Papers by nitin raithatha
Non-transfusion dependent thalassemia (NTDT) patients typically remain asymptomatic until certain... more Non-transfusion dependent thalassemia (NTDT) patients typically remain asymptomatic until certain triggers, such as pregnancy, necessitate transfusions and increase the risk of pregnancy-related complications if not managed appropriately. We present the case of a 38-year-old female with NTDT, splenectomised at age six, who presented at 17 weeks of gestation with weakness and bipedal edema. She was advised to undergo regular blood transfusions and take aspirin, targeting a haemoglobin level of 9 g/dl. The patient was lost to follow-up and she returned later to underwent an emergency caesarean section at 32 weeks due to absent fetal movements and absence of end-diastolic flow. Postpartum, she experienced thromboembolism and was diagnosed with severe osteoporosis, treated with low molecular weight heparin, calcium, and vitamin D supplements. Pregnancy exacerbates anemia and thrombosis risk in thalassemia patients, leading to complications such as intrauterine fetal death, growth retardation, and spontaneous abortions. Aspirin or low molecular weight heparin, along with blood transfusions, are often required to prevent these complications. Iron chelating agents, contraindicated during pregnancy due to teratogenic risks, are typically recommended post-breastfeeding. Thalassemia also impacts other body systems, including cardiovascular, gastrointestinal, and skeletal systems. Therefore, a multidisciplinary approach with a well-planned treatment regimen and comprehensive family planning counselling is essential for NTDT patients.
Pre-term labour: A study on evaluation of causes and outcome
Journal of family medicine and primary care, Feb 1, 2024
International journal of community medicine and public health/International journall of community medicine and public health, Feb 29, 2024
Background: This study aimed to determine the utility of RMI 2 in distinguishing benign and malig... more Background: This study aimed to determine the utility of RMI 2 in distinguishing benign and malignant adnexal masses in low-income countries. Methods: For the purpose of this retrospective observational study, relevant data from patients who attended a tertiary care institution in central Gujarat between June 2020 and June 2022 were obtained from the Medical Records Department (MRD). Ultrasound and biochemical parameters along with epidemiological factors were identified and an RMI 2 score was calculated followed by statistical analysis. Results: Twenty-five (37.87%) of the sixty-six instances that were investigated were benign, two (3.03%) were borderline, and thirty-nine (59.09%), were malignant. Using RMI 2 at the traditional cut-off value of 250, results showed a sensitivity of 85.2% (95 %; CI=68.9-95.05), a specificity of 66.6% (95 %; CI=47.1-82.7 %), a positive predictive value of 74.36%, and a negative predictive value of 80.0 %. The ROC showed an AUC of 0.68 (CI=0.5-0.7) with a standard error of 0.07 (p=0.009). Conclusions: With a cut-off point of 250, RMI 2 was able to identify malignant masses with an 85.2% sensitivity and 66.6% specificity to enable timely referral to more advanced institutions for improved management in resourceconstrained settings where its affordability and user-friendliness are favourable.
The Study of the Prevalence of Knowledge and Vaccination Status of HPV Vaccine Among Healthcare Students at a Tertiary Healthcare Center in Western India
The Journal of Obstetrics and Gynecology of India, 2024
Research Square (Research Square), Oct 23, 2023
The mother-baby dyad creates a synergistic being during pregnancy, and women's health at this tim... more The mother-baby dyad creates a synergistic being during pregnancy, and women's health at this time is crucial for fetal development and wellness. The time of pregnancy is one of excitement and joy. Unfortunately, it comes with stress and anxiety regarding the baby's health, the delivery method, and any potential complications. These worries can predispose women to developing depression as a result. Using a purposive sampling method, a prospective nonrandomised cohort research study was carried out at the Department of Obstetrics and Gynaecology in 2021-2022. Patients who satis ed the inclusion criteria were enrolled whereas patients who were unable to devote the required time and adherence to various mindfulness interventions were placed in the control group. The researcher administered questionnaires such the FFMQ-15, EPDS, and PSS to each patient. Descriptive analysis was used for the various demographic characteristics that were recorded. The intervention and control groups were compared using independent t tests and chi-square tests for the continuous variables viz-EPDS, PSS, and FFMQ-15. The study comprised 36 patients in total; 13 patients were in the control group and 23 patients were a part of the intervention group. The mean ages of the intervention and control groups were 30.78 years and 25.69 years, respectively. A su cient amount of mindfulness meditation interventions had been practiced by 79% of the patients. Two of the ve FFMQ subscales, observing (p=0.001) and describing (p=0.013), indicated a substantial improvement in the mindfulness score in the intervention group. Whereas, acting with awareness, one of the FFMQ's ve subscales, saw a substantial increase in the mindfulness score in the control group (p=0.010). There was a statistically signi cant reduction in the EPDS score in the intervention group before and after the intervention (p=0.007). The reduction in the PSS score after the intervention was statistically signi cant in the intervention group (p=0.030). The intervention was perceived as more readily acceptable to women belonging to a higher socio-economic stratum owing to awareness prevalent due to a better education status. The positive impact of mindfulness practices was witnessed owing to the contrast of levels of stress and depression upon enrolment, and their observed decrease after following the various mindfulness interventions.
Cureus, Nov 14, 2023
Choriocarcinoma, an aggressive gestational trophoblastic disease, infrequently manifests with spo... more Choriocarcinoma, an aggressive gestational trophoblastic disease, infrequently manifests with spontaneous uterine perforation. We report the case of a 22-year-old female with five months of amenorrhea presenting with acute abdominal pain. Ultrasound and MRI assessment highlighted a uterine perforation with choriocarcinoma. Subsequent total abdominal hysterectomy revealed choriocarcinoma in the bicornuate uterus with uterine perforation. Histopathological analysis confirmed the diagnosis of choriocarcinoma in the cornu of the uterus. Timely diagnosis is vital to reduce mortality. Notably, choriocarcinoma in a bicornuate uterus is exceptionally rare. Radiological evaluations are critical for diagnosis, staging, and follow-up.
Changing Trends of Obstetric Hysterectomy Over Last 2 Decades: A Retrospective Analysis from a Single Center Tertiary Care Rural Teaching Hospital of Western India
The Journal of Obstetrics and Gynecology of India
Silent upsurge of gestational diabetes: Are we aware? A rural tertiary care experience of Central Gujarat
Journal of Family Medicine and Primary Care, 2022
Nucleotide sequences spanning TLR9 gene segment for C296T single nucleotide polymorphism, obtained after performing Sanger sequencing on five samples each of cervical cancer and healthy controls
Raw, unedited polyacrylamide gel electrophoresis image of 27 controls and 24 cervical cancer PCR amplified products that underwent restriction fragment length polymorphism (RFLP) analysis
Age, clinical stage and TLR9 genotype status among cervical cancer patients as well as age and TLR9 genotype status among controls
Raw, unedited agarose gel images of PCR amplification of TLR9 gene segment for C296T/ Pro99Leu polymorphism from 50 samples consisting of 26 controls and 24 cervical cancer cases
Human Papillomavirus Infection and Association of TLR4 and 9 Gene Polymorphisms with Cervical Cancer in Gujarat, India
Genetic polymorphism of CYP450, GST genes and HPV infection in cervical cancer patients from Charotar region of Gujarat, India
Human Papillomavirus Infection in Chronic Cervicitis: Adding Insult to Injury!
Background: Efforts by the Indian government to improve maternal and child health (MCH) outcomes ... more Background: Efforts by the Indian government to improve maternal and child health (MCH) outcomes have failed to have significant impact, calling for a more evidence-based approach. This study stems from an Indo-US collaboration led by two U.S. medical students designed to address critical gaps in knowledge about the underlying causes of adverse MCH outcomes. Methods: The pilot longitudinal study will enroll 150 pregnant women between the ages of 18-45 and spans from first trimester of a pregnancy to six months post-partum and includes eight visits at a tertiary healthcare center in rural Western India. Participants receive clinical evaluations, ultrasound imaging studies, and serum biomarker measurements. Trained research coordinators manage their visits and conduct standardized interview surveys in the local language. Results: Currently, 86 participants are enrolled, with enrollment projected to conclude in May 2014. To date, 53 participants reported a previous pregnancy, with only...
Critically ill obstetric patients requiring mechanical ventilation in rural western India: A retrospective analysis
The National Medical Journal of India, Mar 1, 2016
There is a dearth of studies on the clinical profile and therapeutic aspects of critically ill ob... more There is a dearth of studies on the clinical profile and therapeutic aspects of critically ill obstetric patients from rural areas, especially those requiring tertiary care support and ventilator therapy. We retrospectively analysed the aetiological, clinical, interventional and outcome-related factors of obstetric patients requiring mechanical ventilation in western India. We analysed factors that influence seeking of antenatal care, pregnancy and its complications, severity assessment score, indications and initiation of mechanical ventilation, multiorgan failure and their correlation with maternal mortality. Of the 6708 obstetric admissions studied, 1112 were of critically ill (16.5%) patients and 200 (17%) of these required mechanical ventilation. Over three-fourths (77%) of patients were from rural areas, 83.5% were referred and 97% had inadequate antenatal care. Severe pregnancy-induced hypertension/eclampsia, massive haemorrhage and sepsis were the common obstetric complications. Pulmonary oedema (32.5%), acute respiratory distress syndrome (ARDS, 14%) and acute lung injury (22.5%) were the three most common indications for mechanical ventilation. In 26% of patients, mechanical ventilation was initiated early based on a worsening cardiorespiratory profile. A sequential organ failure assessment score of >5 on admission and delay in treatment resulted in multi-organ failure and worsening outcome. The maternal mortality ratio was 32.5%, incidence of multi-organ dysfunction syndrome was 71%, and pregnancy loss was 43.5%. The odds ratio for maternal mortality in patients ventilated early was 0.39 as against 5 in those with ARDS. Inadequate antenatal care, delayed referral practices, pregnancy-induced hypertension, obstetric haemorrhage and sepsis remain the major causes of complications in obstetric patients from rural areas. The common indications for mechanical ventilation were pulmonary oedema, ARDS and acute lung injury. Early initiation of mechanical ventilation upon detection of imminent.
scopemed.org
Lifeline of the fetus in the womb is umbilical cord and is not spared in having anatomical and fu... more Lifeline of the fetus in the womb is umbilical cord and is not spared in having anatomical and functional variance. Velamentous insertion of umbilical cord is more common in twins (incidence 8.7%). Increased risk for intra uterine growth retardation, preterm birth, congenital anomalies and fetal bleeding is associated with it. Intrauterine diagnosis can help to improve the fetal prognosis. So we have presented a case of twin pregnancy with one cord have Velamentous insertion and the other has normal; increase of Monochorionic diamniotic placenta. Both baby were still birth.
TLR9 polymorphism and its association with HPV infection in Cervical Cancer and Cervicitis patients from Gujarat, India
Spleenic Rupture In Pregnancy - In A Rural Based Tertiary Care Hospital
National journal of integrated research in medicine, 2013
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Papers by nitin raithatha