Postpartum spontaneous bladder rupture

Spontaneous bladder rupture after normal vaginal delivery is a rare complication. Patients may present with abdominal distention, fever, haematuria, oliguria and deranged KFT (kidney function test). We are reporting two cases of primigravida with postpartum bladder rupture, one case was diagnosed at laparotomy and the other preoperatively. A patient who presents with retention of urine, haematuria ascites and deranged KFT after uneventful normal vaginal delivery, spontaneous bladder rupture should be suspected. Early diagnosis and management can decrease the morbidity. 

Fetal colon diameter as a tool for estimating gestational age in advanced pregnancy in north Indian population: a pilot study

Background: Conventional Ultrasound dating is not very accurate after 34 weeks of gestation and has standard deviation of about 2 weeks. The aim of the study was to verify whether fetal colon diameter can be used as a tool for estimating gestational age (GA) of fetuses between 32 to 40 weeks.Methods: 100 healthy pregnant women aged 20-35 years were recruited. Fetal bi-parietal diameter, head circumference, abdominal circumference, and femoral lengths were assessed by ultrasound. In addition descending colon diameter was assessed at the level of colonic haustra. The correlation between GA and colon thickness was assessed by the Pearson correlation test.Results: Significant correlation between fetal colon diameter and maternal gestational age was observed (r=0.582). Correlation between gestational age and femur length (r = 0.725) was found to be higher than that between gestational age and colon diameter (r = 0.528) suggesting that femur length is a better parameter than colon diameter for gestational age estimation. The regression equation for gestational age as a function of colon diameter was derived as GA = 28.614 + 0.629 × CD. The diagnostic accuracy of CD of ≥ 12mm in predicting term pregnancy was 75% with a high negative predictive value of 88.9% and positive predictive value of 58.7%.Conclusions: The present study suggested that colon diameter can be used for predicting term pregnancy. Further studies are required to validate this novel marker of maturity amongst Indian population

PHYSICOCHEMICAL CHARACTERIZATION AND EVALUATION OF TELMISARTAN: HYDROXYPROPYL-β-CYCLODEXTRIN: TWEEN 80 INCLUSION COMPLEX

Objective: The present work was aimed to study the effect of the ternary component on complexation efficiency of cyclodextrins towards telmisartan which is a poorly soluble anti-hypertensive agent.Methods: The elucidation of inclusion complexation of telmisartan (TEL) with hydroxypropyl-β-cyclodextrin (HP-β-CD) in the presence and absence of tween 80 was done by investigating their interactions in solid and solution state. The solid state characterization was performed using differential scanning calorimetry (DSC), powder X-ray diffraction studies (PXRD) fourier transform infra-red spectroscopy (FTIR) studies. The host guest stoichiometry was confirmed in solution state by proton nuclear magnetic resonance (1HNMR) and solution calorimetry studies. The improvement in solubility was evaluated through dissolution studies, which was further confirmed by in vivo studies.Results: In solution state, the phase solubility studies indicated 1:1 stoichiometry between TEL and HP-β-CD both in presence and absence of tween 80. The NMR and molecular modelling studies indicated the insertion of N-methyl benzimidazole and biphenyl carboxylate regions of TEL into HP-β-CD cavity suggesting the coexistence of two 1:1 complexes in equilibrium with each other. The stability constants, K1 (imidazole region of TEL-CD) and K2 (biphenyl acetic acid region of TEL-CD), were enhanced in the presence of tween 80 as evident by the higher value of stability constants. Efficacy of ternary complex was established by a significant decrease in the systolic blood pressure of deoxycorticosterone acetate (DOCA) induced hypertensive rats.Conclusion: It can be concluded that solubility of TEL was increased by encapsulation with HP-β-CD. Tween 80 further increased the complexation efficiency and decreased the bulk of cyclodextrin

Characterisation and evaluation of pharmaceutical solvates of Atorvastatin calcium by thermoanalytical and spectroscopic studies

BACKGROUND: Atorvastatin calcium (ATC), an anti-lipid biopharmaceutical class II drug, is widely prescribed as a cholesterol-lowering agent and is presently the world’s best-selling medicine. A large number of crystalline forms of ATC have been published in patents. A variety of solid forms may give rise to different physical properties. Therefore, the discovery of new forms of this unusual molecule, ATC, may still provide an opportunity for further improvement of advantageous properties. RESULTS: In the present work, eight new solvates (Solvate I-VIII) have been discovered by recrystallization method. Thermal behaviour of ATC and its solvates studied by DSC and TGA indicate similar pattern suggesting similar mode of entrapment of solvent molecules. The type of solvent present in the crystal lattice of the solvates is identified by GC-MS analysis and the stoichiometric ratio of the solvents is confirmed by (1)HNMR. The high positive value of binding energy determined from thermochemical parameters indicates deep inclusion of the solvent molecules into the host cavity. The XRPD patterns point towards the differences in their crystallanity, however, after desolvation solvate II, III, IV, V and VIII transform to isostructral amorphous desolvated solvates. The order of crystallinity was confirmed by solution calorimetric technique as the enthalpy of solution is an indirect measure of lattice energy. All the solvates behaved endothermically following the order solvate-VIII (1-butanol solvate) < solvate-I (isoproplyate) < solvate-V (methanol solvate) < solvate-III (ethonalate) < solvate-VI (acetone ethanol solvate) < solvate-IV (t-butanol solvate) < solvate-II (THF solvate) < solvate-VII (mixed hemi-ethanol hydrate). The positive value of the heat capacity of the solvate formation provides information about the state of solvent molecules in the host lattice. The solvents molecules incorporated in the crystal lattice induced local chemical environment changes in the drug molecules which are observed in (13)CP/MAS NMR spectral changes. CONCLUSIONS: Aqueous solubility of solvate-VIII was found to be maximum, however, solvate-I and VIII showed better reduction in total cholesterol and triglyceride levels as compared to atorvastatin against triton-induced dyslipidemia

Bartholin’s gland cyst presenting as anterior vaginal wall cyst: an unusual presentation

The Bartholin’s cyst can occur due to duct obstruction as a result of non-infectious occlusion of the ostium or from infection and edema compressing the duct. In this paper we are reporting a patient who presented to our hospital with something coming out through vagina. Her gynecological examination revealed, a 5*5 cm cystic, mobile, nontender mass arising completely from anterior vaginal wall with normal overlying vaginal mucosa. Intraoperatively, this cyst got ruptured, draining thick chocolate coloured material. Cyst wall was excised completely and sent for histopathology. To our surprise, histopathology reported this as Bartholin duct cyst. Literature search does not report any such case of Bartholin gland cyst

Effects of microquantities of testosterone on the epididymis and accessory glands of the castrated rhesus monkey, Macaca mulatta

Release of testosterone from silastic implants over a period of 90 days resulted in variable stimulation of the epididymis and accessory glands of reproduction in the castrated rhesus monkey. While the weights of the seminal vesicles, prostate gland and bulbo-urethral glands were maintained at the same level as the intact control animals by four or eight implants of testosterone, those of the epididymis and ductus deferens were not affected by either dose of testosterone. Fructose in the seminal vesicles was stimulated significantly above intact control levels by eight implants of testosterone. There was no regional variation in the levels of sialic acid in the caput, corpus and cauda epididymides, but the concentrations of phospholipid and total lipid were significantly higher in the caput epididymidis. Our observations suggest there may be differential threshold requirements of androgens for the maintenance of the epididymis and accessory glands in the male rhesus monkey

COMPARISON OF CERVICAL BIOPSY USING PUNCH BIOPSY FORCEPS VERSUS LOOP ELECTRODE

Context: The biopsy of cervix can be obtained by various methods with availability of newer modalities like loop electrode. Objectives: To compare the histo-pathological parameters and clinical outcome of cervical biopsy obtained using punch biopsy forceps versus loop electrode. Methods: Women attending OPD were screened for cervical pathology, and colposcopy was done for those who screened positive. Patients who required cervical biopsy after colposcopy were allocated into 2 group; one undergoing LEEP biopsy and other half biopsied with Punch forceps. During procedure patients were evaluated for the intra-op pain and bleeding and their severity. The histo- pathological diagnosis was carried out and the sample was studied for its size, adequacy, and presence of any thermal or crush artefacts. Result: The two methods of biopsy were comparable in intra-op parameters, except for the increased requirement for additional haemostasis in LEEP biopsy. There was no case of bleeding from biopsy site at the follow-up visit. LEEP biopsy was&nbsp; associated with continued vaginal discharge more often than punch biopsy. An adequate sample for histopathological diagnosis was obtained in 91.25% of all cases.&nbsp; The comparative findings were reflective of comparable efficacy of both methods in providing an acceptable tissue sample for diagnosis. Conclusion: After analysing and comparing the aforementioned parameters, we opined that neither method can be deemed clearly superior to the other as a cervical biopsy procedure. Keywords: Punch biopsy forceps; Loop electrode; Cervical biopsy

COMPARISON OF CERVICAL BIOPSY USING PUNCH BIOPSY FORCEPS VERSUS LOOP ELECTRODE

Context: The biopsy of cervix can be obtained by various methods with availability of newer modalities like loop electrode. Objectives: To compare the histo-pathological parameters and clinical outcome of cervical biopsy obtained using punch biopsy forceps versus loop electrode. Methods: Women attending OPD were screened for cervical pathology, and colposcopy was done for those who screened positive. Patients who required cervical biopsy after colposcopy were allocated into 2 group; one undergoing LEEP biopsy and other half biopsied with Punch forceps. During procedure patients were evaluated for the intra-op pain and bleeding and their severity. The histo- pathological diagnosis was carried out and the sample was studied for its size, adequacy, and presence of any thermal or crush artefacts. Result: The two methods of biopsy were comparable in intra-op parameters, except for the increased requirement for additional haemostasis in LEEP biopsy. There was no case of bleeding from biopsy site at the follow-up visit. LEEP biopsy was&nbsp; associated with continued vaginal discharge more often than punch biopsy. An adequate sample for histopathological diagnosis was obtained in 91.25% of all cases.&nbsp; The comparative findings were reflective of comparable efficacy of both methods in providing an acceptable tissue sample for diagnosis. Conclusion: After analysing and comparing the aforementioned parameters, we opined that neither method can be deemed clearly superior to the other as a cervical biopsy procedure. Keywords: Punch biopsy forceps; Loop electrode; Cervical biopsy