Abstract
Background: Incisional hernia, by definition represents a breakdown or loss of continuity of a fascial closure. Surgical management of incisional hernias has evolved over the last century. This study was performed to review clinical profile and management of incisional hernia in our institute. AIMS AND OBJECTIVES: To analyze the etiopathogenesis of incisional hernia with respect to patient variable factors, types of surgical intervention. Materials and Methods: This a prospective study conducted at our institute between July2014 to Oct 2016. 50 patients were included and followed up for immediate post-operative complications. OBSERVATIONS AND Results: Incisional hernia was found to occur more often in 31-40yr age group,and mostly in females. Most commonly occurred following gynecological operations, lower abdominal incisions, post-operative wound infection. Conclusion: In Incisional hernias the choice of operative technique is crucial. Incisional hernias occur more often in females as they are more likely to undergo lower abdominal surgeries. Mesh repair is considered superior to anatomical repair.

2016040222-A STUDY OF INCISIONAL HERNIA pdf

Abstract
INTRODUCTION: Upper gastrointestinal tract disorders are one of the most commonly encountered problems in clinical practice. Patients with symptoms of esophageal diseases are commonly encountered in surgical practice. The evaluation of esophageal diseases and their management has been challenging to physicians and surgeons. Endoscopy is the procedure of choice for the diagnostic evaluation of Esophagus because of its ease, reliability, diagnostic superiority, wide availability and the ability it gives the endoscopist to perform biopsies and therapeutic interventions.
OBJECTIVES: 1. To study the incidence of various esophageal diseases with respect to age, sex. Socioeconomic status, risk factors, symptomatology in our hospital (RMMCH) .2. To study the pattern of presentation of various esophageal diseases.
3. To study the need for different therapeutic procedures that can be done endoscopically in our hospital.
SETTING: Endoscopy clinic in Rajah Muthiah Medical College & Hospital, Annamalai nagar,Tamilnadu-a large rural based tertiary care hospital.
MATERIALS & METHODS: This is a prospective study of 200 patients with symptoms of esophageal diseases who attended department of surgery and underwent UpperGI Endoscopy under SII unit in RAJAH MUTHIAH MEDICAL COLLEGE HOSPITAL during the period from JULY 2016 to OCTOBER 2016 . These patients underwent upper gastrointestinal endoscopy both on IP and OP basis. Documentations of patients which includes, identification, history, clinical findings, investigative tests, endoscopy findings and complications during the stay in hospital and during subsequent follow up period, were all recorded in a proforma specially prepared.
Results: In our Series of 200 cases, 50 cases (25%) had normal findings, 150 cases (75%) had abnormal findings. Males constituted about 62.5 % and Females 37.5% of total population. Among those having diseases Reflux Esophagitis (41.3%) was the commonest, followed by Hiatus hernia at 26.6 %, Carcinoma Esophagus presented in 4 % of cases. Among age groups, majority belonged to 26-50 yrs (59.5%).Among 200, 45% are smokers and 38% are alcoholics. Heartburn is the commonest presenting complaint found in 55% cases, followed by difficulty swallowing, regurgitation, chest pain, loss of appetite, malena and hematemesis.
Conclusion: In our study, the commonest Esophageal pathology in patients with upper gastrointestinal symptoms and underwent UGI Endocscopy was Reflux Esophagitis at 41.3%. We therefore conclude that upper GI endoscopic evaluation is a must in all patients who present with upper gastrointestinal tract symptoms and to identify early identification of lesions with malignant potential.

2016040221-A Study of Esophageal Diseases in Rajah Muthiah Medical CollegeHospital…pdf

Abstract
Background: Prematurity and its prevention continue to be a major challenge for both the obstetrician and neonatologist. Preterm labour is the most common obstetrical complication associated with perinatal deaths. Despite all advances in neonatology, the delivery of a preterm neonate is a clinical crisis that threatens the life and health of an infant. The obstetrician thus faces the challenge of affecting the delivery in such a way as to optimize the status of fetus-infant at birth It is far more preferable to prevent the initiation of preterm labour than once the cascade of events has already been established. Objective: To assess the efficacy of magnesium sulphate as a tocolytic agent in preterm labour. Material and Methods: 35 pregnant patients with gestational age 28-37 weeks with cervical dilatation not more than 3cm and cervical effacement not more than 50 % with intact membranes with regular uterine contractions with a frequency of 2 or more per 10 minutes lasting for at least 30 seconds were put on magnesium sulphate. Results: Magnesium sulphate was successful in attaining tocolysis in majority of patients
Conclusion: Magnesium sulphate is an effective, safe and well tolerated tocolytic agent.

2016040220.ROLE OF MAGNESIUM SULPHATE IN THE MANAGEMENT OFPRETERM LABOUR pdf.

Abstract
Background: Pre-eclampsia is a pregnancy specific disorder which constitutes hypertension after 20 weeks of gestation and proteinuria. It is being speculated that associated subclinical left ventricular dysfunction may contribute to cardiac mortality and morbidity. This prospective study on left ventricular systolic function by echocardiography was undertaken in normal and pre-eclamptic pregnancies. Methodology: This prospective study was carried in Rajah Muthiah Medical College and Hospital, Chidambaram. Forty subjects were enrolled of which 20 had pre-eclampsia and 20 were normotensive. All were subjected to echocardiography.Results: Echocardiography reveals no significant systolic dysfunction was noted in pre-eclamptic patients and normotensive patients.

2016040219.SYSTOLIC FUNCTION IN PRE ECLAMPSIA pdf.

Abstract
Objective
To compare the Transvaginal cervical length with modified Bishop’s score for cervical assessment in women undergoing labour induction at term to predict the need for caesarean delivery and to estimate the cut-off points for cervical length measured by TVS and modified bishop’s score in successful induction.
Methods: A prospective study was performed on One hundred and twenty five nulliparous women admitted for induction of labour. The cervical length was measured by TVS in cm followed by Digital vaginal examination done to record the modified Bishop’s score. Dinoprostone gel (0.5mg) was kept in the endocervical canal for inducing labour.
Results: Bishop’s score of 4 and cervical length by transvaginal ultrasound of 2.6cm are considered as cutoff values. Patients with TVS Cervical length of (2.54±0.50) cm delivered vaginally, whereas patients with TVS Cervical length of (3.26±0.45) cm delivered by caesarean section. A total of 32 (61.5%) of the patients delivered vaginally, and 3 (4.1%) of the patients delivered by caesarean section had cervical length ≤2.6 cm. Patients with modified Bishop’s score around (4.9±3.1) delivered vaginally, whereas patients delivered by caesarean section had modified Bishop’s score around (3.1±1.1). Moreover, 39 (75%) of the patients delivered vaginally, and 20(28.7%) of the patients delivered by caesarean section had modified Bishop’s score ≥4.
Conclusions: Both TVS cervical length and modified Bishop’s score are useful predictors of the need for caesarean delivery following labour induction.

2016040218.Study of comparison on transvaginal cervical length and modified Bishop’s score pdf.

Abstract
Post partum hemorrhage (PPH) is an important cause of maternal mortality accounting for nearly 25% of maternal deaths worldwide. Atonic PPH is the most common cause of PPH. PPH is a preventable condition. Third stage of labour is indeed a unforgiving stage of labour where normal case can become abnormal within a minute and successful delivery can turn into a disaster. This paper represent a case of atonic PPH as well as literature review.

2016040217.CHALLENGING CASE OF POSTPARTUM HEMORRHAGE – A CASE REPORT pdf.

Abstract
Introduction: Gestational diabetes mellitus (GDM) according to ACOG is any degree of glucose intolerance that either commences or is first diagnosed in pregnancy.
Babies of GDM mothers are regarded as a major risk factor for birth trauma, respiratory distress syndrome, birth asphyxia, transient tachypnea of the newborn and jaundice. These babies are also at a risk for microvascular (e.g., ocular and renal complications) and macrovascular complications (e.g., cerebrovascular accident, atherosclerosis and cardiovascular insult). The neonatal mortality rate is over five times higher than that of infants of normal mothers. In this study, therefore we aimed to assess the effect of maternal diabetes on cord serum lipid profile.
Objective: The aim is to analyse the impact of gestational diabetes mellitus (GDM) on cord serum lipid profile.
Methods: Study group included 30 babies of GDM women and control group included 30 equal cohort babies of normal pregnant women. Cord blood was collected at the time of delivery and lipid profile which includes serum cholesterol, serum triglycerides, serum low density lipoprotein and serum high density lipoprotein were estimated by autoanalyser.
Result: There was a significantly higher value of total cholesterol (75.45mg/dl vs 62.48mg/dl) and HDL (27.17mg/dl vs 24.55mg/dl) in babies of GDM women compared to babies of normal pregnant women. On the other hand slightly lower LDL (29.14mg/dl vs 30.16mg/dl) and triglycerides (56.44mg/dl vs 58.41mg/dl) were noted in babies of GDM women.
Conclusion: Total cholesterol and high density lipoprotein were significantly higher in babies of GDM women whereas LDL and TG were slightly lower compared to babies of normal women.

2016040216,IMPACT OF GESTATIONAL DIABETES MELLITUS ON CORD SERUM LIPIDS pdf.