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Introduction: The superficial palmar arch (SPA) is the main source of arterial supply to the palm. It is an arterial arcade formed mainly by the ulnar artery and is completed by the superficial palmar branch of the radial artery. The study was conducted with objective to study the variations in formation of superficial palmar arch in Nepalese cadaveric hands. Methodology: Two horizontal incisions were made, one at the wrist joint and another incision along the root of fingers. A vertical incision was made from the middle of the wrist to the 3rd metacarpo-phalangeal joint. The skin of the palm and the palmar aponeurosis was reflected. The surrounding adipose tissue was removed to view the superficial palmar arch and its branches. Result: In present study, out of 50 specimens of hands, 64% of superficial palmar arch was formed as normal pattern and in 36% cases it was formed by ulnar artery alone. Normal SPA pattern was seen 63% in male and 66.7% in female i.e. higher percentage in female than in male but it was statistically insignificant (P<0.05). SPA-ulnar artery alone pattern was seen 37% in male and 33.3% in female i.e. higher percentage in male than in female, however it was also statistically insignificant (P<0.05). Conclusion: Normal pattern of SPA observed in Sixty-four percent of Nepalese hands and in thirty-six percent cases it was formed by ulnar artery alone. There was no statistically significant difference in SPA pattern distribution between Nepalese male and female.

Pre-eclampsia is a syndrome that belongs to the group of hypertensive disorders of pregnancy. It is a multi-organ disease and can affect the kidney, liver, brain and the blood clotting system [1,2]. Pre-eclampsia is one of the most common causes of maternal and fetal morbidity and mortality [3]. Pre-eclampsia is defined as new-onset hypertension developed after 20 weeks of gestation (systolic or diastolic blood pressure ≥140 and/or ≥90 mmHg, respectively, measured at least two occasions, 4 hour to 1 week apart) and proteinuria(≥300 mg in a 24- hour urine collection, or two random urine specimens obtained 4 hours to 1 week apart containing≥1+ by dip stick or one dipstick demonstrated ≥2+ protein)[22,23]. Mild pre-eclampsia was diagnosed as pre-eclampsia was systolic blood pressure <160 mmHg, diastolic blood pressure <110 mmHg, platelet count≥100,000 per mm3, non-elevated liver enzymes, absence of renal insufficiency, pulmonary edema, cyanosis, new-onset cerebral/visual disturbances, and/or right upper quadrant or epigastric pain[24,25]. Severe pre-eclampsia is diagnosed as pre-eclampsia with systolic blood pressure ≥160 mmHg, or diastolic blood pressure ≥110 mmHg, platelet count <100,000 per mm 3, elevated liver enzymes, renal insufficiency, pulmonary edema or cyanosis, new-onset cerebral/visual disturbances, and/or right upper quadrant or epigastric pain [24,25]. A major advance in the classification of pre-eclampsia is its subdivision into early-onset and late-onset pre-eclampsia[26,27]. Especially, early-onset and late-onset pre-eclampsia have a serious threat to the maternal and neonatal lives, and in the clinical practice, it is of great difficulties and challenging in its treatment. Therefore, it is of great importance to pay enough attention to early-onset and late-onset pre-eclampsia. According to the statistics of recent years in China, the prevalence of pre-eclampsia has become less due to increase in attention paid to the pregnant women with the hypertensive disorder and in the maternity examination during their period of antenatal check-up.

Objective: To investigate the effects of vitamin E in Hypertensive Disorder of Pregnancy and the effects of vitamin E in Pregnancy Outcomes in Hypertensive Disorder of Pregnancy. Study Design: Prospective Cohort Study Materials and Method Data source: A total of 1910 pregnant women visited to the OPD and admitted in the Obstetrics and Gynecology Department of the First Affiliated Hospital of Dali University in Yunnan Province from June 2017 to May 2018 fulfilling the inclusion criteria were included in our study group. Case selection: All the pregnant women between the ages 23 to 35 years were included in the study and were divided into four groups: Normal pregnant group, gestational hypertension group, Pre-eclampsia group, and severe Pre-eclampsia group. Control group: Normal pregnant women were included in this group. Statistical Method: This study was performed prospectively and collected data were statistically analyzed using SPSS software (version 20.0) using independent t-test, Pearson Chi-square test, and one-way ANOVA test. The P values considered significant at value P<0.05. The descriptive data were presented using frequency and percentage. Multivariate Logistic regression analysis was conducted to examine the effect of vitamin E in HDP and Pregnancy outcomes including PPH, HIE, Neonatal rescue and 1≤Apgar Score≤7. Results: 1. There was no statistically significant difference in the results of all studies on BMI, WOG in the third trimester, parity, and maternal age (P>0.05). 2. Analysis between the effect of vitamin E and Hypertensive Disorder of Pregnancy: 2.1.1. There was no significant difference between the hypertensive group and control group during pregnancy in vitamin E level (t=1.665 P=0.096) (P>0.05). 2.1.2. The difference between pre-eclampsia and severe pre-eclampsia group was statistically significant in vitamin E level (t=27.692 P=0.000) (P<0.05). 2.2. Analysis between the effect of vitamin E levels and Hypertensive Disorders of pregnancy: 2.2.1. When vitamin E was excess, there was no significant difference between the control group, the gestational HTN group, pre-eclampsia group and severe pre-eclampsia group (X2 =0.164, P=0.983) (P>0.05). 2.2.2. When vitamin E was deficient, the difference between the control group and the hypertensive group during pregnancy was statistically significant (X2 =20.580, P=0.00) (P <0.05). 2.2.3. When vitamin E was deficient, there was no significant difference between the pre-eclampsia group and severe pre-eclampsia group (X2 =0.827, P=0.399) (P>0.05). 3. Effects of vitamin E in Pregnancy Outcomes in Hypertensive Disorders of pregnancy: When vitamin E level was deficient ： In Gestational Hypertension group there is 8.3% occurrence of PPH, 8.3% newborn has HIE. In pre-eclampsia group, there is 10% occurrence of PPH, 5% newborn has HIE, 5% newborn needed neonatal rescue and 5% newborn has 1≤Apgar Score≤7. In severe pre-eclampsia groups there is 5.7% occurrence of PPH, 5.7% newborn has HIE, 5.7% newborn needed neonatal rescue and 2.9% newborn has 1≤Apgar Score≤7. (X2 =2.325, P=0.887) (P> 0.05) There was no significant difference in the incidence of 1≤Apgar Score≤7 and Neonatal rescue between the pre-eclampsia and the severe pre-eclampsia. Conclusion: 1. Vitamin E contents are related to the hypertensive disorder of pregnancy. 2. Vitamin E deficiency is related to the occurrence of hypertensive disorders of pregnancy and has effects on maternal health and fetal outcomes. 3. Serum levels of vitamin E detection during pregnancy can help in the prediction of HOP; hence, it can help to reduce the risk of Pre-eclampsia.

is more scarce and demands for fresh water are increasing in Eddy and Lea Counties of southeastern New Mexico; • Oil and gas industries devote considerable financial resources to managing large volume produced water; and, • Decision-makers and stakeholders require information regarding produced water spatial distribution, quality and volume, geochemical composition, the regulatory framework, available treatment options, and water quality thresholds for different potential uses.