Central cervical fibroid with a typical Lantern on top of St. Paul’s cathedral appearance

Leiomyoma of the uterus in one of the common benign gynecological conditions and one of the rare locations of a fibroid is from the cervix with an incidence of upto 2%. We are reporting a case of a 46 year old patient who came with complaints of mass per abdomen and with a history of retention of urine twice in the past one and half months. Abdominal examination revealed a firm mass of 24 weeks size gravid uterus with restricted mobility arising from the pelvis and a speculum examination, showed a mass protruding through the vagina with all the walls ballooned out and it appeared as if a head of the baby was protruding out in second stage of labor. It was a 1.9kg central cervical fibroid with a typical "Lantern on top of St. Paul’s cathedral" appearance which was operated without any complications

Impact of socio demographic factors on the severity of maternal anaemia

Background: Anaemia in pregnancy is still a global problem and one of the leading causes for maternal mortality and morbidity in most of the developing countries. The aim and objective of the study was to know the role of various sociodemographic factors and its association with maternal anaemia.Methods: This is a retrospective observational study at a Community Health Centre in Chamarajanagar District. For the study purpose WHO categorization of severity of anaemia was used. All the delivered patients were divided into mild, moderate or severe degree of anaemia based on their hemoglobin (Hb%) levels at the time of delivery and the impact of the sociodemographic factors on the degree of anaemia was expressed as the percentage of severity.Results: A total of 1270 cases were included in the study out of which 270 (21.3%) of pregnant women had a normal hemoglobin level and 503 (39.6%) parturient were mildly anaemic, 460 (36.2%) with moderately anaemic and 2.9% (n=37) were severely anaemic. Patients who had an interpregnancy interval of >2 years, 60 % had normal Hb% and only 1.6% were severely anaemic. Moderate and severe anaemia was found more in women who were illiterates and an education level of less than high school level.Conclusions: Anaemia in pregnancy is associated with several social and demographic factors. Strategies must be taken from the conceptional level itself by providing proper antenatal counseling and women should be economically empowered and good antenatal care must be made available and accessible to all of them. Even with routine iron prophylaxis in pregnancy, still the prevalence of anaemia is high, so should we consider one or two doses of routine parenteral iron therapy for all pregnant women

A VERY INFREQUENT ASSOCIATION OF WILLIAM-BEURAN SYNDROME AND TETRALOGY OF FALLOT

WB-S Autosomal Dominant Disorder is the most common genetic disorder. We report a case of 20 year old with infrequent association of WBS and TOF. Clinical examination and ECHO confirmed TOF, WB-S was suspected based on the clinical signs used in the scoring system of WB-S which were described by AAP(2001), FISH study was performed in this patient because of having more than 3 clinical signs of WB-S and FISH study showed 7q11.23 deletion and remains the gold standard laboratory investigation for WB-S. KEYWORDS: Tetralogy of Fallot; William Beuren Syndrome; Clinical Diagnosis; Fluroscence In Situ Hybridisation

A VERY INFREQUENT ASSOCIATION OF WILLIAM-BEURAN SYNDROME AND TETRALOGY OF FALLOT

WB-S Autosomal Dominant Disorder is the most common genetic disorder. We report a case of 20 year old with infrequent association of WBS and TOF. Clinical examination and ECHO confirmed TOF, WB-S was suspected based on the clinical signs used in the scoring system of WB-S which were described by AAP(2001), FISH study was performed in this patient because of having more than 3 clinical signs of WB-S and FISH study showed 7q11.23 deletion and remains the gold standard laboratory investigation for WB-S. KEYWORDS: Tetralogy of Fallot; William Beuren Syndrome; Clinical Diagnosis; Fluroscence In Situ Hybridisation

Research Need Assessment and Agricultural Research Priorities for South and West Asia: Proceedings of a Workshop held at ICRISAT, Patancheru 7-8 October 2004

Despite the impressive gains in food production,food security, and reduction in rural poverty in South Asia in recent times, problems such as degradation of natural resources, water scarcity, and lowproductivity persist in the region. The threat of marginalization of agriculture and livelihoods of the poor looms large in South and West Asia, where agriculture is the dominant economic activity. The emerging global challenges, paucity of resources, and the need for greater and quicker impacts now compels organizations to prioritize research. Thisworkshop was organized as part of APAARI, ICRISAT, and ICAR's on going effort to establish ademand - driven research agenda based on a participatory approach.The objective was to identify research priorities based on gap analysis by national programs. Representatives of five South and West Asian countries (India,Sri Lanka, Bangladesh, Nepal and Iran), CGIAR institutes, donors, NGOs,farmer ssociations, agricultural universities, and the private sector presented their research needs and emerging challenges, on the basis of identified critical gaps and alternative approaches for addressing these. This book is acompilation of the country papers presented, and spells out specific priorities at macro-, meso-, and micro-levels under the broad themes of genetic improvement, natural resources management, and socioeconomic and policy research

Research need assessment and agricultural research priorities for south and west Asia: proceedings of the Workshop, International Crops Research Institute for the Semi-Arid Tropics, Patancheru, Andhra Pradesh, India, 7-8 Oct 2004

Despi t e the impressive gains in food product ion, food security, and reduct ion in rural pover t y in South Asia in recent t imes, problems such as degradat ion of natural resources, water scarcity, and low product ivi t y persist in the region. The threat of marginal izat ion of agr icul ture and l ivel ihoods of the poor looms large in South and West Asia, where agr icul ture is the dominant economic activity. The emerging global challenges, pauci t y of resources, and the need for greater and quicker impacts now compels organizations to pr ior i t ize research. Thi s workshop was organized as par t of APAARI , ICRISAT, and ICAR' s ongoing ef for t to establish a demand-dr iven research agenda based on a par t icipator y approach. The object ive was to ident i f y research pr ior i t ies based on gap analysis by national programs. Representatives of f ive South and West Asian count r ies ( India, Sri Lanka, Bangladesh, Nepal and I ran) , C G I A R inst i tutes, donors, NGOs , farmer associations, agr icul tural universi t ies, and the pr ivate sector presented thei r research needs and emerging challenges, on the basis of ident i f ied cr i t ical gaps and al ternat ive approaches for addressing these. Thi s book is a compi lat ion of the count r y papers presented, and spells out specific pr ior i t ies at macro- , meso- , and micro- levels under the broad themes of genetic improvement , natural resources management , and socioeconomic and pol icy research

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Central cervical fibroid with a typical Lantern on top of St. Paul's cathedral appearance

Leiomyoma of the uterus in one of the common benign gynecological conditions and one of the rare locations of a fibroid is from the cervix with an incidence of upto 2%. We are reporting a case of a 46 year old patient who came with complaints of mass per abdomen and with a history of retention of urine twice in the past one and half months. Abdominal examination revealed a firm mass of 24 weeks size gravid uterus with restricted mobility arising from the pelvis and a speculum examination, showed a mass protruding through the vagina with all the walls ballooned out and it appeared as if a head of the baby was protruding out in second stage of labor. It was a 1.9kg central cervical fibroid with a typical "Lantern on top of St. Paul’s cathedral" appearance which was operated without any complications