Maternal and fetal outcome of pregnancy complicated by convulsions

Background: Convulsions in pregnancy pose serious morbidity and mortality to both mother and the fetus. Eclampsia being the most common cause. However, many medical disorders like epilepsy, cerebral malaria, meningitis, metabolic disorders etc can result in convulsions in pregnancy. This study was conducted to determine the prevalence of various aetiologies leading to convulsions and to assess how the various demographic-clinical characteristics affect the maternal as well as fetal outcome in patients with eclampsia as compared to those with convulsions other than eclampsia.Methods: This was an observational study conducted over a period of one and a half year at a tertiary institute in India. A total of 56 patients were studied in this duration. The primary objective was to determine the prevalence of the aetiologies causing convulsion as well as the maternal and fetal outcome of the pregnancy complicated by convulsions. The data regarding age, parity, mode of delivery, gestational age at birth, risk factors was obtained by a predesigned proforma.Results: A total of 56 patients were included in the study after screening 18,840 patients in the hospital. Hence the estimated prevalence of convulsions in pregnancy was 1:336 in this hospital. The most common aetiology noted was Eclampsia (69.6%) followed by epilepsy (16.1%).  Others included Cerebral Malaria (3.6%), Hypocalcemia (3.6%), Neurocysticerosis (2%), Hypokalemia (1.8%) and Hypoglycemia (1.8%). Maternal case fatality rate was 3.6%. Total perinatal mortality was 14.2% of which 6 (10.7 %) were still birth.Conclusions: Eclampsia is a major cause of convulsions in pregnancy and considered to be the diagnosis unless proved otherwise. However other causes of convulsions should not be ignored. A thorough evaluation of the patient which lays a major emphasis on a detailed history taking and examination, form the crux of diagnosing the cause of convulsions and can expediate a timely and accurate treatment

L3Cube-MahaSBERT and HindSBERT: Sentence BERT Models and Benchmarking BERT Sentence Representations for Hindi and Marathi

Sentence representation from vanilla BERT models does not work well on sentence similarity tasks. Sentence-BERT models specifically trained on STS or NLI datasets are shown to provide state-of-the-art performance. However, building these models for low-resource languages is not straightforward due to the lack of these specialized datasets. This work focuses on two low-resource Indian languages, Hindi and Marathi. We train sentence-BERT models for these languages using synthetic NLI and STS datasets prepared using machine translation. We show that the strategy of NLI pre-training followed by STSb fine-tuning is effective in generating high-performance sentence-similarity models for Hindi and Marathi. The vanilla BERT models trained using this simple strategy outperform the multilingual LaBSE trained using a complex training strategy. These models are evaluated on downstream text classification and similarity tasks. We evaluate these models on real text classification datasets to show embeddings obtained from synthetic data training are generalizable to real datasets as well and thus represent an effective training strategy for low-resource languages. We also provide a comparative analysis of sentence embeddings from fast text models, multilingual BERT models (mBERT, IndicBERT, xlm-RoBERTa, MuRIL), multilingual sentence embedding models (LASER, LaBSE), and monolingual BERT models based on L3Cube-MahaBERT and HindBERT. We release L3Cube-MahaSBERT and HindSBERT, the state-of-the-art sentence-BERT models for Marathi and Hindi respectively. Our work also serves as a guide to building low-resource sentence embedding models.Comment: Accepted at Computing Conference 202

Equation for Aeroacoustics in a Quiescent Environment

The perturbation equation for aeroacoustics has been derived in a dissipative medium from the linearized compressible Navier-Stokes equation without any assumption, by expressing the same in spectral plane as in Continuum perturbation field in quiescent ambience: Common foundation of flows and acoustics Sengupta et al., Phys. Fluids,35, 056111 (2023). The governing partial differential equation (PDE) for the free-field propagation of the disturbances in the spectral plane provides the dispersion relation between wavenumber and circular frequency in the dissipative medium, as characterized by a nondimensional diffusion number. Here, the implications of the dispersion relation of the perturbation field in the quiescent medium are probed for different orders of magnitude of the generalized kinematic viscosity, across large ranges of the wavenumber and the circular frequency. The adopted global spectral analysis helps not only classify the PDE into parabolic and hyperbolic types, but also explain the existence of a critical wavenumber depending on space-time scales.Comment: 19 pages, 10 figure

Hotdog in bun: a recent technique for oophoropexy

Ovarian torsion is an acute gynaecological emergency. It may present at any age group, however it is more common in the reproductive years. The patient may present with a myriad of clinical features which are often non-specific posing a diagnostic dilemma. Ultrasonography is the best initial modality of imaging. Once diagnosed a surgical approach is the mainstay of treatment. Preservation of ovaries and preventing recurrence in young patients is crucial. We present a case of a young adolescent girl diagnosed with an ovarian torsion who was managed laparoscopically. Oophoropexy was done to avoid future recurrence by an emerging method called the “Hotdog in bun” technique

A novel approach for laparoscopic retrieval of dermoid cyst

A dermoid cyst is a germ cell tumour, benign in nature and common in young women under the age of 30. They are usually asymptomatic and often detected incidentally on imaging. Resection of the cyst is important owing to complications like torsion or malignancy. Laparoscopic surgery is the modality of choice in today’s era. However, rupture of the cyst during laparoscopic retrieval is any surgeon’s nightmare. Hence, good surgical skill and a reliable method of retrieval are of prime importance here. Authors present a novel method of dermoid extraction done laparoscopically with a sterile urine collection (urobag) bag. This is an easy and simple method which decreases the rate of spillage owing to the strength of the bag

Cesarean scar pregnancy: scope for hysteroscopy

Scar ectopic pregnancy also known as cesarean scar pregnancy is a rare form of an extrauterine pregnancy. The blastocyst is implanted at the site of the previous cesarean scar. Most patients remain asymptomatic and are detected on routine ultrasonography imaging. The diagnosis and management of this condition is hence challenging and difficult. A timely ultrasonography in the early weeks of gestation is the key to preventing catastrophic events like uterine perforation and excessive hemorrhage. There is a wide armamentarium of treatment modalities to choose from, however each case must be individualised. Medical management has its own limitations and often patients are required to have a long-term follow-up. We present a case of a cesarean scar pregnancy managed conservatively with systemic methotrexate but subsequently requiring surgical intervention done successfully via hysteroscopy. A repeat ultrasonography done a fortnight later revealed no retained products of conception

Footprint lesion: a mirror image of an endometrial polyp

Endometrial polyps may present with a variety of symptomatology. They are mostly benign and commonly encountered in the reproductive age group. Hysteroscopy is an emerging tool for diagnostic as well as a therapeutic purposes. We report a case of endometrial polyp diagnosed on hysteroscopy, with a “footprint”, that is contact lesion visible. This is a relatively rare phenomenon, and there is sparse information and literature regarding this entity. Hence the true nature of its effects is yet unknown

Endoscopy in the management of a rudimentary non-communicating functional horn

Mullerian anomalies are developmental malformations of the female reproductive tract, often diagnosed late. They are classified into numerous types like a septate uterus, bicornuate or unicornuate uterus etc. A rudimentary non-communicating functional horn is a rare variant of a unicornuate uterus. It may present with a wide spectrum of symptoms like severe dysmenorrhea, infertility, lump in abdomen or rarely maybe diagnosed with a ruptured ectopic in the horn. The diagnosis of this entity is a difficult and challenging. Authors present a case of a young adolescent diagnosed with this Mullerian anomaly, the role of hysteroscopy in confirmation of diagnosis and the management of the patient by laparoscopy successfully. The patient was completely relieved of her symptoms post-surgery