Caesarean scar ectopic pregnancy masquerading as gestational trophoblastic disease.

Cesarean scar ectopic pregnancy (CSEP) is a very rare form of ectopic pregnancy in which implantation occurs at the site of the previous cesarean scar with low or absent beta-human chorionic gonadotropin (hCG) levels. It has various differential diagnoses on gross and microscopic examination. A delay in the identification and management of this condition may lead to life-threatening complications. Here, we discuss the incidence and clinicopathological features of chronic CSEP, its types, and differential diagnoses.

Coat's-like exudation in rhodopsin retinitis pigmentosa: successful treatment with an intravitreal dexamethasone implant.

PURPOSE: Role of intravitreal injection of dexamethasone implant (Ozurdex) for refractory macular thickening. METHODS: A case report of a 13-year-old boy with Rhodopsin-positive, CRB1-negative retinitis pigmentosa presenting with Coat's-like exudative vitreoretinopathy and treatment-resistant cystoid macular oedema. RESULTS: A reduction in the macular thickening following a single injection of Ozurdex. CONCLUSION: We present our experience in successful treatment of refractory macular oedema with intravitreal injection of dexamethasone implant resulting in clinically significant resolution of macular thickening.

Topical Phenytoin Application in Grade I and II Diabetic Foot Ulcers: A Prospective Study.

BACKGROUND: India is fast becoming world diabetes capital. Diabetic foot infections are major problems among innumerable complications associated with diabetes. MATERIAL AND METHODS: A randomized control study was conducted to evaluate the effect of topical phenytoin on healing in diabetic foot ulcers. One hundred patients with grade I/ II diabetic foot ulcers were randomly divided into two equal groups. Patients subjected to topical phenytoin dressing were classified under study and those who underwent normal salinewound dressings were classified as control. Both the groups were compared in terms of discharge, slough, wound area reduction and duration of hospital stay. RESULTS: Discharge and slough from wound reduced significantly by day 14 in phenytoin group and within 21 days in control group. Mean duration of hospital stay in phenytoin group was 20 days, whereas in control group, it was 26 days. This difference was statistically significant (p value <0.005,df 1). CONCLUSION: Hence, Phenytoin proved to be useful as a topical agent in promoting healing and in controlling infections in diabetic foot ulcers.

Spontaneous rupture of pyometra - a rare cause of peritonitis in elderly female.

The incidence of spontaneous perforations in pyometra is rare, being 0.01-0.5% in gynaecological patients. However, they are more common in postmenopausal females and their incidence is 13.6%. Here, we are reporting a rare case of peritonitis with a pneumoperitoneum in an elderly female, which was caused by a spontaneous perforation of pyometra. A 74-years old postmenopausal female with uncontrolled diabetes mellitus was admitted to surgical emergency with signs of diffuse peritonitis and she was in shock. After resuscitation, an emergency laparotomy was performed because of suspicion of a hollow viscous perforation with peritonitis. At laparotomy, about 2000ml of purulent fluid was found to be present in peritoneal cavity, while alimentary tract was intact. A rent with a diameter of 0.8 cm was found on fundus of uterus. A total abdominal hysterectomy with a bilateral salphingo oophorectomy was performed. Patient got discharged on 12(th) post-operative day without major complications. Histopathological studies revealed endometritis and myometritis, with no evidence of malignancy.

Histochemical and ultrastructural analyses of adhesive setae of lizards indicate that they contain lipids in addition to keratins.

We studied the distribution of lipid material and organelles in the epidermal layers of toe pads from two species of lizards representing the two main lizard families in which adhesive scansors are found (gekkonids and polychrotids), the dull day gecko, Phelsuma dubia and the green anole, Anolis carolinensis. Although lipids are a conspicuous component of the mesos layer of squamate reptiles and function in reducing cutaneous water loss, their distribution has not been specifically studied in the highly elaborated epidermal surface of adhesive toe pads. We found that, in addition to the typical cutaneous water loss-resistant mesos and alpha-layer lipids, the Oberhutchen (including the setae) on the most exterior layers of the epidermis in P. dubia and A. carolinensis also contain lipid material. We also present detailed histochemical and ultrastructural analyses of the toe pads of P. dubia, which indicate that lipid material is closely associated spatially with maturing setae as they branch during the renewal phase of epidermal regeneration. This lipid material appears associated with the packing of keratin within setae, possibly affecting permeability to water loss in the pad lamella, where the surface area is from 4­60-fold greater compared with normal scales.

Cr2O3-modified ZnO thick film resistors as LPG sensors.

Thick films of pure ZnO were obtained by screen-printing technique. Surface functionalized ZnO thick films by Cr(2)O(3) were obtained by dipping pure ZnO thick films into 0.01M aqueous solution of chromium trioxide (CrO(3)). The dipped films were fired at 500 degrees C for 30 min. Upon firing, the CrO(3) would reduce to Cr(2)O(3). Cr(2)O(3)-activated (0.47 mass%) ZnO thick films resulted in LPG sensor. Upon exposure to 100 ppm LPG, the barrier height between Cr(2)O(3) and ZnO grains decreases markedly, leading to a drastic decrease in resistance. The sensor was found to sense LPG at 350 degrees C and no cross sensitivity was observed to other hazardous, polluting and inflammable gases. The quick response ( approximately 18s) and fast recovery ( approximately 42s) are the main features of this sensor. The effects of microstructures and dopant concentrations on the gas sensing performance of the sensor were studied and discussed.

Anti-malarial activity of Eclipta alba against Plasmodium berghei infection in mice.

The anti-malarial activity of Eclipta alba leaves extract was evaluated against Plasmodium'berghei ANKA strain in mice. A standard inoculum of 1 x 10(6) infected erythrocytes was used. The methanolic leaf extract (250-750 mg/kg) produced a dose-dependant chemosupression or schizontocidal effect during early and established infection and high mean survival time (m.s.t.) values particularly in the group administered 750 mg/kg/day of extract. The plant extract also exhibited repository activity. The results of the preliminary studies carried out with E. alba are encouraging, which can be exploited in malaria therapy.

Changes in pituitary growth hormone cells prepared from rats flown on Spacelab 3.

Anterior pituitaries from "small" (250 g) and "large" (400 g) rats flown on the 7-day Spacelab 3 mission were pooled and trypsinized into two single-cell suspensions. Compared with ground-based controls, flight cells appeared to contain more intracellular growth hormone (GH) but release less GH over a 6-day culture period. After implantation into hypophysectomized rats, both sets of flight cells released only 50% of the GH compared with the control cells. Glands from large flight rats contained 44% somatotrophs compared with 37% for controls; small animals showed no difference. There were no striking differences in somatotroph ultrastructure between cells in the four groups. Western blot analysis indicated that there were no major differences in immunoactive GH variants. High-performance liquid chromatography fractionation of culture media indicated that small flight cells released much less of a high-molecular weight variant rich in GH bioactivity. The results suggest that GH cells from rats exposed to microgravity may experience secretory dysfunction. The possibility that this occurs directly at the pituitary cell level is discussed.

Salmonella typhimurium mutants with altered glutamate dehydrogenase and glutamate synthase activities.

Although glutamate is a key compound in nitrogen metabolism, little is known about the function or regulation of its two biosynthetic enzymes, glutamate dehydrogenase and glutamate synthase. To begin the characterization of glutamate formation in Salmonella typhimurium, we isolated mutants having altered glutamate dehydrogenase and glutamate synthase activities. Mutants which failed to grow on media with glucose as the carbon source and less than 1 mM (NH(4))(2)SO(4) as the nitrogen source (Asm(-)) had about one-fourth the normal glutamate synthase activity and one-half the glutamine synthetase activity. The asm mutations also prevented growth with alanine, arginine, or proline as nitrogen sources and conferred resistance to methionine sulfoximine. When a mutation (gdh-51) causing the loss of glutamate dehydrogenase activity was transferred into a strain with an asm-102 mutation, the resulting asm-102 gdh-51 mutant had a partial requirement for glutamate. A strain isolated as a complete glutamate auxotroph had a third mutation, in addition to the asm-102 gdh-51 lesions, that further decreased the glutamate synthase activities to 1/20 the normal level. Both the asm-102 and gdh-51 mutations were located on the S. typhimurium linkage map at sites distinct from those found for mutations causing similar phenotypes in Klebsiella aerogenes and Escherichia coli.

Regulation of the ammonia assimilatory enzymes in Salmonella typhimurium.

The regulation of glutamate dehydrogenase (EC 1.4.1.4), glutamine synthetase (EC 6.3.1.2), and glutamate synthase (EC 2.6.1.53) was examined for cultures of Salmonella typhimurium grown with various nitrogen and amino acid sources. In contrast to the regulatory pattern observed in Klebsiella aerogenes, the glutamate dehydrogenase levels of S. typhimurium do not decrease when glutamine synthetase is derepressed during growth with limiting ammonia. Thus, it appears that the S. typhimurium glutamine synthetase does not regulate the synthesis of glutamate dehydrogenase as reported for K. aerogenes. The glutamate dehydrogenase activity does increase, however, during growth of a glutamate auxotroph with glutamate as a limiting amino acid source. The regulation of glutamate synthase levels is complex with the enzyme activity decreasing during growth with glutamate as a nitrogen source, and during growth of auxotrophs with either glutamine or glutamate as limiting amino acids.