Episiotomy site endometriosis: a rare case report

Endometriosis is defined as the presence of endometrial tissue apart from its usual location. Scar endometriosis is an infrequent type of extra pelvic endometriosis. Viable decidual endometrial cells are likely to be transplanted in the episiotomy wounds during normal delivery and subsequent growth may occur. We present here a case of 22 year old female with perineal endometriosis at the episiotomy site. The clinical, operative and pathological findings are reported.

Risk Factors For Chronic Respiratory Diseases Among Rural Adults in Northwest India

Chronic respiratory diseases(CRD) remain a formidable challenge for public health experts acrossthe world due to their ever increasing morbidity and mortality. This study investigated various riskfactors for CRD among rural adults aged 20 years and above. The study was conducted in fourvillages under sub-health centre Domana in Kot Balwal health block and these villages wereselected randomly. For this cross-sectional population based study, a pre-tested respiratory healthquestionnaire was used. Those respondents who were found to be diagnosed cases of CRD werefurther enquired in detail about various risk factors for CRD. Out of 2018 respondents surveyed,177confirmed cases of CRD were detected.Various risk factors like being male, smoking, overcrowding,recurrent chest infections and use of non-clean fuel (wood, cow dung) were found to bestatistically significant. Among other risk factors, ventilation and history of allergy were found tobe highly significant statistically (p< 0.000). Smoking, recurrent chest infections, use of biomass fuel,ventilation and history of allergy were risk factors for CRD in rural adults aged 20 years andabove.

Anaemia in adolescent girls: An intervention of diet editing and counselling.

Background. Though a major public health problem of nutritional anaemia in schoolchildren is being addressed by iron supplementation and/or fortified food, they continue to be anaemic. We aimed to study the effect of fluoride consumption on haemoglobin levels and whether elimination of fluoride from the diet would correct anaemia in children. Methods. Two hundred and fifty adolescent girls, 10–17 years of age, from a government senior secondary girls school in East Delhi, participated in the programme. Only those girls who were dewormed in the school health programme and not on any medication particularly for malaria, were included. The investigations done were (i) haemoglobin level; (ii) fluoride content in urine; and (iii) fluoride content in drinking water both at home and in school. The anaemic students consuming safe drinking water with fluoride level <1.0 mg/L and with urine fluoride >1.0 mg/L were introduced to interventions, viz. diet editing and diet counselling when parents came for the monthly parent–teacher meeting. Besides the parents, their wards and class teachers also attended the counselling session. The students were monitored by re-testing haemoglobin and urine fluoride levels at 1, 3 and 6 months after the start of the intervention. Results. There was an inverse relationship in the levels of urine fluoride and haemoglobin. Reduction in the level of urine fluoride led to a rise in the haemoglobin level. Following interventions, the haemoglobin level revealed significant improvement from the anaemic (<12.0 g/dl) to the nonanaemic range (12.0–14.4 g/dl). At 6 months of follow-up, of the 244 girls studied, those with severe anaemia decreased from 3% to 1%, with moderate anaemia from 97% to58% and the non-anaemic girls increased from 0% to 41%. Conclusion. Non-toxic nutritive food and safe water with fluoride level <1.0 mg/L are useful in improving haemoglobin levels in a high percentage of anaemic schoolchildren. A haemoglobin level of >12.0–14.4 g/dL is an achievable target in children without iron supplementation. Natl Med J India 2016;29:200–4

Cardiac risk factors in descendants of parents with history of coronary artery disease (CAD) : An evaluation focusing on small dense low density lipoprotein cholesterol (sdLDLc) and high density lipoprotein cholesterol (HDLc).

The risk of coronary artery disease (CAD) in descendants with positive family history of CAD was evaluated in either one of or both the parents among 71 selected families. Subjects were grouped as parents and descendants without and with CAD and descendants spouses without CAD or family history of CAD. All subjects were examined for anthropometric characteristics, fasting blood sugar, serum lipids, lipoprotein sub-fractions, insulin, insulin resistance and pancreatic beta cell function. The results were subjected to statistical analysis by using the analysis of variance (ANOVA). Metabolic syndrome (MetS) was prevalent in the 83% descendants with CAD and 54.6% parents with CAD. The traditional risk factors were observed in both parents and descendants with CAD. Metabolic risk factors, including hypertriglyceridemia, low HDLc levels and hyperglycaemia had a higher frequency in the descendants with CAD. ANOVA showed significant ‘F’ ratio for the anthropometric characteristics, hypertension, serum lipids, small dense (sd) LDLc levels, HDL2c levels and HDL3c levels in the descendants parents with CAD and CAD + diabetes mellitus (DM), as compared to those without CAD. The descendants without CAD, but with a positive family history had central adiposity, hypertension and had lower HDL levels and elevated sdLDLc levels. Multiple analyses of variance showed that sdLDLc and waist circumference were the most potent risk factors for prevalence of CAD. Thus, we conclude that a positive family history of CAD along with central adiposity and elevation of sdLDLc levels appear to be important factors in the assessment of CAD risk in humans.

To Study The Relationship Between The Axial Length of The Eye Ball and the Retinal Vein Occlusion.

The study was conducted on 50 patients attending the Eye OPDs of Ophthalmology Department of Government Medical College Jammu during the year. 25 patients were clinically diagnosed to have Retinal Vein Occlusion and were compared with 25 age and sex matched controls. The axial lengths of both eyes of all 50 patients were measured using A-Scan Biometry, the data was analyzed by student t-test and chisquare test.It was concluded that the axial lengths in retinal vein occlusion were significantly shorter than the controls. This significant difference can be a risk factor in the development of retinal vein occlusion.

Use of different primer directed sequence amplification by polymerase chain reaction for identification of Pneumocystis jirovecii in clinical samples.

BACKGROUND: Pneumocystis carinii pneumonia (PCP), caused by opportunistic agent Pneumocystis jirovecii (formerly, Pneumocystis carinii is one of the most serious respiratory infection in immunocompromised patients. AIM: The present study was conducted to compare polymerase chain reaction (PCR) assays targetting three different genes of Pneumocystis to study their application in its diagnosis. METHODS: One hundred and eighty (n = 180) clinical samples from 145 immunocompromised patients with clinical suspicion of PCP and 35 samples from control group of 30 immunocompetent individuals with respiratory infections other than PCP were prospectively examined for the presence of Pneumocystis jirovecii (P. jirovecii). All the samples were subjected to microscopic examination, one single [major surface glycoprotein, (MSG)] and two nested [mitochondrial large subunit ribosomal ribonucelic acid, (mtLSU rRNA) and internal transcribed spacer (ITS) region], polymerase chain reaction assays. RESULTS: Microscopic examination was positive in only six (n = 6) patients, whereas single round MSG PCR detected P. jirovecii deoxyribonucleic acid (DNA) in 16 cases. When the clinical samples were tested by mtLSU rRNA and ITS nested PCR assays, it was possible to detect seven additional cases of PCP, making it to a total of 23 cases. None of the clinical specimens in control group (n = 30) were positive by any of the above-mentioned techniques. Amongst the 81 bronchoalveolar lavage (BAL) samples tested, 16 were positive by MSG PCR, while 20 were positive by both nested, i.e., mtLSU rRNA and ITS PCR assays. Similarly, out of 50 sputum samples, only three were positive by MSG, seven by mtLSU rRNA and six by ITS nested PCR assays. CONCLUSION: It has been observed that MSG is relatively more sensitive when single round PCR assay is used for detection of human Pneumocystosis compared to the first (single) rounds of either ITS or mtLSU rRNA nested PCRs. However, the two nested PCRs using ITS and mtLSU rRNA have been found to be more sensitive. On comparison of two nested PCR assays, the results have been more or less comparable.