Background: Depressed neonates born through meconium stained amniotic fluid (MSAF) are at high risk for developing meconium aspiration syndrome (MAS). Benefits and risk of endotracheal suctioning in non-vigorous infants at birth, though widely practiced till recent have not been established. Objectives: To evaluate effect of endotracheal suctioning at birth on incidence of MAS, its severity and outcome among non-vigorous MSAF born infants. Methods: This randomized open level trial was conducted over one year period at a tertiary care teaching hospital. 155 non-vigorous infants (vigour assessed within 5-10 s of birth) were randomized to receive either endotracheal (ET) suctioning just after birth (n = 76) or no-endotracheal suction (n = 79). Subsequent resuscitation was performed as per neonatal resuscitation guideline. All infants were admitted for subsequent care and monitoring. Antenatal, intrapartum, and neonatal details; respiratory support; complications, hospital stay and outcome were recorded. Results: Incidence of respiratory distress due to MAS (with consistent chest radiology) was 41.3% and 57.1% [OR = 0.53(0.28to 1.01); p = 0.052], while non-MAS respiratory distress was 33.3% and 27.3% [OR = 1.69(0.81 to 3.54); p = 0.17] in ET suction and no-ET suction group, respectively. Severity of MAS in ET suction vs. no-ET suction group were mild:16.1%(5/31)vs15.9%(7/44); moderate:61.3%(19/31)vs65.9%(29/ 44) and severe:22.6%(7/31)vs18.2% (8/44). Respiratory support requirement including mechanical ventilation; its duration, and mortality were similar in both groups, however, hospital stay was shorter in ET suction group (9.91 ± 3.22vs. 11.17 ± 3.73 days; mean diff:−1.26(−3.36 to −0.17); p = 0.024). Conclusions: Endotracheal suctioning at birth in non-vigorous infants born through MSAF tends to decrease the incidence of MAS and duration of hospital stay, however, overall incidence of respiratory distress and mortality remain unchanged.

Background:The present paper has examined the sources of stress among the healthcare professionals and the difference between responses of personality type A and type B healthcare professionals toward stressful situations. Further, the difference in the performance of both the personality types has been studied. The relationship between stress and performance among the healthcare professionals in general and with respect to personality type A and type B healthcare professionals in particular has also been investigated.Methods:A total of 160 healthcare professionals of Post Graduate Institute (PGI), Chandigarh, were subjects of this study.Results:Identification with patients, deterioration and complication in the patient condition, and job criticism emerged to be the sources of stress. Significant difference between personality type A and personality type B professionals’ response pertaining to identification with the patients only has been reported. However, type A individuals showed slightly higher inclination as compared to type B individuals on majority of stressful situations. It was further noted that type A individuals had scored higher on almost all the performance indicators as compared to personality type B individuals. The mean difference between the personality types was found to be significant for two performance dimensions, i.e., relationship with colleagues, and teaching and training.Conclusions:The stressful situation relationship with patients was found to have significantly negative impact on the performance factors such as good clinical care and rapport with patients. Daily work was also found to be negatively related to good medical practice.

Background: Uric acid is the final product of the purine metabolism in humans. The two final reactions in its production which catalyze the conversion of hypoxanthine to xanthine and the latter to uric acid are catalyzed by the enzyme xanthine oxidoreductase. The role of uric acid in the progression of prediabetes to diabetes has been known. Serum uric acid has been shown to be associated with cardiovascular disease, hypertension, and chronic kidney disease. The present study was done to see the level of uric acid in preeclampsia and healthy pregnant controls, to relate serum uric acid results to the severity of hypertension and its relation to fetomaternal outcome in patients attending OPD at RMC Ajmer. Methods: 100 cases of preeclampsia of age group between 20-40 year and gestational age ≥28 weeks and 100 normal healthy women with similar gestational age and age group were included in the study and maternal serum uric acid was estimated in both groups. Results: Mean serum uric acid levels in preeclampsia was 7.65±081 mg/dl and 3.21±072 mg/dl in control group. Perinatal complication was more in case group, 74 % were preterm compared to 11% in control group. Mean birth weight in study group was 2.07 kg, of which 24% babies were VLBW 52% were LBW, and 24% babies had normal birth weight, in control group mean birth weight was 2.82 kg. The difference was found to be statistically significant (p value 0.001). In the study group, the MSUA concentration is found higher in LBW and VLBW babies compared to normal birth weight babies. Conclusions: There is a positive correlation between SUA & severity of preeclampsia, and a significant adverse fetal outcome is observed with raised MSUA in preeclamptic patients.

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