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Background: High-risk human papillomaviruses (HPV) infection has been the most common sexually transmitted infection worldwide. Moreover, it is a necessary factor for the development of cervical cancer. Several studies have been carried out that screen HPV and other sexually transmitted infections (STI)s occurring in patients at the same time. Timely screening can help early diagnosis of pre-cancerous lesions and assist in prompt treatment to reduce mortality in such patients. The objective of the present study was to screen women for the presence of high-risk HPV (hrHPV) for the early diagnosis of cervical cancer. Some women were additionally screened for STIs. We also aimed to establish an association between the presence of HPV and STI.Methods: A total of 40 women aged 20-67 years participated in this study. Cervical and or vaginal swabs were collected in liquid-based cytology containers. The samples were tested for fourteen HPV genotypes by USFDA-approved Cobas HPV test. Out of these 40 women 26 were also tested for STI panel.Results: All women participants were screened for hr-HPV. A total 65% of the study population underwent both the HPV test and the STI test. 7.5% of total women were positive for hrHPV. 30.76% of women tested positive for Ureaplasma and Gardnerella vaginalis in the STI panel. Some women also showed simultaneous presence of STI and HrHPV.Conclusions: The results of this study will help in better and early diagnosis of women at risk of cervical cancer. The detection of HPV and STI present simultaneously can further help in establishing the role of these two conditions in the development of cervical cancer. Such studies are an encouragement to the HPV elimination programme and vaccination drive that has taken an impetus in recent times in India.
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Background: The study shows the incidence of postdatism in a pregnancy, and to find out the incidence of maternal and fetal complications, perinatal mortality in postdated pregnancy.Methods: All registered ANC patients coming to OPD and labour ward completed 40 weeks of gestational age by date (who were sure of the date of last menstrual period) or by scan (considering early weeks scan) are considered in the study. History and examination of the patients are done and mode of delivery was decided accordingly. Fetal monitoring was done using non stress test, ultrasonography and DFKC charting maintained.Results: Postdatism is very common in primigravida (61%) than multigravida, and is common in age group of 21-30 years (67%), most common mode of delivery was vaginal delivery with approximately 30% undergoing LSCS due to various reasons. In perinatal assessment there was one IUFD and 5 NICU admissions in a total of 100 postdatism pregnancies. Maternal morbidities like sepsis, postpartum hemorrhage, perineal tear ivo shpulder dystocia and big baby will also be present in small number of cases.Conclusions: This study shows the incidence of postdatism according to gravida score and age factors. It also shows the associated perinatal and maternal morbidities in a patient with postdatism.
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Background: Laproscopy in chronic pelvic pain can revel findings that cannot be detected clinically, by ultrsonography, so it can be treated and diagnosed at the same sitting. This study was undertaken to evaluate role of laproscopy in chronic pelvic pain.Methods: Study design is a prospective study conducted in JJ hospital and Cama and Albless Hospital. A total of �� women presenting in OPD with chronic pelvic pain for more than 6 months duration were taken for the study.Results: Out of 44 patients who presented with pelvic pain 1 (2.27%) patient had no detectable pelvic pathology by laparoscopy. Prior ultrasound done in these 44 patients revealed that 14 (31%) had normal pelvic scan. Hence, ultrasound underdiagnosed 13 patients who actually had pelvic pathology on laparoscopy. Out of 44 patients 3 (6%) had normal clinical diagnosis, hence clinical examination under-diagnosed 2 other patients who on laparoscopy did not have any pelvic pathology.Conclusions: Laparoscopy is valuable in definitive diagnosis of pelvic pain. Use of laparoscopy for diagnostic and therapeutic purposes helps in avoiding laparotomy in majority of patients and morbidity and mortality associated with it.
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Background & objectives: The pandemic caused by the SARS-CoV-2 has been a threat to humankind due to the rapid spread of infection and appearance of multiple new variants. In the present study, we report the dynamics and persistence of immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies in asymptomatic and symptomatic COVID-19 patients by chemiluminescent assay. Methods: A total of 463 serum samples from 218 SARS-CoV-2 PCR-positive patients were collected over a period of 124 days post-onset of disease (POD). Antibody levels were measured by chemiluminescence bioanalyzer. Neutralizing antibody titres were assessed by plaque reduction neutralization test (PRNT) for SARS-CoV-2. Results: Both IgM and IgG started appearing from day five post-infection in symptomatic and asymptomatic patients. IgM antibody response peaked around day 35 POD and rapidly diminished thereafter, with the last IgM-positive sample observed at 90 days POD. IgG antibody response peaked around 45 days POD and persisted till 124 days. The chemiluminescence immunoassay (CLIA) results showed a moderate correlation (R=0.5846, P<0.001) compared with PRNT. Additional analysis indicated a neutralizing titre of 250 corresponded to 12.948 AU/ml of YHLO iFlash SARS-CoV-2 IgG units. Interpretation & conclusions: Both symptomatic and asymptomatic COVID-19 patients seem to initiate production of antibody responses from day five of onset of disease. Although the CLIA gives high sensitivity and specificity and also its binding IgG antibody titres may correlate moderately with protective immunity, our results indicate that the values of binding antibody alone may not be a perfect guide to represent virus neutralization titre during donor selection for plasma therapy. However, IgM and IgG antibody detection may help in monitoring the status of disease progression and burden in the community.
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Background: Many studies have attempted to examine and evaluate the changes in population characteristics that may have contributed to the observed increase in CS rate. The aim of this study was to determine the caesarean section rate and demographic characteristics of women undergoing caesarean section in our rural tertiary health centre of central India.Methods: This prospective study was conducted in department of obstetrics and gynecology. The study instrument comprised a pre-structured data collection proforma which had various sections; social demographic characteristics, obstetric history and gestation details.Results: The overall caesarean section rate (CSR) was 36.88%. Maximum women (39.62%) who underwent Caesarean section were of age group 25-29 years. 58.05% from rural while 41.95% from urban area. CS was more in women of lower middle (22.80%) and upper lower (20.80%) class. Majority of women who had caesarean section were educated till higher school (31.87%) or were graduate (22.61%), 5.85% were illiterate. Majority of women (56.40%) were housewives. CSR was 70.83% in referred and 28.31% in booked. 52.86% women were nulliparous. Caesarean section was maximum (83%) in term, 16.92% preterm women and 0.08% post term women. 38.69% were referred from other health facilities. Maximum referrals 43.21% were from the district hospital.Conclusions: It was noted that the preference for caesarean section is more in women of 25-29 years, lower middle and upper middle class, rural women, educated upto high school and housewives at our centre. This hospital also serves as referral centre from surrounding health facilities increasing the caesarean section rate of the institute.
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Background: Diseases of hepatobiliary system is a major problem in patients with HIV infection. It has been estimated that approximately one third of the death of patients with HIV infection are in some way related to liver disease. While this is predominantly a reflection of the problems encountered in the setting of co-infection Hepatitis B or C, it is also a reflection of the hepatic injury in the form of hepatic steatosis, that can be due to antiretroviral therapy. There had been little work done on liver function tests in HIV patients without pre-existing liver disease like viral hepatitis, or alcoholic hepatitis. So, this study was designed to assess the pattern of liver function test derangement in HIV patients. Aims and objective was to study the different pattern of hepatobiliary involvement in HIV positive patients, and to gauge the extent of liver damage.Methods: The study included 50 HIV positive patients coming to SMS hospital and Medical College, Jaipur, in medicine and HIV clinic of skin and VD department. Subjects having HIV test positive by ELISA, are included in this study. Other causes of liver function derangements were excluded from the study.Results: Maximum number of the patients were in the age group of 23-32 years. Out of 50 cases studied, 41 (82 %) cases had abnormal liver function tests, while 9 (18%) had normal liver function tests. Most of the cases had liver function abnormalities, and most common abnormality was raised SGOT/SGPT.Conclusions: Almost all types of liver function tests are found to be deranged in HIV patients. The pattern of hepatobiliary involvement varied from fatty liver, cholestasis to Toxic necrosis and granulomas.
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Fetus–in–fetu (FIF) is an uncommon pathology with an incidence of 1 in 500000 births. Less than 200 cases have been reported worldwide. Multiple theories are proposed regarding emyogenesis 1,2. The anomaly can be antenatally diagnosed or present at later age as abdominal lump or complications due to pressure symptoms. We report a case of antenatally diagnosed fetus in fetu which was removed in neonatal age.
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Long QT syndrome (LQTS) is a cardiac electrical disorder. One of the rare symptoms of long QT caused by ventricular arrhythmia is seizure. Patients with LQTS may develop seizures due to an acute hypoxic-ischemic event associated with a ventricular arrhythmia. We present a case of a 47-year-old male who came to the Emergency Department (ED) with seizures and was diagnosed as LQTS. The cardiac cause of seizures was suspected because the patient was pulseless during the episode of seizures. The patient developed refractory ventricular tachycardia in the ED and was cardioverted (synchronized) multiple times. He was also put on amiodarone infusions. The patient was then urgently shifted to the Coronary Cath Lab for temporary pacemaker insertion with overdrive pacing. He was advised for an automated implantable cardioverter-defibrillator. This case illustrates that prolonged QT syndrome can masquerade as seizure. Therefore, a careful examination should be done in the patient presenting with the same and a cardiac cause should be excluded. Delays in recognition and treatment may expose the patient to a high risk of sudden cardiac death
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Abstract: Peripheral Giant Cell Granuloma is a non-neoplastic, tumor-like, reactive lesion occurring exclusively on gingiva/alveolar crest. It is thought to arise from the periodontal ligament or periosteum. Clinically, it bears resemblance to pyogenic granuloma, peripheral ossifying fibroma and many other peripheral soft tissue lesions seen in the oral cavity, thereby making histopathology mandatory for the diagnosis of this lesion. The lesion although being relatively common still carries a lot of ambiguity. The ambiguity is in terms of its etiology, growth potential, biological behavior (recurrence), histogenesis of its cells as well as its treatment. The entity further holds significance because of its notorious behavior and its high tendency to recur. The present paper describes a case report on recurrent peripheral giant cell granuloma with a comprehensive insight of the literature on its clinical and histological aspects. Special attention has been given on the histogenesis of its cells and treatment of this lesion.
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Objective: Clinicians are less familiar with clinical presentation of rare disorder like mucopolysaccharidosis (MPS), especially as presentation is complex and varied with different subtypes of this disorder. This case report highlights severe behavioural problems and non-recognition of MPS by clinicians. Though behavioural problems, hyperactivity and aggression are common in children suffering from mental disability, they are also seen in rare metabolic disorders like MPS. Methods: We have reported a seven year old girl who presented with severe episodes of hyperactivity, poor social interaction, impaired understanding of speech and delay as well as regression in developmental milestones is presented along with the investigations and treatment given. Results: Initially, the child was thought to be suffering from intellectual subnormality and/or pervasive developmental disorder. However, radiological studies showed x-ray findings suggestive of MPS. Her developmental history, physical findings, hearing loss as noted on BERA further supported this diagnosis. Due to financial constraints of the family detailed investigations (enzyme assays) to know the exact type of MPS could not be done. Behavioural problems had to be managed with low dose clonazepam and carbamazepine. Conclusion: It is worth considering metabolic disorders as one of the important differential diagnosis in any child presenting with developmental problems, dysmorphic facies along with behavioural problems.