IMA may act as a marker of ischemia and oxidative stress in newborns delivered to pre-eclamptic mothers.

Introduction: Newborn suffers hypothermia in the extra-uterine environment, soon after birth, leading to a transient increase in TSH levels. Winters are the most stressful period in terms of cold stress. Methods: In this observational study, data of cord blood TSH and time of birth 1500 neonates was taken from hospital records which were routinely screened for congenital hypothyroidism at a tertiary care hospital in northern India. Two groups of neonates were formed on the basis of their birth months. In the first group (i.e. winters), neonates born in December, January and February were taken while those born in April, May and June were included in the second group (i.e. summers). Results:The cord blood TSH of neonates born in winters (median CBTSH=8.4 mIU/ml) was significantly higher (p=0.001) than that of neonates born in summers (median CBTSH=7.1 mIU/ml). The month wise distribution of CBTSH did also show the same pattern in winters and summers. The recall rate was also significantly higher (p=0.002) in winters (9.76%) than summers (4.84%). Discussion: Thyroid hormones play essential role in successful transition to extra uterine life. There is sudden and transient increase in cord blood TSH especially in winters. It leads to increased recall rates (recall of neonates with cord blood TSH >20 mIU/ml for further assessment to rule out congenital hypothyroidism at 3 rd postnatal day) for congenital hypothyroidism screening program. Thyroid hormones modulate the other hormones like thymulin in neonates, which are deserved to be studied to enhance immunity and decrease morbidities in them.

Introduction: In the past decade, laparoscopic route of surgery has been on an increase especially for nonneoplastic uterine diseases. The present study aims to study and compare between Total Laparoscopic Hysterectomy (TLH) and conventional TAH (Total Abdominal Hysterectomy) in terms of characteristics like blood loss, operative time, intraoperative complications, postoperative pain & mobilisation, analgesic requirements, duration of hospital stay and finally patient satisfaction. Materials and methods: In this randomized prospective comparative study, 100 consecutive patients of hysterectomy (50 each of total TAH and TLH) at a tertiary care center in western India, were recruited. The present study aims to study and compare between TLH and conventional TAH (Total Abdominal Hysterectomy), in non-neoplastic uterine diseases, in terms of characteristics like blood loss, operative time, intraoperative complications, postoperative pain & mobilisation, analgesic requirements, duration of hospital stay and finally patient satisfaction. Results: We observed that average blood loss, postoperative pain and analgesic requirement and mean length of hospital stay in TLH was lesser than TAH group (p< 0.001). An average time taken for TLH as well as patient satisfaction level was more (p< 0.001) than that in TAH group. Intraoperative complications were comparable and not significantly different among the two procedures. Mobilization after the procedure was quicker in laparoscopic hysterectomy. Mobilization of patients during postoperative period was significantly earlier (p< 0.0001) in TLH group (12.2 hours) while in TAH (22.3 hours. Patient satisfaction level was 90% in patients in TLH group while only 60% for patients in TAH group. Conclusion: TLH is a safe and effective method of doing hysterectomy and it is a good alternative of conventional abdominal hysterectomy, especially after good training to standardized the procedure, proper case selection, day to day practice of the technique and application of sound surgical principles.

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