bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and Efficacy of Intravenous Iron Therapy in Postnatal Patients with Iron Deficiency Anemia
Authors: Kouser Shahnaz , Kouser Shaheen , Malik Mariam , Malik Ahmad
Published: June 2011

Objective

This prospective study was conducted to establish safety and efficacy of intravenous iron therapy in postnatal anemic patients.

Results

Around 217 anemic women were included in the study. Most of these patients (82.2%) were of 21 to 30 years of age having parity of 2 to 4 (53.9%). Almost 71% of patients had moderate anemia with Hb of 7 to 9 gm/dl. Around 208 patients (95.86%) required two to four injections of intravenous iron to build up Hb to optimum acceptable level. Only seven patients (3.22%) suffered from minor complications of local rash, while three (1.38%) had more severe allergic reactions but were managed successfully.

Conclusion

Intravenous iron is a safe and effective alternative in postnatal patients as it ensures iron therapy in low resource and noncompliant patients.
Progressive Muscle Relaxation in Hyperemesis Gravidarum
Authors: Vaidya Madhuri , Gawande Sushil , Tadke Rahul , Kirpekar Vivek , Bhave Sudhir
Published: June 2011

Aims

To assess the role of progressive muscle relaxation in the management of hyperemesis gravidarum.

Methods

This is a prospective, randomized, observer blind and comparative study. Around 30 pregnant women admitted for the treatment of hyperemesis gravidarum were enrolled and randomized into experimental and control groups. Each group was of 15 patients. Experimental group patients received pharmacotherapy with daily progressive muscle relaxation for 2 weeks, while patients in control group received only pharmacotherapy.

Results

(1) Significantly high number of patients required three or more drugs in control group as compared to experimental group, (2) experimental group patients achieved complete response within 2.73 days ± SD, while control group patients achieved complete response within 4 days ± SD, (3) none of the patients in experimental group had recurrence within 2 weeks of observation period, while 13% patients in control group had recurrence after complete response, (4) on clinical global improvement scale, patients in experimental group achieved better improvement.

Conclusions

Progressive muscle relaxation is effective in hyperemesis gravidarum and when combined with antiemetics, it reduces the number of antiemetics required to treat hyperemesis gravidarum. Patients also show early response to treatment, less recurrence and better improvement when combined with antiemetics.
A Rare Case of Recurrent Vaginal Wall Abscess in Communicating Bicornuate Uterus with Renal Agenesis
Authors: Bhute Sindhu , Shrivastava Deepti , Mukherjee Satarupa , Rani Deepika
Published: June 2011

Clinical presentation of müllerian anomalies vary widely. We are reporting here a case of müllerian anomaly, had suffered from secondary infertility and purulent vaginal discharge for last two years. After thorough clinical examination and systematic investigations, her proper diagnosis of communicating bicornuate uterus (H shaped) with partial agenesis of left cervix and total agenesis of right cervix and right kidney was made and patency of right tube was restored, so that not only her symptoms were resolved but she had successful pregnancy too.
Primary Adenocarcinoma of the Fallopian Tube
Authors: Udaya Kumar M , Narayana Swamy M , Manjunath RL , Kalyani R , Patil Avinash , Jain Shobithe
Published: June 2011

Carcinoma of the fallopian tube is not one of the commonest cancer encountered in the clinical practice. Nevertheless, it is vital to have clear knowledge about this disease, since it often presents with various common disorders and when missed, it lends poor prognosis to the patient.
A Rare Case of Invasion of LSCS Scar by Partial Mole
Authors: Singh Amreen , Bhute Sindhu , Shrivastava Deepti , Mukherjee Satarupa
Published: June 2011

Invasive mole can mimic in presentation to inevitable, incomplete and missed abortion, and sometimes obstetric emergencies like intraperitoneal hemorrhage with heavy vaginal bleeding. Although rare, but with increasing incidence of LSCS, isolated invasion at LSCS (lower segment cesarian section) scar by partial mole may be seen, as in this case.

To exclude pregnancy before Copper-T (Cu-T) insertion is important, even in a lady with irregular period presenting at 5th day of menses because bleeding may be related to pregnancy.
Dengue Fever in Pregnancy Mimicking Obstetric Hemorrhage
Authors: Mehta Meghana Narendrabhai , Shah Jitesh Mafatlal , Vachhani Ashvin Dayalal , Desai Archish Ishvarbhai
Published: June 2011

Dengue is a major public health problem in the tropical and subtropical area. Dengue fever is caused by one of the four dengue virus serotypes of the genus Flavivirus, family flaviviridae, RNA virus.1-3 Dengue is transmitted to humans by the mosquito Aedes aegypti. The principal maternal complications are abortion, premature labor, retroplacental hematoma leading to antepartum hemorrhage and hemorrhage during and after delivery. Fetal complications are prematurity, intrauterine fetal death (IUFD), acute fetal distress in labor, maternal-fetal (vertical) transmission and neonatal death. Management of dengue fever is conservative with intravenous fluid replacement and close observation of vital signs and bleeding.
Postcesarean Colonic Obstruction due to Sigmoid Volvulus
Authors: Kokila MS , Dwivedi Akhilesh Dutta , Tejeswini K , Arava Srinivas
Published: June 2011

Sigmoid volvulus causing intestinal obstruction in immediate postcesarean period is extremely rare, commonest being adhesions and adynamic ileus. The presenting features of this complication are mistaken for usual postoperative signs and symptoms causing delayed diagnosis. Thus, a case of intestinal obstruction due to sigmoid volvulus in immediate postcesarean period is presented. Detorsion of sigmoid and decompression of bowel was done. Intestines were viable because of early detection and prompt intervention. Therefore, high index of suspicion and prompt surgical interventions are required to minimize maternal morbidity and mortality.
A Rare Case of Autosomal Dominant Polycystic Kidney Disease Presenting in utero
Authors: Dhumale Hema , Pujar Yeshita , Sherigar Bhavana , Desai Babasaheb Raosaheb , Durdi Geeta , Dalal Anita
Published: June 2011

Autosomal dominant polycystic kidney disease (ADPKD) is the most widespread cause of genetic nephropathy. Only 25% of patients are symptomatic.1 One in 1,000 people carries the autosomal dominant polycystic kidney disease mutant gene. Autosomal dominant polycystic kidney disease is usually asymptomatic until the third or fourth decade of life, although histological evidence of the disease is likely to be present from intrauterine life. Rarely, however, kidneys that are anatomically similar may cause death in infancy or early childhood, and the condition has been designated as “adult variety occurring in infancy”.2 In ADPKD, cysts develop only later in adulthood yet exceptionally cysts may be encountered in utero.

We report a rare case of ADPKD, which was diagnosed by ultrasonography in utero as infantile polycystic kidney disease due to the presence of bilateral enlarged hyperechogenic kidneys with oligohydramnios. Pregnancy was terminated and autopsy revealed it to be an adult polycystic kidney disease. This case is reported due to its rare presentation in utero.
A Rare Case of Acardiac Twin
Authors: Damani Manisha
Published: June 2011

This is a very rare condition happening on average once in every 35000 pregnancies. One twin is usually normal. The other is body like tissue often with malformed legs and lower body but no upper body or heart. Abnormal blood vessels on the placental surface allow the normal twin (pump twin) to pump blood through the tissues of abnormal twin. Because the pump twin heart has to pump for two, there is high risk of going into heart failure and death of normal twin. In our cases nature miraculously interrupted the blood circulation to acardiac twin which resulted in normal growth of normal twin. I present here this interesting case diagnosed and followed up and delivered at our institution.
Comparison of Radiant Warmer Care and Kangaroo Mother Care Shortly after Birth on the Neurobehavioral Responses of the Newborn
Authors: John Renjana Rebecca , Nayak Sabitha , Paul Shiney
Published: June 2011

Background of the study

In 1978, kangaroo mother care (KMC) was proposed as a caring alternative for low birth weight infants. The method of skin to skin contact has shown physiologic, cognitive and emotional gains for preterm infant, however, kangaroo mother care has not been studied adequately in term newborns. The present study reporting early outcomes of comparing the kangaroo mother care to radiant warmer care.

Objectives of the study:

• To assess the neurobehavioral response of the newborn during radiant warmer care (RWC) and kangaroo mother care

• The effect of radiant warmer care and kangaroo mother care on neurobehavioral response of the newborn.

Methods

A quasi-experimental post-test design was used in this study to compare the effect of kangaroo mother care and radiant warmer care on neurobehavioral response of term newborn. A total of 40 subjects who met the inclusion criteria were randomized—20 to KMC and 20 to RWC by simple random sampling technique. The data was collected by using the following tools:

1. Observational check list

2. Modified Brazelton Behavioral Assessment Scale.

Results

Both study groups were similar regarding all physiologic state variables. There is a slight difference in the behavioral state, the mean behavioral response scores of the RWC and KMC were 5.6500 and 5.9500 respectively, and the mean difference was 0.300. Interpretation and conclusion: The findings of the study showed that kangaroo mother care seems to influence state organization and physiologic state regulation of the newborn infant shortly after birth.
Reappraisal of Endometrial Stromal Sarcoma: Report of Four Cases with Review of Literature
Authors: Gayathri BN , Rao Kadam Satyanarayan , Chatura KR
Published: June 2011

Endometrial stromal sarcomas (ESSs) are morphologically heterogenous and diagnosed by light microscopy in most instances. The distinction between smooth muscle neoplasms, such as cellular leiomyoma and low-grade ESS can be problematic. The diagnoses of ESS on the basis of systematic assessment of gross and histological parameters are highlighted.

Hysterectomy from four patients for a clinical diagnosis of leiomyoma was studied. Grossly, three had polypoidal lesion and in one myometrial widening with obvious permeation was noted. Microscopy showed features of ESS in three cases. Other case was diagnosed as cellular leiomyoma thought to be endometrial polyp. Reticulin stain was employed to highlight the characteristic spiral arterioles in ESS and thick-walled vessels in cellular leiomyoma.
Complications during Vaginal Hysterectomy: How to get over Them?
Authors: Joshi Sulabha , Ghike Sunita , Bhalerao Anuja , Kawthalkar Anjali
Published: June 2011

Today vaginal hysterectomy is the most commonly performed gynecological surgery for prolapsed uteri and for other conditions, like fibroid, dysfunctional uterine bleeding, cervical intraepithelial neoplasia, etc.

Vaginal hysterectomy has least incidence of complications. Complications like hemorrhage, infection, bladder injury, etc. are known.

This prospective study was carried out at a tertiary hospital to analyze the complications and find measures to prevent or decrease complications.

Primary hemorrhage was the most common complication, followed by bladder injury and infection. Thus proper selection of cases, preoperatively prepare for any eventuality and intraoperative proficiency can decrease vaginal hysterectomy complications.
Evaluation of Downstaging, Visual Inspection with Acetic Acid and Lugol's Iodine in Screening of Cervical Cancer
Authors: Durdi Geeta , Patil Kamal , Lumb Lakshita
Published: June 2011

Objectives

To detect and compare the sensitivity and specificity of downstaging and visual inspection with acetic acid (VIA) and with Lugol's iodine (VILI).

Methods

Screening with downstaging, VIA and VILI were done on 680 women who fulfilled the inclusion criteria at a primary health center attached to the university hospital, over a period of one year. Those who had abnormal results in downstaging, VIA and VILI were biopsied and sensitivity, specificity, negative predictive value and positive predictive value were calculated.

Results

The sensitivities of downstaging, VIA and VILI were 54.55, 63.64 and 90.91% and specificities were 93.42, 95.07 and 97.46% respectively. The positive predictive value of downstaging, VIA and VILI were 12.01, 17.5 and 35.7% and negative predictive values were 99.2, 99.37 and 98.85% respectively.

Conclusion

VIA and VILI are suitable primary screening procedures as compared to downstaging because of high sensitivity and specificity. The negative predictive value of downstaging, VIA and VILI is better than the positive predictive value. Downstaging can be used in rural areas where acetic acid and Lugol's iodine are not available.
Intravenous Iron Therapy versus Oral Iron in Postpartum Patients in Rural Area
Authors: Inamdar SA , Verma Sunayana
Published: June 2011

Objectives

The aim of this study is to evaluate the efficiency and safety of intravenous iron sucrose complex and comparison with oral iron therapy in postpartum period in rural area.

Materials and methods

It is a prospective, randomized, hospital-based clinical study carried out in over 150 patients, having Hb < 8 mg/dl after 24 hours of delivery. 600 to 800 mg iron sucrose has been given in divided doses, 200 mg on alternate day in 100 ml of normal saline to half of the patients whereas rest of the patients given 200 mg bd dose of ferrous sulphate by oral route for one month. Data was collected after 1st, 2nd, 3rd and 4th week for the hemoglobin estimation and assessment of the impact of intravenous iron sucrose treatment on the postpartum parameters.

Results

The mean Hb was significantly increased in the intravenous iron sucrose group in 7 days (7.42 ± 1.04 gm/dl to 9.8 ± 0.76 gm/dl) of treatment but there was no change observed in mean Hb in the patients treated with oral ferrous sulphate. Women treated with intravenous iron sucrose has shown significantly higher Hb on day 7, day 15 and day 30 as compared to the women those were treated with oral iron (p < 0.0001).

Conclusion

Overall intravenous iron sucrose appears to be an effective mode of treatment in postpartum patients with no serious side effects and associated with faster recovery in shorter duration of hospital stay than oral iron treatment.
A Study of Serum Homocysteine Levels during Normal Pregnancy and Pre-eclampsia
Authors: Ghike Sunita , Jain Sheela , Kumare Bhavna , Gupta Madhur , Shembekar Chaitnya
Published: June 2011

Elevated plasma homocysteine level is a risk factor for vascular problems, including atherosclerosis and arterial thrombosis. Hyperhomocysteinemia during pregnancy causes endothelial dysfunction as a result of increased oxidative stress. The ultimate results are vasculopathy and platelet dysfunction.

The aim of the study was to find the association of the homocysteine levels in pre-eclampsia and normal pregnancy and to know, if there exists any correlation between serum homocysteine levels and severity of PET.

Study design

Prospective case control study

Study place

Women attending antenatal OPD or admitted in antenatal ward of Department of Obstetrics and Gynecology, NKPSIMS.

Study duration

1 March 2010 to 1 September 2010 Study population and sample size

Group 1

30 pregnant normotensive healthy women, GA 28 to 42 weeks and fulfilling inclusion criteria.

Group 2

30 pregnant women, GA 32 to 42 weeks with pre-eclamptic toxemia (mild and severe) and meeting inclusion criteria.

30 pre-eclamptic women were matched with 30 normotensive women of same gestational age.

Results

Mean level of homocysteine was significantly raised in pre-eclamptic women than in control group.

The rise in mean serum homocysteine level was more in women with severe PET as compared to those with mild PET, though not statistically significant. The women in pre-eclamptic group having increased homocysteine levels showed increased incidence of IUGR, IUD, still birth and abruptio placenta and increased incidence of cesarean section.

Conclusion

It is concluded from our study that serum homocysteine levels were significantly elevated in women with PET compared with control group and strong correlation may exist between serum homocysteine levels and severity of pre-eclampsia.
Anemia during Pregnancy: Most Preventable yet most Prevalent
Authors: Joshi Sulabha , Ghike Sunita , Bhalerao Anuja , Kawthalkar Anjali
Published: June 2011

Objective

To study the relationship between maternal hemoglobin and maternal and perinatal outcomes in a cohort of 1200 women, and to highlight the importance of antenatal care to improve maternal health, maternal and fetal outcome.

Method

All singleton pregnancies delivering at NKPSIMS, from January 2009 to December 2009 that fulfilled the required criteria were included.

Results

Out of 1200 women, 787 were anemic (67.2%) < 11 gm of Hb and 413 were nonanemic. Perinatal outcome included preterm delivery, birth weight, intrauterine growth restriction, perinatal death, low Apgar scores and intrauterine fetal death. Risk of preterm and low birth weight among anemic women was 4.2 times and 1.8 times more than nonanemic women. The neonates of anemic women had 1.8 times more risk of low Apgar scores at 1 minute. Among anemic women there was 2.4 times greater risk of intrauterine fetal death than nonanemic women. The women with anemia had 2.5 times higher incidence of PPH than nonanemic women. Puerperal complications were 2.5 times more in anemic women than nonanemic women.

Conclusions

Regular patient education by imparting proper knowledge regarding iron-rich foods, food fortification, implementation of anemia prophylaxis program from adolescence, regular antenatal care from 1st trimester has a vital role in assessing and managing maternal anemia timely, and it directly affects the perinatal outcome. The patients with anemia have higher risk of having low birth weight, preterm birth and Intrauterine fetal death (Rawalmeds 2007,32:102:101:104).
Respiratory Function in Normal Singleton Pregnancy, Multifetal Gestation and Polyhydramnios
Authors: Kundu Susmita , Dasgupta Shyamal , Koppolu Gayetri , Ghosh Tarun Kumar , Mukherjee Amitava , Dasgupta Subhankar
Published: June 2011

Study of respiratory functions of four groups of women

Nonpregnant, early pregnancy, singleton pregnancy at 36 weeks and twin/ polyhydramnios at 36 weeks reveal that inspiratory capacity (IC), tidal volume (TV) and expiratory reserve volume (ERV) in different group pairing have statistically significant difference. This is very important during the assessment of pregnant mother suffering from respiratory or cardiopulmonary disorder.

Objectives

This study aims to observe the additional demands placed on the maternal respiratory system in cases of advanced normal pregnancy or over distended uterus, like multifetal gestation and polyhydramnios, and whether the average Indian woman is able to cope with these respiratory changes.

Methods

Around 80 women were divided into four equal groups which included non-pregnant controls, normal early pregnancy (< 20 weeks), normal singleton pregnancy at 36 weeks and multifetal gestation/polyhydramnios, underwent spirometry for static lung volume measurement. The overall comparison was done by using the Kruskal-Wallis test whereas the individual comparison by Mann-Whitney test. Final statistical computing was performed with SPSS statistical package.

Results

The groups were comparable on the basis of age, height and hemoglobin levels. Comparisons of various groups show statistically significant difference in tidal volume, inspiratory capacity and expiratory reserve volume specially in advance pregnancy with control nonpregnant mothers without significant adverse effect on respiratory system.

Conclusions

Results of the study indicate that though there are significant respiratory functional changes, healthy women, even having twin/polyhydramnios, can tolerate this well. But this knowledge is very important to assess and to formulate management of pregnant women with respiratory or cardiopulmonary compromise.
Impact of HIV Positive Status on Reproductive Decision Making
Authors: Goswami Sebanti , Tibrewal Ranjana
Published: June 2011

Objective

The purpose of this study was to investigate the various factors that influence pregnancy decisions in HIV positive women.

Methods

This was a prospective observational study conducted in the Department of Obstetrics and Gynecology, Medical College and Hospital, Kolkata. Around 65 pregnant women testing positive for HIV and receiving care at our antenatal clinic or opting for MTP were included. An interview was taken regarding factors influencing reproductive decision making.

Results

Around 13.9% of the patients underwent MTP and 86.1% continued their pregnancy. When asked about the reason of opting for MTP, a varied response was noted out of which the fear for vertical transmission and concern of stigma took the major share.

Conclusion

The counseling approach is to be proposed that advocates encouraging HIV-infected women to make reasoned and considered decisions concerning childbearing. Such an approach would require providers to discuss with women not only the medical facts relevant to vertical transmission but also many of the psychosocial issues relevant to the woman's interest in bearing a child. Moreover, the encounter would be contextualized to include discussion of issues unique to the woman's situation and other family considerations.
Role of O'sullivan's Test in Screening of Pregnant Women for Gestational Diabetes in Rural Area
Authors: Acharya Neema , Inamdar Anil
Published: June 2011

Objective

To study the role of O'sullivan's test in screening of pregnant women for gestational diabetes in rural area.

Materials and methods

A total of 1000 antenatal patients were screened for gestational diabetes with 50 gm glucose test (O'sullivan's test), 1-hour plasma glucose value more than 130 gm/dl was considered screen positive who were subjected to 3-hour GTT.

Results

The incidence of gestational diabetes in our study was 0.5%, the maternal and fetal high-risk factors in these patients were PROM, hydromnios and birth weight more than 3.5 kg.

Conclusion

O'sullivan's test is a cost-effective method of screening of diabetes in pregnancy which is associated with increased maternal and perinatal morbidity.
Variants of Leiomyoma: Histomorphological Study of Tumors of Myometrium
Authors: Manjula K , Rao Kadam Satyanarayana , Chandrasekhar HR
Published: June 2011

Objectives

To study the histomorphological features of variants of leiomyomas of myometrium in our institution from hysterectomy and myomectomy specimens.

Methods

In this prospective study, 1,845 hysterectomy and myomectomy specimens collected over a period of two years were studied. A detailed gross and microscopic examination of tumors of myometrium were made after fixing and staining the specimen with routine H&E.

Results

Neoplastic lesions of the myometrium were diagnosed in 441 (23.90%) of the total 1,845 specimens. Benign tumors were diagnosed in 440 cases, and all the benign tumors were leiomyomas except one case of adenomyoma. Leiomyoma was the most common tumor of the myometrium constituting 99.54%. Usual leiomyoma constituted for 95.45% and variants of leiomyomas were 4.55%. Malignant tumor of the myometrium was diagnosed in one hysterectomy specimen out of 1,845 specimens.

Conclusion

Variants of leiomyomas were relatively less, but it is important to differentiate them from malignant neoplasms of the myometrium, as they have good prognosis. Tumor size, nature of margin, presence or absence of vascular invasion, coagulative necrosis and cytological atypia are the most important histological features for differentiation.
Undergraduate Teaching Curriculum in Obstetrics and Gynecology
Authors: Singh Manpreet , Grover Namita , Vaid NB
Published: June 2011

Background

Evaluation of teaching curriculum is extremely logical and is firmly recommended as a part of teaching-learning process. The utility of feedback from students to evaluate a teaching curriculum cannot be overemphasized.

Aim

The present study was conducted to evaluate the effectivity of undergraduate teaching curriculum in obstetrics and gynecology.

Materials and methods

We attempted to seek view point of a batch of 100 students in 9th semester to evaluate the effectivity of undergraduate teaching curriculum in obstetrics and gynecology through a pertinent and simple questionnaire.

Results and conclusion

Out of a batch of 100 students, there were 91 respondents. Majority of them were satisfied with lecture taking but desired that lectures be taken by senior faculty. Four most difficult topics to understand were related to labor followed by malignancies, operative procedures and dysfunctional uterine bleeding respectively. Shockingly, 91.20% students had not conducted even a single delivery, and 10.98% were yet to witness a cesarean section. A meager 2.19% devoted maximum time to study obstetrics and gynecology. Since this study involved a single batch of students, after obtaining further feedback from other batches, larger database will be assessed, and inferences used to evaluate the undergraduate teaching program.
Postmenopausal Infiltrating Desmoid Tumor: A Rare Postoperative Complication
Authors: Patil Neelamma , Sajjan GR , Vallabh Tejaswini , Korbu Jyoti , Aggarwal Shilpi
Published: June 2011

Postoperative desmoid tumors in postmenopausal women is a rare condition. Desmoid tumors are unusual soft tissue benign tumors that arise from musculoaponeurotic tissues. They also have ingrowing tendencies to intestines causing unusual clinical presentation. Recent surgical intervention is known in such cases. FNAC is not contributory due to hypocellularity. CT pelvis, abdomen is helpful. Surgical treatment is usually required. Case report is of this unusual condition in our practice.
Unilateral Twin Ectopic Pregnancy (Diamniotic-Dichorionic): A Rare Case
Authors: Ghike Sunita , Somalwar S , Mitra Kajal , Kulkarni Sayali , Ladikar Mugdha , Baisakhiya Niraj , Sabharwal Glossy
Published: June 2011

Unilateral twin ectopic is a rare condition. Only 100 cases reported till date in the literature. A 34-year-old woman having secondary infertility reported to emergency with amenorrhea of one and half months and pain in abdomen. Her urine pregnancy test was positive and ultrasonography showed multiple (twin) ectopic gestational sacs in left adenexa. Color Doppler showed ring of fire sign encircling both the gestational sacs suggestive of twin ectopic pregnancy (diamniotic-dichorionic) in left adenexa. Exploratory laparotomy confirmed the diagnosis.
A Rare Case of Synchronous Genital Carcinoma Involving the Endocervix and Bilateral Fallopian Tubes
Authors: Swarup Asha , Manjunath RL , Sudha HM
Published: June 2011

A 53-year-old postmenopausal woman came with profuse watery discharge per vagina and underwent type III radical hysterectomy with pelvic lymph node dissection, as the biopsy from the cervical growth revealed papillary adenocarcinoma. She also received adjuvant combination chemotherapy as it was opined as synchronous genital carcinoma involving the endocervix and bilateral fallopian tubes, which is a rare and unique condition. Patient is on regular follow-up with no evidence of recurrent disease.
Effects of Aging on Nasal Mucociliary Clearance
Authors: Yadav Jyoti , Singh Jagat , Ranga Rupender K
Published: June 2011

Nasal mucociliary clearance is a primary physiological defense mechanism of upper as well as lower respiratory tract, and thus maintains the state of health of the respiratory tract. Any disturbance in number or movement of cilia and change in character or amount of mucus production leads to an altered nasal mucociliary clearance. The present study was undertaken to study the effect of aging on nasal mucociliary clearance.

Nasal mucociliary clearance time was assessed in 240 normal subjects, 120 males and 120 females, which were divided in six groups, each comprising of one decade starting from 11 to 20 years. The mean nasal mucociliary clearance time ranged 7.34 to 14.48 minutes in males and 7.36 to 15.38 minutes in females in different groups (A-F). There was no statistical difference between males and females in each group (p > 0.05). The nasal mucociliary clearance time was not found to be increased till 5th decade (p = 0.05). However, the nasal mucociliary clearance time was found to be increased in 6th and 7th decades (group E&F) significantly (p 0.001), which was more marked in group F. This may explain the increased susceptibility of elderly to sinusitis chronic bronchitis, deep lung infections and increased incidence of pneumonia.
Varied Ophthalmic Presentations in Sphenoid Sinus Lesions
Authors: Aiyer RG , Gupta Rahul , Dhameja Prarthna S , Damania Virag , Sharma Abhishek , Prinja Sumit
Published: June 2011

Sphenoid sinus lesions can present with a multitude of symptoms/signs including ophthalmic disturbances.

We describe a total of five patients, of which two had mucoceles and rest three had fungal infection. Ophthalmic symptoms/signs were the ones we were really interested in. We also present one case which had isolated sphenoid fungal sinus. We also give details of their presentation, investigations and treatment. Possible ocular manifestations of mucoceles and the diagnostic imaging techniques used are discussed. The treatment of mucoceles is reviewed. It is stressed that a team approach involving the ophthalmologist, otolaryngologist and radiologist is essential for accurate diagnosis and management.
Primary Nasal Tuberculosis
Authors: Mohindroo NK , Sharma DR , Chauhan Ishan , Mohindroo Shobha
Published: June 2011

Tuberculosis of nose, nasopharynx and paranasal sinus is extremely rare even in countries with a high incidence of pulmonary disease. We present two cases of primary nasal tuberculosis managed in last three years in our department with 2500 to 3000 patient visits per month. One case simulated basal cell carcinoma while other case was an ATT defaulter. Both the cases were managed on RNTCP guidelines. Nasal tuberculosis needs high level of suspicion and is diagnosed with laboratory support.
Endoscopic Excision of Solitary Neurofibroma Arising from Posterior Nasal Septum
Authors: Kohli Parvinderjit Singh , Goel Kanu
Published: June 2011

Neurogenic tumors form a very small percentage of all neoplastic lesions of the head and neck region. However, the head and neck region is by far the most common location for benign peripheral neural tumors. Several cases involving the nasal cavity and paranasal sinuses have been sporadically documented throughout the medical literature. We present a rare case of a solitary neurofibroma arising from the posterior nasal septum of a 37-year-old woman. En bloc surgical resection of the mass was achieved by endoscopic approach. This case highlights the importance of considering this clinical entity in the differential diagnosis when encountering a unilateral soft tissue mass in the nasal cavity and use of endoscopic technique in the management of such tumors.

Abbreviations

Contrast enhanced computed tomography (CECT), Magnetic resonance imaging (MRI).
A Forgotten Nasogastric Tube
Authors: Reddy C Ekambar E , Kinshuck Andrew J , William Claire E
Published: June 2011

Nasogastric tubes are commonly used in hospitals for both feeding and/or decompression of the upper gastrointestinal tract. We present a case of a forgotten nasogastric tube coincidentally found, four years after difficult removal, lodged in the nose and nasopharynx. We also describe the problems of knotted nasogastric tubes and different methods of removal.
Nasal Hirudiniasis: An Uncommon Cause of Unilateral Nasal Obstruction and Epistaxis
Authors: Thakar Alok , Verma Rohit , Sikka Kapil , Preetam C
Published: June 2011

Leech infestations are known as hirudiniasis.1 Leeches are blood-sucking hermaphroditic parasites that vary in color and range in length from a few millimeters to half a meter. They enter the human body through drinking water, and localize on the mucosa of the upper aerodigestive tract.2 In this paper, we present a case with one month history of intermittent epistaxis and nasal obstruction. The cause was found to be a leech in the nose by means of endoscopic examination. We used an easy method to remove the parasite.
Adenomatoid Odontogenic Tumor of Maxillary Sinus
Authors: Gupta Kirti , Yadav Jagveer Singh , Mohindra Satyawati
Published: June 2011

Adenomatoid odontogenic tumor (AOT) is an uncommon tumor of odontogenic origin, constituting only 3% of all odontogenic tumors. AOT is characterized histologically by the formation of duct-like structures with amyloid-like deposits.

An 18-year-old male presented with right chek swelling. CT scan revealed well-defined expansile heterogeneous mass with central hypodensity. Patient underwent excision of the mass by Caldwell-luc approach and histopathologically the diagnosis adenomatoid odontogenic tumor was made. Since it is a benign tumor, the treatment should consist of enucleation and curettage.
Rhinophyma: Excision and Reconstruction with Local Nasolabial Flap
Authors: Gajjar Yogesh , Parikh Rupa
Published: June 2011

Rhinophyma is a rare disease which causes disfiguring soft tissue hypertrophy of the nose. Various medical and surgical treatment modalities have been proposed and tried with varying degree of success. We report a case where we adopted excision of the rhinophymatous tissue and reconstructed with the local nasolabial flap. The result was cosmetically good enough and the procedure technically simple.
Bilateral Nasal Polyp with Unilateral Pathology
Authors: Grover Mohnish , Charaya Kshitij
Published: June 2011

The antrochoanal polyp or Killian's polyp is a benign, solitary lesion that affects mainly children and young adults. It is unilateral in occurrence though a few cases of bilateral antrochoanal polyps have also been reported.

We report a unilateral antrochoanal polyp extending to the opposite side, a presentation not mentioned in literature till date.
Using a mobile laboratory to characterize the distribution and transport of sulfur dioxide in and around Beijing
Authors: Wang M. , Zhu T. , Zhang J. P. , Zhang Q. H. , Lin W. W. , Li Y. , Wang Z. F.
Published: June 2011

Abstract. Megacities are places with intensive human activity and energy consumption. To reduce air pollution, many megacities have relocated energy supplies and polluted industries to their outer regions. However, regional transport then becomes an important source of air pollution in megacities. To improve air quality before and during the 2008 Beijing Olympics, a wide range of control strategies were implemented, including the relocation of polluting industries. High sulfur dioxide (SO2) concentrations were occasionally observed during this period. Potential sources from southern regions of Beijing were indicated by backward trajectories and urban/rural stationary measurements, but direct evidence was lacking. Here we used a mobile laboratory to characterize the spatial distribution and regional transport of SO2 to Beijing during the Campaign for Air Quality Research in Beijing and the Surrounding Region (CAREBEIJING)-2008. Among the five days chosen for the case studies during the Olympic air pollution control period, four had high SO2 concentrations (6, 20 August and 3, 4 September 2008) while one had low SO2 concentration (11 September 2008). The average values of SO2 during the low SO2 concentration day were 3.9 ppb, much lower than during the high concentration days (7.8 ppb). This result implied an impact by regional transport from outside Beijing. During these days, we captured transport events of SO2 from areas south of Beijing, with a clear decrease in SO2 concentrations southeast of the 6th to 4th Ring Roads around Beijing and along the 140 km highway from Tianjin to Beijing. The influx of SO2 through the 4th to 6th Ring Roads ranged from 2.07 to 4.64 kg s−1 on 4 September and 0.21 to 1.56 kg s−1 on 20 August 2008. Locally emitted SO2 from a source located along Jingshi Highway outside the southwest section of the 5th Ring Road of Beijing was identified using wind field data generated by the Weather Research and Forecasting model and the measured particle size distribution, with an estimated flux of 0.11 kg s−1 to Beijing.
Simulated climate variability in the region of Rapa Nui during the last millennium
Authors: Junk C. , Claussen M.
Published: June 2011

Abstract. Rapa Nui, an isolated island in the Southeast Pacific, was settled by the Polynesians most likely around 1200 AD and was discovered by the Europeans in 1722 AD. While the Polynesians presumably found a profuse palm woodland on Rapa Nui, the Europeans faced a landscape dominated by grassland. Scientists have examined potential anthropogenic, biological and climatic induced vegetation changes on Rapa Nui. Here, we analyse observational climate data for the last decades and climate model results for the period 800–1750 AD to explore the potential for a climatic-induced vegetation change. A direct influence of the ENSO phenomenon on the climatic parameters of Rapa Nui could not be found in the model simulations. Furthermore, strong climatic trends from a warm Medieval Period to a Little Ice Age or rapid climatic fluctuations due to large volcanic eruptions were not verifiable for the Rapa Nui region, although they are detectable in the simulations for many regions world wide. Hence, we tentatively conclude that large-scale climate changes in the oceanic region around Rapa Nui might be too small to explain strong vegetation changes on the island over the last millennium.
Combining satellite radar altimetry, SAR surface soil moisture and GRACE total storage changes for hydrological model calibration in a large poorly gauged catchment
Authors: Milzow C. , Krogh P. E. , Bauer-Gottwein P.
Published: June 2011

Abstract. The availability of data is a major challenge for hydrological modelling in large parts of the world. Remote sensing data can be exploited to improve models of ungauged or poorly gauged catchments. In this study we combine three datasets for calibration of a rainfall-runoff model of the poorly gauged Okavango catchment in Southern Africa: (i) surface soil moisture (SSM) estimates derived from radar measurements onboard the Envisat satellite; (ii) radar altimetry measurements by Envisat providing river stages in the tributaries of the Okavango catchment, down to a minimum river width of about one hundred meters; and (iii) temporal changes of the Earth's gravity field recorded by the Gravity Recovery and Climate Experiment (GRACE) caused by total water storage changes in the catchment. The SSM data are shown to be helpful in identifying periods with over-respectively underestimation of the precipitation input. The accuracy of the radar altimetry data is validated on gauged subbasins of the catchment and altimetry data of an ungauged subbasin is used for model calibration. The radar altimetry data are important to condition model parameters related to channel morphology such as Manning's roughness. GRACE data are used to validate the model and to condition model parameters related to various storage compartments in the hydrological model (e.g. soil, groundwater, bank storage etc.). As precipitation input the FEWS-Net RFE, TRMM 3B42 and ECMWF ERA-Interim datasets are considered and compared.
Heterogeneity of soil carbon pools and fluxes in a channelized and a restored floodplain section (Thur River, Switzerland)
Authors: Samaritani E. , Shrestha J. , Fournier B. , Frossard E. , Gillet F. , Guenat C. , Niklaus P. A. , Pasquale N. , Tockner K. , Mitchell E. A. D. , Luster J.
Published: June 2011

Abstract. Due to their spatial complexity and dynamic nature, floodplains provide a wide range of ecosystem functions. However, because of flow regulation, many riverine floodplains have lost their characteristic heterogeneity. Restoration of floodplain habitats and the rehabilitation of key ecosystem functions, many of them linked to organic carbon (C) dynamics in riparian soils, has therefore become a major goal of environmental policy. The fundamental understanding of the factors that drive the processes involved in C cycling in heterogeneous and dynamic systems such as floodplains is however only fragmentary. We quantified soil organic C pools (microbial C and water extractable organic C) and fluxes (soil respiration and net methane production) in functional process zones of adjacent channelized and widened sections of the Thur River, NE Switzerland, on a seasonal basis. The objective was to assess how spatial heterogeneity and temporal variability of these pools and fluxes relate to physicochemical soil properties on one hand, and to soil environmental conditions and flood disturbance on the other hand. Overall, factors related to seasonality and flooding (temperature, water content, organic matter input) affected soil C dynamics more than soil properties did. Coarse-textured soils on gravel bars in the restored section were characterized by low base-levels of organic C pools due to low TOC contents. However, frequent disturbance by flood pulses led to high heterogeneity with temporarily and locally increased C pools and soil respiration. By contrast, in stable riparian forests, the finer texture of the soils and corresponding higher TOC contents and water retention capacity led to high base-levels of C pools. Spatial heterogeneity was low, but major floods and seasonal differences in temperature had additional impacts on both pools and fluxes. Soil properties and base levels of C pools in the dam foreland of the channelized section were similar to the gravel bars of the restored section. By contrast, spatial heterogeneity, seasonal effects and flood disturbance were similar to the forests, except for indications of high CH4 production that are explained by long travel times of infiltrating water favoring reducing conditions. Overall, the restored section exhibited both a larger range and a higher heterogeneity of organic C pools and fluxes as well as a higher plant biodiversity than the channelized section. This suggests that restoration has indeed led to an increase in functional diversity.
Possible interrelation between the lead time of precursory seismic electric signals (SES) and geodynamics in Aegean Sea
Authors: Dologlou E.
Published: June 2011

Abstract. The seismicity of the last 15 years in the Aegean Sea revealed that earthquakes (Mw > 5) with epicentres falling within the Sporades basin and the confined area north of Samos island were preceded by electric seismic signals (SES) with a remarkably long lead time. A possible explanation of this behaviour by means of specific tectonics and geodynamics which characterise these two regions, such as a significant small crustal thickness and a high heat flow rate, has been attempted. New data seem to strengthen the above hypothesis.
Kinematics of a mass movement constrained by sparse and inhomogeneous data
Authors: Karbon M. , Brückl E. , Hegedüs E. , Preh A.
Published: June 2011

Abstract. On 12 February 2008, a landslide occurred along a 50 m high bank of the Danube river near Dunaszekcsö, Hungary. The initial state is only incompletely documented and the geodetic data acquired after the mass movement are sparse. A generalized 3-D topographic model of the landslide and its surrounding area was assembled and a representative longitudinal profile extracted. The reconstruction of the original surface is based on an orthophoto as well as on morphological considerations. Recorded observations include the locations of the outcrops of basal sliding surfaces, displacements at the main scarp and in the lower part of the slide, and a value to describe the total mass transport. Such sparse and inhomogeneous data were insufficient to derive a comprehensive documentation of the landslide or obtain adequate constraints for an accurate numerical analysis. Therefore, slider block models were fitted to the field data, which have only a small number of free parameters. A general view on the morphology of the mass movement justifies its classification as a rotational slide. A double slider block model fits all observational parameters within their error margin and supplies valuable information on the geometry of the slide. Estimates of the residual friction angles were derived and the question of reactivation was addressed. Finite Difference (FD) modelling and the application of conventional stability analysis support the geometry of the slider blocks and the computed average residual friction angles. Generally, the results are assumed to represent preliminary information, which could only be attained by the combination of the thinly distributed geodetic data with qualitative morphological observations and the implementation of a model. This type of information can be gained quickly and may be valuable for preliminary hazard mitigation measures or the planning of a comprehensive exploration and monitoring program.
Sensitivity analysis of an ocean carbon cycle model in the North Atlantic: an investigation of parameters affecting the air-sea CO2 flux, primary production and export of detritus
Authors: Scott V. , Kettle H. , Merchant C. J.
Published: June 2011

Abstract. The sensitivity of the biological parameters in a nutrient-phytoplankton-zooplankton-detritus (NPZD) model in the calculation of the air-sea CO2 flux, primary production and detrital export is analysed. We explore the effect on these outputs of variation in the values of the twenty parameters that control ocean ecosystem growth in a 1-D formulation of the UK Met Office HadOCC NPZD model used in GCMs. We use and compare the results from one-at-a-time and all-at-a-time perturbations performed at three sites in the EuroSITES European Ocean Observatory Network: the Central Irminger Sea (60° N 40° W), the Porcupine Abyssal Plain (49° N 16° W) and the European Station for Time series in the Ocean Canary Islands (29° N 15° W). Reasonable changes to the values of key parameters are shown to have a large effect on the calculation of the air-sea CO2 flux, primary production, and export of biological detritus to the deep ocean. Changes in the values of key parameters have a greater effect in more productive regions than in less productive areas. The most sensitive parameters are generally found to be those controlling well-established ocean ecosystem parameterisations widely used in many NPZD-type models. The air-sea CO2 flux is most influenced by variation in the parameters that control phytoplankton growth, detrital sinking and carbonate production by phytoplankton (the rain ratio). Primary production is most sensitive to the parameters that define the shape of the photosynthesis-irradiance curve. Export production is most sensitive to the parameters that control the rate of detrital sinking and the remineralisation of detritus.