Rupture uterus: a one year review to find out the causative factors

Background: Rupture uterus is a life-threatening obstetric emergency associated with high perinatal mortality. This study aims to find out the common factors associated with this catastrophic condition so as to help in decreasing the incidence of this condition in this study set-up. The objective of this study was to determine incidence, socio-demographic factors, etiology, types of presentation, patterns of management and maternal and fetal outcome in cases of rupture uterus presenting in this study hospital in one year.Methods: In this retrospective study 40 cases of ruptured uterus admitted in the hospital between January to December 2016 were analyzed. Detailed history of relevant socio-demographic factors, prior obstetric and surgical history, clinical findings, nature of management done, fetal and maternal outcome were thoroughly analyzed from the record.Results: A total 40 cases of ruptured uterus during this one-year period out of total 1220 deliveries constituted an incidence of 3%. The commonest age group is 25-30 years (47%). Majority of patients of rupture uterus were those with previous scarred uterus trying for vaginal delivery in hands of dais, untrained birth attendants and midwives. Repair was possible in the majority of cases. There were no maternal deaths but fetal mortality was 92.5%.Conclusions: Proper antenatal care, transportation facilities, good counseling of patients with history of previous uterine surgery for institutional delivery can help in reducing the incidence of rupture uterus in developing countries like India. Prompt surgical intervention can help in reducing the maternal morbidity and mortality associated with rupture uterus.

Bentall Surgery for Aortic Root Aneurysm in a Patient with Marfan Syndrome.

A 34 yrs old man of marfan syndrome, visited us with the complaints of palpitation, easy fatigability and chest discomfort for last 1year. He was pointed out to have the aortic root enlargement with severe aortic regurgitation & mild mitral regurgitation by echocardiography and CT angiogram. We excised the aneurysm, implanted a composite graft with prosthetic valve conduit (Bentall operation), directly attached the coronary arteries to the aortic graft, and made the distal anastomosis to the divided aorta. Postoperative course was uneventful. To our knowledge, this is the first successful case of Bentall operation in national Institute of cardiovascular Diseases.

Protective effects of Moringa oleifera Lam. leaves against arsenic-induced toxicity in mice

Objective: To evaluate the protective role of leaves of Moringa oleifera (M. oleifera) Lam. against arsenic-induced toxicity in mice.Methods:non-treated control group while, the second, third, and fourth groups were treated with M.oleifera leaves (50 mg/kg body weight per day), sodium arsenite (10 mg/kg body weight per day) and sodium arsenite plus M. oleifera leaves, respectively. Serum indices related to cardiac, liver and renal functions were analyzed to evaluate the protective effect of Moringa leaves on arsenic-induced effects in mice.Results:Swiss albino male mice were divided into four groups. The first group was used as induced elevation of triglyceride, glucose, urea and the activities of alkaline phospatase, aspartate aminotransferase and alanine aminotransferase in serum. M. oleifera leaves also prevented the arsenic-induced perturbation of serum butyryl cholinesterase activity, total cholesterol and high density lipoprotein cholesterol.Conclusions:The results indicate that the leaves of M. oleifera may be useful in reducing the It revealed that food supplementation of M. oleifera leaves abrogated the arsenic-effects of arsenic-induced toxicity.

Seeking optimal means to address micronutrient deficiencies in food supplements: A case study from the Bangladesh Integrated Nutrition Project.

In seeking to improve the micronutrient contents of a food supplement used in a major community-based nutrition project in Bangladesh, operations research was conducted to compare the provision of needed micronutrients through additional food sources (fresh or dried fruits or vegetables), a micronutrient multi-mix, and a combination of the two. Micronutrient gaps (the difference between micronutrient requirements and actual micronutrient intake) were estimated for four groups of project beneficiaries, with target intakes defined as requirements for iron, calcium, zinc, vitamin A, vitamin C, riboflavin, niacin, and vitamin B12 recommended by the Food and Agriculture Organization/World Health Organization. Primary focus was placed on iron and vitamin A. Cost and bulk constraint analyses, based on cost of supplement, feasibility of delivery, and serving volume needed to achieve micronutrient targets, were used for comparing the supplement options. In terms of these analyses, the micronutrient multimix proved, by far, to be the most advantageous. Food options, however, are arguably desirable in that they provide dietary benefits additional to that of known micronutrients and may increase demand to boost production of domestic fruits and vegetables for the population as a whole. The study concludes that it is cost-effective to use powdered micronutrient mixes for such specific purposes as enrichment of supplementary food and food fortification, but encourages production and consumption of micronutrient-rich foods through programme messages and activities.

Mature teratoma of the mesentery.

Teratoma of the mesentery is an extremely rare tumour of the germ cells and imposes diagnostic dilemma in clinical practice and is reported because of its very uncommon occurrence. With the advent of modern imaging modalities like ultrasonography, computerised tomography (CT) and magnetic resonance imaging (MRI), it is now confidently diagnosed and rarely requires diagnostic laparotomy. CT shows characteristic appearance (Rokitansky sign).