestational diabetes, screening for early diagnosis, patient education, multidisciplinary approach and good metabolic control maintained throughout the pregnancy is the key to successful fetomaternal outcome.
ORIGINAL RESEARCH ARTICLE | Dec. 30, 2019
Comparative Study of Laparoscopic Assisted Vaginal Hysterectomy versus Total Abdominal Hysterectomy in Benign Gynecological Conditions
Dr Amatunnafe Naseha
Page no 327-331
| DOI: 10.36348/sijog.2019.v02i12.006
Introduction: The term “hysterectomy” though means removal of uterus, in practice it has a much wider classification depending upon the indication. At times, it is done without removal of cervix (Supracervical hysterectomy) or with removal of adnexa (Hysterectomy with salpingooopherectomy). It can also be a part of staging laparotomy or radical hysterectomy. Hysterectomy can be performed abdominally, vaginally or through abdominal ports with the help of laparoscope. Materials and Methods: This is a Prospective and Comparative Study conducted in the Department of Obstetrics and Gynaecology, Shadan Institute of Medical Sciences, Teaching Hospital & Research Centre over a period of 1 year. Total 100 patients undergoing hysterectomy for benign uterine pathology meeting the inclusion and exclusion criterion will be included in the study. 50-Laparoscopic assisted vaginal hysterectomy and 50-Total abdominal hysterectomy. Results: 95% of women of TAH group needed spinal anaesthesia and only 5% needed general anaesthesia. On the other hand, all the women of LAVH group needed general anaesthesia. Duration of surgery was little more in patients who underwent LAVH when compared to patients who underwent TAH. The average duration of surgery in TAH group is 50 minutes and it is 75 minutes in LAVH group. Only 2 patients in LAVH group needed conversion into laparotomy because of adhesions and uncontrollable haemorrhage. Fever and wound infection was more with TAH group 11.6% compared to LAVH group 5% and 3.3%. UTI was also comparatively more with TAH group., which was the reason for longer hospital stay in TAH group. RTI was observed in 3 patients of LAVH group. Conclusion: LAVH is associated with less blood loss and decreased intra operative complications when compared to TAH. Length of hospital stay is significantly less for LAVH when compared to TAH. Post-operative pain, complications and blood transfusions are more with TAH group, because of which patient had longer hospital stay and took longer time for recovery and return to work.