Bronchopulmonary Dysplasia in Preterm Neonates in a Level III Neonatal Unit in India

Objective: To find out the incidence and associations ofbronchopulmonary dysplasia (BPD) in preterm neonates.Design: Descriptive cohort.Methods: All consecutively born neonates <33 weeks gestationrequiring oxygen or respiratory support during first 3 days of lifewere enrolled from a level III neonatal unit in Chandigarh, India.Those with malformations were excluded. Placenta wasexamined for histological chorioamnionitis in preterm rupture ofmembranes and/or preterm spontaneous onset of labour. SerumMalondialdehyde (MDA) and Superoxide dismutase (SOD) andCatalase levels were estimated on day 3 of life. All recruitedneonates were followed up till discharge or death.Results: Out of 250 neonates enrolled, 170 (68%) survived tillday 28 and BPD developed in 19 (11.2%) infants. The meangestation and birth weight were significantly lower in infants whodeveloped BPD. Chorioamnionitis (clinical 5.3% vs 1.9%,P=0.375; and histological 37.5% vs 16.7%, P<0.001), patentductus arteriosus (PDA) (52.6% vs 8.9%, P<0.001), median (IQR)sepsis episodes [2 (2,3) vs 1 (1,2), P<0.001], invasive ventilation(84.2% vs 11.3%, P<0.001), and duration of ventilation [56 (4) d vs4 (5) d, P=0.001] were significantly higher in infants with BPD.Serum MDA, SOD and Catalase levels were comparable betweenthe two groups.Conclusion: Chorioamnionitis, PDA and sepsis were significantlyassociated with BPD.

Secretory cell outgrowths, p53 signatures, and serous tubal intraepithelial carcinoma in the fallopian tubes of patients with sporadic pelvic serous carcinoma.

Context: High‑grade serous carcinomas of ovarian, tubal, and peritoneal origin are together referred as pelvic serous carcinoma. The fallopian tubes, ovarian surface epithelium, and the tuboperitoneal junctional epithelium are all implicated in pelvic serous carcinogenesis. Aims: The aim of this study is to identify putative precursor lesions of serous carcinoma including secretory cell outgrowths (SCOUTs), serous tubal intraepithelial carcinoma (STIC), and p53 signatures and assign its probable site of origin. Settings and Design: Prospective case–control study of consecutive specimen comprising 32 serous carcinomas and 31 controls (10 normal adnexa, 10 benign and 6 atypically proliferative surface epithelial tumors, and 5 other carcinomas). Subjects and Methods: Sectioning and extensive examination of the fimbrial end (SEE‑FIM) protocol along with immunohistochemistry for Bcl‑2, p53, and Ki‑67 was employed for evaluating invasive carcinoma and precursor lesions in cases versus controls. Results: SCOUT, p53 signatures, and STIC were most frequent in the serous carcinomas. p53 signatures and STIC were always seen in the fimbrial end. STICs were exclusively present in serous carcinomas, more common in ipsilateral tubes of cases with dominant ovarian mass. Multifocal p53 signatures with STIC were seen in 7 (21.9%) cases. STIC was present with or without an invasive carcinoma in 25% and in 6.25% of cases of pelvic serous carcinomas, respectively. The junctional epithelia did not show any lesion in any group. Conclusions: SEE‑FIM protocol is recommended for evaluation of sporadicpelvic (ovarian/tubal/peritoneal) serous carcinoma. Based on the presence of STIC or invasive carcinoma, nearly 60% of all pelvic serous carcinomas are of fallopian tubal origin.

A randomised controlled trial of exercise and hot water bottle in the management of dysmenorrhoea in school girls of Chandigarh, India.

Objectives : To estimate the prevalence of primary dysmenorrhoea among school girls and to compare the impact of exercise and hot water bottle on the occurrence and severity of primary dysmenorrhoea among the study population. Material and methods : A cross sectional study was done to estimate the prevalence of dysmenorrhoea in two schools of Chandigarh, India. For the Randomised Controlled Trial, group randomisation of the two schools was done into 2 intervention groups (exercise & hot water bottle groups). 53 girls in school 1 and 75 girls in school 2 participated in the intervention. Comparison of baseline Menstrual Distress Questionnaire (MDQ) scores & Visual Analogue Scale for Pain (VASP) scores were done with 1st, 2nd & 3rd month post intervention scores using mean, standard deviation, t-test. Results : Prevalence of dysmenorrhoea was 60.7%. Median age of the school girls was 14 years. The mean VASP score decreased from 5.75 to 2.96 (P<0.0001) and from 5.16 to 2.06 (P<0.0001) at 3 months, in the exercise and hot water bottle group respectively. The mean MDQ score decreased from 14.53 to 7.85 (P<0.0001) and from 14.92 to 8.16 (P<0.0001) at 3 months, in the exercise and hot water bottle group respectively. Conclusion : Both exercise & hot water bottle can be used in dysmenorrhoeic girls in home setting to provide relief from pain and menstrual distress.

Renal hematoma: An unusual cause of acute abdomen and fetal demise in severe Pre-Eclampsia.

Retroperitoneal hematoma occurs rarely in an obstetric patient. Renal hematoma may present with signs and symptoms, which may mimic the clinical presentation of abruptio placentae or rupture uterus. Although renal hematoma is sometimes a surgical emergency due to hypovolemic shock, conservative management by angiographic embolization may be done. Timely diagnosis and management is required to decrease the maternal mortality and morbidity. We hereby report a case of spontaneous renal hematoma in a patient with severe pre-eclampsia who presented with acute abdomen and intrauterine fetal death.

Aggressive Angiomyxoma Pelvis Presenting As An Ovarian Tumor With Vault Prolapse.

Angiomyxoma is a rare tumor arising from the pelvis. Preoperative diagnosis and treatment may be difficult. We report a case of aggressive angiomyxoma pelvis that presented as vault prolapse and was misdiagnosed as ovarian tumor. Conclusion: As surgery is the main treatment, preoperative diagnosis and assessment of extent of the tumor for planning surgery cannot be overemphasized.