Maternal outcomes after 12hours and 24hours of magnesium sulfate therapy for eclampsia.

OBJECTIVE: To assess the effectiveness of a reduced duration (12hours) of magnesium sulfate (MgSO4) administration for eclampsia. METHODS: In a prospective randomized study, women with eclampsia (prepartum, intrapartum, or postpartum) attending Jawaharlal Nehru Medical College, Aligarh, India, between January 2012 and September 2013 were enrolled. The inclusion criteria were blood pressure of at least 140/90mm Hg after 20weeks, proteinuria (dipstick value≥+1), and seizures not attributed to other causes. Participants were assigned to control and study groups according to the time of enrollment (6-month blocks). All patients received a MgSO4 loading dose (4g, intravenously), followed by maintenance doses (1g/hour) for 12hours (study group) and 24hours (control group). The primary outcome was recurrent convulsions after completion of MgSO4 therapy. Patients with treatment failure were excluded from analyses. RESULTS: Analyses included 132 patients in the study group and 72 patients in the control group. No convulsions recurred in either group after the completion of treatment. CONCLUSION: For women with eclampsia, 12hours of magnesium sulfate could effectively prevent recurrent convulsions.

Endometrial adenocarcinoma with osteoclastic giant cells in stroma: a case report and review of literature.

It is rare to find osteoclastic giant cells (OGCs) as a stromal reaction in uterine adenocarcinoma of endometrium. Here, we report a case of a 60-year-old female diagnosed with adenocarcinoma of endometrium. Total hysterectomy with bilateral salpingo-oopherectomy and removal of pelvic lymphnodes was performed. Histologically, the tumour showed adenocarcinoma of the endometrium with mucin secretion. The stroma showed some plump reactive pleomorphic cells, resembling stromal cells, infiltrated uniformly with OGCs and mononuclear cells (MNCs). The epithelial cells of adenocarcinoma stained positive for cytokeratin (CK 7) (CAM 5.2). The osteoclastic giant cells and mononuclear cells stained positive with CD68 and negative with cytokeratin and vimentin. We conclude that the osteoclastic giant cells originated from reactive histiocytes/monocytes as a stromal reaction to malignancy.

Application of a multiplex PCR to cervical cells collected by a paper smear for the simultaneous detection of all mucosal human papillomaviruses (HPVs) and typing of high-risk HPV types 16 and 18.

A simple paper smear (PS) method for dry collection and storage of cervical specimens was employed to develop an easy multiplex (MPX) PCR for simultaneous detection of generic human papillomaviruses (HPVs) as well as typing of the high-risk HPV-16 and -18, the two clinically most important HPV genotypes, which are responsible for more than 80 % of cervical cancers. Multiplexing was performed with a small amount of DNA eluted by boiling from a single PS punch in a single tube and using a mixture of four pairs of primers specific for the HPV L1 consensus sequence, HPV-16, HPV-18 and the ß-globin gene. Sixty HPV-positive biopsies and corresponding PS specimens from cervical cancer patients as well as cervical smears from 100 healthy women with or without abnormal cytology were collected both as PSs and in PBS. Detection of HPV DNA from cervical biopsies collected in PBS and corresponding cervical scrapes on a PS or in PBS by conventional and MPX-PCR showed a concordance of 100 % and adequacy of 93 %. A similar comparative study in cervical scrapes from normal women also revealed 100 % concordance. The technique was validated in a multicentric study at four different national laboratories. PSs collected by different centres showed variable adequacy (73-82 %) but the use of multiple PS discs for DNA extraction significantly increased the adequacy. Integration of PSs with MPX-PCR for the detection and typing of HPVs is a highly convenient, efficient, simple and cost-effective method for large-scale clinico-epidemiological studies and is also suitable for HPV vaccine monitoring programmes in resource-poor settings.

Pelvic actinomycosis: a rare entity presenting as tubo-ovarian abscess.

A 24-year-old woman having two children using an intrauterine contraceptive device was admitted with lower abdominal pain and fever. On clinical and radiographic examination revealed a 7x6 cm multi-loculated cystic mass in the lower abdomen. The differential diagnosis included twisted ovarian cyst, ectopic pregnancy, tubercular tubo-ovarian (TO) mass red degeneration fibroid, diverticular diseases, emphysematous cystitis, pelvic malignancy, and mesenteric cyst. On histologic examination, an actinomycotic TO abscess was found with sulfur granules.

Human papillomavirus type 16 variant analysis of E6, E7, and L1 genes and long control region in biopsy samples from cervical cancer patients in north India.

High-risk human papillomaviruses (HPVs), particularly HPV types 16 and 18 (HPV-16 and HPV-18, respectively), play a cardinal role in the etiology of cervical cancer. The most prevalent type, HPV-16, shows intratypic sequence variants that are known to differ in oncogenic potential and geographic distribution. This study was designed to analyze sequence variations in E6, E7, and L1 genes and the LCR (for long control region) of HPV-16 in cervical cancer patients to identify the most prevalent and novel HPV-16 variants and to correlate them with the severity of the disease. Cervical biopsies from 60 HPV-16-positive cancer cases were analyzed by PCR and DNA sequencing. The most frequently observed variations were T350G (100%) in E6, T789C (87.5%) in E7, A6695C (54.5%) in L1, and G7521A (91.1%) in the LCR. In addition, only one novel variant (T527A) in E6 and four new variants each in L1 (A6667C, A6691G, C6906T, and A6924C) and in the LCR (C13T, A7636C, C7678T, and G7799A) were identified. While E7 was found to be highly conserved, the variant 350G of E6 was the most prevalent in all of the histopathological grades. The majority of LCR variants were found at the YY1 transcription factor binding sites. Interestingly, a complete absence of the Asian lineage and a high prevalence of European lineages in E6, E7, L1, and the LCR (85, 86.7, 67.7, and 63.3%, respectively) indicate a possible epidemiological linkage between Europe and India with regard to the dissemination of HPV-16 infections in India.