Pouch of sorrow: Undiagnosed isthmocele – presenting as secondary infertility of 11 years in a middle age female

In the past decade, the rate of cesarean sections has doubled leading to the more frequent occurrence of cesarean-related complications. Cesarean scar site diverticulum or isthmocele is one such complication that is defined as an outpouching of the anterior uterine wall at the cesarean scar site in continuity with the endometrial cavity, creating a wedge-shaped defect of variable depth. We report a case of a middle-aged female with secondary infertility for the last 11 years with one live issue 12 years back through a cesarean section at term. She had undergone an array of investigations for infertility for the past 5 years. She was diagnosed as having an isthmocele and managed with surgical repair of the defect at our hospital with subsequent assisted conception 8-month post-surgical repair. The importance of diagnosing a cesarean scar diverticulum cannot be understated not only because it is a surgically treatable cause of infertility but also because if such patients conceive, they may land in uterine rupture, placenta accreta, or scar ectopic pregnancy which can complicate into life-threatening situations.

Effect of Rhustox on Micropropagation of Scoparia dulcis L. through Leaf Explants Culture

Aim: To investigate the effect of Rhus toxicodendron (30CH) along with different compositions of phytohormones (Auxin and Cytokinin) on the basis of growth and multiplication of explants under optimum temperature under in-vitro conditions. Study Design: To establish and design the standard protocol for the in-vitro propagation through leaf explant of Scoparia dulcis under stress of phytohormones and homeopathic medicine Rhus toxicodendron (30CH). Place and Duration of Study: The plant materials were procured from the Herbal Botanical Garden Patna Science College, Department of Botany, Patna University, Patna, Bihar. The experimental part was carried out in Plant Tissue Culture Laboratory, between December 2017 to August 2018 in Department of Botany P.U. Patna. Methodlogy: The sterilized leaf explants were inoculated into MS media fortified with different phytohormones (Auxin and Cytokinin) and Rhus tox(30CH) under aseptic environmental conditions for the growth and development of callus, embryoids etc. Result: The explants in MS medium supplemented with auxins phytohormones and Rhus tox(30CH) exhibited that IAA (0.10 to 2.0 mg/l) and BAP (0.10 to 2.5 mg/l) induces green and compact calli. Whereas at 0.30mg/l of IAA and 0.50 mg/l BAP induced brown friable calli. 2,4-D (1.5 mg/l) and Kinetin (1.5-6.5mg/l) concentrations induced brown and friable calli. Rhus tox(30CH) (100 µl/100 ml) enhances proliferation with 2,4-D and Kinetin (1.5/1.5 mg/l.). Conclusion: After 42 days of culture initiation and establishment the callus was 520.0±1.12 mg in the mixture of 2,4-D and Kinetin (1.5 mg/l) in Rhus tox free medium. Whereas weight of callus were found to be 1092±0.74 mg after 42 days in the same medium of 2, 4-D and Kinetin (1.5/5.5 mg/l) supplemented with Rhus tox (100 µl/100 ml). Hence, the investigation proponded that the Rhus tox (CH30) has increased the rate of callus development and plantlet regeneration.

Study on Self-medication Practices among University Students of Bangladesh.

Aims: To know how much knowledge and awareness university students of Bangladesh have about commonly used medicines. Study Design: The study was conducted on 1200 students randomly selected from 9 university of Bangladesh, in which 87.5% were master’s student and remaining 12.5% were honor’s students. Each willing participant shared their opinion. Place and Duration of Study: Dhaka University (DU), Jahangirnagar University (JU), Eastern University (EU), East West University (EWU), Daffodil International University (DIU), North South University (NSU), International Islamic University Chittagong (IIUC), University of Information Technology & Science (UITS) and University of Science & Technology (USTC), Bangladesh, from May to July 2012. Methodology: Questionnaires were distributed among the students, information about students and knowledge about self-medication practices of medicine was determined. Results: The present study revealed that most frequently used medicine was analgesic/antipyretic (58.75%), followed by antiulcerants (40.17%), antibiotics (18.17%), antihistamines (10.58%) and antitussive (9.33%). 54.5% students took analgesic/antipyretic based on self-decision, followed by 49.83% antibiotics, 43.5% antiulcerants, 46.83% antitussives and 31.08% antihistamines respectively. Based on retailer advice 25% students took antimicrobials. 47.83% students said that they took antibiotics because of fever, 27% said the reason was infection, 13.58% took antibiotics because of GI disease and 12.5% mentioned others. 67.67% had no idea about side effect of antibiotics, followed by 53.17% for analgesic/antipyretic, 53.2% for antihistamine, 47.75% for antitussives and 28% for antiulcerants. Conclusion: Self-medication was practiced with a range of drugs from the analgesic/antipyretic to antibiotics. Most of the students didn’t know about the side-effects of these medicines as well as the antibiotics resistance. Although the practice of self-medication is unavoidable; drug authorities and health professionals need to educate students about the health hazards of self-medication.

Immunoglobulin levels in panic disorder patients

The study was conducted to evaluate the serum immunoglobulin levels in patients suffering from panic disorder and to assess the relationship between the changes of immunoglobulin levels and the socioeconomic parameters, as well as nutritional status. 54 panic patients were randomly selected from the Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University [BSMMU] and Dhaka Medical College Hospital, Bangladesh. Fifty two, age and gender matched healthy volunteers [42 males and 10 females, mean age of 30 +/- 6 yrs] were also enrolled in this study. Immunoglobulin levels were measured by turbidimetry method using immunoglobulin kits. It was found that the mean serum immunoglobulin concentrations of IgG, IgM and IgA of panic disorder patients were 0.999 +/- 0.26 [g/L], 0.1 +/- 0.028 [g/L] and 0.194 +/- 0.066 [g/L] respectively whereas the values were 1.24 +/- 0.39 [g/L], 0.096 +/- 0.022 [g/L], 0.194 +/- 0.053 [g/L] in healthy volunteers. IgG level in panic disorder patient was found significantly [p <0.05] lower than that of the controls but the change in concentration of IgM and IgA were not significant [p=0.497, p=0.962]. Socioeconomic data reveals that most of the patients were from lower income group and educated. BMI [Mean +/- SD] of the patients [22.62 +/- 3.74 kg/m[2]] and controls [23.74 +/- 2.71 kg/m[2]] were well within the normal range. From correlative analysis it has been found that income has significant effect [p=0.047] on the change of the serum IgG level in panic disorder patient and it was also been justified by the regression analysis [p=0.049]. This finding may play a key role in the diagnosis and treatment of the panic disorder patients. Further studies have been suggested with a large number of populations to confirm these findings