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BACKGROUND: Adnexal masses is a significant condition commonly seen in women’sreproductive age. Most common masses arise from ovaries due to their complexembryologic & histologic origin. For diagnosis, ultrasonography is the gold standard.Laproscopy is the gold standard surgical intervention.METHODS: This study was a prospective study that was conducted at a tertiary carehospital in the obstetrics and gynecology department from October 2021 to December2021.RESULTS: In this study, No. 31% of the patients were between the ages of 26 and 35.Of the patients, 12.90% came from the upper socioeconomic class, 72.58% from themiddle, and 14.51% from the lower socioeconomic class. The most common complaintwas abdominal pain (41.93%) followed by menstrual irregularities (25.80%). 46.77% ofpatients were managed medically. In 32.25% of patients, laparoscopy was performed andin 20.96% of patients, laparotomy was performed.CONCLUSION: Adnexal masses are a very common gynecological problem, Presentwith abdominal pain / other symptoms /an incidental finding on ultrasonography done forother purposes. So, the basic approach should be early diagnosis and appropriate medicalor surgical treatment, to minimize morbidity and avoid mortality.
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BACKGROUND: Abnormal uterine bleeding complaints constitute about one-third ofpatients attending the Obstetrics and Gynaecology OPD. To standardize nomenclature ofAUB, a new system known by the acronym PALM-COEIN, was introduced in 2011 byFIGO.AIMS AND OBJECTIVES:To study the various abnormal patterns of bleeding presenting in perimenopausal agegroup.To study the etiology, predisposing and associated factors of AUB.To study the various treatment options available for AUB.METHODS: This study was carried in department of obstetrics and gynaecology amongperimenopausal women attending out patient department. The clinical presentation,ultrasonographic findings associated medical disorders, routes of hysterectomy werecorelated.RESULTS: Menorrhagia is the predominant symptom of 109 patients. 101 were associatedwith complain of heavy menstrual bleeding followed by dysmenorrhea. Adenomyosis wasthe most common abnormality found on TVS followed by Endometrial Hyperplasia,Fibroid and polyp. Treatment was initiated in form of conservative medical therapyfollowed by, combination therapy of hormonal drugs-Progesterone and COC and nonhormonal drugs like tranexamic acid + mefenamic acid were used to control bleeding.Hysterectomy was served as a final measure for all patients who didn’t respond toconservative management.CONCLUSION: AUB is a common problem in peri-menopausal age group and itsaccounts for one third of patients visiting Gynecological OPD. It significantly affects thequality of life in general population.
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Learning about human eye movements broadens our comprehension of the visuomotor system and aids in the effective management of strabismus. One’s clinical practice is improved by a dynamic simulation of human eye movements using physical models of the extraocular muscles (EOMs). We use our eyeball model to teach the basics of strabismus to undergraduate students and ophthalmology residents. In Listing’s plane, extraocular movements of each muscle and the angle demonstration are being used to familiarize students with their knowledge. The degree of the residents’ understanding of strabismus is significantly influenced by the eyeball strabismus simulator. This model is an inexpensive, Do It Yourself (DIY) model that is simple to build.
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Introduction: Pseudocyst or seroma is an uncommon asymptomatic, non-in?ammatory swelling of the pinna, characterized by endochondral cyst formation. Pseudocyst commonly occur as a post trauma sequela. The objective of our study is to compare and analyse the outcomes of aspiration and window technique in treating auricular seroma. Randomized control study. This study comprised of 20 patients who presented with Study Design: Setting: auricular seroma to the Department of ENT, HSK Hospital, Bagalkot from August 2020 to December 2022. The Methods: diagnosis of the auricular pseudocyst was made clinically. Out of 20 patients, 10 patients were taken up for wide bore needle aspiration followed by contour pressure dressing, and 10 patients underwent the window procedure. Patients were followed up for a period of 6 months. In the 10 cases primarily taken up for needle aspiration, there was a recurrence in 8 out of the Results: 10 cases; while 2 patients showed successful outcome during the 6 months of follow-up. Of the 10 cases taken up primarily for the window procedure, no recurrences were noted as compared to aspiration group, which was statistically signi?cant (p=0.0003) Considering the rate of success and minimal complications encountered in our study, we would . Conclusion: advocate the use of deroo?ng technique for achieving better outcome in the management of pinna pseudocysts.
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Background@#Attitudes towards smoking, lung cancer screening, and perceived risk of lung cancer have not been widely studied in Malaysia. The primary objective of this study was to describe the factors affecting the willingness of high-risk current smokers and ex-smokers to undergo low-dose computed tomography (LDCT) screening for lung cancer. @*Methods@#A prospective, cross-sectional questionnaire study was conducted in current smokers or ex-smokers aged between 55 and 80 years at three hospitals in Kota Kinabalu, Sabah, Malaysia. The questionnaire recorded the following parameters: perceived lung cancer risk; Prostate Lung Colon Ovarian Cancer 2012 risk prediction model excluding race and ethnicity predictor (PLCOm2012norace); demographic characteristics; psychosocial characteristics; and attitudes towards lung cancer and lung cancer screening. @*Results@#A vast majority of the 95 respondents (94.7%) indicated their willingness to undergo screening. Stigma of lung cancer, low levels of knowledge about lung cancer symptoms, concerns about financial constraints, and a preference for traditional medication were still prevalent among the respondents, and they may represent potential barriers to lung cancer screening uptake. A desire to have an early diagnosis (odds ratio [OR], 11.33; 95% confidence interval [CI], 1.53 to 84.05; p=0.02), perceived time constraints (OR, 3.94; 95% CI, 1.32 to 11.73; p=0.01), and proximity of LDCT screening facilities (OR, 14.33; 95% CI, 1.84 to 111.4; p=0.01) had significantly higher odds of willingness to undergo screening. @*Conclusion@#Although high-risk current smokers and ex-smokers are likely to undergo screening for lung cancer, several psychosocial barriers persist. The results of this study may guide the policymakers and clinicians regarding the need to improve lung cancer awareness in our population.
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Background: Delirium is a complex, reversible neuropsychiatric disorder that frequently occurs in the geriatric age group in acute care settings with multifactorial etiology and numerous knowledge gaps in the pathogenesis. Objective: This study aimed to establish an association between leptin levels and delirium in patients aged 60 years and above admitted under the geriatric medicine department of a tertiary care hospital. Materials and Methods: A prospective observational study was conducted in consecutively admitted patients to the geriatric ward. Patients were assessed for delirium within 24 h of admission and daily thereafter until they were discharged from the hospital or died using the Confusion Assessment Method (CAM) or CAM?intensive care unit with subsequent division into delirium and nondelirium groups. Serum leptin levels were measured using enzyme?linked immunosorbent assay. Results: Two hundred patients were recruited in the study. The mean age of participants was found to be 73.1 ± 8.8 years. Prevalence rates of delirium at the time of admission and incidence rates during hospital stay were found to be 20% and 5%, respectively. The occurrence of delirium was also found to be significantly associated with mortality (32.5% vs. 8.7%, P = 0.001). Serum leptin levels were found to be significantly lower in patients with delirium (2.58 ± 1.01 ng/mL vs. 10.72 ± 1.46 ng/mL, P = 0.03). Multivariable regression analysis revealed delirium to significantly correlate positively with age (Odds Ratio [OR]: 1.63 (1.07–2.47), P = 0.021) and negatively with leptin levels (OR: 0.94 (0.90–0.99), P = 0.018). Conclusion: Delirium is a frequently occurring condition in hospitalized older adults with high mortality rates. Leptin might serve as a potential predictor of delirium owing to its probable role in the pathophysiological processes of delirium.
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Aphids are one of the most devastating pests, affecting the potential yield and quality ofBrassica juncea. In the current study, we have attempted to pyramid two transgenic lines containing chickpea lectin (CHPL, P1) and urdbean protease inhibitor (UPI, P2) in each under the phloem specific rolC promoter, through conventional breeding approach. In the derived F2 population, both lectin and protease inhibitor genes were segregating in a 9:3:3:1 ratio (p-value: 0.81), indicative of a single copy of the transgenes in the parents. Furthermore, the parental, as well as pyramided progenies were evaluated for their potential resistance to aphids in terms of mortality and natality. The lines containing both the transgenes were found to be superior over single gene transgenics as a higher mortality rate (96%) was found in F2on the 9th day as compared to single gene transgenics (86% and 80% in P1 and P2 respectively). A significant decrease in the number of nymphs was observed in P1 and P2 but most in F2 plants as almost 43, 32.08, and 107.5 times decrease in the number of nymphs was found in P1, P2, and F2 individuals over control. Expression profiling was done to see if there was any impact of gene pyramiding on the expression pattern of both transgenes before and after aphid treatment, and no significant changes were observed, indicating constitutive expression of transgenes in pyramided lines also. In conclusion, pyramided lines were found to be promising and were superior for aphid resistance.
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Aphids are one of the most devastating pests, affecting the potential yield and quality ofBrassica juncea. In the current study, we have attempted to pyramid two transgenic lines containing chickpea lectin (CHPL, P1) and urdbean protease inhibitor (UPI, P2) in each under the phloem specific rolC promoter, through conventional breeding approach. In the derived F2 population, both lectin and protease inhibitor genes were segregating in a 9:3:3:1 ratio (p-value: 0.81), indicative of a single copy of the transgenes in the parents. Furthermore, the parental, as well as pyramided progenies were evaluated for their potential resistance to aphids in terms of mortality and natality. The lines containing both the transgenes were found to be superior over single gene transgenics as a higher mortality rate (96%) was found in F2on the 9th day as compared to single gene transgenics (86% and 80% in P1 and P2 respectively). A significant decrease in the number of nymphs was observed in P1 and P2 but most in F2 plants as almost 43, 32.08, and 107.5 times decrease in the number of nymphs was found in P1, P2, and F2 individuals over control. Expression profiling was done to see if there was any impact of gene pyramiding on the expression pattern of both transgenes before and after aphid treatment, and no significant changes were observed, indicating constitutive expression of transgenes in pyramided lines also. In conclusion, pyramided lines were found to be promising and were superior for aphid resistance.
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Purpose: To study the clinical presentation, mycological profile, and risk factors of fungal keratitis (FK) cases presenting at two tertiary?care centers, one each at North (Chandigarh) and Northeast (Assam) India, and to compare the spectrum of fungi recovered from the clinical and environmental samples at both locations. Methods: All patients with suspected FK were enrolled from both the centers between January 2018 and December 2019. Corneal samples were collected and processed as per standard laboratory protocols. Demographic details and clinical and mycological profiles were noted in all patients. Environmental sampling from the soil, air, and the vegetative matter was performed from both locations and neighboring districts. Results: Of the 475 suspected cases, 337 (71%) were diagnosed as FK (median age: 50 years; 77.2% males). The presence of diabetes, hypertension, blurred vision, and corneal discoloration was significantly higher in patients with FK compared to those without FK. Aspergillus sp. (52.1%) and Fusarium sp. (47.61%) were the predominant etiological agents isolated from cases in North and Northeast India, respectively. FK due to melanized fungi was associated with diabetes, trauma with animal tail, and corneal discoloration. A similar spectrum of fungi was seen in environmental and clinical samples in both the regions. Conclusion: The difference in etiological agents of FK and environmental fungal isolates in North and Northeast India highlights the need to identify the ecological niche of potential fungal pathogens. Prospective, multicenter studies, systematic environmental sampling, and the evaluation of the differences in causative agents and clinical presentation of FK from different parts of the country can substantially improve our understanding of its region?specific clinico?epidemiological profile.
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Purpose: To analyze the reasons for delay in cataract surgery in patients with advanced cataracts during the COVID?19 pandemic. Methods: This was a prospective, cross?sectional, multicenter questionnaire study which included patients with mature cataract, nuclear sclerotic cataract grade IV, and cataracts with best corrected visual acuity (BCVA) <5/60, during the COVID?19 pandemic from December 2020 to April 2021. Reasons for delay in presentation to the hospital were analyzed. Results: One thousand four hundred seventy two patients were recruited with advanced cataracts. Absence of ophthalmic care nearby (44.2%), lack of awareness regarding elective surgeries (42.6%), lack of public transportation (37%), fear of contracting COVID?19 (23.4%), and waiting for outreach camps (20.4%) were found to be the reasons behind the delay in cataract surgery. 53.7% of the patients had worsening of defective vision and 55.3% of them had difficulty in carrying out activities of family living. 30.8% of the patients faced difficulty in commuting and 8.4% of the patients suffered a fall during this pandemic due to worsening of the visual acuity. Conclusion: The lockdown imposed during the pandemic has created a significant backlog of patients who are progressing to advanced cataracts due to lack of ophthalmic care nearby, lack of awareness regarding elective surgeries, lack of public transportation, and no outreach camps. Proactive measures to deal with this backlog are of utmost need to prevent blindness due to cataract
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Introduction : Placental Neoplasms are classified in to two categories based on their origin: Trophoblastic and nontrophoblastic. Non trophoblastic tumors are common and benign ones include chorioangioma andteratoma. Chorioangioma of placenta is the commonest benign tumor of the placenta. It consists of abenign angioma arising from the chorionic tissue. It has been found to be associated with manyserious complications such as nonimmune hydrops, congenital abnormalities, hemolytic anemia,polyhydramnios, IUGR, and IUFD.Methods:A 21 years old pregnant female 2nd gravida with 32 weeks of gestation presented to Ob/Gydepartment at L.G. Hospital with complaints of abdominal distension for 2 weeks associated withlower abdominal pain for 2 days. She had a history of one full term normal delivery withoutsignificant peripartum events. General examination was unremarkable. P/A was grossly enlarged withFundal height more than gestational age, fetal heart rate was 144 /min. Per vaginal examinationrevealed 2 cm dilated and early effaced cervix with intact membrane. USG revealed a single live fetuswith 32 weeks of gestation and without structural malformations and hydrops AFI of 42 cmhyperechoic mass of 8.5 *6.5cm on placental surface, near cord insertion with hypervascularity,separate from placental tissue suggestive of placental chorioangioma. Estimated fetal weight was1.6kg. After a course of dexamethasone, therapeutic amniocentesis was done; She developed grosspolyhydramnios after 4 days of amniocentesis followed by spontaneous preterm normal labor anddelivered 1.7kg live baby without peripartum complications. Histopathological analysis of the massrevealed proliferation of capillary sized vascular channels with endothelial cells, hemorrhagic andfocal area of calcifications. The neonate was admitted to NICU and was discharged after a weekwithout complications.Conclusion :This case illustrates the prompt and accurate diagnosis of placental chorioangioma canhelp apply timely interventions improving patient outcome.
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Cancer therapy is a fast-emerging biomedical paradigm that elevates the diagnostic and therapeutic po-tential of a nanovector for identification,monitoring,targeting,and post-treatment response analysis.Nanovectors of superparamagnetic iron oxide nanoparticles(SPION)are of tremendous significance in cancer therapy because of their inherited high surface area,high reactivity,biocompatibility,superior contrast,and magnetic and photo-inducibility properties.In addition to a brief introduction,we summarize various progressive aspects of nanomagnets pertaining to their production with an emphasis on sustainable biomimetic approaches.Post-synthesis particulate and surface alterations in terms of pharmaco-affinity,liquid accessibility,and biocompatibility to facilitate cancer therapy are highlighted.SPION parameters including particle contrast,core-fusions,surface area,reactivity,photosensitivity,photodynamics,and photothermal properties,which facilitate diverse cancer diagnostics,are discussed.We also elaborate on the concept of magnetism to selectively focus chemotherapeutics on tumors,cell sorting,purification of bio-entities,and elimination of toxins.Finally,while addressing the toxicity of nanomaterials,the advent of ultrasmall nanomagnets as a healthier alternative with superior properties and compatible cellular in-teractions is reviewed.In summary,these discussions spotlight the versatility and integration of multi-tasking nanomagnets and ultrasmall nanomagnets for diverse cancer theragnostics.
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Acute lymphoblastic leukemia (ALL) is the most common malignancy of children.Gastrointestinal complications can occur during treatment of these children due to disease infiltration in gut or treatment-related toxicity. Intestinal obstruction is one of these complications and this occurs mostly due to constipation and impacted stool. Intussusception is a very rare entity in children with ALL. Left sided colo-colic intussusception is even rarer. Most of the intussusceptions are ileo-colic and are associated with a lead point. We present a case of left sided colo-colic intussusception in an 8-year-old child with ALL. There was no lead point or leukemic infiltrate in the resected part of the intussusception. Our child had typhlitis leading to intussusception which is a very rare occurrence. Awareness regarding this complication with ALL is important for prompt diagnosis and treatment.
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Objective:To explore natural compounds as potential inhibitors against main protease (Mpro) of SARS-CoV-2. Methods:In the current study, systematic molecular docking analysis was conducted using AutoDock 4.2 to determine the binding affinities and interactions between natural compounds and Mpro. Selected natural compounds were further validated using a combination of molecular dynamic (MD) simulations and molecular mechanic Poisson-Boltzmann surface area (MM/PBSA) free energy calculations. Results:Out of twenty natural compounds, four natural metabolites namely, amentoflavone, guggulsterone, puerarin, and piperine were found to have strong interaction with Mpro of SARS-CoV-2 based on docking analysis. During MD simulations, all four natural compounds bound to Mpro at 50 ns and MM/G/P/BSA free energy calculations showed that all four shortlisted ligands had stable and favorable energies with strong binding to Mpro protein. Conclusions:Guggulsterone is a potential inhibitor of COVID-19 main protease Mpro. Further in vitro and pre-clinical studies are needed.
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In India, about 15 million people are bitten by animals, mostly dogs, every year and need post-exposure prophylaxis. Most animal bites in India (91.5%) are by dogs, of which about 60% are strays and 40% pets. The incidence of animal bites is 17.4/1000 population. Oral anticoagulants are usually prescribed for patients recovering from cardiovascular diseases, ischemic incidents such as myocardial infarction and angina pectoris followed by cerebrovascular accidents. Patients are usually placed under antiplatelet or oral anticoagulants increase the hemorrhage risk after oral surgical procedures. Here, we report a case of a patient on anticoagulants who, while seeking dental treatment, was bitten by a rabid street dog and shed light on the decisions faced by a dental professional while treating such patients.
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Background and Objectives: Non-stress test (NST) is one of the most widely used primary tests for the assessment of fetal well-being. It is a graphical recording of fetal heart activity and uterine contractions simultaneously and continuously when uterus is quiescent with fetal movements. It has been incorporated into biophysical profile system. It is simple, inexpensive, non-invasive, easily performed, and interpreted. Hence, it can be used to screen a large population as an outpatient department procedure. This study was done to observe the efficacy and diagnostic value of NST for antenatal surveillance and comparison of test results with mode of delivery and adverse perinatal outcome. Materials and Methods: A total of 100 high-risk (HR) pregnant women (study group – selected based on inclusion and exclusion criteria) and 100 low-risk (LR) pregnant women (control group) were randomly enrolled into study and followed up with NST from 32 weeks of gestation and repeated at appropriate intervals in cases of the HR group. Results: In the LR group, there was an increased incidence of intrapartum fetal death (IPFD), meconium-stained amniotic fluid (MSAF), and decreased liquor quantity in non-reactive (NR) subgroup compared to reactive NST (R-NST) subgroup. However, in the HR group, NR-NST was associated with significantly increased incidence of decreased liquor quantity, low Apgar score at 5 min of birth, and perinatal mortality compared to the R-NST subgroup. Although the statistical incidence of IPFD was not significant in the NR-NST subgroup compared to R-NST, it appeared clinically significant. MSAF incidence was not significant in these two NST result subgroups. Sensitivity, specificity, and negative predictive value of NST in the LR group were 100%, 81.8%, and 100%, respectively; likewise, in the HR group, they are 75%, 78.1%, and 98.7%, respectively, for perinatal mortality. Conclusion: NST is a valuable screening test for detecting fetal compromise in both HR and LR fetuses that may have a poor perinatal outcome. Predictive value of NST for perinatal mortality was higher in the LR group compared to the HR group though statistically was not significant.
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Hollow-fiber liquid-phase microextraction (HF-LPME) and electromembrane extraction (EME) are miniaturized extraction techniques, and have been coupled with various analytical instruments for trace analysis of heavy metals, drugs and other organic compounds, in recent years. HF-LPME and EME provide high selectivity, efficient sample cleanup and enrichment, and reduce the consumption of organic sol-vents to a few micro-liters per sample. HF-LPME and EME are compatible with different analytical in-struments for chromatography, electrophoresis, atomic spectroscopy, mass spectrometry, and electrochemical detection. HF-LPME and EME have gained significant popularity during the recent years. This review focuses on hollow fiber based techniques (especially HF-LPME and EME) of heavy metals and pharmaceuticals (published 2017 to May 2019), and their combinations with atomic spectroscopy, UV-VIS spectrophotometry, high performance liquid chromatography, gas chromatography, capillary elec-trophoresis, and voltammetry.
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The brown planthopper (BPH) Nilaparvata lugens (Stål) (Homoptera: Delphacidae) is considered a threat to rice (Oryza sativa ssp.) crop in many parts of the world including India. Among the BPH-resistance (R) genes so far reported in rice, most of them are ineffective against BPH biotype 4 predominant in the Indian sub-continent. In this study, we show the introgression line RPBio4918-230S was identified as BPH resistant after five years of rigorous screening at seedling stage and two years at tillering and reproductive stages. The inheritance of resistance indicated that two recessive genes are involved at seedling and reproductive stages. The allelic relation with known genes using linked reported markers suggested that the genes present in RPBio4918-230S are different. We report here the genetics of the two newly introgressed BPH resistance genes from O. nivara in the background of Swarna which are effective at all the important growth stages. The genes have been tentatively named as bph39(t) and bph40(t). The honeydew area (feeding rate) and days to wilt parameters observed at 30 days after sowing in BC1F3 indicated that newly introgressed genes have both antibiosis and tolerance mechanisms for resistance. The BPH resistance genes identified in this study would facilitate the breeding of broad spectrum and durable resistance in rice against BPH biotype 4.
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Background: Anaemia is a very common complication in cancer patients. Up to 60% of solid tumor patients and 70-90% of patients receiving myelosuppressive chemotherapy have anaemia. Pathophysiology of anaemia in cancer patients is multifactorial. The treatments for cancer related anaemia include Erythropoietin Stimulating Agents (ESAs), iron supplementing therapies (intravenous iron, oral iron) and blood transfusion. There are various safety concerns regarding usage of ESAs; also, their usage is less in India due to cost factor. There is scant literature regarding blood transfusion practices in patients undergoing chemotherapy.Methods: Patients diagnosed with cancer and patients receiving chemotherapy were included in the study. Retrospective case record review of cancer patients who received chemotherapy between January to March 2019 was done. Type of malignancy, presence of symptoms related to anemia and trigger for packed red cell transfusion were recorded.Results: Among 342 patients received total of 1365 cycles of chemotherapy in this time period. Mean age of patients was 46 years. 46 of the 342 patients received blood transfusion. Only 13% of the patients had symptoms of anemia like weakness and fatigue the average hemoglobin level at which transfusion was given was 6 gm/dL.Conclusions: Packed Red blood cell transfusion was usually administered at Hb <7 gm/dL. Very few patients reported anaemia related symptoms prior to transfusion. No patient received erythropoietin. Further data is needed from other tertiary cancer centres to understand the blood transfusion practices in Indian cancer patients undergoing chemotherapy.
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Background: India contains largest populations of child victim of sexual abuse. Current study aimed to find out awareness, orientation, execution of parents for child sexual abuse (CSA) prevention education and study the awareness of CSA prevention education among children attending pre-primary and primary school.Method: It was cross-sectional study carried out during 2016-2017 at government and private school of Gwalior. Total 500 parents and 500 children were selected' Proforma based assessment was done among parents and diagrammatic (picture) based assessment among children, Children are explained about diagrammatic proforma and give to color area of good touch and bad touch.Results: The study revealed that 34% of parents are unaware of various facts of child sexual abuse (p <0.005). Post graduate parents have more CSA awareness (90.3%) (p<0.001).Total36% parents have shown negative orientation towards child sexual abuse prevention education. CSA prevention awareness more in upper class parents (88.3%) as compared to lower class (43.8%) (p < 0. 001). post graduate parents have more CSA awareness as compared to illiterate and higher secondary. On assessing the knowledge of good touch and bad touch among children. It was found that only 6% of children have good knowledge, 36%children have some knowledge and 58 % no knowledge regarding good touch and bad touch .Conclusion: Majority of parents and kid are unaware of various fact of child sexual abuse. Parents education level has direct correlation, highly qualified mother father has positive attitude toward child sexual abuse prevention education. Lack of knowledge found in lower socioeconomic class.