European Journal of Molecular & Clinical Medicine

Introduction: Preeclampsia is a multisystem disorder and is a major contributor of maternal and perinatal morbidity and mortality. Identifying women, who are at risk is important to prompt gestational management. Uterine artery waveform and biomarkers like pregnancy-associated plasma protein-A (PAPP-A) may reflect the pathophysiology of preeclampsia.
Aim: We aim to find out whether abnormal uterine artery pulsatility index (PI) and low serum PAPP-A in the first trimester can be used to predict preeclampsia.
Material And Methods: Antenatal women at 11-13⁺⁶ weeks of gestation visiting Sri Guru Ram Das Universty Of Health And science, Amritsar were enrolled after informed consent. Uterine artery Doppler was done with the early anomaly scan at 11-13⁺⁶ weeks. Serum levels of PAPP-A were analyzed. The women were followed up at intervals up to delivery. Incidence of preeclampsia was noted.
RESULTS: The incidence of preeclampsia was 26%. The mean uterine artery PI among those who developed preeclampsia was 2.03, which was significantly higher than the unaffected group (p=0.001). The first-trimester uterine artery PI as a screening tool showed a sensitivity of 84.67% and specificity of 75.68 % .The mean PAPP-A MoM of the affected group was 0.91 which was lower than the unaffected group (p=0.028). The first trimester PAPP-A as a screening tool showed a sensitivity of 15.38%, specificity of 91.89%.
Conclusion: Both the tests were concluded to be good predictors of preeclampsia. Identification of high-risk factors, screening, and surveillance are  important for timely  prediction of  preeclampsia and initiation of preventive therapy.

Background: Poisoning in children is a worldwide epidemic, and there is no region in the world that is immune to this catastrophe. In paediatric practise, it is one of the most frequently encountered situations that could have been avoided. Both the cause of poisoning and the type of poisoning can vary greatly from one region of the world to another. This is because the availability of poison to children is influenced by a variety of factors, including population, socioeconomic standing, level of education, as well as local beliefs and practises.
Martial and Methods: A future hospital-based study in India with a prospective design. Over the course of three years, beginning in June 2021 and ending in June 2022, children hospitalized to Sambaram Institute of Medical Sciences and Research with suspected acute poisoning were the subjects of a study that was designed as a prospective investigation. A parent or other relative who was present throughout the interview provided background information about the youngster.
Results: 210 children were found to be suffering from acute poisoning. There were 125 males, and there were only 85 girls. In 110 of the instances, household goods were involved, while pharmaceuticals were involved in 62, toxic plants were involved in 21, agrochemicals were involved in 13, and other substances were involved in 4.
Conclusion: In conclusion, I would like to offer some suggestions for some strategies that can assist to minimize the prevalence of childhood poisoning in India, in addition to the morbidity and death associated with it. Keep the containers of kerosene oil securely sealed and out of the reach of youngsters at all times. Do not keep kerosene oil in soft drink bottles. Make people aware of the potential risks associated with vomiting after consuming kerosene oil. Keep any agricultural chemicals in a secure location. Instruct the general public on how to properly dispose of unused medication.

Background: Second stage caesarean sections (SSCS’s) are becoming more common. More possibilities of foetal and maternal harm are linked to second stage caesarean sections. Although there are a number of methods stated to deliver the foetal head during a second stage caesarean operation, the "pull" approach has less risks. Aim & Objective: The purpose of the current study is to learn more about the surgical challenges, maternal complications, and neonatal problems associated with recurrent caesarean sections in second stage labour. Material and Methods:This was prospective observational study conducted at a rural tertiary care canter Karad. All second stage caesarean sections performed between June 2020 to May 2022 were analysed in terms of incidence, indications of caesarean-section, intra-operative and postoperative complications, maternal and fetal outcome. Results: During the study period there were total 6102 deliveries was observed. Out of them 100 were 2^nd stage caesarean sections contributing to 2.8% of total sections. Patwardhan method was used in 33% cases for delivery of deeply engaged head. Intra-operative complications were identified 51% patients in that majority of 26 patients had extraction difficulty in which 19 patients had lower uterine segment tear and angle extension and 7 patients had hematoma. In 11 patients there was atonic post-partum haemorrhage out if which 10 patients were managed medically and 1 patient underwent surgical intervention (B-lynch suture). In 3 patients there was injury to the bladder in which bladder repair was done. Conclusion: Caesarean sections during the second stage of labour are substantially more likely to result in maternal morbidity. The morbidity and death of new-borns are also rising. A professional obstetrician must use sound judgement when deciding whether to perform a caesarean section at complete cervical dilation.

Background: The most frequent presenting symptom in the gynecology outpatient department is abnormal uterine bleeding (AUB). Endometrial sampling may be effectively the initial diagnostic step in AUB, though it frequently presents a difficult interpretation for pathologists in practice. This study was done to evaluate the histopathology of endometrium for the purpose of identifying the endometrial causes of AUB. Additionally, we tried to observe the incidence of various pathologies in different age groups presenting with abnormal uterine bleeding.
Materials and methods: This is a prospective study done on cases of AUB who underwent endometrial biopsy from August 2020 to August 2021 in the department of pathology at Kakatiya Medical College, Warangal, and Telangana, India. All the biopsies were routinely processed and a histopathological diagnosis was made. A statistical analysis between age of presentation and specific endometrial causes was done using the Chi-square test.
Results: The most common age group presenting with AUB was 35–72 years old. Out of 133 cases studied, 48% of cases were found to be proliferative endometrium, 28% of cases were of secretory endometrium, 2% of cases were of atrophic endometrium, 3% were of irregular maturation, 17% were of simple hyperplasia, and 2% were of endometrial carcinoma. Endometrial causes of AUB and age pattern was statistically significant with P value<0.05.
Conclusion: Endometrial lesions are associated with particular ages. AUB is more frequently dysfunctional in perimenopausal women, so when they are in the reproductive age range, they should first rule out pregnancy-related issues. This study's significantly high incidence of aberrant proliferative patterns suggests that these patients present at an early stage.

Background: A potentially lethal condition is known as venous thromboembolism (VTE), which includes pulmonary embolism and deep vein thrombosis (DVT). To determine the effectiveness of pharmacological prophylaxis against PE or DVT (Pulmonary Embolism). To ascertain the prevalence of DVT (Deep Venous Thrombosis) or PE (Pulmonary Embolism) despite prevention. On the subject, relatively few studies from India have been published, and nothing is known about the true prevalence of the disorder. Due to a sharp rise in the number of joint replacement surgeries, the topic has recently taken on more importance among Indian people. Regarding the prophylaxis for VTE in Indian patients, there are no precise recommendations.
Materials and Methods: In order to investigate the prevalence of DVT, we designed and carried out a prospective study. The current study comprised a total of fifty patients who had undergone THR, TKR, or HRA. The duplex ultra-sonography was performed on each of the patients between the seventh day and the third week of postoperative day. As a preventative measure against deep vein thrombosis (DVT), all patients received subcutaneous Enoxaparin 40 mg once day for 5 days and Asprin for 4 weeks.
Results: Only two patients or four percent of the total, revealed sonographic evidence of distal asymptomatic DVT, and both of those patients' symptoms went away on their own without any treatment. During the follow-up scan, there was no evidence of proximal DVT propagation, and there were also no incidences of pulmonary embolism.
Conclusion: DVT in patients who have undergone THR, TKR, or HRA is not nearly as common as it is reported to be in the Western medical literature. It is essential to maintain a high level of suspicion, in addition to close clinical surveillance. In our society, deep vein thrombosis (DVT) is hardly an unheard-of condition. Although low molecular weight heparin is a safe medicine, it appears that the risk of bleeding problems is higher than what is described in Western medical literature. In the future, it will be necessary to conduct additional trials that involve a greater number of patients and take place at many centres in order to corroborate the findings of our study and evaluate the actual efficacy and safety of LMWH.

Introduction: More over 20% of the world's population is in the adolescent age range, which is defined as being between 10 and 19 years old. Around 16 million teenage girls give birth each year, or 11.0% of all births worldwide. Pregnancy among teenagers aged 10 to 19 is referred to as adolescent pregnancy. Teenage birth rates are rising, particularly in developing nations where the consequences for their health are worse. Around the world, adolescent moms were responsible for more than 11% of births. Adolescent pregnancy has been linked to medical, social, and economic issues that affect girls, their families, and nations, according to earlier research.
Aims and Objectives: To look into the impact that being pregnant as a teenager has on both the mother and the unborn child. The purpose of this study is to estimate the frequency of pregnancy among teenage girls and to evaluate its effects on those girls (15-19 years). In order to investigate the factors that lead to pregnancy among adolescents. To investigate the challenges associated with pregnancy and delivery in adolescents.
Methods: The investigation was conducted at Hyderabad's Peltaburz Modern Government Maternity Hospital. Study population: all 15-19-year-old pregnant girls. Cross-sectional prospective study 2019-2020: Studied Used 50 samples. Eligibility: During the study period, all 15-19-year-old pregnant girls were admitted, regardless of parity. Exclude non-obstetric instances. All pregnant women in the research were 20 or older. Before beginning the probe, ethics committee approval was acquired. The study's participants gave signed, informed consent. They had a general checkup, abdominal and vaginal exams. Routine and repeat ultrasonography ruled out congenital defects, placental maturity, amniotic fluid index, biophysical profile, and issues.
Results and discussion: In the study, the prevalence of adolescent pregnancy was determined to be 4.6%. 1260 of the 27376 women who gave birth during this time were in the adolescent age bracket. 50 of these teen pregnancies were examined and evaluated. Adolescent women's pregnancy and childbearing have negative health, demographic, and societal effects. Compared to pregnancy in non-adolescent women, an adolescent mother and her child are more at risk. Adolescent pregnancy is a high risk pregnancy, so organised prenatal care is crucial. In this study, 50% of the patients are from low socioeconomic position, 40% are from middle socioeconomic status, and 10% are from high socioeconomic status. 54% of the cases in this study were illiterate, 16% had only received their primary education, 20% had completed high school, and 10% had attended college.
Conclusion: Adolescent pregnancy and childbirth are associated with negative outcomes across a variety of domains, including health, demographics, and society. When compared to pregnancy in non-adolescent women, the potential dangers to an adolescent mother and her child are significantly higher. Because adolescent pregnancy is a high-risk pregnancy, it is absolutely necessary to have prenatal care that is well organised

Background
Cardiorenal syndrome (CRS) is not a newly discovered syndrome. The adverse outcomes of
the renal impairment in patients with Heart failure were known since long. Our aim in this
study was to evaluate the occurrence of AKI, to determine the outcome (morbidity and
mortality) in patients suffering with AKI.
Methods
The present observational prospective study was conducted for a duration of 1 yearamong
100 patients (age 18 years or more) admitted to hospital with acute decompensated heart
failure.A written informed consent taken from each patient and were then screened for
cardiac dysfunction by a detailed history, clinical examination and
echocardiography.Univariate logistic regression was used to find out association of various
outcomes with AKI. A p value of <0.05 was considered statistically significant.
Results
The mean age of the study population was 58.98 ± 17.16 years. The mean Boston criteria for
the population was 9.87 ± 1.36. Baseline S. creatinine, eGFR and even B. Urea were strongly
associated with the occurrence of AKI. Presence of diastolic dysfunction was associated with
AKI. Mortality and readmission were significantly higher in AKI group as compared to non-
AKI group.The predictive value of AKI was maximum with the baseline S. creatinine.
Conclusion
Cardio-renal syndrome is a commonly seen in patients admitted in hospital. AKI can lead to
poor cardiac output or pre-renal failure as a result of overuse of diuretics. The mechanism
involved is complex. AKI in patients admitted with ADHF has poor prognosis with increased
mortality and longer duration of hospital stay.