Microperforate hymen with infertility: rare case report

Female genital tract anomalies are rare but may have a serious impact on the reproductive health. Here we are going to discuss a rare case of pin point hymenal opening. Here the patient presented to us with primary infertility. She presented to a health care centre for the first time therefore she had never been examined. After all the initial investigations a diagnosis of micro perforate hymen was made. She was posted in OT for hymenectomy. She underwent excision of the hymenal tissue and the edges were sutured to the introitus to prevent reclosure of the hymen. She had an uneventful postoperative period. Patient was discharged after complete recovery at 5th post-operative day. She resumed sexual functions 6 weeks after the surgery. These anomalies usually require surgical interventions. Correct surgical intervention is required for a better psychological and reproductive health

Causes of stillbirth according to different gestational ages

Background: Stillbirth is one of the most common yet the most poorly studied adverse outcome of pregnancy. Objective of present study was to determine the risk factors and prevalence of stillbirth at Department of Obstetrics and Gynecology, Kamla Nehru State Hospital, for Mother and Child, Indira Gandhi Medical College, Shimla, Himachal Pradesh.Methods: A prospective non-interventional study was conducted with effect from 1st August 2015 to 31st July 2016, during which all the intrapartum and antepartum stillbirths were enrolled.Results: During the study period total number of stillbirth were 94 and the total number of live births were 6412, giving a stillbirth rate of 14.66/1000 live births. The perinatal mortality was 22.1/1000 births. The most common cause of stillbirth as revealed in the study was hypertensive disorder.Conclusions: The stillbirth rate in the study was higher than the stillbirth rate of developed countries. Improvement of socioeconomic conditions, literacy and health education among women will definitely be important to curb the staggeringly high stillbirth rate, but the need of the hour is to deploy adequate number of dedicated skilled providers

Analysis of Intermediary Liability

Today’s digital era brings with it an expanding online world which needs special laws for the protection of its users from various forms of criminal acts. New challenges arise especially in the context of copyright infringement as now anyone and everyone has the tools to copy and distribute copyrighted content to the masses across the world with a mere click. Technology allows users to stay anonymous and commit such acts at no additional costs to them and at huge perils of the intellectual property rights holders. To overcome this problem and to offer substantial reliefs to the rights holders, the legal liability is placed upon the intermediaries who allow and at times facilitate such wrongs. This is known as intermediary liability

Women Are More Susceptible to Caries but Individuals Born with Clefts Are Not

The identification of individuals at a higher risk of developing caries is of great interest. Isolated forms of cleft lip and palate are among the most common craniofacial congenital anomalies in humans. Historically, several reports suggest that individuals born with clefts have a higher risk for caries. Caries continues to be the most common infectious noncontagious disease worldwide and a great burden to any health system. The identification of individuals of higher susceptibility to caries is of great interest. In this paper, we assessed caries experience of 1,593 individuals from three distinct populations. The study included individuals born with clefts, their unaffected relatives, and unrelated unaffected controls that were recruited from areas with similar cultural pressures and limited access to dental care. DMFT/dmft scores were obtained, and caries experience rates were compared among the three groups in each geographic area. Individuals born with clefts did not present higher caries experience in comparison to their unaffected relatives or unrelated unaffected controls. Women tend to present higher caries rates in comparison to men. Our work provides strong evidence that individuals born with clefts are not at higher risk to caries; however, women tend to have more severe caries experience

Women are more susceptible to caries but individuals born with clefts are not

The identification of individuals at a higher risk of developing caries is of great interest. Isolated forms of cleft lip and palate are among the most common craniofacial congenital anomalies in humans. Historically, several reports suggest that individuals born with clefts have a higher risk for caries. Caries continues to be the most common infectious noncontagious disease worldwide and a great burden to any health system. The identification of individuals of higher susceptibility to caries is of great interest. In this paper, we assessed caries experience of 1,593 individuals from three distinct populations. The study included individuals born with clefts, their unaffected relatives, and unrelated unaffected controls that were recruited from areas with similar cultural pressures and limited access to dental care. DMFT/dmft scores were obtained, and caries experience rates were compared among the three groups in each geographic area. Individuals born with clefts did not present higher caries experience in comparison to their unaffected relatives or unrelated unaffected controls. Women tend to present higher caries rates in comparison to men. Our work provides strong evidence that individuals born with clefts are not at higher risk to caries; however, women tend to have more severe caries experience.Instituto Multidisciplinario de Biología Celula

Bronchiectasis in India:results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry

BACKGROUND: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India. METHODS: The Indian bronchiectasis registry is a multicentre, prospective, observational cohort study. Adult patients ( 6518 years) with CT-confirmed bronchiectasis were enrolled from 31 centres across India. Patients with bronchiectasis due to cystic fibrosis or traction bronchiectasis associated with another respiratory disorder were excluded. Data were collected at baseline (recruitment) with follow-up visits taking place once per year. Comprehensive clinical data were collected through the European Multicentre Bronchiectasis Audit and Research Collaboration registry platform. Underlying aetiology of bronchiectasis, as well as treatment and risk factors for bronchiectasis were analysed in the Indian bronchiectasis registry. Comparisons of demographics were made with published European and US registries, and quality of care was benchmarked against the 2017 European Respiratory Society guidelines. FINDINGS: From June 1, 2015, to Sept 1, 2017, 2195 patients were enrolled. Marked differences were observed between India, Europe, and the USA. Patients in India were younger (median age 56 years [IQR 41-66] vs the European and US registries; p<0\ub70001]) and more likely to be men (1249 [56\ub79%] of 2195). Previous tuberculosis (780 [35\ub75%] of 2195) was the most frequent underlying cause of bronchiectasis and Pseudomonas aeruginosa was the most common organism in sputum culture (301 [13\ub77%]) in India. Risk factors for exacerbations included being of the male sex (adjusted incidence rate ratio 1\ub717, 95% CI 1\ub703-1\ub732; p=0\ub7015), P aeruginosa infection (1\ub729, 1\ub710-1\ub750; p=0\ub7001), a history of pulmonary tuberculosis (1\ub720, 1\ub707-1\ub734; p=0\ub7002), modified Medical Research Council Dyspnoea score (1\ub732, 1\ub725-1\ub739; p<0\ub70001), daily sputum production (1\ub716, 1\ub703-1\ub730; p=0\ub7013), and radiological severity of disease (1\ub703, 1\ub701-1\ub704; p<0\ub70001). Low adherence to guideline-recommended care was observed; only 388 patients were tested for allergic bronchopulmonary aspergillosis and 82 patients had been tested for immunoglobulins. INTERPRETATION: Patients with bronchiectasis in India have more severe disease and have distinct characteristics from those reported in other countries. This study provides a benchmark to improve quality of care for patients with bronchiectasis in India. FUNDING: EU/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis Consortium, European Respiratory Society, and the British Lung Foundation

Women are more susceptible to caries but individuals born with clefts are not

The identification of individuals at a higher risk of developing caries is of great interest. Isolated forms of cleft lip and palate are among the most common craniofacial congenital anomalies in humans. Historically, several reports suggest that individuals born with clefts have a higher risk for caries. Caries continues to be the most common infectious noncontagious disease worldwide and a great burden to any health system. The identification of individuals of higher susceptibility to caries is of great interest. In this paper, we assessed caries experience of 1,593 individuals from three distinct populations. The study included individuals born with clefts, their unaffected relatives, and unrelated unaffected controls that were recruited from areas with similar cultural pressures and limited access to dental care. DMFT/dmft scores were obtained, and caries experience rates were compared among the three groups in each geographic area. Individuals born with clefts did not present higher caries experience in comparison to their unaffected relatives or unrelated unaffected controls. Women tend to present higher caries rates in comparison to men. Our work provides strong evidence that individuals born with clefts are not at higher risk to caries; however, women tend to have more severe caries experience.Instituto Multidisciplinario de Biología Celula

Microperforate hymen with infertility: rare case report

Female genital tract anomalies are rare but may have a serious impact on the reproductive health. Here we are going to discuss a rare case of pin point hymenal opening. Here the patient presented to us with primary infertility. She presented to a health care centre for the first time therefore she had never been examined. After all the initial investigations a diagnosis of micro perforate hymen was made. She was posted in OT for hymenectomy. She underwent excision of the hymenal tissue and the edges were sutured to the introitus to prevent reclosure of the hymen. She had an uneventful postoperative period. Patient was discharged after complete recovery at 5th post-operative day. She resumed sexual functions 6 weeks after the surgery. These anomalies usually require surgical interventions. Correct surgical intervention is required for a better psychological and reproductive health

Causes of stillbirth according to different gestational ages

Background: Stillbirth is one of the most common yet the most poorly studied adverse outcome of pregnancy. Objective of present study was to determine the risk factors and prevalence of stillbirth at Department of Obstetrics and Gynecology, Kamla Nehru State Hospital, for Mother and Child, Indira Gandhi Medical College, Shimla, Himachal Pradesh.Methods: A prospective non-interventional study was conducted with effect from 1st August 2015 to 31st July 2016, during which all the intrapartum and antepartum stillbirths were enrolled.Results: During the study period total number of stillbirth were 94 and the total number of live births were 6412, giving a stillbirth rate of 14.66/1000 live births. The perinatal mortality was 22.1/1000 births. The most common cause of stillbirth as revealed in the study was hypertensive disorder.Conclusions: The stillbirth rate in the study was higher than the stillbirth rate of developed countries. Improvement of socioeconomic conditions, literacy and health education among women will definitely be important to curb the staggeringly high stillbirth rate, but the need of the hour is to deploy adequate number of dedicated skilled providers