Primary ovarian ectopic pregnancy: an unusual case study

Ovarian pregnancy is rare variant of ectopic pregnancy. An accurate preoperative diagnosis is very challenging various advances in diagnostic modalities like Transvaginal ultrasonography has evolved in identifying an ovarian pregnancy. It results in significant maternal morbidity, fetal loss, repeat ectopic, impairment of subsequent fertility. The case report a 34-year female who presented with pain and severe anemia and explored keeping in view ruptured tubal ectopic but intraoperatively diagnosed as primary ovarian pregnancy and managed conservatively by ovarian wedge resection

Degradability of cross-linked polyurethanes/chitosan composites

Polyurethanes with synthetic poly([R,S]-3-hydroxybutyrate) in the soft segment and with polycaprolactone triol as cross-linker were blended with chitosan and degraded in hydrolytic and oxidative solutions. Progress of the degradation of the samples was evaluated by changes in their weight, surface topography and thermal properties. Increasing the poly([R,S]-3-hydroxybutyrate) content in soft segment as well as blending with chitosan resulted in an increase in degradability of cross-linked polyurethanes in both solutions.Centre of Polymer and Carbon Materials, Polish Academy of Sciences, University of Wolverhampton, University of the Basque Country (UPV/EHU), Gdynia Maritime Universit

Gallbladder reporting and data system (GB-RADS) for risk stratification of gallbladder wall thickening on ultrasonography:an international expert consensus

The Gallbladder Reporting and Data System (GB-RADS) ultrasound (US) risk stratification is proposed to improve consistency in US interpretations, reporting, and assessment of risk of malignancy in gallbladder wall thickening in non-acute setting. It was developed based on a systematic review of the literature and the consensus of an international multidisciplinary committee comprising expert radiologists, gastroenterologists, gastrointestinal surgeons, surgical oncologists, medical oncologists, and pathologists using modified Delphi method. For risk stratification, the GB-RADS system recommends six categories (GB-RADS 0–5) of gallbladder wall thickening with gradually increasing risk of malignancy. GB-RADS is based on gallbladder wall features on US including symmetry and extent (focal vs. circumferential) of involvement, layered appearance, intramural features (including intramural cysts and echogenic foci), and interface with the liver. GB-RADS represents the first collaborative effort at risk stratifying the gallbladder wall thickening. This concept is in line with the other US-based risk stratification systems which have been shown to increase the accuracy of detection of malignant lesions and improve management. Graphical abstract: [Figure not available: see fulltext.]

Articles Ledipasvir and sofosbuvir for hepatitis C genotype 4: a proof-of-concept, single-centre, open-label phase 2a cohort study

Summary Background Worldwide, although predominantly in low-income countries in the Middle East and Africa, up to 13% of hepatitis C virus (HCV) infections are caused by HCV genotype 4. For patients with HCV genotype 1, the combination of ledipasvir and sofosbuvir has been shown to cure high proportions of patients with excellent tolerability, but this regimen has not been assessed for the treatment of HCV genotype 4. We assessed the effi cacy, safety, and tolerability of 12 weeks of combination therapy with ledipasvir and sofosbuvir for patients with chronic HCV genotype 4 infections

Immune Therapies for Myelodysplastic Syndromes and Acute Myeloid Leukemia

Myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) are hematologic malignancies arising from the bone marrow. Despite recent advances in treating these diseases, patients with higher-risk MDS and AML continue to have a poor prognosis with limited survival. It has long been recognized that there is an immune component to the pathogenesis of MDS and AML, but until recently, immune therapies have played a limited role in treating these diseases. Immune suppressive therapy exhibits durable clinical responses in selected patients with MDS, but the question of which patients are most suitable for this treatment remains unclear. Over the past decade, there has been remarkable progress in identifying genomic features of MDS and AML, which has led to an improved discernment of the molecular pathogenesis of these diseases. An improved understanding of immune and inflammatory molecular mechanisms of MDS and AML have also recently revealed novel therapeutic targets. Emerging treatments for MDS and AML include monoclonal antibodies such as immune checkpoint inhibitors, bispecific T-cell-engaging antibodies, antibody drug conjugates, vaccine therapies, and cellular therapeutics including chimeric antigen receptor T-cells and NK cells. In this review, we provide an overview of the current understanding of immune dysregulation in MDS and AML and an update on novel immune therapies for these bone marrow malignancies

Impact of a spaced learning initiative in an undergraduate student teaching program in pediatrics

Objective: The purpose of this study is to assess the impact of spaced learning in an undergraduate teaching and learning program in pediatrics. Methodology: Analytical study involving the final year medical students posted in the Department of Pediatrics. “Spaced” learning opportunities were provided in addition to the conventional didactic lectures over 8 weeks for the assigned topics. The scores obtained before and after the spaced learning were analyzed using “t”-test. Results: A total of 37 students who underwent the spaced learning initiative and participated in both the tests (before and after spaced learning) were included in the analysis. There was significant positive correlation between the scores of the two groups r = 0.526 (P < 0.001). Paired sample “t”-test showed that there was a statistically significant difference between the test scores with a mean of 11.23, t = 7.434 (P < 0.001). Conclusion: Spaced learning had a significant impact on the students in their learning and recall, leading to better performance in their examination

A retrospective observational study of epidemiology, clinical characteristics and outcomes of melioidosis in a tertiary care hospital in Hyderabad

Background: Melioidosis, caused by Burkholderia pseudomallei, is becoming a disease of public health importance. Despite appropriate treatment, the disease is associated with a high mortality due to the non-availability of diagnostic modalities at primary care and due to delayed presentation to the tertiary care hospital. Methods: This is a retrospective observational study of 12 cases of culture-proven melioidosis diagnosed at a tertiary care hospital in Hyderabad in South India over a period of 15 months. This study presents the epidemiology, risk factors, clinical and radiological manifestations and outcomes of patients with culture-proven melioidosis. Results: The study included 12 participants, out of which 11 were male, with a mean age of 39 years. Diabetes mellitus was the most common comorbidity in our series. The most common organs involved were lung (n = 5) and bone (n = 4). The other organs involved were prostate, liver, skin and soft tissue, spleen, aorta, brain, kidney and bone marrow. B. pseudomallei was isolated from pus culture in eight patients, blood cultures in seven patients and bone marrow culture in one patient. Eleven out of 12 patients were treated with meropenem. In our series, 7 out of 12 patients died; thus, a mortality of 58.3% was noted. Conclusions: Melioidosis is an emerging disease in India but remains under-recognised. This study showed that young males with diabetes, working in agricultural fields, are susceptible. Although the clinical manifestations are diverse, melioidosis should be suspected when patients with diabetes present with pneumonia and abscesses