Shikha Singh

Epidemiology of Critical Illness in Obstetrics

Critical illness in pregnancy as a morbidity outcome is difficult to define and therefore difficult to measure and study precisely. As stated by Harmer, “Death represents the tip of the morbidity iceberg, the size of which is unknown.” The stage at which any condition becomes severe enough to be classified as a critical illness has not been clearly defined. However, it may be helpful to consider critical illness as impending, developing, or established significant organ dysfunction, which may lead to long-term morbidity or death. This allows some flexibility in the characterization of disease severity since it recognizes condition that can deteriorate rather quickly in pregnancy.

Association of Characters and Selection Parameters for Quality Traits in Maize (Zea mays L.) as Influenced by Late Sown and Drought Conditions

An experiment consisting of twenty-one maize hybrids was conducted during kharif 2012 at Oilseeds Research Farm, Kalyanpur, Kanpur. Each genotype was sown in two rows each of 4 meter long spaced at 60x25 cm between rows and plants respectively in a randomized complete block design in three replications. The observations were recorded on five randomly selected plants for chlorophyll intensity at 30 and 60 DAS, Proline content (mm) at 60 DAS, Dry weight/plant at the intervals of 30, 60 and 90 DAS, cob weight per plant (g) and protein content. The statistical and biometrical analysis was carried out using standard formula. The results showed high heritability coupled with high genetic advance for total dry weight at maturity followed by cob yield per plant, dry weight at 60 DAS and proline content at 60 DAS reflecting the role of additive gene action. High heritability and low genetic advance was observed for chlorophyll intensity at 30 and 60 DAS and plant dry weight at 30 DAS indicating the presence of both additive and non-additive genes for controlling the characters. Cob yield per plant showed positive and significant correlation with plant dry weight at maturity. Its association with plant dry weight at 60 DAS was negatively significant.

A Comparative Study to Evaluate the Efficacy and Safety of Single Dose Intravenous Iron Carboxymaltose vs Multidose Iron Sucrose in Postpartum Cases of Severe Iron Deficiency Anemia

Materials and methods: One hundred cases with iron deficiency anemia in postpartum patient were selected from postpartum wards and assigned in two groups of 50 each. In group A, iron carboxymaltose injection administered by intravenous infusion upto a maximum single dose of 20 ml of iron carboxymaltose injection (1000 mg of iron). In group B Iron sucrose was given as 200 mg elemental iron (2 ampules of 5 ml) in 100 ml of 0.9% normal saline infusion over 15 minute alternate days up to 5 days. All the patients were monitored for rise in hemoglobin level at 2, 4, 8 and 12 weeks of iron therapy, adverse effect and rise in hematological parameter at 4 weeks.

Experience of HIV voluntary counseling and testing in antenatal women at a tertiary health centre of North India

Background: Integrating routine HIV counseling and testing as a mandatory part of antenatal care in India has led all pregnant women enter into the prevention of mother to child transmission (PMTCT) of HIV program. Despite such strategies, the effective execution and uptake of these programs remains a major obstacle. It is thus, important to understand the experiences of pregnant women undergoing HIV testing to detect the flaws on the part of the provider and the benefiter and eliminate them to strengthen the PMTCT services. Aim: We studied the acceptability of HIV voluntary counseling and testing (VCT) in antenatal women attending a tertiary health center of the North India. The impact of the sociodemographic factors on HIV prevalence and uptake of PMTCT was also studied, and the possible reasons for dropouts were determined. Methods: Pretest counseling was performed, and sociodemographic data and blood samples were collected from the consenting antenatal pregnant women. Samples were tested for HIV antibodies as per the World Health Organization guidelines. Data were analyzed and presented as mean, percentages, and tables. Results: Of 30,150 pregnant women counseled, 23,464 (77.82%) underwent testing. 136/23,464 women tested seropositive. The prevalence of HIV in antenatal women was found to be 0.58%. The majority of these women were young and belonged to the age group 20–24 years (0.23%). 22% refused testing, the reasons for which were sought. Strong associations were found between the HIV seroreactive status and marital status, low education status, low social class, high parity, and unemployment. Conclusion: To eliminate pediatric transmission of HIV and to create more awareness regarding HIV infection and MTCT, there is a need to make VCT and PMTCT programs more acceptable to the population. The observations found in the study were consistent with the national projections.

To evaluate the efficacy and safety of single dose intravenous iron carboxymaltose verses multidose iron sucrose in post-partum cases of severe iron deficiency anemia

Background: Iron deficiency is the most common nutritional deficiency worldwide. Anemia is the most common treatable, direct/indirect cause of maternal and neonatal morbidity and mortality in developing countries like India. Methods: 100 cases with iron deficiency anemia in post-partum patient were selected from postpartum wards and assigned in two groups of 50 each. In group A iron carboxymaltose injection administered by intravenous infusion up to a maximum single dose of 20 ml of iron carboxymaltose injection (1000 mg of iron). In group B Iron sucrose was given as 200mg elemental iron (2 ampules of 5 ml) in 100ml of 0.9% normal saline infusion over 1 5 min alternate days up to 5 days. All patients were monitored for rise in hemoglobin level and any adverse effect at 2 weeks, 4 weeks, 8 weeks and 12 weeks of iron therapy. Results: In group A mean Hemoglobin level rise is 3.95 g/dl and in group B it is 3.32 g/dl at 4 weeks of initial therapy. In group A 100% cases achieved target hemoglobin at 12 weeks after therapy while in group B 98% cases achieved target hemoglobin at 12 weeks after therapy. In group A 12% cases have grade 1 adverse reaction while in group B 20% cases have adverse reaction. Conclusions: Administration of intravenous iron has a good clinical result, with minimum adverse reactions. Thus we can conclude that intravenous ferric carboxymaltose therapy is safe, convenient, more effective and faster acting than intravenous iron sucrose for treatment of severe iron deficiency anemia in postpartum patient.