bluuebunny/crossref_metadata_2025 huggingface dataset:
Rheological models of biological cells
Authors:   V.N. Karazin Kharkov National University, Batyuk Liliya , Kizilova Natalya ,   V.N. Karazin Kharkov National University
Published: November 2022

The most important experimental methods of studying the mechanical properties of cells, as well as the most common rheological models, among which the discrete models of the micro/nanostructure of the cell and continuous models that allow calculating the modulus of elasticity and viscosity of the cell in normal and pathological conditions are discussed. A review of continuous models is given with an indication of their features and differences. A new continuum model of the cell as a multi-layer shell filled with a viscoelastic fluid is proposed. Equations of the model and their solutions for cases of isotonic, isometric and dynamic experiments are obtained. Peculiarities of the mechanical behavior of the models depending on the identified parameters are investigated. A comparison with the data of experimental measurements is given. It is shown that the proposed multi-layer model allows evaluation of separate contribution of the mechanical properties of the cytoskeleton, membrane, adsorbed substances and the hydrated shell, which is important for clinical diagnosis of diseases by measuring the mechanical parameters of cells.
Sorolla y la escultura clásica: Una aproximación a través de sus academias del antiguo.
Authors: Fenoll Cascales José
Published: November 2022

El presente trabajo analiza tres academias del antiguo que Joaquín Sorolla Bastida realizó durante su estancia como pensionado de pintura en Roma entre 1885 y 1888. Dos de estos estudios tienen como objeto de representación algunas secciones pertenecientes a los mármoles del Partenón, mientras que en el restante se corresponde con la Madona Medici de Miguel Ángel. Así pues, a través de un estudio documental y comparativo de las fuentes paleográficas incluidas en estos dibujos y las documentales que alberga el Museo Sorolla, se tratarán de identifican las referencias visuales que el pintor tomó para realizar estas piezas. Con el fin de vislumbrar la relación que tuvo Sorolla con la escultura clásica y los lugares en los que estudió la misma durante su etapa italiana.
Michigan Amish Fellowship: A Case Study for Defining an Amish Affiliation
Authors: Burdge Jr. Edsel
Published: November 2022

The Michigan Amish Fellowship is a distinct Reformist Amish affiliation marked by intentionality in its religious vision, decision-making procedures, and planned daughter settlements. This article explores the Fellowship’s understandings of “true spirituality,” “scriptural church,” and “living witness.” In the process, the article advances a tentative definition of what constitutes an Amish affiliation.
Choriocarcinoma on hysterectomy specimen in Senegal: histological study
Authors: Ndiade Amadou , Gaye Abdou M. , Sy Mama , Thiam Ibou , Diop Ndiaga , Gueye Mame V. , Diatta Robert , Diatta Ange L. , Senghor Fabrice , Faye Oumar
Published: November 2022

Background: Trophoblastic diseases are in general exclusive to women in their reproductive years. Gestational choriocarcinoma (GC) is a rare malignant tumor derived from the trophoblast of women in childbearing age. Our objective was to study the epidemiological and clinicopathologic aspects at the laboratories of pathological anatomy and cytology (ACP) of Aristide Le Dantec Hospital and General Idrissa Pouye Hospital.Methods: Our study was conducted in the anatomy and pathology laboratories of the Hôpital Général Idrissa Pouye and the Hôpital Aristide Le Dantec in Dakar. This study was based on records of pathological reports of gestational choriocarcinomas from these different laboratories. This was a retrospective and descriptive bi-centric study, spread over eight (8) years from January 1, 2013, to December 31, 2020. All cases diagnosed on hysterectomy specimens and with a formal conclusion of choriocarcinoma have been included. We recorded the data collected in Excel 2007 software and the analysis was made using Epi Info.Results: We collected 25 cases of choriocarcinomas. The mean age of the patients was 38.1±9.7. Mixed seat tumors (intra-cavitary and intra-mural) were the most frequent with 48% of cases. Patients who were at FIGO stage 1 represented for 88% of cases.Conclusions: Gestational choriocarcinoma (GC) is a proliferation of the trophoblast (cytotrophoblast and syncitiotrophoblast). This study has helped establish histopathological data of choriocarcinoma on hysterectomy specimen in Dakar.
Attitude and knowledge of Latvian women towards episiotomy
Authors: Gauja Anna Jete , Bebere Sabīne , Rezeberga Dace
Published: November 2022

Background: Although episiotomy is one of the most common surgical procedures, there is still not a lot of research on patients' experience, knowledge and attitudes.Methods: A structured questionnaire was developed and carried out online to evaluate the knowledge and attitudes toward episiotomy among pregnant women and women who had given birth in the previous three years.Results: In this study, 1394 respondents were included. 72.6% of respondents knew what episiotomy was and why the procedure was performed, and 50.9% of those women acknowledged that before labour they did not receive an adequate amount of information. There is a correlation between the knowledge of episiotomies and refusal of the procedure (Spearman’s r=-0.133, p≤0.001). In case of insufficient information, women were more likely to refuse the procedure. 36.2% of women who experienced episiotomy were informed about the procedure and gave their consent to it and 51.9% did not, the rest could not give a concrete answer.Conclusions: Women are not provided with sufficient information about episiotomies during pregnancy. In the majority of cases, patient involvement in the decision-making is not observed. Women must be provided with choices and obtaining their consent should be an integral part of the procedure.
Effects of Ebola epidemic on obstetrical emergencies and outcomes in the region of Kindia, Guinea
Authors: Camara Sadan , Balde Mamadou D. , Camara Bienvenu S. , Diallo Aissatou , Diallo Ramata , Toure Amadou O. , Soumah Anne M. , Sall Alpha O. , Kourouma Karifa , Delamou Alexandre
Published: November 2022

Background: Maternal mortality is still high in Guinea despite a decline from 724 to 550 maternal deaths per 100,000 live births between 2012 and 2018. The proportion of births attended by skilled personnel is estimated at 45%. The objective of this study was to assess the effect of Ebola virus disease (EVD) epidemic on the frequency of absolute maternal indications, as well as the outcomes of these interventions for mother and child in the region of Kindia.Methods: This was a longitudinal study using 20 months of retrospective data collected in the pre-Ebola (March to December 2012 and March to December 2013) and intra-Ebola (March to December 2014 and March to December 2015) periods. The proportions of maternal health indicators in both study periods were compared using a significance level of 0.05.Results: A total of 1747 women were included in this study. The proportion of women who received a major obstetric procedure in Kindia regional hospital was 85% in each pre and post Ebola periods. Ebola, however, contributed to a significant increase in maternal deaths.Conclusions: The Ebola epidemic has contributed to a significant increase in maternal deaths in health facilities. Measures encouraging health workers to manage obstetric emergencies during critical periods would be necessary.
A clinicopathological study of adnexal masses in the tertiary care hospital, Kadapa
Authors: Bandi Sowjanya , Thulamandi Lakshmi Suseela , Eka Sowjanya
Published: November 2022

Background: Adnexal mass is a common clinical presentation among women of all age groups and is extremely common among reproductive age groups. It may be gynecological or non-gynecological origin. The exact prevalence of adnexal mass could not be determined, as most of them develop and resolve without any clinical symptoms. Adnexal mass poses a special perplexity to the attending gynecologists, because the differential diagnosis is extensive and most masses are benign. Differential diagnosis of adnexal mass is complex and includes benign and malignant ovarian tumors, functional cysts, para ovarian cysts, tubo-ovarian abscess, ectopic pregnancy, hydrosalpinx, fimbrial cyst, tubal malignancies, broad ligament fibroid.Methods: It was a prospective study conducted in the department of gynecology, GGH, Kadapa. It was a tertiary care hospital. Total of hundred cases were included in the study based on selection criteria. Ethical committee approval was taken prior to the study.Results: A total 100 cases of adnexal masses were included in the study. 40% of study subjects had parity 2 and 11% had maximum parity 4. 81% of study subjects had surgical management. 45 patients had CA125 >35 u/ml. Among them 48% have benign lesions and 51% have malignant lesions. 92.72% of patients with CA125 <35 u/ml have benign lesions and 7.27% have malignant lesions.Conclusions: Adnexal mass was found to be more common in middle females (54%) in age group 31-50 years. Serous cystadenoma and simple serous cyst (25%) were common benign lesions and most common malignant lesion was serous cystadenocarcinoma.
Comparison of cervical acid phosphatase papanicolaou stain and standard papanicolaou stain as a screening tool for cancer cervix
Authors: E. Nandhini , R. Sasikala , Perumal Varadharaja
Published: November 2022

Background: Carcinoma cervix is the second most common cancer in women (18%). Cervical smear by routine Papanicolaou (Pap) smear screening has significant rates of false-positive and false-negative results. To minimise this, we compare the efficacy of cervical acid phosphatase-papanicolaou (CAP-Pap) smear with conventional Pap smear in detecting premalignant lesions of cervix. The red-colored granules (enzyme coated abnormal cells) that are clearly detected, CAP-Pap positive aids in the quick and early diagnosis of aberrant cells, which speeds up the screening procedureMethods: The present observational study conducted among the patients presenting to gynaecology department for cancer cervix screening. Two cervical smears were collected for Pap and CAP-Pap staining. Cytology report showing abnormality either in Pap smear or CAP-Pap smear were subjected for colposcopy guided cervical biopsy after VIA/VILI and their results were correlated with histopathology reports as gold standard.Results: Total of 321 women were enrolled in the study. On comparison with Cervical biopsy, Pap smear had a sensitivity of 83.3%, specificity of 50%, Positive predictive value of 88.2%, Negative predictive value of 40.0%. CAP-Pap had a sensitivity of 100%, specificity of 50%, PPV of 90%, NPV of 100%. As evidenced by the 100% sensitivity, CAP-Pap meets the screening test criteria.Conclusions: The CAP- Pap test has a bright future as a rapid, inexpensive, and efficient method for initial screening or as an addition to Pap smear in primary health care of India for effective cervical cancer screening.
The diagnostic value of endometrial thickness and volume measurements by transvaginal three-dimensional ultrasound in patients with perimenopausal bleeding
Authors: Atia Naira A. , El Namoury Mohamed M. , Farhat Manal A. , Hamouda Mahmoud S.
Published: November 2022

Background: Endometrial hyperplasia (EH) represents a spectrum of irregular morphological alterations, whereby abnormal proliferation of the endometrial gland results in increased thickness of endometrial tissue with alterations of glandular architecture (shape and size) and in an increase in gland-to-stroma ratio when compared to endometrium from the proliferative phase pf the cycle. The aim of this study was to detect the role of measurement of endometrial thickness and volume by transvaginal three-dimensional ultrasound as predictors of abnormal endometrial pathology in women with peri menopausal abnormal uterine bleeding.Methods: This study was conducted at the department of obstetrics and gynecology of Tanta University Hospital. The cases were selected from admitted patient suffering from perimenopausal uterine bleeding. The study started after protocol approval from 2020 to 2022. The calculated sample size was 50 cases. The studied cases were subjected to 3D-TVS measuring endometrial volume and endometrial thickness, study uterine size, shape, endometrial curettage and histopathological examination.Results: Regarding provisional diagnosis by ultrasound in the examined patients, the most frequent diagnosis was benign endometrial pathology: 46% (n=23) of all cases then endometrial hyperplasia 44% (n=22) then endometrial carcinoma 10% (n=5), there was statistically significant difference between the three endometrial pathologies regarding endometrial thickness (p˂0.001),  and  endometrial  volume  (p˂0.001).There was statistically significant difference between the benign endometrial pathology and endometrial carcinoma regarding endometrial thickness (p˂0.001), and endometrial volume (p˂0.001).There was statistically significant difference between the endometrial hyperplasia and endometrial carcinoma regarding endometrial thickness (p˂0.001), and endometrial volume (p˂0.001).Conclusions: From our study we conclude that histopathological examination of the endometrium is the gold standard for diagnosis or exclusion of endometrial pathology. 3D ultrasound is a reasonably accurate, helpful, and non-invasive tool for assessing the endometrium.
A clinical study evaluating maternal and perinatal outcomes in patients with decreased amniotic fluid in term pregnancy
Authors: Thorat Sukanya Nagsen , Ravooru Abhyudai , Bansal Anita
Published: November 2022

Background: Oligohydramnios is the most frequent third trimester complication resulting in a greater number of caesarean sections. This study was carried out to determine the role of oligohydramnios (AFI<5) and borderline amniotic fluid index (AFI between 5.1-8) for term pregnancy and their impact on maternal and perinatal outcomes. Objectives of current investigation were to study incidence of oligohydramnios in term pregnancy and to study maternal and perinatal outcome in cases with oligohydramnios.Methods: Present study is done during August 2018 to May 2019 in department of obstetrics and gynaecology, northern central railway hospital, Delhi on 90 women with singleton term pregnancy (37-41weeks) with cephalic presentation, with no leaking PV. According to the AFI measurements (1 week before delivery), 3 groups were formed AFI 0-5 cm (oligohydramnios), 5.1-8cm (borderline AFI), 8.1-24 cm (normal AFI), AFI >24 cm was excluded. Maternal and fetal outcome were assessed.Results: The incidence of oligohydramnios (AFI<5 cm) was 4.4%. Induction of labour was 50% in AFI <5 cm group, 57.1% in borderline AFI and 13.9% in normal AFI group. In AFI <5 cm group, 75% had LSCS, in AFI5-8 cm group, 71.42% had LSCS. Most common indication of LSCS in AFI <5 cm and AFI 5-8 cm was fetal distress. APGAR score <7 at 1, 5 mins was 50% in AFI <5 cm and AF 5-8 cm group as against 8.9% in Normal group. Babies weighing less than 2.5kg were 50% in AFI <5cm group, 42% in borderline group and 15.1% in normal AFI group.Conclusions: AFI determination helps to identify foetuses at risk of poor perinatal outcome. It is a valuable screening test to predict fetal distress in labor that may need caesarean section.
Prospective study to evaluate management of ectopic pregnancy in a tertiary care centre
Authors: . Bhavna , Pathania Kushla , Gupta Kumud Bala , Kaushal Sushruti
Published: November 2022

Background: To study the pattern of management of ectopic pregnancy in a referral Centre in North India.Methods: This prospective study was conducted over a period of one year in the department of obstetrics and gynecology, in a tertiary care Centre in North India. Total number of cases who reported to hospital with ectopic pregnancy during the study period were 110. All the cases were analyzed and managed either with conservative, medical or surgical treatment depending on the condition of cases at the time of presentation to the hospital. Frequencies of different variables were compared by chi square test using Graphpad Prism 9, p value less than 0.05 was considered statistically significant.Results: The incidence of ectopic pregnancies reported in present study was 18.62 per 1,000 deliveries. Total of 110 cases with ectopic pregnancy reported to hospital during the study period. Mean age of the cases was 28.72 years. Out of 110 cases, laparotomy was performed in 100 cases and medical management in 10 cases. Medical management failed in one case and necessitated surgery in that case. There was no maternal mortality during the study period.Conclusion: Most of the cases presented late to the hospital due to lack of awareness, topographically tough terrain in Himachal with limited transport facilities which delayed management of ectopic pregnancy and precludes conservative management either in the form of medical management or conservative surgery. Screening of high-risk cases, early diagnosis, early referral and early intervention reduces the maternal mortality and morbidity. So awareness at the primary health care level is the necessity of the hour.
Study of hypothyroidism in pregnancy and it’s fetomaternal outcome: a prospective study at tertiary care hospital
Authors: . Monika , Khoiwal Susheela , Mourya Aditi , Sharma Nisha , Jorwal Anju
Published: November 2022

Background: Pregnancy is a stress test of maternal thyroid function. The prevalence of thyroid dysfunction in pregnant women is high. This study is aimed to evaluate maternal and fetal outcomes in pregnant women with deranged thyroid profile. The relevance of this study is to document the association of hypothyroidism and its adverse effects on mother and fetus.Methods: All pregnant mother included in the study are subjected to written consent and detailed history taking and fasting blood sample collection. Blood sample collected in fasting state, because lipidemic content in blood interferes with serum thyroid stimulating hormone (TSH) level if blood sample collected in the fed state.Results: A total of 1000 cases were studied. Out of 1000 cases, 71(7.1%) cases found to be hypothyroid. Among them, 14 (19.4%) had overt hypothyroidism and 57 (80.5%) demonstrated subclinical hypothyroidism.Conclusions: Prevalence of subclinical hypothyroidism is 5.6% in 3rd trimester of pregnancy. Anemia, pre-eclampsia, high caesarean rates and neonatal morbidities is significantly associated with hypothyroidism.
Comparative evaluation of different methods to quantify proteinuria in preeclampsia
Authors: Kannali Pavani , Akki Poornima , S. Nafeesa Farheen
Published: November 2022

Background: Worsening of condition in preeclampsia is indicated by progressive proteinuria, hence its quantification helps in decision making and plan treatment accordingly. The present study was undertaken to compare different methods of estimation of proteinuria to find best method for quantification.Methods: It was a hospital based prospective study conducted on a group of 100 pregnant women diagnosed as preeclampsia after 20 weeks of gestation, they were subjected to different methods of quantification of proteinuria after admission in department of obstetrics and gynaecology, Narayana medical college and hospital, Nellore over a period of one year.Results: Present study showed strong positive strength of association of SSA test was higher compared to the spot urinary PCR and spot urinary dipstick. To assess the predictability of three methods compared against 24-hour urine protein estimation by ROC curve. The AUC of the SSA test and spot urinary PCR was stronger than the urinary dipstick. Study showed a significant better method as SSA>>Urinary PCR>>dipstick with accuracy of 96.04%, 95.0% and 54% respectively.Conclusions: This study concluded that spot urine SSA and urine PCR are reliable investigations compared to dipstick method. So, spot urine SSA and urine PCR can be used for detection of proteinuria in pregnant women with pre-eclampsia with high accuracy, which is more rapid than time consuming 24-hour urine protein estimation. Thus, this quick method with high accuracy is very useful to prevent feto-maternal morbidity and mortality in India.
Maternal outcome in pregnancy with sickle cell trait haemoglobinopathie
Authors: Thakor Rutvi R. , Patel Falguni B. , Chaudhary Minal , Shrivastava Anjani
Published: November 2022

Background: Sickle cell trait, the heterozygous state for sickle cell disorders (SCD), which is associated with various obstetrical and non- obstetrical complication. Our objective was to study the pregnancy outcome in women with sickle cell trait.Methods: A prospective observational study was conducted collecting data from medical records of around 40 consecutive consenting subjects admitted in a tertiary health care center of south Gujarat over a period of May 2020 to April 2021 after Human Research Ethics Committee (HREC) approval.Results: In our study majority of the subjects (52.5%) belonged to age group of 18-25 years, majority (62.5%) of subjects were belonged to tribal population. Majority (92.5%) of subjects in our study diagnosed as sickle cell trait post -conceptional. 67% of subjects had various antenatal maternal morbidity among them anemia (45%); preterm labour (12.5%); hypertensive disorder (7.5%) and respiratory failure (2.5%). 65% of our subjects were delivered vaginaly. 5% of subjects had post- partum complication.Conclusions: Though sickle cell trait is considered as a low risk factor during pregnancy, expansion of SCT screening and educational efforts, the availability of reproductive technologies, and the increasing research on clinical complications of SCT have important implications for reproductive and genetic counselling guidelines.
A study of perinatal mortality with obstetrics point of view with etiological factors and preventive approach
Authors: Upadhyay Hemangini J. , Ninama Pallavi G. , Shah Margi A.
Published: November 2022

Background: Perinatal mortality rate (PNMR) serves as the most sensitive index, directly reflecting prenatal; intrapartum and newborn care. In order to reduce perinatal mortality, it is necessary to study the various factors influencing perinatal deaths.Methods: It was a retrospective study done over the period of 1 year from January 2021 to December 2021. Total 4389 deliveries were included out of which 228 perinatal deaths occurred. Causes of perinatal deaths were identified and studied.Results: Results showed that perinatal mortality rate was 17.5 per 1000 live births. Incidence of early neonatal death was 17.5% per total admissions. Majority of perinatal deaths occurred due to preterm, low birth weight. Maternal factor associated with perinatal mortality were antepartum haemorrhage, eclampsia, obstructed labour, malpresentation, medical problems in pregnancy.Conclusions: The perinatal mortality could be prevented with strengthening of antenatal care screening, educating pregnant women to recognize the signs of complications of pregnancy, timely access to obstetric care, monitoring of labour for fetal distress, and proper newborn resuscitation. With proper coordination of neonatologist and obstetrician, sizeable reduction in perinatal mortality can be achieved.
Trends of maternal mortality in a tertiary care hospital: a five year retrospective study
Authors: Singh Leimapokpam Roshan , Devi Khumanthem Pratima , Priyadarshinee Lipsa , Singh M. Rameswar , Devi Yengkhom Mandakini , Krupa Bandi
Published: November 2022

Background: Maternal mortality is a measure of quality of health care in community. Maternal mortality ratio is a very sensitive index that reflect the quality of reproductive care provided to the pregnant women. The aims and objectives were to study the institutional maternal mortality, the causes of maternal death and the impact of COVID-19 on MMR.Methods: A retrospective hospital-based study of 38 maternal death was done over a period of 5 years from June 2016 to May 2021 in obstetrics and gynaecology department, RIMS Imphal. Details of all the mortalities were collected from individual case sheets, facility based maternal death review forms and MDR case summary.Results: A total of 38 deaths were analysed. MMR in the study period was 86 per 1 lakh live births. Maximum maternal deaths were reported in the age group of 30-34 years. Majority of maternal death were reported in multipara (57.9%) as compared to primipara (34.2%). Most of them were un-booked (63.2%) and belonged to rural areas (60.5%). The commonest cause was obstetrics haemorrhage (42.1%) followed by hypertensive disorders (23.6%). Acute respiratory distress syndrome associated with SARS-CoV-2 is one of the most important causes of increasing mortality rate (10.5%).Conclusions: Early identification of high-risk pregnancy, regular antenatal check-up and proper training of health personnel along with timely referral to tertiary care centre can help to reduce the mortality. There is an increase in MMR during the current pandemic 2020-2021.
Comparison of oral versus vaginal misoprostol for induction of labour at term
Authors: Fareed Perveena , Rashid Rehana , Wani Saleem A.
Published: November 2022

Background: Preinduction cervical ripening has a great influence on induction of labor. For induction of labor various methods are used. Mechanical methods are Foleys catheter with or without extra-amniotic saline. Various pharmacological methods are misoprostol, dinoprostone, and oxytocin.Methods: This was a prospective observational study conducted on 100 patients with 50 patients in each group in the department of obstetrics and gynecology, Government Medical College, Srinagar from June 2020 to March 2021 over a period of 9 months. Induction with oral misoprostol or vaginal misoprostol was done in respective groups. Various parameters noted were induction delivery interval, number of doses needed, mode of delivery, and fetomaternal outcome.Results: Average number of doses of misoprostol in oral group was 3.84 and average number of doses in vaginal group was 1.90. Mean induction delivery interval in oral group was 16 hours and 10.94 hours in vaginal group. 32% patients delivered by full-term vaginal delivery (FTVD) in oral group and 18% underwent lower segment caesarean section (LSCS), while as 38% patients in vaginal group had FTVD and only 12% patients underwent LSCS.Conclusions: Our data supported the fact that induction with vaginal misoprostol can be equally effective in either oral or vaginal route. However, induction with vaginal misoprostol leads to shorter induction delivery interval compared to induction with oral misoprostol. Our study also highlighted the fact that induction with vaginal misoprostol requires lesser doses as compared to that with oral misoprostol. However, there are no significant differences in number of caesareans between the two groups. Difference in neonatal APGAR scores and maternal complications were non-significant in both the groups.
Pregnant women with COVID-19: a study in tertiary care centre
Authors: Subramaniyan Sindu K. , Thagaraj Malathi
Published: November 2022

COVID-19 had become a pandemic since December 2019. Although the infection rate affecting the pregnant women is less when compared to general population, the data on the effect of coronavirus in pregnancy are limited to a few case studies This was a case series conducted at KIMS Hospital, Bengaluru for a period of 1 year from November 2020 to November 2021. All the pregnant women irrespective of the gestational age admitted at KIMS hospital with COVID-19 reverse transcriptase polymerase chain reaction (RTPCR) positive and gave the consent were included in our study. In our study, out of 480 pregnant women 13 cases were COVID-19 positive. Out of the 13 positive patients, 4 delivered vaginally and 6 of them underwent lower segment caesarean section (LSCS) in view of obstetric indications. 3 cases (23%) were lost to follow up. 9 (90%) of neonates were negative for COVID 19. The results of our study concluded that COVID-19 positivity rate is 2.7% among the admitted patients. There is a risk of adverse pregnancy outcome in severe COVID-19 infections. The limitation of our study was that number of infected pregnant women was less to study the pregnancy outcome. Further studies with larger sample size will be required to study the pregnancy outcome.
Rare association of Turner syndrome and Mayer-Rokitansky-Kuster Hauser syndrome
Authors: Ndiade Amadou , Thiam Mbaye , Dia Sérigne A. M. , Sy Mama
Published: November 2022

Turner syndrome and Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a rare association. The incidences of Turner and MRKH syndromes are estimated at 1/2000 and 1/4500 female births respectively. This is a 23-year-old patient, born of a consanguineous marriage, who was referred to us for exploration of primary amenorrhoea. The karyotype, performed three times, from peripheral blood lymphocytes was 45X0. The diagnosis of Turner syndrome associated with MRKH syndrome was retained.
Acute lower limb ischemia following surgical management of postpartum hemorrhage: about a case and review of the literature
Authors: Inas Rhazi , Harcha Kamal El , Tahiri Hafsa , Saadi Hanane , Mimouni Ahmed
Published: November 2022

This is a 30-year-old patient, without history, primigravida, with a full-term pregnancy, who consulted in the obstetric emergency department for treatment of heavy metrorrhagia. After conditioning, the ultrasound showed a completely covering placenta, hence the indication for an emergency caesarean giving birth to an Apgar boy 5/10th then 9/10th. The patient presented with uterine atony resistant to medical treatment. Uterine padding and triple vascular ligation were performed. With the persistence of uterine atony, ligation of the hypogastric arteries was attempted with accidental lesion of the right external iliac artery requiring its ligation to ensure haemostasis. The patient was transferred to our training for additional care. On admission, the patient was intubated, hemodynamically stable with coldness of the right lower limb and absence of the right femoral pulse. CT angiography of the aorta and both lower limbs revealed partial occlusion of the right external iliac artery with downstream patency. Revascularization by bypass using the great saphenous vein of the contralateral limb was performed. The post-operative follow-up was simple. Postpartum hemorrhage is a serious complication in obstetrics. Hypogastric artery ligation is one of the means for the surgical management of postpartum hemorrhage. It is a standardized and effective technique, but complications are not uncommon.
A rare case of small cell neuroendocrine carcinoma-lung in pregnancy
Authors: Sumathi N. , Divya V. , Karthikeyan Rekha , Begum Shameema , Sivakumar Vishnupriya
Published: November 2022

Neuroendocrine tumours constitute heterogenous group of cancers that arise from cells in our body which have neuroendocrine cells-mostly from gastro intestinal tract and lungs. They are further divided into low grade, high grade and poorly differentiated ones. It is rare in pregnancy and it poses diagnostic challenge even among experts in the speciality. So, multi-disciplinary approach to management of neuroendocrine carcinomas (NECs) is the key for optimal management.
Myxoid degeneration of leiomyoma-a masquerader
Authors: Panda Anuradha , Mahoorkar Deepti N. , Reddy Nikitha , Reddy B. Mounika
Published: November 2022

Uterine leiomyomas are one of the most common benign lesions in the uterus. The lesion can vary in size from a few millimetres to centimetres, location, its presentation and degeneration. They are easy to diagnose clinically with the help of available imaging techniques. Myxoid degeneration is an uncommon degeneration and has to be kept as a differential diagnosis as it mimics uterine sarcoma. Histopathology and Immunohistochemical analysis help in confirming the diagnosis. Here is a patient in reproductive age group who presented with rapidly growing abdominal mass in a span of 1 year with a prior surgical history of myomectomy. Pre-operative imaging was inconclusive for benign etiology and possibility of uterine leiomyosarcoma could not be ruled out. She was hence counselled for a laparotomy with a frozen section to prevent extensive surgery. Myxoid degeneration is not a common degeneration of leiomyoma with a reported incidence of 10% while the incidence of uterine leiomyosarcoma is less than 1% in reproductive age group. Even though rare, myxoid degeneration should be considered as a differential diagnosis of rapidly growing uterine mass with inconclusive pre-operative imaging.
Leptospirosis in pregnancy: a case report
Authors: Guleria Sara , Dev Kapil , Pathania Kushla
Published: November 2022

Leptospirosis is a leading zoonotic disease worldwide with more than 1 million cases in the general population per year. There is significant mortality due to both delays in diagnosis as well as adequate clinical suspicion. There is also an overlap between the signs, symptoms and biochemical disturbances associated with leptospirosis in pregnancy and the presentation of pregnancy associated conditions, such as pre-eclampsia (PET), acute fatty liver of pregnancy (AFLP) and haemolysis elevated liver enzymes low platelets (HELLP) syndrome. This is a case report of a pregnant woman with leptospirosis who delivered a healthy fetus.
Wernicke encephalopathy and extrapontine myelinolysis in pregnancy with hyperemesis gravidarum: a double jeopardy
Authors: Verma Divya , Kumar Sanjeev , Thakur Praveen , Shukla Anurag , Gupta Prateek
Published: November 2022

We report a case of a pregnant woman who had been suffering from hyperemesis gravidarum presented with alteration of consciousness, nystagmus, generalized weakness and extrapyramidal symptoms at 16th week of gestation. Magnetic resonance imaging of the brain showed typical findings of Wernicke's encephalopathy and extrapontine myelinolysis. The clinical features responded dramatically to high dose thiamine supplementation. Wernicke encephalopathy should be diagnosed as early as possible to prevent long-term neurological sequela or death as well as fetal loss.
Closure of a large lumbosacral myelomeningocele post operative defect with a human cadaveric split-thickness skin graft: a case report
Authors: Campos-Lopez Diana E. , Sauceda-Elenes Nora C. , Martinez-Jimenez Mario A. , Cardenas-Cruz Cristopher , Jiménez-Santana Lizeth , Jiménez-Sierra Mariana G. , Medellin-Cristerna Rito J. , Arias-Mendoza Alejandro
Published: November 2022

Spina bifida is the most common birth defect of the central nervous system that is compatible with life, and myelomeningocele represents its most frequent form. Congenital myelomeningocele (CMM) has a worldwide incidence of 0.5 to 0.8 per 1,000 live newborns. CMM is a complex condition resulting from incomplete closure of the neural tube, mainly in the lumbosacral region. The objective of the surgical repair of the CMM is the reconstruction of all the tissue layers of the defect, avoiding possible postoperative complications. The aim of this case review is to present a re-epithelialization closure in a patient with a large CMM defect in who primary hermetic closure was not possible because there was too much tension at the edges of the defect. Therefore, human cadaveric split-thickness skin grafts were placed over the dura mater and the aponeurotic layer, covering the entire defect and an adequate healing and completely closure of the defect were observed in eight weeks. The surgical management of large meningomyelocele defects represents a major challenge and no single protocol exists for its reconstruction. The repair of an MMC defect should be performed during the first 72 hours after birth. After neurosurgical closure of the neural tube and dura, the myelomeningocele defect requires good quality skin and subcutaneous tissue with minimal wound tension for stable coverage. Human cadaveric skin grafts are considered a useful technique for temporary wound coverage because they lead to a more natural healing environment, possess ideal properties, and provide a physiological barrier that reduces microbiological contamination, in addition, it acts as a bridge to adhere to and to seal wound beds.
Innate immune cells and T CD4 cells profile during hepatitis B among HIV co-infection Beninese
Authors: Sdegbindin Rafiou , Lokossou Gatien Adjimon Gbènakpon , Kpodji Paulin , Gnancadja Prisca , Lafia Banarbé , Quenum Olga Rosine , Senou Maximin
Published: November 2022

Background: Worldwide, human immunodeficiency virus (HIV) infection remains a real public health. Hepatitis B virus (HBV) and HIV have the same routes of transmission and shared risk factors and epidemiology similarities. The purpose of this study was to assess the impact of HBV and HIV co-infection on T CD4 cells and innate immune cells.Methods: A cross-sectional and descriptive study was carried among 260 persons living with HIV (PLHIV) admitted and supported with antiviral tri therapy at the national reference center for research and Care of HIV infected person (NRCRC) of the national hospital and university center in Cotonou, Benin. After PLHIV peripheral blood collection, surface hepatitis B antigens (HBsAg) and HIV serology were tested using ELISA (Enzyme linked immuno sorbent assay). White blood cell count and leukocyte formula were performed using flow cytometry. After staining with anti CD4 antibodies, TCD4+ lymphocytes frequency was determined using flow cytometry. Means were calculated using student T test.Results: Of the 260 PLHIV, 10.77% (n=28) were co-infected with HBV. Our data has shown a significant decrease of lymphocytes among HIV and HBV co-infected persons and a very significant increase in immune innate cells including eosinophils, polynuclear basophils and monocytes, suggesting an important role of innate immune cells during HIV and HBV coinfection.Conclusion: HIV and HBV coinfection results in hyperinflammatory response associated with viral clearance. How this hyperinflammatory response is mounted was still unclear. More data are needed for better management of HIV and HBV co-infection.
Clinico-radiological criteria versus GeneXpert for diagnosis of pediatric tuberculosis
Authors: Ali Saïd O. , Samena Hanitriniaina S. C. , Razafindraibe Kanto A. , Robinson Annick L.
Published: November 2022

Background: Diagnosing tuberculosis in children remains a challenge especially in low-income countries. The aim of this study was to assess the performance of the scoring system combined to chest x-ray images compared to GeneXpert for diagnosis of pediatric tuberculosis.Methods: A retrospective diagnostic accuracy study was carried out on hospitalized children aged 0 to 14 years old, tuberculosis suspect in the pediatric department of the Tsaralalana mother child university hospital center from August 2018 to June 2020.Results: Fifty-one medical files were retained. The mean age was 4±2 years old with a sex ratio of 1.55. The reason for consultation was dominated by respiratory signs (56.9%). The GeneXpert was positive in 58.9% of cases. The chest X-ray images were pathological in all cases, dominated by images of condensation or infiltration (72.5%). WHO score was positive (≥7) in 72.5% of cases. The clinico-radiological criteria had a sensitivity of 13.3-63.3%, a specificity of 61.9-95.2%, positive predictive values of 1.5-6.9% and negative predictive values of 98.8-99.3%.Conclusion: Clinico-radiological criteria could be useful in individual diagnosis of pediatric tuberculosis.
Haemoglobin genotype, ABO and rhesus blood group pattern among students of Bamidele Olumilua University of Education, Science and Technology Ikere, Ekitis state, Nigeria
Authors: Ajayi David O. , Omon Emmanuel A. , Orekoya Adefolurin , Oluwayomi Oludare
Published: November 2022

Background: The two most significant blood group systems of clinical importance are ABO and rhesus. An essential blood component that determines haemoglobinopathies is haemoglobin genotype. The aim of the study was to determine the distribution of haemoglobin genotypes, ABO and rhesus blood groups pattern among students of Bamidele Olumilua University of Education, Science and Technology Ikere (BOUESTI), Ekiti state.  Methods: Two thousand (2,000) samples comprising 840 (42%) males and 1,160 (58%) females were recruited for this study. The ABO blood group was determined using tile method, while the haemoglobin genotype was determined using haemoglobin electrophoresis. Data analysis was done using simple percentage and Chi square test.Results: The results obtained showed that out of the two thousand subjects that participated in this study, 1,448 (72.4%) of the subjects had HbAA, 452 (22.6%) had HbAS, 72 (3.6%) had HbAC, 20 (1%) had HbSS and 8 (0.4%) had HbSC. The distribution of ABO blood groups of the subjects were; blood group O (53.6%), blood group B (26.6%), blood group A (17.8%) and blood group AB (2.0%). Furthermore, 96.0% of the subjects were rhesus ‘D’ positive, while 4.0% were rhesus ‘D’ negative. There was no significant difference (p>0.05) in the haemoglobin genotypes and ABO blood groups of the subjects with respect to age and sex.Conclusions: The study concludes that the distribution of ABO blood group in the study population was given by O>B>A>AB, while the genotype was given by AA>AS>AC>SS>SC respectively. Continued haemoglobin genotype test and premarital counselling of potential couples is highly recommended.
The role of magnetic resonance imaging in non-traumatic chronic hip joint pain in adult rural population
Authors: Chougule Soneshkumar R.
Published: November 2022

Background: Magnetic resonance imaging (MRI) has changed the face of diagnostic techniques; it has been used for diagnosing the hip pathologies and is the earliest applications of MRI in diagnosing musculoskeletal disorders. MRI detects articular, extra articular and osseous pathologies in hip joint. Thus, is important in diagnosing the cases of chronic hip pain which indicates a long list of causes. MRI is also the investigation of choice for imaging avascular necrosis, radiographically occult fractures, marrow replacement disorders, musculoskeletal neoplasms, and various arthritides involving the hip joint.Methods: This study was done to assess the role of MRI in non-traumatic chronic hip joint pain in adult age group. The study included 54 patients with hip pain who were evaluated by plain radiograph and MRI.Results: Majority (42.59%) of the patients were from the age group of 31-50 years, majority of the patients, 36 were males (66.67%). Most common chief complaint was unilateral hip pain (79.6%), and most common pathology found was avascular necrosis in 27 cases (50%). There was no significant association between the age groups and AVN (p=0.582), while gender showed significant association with AVN (p=0.021). Plain radiograph was abnormal in 41 out of total 54 cases (75.93%). The accuracy of detecting etiology by MRI in current study was 96.2% as compared to plain radiograph was 75.9% in current study.Conclusions: Thus, MRI was seen to be more effective in diagnosing cases of painful hip joint where plain radiographs may be entirely normal.
Histopathological spectrum of lesions in gastrointestinal endoscopic biopsies in Jawahar Lal Nehru Medical College and associated group of Hospitals, Ajmer, Rajasthan
Authors: Machiwal Kishan , Menghani Bhawika , Kasliwal Neena , Sharma M. P.
Published: November 2022

Background: The gastrointestinal tract which extends from the esophagus to anus is a common site for numerous pathological processes from non-neoplastic, pre-neoplastic, to neoplastic. Gastrointestinal tumors including both benign and malignant tumors are the major cause of morbidity and mortality worldwide. Endoscopy in combination with endoscopic biopsy plays an important role in detecting early cancers and/or high-grade dysplasia and in the diagnosis of upper and lower gastrointestinal tract neoplasms and therefore aids in their early management.Methods: This study was done for 1 year from July 2018 to June 2019 (retrospectively) and over a period of 1 year from July 2019 to June 2020 (prospectively). All endoscopic biopsies samples were received in the department of pathology at J. L. N. Medical College and Associated Group of Hospital, Ajmer, Rajasthan.Results: The mean age of patients were 51.91±18.86 years and highest incidence of gastrointestinal (GI) disease was seen between the age group of 51-60 years. The male: female (M: F) ratio was 1.46: 1. Non neoplastic lesions are more common than neoplastic lesions. Inflammatory lesion was the most commonly observed lesion followed by malignant lesions. The sensitivity of endoscopy is 96.25%, specificity is 68.67%, the positive predictive value is 74.76% and the negative predictive value is 95%. Accuracy for diagnosis by endoscopy is 82.21%.Conclusions: Endoscopic biopsy correlation reflects important advances in understanding the pathophysiology of disease and prognosis and survival rates after staging in the case of carcinomas. It provides diagnostic information and aids in improving patient management.
Study of antimicrobial resistance profile and efflux mediated drug resistance in clinical isolates of Pseudomonas aeruginosa detected by ethidium bromide-agar Cartwheel method
Authors: K. N. Silpa , Kumar K. S. Harish , Theckel Philip George , S. Anagha , Krishnan Shinu , Murali Radhika , Raj Ananthu
Published: November 2022

Background: Development of antibiotic resistance or multidrug resistance (MDR) is one of the major causes of treatment failure of bacterial infections and has rapidly evolved into a threat to global health care. Bacterial efflux pumps play a significant role in the development of antibiotic resistance. This study evaluates the prevalence of efflux pump- mediated drug resistance in clinical isolates of P. aeruginosa.Methods: Clinical isolates (n=100) of P. aeruginosa were collected from various clinical laboratories in Kerala and their efflux mediated drug resistance detected by the ethidium bromide (EB) agar Cartwheel method.Results: The EB agar cartwheel method of screening revealed efflux activity in 17% (n=17) strains. The efflux activity was revealed at a minimum concentration of EB at 0 mg/l. P. aeruginosa strains showed the highest activity up to a concentration of 2.5 mg/l.Conclusions: This study discusses the emergence of efflux pump- mediated drug resistance in P. aeruginosa from various clinical samples. Our results showed that 17% drug resistance in P. aeruginosa is attributable to efflux related mechanisms.