Primary abdominal pregnancy causing diagnostic dilemma: a case report

The aim of the study was to present a case of primary abdominal pregnancy, a rare entity and highlighting the diagnostic dilemma and importance of surgical management. Primigravida with an amenorrhea of 35 days presented to the casualty with acute abdomen, with faintly positive UPT test and USG pelvis was suggestive of ill-defined hypoechoeic mass lesion in right sided adnexal region abutting right ovary. Intra-operatively, blood clots with products of conception were found adherent to anterior layer of right broad ligament. Uterus, both fallopian tubes and both ovaries found intact with normal morphology. On histopathology, no chorionic villi was found inside the lumen of the fallopian tube. Presence of occasional ghost chorionic villi embedded in blood clots, scattered cytotrophoblast and syncytiotrophoblasts also seen in the sample obtained from the anterior leaf of broad ligament. Primary abdominal pregnancy is not only rare but the diagnosis is also a challenge. It can be diagnosed conclusively after laparotomy. There are no symptoms which are pathognomonic for abdominal pregnancy. The symptoms are akin to other types of ectopic pregnancy, so a high index of suspicion is highly necessary for diagnosis. The keys to management are an early diagnosis and prompt surgery

Magnetic resonance imaging in pelvic endometriosis with surgical correlation: a pictorial review

Endometriosis is a common gynaecological problem, primarily affecting women of reproductive age. Most common site of endometriosis is ovaries. Extra ovarian sites include uterine ligaments, fallopian tubes, rectosigmoid, laparotomy or C-section scars and urinary bladder. There can be formation of ovarian endometriotic cysts or deep infiltrating endometriosis. The role of MRI is in the evaluation of deep or more complex disease as it enables a large field of view, superior contrast resolution and multiplanar capabilities as compared to ultrasound. In this article, we are describing MRI imaging appearances of endometriomas and deep pelvic endometriosis in the form of a pictorial essay

Effect of Bleaching on Color Change and Surface Topography of Composite Restorations

This study was conducted to determine the effect of 15% carbamide peroxide bleaching agent on color change and surface topography of different composite veneering materials (Filtek Z350 (3M ESPE), Esthet X (Dentsply India), and Admira (Voco, Germany). Methods. 30 samples were fabricated for evaluation of color change using CIELAB color system and Gonioreflectometer (GK 311/M, ZEISS). 45 disc-shaped specimens were made for evaluation of surface topography after bleaching (Nupro White Gold; Dentsply) using SEM. Statistical analysis. One way ANOVA and Multiple comparison tests were used to analyze the data. Statistical significance was declared if the P value was .05 or less. Results and conclusion. All the specimens showed significant discoloration (ΔE > 3.3) after their immersion in solutions representing food and beverages. The total color change after bleaching as compared to baseline color was significant in Filtek Z350 (P = .000) and Esthet X (P = .002), while it was insignificant for Admira (P = .18). Esthet X showed maximum surface roughness followed by Admira and Filtek Z350. Bleaching was effective in reducing the discoloration to a clinically acceptable value in all the three groups (ΔE < 3.3)

Bacterial community structure of a pesticide-contaminated site and assessment of changes induced in community structure during bioremediation

The introduction of culture-independent molecular screening techniques, especially based on 16S rRNA gene sequences, has allowed microbiologists to examine a facet of microbial diversity not necessarily reflected by the results of culturing studies. The bacterial community structure was studied for a pesticide-contaminated site that was subsequently remediated using an efficient degradative strain Arthrobacter protophormiae RKJ100. The efficiency of the bioremediation process was assessed by monitoring the depletion of the pollutant, and the effect of addition of an exogenous strain on the existing soil community structure was determined using molecular techniques. The 16S rRNA gene pool amplified from the soil metagenome was cloned and restriction fragment length polymorphism studies revealed 46 different phylotypes on the basis of similar banding patterns. Sequencing of representative clones of each phylotype showed that the community structure of the pesticide-contaminated soil was mainly constituted by Proteobacteria and Actinomycetes. Terminal restriction fragment length polymorphism analysis showed only nonsignificant changes in community structure during the process of bioremediation. Immobilized cells of strain RKJ100 enhanced pollutant degradation but seemed to have no detectable effects on the existing bacterial community structur

Effectiveness of Transcutaneous Electrical Nerve Stimulation Therapy on whole Salivary Flow in Patients with Xerostomia and Healthy Adults

Objective: To evaluate and compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on whole salivary flow in patients with xerostomia and healthy adults.&nbsp;Material and Methods:&nbsp; Thirty subjects with a history of xerostomia and subjects with unstimulated salivary flow equal to or less than 0.5 ml in 5 min were included in the study group, and 30 healthy subjects were included in the control group. Low forced spitting unstimulated saliva was collected for five minutes in a test tube fitted with a funnel. Then electrode pads of the TENS unit were applied bilaterally on skin overlying the parotid glands and at optimal intensity, stimulated saliva was collected for 5 minutes with the same method in a separate graduated test tube. The salivary flow rate (per minute) was calculated by dividing the amount of collected saliva (volume in mL) by the duration of collection period (5 minutes) and the salivary flow rates prior and after electrostimulation were compared for both groups. The Student’s t-test (unpaired and paired) was performed for group-wise comparisons.&nbsp;Results:&nbsp;In study group, the mean unstimulated salivary flow rate was 0.07 ± 0.01 mL/min. There was an 85.71% increase in salivary flow (0.13 ± 0.03 mL/min) during the TENS application and the difference was highly significant (p&lt;0.001). In control group, the mean unstimulated salivary flow rate was 0.37 ± 0.07 mL/min. There was a 21.62% increase in salivary flow (0.45 ± 0.07 mL/min) during the TENS application and the difference was highly significant (p&lt;0.001). An increase in mean salivary flow rate both in males and females after TENS application in both groups (p&lt;0.001) was noted. The difference between unstimulated, stimulated and mean difference in salivary flow rate between males and females was not statistically significant in both groups (p&gt;0.05).&nbsp;Conclusion:&nbsp;TENS can be an effective therapy in increasing whole salivary flow rates in patients with xerostomia

Effectiveness of Transcutaneous Electrical Nerve Stimulation Therapy on whole Salivary Flow in Patients with Xerostomia and Healthy Adults

Objective: To evaluate and compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on whole salivary flow in patients with xerostomia and healthy adults.&nbsp;Material and Methods:&nbsp; Thirty subjects with a history of xerostomia and subjects with unstimulated salivary flow equal to or less than 0.5 ml in 5 min were included in the study group, and 30 healthy subjects were included in the control group. Low forced spitting unstimulated saliva was collected for five minutes in a test tube fitted with a funnel. Then electrode pads of the TENS unit were applied bilaterally on skin overlying the parotid glands and at optimal intensity, stimulated saliva was collected for 5 minutes with the same method in a separate graduated test tube. The salivary flow rate (per minute) was calculated by dividing the amount of collected saliva (volume in mL) by the duration of collection period (5 minutes) and the salivary flow rates prior and after electrostimulation were compared for both groups. The Student’s t-test (unpaired and paired) was performed for group-wise comparisons.&nbsp;Results:&nbsp;In study group, the mean unstimulated salivary flow rate was 0.07 ± 0.01 mL/min. There was an 85.71% increase in salivary flow (0.13 ± 0.03 mL/min) during the TENS application and the difference was highly significant (p&lt;0.001). In control group, the mean unstimulated salivary flow rate was 0.37 ± 0.07 mL/min. There was a 21.62% increase in salivary flow (0.45 ± 0.07 mL/min) during the TENS application and the difference was highly significant (p&lt;0.001). An increase in mean salivary flow rate both in males and females after TENS application in both groups (p&lt;0.001) was noted. The difference between unstimulated, stimulated and mean difference in salivary flow rate between males and females was not statistically significant in both groups (p&gt;0.05).&nbsp;Conclusion:&nbsp;TENS can be an effective therapy in increasing whole salivary flow rates in patients with xerostomia

Asymptomatic posterior cervical myelomeningocele with tethered cord in an adolescent: A rare form of spinal dysraphism with rare presentation

Unlike lumbar spinal dysraphism, cervical spinal dysraphism with or without tethered cord are rare lesions. These lesions are generally asymptomatic at birth, but with progression of time symptoms develop. These may be associated with various other anomalies. Not much have been reported in literature about cervical myelomeningocele (MMC) in adults or adolescents. We report a case of a 17 years old adolescent boy with cervical myelomeningocele with tethered cervical cord, who was completely intact neurologically even at this age and was without any associated anomaly. He came to us only for cosmetic reasons. The tethering band, which was evident on imaging was confirmed intra-operatively

What is in Name?

abstract An interesting and rare case of name syndrome is reported here. A young patient presented with stroke (left side hemiperesis due to cardiac embolic stroke) and cutaneous lesions. Further investigations revealed that left atrial myxoma was the cause of cardioembolic stroke. skin lesions were also present which included, nevi, ephelides and neurofibroma hence diagnosis of &quot;NAME sYNDROME&quot; was made

Predictability of STOP-Bang Questionnaire and Epworth Sleepiness Scale in Identifying Obstructive Sleep Apnoea against Polysomnography: A Cross-sectional Study

Introduction: Rising morbidty resulting from Obstructive Sleep Apnoea (OSA) is an emerging public health concern. The estimated prevalence of OSA in India has been investigated. STOP-Bang and Epworth Sleepiness Scale (ESS) have proven beneficial in identifying sleep breathing disorder. Validity of these questionnaire has been verified against polysomnography in many studies. Aim: To assess the predictive ability of STOP-Bang questionnaire and ESS in identifying OSA and comparing their efficacy with polysomnography. Materials and Methods: The cross-sectional study was conducted in the Department of Respiratory Medicine, Government Medical College, Kota, Rajasthan, India, from January 2020 to June 2021, among 100 patients with symptoms of OSA. The STOP-Bang questionnaires were administered to the patients, and scoring was done, followed by overnight attended polysomnography. The normality of data was tested by Shapiro Wilk’s test. The values obtained were statistically analysed and to compare the parameters between groups and with in groups for normal data parametric test One-way Analysis of Variance (ANOVA) followed by Tukey’s HSD test, for intragroup Paired t-test. Results: Mean age of the study population was 49.46±6.523 years, 79 were males and 21 females. Total, 79% of the subjects were males, and 21% of the study subjects were females. Among the 100, 65% had OSA as per polysomnography. STOP-Bang questionnaire had a higher sensitivity as compared to ESS in predicting OSA (75.38% for STOP-Bang and 72.31% for ESS). Conversely, the specificity of ESS (82.8%) was found to be greater than STOP-Bang (45.71%). Similar results were obtained for positive predictive value, in which ESS scored 88.6% while STOP-Bang scored 50%. For negative predictive values, ESS again scored higher (65%) than STOP-Bang (61.7%). Similarly, the Likelihood Ratio for a positive result (LR+) of ESS was greater than STOP-Bang (4.2 and 1.3 respectively). The STOP-Bang questionnaire, however, had higher Likelihood Ratio for a negative test (LR-) as compared to ESS (0.5 and 0.3 respectively). Conclusion: Polysomnography is the gold standard to diagnose OSA. For screening OSA, patients with symptoms of sleep disordered breathing, this study found that STOP-Bang questionnaire is better in identifying OSA as compared to ESS