Primary ovarian ectopic pregnancy: an unusual case study

Ovarian pregnancy is rare variant of ectopic pregnancy. An accurate preoperative diagnosis is very challenging various advances in diagnostic modalities like Transvaginal ultrasonography has evolved in identifying an ovarian pregnancy. It results in significant maternal morbidity, fetal loss, repeat ectopic, impairment of subsequent fertility. The case report a 34-year female who presented with pain and severe anemia and explored keeping in view ruptured tubal ectopic but intraoperatively diagnosed as primary ovarian pregnancy and managed conservatively by ovarian wedge resection.

Extrarenal angiomyolipoma in uterine cervix: rare presentation in unusual site

Angiomyolipoma is a benign neoplasm composed of variable admixture of blood vessels, smooth muscle cells and adipose tissue. Cervical angiomyolipoma are extremely rare and to the best of our knowledge only five cases of angiomyolipoma in cervix have been reported in the literature till date. Authors are presenting a case of angiomyolipoma arising from the uterine cervix. 43 years old female presented with mass descending per vagina for 6 months. This case had no association with tuberous sclerosis. Microscopic examination showed an ill-defined polypoidal, non-encapsulated lesion covered by keratinized stratified epithelium. The lesion is made up of three components, predominantly by fascicles of spindle shaped cells, varying sized blood vessels and multiple foci of mature adipocytes with no evidence of atypia or increased mitotic activity. Smooth muscle component showed strong immunoreactivity to SMA and absence of elastic fibres in the blood vessels were confirmed by histochemistry. Non-vascular smooth muscle cells were negative for HMB-45 in contrast to renal and other extra-renal angiomyolipoma in which HMB-45 immunoreactivity in seen in these cells. To conclude, the differential diagnosis of lower abdominal mass and dysfunctional uterine bleeding should include the angiomyolipoma, even though the uterine cervix is an extremely rare location where they occur.

A cross-sectional study to assess prevalence and determinants of unplanned pregnancy among eligible couples of rural field practice area: RDGMC, Ujjain

Background: Unplanned pregnancy have emerged as one of key public health indicator affecting women, their families and societies at large. Globally, an estimated 40% pregnancies in 2012 were unplanned jeopardising health of millions of women and children. Unplanned pregnancies are also associated with increased risk of low birth weight and high infant mortality. Need of the study was to obtain information which can lead to improvement in use of available products and resources by addressing social determinants of reproductive health affecting pregnancy intensions.Methods: Cross- sectional study was conducted in DSS (Demographic Surveillance Site), RD Gardi Medical College, Ujjain. Study included all consenting eligible couples excluding couples not available at time of interview and sterilized couples. “The London Measures of Unplanned Pregnancy” questionnaire (tested and validated for Indian settings) was used to assess pregnancy outcomes.Results: According to scores 8% pregnancy came out as unplanned, 79% planned and 13% ambivalent. Occurrence of unplanned pregnancy was significantly associated with age (?2=14.216, p=0.027), socio-economic status (?2=19.757, p=0.003) and housing (?2=22.337, p=0.000) conditions of study participants. But when the above factors were further analysed using regression analysis, none was significantly associated.Conclusions: Prevalence of unplanned pregnancy came out to be 8%. Further, none of the studied social determinants came out to be significantly associated with the occurrence of unplanned pregnancy. More studies with a qualitative nature will be needed to know the reasons for unplanned pregnancy.

Evaluation of Stress and its Correlation with Risk Factors of Hypertension among Medical Students of FH Medical College

Background: Obesity is a worldwide health problem. It is associated with excessive fat accumulation in the body to the extent that health and well being are adversely affected. With changing food habits and sedentary lifestyles, the prevalence of obesity has increased.[3] In the 21stcentury, stress is a well known factor affecting health of an individual. Stress is one factor which may influence behaviors and health especially when an individual faces challenges that surpass his or her coping skills.[4] Aims and Objects: To find out prevalence of hypertension and environmental risk factor for hypertension in population under study. Methods: The present study was done on 300 medical students. All anthropometric parameters were taken and hypertensive riskfactors were measured. Results: BMI, WHR were deranged in 29.66%, 21.33%, subjects respectively. Obesity was significantly higher in 29.66% students. Students with the low levels and medium levels of stress were 56% and 38.6% respectively. Conclusion: High fat intake and sedentary life style were positively associated with high blood pressure among non professional students.

Morphometric and Morphological Study of Human Placenta in Hypertensive Females of West U. P. India

Background: During pregnancy the placental mass maintains a dynamic relationship with the weight of developing fetus. Hypertensive disorders of pregnancy are strongly associated with fetal growth restriction, prematurity, contributing largely to perinatal mortality & morbidity. Objectives: A study of 120 placenta was done to find out morphometry & morphological changes of placenta of hypertensive mother in comparison to those of mother with uncomplicatedpregnancies. Methods: This study was carried out on sixty mothers with normal pregnancy and sixty mothers with hypertensive pregnancies. Results: Hypertensive pregnancies are associated with changes in morphometry and morphology ofplacenta including placental weight, diameter, thickness,surface area, volume, number of cotyledons all are decreased in hypertensive placenta. Fetoplacental ratio increases in hypertensive groups. Conclusion: Hypertensive disorders of pregnancy adversely influence the morphology of placenta as well as they effect perinatal outcome

A Study of Hypertensive Risk Factors among Young Adult Males in Western Uttar Pradesh.

Background: Hypertension has been identified as the leading risk factor for mortality. Therefore, the present study has been taken up to find out the relation between anthropometric indices, blood pressure and hypertension so as to identify the population under risk. Methods: The present study was done on 600 male students of age group 16-27 years belonging to FH Medical College, Tundla, Firozabad and St. Andrew`s college, Agra. The anthropometric measurements of the subjects were taken with the slandered instruments with standard techniques described as Height (mt), Weight (Kg), Waist Circumferences (cm), Hip Circumference (cm), Pulse rate Radial pulse felt and counted at wrist for 1 minute. Results: In the present study 43% students were found under low level of stress and more levels of stress were seen in 6%. The prevalence of pre-hypertension was found 69% while hypertension was found 5.75%. Conclusion: Strong association of faulty dietary history, sedentary life style and genetic history was seen with blood pressure.

Correlation between Anthropometric Indices and Lipid Profile in Adults.

Introduction: Obesity is a worldwide health issue, associated with excessive fat accumulation in the body to the extent that health and well-being are adversely affected. Obesity may increase the risk of many diseases such as diabetes, atherosclerosis, hypertension dyslipidemia, gallbladder diseases and cardiovascular diseases. Anthropometric measurements can easily reflect any changes in the lipid concentration in the human body. Intra-abdominal fat has been identified as being the most clinically relevant type of fat in humans. Abnormal visceral fat produces physiological changes that alter lipid profile, leading to dyslipidemia, which in turn increases the risk of cardiovascular events. Body mass index, waist and hip circumferences were found to be useful anthropometric predictors for cardiovascular risk. The aims and objectives of the study are Body mass index, waist and hip circumferences were found to be useful anthropometric predictors for cardiovascular risk. To evaluate the correlation between lipid profiles and anthropometric indices of total and central obesity. Methods: The present study was conducted among 90 adults (45 male, 45 female) in FH Medical College. All subjects were apparently healthy. The serum lipid profile included total cholesterol (TC), highdensity lipoprotein (HDL), low-density lipoprotein (LDL) and triacylglycerols (TG). BMI (kg/m2) was calculated using Quitelet’s index. Adults were classified according to their BMI into three groups. Results: Average age of males is 40.02 years and females 36.46 years. On the basis of BMI, there was 14.44% of normal weight persons, 26.67% overweight and 58.89% obese. Abnormal levels for TG in 35, TC in 20, LDL in 3, HDL in 27 of the total sample were found. Overall correlations were found between anthropometric analysis and lipid profiles. Conclusion: We found good correlations between anthropometric indices of general and central obesity and lipid profiles. Among, the anthropometric indices WHR proved to be a good predictor of dyslipidemia, showing the importance of using it in clinical practice and for screening of cardiovascular risk. Prospective studies using different parameters to assess abdominal obesity and its relationship to metabolic profile and with larger population are needed to quantify the results for application to community health lifestyle modifications.

Intra Hepatic Pattern of Portal Vein in Dog's Liver: A Corrosion Cast Study.

Introduction: The variations in the intrahepatic pattern of portal vein within liver are mandatory factors while dealing with hepatic surgery. The variations in the intrahepatic portal vein branching need to be recognized when contemplating for ligation of the vessel at the porta hepatis during partial hepatectomy. Materials and Methods: This study was done in 50 dogs liver specimen by corrosion cast technique. Results and Discussion: In this study in the entire cases bifurcation pattern was found and in all the cases left branch of portal vein extended transversly to the left and turned in the caudolateral direction and divided into transverse portion and oblique portion and right divided into superior and inferior branch. In 88% cases caudate process received branch from the right portal trunk while the papillary process received branch from the left portal trunk. Conclusion: The knowledge of the portal vein and its intrahepatic branching is important to ensure surgical success pertaining to different surgical procedures.

Anthropometric Measurements of Infraorbital Foramen and its Anatomic Variations in Dried Human Skulls.

Aim: This study was to determine the distance between IOF and IOM, IOF and pyriform aperture,the presence of accessory foraminae, orientation and location in relation with teeth on both the sides. Materials and Methods: Fifty dried human skulls (100 sides) irrespective of age and sex were used for this study. The distance between the IOF and IOM and the distance between the IOF and pyriform aperture were measured by using manual vernier calliper. The orientation, location in relation with teeth and presence of accessory foramina were observed macroscopically. Observations and Discussion: Accessory foramina may give complications during anaesthetization of this region. The mean distance between the IOF and infraorbital margin was 22.6mm and 15.2mm on the left and right side respectively. Mean distance between I.O.F and pyriform aperture was 26.2mm and 25.8mm on the left and right side respectively. In 30% skulls the IOF were directed vertically downward on the right side and in 38% on the left side. In 66% downward medially on the right side and 56% on the left side and in4% skulls medially on the right side and 6% on the left side. The majority of IOF were oriented to second premolar teeth on the right side and between second premolar and first molar on the left side.Accessory foraminae were found in 6% of skulls. The results of our study may be helpful during surgical procedures in the maxillary region in reduction of Lefort fracture, and giving regional nerve block.

Morphometric Evaluation of the Foramen Magnum and Variation in its Shape and Size: A Study on Human Dried Skull.

The foramen magnum is an important landmark located in the posterior part of the cranial base formed by the occipital bone. The purpose of this study was to evaluate the measurements of the foramen magnum in human dried skull and to note the variations in the shape and size of the foramen magnum. Additionally area and index of the foramen magnum were also calculated. Fifty human dried skulls of unknown age and sex were obtained from the department of CMCH Bhopal and FHMC Tundla. Foramen magnum were examined macroscopically for their different shapes. Anteroposterior and transverse diameters, foramen magnum area & foramen magnum index were measured. The foramen magnum shapes were determined as round shaped in 22%, oval shaped in 16%,egg shaped in16%, and irregular in18%,tetragonal in 12% penta and hexagonal 8% each. The mean A-P and transverse diameters of the foramen magnum was determined 38.75mm and 33.44mm respectively. In 4%of skull, the occipital condyle was observed to protrude in to the foramen magnum. The mean foramen index and foramen magnum area were 87.68 & 970.57mm². The data obtained may be useful to the neurosurgeon in analysing the morphological anatomy of craniovertebral junction in trans condylar approach for brain stem lesion.

Abnormal lipid metabolism in collagen-induced arthritis rat model: In vitro, high resolution NMR spectroscopy based analysis.

Collagen-induced arthritis (CIA) was induced in female Wistar rats by intradermal injection of porcine immunization grade native collagen type II (Chondrex). Development and progression of CIA was monitored by studying histopathological, radiographical and biochemical features of arthritic manifestations in the knee joints, hind limb and blood plasma. In addition, oxidative stress status of arthritic animals was determined by measuring lipid peroxidation and the antioxidant enzymes: catalase, superoxide dismutase and glutathione peroxidase. High resolution proton NMR spectroscopy was employed for the analysis of lipid components in the lipid extracts of the joint tissue and plasma of collagen-induced arthritic and control rats. Triglyceride levels showed significant decreases in plasma (1.7 times) but were unchanged in the joint tissue of CIA rats as compared to control. One-dimensional proton NMR spectra showed a 6.2 times reduction in the quantity of choline-containing phospholipids in the plasma of CIA as compared to control rats. There was a 1.6 times elevation of choline-containing phospholipids in the joint tissue of CIA rats as compared to controls. Induction of arthritis showed a 4.0 times reduction in the level of total cholesterol in the plasma and 1.6 times elevation in the joint tissue of CIA rats as compared to controls. The ratio of saturated fatty acids to unsaturated fatty acids was 1.5 times significantly higher in joint tissue and 2.1 times significantly higher in plasma of CIA rats as compared to controls. The results demonstrated significantly altered lipid patterns in the joint tissue and plasma of collagen-induced arthritic rats as detected by one- and two-dimensional NMR spectroscopy compared with controls.

Effect of Aegle marmelos (L.) Correa on alloxan induced early stage diabetic nephropathy in rats.

Diabetic nephropathy (DN) has a complex pathogenesis and poor prognosis due to the lack of therapeutic interventions. The present study investigates the effect of A. marmelos leaf extract (AME) on early alloxan induced DN. The treatment with AME was found to significantly decrease the fasting blood sugar, total cholesterol, blood urea, creatinine and renal TBARS and increased the levels of renal reduced glutathione and catalase significantly as compared to the diabetic control group. The maximum dose-dependent protection was observed at a dose of 200 mg kg-1. Histological examination revealed marked reversal of the morphological derangements with AME treatment as indicated by a decrease in glomerular expansion, tubular dilatation and inflammatory cells. The present results conclude that AME treatment has a significant ameliorative effect on early changes induced in the kidneys by alloxan and improves the outcome of DN.

Multicentric extraskeletal myxoid chondrosarcoma of uterine adnexa in a young female: An unusual presentation.

Extraskeletal myxoid chondrosarcoma is a rare soft-tissue sarcoma, mostly occurring in the proximal extremities and limb girdle. Majority of the patients are in fifth and sixth decades of life with male preponderance. We report here a case of primary extraskeletal myxoid chondrosarcoma of the uterine adnexa involving the broad ligament and fallopian tube synchronously without any evidence of uterine/ovarian involvement in a young multiparous female of 27 years. After the histopathological diagnosis, re-excision of the tumor bed with wide local margins was recommended. Since the tumor has an aggressive course, with propensity for late recurrence and metastases to lungs, the patient must be considered for long-term follow-up.

Costs of management of bile duct injuries.

Background: Only a few studies address the financial impact of the management of bile duct injuries (BDI). This study was aimed to assess the cost of BDI sustained during cholecystectomy. Methods: Patients who underwent surgical repair for post cholecystectomy BDI and due for routine follow up between August 2006 and September 2007 were called for an interview. Results: 47 patients were interviewed. There were 39 (83%) women and 8 (17%) men. The median direct cost was US$ 1626 (451-11,009); ` 73,983 (20,521-500,910). The median indirect cost was US$ 312 (26-2,708); ` 14,196 (1,183-123,214). Total median cost was US$ 2,045 (488- 12,369); ` 93,046 (22,204-562,790). The median total costs of management of BDI was 9.98 times the costs of a cholecystectomy at our centre (US$ 205); (` 9,328) and was 8.41 times the median monthly income of the patients (US$ 243); (` 11,057). Conclusions: Our results will help the hospital administrators and the insurance agencies to calculate and revise the packages and premium for cholecystectomy so that the extra cost of a possible BDI is evenly distributed.