Clinical presentation of tubal ectopic pregnancy

Background: When the fertilized ovum gets implanted at site other than normal position of uterine cavity, it is known as ectopic pregnancy. Incidence of ectopic pregnancy is 1-2% of all reported pregnancies. It is an unmitigated disaster of human production and the most important cause of morbidity and mortality in first trimester with major cause of reduced child bearing potential. It is notorious in its clinical presentation, challenging the attending physician.Methods: women with risk factors, signs and symptoms and with confirmed diagnosis. Women discharged against medical advice. Study population is 50. Retrospective analysis for 3 years (2016-2019). Objectives of this study were to study the incidence, risk factors, clinical presentation, diagnosis and changing trends of modern management. Results analysed after entering the information in the excel sheets using descriptive analysisResults: Out of 4940 deliveries, 50 were tubal ectopic pregnancies 1.012%. Women aged 20-25 years were 52%. In our study, multiparous were 68%. Common symptoms were abdominal pain 80.2%, amenorrhea 72%, urine gravindex test positive 92.8%. Etiology was PID 20%, previous ectopic pregnancy 4%, IUCD 4%, LSCS with tubectomy 16%, most common site is ampulla 82%. About 78% were ruptured. Tubal abortions 4%, salpingectomy done in 82%. Laparotomy in 2.43% in hemodynamically unstable. Medical management 8%. Salpingostomy in 4% and expectant management 2%. Morbidity in the form of blood transfusion 23.48%, DIC with ICU admission 2%. No mortality.Conclusions: A high index of clinical suspicion with underlying risk factors may get us early diagnosis for timely intervention.

Study of neutrophil lymphocyte ratio in patients with type 2 diabetes mellitus and its correlation with glycemic control

Background: Neutrophil lymphocyte ratio (NLR) is an indicator of subclinical inflammation. Subclinical inflammation may be associated with increased cardiovascular risk. Raised NLR is associated with metabolic syndrome and is found to be a predictor of cardiovascular disorders. There are only few studies assessing the correlation between NLR and glycemic control. The aim of the present study is to investigate the relationship between NLR and glycemic control in type 2 diabetes patients.Methods: This observational study was conducted in Department of Medicine, Bangalore medical college. 100 patients diagnosed to have type 2 diabetes mellitus were assessed. They were divided into three groups based upon HbA1c levels: Group 1, HbA1c ≤7%; group 2, HbA1c 7-9%, and group 3, HbA1c>9%. Complete blood count and other relevant investigations were performed. SPSS software was used for statistical analysis. T test was used for continuous variables and chi square test for categorical variables. ANOVA test was used to compare three groups. A p value of <0.05 was considered statistically significant.Results: Out of 100 patients, the white blood cell count (WBC count) was higher in group 3 as compared to group 1 and group 2(p 0.008). Similarly, the absolute neutrophil count was higher in group 3 as compared to group 1 and group 2(p.017). The neutrophil lymphocyte ratio (NLR) was significantly higher in group 3 as compared with group 1 and group 2(p.009). NLR had a positive correlation with HbA1c and was found to be an independent predictor of poor glycemic control in patients with type 2 diabetes mellitusConclusions: Our study found a significant positive correlation between NLR and glycemic control. Increased NLR is associated with elevated HbA1c and poor glycemic control. Type 2 diabetes mellitus patients with raised NLR should be evaluated for cardiovascular, renal and ocular complications of diabetes.

Psychosomatic Disorders Pertaining To Dental Practice

Psychosomatic symptoms are by definition clinical symptoms with no underlying organic pathology. Psychosomatic disorders represent impaired adaptation or deficiencies that limit the capacity to adapt successfully to the demands of everyday life. The symptoms are thought to be a response to stress. Appropriate health consultation should be considered for further evaluation and treatment.

Green tea- A Healthy sip.

After water, tea is the most consumed popular drink in the world. Green tea which is a leading beverage in the Far East for thousands of years is regarded as a health product. It is nothing but a non-fermented tea which contains more catechins, than black tea or oolong tea. Catechins are strong antioxidants with its additional content of certain minerals and vitamins increasing its antioxidant potential. High-molecular-weight polyphenols isolated from green tea which includesepigallocatechin 3 gallate (EGCG) constitute the most interesting components in green tea leaves. Th e aqueous extract or the major polyphenols of green tea possess cariostatic, antimutagenic, antidiabetic, antioxidant, antibacterial, anti infl ammatory, antitumor, hypocholesterolemic, as well as cancer-preventive activities in a variety of experimental animal models system and have been demonstrated in various studies.

Liposarcoma: A Rare Case Report with Review of Literature.

Liposarcoma is one of the most common malignant mesenchymal neoplasms, comprising approximately 15% of all soft-tissue sarcomas. First described by “Virchow” in 1857, it has been extensively reported in the literature, although its incidence remains exceedingly rare in the head and neck region with an annual incidence estimated to be 2.5/1 million inhabitants in population-based studies. It is one of the most common malignant mesenchymal neoplasms, comprising approximately 15% of all soft-tissue sarcomas. It is a heterogeneous disease with distinct sub-entities presenting with differential clinical behavior. The purpose of this article is to report an additional case of liposarcoma of the buccal vestibule and to review the literature.

Skin Carvings: Predictive Diagnosis in Modern Era.

The science and art of markings of the skin especially hands and feet’s is known as dermatoglyphics, where derma means skin and glyph mean carving. For centuries, the features of the hands have fascinated scholars, sages, theologians, doctors, and layman alike. In 1926 Cummins introduced the term “dermatoglyphics.” “Samudra Shastra” was known as ridge pattern study in ancient India. The epidermal ridge patterns were classified into “Chakra, Shankya, and Padma” which corresponds with the whorl, loop, and arch system of modern classification. All individuals have unique fingerprints which remain unchanged over the lifetime. Multiple genes determine fingerprint configurations and the study of fingerprints reveal vital genetic and medical information about an individual. Dermatoglyphics is considered as the window of congenital abnormalities and is a sensitive indicator of intrauterine anomalies. For preliminary investigations in conditions with a suspected genetic basis dermatoglyphic analysis is now beginning to prove itself as an extremely useful tool. In dentistry, various studies have been published on the dermatoglyphics. Here in this present review, the dermatoglyphic patterns of the palms and soles, the methods to record the palm and sole prints and various studies conducted among the dental disorders has been highlighted.

Zygomycosis as a Rare Cause of Surgical Site Infection: A Case Report and Review Literature

Zygomycosis is a rare invasive fungal infection seen most often in patients with haematological malignancies, particularly in the neutropenic phase[1]. Fungal infection causing surgical site infection is uncommon, of which yeast attributes predominant cause, followed by aspergillosis. But zygomycosis manifesting as the surgical site infection is still very rare entity. The treatment of zygomycosis is multimodal, and consists of surgical debridement, use of antifungal drugs and reversal of underlying risk factors, if possible. We report a case of zygomycosis presenting as post-caesarean surgical site infection.