A rare case of giant mucinous cystadenocarcinoma of the right ovary with metastatic deposits and Brenner tumor in the left ovary

Ovarian cancer is the second most common gynecological malignancy. Mucinous tumor accounts for 3% of ovarian tumors and is a challenging task for a surgical pathologist. Association of Brenner tumor, a subtype of epithelial malignancy is a rare entity reported in the literature. Herein, we report a unique case of a 57-years old post-menopausal woman who presented with progressive abdominal distention for 3 years and constipation for 1 year. Clinically, it was suspected as a case of complex ovarian cyst and the patient underwent staging laparotomy. Intraoperatively, a giant mucinous cystadenocarcinoma of the right ovary with deposits in the pouch of Douglas, omentum, umbilical, and the sub-umbilical region was found along with a benign Brenner tumor of the left ovary.

SUSTAINABILITY OF SHRIMP FARMING IN INDIA - A CASE STUDY OF PUDIPARTHI SHRIMP PONDS AT KANDALERU CREEK, ANDHRA PRADESH, INDIA

India being endowed with a vast coastline, has been a successful producer of Aqua culture products and is a competitive supplier of shrimps. Andhra Pradesh emerged as leading producer of this species. However, due to unsustainable farming practices many ponds have become unit for Shrimp culture. Poor farming practices has greatly affected the quality of the environment and this in turn has to led to large scale abandonment of shrimp farms. Further, the abandonment of existing farms has resulted in conversion of agricultural lands and mangroves to new shrimp ponds. The primary objective of this paper is to study the shrimp farming practices of the farmers, understand the challenges faced by the shrimp farmers and explore the underlying causes for abandonment of ponds. The study is based on a focus group discussion conducted among few farmers who have been practicing Shrimp culture near the Kandaleru Creek of Nellore district in Andhra Pradesh. Abandonment of shrimp ponds and conversion of mangroves into new shrimp ponds for culture affects the environmental sustainability and future prospects of the shrimp industry. Further the study also attempts to identify development strategies that could be implemented to revive the existing ponds for practice of sustainable shrimp culture.

Study of Morphometric Analysis of Acetabulum and Its Clinical Correlation in South Indian Population

Introduction: Acetabulum is a cup shaped cavity on the outer surface of the constricted central part of the hip bone, where three components meet and subsequently fuse. In modern world, orthopaedic surgeons and biomedical engineers are trying to make the best possible prosthesis for planning the total hip replacement. Body proportion and absolute dimension vary widely in respect to age, sex and racial groups. While partially due to variability in muscularity and adiposity, such variations are chiefly in skeletal system. Purpose of study: The main intention of this study was to obtain the morphometric data of acetabulum. This data suffices the mechanics of the hip joint so as to plan for suitable prosthesis and various surgical approaches. Material and method: The study was conducted in the department of Anatomy. Hundred hip bones of both sexes were used. In this study we included only healthy adult bones, deformed and eroded bones were excluded from the study. The osteometric parameters such as diameter, depth and capacity of acetabulum, notch width and shape of the anterior acetabular ridge were measured using digital Vernier calipers and measuring jar. The data was analysed statistically using SPSS software. Results: The mean diameter of acetabulum in males was found to be 5.03 cm and in females it was 4.44 cm, whereas on right side it was 4.70 cm and on left side it was 4.77 cm. The mean depth of acetabulum in males was 2.85 cm and in females it was 2.49 cm, whereas on the right side was 2.71 cm and 2.63 cm on the left. The mean notch width of the acetabulum in males was 2.07 cm and in females it was 1.71 cm, whereas on the right side it was 1.92 cm, and 1.85 cm on the left. Total range for the acetabular capacity was 22-30.68 ml. The curved shape anterior acetabular ridge was the most predominant type (39%) and the least type was irregular shaped (15%). Conclusion: The acetabular parameters such as acetabular diameter, depth, capacity and notch width of the acetabulum was greater in males compared to the females. Statistically the comparison was highly significant. Most common anterior acetabular ridge shape is curved type (39%), least was Irregular type (15%). Morphometric data of acetabulum is essential for clinical correlation and it also helps in the detection of disputed sex by Forensic experts. It also helps the orthopaedic surgeons for planning the total hip replacement

Clostridium Difficile is associated with High Mortality among Cirrhotics in India

Background: To assess the prevalence and impact of Clostridium difficile infection (CDI) in hospitalized patients with cirrhosis in India. Methods: In this prospective observational study from June 2015 to March 2016, all hospitalized patients with cirrhosis and acute diarrhea at the time of admission or during hospitalization were included. We studied hospitalized patients with cirrhosis without diarrhea during the same period to detect asymptomatic colonizers.Stool samples were tested for CDI, bacterial cultures, and parasite microscopy in patients with diarrhea.CDI was detected using a stool PCR test that detects the pathogenicity locus of toxigenic Clostridium difficile gene. We analysed the impact of CDI on hospital outcomes and also assessed the risk factors for acquiring CDI. Result: Among 92 hospitalized cirrhotic patients with acute diarrhea [male: 74; median age: 50 (range 19 to 80) years; Child’s class A: B: C: 8:41:43; median MELD score: 18 (range 6 to 44)], 6 (6.5%) had CDI by positive stool PCR. Use of antibiotics (100% CDI Vs 55.8% non-CDI, p= 0.04) and steroids (50% CDI vs 10.5% non-CDI, p =0.028) emerged as risk factors for CDI among cirrhosis patients. Two of the 6 patients (33.3%) with CDI as compared to 6/86 patients (7%) with no CDI died (p-value: 0.08).There were no asymptomatic colonizers amongst 35 hospitalized cirrhosis patients without diarrhea.Conclusions: C. difficile, although uncommon, was an important cause of mortality in cirrhosis patients hospitalized with diarrhea in India.Prior use of antibiotics or steroids were identified as risk factors for CDI.

Study the co-relation between SpO2 and radiological and biochemical markers with the severity and outcome in geriatric Covid-19 patients

Background: Pandemics are natural calamities, which humans have been encountering since time im-memorial. The world has witnessed and endured several pandemics like from Justinian Plague to Spanish Flu. The 21st century has already witnessed three major pandemics like Severe Acute Respiratory Syndrome in 2002, Middle East Respiratory syndrome in 2012 and at present COVID?19. The first case of COVID?19 was reported in Wuhan, Hubein Province in Dec 2019. The first case of COVID?19 was reported in Kerala on 30th January 2020. COVID?19 virus is a single stranded RNA Virus and resembles SARS -2 virus and hence the name SARS -COV 2. There has been a report of around 34 million cases with 1 million deaths. Majority of the deaths occur in the elderly population as they have immunosenescence and multiple comorbidities. Hence a study aiming at analysis of correlation between SpO2, radiological and biochemical markers is essential in management of COVID 19 in elderly. Aims & Objectives: To study the correlation between SpO2 and radiological features in X ray and CT Chest and biochemical markers with the severity and outcome in geriatric patients. Study Period: April 2020 to September 2020, Duration: 6 months. Study Centre: Chengalpattu Medical College, Tamilnadu. Inclusion Criteria: RT PCR positive Covid 19 patients more than 60 years of age. Exclusion Criteria: Covid 19 patients less than 60 years, RT PCR Negative patients. Materials and Methods: Retrospective analysis of records of 300 Covid 19 patients, aged more than 60 years hospitalized in Chengalpattu Medical College during April to September 2020 was done and biochemical parameters mentioned below were corelated with features in CXR and CT Chest RTPCR positive spo2 and analysis with severity of disease and outcome was done. Results and Discussion: On retrospective analysis of records of elderly Covid 19 patients, it was observed that the elderly could be graded as mild, moderate and severe based on clinical criteria. Radiological parameters co-relating in the same group classified as mild, moderate and severe could be derived and could be used for assessment of patients. Similarly, it was observed that the biochemical parameters of D? Dimer, C reactive protein, Neutrophil Lymphocyte Ratio correlated most significantly in that order with the clinical severity of disease and hence could be used as useful tools for assessment of severity of patients and the ranges corelating withseverity could be derived. Conclusion: Analyzing SpO2, radiological features, biochemical parameters individually and in combination with clinical severity and outcome in elderly patients helps in deriving biochemical and radiological parameters to predict severity which in turn helps in a holistic approach and right management at the right time preventing or reducing mortality due to Covid 19 in the elderly.

Frequency of Epstein Barr Virus in Non-Hodgkin s Lymphoma Determined by Latent Membrane Protein 1 Expression.

Non-Hodgkin’s Lymphoma is a haematological malignancy with various etiological factors and one among them is Epstein Barr Virus. The expression of Epstein-Barr virus in Non-Hodgkin’s lymphoma can be identified by immunohistochemistry for detection of Epstein-Barr virus latent membrane protein (LMP-1). In our study, we are trying to clarify the extent of expression LMP-1 in our population. This can be used as a prognostic marker and for therapeutic interventions targeting EBV encoded proteins. We wanted to determine the proportion of LMP1 (EBV marker) expression in Non-Hodgkin’s Lymphoma and evaluate the association of LMP1 expression in B cell and T cell type of NHL.METHODSThis is a cross sectional analytical study conducted at Department of Pathology, Govt. Medical College, Kottayam, from December 2017 to May 2019. A total of 67 cases were studied. All of them were histopathologically diagnosed Non-Hodgkin’s Lymphoma specimens received in the Department of Pathology, Govt. Medical College, Kottayam, during the study period of 18 months. NHL was subtyped into B cell type and T cell type. LMP-1 immunohistochemistry was done on all cases to assess its expression. Then analysis was done using SPSS software and strength of association between LMP 1 positivity and cell type was calculated using Chi square test and Fisher’s exact test.RESULTSMean age of Non-Hodgkin’s lymphoma is 57.82 +/- 7.4 in this study. Minimum age is 2 years and maximum age is 89 years. The present study had 10.4 % LMP 1 positive cases. Of which there were 6% moderately stained positive cases, 3% of weakly stained cases and 1.5% cases of intensely stained cases. Among NHL 86.6% cases were B cell lymphoma and 13.4% cases of T cell lymphoma. And they had a LMP 1 positivity of 10.3% and 11.1 % respectively. But there was no significant association between LMP 1 positivity and cell type according to our study.CONCLUSIONSThe present study was done to determine the proportion of LMP 1 expression in Non-Hodgkin’s Lymphoma and to find out whether there is any association between LMP1 expression in B cell and T cell type of NHL. LMP 1 was positive in 10.4% of NHL and there was no association between LMP 1 positivity in B cell and T cell Lymphoma. This suggest that EBV might play a role in pathogenesis of NHL.

Case report on necrotizing fasciitis following episiotomy

Necrotising fasciitis (NF) is an extremely rare but near fatal bacterial soft tissue infection, complicating the operative wounds. Here is a case report of Necrotising fasciitis in episiotomy wound in low socioeconomic, poorly nourished and anaemic women. A 39 years old, second gravida, delivered normally with medio-lateral episiotomy under local anaesthesia. On postnatal day four, patient developed high grade fever and on examination episiotomy was found to be unhealthy and gaped. She was started on broad spectrum antibiotics empirically but the cellulitis rapidly progressed to vulva, then to the bilateral thighs and extended till knees. Bilateral lower limb Doppler ultrasonography was done to rule out deep vein thrombosis which showed no abnormality. USG abdomen revealed huge pus collection in the lower abdomen. Under anaesthesia, surgical exploration was done, pus was drained followed by wound debridement and pus sent for culture and sensitivity. Pus and blood culture showed growth of Klebsiella pneumoniae, so started on appropriate antibiotics. Patient started recovering, when the wound was healthy, secondary suturing of episiotomy wound done. She was discharged on post-natal day 27 after full recovery. Early diagnosis and aggressive timely management are the corner stone to avoid morbidity and mortality of NF.

A Rare Case of Urethral Fibroid.

Leiomyomas are benign mesenchymal tumours that arise from the smooth muscle, mostly located in genital tract. M/C site of leiomyoma is uterus. (1) Leiomyoma arising from urethra are rare. Leiomyomas are most commonly seen in uterus. (2) Extra uterine leiomyomas are usually seen arising from vulva, ovaries, urethra, urinary bladder, GIT, and Vagina. (3) Leiomyoma of urethra is a rare benign mesenchymal tumor that affects women more often than men. Usually located in proximal urethra, seen in reproductive age group (mean age 41 yrs.) with possible hormone dependence. Presents with a variety of symptoms include – UTI, urinary retention, mass per urethra, dysuria. Diagnosis is by USG, MRI (4) confirmed by HPE. Complete surgical excision is the treatment of choice, recurrence is rare.

Synthesis, Spectral Characterization And Biopotential Significance Of Co(Ii) And Ni(Ii) Complexes With Biologically Active Ligands

New Cobalt(II) and Nickel(II) metal complexes of 2-aminothiazole (ATZ) and benzoate ion (BEN) ligands were synthesized under microwave irradiation. The empirical formulae and the structure of the complexes have been deduced from CHN analysis, electrical conductance, magnetic moment, electronic (DRS method), Infra Red spectra, TGA analysis, cyclic voltammetry and powder-XRD techniques. The low electrical conductance values indicate that the complexes are non-electrolyte (1:0) type. The electronic spectra and the magnetic moment indicate the structures of the complexes are found to be octahedral geometry. Infra Red spectra illustrate that 2-aminothiazole and benzoate ion is bonded to the metal ion in a monodentate approach. The antifungal activities of ligands and their cobalt(II) and nickel(II) metal complexes were studied aligned with the few microorganisms by agar - well diffusion method at 100,200 and 400 conc. µg/ml concentration. The prepared cobalt(II) and nickel(II) metal complexes show prospective action against the tested fungi as compared to free 2-aminothiazole ligand. The free radical scavenging action of the prepared complexes and the ligand has been resolute by measuring their interface with the stable free radical DPPH. The complexes have larger antioxidant activity as compared to the free ligand. DNA-binding properties have been calculated by fluorescence-emissions method. The obtained results suggest that the complexes powerfully bind to DNA because of metal complexes are well-known to speed up the drug action and the capability of healing agent which can repeatedly be enhanced leading coordination with a metal ion.

A Bronchial Lipoma: Occurrence at an Unusual Site and Its Successful Bronchoscopic Resection with an Electrosurgical Snare

Primary tracheobronchial lipoma is an extremely rare entity, the diagnosis of which is often missed initially. Cases are generally diagnosed late after initial treatment for asthma and bronchitis. We report a case of a 42-year-old man with a left main bronchus lipoma that caused near-total obstruction. The lipoma was treated by bronchoscopic resection with an electrosurgical snare and cryoablation.

In vitro Callus Induction of Coccinia indica (W. and A) and Analysis of Its Phytochemical, Antimicrobial, Antioxidant and α-Amylase Inhibitory Activity - A Comparative Study

In the present study an attempt has been made to evaluate the phytochemical, antimicrobial, antioxidant and α-amylase inhibitory activity of Coccinia indica(W. and A) leaf extracts using four solvents and compare it with the callus extracts. Callus was initiated from the leaf explants of C.indicawith 90% efficiency using MS medium supplemented with BAP (1 mg/l) + NAA (0.2 mg/l). Successive extraction method of C.indicawas found to be an efficient method of extraction and methanol was observed to be the best suited solvent for the extraction of phytochemicals and macromolecules that were responsible for antimicrobial, antioxidant and α-amylase inhibition. GC-MS analysis of C.indicahas confirmed the presence of bioactive compounds (Example: 9-Octadecanoic acid, 2-octadecycloxy ethyl ester (100%) in successive methanolic callus extract) in all the extracts where the FTIR analysis has confirmed the presence of various important functional groups of the identified bioactive compounds. Successive methanol extract of callus of C.indicawas found to be the potent antimicrobial agent with drug efflux pump inhibitor property against 5 bacterial strains, Klebsiella pneumoniae (ATCC700603), Escherichia coli (ATCC25922), Staphylococcus aureus (ATCC 25923), Proteus mirabilis (ATCC 25933)and Pseudomonas aeruginosa (clinical isolate) and 3 fungal strains, Candida albicans (IFM 40009), Candida tropicalis (IFM 55058)andCandida krusei (IFM 46521).Successive methanol extract of callus of C.indicawas found to be an efficient antioxidant agent and an efficient α-amylase inhibitor, which proves it to be a potent anti-diabetic agent with IC50 concentration to be 82.5μg/ml. This study is one of the strong evidence for this plant to be used by the traditional practitioners as a phytopharmaceutical agent

Morbidity and mortality of low birth weight babies in early neonatal period in a rural area teaching hospital, Telangana, India

Background: A baby's weight at birth is a strong indicator of newborn health and nutrition. Low birth weight (LBW) babies are more susceptible to morbidities and mortality in early neonatal period than normal birth weight (NBW) babies. Among neonatal deaths, 80% occurs in LBW / preterm babies and 75% of total neonatal deaths occur in early neonatal period. The present study was undertaken to know the incidence and early neonatal outcome of LBW babies in rural area.Methods: Prospective observational study was conducted in babies born with <2.5 kg (LBW) birth weight.Results: The incidence of LBW babies was 25.07% with almost an equal contribution from preterm (50.46%) and Term Intra Uterine Growth Restricted (IUGR) (49.53%) babies. The most common morbidity found in LBW babies was Jaundice (40.09%) followed by respiratory distress (18.16%), sepsis (8.72%) and apnea (4.48%). Preterm-LBW babies had more morbidities in terms of apnea (100%), birth asphyxia (88.88%), respiratory distress (87.01%%), sepsis (80.55%) and jaundice (67.64%). Early neonatal mortality was 21.22 per 1000 live births. Mortality was 100% for babies <1 kg in birth weight, 16% in 1-1.499 kg group and 0.75% in 1.5-2.499 kg group in early neonatal period. According to gestational age, mortality in preterm-LBW babies was 88.88% and 11.11% in Term IUGR-LBW babies. The most common cause of death in LBW babies was birth asphyxia (44.44%) followed by hyaline membrane disease (HMD) (33.33%).Conclusions: The present study revealed that preterm babies contributed 50% to incidence of LBW babies. Morbidity and mortality in LBW babies were inversely related to birth weight and gestational age.

Evaluation of antidepressant activity of tramadol in albino mice using forced swim model

Background: The fact that tramadol can be used as an antidepressant, has been already proved by some animal studies. The objective of the present study was to evaluate antidepressant activity of tramadol in albino mice using forced swim model.Methods: Forced swimming test (FST) model was used to evaluate the antidepressant effect. Mice in the group "I" were given normal saline. Mice in the group II were given imipramine. Mice in the group III were given tramadol 10mg/kg. Mice in the group IV were given tramadol 20mg/kg. Mice in the group V were given tramadol 40mg/kg. All doses in all groups were given by intra peritoneum route.Results: The average values of immobility in group I were higher significantly compared to group III, IV and V. The values of group I and group II were found to be comparable. It was found that the baseline mean value was 196.33 which reduced to 5.16 with the effect of imipramine where imipramine was given to those mice. But in tramadol 10mg group, it was highest, and it came down to 40.66 and as the dose of tramadol was increased, the immobility time reduced from 40.66 at 10mg dose to 31.33 at 20mg dose and finally to 13.33mg at 40mg dose.Conclusions: Considering the results of two different animal models of depression it can be concluded that Tramadol has antidepressant activity at 10mg, 20mg, 40mg which was almost similar to Imipramine.

Efavirinz induced gynecomastia: a case report

Gynecomastia is swelling of the breast tissue in men, caused by an imbalance of the hormones, estrogen and testosterone. Drugs commonly implicated are spironolactone, cimetidine, ketoconazole, hGH, estrogens, hCG, anti-androgens, GnRH analogues and 5-? reductase inhibitors. Medications probably associated with gynecomastia include risperidone, verapamil, nifedipine, omeprazole, alkylating agents, HIV medications (efavirenz), anabolic steroids, alcohol and opioids. HIV infected patients who are treated with highly active antiretroviral therapy (HAART) can develop breast enlargement due to benign and malignant mammary diseases. We report here a case of gynecomastia due to efavirinz.

Weather based prediction model for beet armyworm (Spodoptera exigua Hubner) in chickpea

Aim: The study aimed to develop and validate weather based prediction model for beet armyworm (Spodoptera exigua) population in chickpea through adult catches in pheromone traps. Methodology: The data on adult trap catches of S. exigua were recorded daily and weekly means were computed. Log transformed trap catches data were used for correlation with weather parameters of current week, 1-lag, 2-lag and 3-lag weeks. Thereafter, multiple-linear regression analysis was done and a model was developed. The prediction model of S. exigua was validated with the appropriate statistical tools. Results: Peak incidence of S. exigua was recorded during 45th standard meteorological week (SMW) with 15.6 moths per trap per week. Amongst current, 1-lag, 2-lag and 3-lag week weather parameters, the male moth population had significant positive correlation with maximum temperature (Tmax) and minimum temperature (Tmin), and negative correlation with morning relative humidity (RH1) of 2-lag week. The sunshine hours/day (SSH) of current week had a significant negative association with S. exigua male moth catches, while the soil temperature (ST) of 2-lag week had highest positive correlation with trap catches. Regression equation was computed by regressing male moth catches of S. exigua against weather data of weeks with highest correlation coefficient. Interpretation: Often, pest-weather models are developed based on current week weather factors. However, it has been witnessed in this study that weather of preceding weeks (up to 3-lag) may also influence the pest population, and thus it needs to be considered for proper understanding of pest dynamics

Serum β HCG as a predictor and potent marker for pregnancy induced hypertension

Background: Hypertensive disorders are also responsible for perinatal mortality and morbidity. Preeclampsia is a risk factor for stillbirth, IUGR, LBW, Preterm delivery, Respiratory distress syndrome, and admission in the neonatal intensive care unit. Hypertensive disorders account for 8-10% of all preterm births. Aim of the study: This study was conducted to predict gestational hypertension by using serum beta HCG and thereby to follow up the risk patients and to reduce both maternal and perinatal morbidity and mortality. Materials and methods: A prospective study was done to determine the role of βHCG in 100 pregnant women in their second trimester (13-20) weeks, attending Tirunelveli medical college OPD. Duration of study was from March 2018- January 2019. Routine antenatal investigations were done. 5 ml of venous blood sample was collected and tests were carried out. Estimation of serum beta HCG level was done by enzyme-linked fluorescence immunoassay. In the antenatal clinic, the patients were followed up. Results: From the study, it was found, women who have elevated βHCG values in 13-20 weeks were at increased risk of developing PIH. For any test to be used as screening test it should have good sensitivity, specificity, and positive predictive value. In this study, β HCG had Sensitivity – 71.4%, Specificity - 87.1%. Conclusion: While comparing patients with normal BP and pre-eclampsia - βHCG values are elevated in patients with preeclampsia. The sensitivity and specificity of βHCG are very low to be Sheba Rosatee Victor, D Jayalakshmi. Serum β HCG as a predictor and potent marker for pregnancy induced hypertension. IAIM, 2019; 6(3): 38-43. Page 39 useful as a mass screening marker on its own and therefore it should be combined with other serum markers and ultrasound parameters like Doppler study of uterine vessels, which will help in improving its role as a screening tool.