Objectives Preeclampsia (PE) remains the major cause for maternal and foetal mortality and morbidity. Invasion of endovascular trophoblast and remodelling of spiral artery are crucial actions of normal placental development. Non-fulfilment of these processes plays a leading role in the development of preeclampsia. Vascular endothelial growth factor (VEGF) is produced by extravillous trophoblastic tissue and decidual cell population is a well-known angiogenic growth which plays a fundamental role in placental pathogenesis of PE. Annexin A2 (ANXA2) is a profibrinolytic protein receptor required for plasminolysis, which is an important step in the formation of new blood vessel along with VEGF. Role of ANXA2 is poorly studied in context with human reproductive disease like preeclampsia. The purpose of the present study is to examine the expression and association of VEGF and ANXA2 in the term placentas of pregnancies with and without PE. Methods The study group comprised of placental tissues procured from gestations with PE (n=30) and without (n=20) PE. The expression of VEGF and ANXA2 in the placental villous tissue was evaluated quantitatively by means of IHC, western blotting and reverse transcriptase-polymerase chain reaction (RT-PCR). Results Our IHC, western blotting and RT-PCR analysis illustrated the significant decrease in the expression of VEGF and ANXA2 in PE group compared with the normotensive control group (p<0.005). We observed statistically significant positive correlation among the expression of ANXA2 and VEGF in placentas of normotensive control group (p<0.0001). Conclusions The diminished expression of VEGF and ANXA2 in placenta may be associated with the defective angiogenesis and which may possibly play a vital role in PE pathogenesis.
Background: Cervical cancer is the second leading cause of death in india. it is also one of the few malignancies where an infectious etiological agent human papilloma virus (HPV) has been identified. With the advent of HPV vaccination, it is possible to reduce the morbidity and mortality associated with carcinoma cervix. But biggest hurdle to achieve this is the lack of awareness about the availability and use of HPV vaccine. This study was conducted to know knowledge and awareness of HPV infection and vaccination among medical and paramedical students. We also evaluated the acceptability and coverage of HPV vaccine among these students.Methods: This study was conducted among a total of 520 female students of the Sri Dharmasthala Manjunatheshwara University with the help of a questionnaire. The study group included 207 MBBS students, 167 BDS students, 89 nursing students and 57 physiotherapy students.Results: Most of the students were in 18-20 years’ age group. Nearly 40.57% of the students knew that HPV is sexually transmitted and 29.80% were aware that this infection can be prevented. Availability of HPV vaccine was known to 75% of the students and the main source of their information was through their college teachings. Nearly 43.75% of the students knew HPV vaccine protects against cervical cancer and 26.73% of the students were vaccinated. Overall knowledge and awareness were better among medical students.Conclusions: A lot of work needs to be done so as to make the target population accept HPV vaccine. There is a great difference between awareness of availability of the vaccine and its use. This emphasizes the need for health care professionals to take special interest in promoting this vaccine in the general population.
Background: Pre-eclampsia affects 2-5% of pregnancies and is a major cause of perinatal and maternal morbidity and mortality. Doppler is a non-invasive method for evaluation of feto-placental circulation without affecting pregnancy. A high resistance index in uterine artery Doppler waveform has been shown to be the best non-invasive screening test. Thus, we have conducted this study to find out the predictive value of transvaginal uterine artery doppler in early pregnancy for the prediction of pre-eclampsia. The aim of the study was early prediction of pre-eclampsia by trans-vaginal uterine artery Doppler study at 12-16 weeks.Methods: According to the study criteria 100 antenatal women between 12 to 16 weeks of singleton pregnancy attending out patient in the Department of OBG of S. D. M. Medical College Dharwad were included. After an informed consent, the women underwent ultrasound for dating and subsequently trans-vaginal ultrasound along with color doppler was performed to obtain uterine artery indices. These women were again rescanned at 24-26 weeks of gestation trans-abdominally and further followed up clinically for development of preeclampsia.Results: Out of 100 women, 22 patients developed preeclampsia. At 12-16 weeks 35% of women had bilateral uterine artery notching, mean RI was 0.57 and PI was 0.89. When uterine artery notch at 12-16 weeks alone was considered, 34.28% of women developed preeclampsia. Detection rate increased to 85.71% when RI>0.65 was also included along with notching. Uterine artery notching at 12-16 weeks gestation had 34.29% sensitivity, 84.62% specificity, 70.51% NPV. When notch and RI>0.65 considered together sensitivity and NPV increases to 85.71% to 98.25%.Conclusions: The uterine artery Doppler waveform indices at 12-16 weeks are the best non-invasive screening test available for early prediction of preeclampsia.
Background: The nationwide Family Planning Programme was started in India in 1952, making it the first country in the world to do so. In spite of this about 56% eligible couples in India are still unprotected against conception. Even after 63 years of national level family planning programme there exists a KAP- GAP i.e. a gap between the knowledge, attitude and practices regarding contraception. Hence this study to reassess where we stand and also use it as an opportunity to increase the awareness, sensitize and motivate the eligible couples for contraceptive use and decrease the KAP-GAP.Methods: A structured questionnaire was given to postnatal breastfeeding mothers attending Outpatient department Obstetrics and gynecology and Pediatrics and postnatal wards of Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Dharwad from 1 November 2014 to 1 October 2015, and results tabulated.Results: In this study 48.4% of the mothers knew that exclusive breast feeding could be used as a method of contraception. About 54.6% mothers used one or the other type of contraception during breastfeeding. Most practiced contraception being condom followed by Cu-T. A very small number of mothers considered oral contraceptive pills and injectable contraception in the form of Depot-Provera.Conclusions: In most of the women attitude towards use of family planning method was satisfactory but there exists disparity between the knowledge and practice of contraception.
Background: Objective of this study was to study the effect of vaginal misoprostol, dinoprostone gel, foley catheter, extra amniotic saline infusion along with vaginal misoprostol for induction of labor at term on maternal and fetal outcome.Methods: A one-year prospective observational study was conducted in the department of obstetrics and gynecology, SDM College of Medical Science and Hospital, Dharwad. Totally 100 postdated primigravida women with singleton gestation, vertex presentation and intact membrane who were induced with any four methods of induction 1) Tab. misoprostol 25 µg vaginally, 2) Intracervical dinoprostone gel, 3) Foley catheter and 4) Extra amniotic saline infusion along with tab. misoprostol 25 µg vaginally with 25 patients selected in each group, by random allocation technique and included in the study. Outcome measures analysed were the demographic profile, bishop score, induction to delivery interval, mode of delivery, maternal and fetal complications. Statistical analysis was done using SPSS 17 software.Results: Mean induction delivery interval was significant between PGE1 versus foley group (p=0.0034). In this study, 60% patients in dinoprostone group had Vaginal delivery and 72% in the EASI + misoprostol group underwent cesarean section (p=0.0372). NICU admission was maximum with EASI + vaginal misoprostol group and minimum with vaginal misoprostol alone.Conclusions: The groups were comparable with respect to maternal age, bishop score and fetal weight. The vaginal misoprostol group had shortest induction delivery interval. The maximum number of patients in dinoprostone gel group underwent vaginal delivery with a highest cesarean section and NICU admission with the EASI + misoprostol group.
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