Background: Intrauterine growth restriction (IUGR) is defined as fetal growth less than the normal growth potential of a specific infant because of genetic or environmental factors. Fetal growth restriction or intrauterine growth restriction is one of the leading causes of perinatal mortality and morbidity in newborns. Fetal growth restriction is a complex multifactorial condition resulting from several fetal and maternal disorders. Objective of present study was to find out incidence of IUGR and assessment and evaluation of different important changes in IUGR.Methods: Women who attended the Obstetric OPD in their 1st trimester of pregnancy and those who were thought would be able to visit the antenatal clinic for their fortnightly check-up regularly were screened for intrauterine foetal growth retardation. Women with irregular and uncertain menstrual history and where the 1st trimester USG foetal crown rump length did not corroborate with the menstrual gestational age were excluded from this study.Results: Incidence of IUGR was 18.2% and 84% were found to be asymmetrical. IUGR was found to be double among primigravids and women above 30 years. It had been observed that IUGR was associated with certain conditions like short stature (52%), pregnancy induced hypertension (24%) and anaemia (12%).Conclusions: Thus, early USG screening along with robust screening for maternal BMI, nutritional status, and anaemia can assist the obstetric team in providing early diagnosis, prompt intervention, and better outcome in pregnancy with fetal growth restriction.

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorder affecting five to ten percent women of reproductive age group. Variability of signs and symptoms along with metabolic syndrome as one of the long term complications make it worthy of early diagnosis and treatment. Medical management of PCOS is aimed at the treatment of metabolic derangements, anovulation, hirsutism, and menstrual irregularities.Methods: 140 patients, using inclusion and exclusion criteria, were selected and randomly divided into two groups (seventy in each) and age, BMI, waist hip ratio, blood pressure (systolic, diastolic), serum fasting insulin, fasting blood sugar, total cholesterol, HDL, LDL, triglycerides were measured. Study group were given {Myo-inositol (550 mg) + D-chiro-inositol (13.8 mg)} (MI+DCI) twice daily and the control group were given Myo-inositol (1 gm) (MI) twice daily for six months. Same variables were measured at the end of three and six months and compared with repeated measurement ANOVA using SPSS (version 20).Results: Comparison between these two groups before study was non-contributory. Combined drug therapy has provided statistically significant decrease in BMI, W:H ratio, Diastolic BP, Fasting blood sugar at the end of both 3rd and 6th month but in case of LDL it was at the end of 3 months. Combined drug therapy also increased the HDL level significantly in both the occasions.Conclusions: Combined medical therapy by (MI+DCI) is very much helpful in reducing the metabolic complications of PCOS without any major side effects.

Background: Endotracheal intubation has become the mainstay of modern anaesthesia. Stimulation of upper respiratory tract during tracheal intubation under general anaesthesia causes activation of sympatho-adrenal system and results in increased serum catecholamines. Aims and Objectives: To identify and compare the hemodynamic responses contributed by each stage of nasotracheal with that of orotracheal intubation. Material and Methods: About 125 patients in the age group 18-50 years, ASA physical status I-II of either sex, scheduled to undergo various elective surgical procedures requiring nasotracheal or orotracheal intubation were evaluated in the present study.After 4 minutes of ventilation, patients requiring nasal intubation (n=75) were allocated to three groups-nasopharyngeal intubation group (NPI), nasopharyngeal intubation with laryngoscopy group (NPIL) and nasotracheal intubation group (NTI). Those requiring oral intubation (n=50) were allocated to two groups namely-laryngoscopy only group (L) and laryngoscopy followed by orotracheal intubation group (OTI). Haemodynamic parameters like heart rate and blood pressure, SpO2, ECG, ETCO 2 were monitored continuously and data were recorded before induction, just after induction and after intubation at one minute interval for five minutes. Results: The pre-induction and pre-procedure values of systolic, diastolic and mean arterial pressures and also heart rate were similar in each group (P<0.05). Induction of anaesthesia caused a significant decrease in systolic, diastolic and mean arterial pressures in all groups compared to their pre-induction values (P<0.0012). Our study showed that systolic, diastolic and mean arterial pressures were significantly increased after intubation procedures in all the five groups compared to pre-procedure values. Conclusion: All the procedures evoked cardiovascular responses characterized by increases in heart rate and blood pressure. NTI produced a significant rise in blood pressure.

Background:An ideal pre-medicant should allay fear and anxiety without producing its effect on vital functions of the body and body chemistry, with minimal depression of the respiratory and circulatory systems. The ideal pre-medicant with all good qualities and no side effects at all is yet to be found. The search for a drug which will be an appropriate pre-anesthetic medication is still going.Methods: Four drugs of BZD group namely diazepam, nitrazepam, lorazepam, and oxazepam were chosen as oral pre-anesthetic medication. Total number of cases were 100, of which 25 patients belonging to each group of drug respectively. Standard doses of oxazepam (30 mg), nitrazepam (5 mg), diazepam (10 mg) and lorazepam (2 mg) by oral route were administered. All study participants were examined night before operation to observe the following clinical parameters like level of apprehension, excitement, blood pressure, heart rate, respiration (rate, rhythm and minute volume).Results:Diazepam and nitrazepam produced fair degree of sedation whereas oxazepam appears to be lagging behind. So far as anxiolysis is concerned, all the drugs appear to be good anxiolytics. Nausea, vomiting and dizziness are some of the problems which may occasionally be faced by this group of drug. On reassessment of patients 60 minutes after premedication, it was revealed that the efficacy so as anxiolysis and sedative effect is concerned was in the following order, lorazepam headed the list; diazepam and nitrazepam followed closely and oxazepam was at the bottom. Toxicity in all the four drugs were minimal. The degree of sleepiness varied from drug to drug. Ninety minute after premedication patients were found to be in a better state of sedation than at 60 minute’s level in all the four groups. The degree of sedation and anxiolysis was in the same order as that of 60 minutes level.Conclusions:The overall impression was that four members of the benzodiazepines, serve as as a good premedication in the absence of pain. The sedation and anxioysis produced by them are of fair degree even when given orally. Side effects produced were minimal except in the lorazepam group when they are used as night time sedative. Given orally only lorazepam is capable of producing anterograde amnesia.

Background. Tuberculosis (TB) is one of the common infections in the world, especially in developing countries like India. Therefore, early diagnosis is important. This study was undertaken to compare the yield of sputum induction with bronchoalveolar lavage (BAL) in smear-negative suspected pulmonary TB patients in a tertiary care hospital in Agra.Methods. Fifty patients were included in the study. In all patients, induced sputum, fibreoptic bronchoscopy and BAL fluid were subjected to diagnostic testing.Results. On acid-fast smear examination, induced sputum and BAL fluid tested positive in 27/50 and 25/50 patients, respectively with a sensitivity of 83.3% and 90% respectively (p<0.0001). On comparing sputum induction versus BAL on culture, 30 patients were positive by sputum induction and 27 patients were positive on BAL fluid, with the sensitivity of 85.7% and 77.1%, respectively. The results showed that the sputum induction showed a significantly higher yield than that of BAL fluid (p=0.0013). Conclusion.Sputum induction offers an alternative approach in the diagnosis of smear-negative suspected pulmonary TB patients and would enhance sensitivity for the diagnosis of TB.