ABSTRACT
Background: The World Health Organization (WHO) 2016 classification incorporated molecular subtyping in glioma, highlighting the diagnostic and prognostic significance. The study aims to determine the isocitrate dehydrogenase (IDH-1) gene, α-thalassemia/mental retardation syndrome X-linked (ATRX) gene, and tumor suppressor gene-53 (p53) mutation in glioma and their correlation with various clinical and radiological parameters.Methods: In this prospective observational study, histopathological slides of glioma (2017-2018), were analyzed for IDH-1, ATRX and p53 mutations and their correlation with various clinical and radiological parameters.Results: IDH-1 mutation was found in 48 (38.7%), ATRX loss in 38 (30.6%) and p53 mutation in 40 (32.5%) patients. The expression of IDH-1 was significantly higher (43.7%) in adults; however, no significant difference was seen with gender. Also 51.2% of patients, who presented with seizures, showed IDH-1 expression; and 27.7% of patients, who had neurological deficit also showed IDH-1 expression. IDH-1 expression was high in glioma located at insula (73.3%) and parietal lobe (71.4%); while ATRX loss was seen in glioma located at insula (80%). Intraventricular glioma characteristically lacks all three markers: IDH-1 expression, p53 overexpression and ATRX loss. IDH-1 expression and p53 overexpression was seen mainly in diffuse fibrillary astrocytoma, oligodendroglioma, anaplastic astrocytoma and glioblastoma.Conclusions: Molecular subtyping is of paramount importance in glioma management. IDH-1 mutation is commonly observed in adults and patients presenting with seizures. The duration of symptoms correlates with IDH-1 and ATRX mutations. Hypothalamic tumors lack all three mutations.
ABSTRACT
Hematometra is a collection or retention of blood in the uterine cavity. This condition is most commonly associated with congenital uterine anomalies that result from abnormal formation, fusion or resorption of Mullerian ducts during fetal life or may be due to prior surgical procedures, causing an obstruction of the genitourinary outflow tract. We report an unusual case of hematometra with endometriosis secondary to cervical stenosis. This is a rare and important case report due to the complexity of diagnosis as cervical stenosis was not presented as primary amenorrhoea as its usual presentation. This case was successfully managed by Hysteroscopic cervical dilatation under USG guidance followed by transcervical insertion of a catheter to prevent recurrent stenosis.
ABSTRACT
India’s population as per 2011 census was 1.028 billion. Even though a wide variety of contraceptive choices are available in India, contraceptive prevalence in the country is only 56% as per the WHO global health statistics 2012. Most couples in India do not want to use a contraceptive method on a long-term basis hence unwanted and unplanned pregnancies are common. Emergency contraceptive Pills are largely underutilized in India resulting in women resorting to unsafe or illegal abortions contributing 8% to the cause of maternal mortality in India, which if taken correctly can reduce the risk of an unintended pregnancy to the range of 75-79%. The objective of the study is to assess knowledge, attitude& practice (preference &experience) of emergency contraceptive pills among women of child bearing age. Methods: A cross sectional study was conducted among 328 females of reproductive age group. Data was collected using an anonymous pretested structured questionnaire. Results: Out of 328 subjects 300 women gave consent for the study. Around 56% women had heard of emergency contraceptive pills but only 19.3% had ever used it. Detailed and specific knowledge of ECPs are poor and misinformation is high. This was because main source of information was through electronic media which are unreliable and gives limited information. Conclusion: The study concludes that in spite of having awareness about EC Pills there is great knowledge and attitude gap in the community. Public information strategy needs to be devised to generate awareness and bring attitudinal change among females for emergency contraceptive pills. Support from women advocacy groups is thus necessary and their views, apprehensions, doubts and perceptions have to be adequately addressed to make their occasional use to prevent unwanted pregnancy is likely to bring down the load on the therapeutic abortion services.