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Objective: To study the socio-demographic profile and etiological factors responsible for failure of tubal ligation. Their outcome and further adopted methods of contraception.Methods: This was a retrospective observational study done in a tertiary care centre from January 2009 to December 2018. All cases who came with sterilization failure were reviewed including their demographic patterns, previous methods used and the contraception choices adopted after procedural failure.Results: Over a period of ten years, out of a total of 157 cases of sterilization failure 43.33% (n=68) were laparoscopic interval ligation, 42.60% (n=67) were laparoscopic ligation with termination of pregnancy, 10.20% (n=16) were sterilization done along with lower segment cesarean section and 1.9% (n=3) were mini-laparotomy (minilap) done in postpartum period. Only 63.05% (n=99) got repeat sterilization procedure done despite previous failure. Out of 157 cases, in 50.9% (n=80) recanalization was found, tuboperitoneal fistula was responsible in 5.7% (n=9) women, slipped fallope ring was found in 5.7% (n=9) women, wrong application of fallope ring was seen in 1.9% (n=3) and 35.6% (n=56) did not opted for religation.Conclusion: Failures of sterilization procedures do exist especially in laparoscopic ligation. Counseling prior to adoption of this method, risk of failure and other noninvasive options of contraception must be discussed.
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Collection of more than normal quantity fluid in a serous cavity is called effusion. Itis classified as per location i.e. pericardial, pleural and peritoneal. Fluid collection inabdominal cavity is called ascites. Effusions are of two types - (1) Transudate (2)Exudate. Transudate develops as a result of physiological disturbances of circulationusually a rise in venous pressure or decrease in oncotic pressure, while exudateforms as a result of increased capillary permeability which is usually due toinflammation. Transudates usually have low specific gravity due to low proteincontent whereas exudates have high specific gravity due to high protein content.Transudates are usually associated with cardiac-, hepatic- or renal-disease. Whileexudates are caused by inflammatory conditions like tuberculosis and malignanciesof pelvic and abdominal organs. Recently fibronectin and cholesterol levels ofperitoneal fluid have been found to differentiate between ascites of differentaetiologies. The estimation of fibronectin levels in fluid is sensitive but complicated.So, in this study we have taken the value of cholesterol for the aetiologic diagnosisof ascites as a simple procedure.METHODSThe present descriptive study of 100 cases of ascites was conducted over a period of12 months i.e. January. 2019 to January 2020. Various fluids were collected fromOPD and IPD of Medical and Surgery units.RESULTSIn the present study, 84% of the cases were transudates while exudates accountedfor 16% of cases. Cirrhosis (65%) was the commonest cause among transudates.Other causes included congestive cardiac failure (09%), nephrotic syndrome (06%),& anaemias (04%). Exudative ascites was caused by tuberculosis in 10% cases &malignancy in 06% cases. Cholesterol level of >70 mg/dL was found in 82% ofmalignant ascites. So, it was concluded that ascitic fluid cholesterol levels weresignificantly greater in malignant cases in comparison to ascites caused by non -malignant aetiologies. Inference - Cholesterol concentration in ascitic fluid helps todifferentiate ascites in malignancy, from non - malignant ascites.CONCLUSIONSCholesterol estimation in ascitic fluid is a better parameter to differentiatemalignant ascites from non - malignant ascites.
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The aim of the present study is to evaluate the utility of FNAC in diagnosing bone lesions especially bone tumours. Methods: A total of 120 cases were selected from patients attending OPD and admitted in IPD in MLB Medical College, Jhansi, presenting with complaints of swelling arising from bone. FNAC of the lesion was performed, with guidance of X-Ray reports when available, clinical details, history of present illness & other physical findings have also been noted, and considered while making the diagnosis, and the findings were compared with that of histolgical specimen whenever available. Results: The present study includes 355 malignant cases, of which 53.8% are primary neoplasms, 7.6% are metastatic lesions, and 38.4% are locally malignant lesions. The most common primary bone malignancy in this study is Osteosarcoma. Comparison of Cytological and Histological Diagnosis in all cases was done. 39 malignant lesions were reported on Cytological basis and all 39 were found correct on histological correlation, while 18 out of total 21 benign lesions were diagnosed correctly, as confirmed by subsequent histological examination. Out of total 51 inflammatory lesions 42 were diagnosed correctly, 9 aspirations were found inadequate for reporting. Conclusion: Fine Needle Aspiration Cytology (FNAC) is a very valuable procedure in patients with bone lesions. The complications are almost nil, the cost is very low, is minimally painfull, is an OPD procedure and informative reports are available within 12-48 hours.
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Background: Aim of the present study was to evaluate the role of Mast cells in the Histo-Pathogenesis of Leprosy by assessing incidence of various Histo-Pathological types of Leprosy, Correlating of Mast cell profile (Mast cell Density & Morphology) in different Histological types of Leprosy lesions, by correlating with Reactional & Non-Reactional groups of Leprosy cases and by correlation of Mast cell profile in doubtful cases as in Indeterminate type. Lepromatous Leprosy was observed in higher age group as compared to Tuberculoid leprosy. Mast Cell Density was found increasing from Polar Tuberculoid to Polar Lepromatous spectrum of disease. In every type of Leprosy, mast Cell Density was reduced significantly in the Reactional Group as compared to Non-Reactional Group. The aim of the present study was to evaluate the role of Mast cells in the Histo-Pathogenesis of Leprosy by assessing incidence of various Histo-Pathological types of Leprosy. Methods: A cross sectional, observational study was conducted among 200.Correlation of mast cell profile (Mast cell Density & Morphology) in different Histological types of Leprosy lesions was done, by correlating with Reactional & Non-Reactional groups of Leprosy cases and by correlation of Mast cell profile in doubtful cases as in Indeterminate type. Lepromatous Leprosy was observed in higher age group as compared to Tuberculoid leprosy. Results: Mast Cell Density was found Increasing from Polar Tuberculoid to Polar Lepromatous spectrum of disease. In every type of Leprosy, mast Cell Density was reduced significantly in the Reactional Group as compared to Non-Reactional Group. Conclusion: Larger such studies of Leprosy employing special staining methods viz. pH dependent Toluidine Blue staining, studies employing Immuno-Fluorescence on Tissue biopsy specimens, as well as studies on experimental animals, to help us achieve a better understanding of the pathogenesis, outcome and prognosis of Leprosy.
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Aim: To assess the efficacy, safety and acceptability of mifepristone followed by vaginal misoprostol for medical termination of pregnancy (MTP) between 13-20 weeks of gestation. Material and methods: Forty women who fulfilled the criteria of MTP Act of India, were given 200 mg oral mifepristone, followed after 36-48 hours by 800 μg vaginal misoprostol and subsequently 400 μg vaginal misoprostol 3-hourly (maximum 2,400 μg). Success was taken as complete expulsion of fetus and placenta within 15 hours of first dose of misoprostol. Results: Success rate of complete abortion was 92.5%, which increased to 95% at 24 hours and successful expulsion of fetus was seen in 100% cases within 24 hours of first dose of misoprostol. Median induction-abortion interval was 6 hours. There were no major side effects. Nulliparous women took significantly longer time to abortion and required more analgesia than multiparous women. Conclusion: Mifepristone followed by vaginal misoprostol is a safe, effective and acceptable method for second trimester termination of pregnancy.