It remains unknown whether SARS-CoV-2 infection specifically increases the risk of serious obstetric morbidity. To evaluate the association of SARS-CoV-2 infection with serious maternal morbidity or mortality from common obstetric complications. Retrospective cohort study of 14 104 pregnant and postpartum patients delivered between March 1, 2020, and December 31, 2020 (with final follow-up to February 11, 2021), at 17 US hospitals participating in the Eunice Kennedy Shriver National Institute of Child Health and Human Development's Gestational Research Assessments of COVID-19 (GRAVID) Study. All patients with SARS-CoV-2 were included and compared with those without a positive SARS-CoV-2 test result who delivered on randomly selected dates over the same period. SARS-CoV-2 infection was based on a positive nucleic acid or antigen test result. Secondary analyses further stratified those with SARS-CoV-2 infection by disease severity. The primary outcome was a composite of maternal death or serious morbidity related to hypertensive disorders of pregnancy, postpartum hemorrhage, or infection other than SARS-CoV-2. The main secondary outcome was cesarean birth. Of the 14 104 included patients (mean age, 29.7 years), 2352 patients had SARS-CoV-2 infection and 11 752 did not have a positive SARS-CoV-2 test result. Compared with those without a positive SARS-CoV-2 test result, SARS-CoV-2 infection was significantly associated with the primary outcome (13.4% vs 9.2%; difference, 4.2% [95% CI, 2.8%-5.6%]; adjusted relative risk [aRR], 1.41 [95% CI, 1.23-1.61]). All 5 maternal deaths were in the SARS-CoV-2 group. SARS-CoV-2 infection was not significantly associated with cesarean birth (34.7% vs 32.4%; aRR, 1.05 [95% CI, 0.99-1.11]). Compared with those without a positive SARS-CoV-2 test result, moderate or higher COVID-19 severity (n = 586) was significantly associated with the primary outcome (26.1% vs 9.2%; difference, 16.9% [95% CI, 13.3%-20.4%]; aRR, 2.06 [95% CI, 1.73-2.46]) and the major secondary outcome of cesarean birth (45.4% vs 32.4%; difference, 12.8% [95% CI, 8.7%-16.8%]; aRR, 1.17 [95% CI, 1.07-1.28]), but mild or asymptomatic infection (n = 1766) was not significantly associated with the primary outcome (9.2% vs 9.2%; difference, 0% [95% CI, -1.4% to 1.4%]; aRR, 1.11 [95% CI, 0.94-1.32]) or cesarean birth (31.2% vs 32.4%; difference, -1.4% [95% CI, -3.6% to 0.8%]; aRR, 1.00 [95% CI, 0.93-1.07]). Among pregnant and postpartum individuals at 17 US hospitals, SARS-CoV-2 infection was associated with an increased risk for a composite outcome of maternal mortality or serious morbidity from obstetric complications.
Agro-Homeopathy is the specialized area of homeopathic practice used to treat garden and agriculture.Homoeopathic preparations are being used efficiently for increasing active principles in medicinal plants, plant detoxification for metals, increasing plant growth rate and productivity, plant metabolism and control of diseases.This controlled experimental prospective study was planned to evaluate the effects of homoeopathic potentised medicines Phosphorus 200 CH and Pulsatilla 200 CH on plant growth (length, diameter and mass of fresh matter of whole plant) using Allium cepa L. as model system in natural environment.Seeds were sown in designated area of campus of Homoeopathy University, Saipura, Sanganer, jaipur, Rajasthan, India.Total 105 plants were grown in three groups (A, B and C) each having 35 plants.They were treated with Phosphorus 200 CH, Pulsatilla 200 CH and normal water respectively.After 14 weeks all the plants were measured in their entire growth for length, bulb diameter and mass.The application of potentised homoeopathic medicine Phosphorus 200CH and Pulsatilla 200CH on Allium cepa demonstrated a beneficial result as observed by significant difference in plant length, bulb diameter and mass between the experimental and control groups.Pulsatilla 200 CH induced early flowering in Allium cepa in relation to the control group.
Introduction: There are various researches for increased anxiety in Coronavirus Disease 2019 (COVID-19) patients and their relatives due to separation, but most of them are observational. Audio-video communication can be employed for communication between patients in rigorous isolation and their relatives. There were few researches available about the effectiveness of video calling on anxiety in COVID-19 patient. Gujarat lags considerably behind, according to bibliometric analysis of the India-based COVID-19 publication. Thus, the authors sought to conduct present study to evaluate that how video conferencing between COVID-19 patients in isolation and their relatives, affects anxiety. Aim: To determine the effect of standardised virtual communication on anxiety levels in relatives of COVID-19 intubated patient’s. Materials and Methods: This prospective interventional study was conducted at a tertiary care centre, Gujarat Medical Education and Research Society Medical College and Hospital, Vadodara, Gujarat, India, from April 2021 to July 2021. Total 283 relatives of COVID-19 patient were recruited by purposive sampling. Virtual communication unit was set up, where relatives can communicate audio-visually with their patient and caregiver with help of video calling technology. Inside Intensive Care Unit (ICU), the caregivers (intern, doctors or nurses) wearing Personal Protective Equipment (PPE) kit handled the portable audio-visual screen and answered on behalf of the patient. The Hamilton anxiety scale was used to measure the anxiety of relatives before and after the communication. Paired t-test was used to statistically analyse the data. Level of significant p-value <0.05 was considered. Results: A total of 283 subjects with 178 males and 105 female relatives were enrolled in the study. As an effect of communication, the mild anxiety prevalence decreased from 69.71% to 46.27%, the moderate anxiety prevalence decreased from 4.93% to 3.81%, and 49.92% of relatives reported being anxiety-free after communication. Statistical analysis of the paired t-test of Hamilton anxiety score showed a drop in anxiety score after communication from 4.77±3.66 to 2.88±2.34 (p-value <0.001). Conclusion: Audio-visual technology is effective as a mode of communication and counselling during a pandemic to reduce anxiety in COVID-19 victim families.
Acute pancreatitis is rare in pregnancy; however, the associated morbidity and mortality make prompt diagnosis and appropriate management essential. 1,2 Although most cases are mild and improve with limited interventions, severe cases require a multidisciplinary approach in a critical care setting. The main principles of management include identification of an etiology to guide therapy, fluid resuscitation, electrolyte repletion, early nutritional support, and pain management. Antibiotics are not indicated for prophylaxis and should be reserved for cases with a suspected infectious process. Surgical management is indicated in select cases. Management in pregnant patients has few differences which are outlined below.
A 12-year-old girl presented to the emergency department with a three-day history of worsening, colicky periumbilical and lower abdominal pain. Associated symptoms included anorexia, nausea and nocturnal awakening. This was preceded by two days of upper respiratory tract infection symptoms including malaise, cough and fever.
Vital signs demonstrated fever (38.8°C), tachycardia (heart rate 148 beats/min) and tachypnea (respiratory rate 28 breaths/min), but normal blood pressure and oxygen saturation on room air. Abdominal examination demonstrated tenderness in the mid and left lateral abdomen, with palpable fullness in the left lower quadrant.
Elevated white blood cell count (15.7×109/L), platelet count (426×109/L), C-reactive protein level (17 mg/L [161.9 nmol/L]), erythrocyte sedimentation rate (16 mm/h) and normal serum albumin were noted. Abdominal ultrasound identified marked ascites and isolated bowel wall thickening of the sigmoid colon.
The patient was admitted for observation. Gastroenterology and Pediatric Surgery were consulted regarding the abdominal pain and ultrasound findings. On further history, it was discovered that the patient had a five-year history of stereotypical recurrent abdominal pain. These episodes were much milder than at the time of presentation, and they occurred up to twice per month, resolving spontaneously within two days. Further history suggested the underlying diagnosis.
INTRODUCTION: Supervising resident interns during surgery and teaching can be variable. Not all feedback is taken in a positive manner by the recipient. We adopted the Cesarean section surgical competency operating room evaluation (CS-SCORE) from the O-SCORE in literature. The control group was those interns who learnt the cesarean delivery (CD) procedure by traditional methods. The video group watched a video of CD being performed along with the traditional methods. Our objective was to determine whether using a video of CD as an alternative teaching method and the CS-SCORE as an evaluation tool will help intern performance. METHODS: An evidenced based video of a primary CD was made. The 2013–2014 interns comprised the control. The 2014–2015 interns were the video group. The CS-SCORE was completed by the faculty present at surgery. The video group was compared to the control. The CS-SCORE included preop preparation of patient, each step of the surgery and immediate post op care. Each of these was compared using Mann-Whitney test and student t test. P value<.05 was significant. RESULTS: Eight interns from UTMB and 6 from UCSD were included in each group. 112 CS-SCORE were completed for control group and 87 for video group. Survey indicated that video improved understanding and learning in a low stress environment. Comparing CS-SCORE forms revealed better performance of the controls for most of the CD steps than the video group. CONCLUSION: CS-SCORE form may be a useful tool for feedback but has a learning curve for those providing the feedback.
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