Medical termination of a partial hydatidiform mole with coexisting fetus during second trimester; management dilemma: a case report

Partial hydatidiform mole and coexisting foetus is a rare condition, with an incidence of 122,000-1,000,000 pregnancies. It presents a dilemma for obstetricians when detected in second trimester of pregnancy. Medical termination is effective during second trimester; however, it increases the risk of occurrence of persistent trophoblastic disease. Following a review of literature, it was seen that most of the PHMCF terminated by medical induction during second trimester resulted in the development of PTD and lung metastasis. However, cases terminated by caesarean section during the third trimester did not develop PTD or metastasis. A 34 year old woman, gravida 3 para 2 at 25 weeks and 3 days of gestation, presented with absent fetal movements. She was markedly pale. She had no prior antenatal visits. Ultrasound examination revealed a single intrauterine foetus at 23 weeks of gestation with no cardiac activity. Spalding sign was positive. Liquor was reduced and showed internal echoes, secondary to intramniotic bleed. Placenta was grossly enlarged, anterior in location with multiple cystic areas suggestive of a partial mole. As her haemoglobin was 5.6 grams, she was transfused with 3 units of packed cells. The patient underwent induced medical abortion after counselling for risk of persistent trophoblastic disease and long term follow up. She was followed up with weekly serial serum beta hCG monitoring, which returned to normal within a month. She showed no signs of persistent trophoblastic disease at 3 months follow up and has been advised to continue follow up for a year. Mid-trimester termination of pregnancy due to PHMCF is challenging due to high risk of PTD and metastasis associated with it. Performance of caesarean section is not recommended during second trimester of pregnancy but is a relatively safer strategy to avoid the risks of persistent trophoblastic disease

QUALITY CONTROL STANDARDIZATION OF THE BARK OF MORINGA OLEIFERA LAM.

Objective: Moringa oleifera Lam. (Morangaceae) is a large glabrous tree, found throughout India. It is well known for curing a variety of ailments such as wound Healing, dysentery, fever, diarrhea and urinary problems. The present study highlights the pharmacognostical and phytochemical parameters of the bark of M. oleifera.Methods: The quality control standardization was performed following the standard parameters prescribed in World Health Organization guidelines and Indian Herbal Pharmacopoeia.Results: Standardization parameters show that it contains calcium oxalate crystal, starch grains and stone cells. High ash value may be due to presence of calcium oxalate crystals. Extractive value is high for water as compared to other solvent which accounts for the presence of comparatively more polar compounds. It contains different chemical constituents as carbohydrate, amino acid, terpenoid and saponin. Total saponin content was found to be 3.022 mg/g equivalent to diosgenin.Conclusion: The present observations will aid in the botanical identification and standardization of the drug in crude form and will help to distinguish the drug from its other species.Â

Smart Phone Controlled Fan using Bluetooth Technology

Abstract This paper includes the advancement in the Bluetooth technology. Bluetooth has been used in mobile phones, PCs, laptops etc. during the past few year, which has provided a wireless connection between the various devices to monitor them using a single microcontroller. This technology provides the remote access of a device in families and individuals with physical limitations. This is not only used in home but also in industries to control various electrical appliances which reduces man power and provide an ease to access the appliances from a remote location and reduces maintenance cost. It has a network, which contains a remote, mobile host controller and several clients. The clients communicate with the host controller through Bluetooth devices

Evaluation of anticonvulsant activity of polyherbal formulation based on ayurvedic formulation Brihad Panchagavya Ghrita

Background: The aim of the present study was to develop a polyherbal formulation for epilepsy. Present polyherbal formulation (PHF) (containing Operculina turpethum (L.) Silva Manso, Mimosa pudica L., Uraria picta (Jacq.) DC., Cajanus cajan (L.) Millsp, and Lawsonia inermis L.) is based on an ayurvedic formulation " Brihad Panchagavya Ghrita" indicated for epilepsy. Materials and Methods: To establish the scientific basis of mechanism, we examined the effects of methanolic extract of PHF (100, 200, and 400 mg/kg, p.o.) on maximal electric shock (MES), pentylenetetrazol (PTZ), and isoniazid (INH)-induced convulsions as well as gamma-aminobutyric acid (GABA)-glutamate level in the brain tissues in PTZ-induced seizure model. Phenytoin (25 mg/kg, i.p.) for MES-induced seizure and diazepam (2 mg/kg, i.p.) for PTZ and INH-induced epilepsy were used as reference drugs, respectively. Results: The extract showed no toxicity and significantly prolonged the onset and reduced the duration of the seizures induced by MES. Phenytoin (25 mg/kg, i.p.) completely inhibited the seizures in this model. Similarly, in the seizures induced by PTZ and INH, the extract also prolonged the onset and reduced the duration of the seizures though not in a dose-dependent manner. Diazepam also inhibits the PTZ and INH-induced seizures. The plant extract however showed a significant anticonvulsant activity at 400 mg/kg in comparison with diazepam. The extract also attenuates the chemical (PTZ) induce oxidative stress in the brain. Moreover, the extract (400 mg/kg) also significantly decreases the GABA-transaminase enzyme activity in PTZ model. The PHF was also found to be capable in reversing the INH-induced decline in GABA level and increase in glutamate level in the brain. Conclusions: The results obtained from this work suggest that PHF has anticonvulsant activity, and this supports the use of the formulation traditionally in the treatment of convulsions

Cytodiagnosis and pitfalls of genital tuberculosis: A report of two cases

Genital tuberculosis is fairly common in Indian women due to high prevalence of pulmonary tuberculosis in the general population. Histopathological diagnosis is invaluable but often, diagnosis can be made with reasonable accuracy by Papanicolaou (Pap) smear test if the index of suspicion is kept high. Also, genital tuberculosis is considered to be more common in patients less than 40 years of age and rare after menopause. We describe two cases of cervical tuberculosis in patients over 40 years of age, including a postmenopausal case, diagnosed by smear tests and later confirmed by histopathology and bacteriology. The differential diagnoses as well as problems encountered in the diagnosis of a tuberculous lesion in Pap smears are also discussed