A Case Report on Acute Fatty Liver of Pregnancy: A Difficult Differential Diagnosis of Liver Disorder.

Acute fatty liver of pregnancy is a rare but potentially dangerous pregnancy condition with significant maternal and fetal fatality rates. The disorder is driven by a complex pathophysiology and clinically manifests as a rapid worsening in health conditions, increasing the rate of mortality and necessitating expert diagnosis and management. The condition progresses from spontaneous resolution to post-operative complications, resulting in negative consequences. We offer a case report of a young primigravida patient diagnosed with acute fatty liver of pregnancy at term. The report describes the clinical course and its effect. The perinatal result, however, could not be improved due to the late diagnosis. Over the last 40 years, death rates have been dramatically lowered because of competence and a multidisciplinary approach, increasing maternal-fetal outcomes. In this scenario, time management is crucial to success.

Coronavirus disease identification using Multi-subband feature analysis in DWT domain.

Coronavirus disease early identification and differentiating it with other lung infections is a complex and time-consuming task. At present RT-PCR and Antigen tests are used for diagnosis, but the whole process is tedious, time exhausting and sometimes gives inaccurate results. Radiological scans like CT scan and X-rays are often considered for confirmation of infection, as it contains vital information about region of infection, disease state and severity, texture, size and opacity of infection. Automated machine learning techniques along with CXR (Chest X-ray) images can serve as alternative approach for Covid-19 diagnosis and differentiating it with other health conditions. In this work, Covid-19 disease identification is performed based on multi-subband feature extraction using 2D Discrete Wavelet Transform (DWT) on CX-Ray images. The CX-ray images are decomposed into multi-subbands of frequencies using DWT. The quarter-sized decomposed low and high frequency components are concatenated into single feature vector. In order to find suitable wavelet filter for extracting features from CX-ray images, a rigorous experimentation is carried out among various wavelet families such as Haar, Daubechies, Symlets, Biorthogonal and their respective members that have different vanishing moment and regularity properties. The feature vector is then used for training machine learning model based on support vector machine classifier. Experimental result shows that the classification model based on Haar wavelet feature extraction performs better as compared to other wavelet families with classification accuracy of 100%.

Interstitial Pregnancy Managed with Single-dose Systemic Methotrexate: A Case Report.

Interstitial pregnancy is a rare type of ectopic pregnancy with a high risk of massive hemorrhage on rupture as compared to ectopic on other sites. The mortality rate for the ruptured interstitial pregnancy is high. Therefore, early diagnosis of such pregnancy before the rupture occurs facilitates appropriate management and avoids life-threatening complications. With the advancement in diagnostic imaging modalities, early diagnosis and more conservative management for interstitial pregnancy have become possible. Here, we report a case of primigravida diagnosed with interstitial pregnancy with ultrasonography and successfully managed with a single dose of methotrexate.

Obstructed Hemivagina and Ipsilateral Renal Anomaly Syndrome Rare Obstructive Uterovaginal Anomaly: A Case Report.

Obstructed Hemivagina and Ipsilateral Renal Anomaly syndrome is a rare obstructive uterovaginal anomaly involving both mesonephric and paramesonephric ducts. It usually presents after menarche with non-specific symptoms like pelvic pain, dysmenorrhea, or paravaginal mass and examination findings of paravaginal or pelvic mass. Because of non-specific symptoms and signs, the diagnosis is usually overlooked, which leads to complications like endometriosis, tubo-ovarian abscess compromising patient’s fertility, and quality of life. Therefore, in presence of these nonspecific clinical features along with imaging findings of uterine didelphys and unilateral renal agenesis, this syndrome should be considered in the diagnosis. We present a case of a 17-year-old lady with Obstructed Hemivagina and Ipsilateral Renal Anomaly syndrome, diagnosed by finding of paravaginal mass on examination and uterine didelphys with ipsilateral renal agenesis in USG and managed successfully by resection of vaginal septum. Keywords: ipsilateral renal anomaly;paravaginal mass;uterovaginal anomaly.

Butorphanol in Labour Analgesia.

INTRODUCTION: Labour is the process where uterine contractions lead to expulsion of product of conception through the vagina into the outer world. Labour pain is one of the most severe pains which has ever been evaluated and its fear is one of the reasons women wouldn't go for natural delivery. Delivery is a painful experience for all of the women except a few of them. The labor pain results from some physiological-psychological causes. Different pharmacological and non-pharmacological methods have been tried for pain relief in labour. The objective of this study is to see the effect of butorphanol injection in labour pain. METHODS: It is a descriptive cross-sectional study conducted in B.P. Koirala institute of health sciences. We observed 200 pregnant women meeting the inclusion criteria and giving the informed consent who were on 1 mg butorphanol i.m. at the onset of active stage of labour every 4 hourly and on demand. Pain assessment was done by Numerical Pain analogue scale measured from 1 to 10. Fetal heart rate monitoring was done according to the hospital protocol. Caesarean section was performed for obstetrical indication. Neonatal outcome was evaluated by on duty pediatrician and APGAR score were noted at 1 and 5 min. RESULTS: The pain scores in first, second, third, fourth hour were (8.83±0.773), (9.84±0.544), (9.94±0.338), (9.6±0.298) respectively, where 1st and 2nd hour is statistically significant. CONCLUSIONS: Butorphanol is an effective labour analgesia without significant adverse effects on women and the neonatal outcome.