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Wadhwa L.,ESI PGIMSR | Rani P.,ESI PGIMSR | Bhatia P.,Sharda Hospital
Journal of Human Reproductive Sciences | Year: 2017

Aim: To compare the findings and diagnostic accuracy of Hysterosalpingography (HSG) and hysteroscopy in infertile women. Setting and Design: Prospective comparative study in a tertiary care Centre. Material and Methods: 108 women with primary or secondary infertility were recruited. In all women after basic infertility workup, both HSG and hysteroscopy were performed. Results: Out of 108 women, in 3 women HSG couldn't be done and in one woman there was uterine perforation on hysteroscopy. HSG showed normal uterine cavity in 77.8% (81/105) women and abnormal in 22.85% (24/105). Hysteroscopy findings were normal in 70.09% (75/107) and abnormal in 29.91% (32/107). Hysteroscopy detected incidental findings in 15.38% (16/104) cases. HSG showed irregular uterine cavity in 14.15% (15/105) women but on hysteroscopy; normal cavity was present in 6 (40%) women and abnormality was detected in 9 (60%) women. The sensitivity, specificity, positive predictive and negative predictive value of HSG in evaluating uterine cavity abnormalities were 44.83% (95% confidence interval (CI); 0.26-0.64), 86.67% (95% CI; 0.76-0.93), 56.52% (95% CI; 0.34-0.76) and 80.25% (95%CI; 0.69-0.88). Positive likelihood ratio and negative likelihood ratio of HSG in detecting uterine cavity abnormality was 3.36 and 0.64 respectively. The agreement between HSG and hysteroscopy was 75%. This was statistically significant (P value = 0.001) with fair strength of agreement between HSG and hysteroscopy. (k value= 0.336). Conclusion: Hysteroscopy should be performed in all infertile patients as it can detect significant number of incidental findings missed by HSG. © 2017 Journal of Human Reproductive Sciences | Published by Wolters Kluwer - Medknow.

Vernekar M.,ESI PGIMSR | Rajib R.,ESI PGIMSR
Journal of Obstetrics and Gynecology of India | Year: 2015

Introduction: Uterine rupture is a catastrophic obstetrical emergency associated with a significant feto-maternal morbidity and mortality. Many risk factors for uterine rupture, as well as a wide range of clinical presentations, have been identified. Objectives: To analyze the frequency, predisposing factors, and maternal and fetal outcomes of uterine rupture. Methods: A retrospective analysis of cases of unscarred uterine rupture was conducted at the Department of Obstetrics and Gynecology, RIMS, Imphal from June 1, 2010 to June 30, 2012. Results: Our analysis comprised 13 cases. Of these, 30.8 % were booked cases. Most of the cases (46.2 %) were Para 2. Uterine rupture occurred at term in 10 cases. The rupture occurred due to mismanaged labor (30.8 %), the use of oxytocin (23 %), instrumental delivery (15.4 %), obstructed labor (15.4 %), induction by prostaglandin gel (7.7 %), and placenta percreta (7.7 %). Maternal deaths and perinatal deaths were 30.8 and 53.8 %, respectively. Sub-total hysterectomy was done in 8 cases and in 1 patient laparotomy with repair was performed. Conclusion: Ruptured uterus causes a high risk in patients. An unscarred uterus can undergo rupture even without etiological or risk factors. The patients with mismanaged labor, grand multiparas, and obstructed prolonged labor must be managed by properly trained personnel at a tertiary care center in order to avoid the morbidity or mortality. © 2015 Federation of Obstetric & Gynecological Societies of India

Journal of Clinical and Diagnostic Research | Year: 2013

A parameatal urethral cyst is a very rare congenital anomaly. It was first reported in two males in 1956 by Thompson and Lantin. About 50 cases have been published since then. Most of the cases which have been reported were from Japanese population and on extensive literature search, few cases were found to have been reported from India. We are reporting a case of a parameatal urethral cyst in a 7-year-old boy. Complete excision of the cyst with total removal of the epithelium is required for treatment and for prevention of recurrence.

Shanmugapriya V.,ESI PGIMSR
BMJ case reports | Year: 2013

A 9 year-old boy presented with a 3-week history of low-grade fever, on and off, and additive arthritis of the lower limb joints with no overt antecedent trauma. Investigations for juvenile idiopathic arthritis (JIA), reactive and tuberculous arthritis were normal. He was started on anti-inflammatory drugs as for seronegative oligoarticular JIA. Since arthritis persisted despite treatment, MRI of the left knee joint was planned prior to an aspiration/synovial biopsy. MRI revealed a partial tear of the anterior cruciate ligament with a significant effusion. On careful re-examination, at this point, he was found to have generalised hypermobility with a Beighton score of 9/9. This had been missed initially, leading to a delay in diagnosis and management. He was managed with careful physiotherapy and lifestyle modification. The left knee effusion resolved within a month. This case is being reported in order to highlight the fact that joint hypermobility syndrome can be misdiagnosed as arthritis.

Das S.K.,ESI PGIMSR | Mukherjee S.,Amrita Institute of Medical science
Oxidative Medicine and Cellular Longevity | Year: 2010

Background: Alcohol abuse is a systemic disorder. The deleterious health effects of alcohol consumption may result in irreversible organ damage. By contrast, there currently is little evidence for the toxicity of chronic alcohol use on lung tissue. Hence, in this study we investigated long-term effects of ethanol in the lung. Results: Though body weight of rats increased significantly with duration of exposure compared to its initial weight, but there was no significant change in relative weight (g/100 g body weight) of lung due to ethanol exposure. The levels of thiobarbituric acid reactive substances (TBARS), nitrite, protein carbonyl, oxidized glutathione (GSS G), redox ratio (GSS G/GSH ) and GST activity elevated; while reduced glutathione (GSH ) level and activities of glutathione reductase (GR), glutathione peroxidase (GPx), catalase, superoxide dismutase (SOD) and Na+K+ATPase reduced significantly with duration of ethanol exposure in the lung homogenate compared to the control group. Total matrix metalloproteinase activity elevated in the lung homogenate with time of ethanol consumption. Histopathologic examination also demonstrated that severity of lung injury enhanced with duration of ethanol exposure. Methods: 16-18 weeks old male albino Wistar strain rats weighing 200-220 g were fed with ethanol (1.6 g/kg body weight/day) up to 36 weeks. At the end of the experimental period, blood samples were collected from reteroorbital plexus to determine blood alcohol concentration and the animals were sacrificed. Various oxidative stress-related biochemical parameters, total matrix metalloproteinase activity and histopathologic examinations of the lung tissues were performed. Conclusions: Results of this study indicate that long-term ethanol administration aggravates systemic and local oxidative stress, which may be associated with lung tissue injury. © 2010 Landes Bioscience.

Upadhyaya G.P.M.,Kempegowda Institute of Medical science | Lingadevaru U.B.,ESI PGIMSR | Lingegowda R.K.,Kempegowda Institute of Medical science
Journal of Infection in Developing Countries | Year: 2011

Introduction: Because of increasing difficulty in treating enterococcal infections, effort is being devoted to understanding factors that are responsible for causing nosocomial infection, with a focus toward targeting these factors with new therapeutics. Evidence has emerged that the esp gene mediates biofilm formation in vitro, which helps the organism colonize and cause infection. Methodology: This study was conducted over a four-year period in a tertiary-care hospital. There were 200 clinical pathogenic strains isolated from nosocomial infections and 100 commensals from stool specimens of healthy individuals. The study compared the production of biofilm and detection of the esp gene among clinical and commensal isolates. Results: Among 200 clinical isolates of Enterococcus faecalis 65 (32.5%) isolates were positive for biofilm production and 60 (30%) for the esp gene by PCR. Among 100 commensal isolates, 16 (8%) and 14 (7%) were positive for biofilm formation and the esp gene, respectively. Five clinical and two commensal isolates produced biofilm without any amplification of the esp gene. Conclusion: The study shows a significant difference in production of biofilm and presence of the esp gene between clinical and commensal isolates (P < 0.002). Therefore, it can be concluded that biofilm production has an important role in causing nosocomial infection. Although detection of the esp gene correlates with biofilm production, it may not be the only factor determining the formation of biofilm since few isolates produced biofilm without the esp gene. Strains isolated from indwelling medical devices showed high production of biofilm and esp gene. © 2011 Upadhyaya et al.

Chakrabarti S.,ESI PGIMSR | Datta A.S.,IPGME and R | Hira M.,Calcutta Medical College and Hospital
Asian Pacific Journal of Cancer Prevention | Year: 2012

Background: Though open surgical biopsy is the procedure of choice for the diagnosis of bone tumors, many disadvantages are associated with this approach. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of bony tumors and tumor-like lesions which may be conducted in centers where facilities for surgical biopsies are inadequate. Methods: The study population consisted of 51 cases presenting with a skeletal mass. After clinical evaluation, radiological correlation was done to assess the nature and extent of each lesion. Fine needle aspiration was performed aseptically and smears were prepared. Patients subsequently underwent open surgical biopsy and tissue samples were obtained for histopathological examination. Standard statistical methods were applied for analysis of data. Results: Adequate material was not obtained even after repeated aspiration in seven cases, six of which were benign. Among the remaining 44 cases, diagnosis of malignancy was correctly provided in 28 (93.3%) out of 30 cases and categorical diagnosis in 20 (66.67%). Interpretation of cytology was more difficult in cases of benign and tumor-like lesions, with a categorical opinion only possible in seven (50%) cases. Statistical analysis showed FNAC with malignant tumors to have high sensitivity (93.3%), specificity (92.9%) and positive predictive value of 96.6%, whereas the negative predictive value was 86.7%. Conclusion: FNAC should be included in the diagnostic workup of a skeletal tumor because of its simplicity and reliability. However, a definitive pathologic diagnosis heavily depends on compatible clinical and radiologic features which can only be accomplished by teamwork. The cytological technique applied in this study could detect many bone tumors and tumor-like conditions and appears particularly suitable as a diagnostic technique for rural regions of India as other developing countries.

Parthasarathy V.,ESI PGIMSR | Rathnam U.,ESI PGIMSR
International Journal of Preventive Medicine | Year: 2012

Nipple discharge (ND) can be the earliest presenting symptom of breast cancer. We hereby present two cases of breast cancer with no palpable mass manifesting as isolated ND, which was whitish in color. In both cases, cytology of the discharge revealed highly pleomorphic cells indicating a high grade malignancy. Mammography showed diffuse, extensive microcalcifications. Simple mastectomy with axillary clearance was done. Histology in both cases revealed diffusely spreading intraductal carcinoma, with focus of microinvasion in one case. ND if scanty or not blood stained is often ignored by the patients and at times, the clinicians. This article highlights that ND can be an early warning sign of intraductal carcinomas that are non-invasive in early stage. Irrespective of the color or nature of the discharge, unilateral ND needs to be evaluated. Proper clinical assessment, cytological evaluation of the ND, and mammography ought to be performed in all such cases. Considering the low level of awareness in women regarding the warning signs of breast cancer, the current focus is to create "breast awareness." Women should be sensitized to recognize any unusual changes in their breasts and report to their health care providers at the earliest.

Thiyam R.,ESI PGIMSR | Lalchandani R.,ESI PGIMSR
Journal of Clinical Orthopaedics and Trauma | Year: 2015

Tardy ulnar nerve palsy is a chronic clinical condition characterised by delayed onset ulnar neuropathy. Typically tardy ulnar nerve palsy occurs as a consequence of non-union of lateral condyle in child resulting in cubitus valgus deformity which ultimately is the cause of ulnar nerve palsy. However very few literature are available for tardy ulnar nerve palsy as a result of old fracture of medial epicondyle without cubitus varus or valgus deformity. We report a rare case of tardy ulnar nerve in an adult male with fracture non-union of medial epicondyle of humerus. © 2014 Delhi Orthopaedic Association.

European Journal of Inflammation | Year: 2011

Most cells in the human body have a spherical or ovoid nucleus. The mature human neutrophil, unlike most other cells exhibits a distinctly non-spherical nucleus, which is segmented into three to five lobes. The possible mechanisms underlying this segmented nuclear shape have been explored. The structure of the nuclear envelope, composition of lamins and lamin-B receptor seems to have an important role in shaping the nucleus. Being the first line of defense, neutrophils migrate rapidly to the site of infection and destroy the invading pathogen. This requires negotiation through narrow capillaries, transmigration across the vessel wall and passage through tight tissue spaces. Segmented shape confers increased nuclear flexibility, thereby easing the migration of neutrophils through narrow channels. The segmented shape of the nucleus may also play a role in intranuclear chromatin organization and gene expression. The unique shape of the neutrophil nucleus seems to be an adaptation to facilitate its function. Copyright © by BIOLIFE, s.a.s.

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