Traumatic avulsion of female urethra: a case report

Traumatic female urethral avulsion in the absence of a pelvic fracture is an exceedingly rare entity. We report a case of 26 years old lady with crescentic tear of anterior urethra from pubic symphysis. Management consisted of primary urethral repair

Pregnancy with lupus nephritis: a case report

Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disorder that commonly affects women of childbearing age. Lupus nephritis in pregnancy increases risk of maternal and fetal morbidity and mortality. Active disease during pregnancy and disease flares can lead to poor outcome. Higher rates of fetal loss, preterm birth, intra-uterine growth restriction (IUGR), and neonatal lupus syndromes, gestational diabetes, osteoporosis, avascular necrosis, hypertension, preeclampsia, ecclampsia, stroke, HELLP syndrome, and maternal death are major issues. There is difficulty in recognizing disease flare because of normal physiological changes during pregnancy. Preeclampsia mimics disease symptoms of lupus nephritis and presents confusion in diagnosis. Management option is limited to few safer drugs. Lupus nephritis with antiphospholipid antibodies presents with refractory fetal loss and complete heart block associated with anti-Ro antibodies. A multidisciplinary approach, with close medical, obstetric and neonatal monitoring, is essential for optimal outcomes. Our aim is to report a case of primigravida 37 years old with controlled lupus nephritis

Sustainable dyeing of wool fabric with Talaromyces purpurogenus

Natural dyes had been used by human being since ancient times for colouring of various materials including textiles. These were replaced completely by synthetic dyes, continuous use of which created the problem of pollution and environmental degradation. With the development of green technology and increased awareness of sustainability, the use of non-allergic, non-toxic and eco-friendly natural dyes on textiles has become a matter of significant importance. Among the natural sources of colourants, microorganisms such as bacteria and fungi have gained interest in the field of textile coloration.  In the present study, the pigment solution yielded from growth of Talaromyces purpurogenus sp. on organic waste was used for dyeing of wool fabric. Under the dyeing conditions i.e. 1:30 M:L ratio, pH 5, 80º C temperature and 45 minutes dyeing time, the percent absorption could reach 57 %, 32%, 36% and 49% respectively. The wool fabric samples dyed with the fungal dye exhibited very good to excellent washing and rubbing fastness properties. The colour pigment obtained from fungal thus offered an opportunity to reduce impact on plant resources for dye source exploration. So it can be concluded from the study that a natural fungal dye could help to sustain the environment and to minimize the over exploitation of natural resources

Maternal and perinatal outcome in a pregnancy with nephrotic syndrome

The influence of pregnancy on the subsequent course of pre-existing nephrotic syndrome is controversial as also the effect of membranous glomerulonephritis on maternal and perinatal outcome. We describe a case of successful pregnancy outcome in Hepatitis B reactive patient with pre-existing nephrotic syndrome (renal biopsy proven case of Membrano-proliferative Glomerulonephritis). She had regular nephrology consultation and her renal disease was well compensated. After sonographic confirmation of live intrauterine pregnancy at 9th gestational week, patient was given methylprednisolone (5mg once daily). Antihypertensive drugs were also given. At 35 weeks of gestation, patient went in labour and cesarean section was performed in view of previous caesarean section. Feto-maternal outcome was good. The intrapartum and postpartum period was uneventful. Renal functions were well preserved. A vigourous healthy 1.93 kg baby was discharged with mother in a stable condition after receiving hepatitis B immunoglobulin

Therapeutic plasma exchange for early aggressive management of post-partum hemolytic uremic syndrome: a tertiary care centre experience

Postpartum hemolytic uremic syndrome is an unusual condition of obscure origin that manifests with hemolytic anemia, thrombocytopenia and acute renal failure after delivery. We describe a case of 28 year old woman referred to our hospital in view of severe renal failure, 24 hours after the delivery by caesarean section for scar rupture and placental abruption. She was in a delirious state and had anuria, severe anemia and moderate thrombocytopenia. After many diagnostic dilemmas, a final diagnosis of hemolytic uremic syndrome was made. Aggressive treatment with plasma exchange in conjunction with hemodialysis was started. Fresh frozen plasma was used for replacement and four consecutive plasmapheresis sessions were instituted. Simultaneously steroids and anti-hypertensive drugs were given. Two weeks later, quick clinical and laboratory response was noted. There was significant improvement in renal functions along with resolution of signs of active hemolysis. This case collaborates with the ideal scenario involving prompt diagnosis and early aggressive treatment with plasma exchange in a postpartum hemolytic uremic syndrome patient

Effect of Low-level LASER Therapy on P6 Acupoint to Control Gag Reflex in Children: A Clinical Trial

Objective: To investigate the effect of low level laser therapy (LLLT) on PC6 acupuncture point in suppressing gag reflex, regulating pulse rates and oxygen saturation, thereby reducing the anxiety levels. Materials and Method: A total of 40 patients who demonstrated hyperactive gag reflex in the age group of 4-14 years were included in the study. In Group A (20 patients), maxillary impression was recorded. In the second step, PC6 acupuncture point was stimulated with LLLT followed by recording of second maxillary impression. In group B (20 patients), steps were reversed. Gag reflex, anxiety levels, pulse rate and oxygen saturation levels were assessed. Results: Values of pulse rate and oxygen saturation were regulated to normal, signifying lowered anxiety levels. Gag reflex was also significantly decreased after stimulating PC6 acupuncture point with LLLT. Conclusion: LLLT on PC6 point was found to be effective in lowering anxiety levels as observed by faces modified anxiety rating scale. Further, it was authenticated as the pulse rates were significantly reduced and oxygen saturation levels were significantly increased. Also, gag reflex was significantly controlled when LASER stimulation was done at PC6

A prospective case–control trial to evaluate and compare the efficacy and safety of atosiban versus placebo in In vitro Fertilization-embryo transfer program

Background: Recent developments in assisted reproductive technology focus on potential advances to improve its success rate. Atosiban, a combined oxytocin/vasopressin V1a receptor antagonist, is a novel class of drug involved in basic priming of the uterus for successful implantation during embryo transfer (ET). Objectives: The objective of this study is to evaluate the efficacy of atosiban (study group) in ET patients in comparison to placebo (control group) regarding implantation rate (IR), clinical pregnancy rate (CPR), and ongoing pregnancy rate and to assess the safety profile of atosiban. Materials and Methods: A total of 320 women undergoing in vitro fertilization-ET at a tertiary care hospital were enrolled in the study. In the study group, atosiban was given as initial intravenous (IV) bolus injection 0.9 ml (6.75 mg), 30 min before ET followed by continuous IV infusion of atosiban. In the control group, placebo (normal saline) was infused at the same rate and dose. Pregnancy was confirmed 14 days after ET by β-human chronic gonadotropin level. IR and CPR were determined by doing transvaginal sonography 3 weeks and 6 weeks postET, respectively. Results: In women with atosiban treatment, the positive pregnancy rate and CPRs were 41.25% and 36.25%, respectively. The IR per embryo transferred was 17.5%. No major side effects of atosiban were noted among enlisted patients. The miscarriage rate and ectopic pregnancy rate were low (12.12% and 4.54%, respectively). Forty-two women had singleton gestation, while twin and triplet pregnancies were encountered in 13 and 3 women, respectively. No congenital anomalies were observed during an antenatal scan at 18–20 weeks in ongoing pregnancies. The positive pregnancy rate, the CPR, and the IR in the control group was 35%, 30%, and 16.5%, respectively, which was significantly lower than the atosiban group. Conclusion: Atosiban reduces uterine contractions and increases endomyometrial perfusion, both of which have potential benefits regarding improved IRs, CPR, and ongoing pregnancy rates. Atosiban has a good embryonic safety profile

Forgotten Lippes loop in menopausal woman left in utero for 45 years: a case report

Intrauterine contraceptive devices are extremely effective and long lasting. They were intended for long term use and were retained for year’s altogether. Menopausal ladies often present with Lippes Loop in situ either deliberately or forgotten. We report a case of 80 years old patient who came with complaints of pain in lower abdomen and vaginal discharge and had Lippes Loop insitu, which was inserted 45 years back. The inserted Lippes Loop thread was not seen in clinical examination but visualized on Transvaginal Ultrasonography along with pyometra. It was removed under hysteroscopic guidance

Forgotten Lippes loop in menopausal woman left in utero for 45 years: a case report

Intrauterine contraceptive devices are extremely effective and long lasting. They were intended for long term use and were retained for year’s altogether. Menopausal ladies often present with Lippes Loop in situ either deliberately or forgotten. We report a case of 80 years old patient who came with complaints of pain in lower abdomen and vaginal discharge and had Lippes Loop insitu, which was inserted 45 years back. The inserted Lippes Loop thread was not seen in clinical examination but visualized on Transvaginal Ultrasonography along with pyometra. It was removed under hysteroscopic guidance