Uterine inversion - an obstetrician’s nightmare: a series of 3 cases of uterine inversion and a review of management options

Acute puerperal uterine inversion is an extremely rare but potentially life-threatening complication in which the uterine fundus collapses within the endometrial cavity and beyond. Although the causes of uterine inversion are unclear, several predisposing factors have been described. Maternal mortality is extremely high unless the condition is recognized and corrected. We present here a series of three cases of uterine inversion managed in our hospital over a period of 3 years. Our first case, Mrs XYZ referred to our hospital after vaginal delivery followed by postpartum collapse. The patient was in hypovolemic shock with 2nd degree uterine inversion. Second case, Mrs ABC referred to our hospital after vaginal delivery and mass coming out of the vagina. The patient had postpartum haemorrhage with 2nd degree uterine inversion. Our third case, Mrs DEF, c/o full term vaginal delivery at our hospital with 2nd degree uterine inversion with postpartum haemorrhage. In all three cases, the patients were explored in the OT under general anaesthesia and uterine reposition was done vaginally. Two of the patients required mechanical ventilation post operatively and all the patients required blood and blood product transfusion. The clinical management, treatment options and surgical nuances of management of uterine inversion are discussed

Amniotic band syndrome at 14 weeks of gestation: a case report and literature review

Amniotic band syndrome comprises of a group of congenital anomalies involving the limbs, trunk, head and face characterised by asymmetry of involvement and varying severity. While mild variants have a good prognosis with normal life expectancy, severe cases may be incompatible with life. It is sporadic in occurrence with many theories postulated towards the pathogenesis. We report a case of amniotic band syndrome diagnosed at 14 weeks gestation in a 22 year old low risk primigravida-the foetus was seen as an amorphous mass with multiple anomalies, confirmed by autopsy. While early ultrasound helped detect lethal anomalies, correlation with autopsy provided an insight into possible disruptions in early foetal development leading to the various anomalies

IDENTIFICATION OF PUTATIVE DRUG TARGETS IN MASTITIS CAUSING STAPHYLOCOCCUS AUREUS BY IN SILICO APPROACH

Objective: In the present study an attempt has been made by the use of a computational approach to investigate putative drug targets in Staphylococcus aureus.Methods: In silico comparative analysis of the metabolic pathways between the pathogen and the Bos taurus was carried out. Further detection of bacterial genes that are non homologous to host, but are essential for the survival of the pathogen represents a promising means of identifying novel drug targets. Metabolic pathways were obtained from the metabolic pathway database Kyoto Encyclopedia of Genes and Genomes (KEGG) and were compared to identify unique pathways present only in the pathogen and absent in the host.Results: We have identified total 1930 proteins, which are non homologous to Bos taurus protein sequences and among them 374 enzymes are found to be essential for survival of the S. aureus according to the database of essential genes (DEG) database. Further, 10 proteins were predicted as cytoplasmic and cell wall associated proteins, which could serve as potential drug target candidates.Conclusion: The identified potential drug targets form a platform for further investigation in discovery of novel therapeutic agents against S. aureus.Â

Market Information System for Horticultural Crops:Web Application Development for Interactive Graphs

Marketing information service has been recognized as key for success in marketing of perishable commodities. Effort has been made to improve access to market information to all stakeholders involved in marketing of horticultural crops. Current study is an attempt in this direction to review various modes of such information support and also to highlight the effort made by premier institution like Indian Institute of Horticultural Research. Web application has been developed for Market information to display the data as Interactive graphs. Data for the study includes the month-wise arrival and price information of different horticultural commodities from different markets for a period of ten years. This is collected from primary sources such as District -wise, Marketwise and secondary sources such as NHB, NHRDF etc., the data were tabulated and uploaded to Microsoft SQL server database through customized CMS module. Further, the price arrival data has been translated to the Interactive Charts by programs developed using Microsoft Visual studio. NET technologies, which is a relatively new addition to IIHR website. Interactive Charts are used for drilling down for more information on price and arrivals. It consists of several interactive components like zoom, compare etc. Zoom component of the chart enables the user to zoom the graph to read the price trend prevailed in market in detail, which cannot be possible on Basic Chart. The Compare option allows user to compare price data with several other markets. The farmers and traders will get the advantage of taking precise decisions regarding choice of time and place for sale of their produce using this information system. Further, lean, peak stabilization periods prevailing in various markets enable farmers to schedule the cultivation plans

Canonical steering ellipsoids of pure symmetric multiqubit states with two distinct spinors and volume monogamy of steering

Quantum steering ellipsoid formalism provides a faithful representation of all two-qubit states and helps in obtaining correlation properties of the state through the steering ellipsoid. The steering ellipsoids corresponding to the two-qubit subsystems of permutation symmetric $N$-qubit states is analysed here. The steering ellipsoids of two-qubit states that have undergone local operations on both the qubits so as to bring the state to its canonical form are the so-called canonical steering ellipsoids. We construct and analyze the geometric features of the canonical steering ellipsoids corresponding to pure permutation symmetric $N$-qubit states with two distinct spinors. Depending on the degeneracy of the two spinors in the pure symmetric $N$-qubit state, there arise several families which cannot be converted into one another through Stochastic Local Operations and Classical Communications (SLOCC). The canonical steering ellipsoids of the two-qubit states drawn from the pure symmetric $N$-qubit states with two distinct spinors allow for a geometric visualization of the SLOCC-inequivalent class of states. We show that the states belonging to the W-class correspond to oblate spheroid centered at $(0,0,1/(N-1))$ with fixed semiaxes lengths $1/\sqrt{N-1}$ and $1/(N-1)$. The states belonging to all other SLOCC inequivalent families correspond to ellipsoids centered at the origin of the Bloch sphere. We also explore volume monogamy relations of states belonging to these families, mainly the W-class of states.Comment: 13 pages, 13 figures; Revised version; Comments welcom

Legume Genetic Resources: Status and Opportunities for Sustainability

Legumes are one of the most valuable gifts of nature to man, animal, and environment. These are sustainable, affordable, water-efficient, and low-carbon footprint crop. Globally, the share of grain legume accessions is 15% of 7.4 million accessions conserved in genebanks, of which more than half of germplasm in genebanks are without characterization and evaluation data which ultimately limit the utilization of germplasm in legume improvement programs. Characterization of all genebank accessions should be of utmost priority for enhancing the utilization. The development of core, mini-core, reference sets, and trait-specific germplasm has provided route to crop breeders for mining genebanks. Identification of new sources of variation became easy with these subsets, but the entire collection also needs to be evaluated for unique and rare traits. In crop species with narrow genetic base, utilization of crop wild relatives as well as new resources aids to widen the genetic base of legume cultigens

An Overview in Management of Intraoral Bleeding

The clinical significance of hemorrhage depends on the volume and rate of bleeding. Rapid loss of up to 20% of the blood volume or slow losses of even larger amounts may have little impact in healthy adults. Bleeding that is confined within the body cavity and is not apparent on the surface is known as internal or concealed bleeding whereas, blood escaping through a wound in the skin is known as external bleeding. This article gives an overview on different types of hemorrhage, various local methods, different drugs used to manage bleeding during oral surgical procedure.   &nbsp

Maternal and perinatal outcome in eclampsia complicated by posterior reversible encephalopathy syndrome; a three years’ experience in a tertiary care hospital

Background: PRES can be associated with number of medical conditions and was observed frequently in patients with preeclampsia and eclampsia. Neuroimaging is important for the diagnosis of PRES. Study was conducted to find out the maternal and perinatal outcome in patients with eclampsia complicated by posterior reversible encephalopathy syndrome (PRES).Methods: This is a retrospective study done at St. Johns Medical College Bangalore, between October 2013 and October 2016. We reviewed case records of all the patients with eclampsia who underwent neuro imaging studies and a diagnosis of PRES was made. The maternal and perinatal outcomes in these women were studiedResults: In the past three years we had 55 cases of eclampsia who underwent neuroimaging studies for persistent neurological symptoms after 24 hours of MgSO­4 treatment. Of these women 30 were diagnosed to have PRES. In the present study PRES was common in multiparous women and more in patients with antepartum eclamptic women. Mean age at diagnosis of PRES was 26±5.1 years. Common presenting symptoms were headache (93.3%) and vomiting (53.3%). The mean SBP/DBP was 180/110 mmHg. All patients who had recurrent seizures were controlled with MgSO­4 alone. 53.3% of our patients had eclampsia related complications and 36.7% required ICU care. There were 3 maternal deaths (10%). Perinatal mortality was 20%.Conclusions: Neuroimaging in eclamptic patients with persistent neurological symptoms could help in early diagnosis of PRES and multidisciplinary approach in management could contribute significantly in reducing the maternal mortality and morbidity