Successful conservative treatment of a caesarean scar twin pregnancy with systemically administered methotrexate and subsequent uterine artery embolization: a rare case report

Caesarean scar pregnancy is a very rare form of ectopic pregnancy. It complicates approximately 1 in 2200 pregnancies. However, it is becoming increasingly more frequent with the increasing number of caesarean sections performed each year. The recommended approach to treatment is therapeutic termination of pregnancy at the time of recognition. In this article, we present a case of caesarean scar pregnancy managed expectantly with Methotrexate and uterine Artery Embolization. We reported a case of 30 years old female, gravida 5, para1, live 1, abortion 3 with a previous history of caesarean section with GA of 8w5d/DCDA twin was admitted in view of low implantation of gestational sacs in lower uterine corpus. Trans vaginal ultrasound done and diagnosis of caesarean scar twin pregnancy was made. She was treated with Methotrexate 50 mg intramuscularly along with uterine artery embolization and follow up with beta HCG levels. Post embolization sac size was reduced and falling level of beta HCG values. Patient was discharged and follow-up with beta HCG level weekly. It is important for obstetrician and radiologist managing women with risk factor for a scar ectopic pregnancy to maintain a high index of suspicion during follow up. Failure to diagnose and initiate prompt management may lead to uterine rupture, massive Haemorrhage and maternal death

Population dynamics of exotic rugose spiralling whitefly, Aleurodicus rugioperculatus Martin (Hemiptera: Aleyrodidae) on coconut as influenced by weather factors and natural enemies

The rugose spiralling whitefly, Aleurodicus rugioperculatus Martin is a new exotic pest occurring in several crops including coconut since 2016 in India. Due to variation in the agro-climatic conditions of different regions, arthropods show varying trends in their incidence also in nature and extent of damage to the crop. Besides, abiotic factors also play a key role in determining the incidence and dominance of a particular pest and their natural enemies in a crop ecosystem. The population dynamics of new exotic whitefly species, A. rugioperculatus and their associated natural enemies was assessed on five-year-old Chowghat Orange Dwarf coconut trees at Coconut Farm of Tamil Nadu Agricultural University. The study indicated that RSW was found throughout the year on coconut and the observation recorded on weekly interval basis shows that A. rugioperculatus population escalated from the first week of July 2018 (130.8 nymphs/leaf/frond) reaching the maximum during the first week of October (161.0 nymphs/leaf/frond) which subsequently dwindled to a minimum during April. The parasitisation by E. guadeloupae on RSW ranged from 31.60 percent in Aug. 2018 to 57.60 percent in December 2018. The association of biotic and abiotic factors with A. rugioperculatus population showed a negative correlation with E. guadeloupae and C. montrouzieri. There was a significant positive correlation between maximum temperature and minimum temperature as well as relative humidity. However, rainfall showed a negative correlation with A. rugioperculatus population

Sequence variation in the haemagglutinin-neuraminidase gene of human parainfluenza virus type 3 isolates in the UK

The sequence variation in a 934 base-pair region of the gene encoding the haemagglutinin-neuraminidase of five human parainfluenza virus type 3 (HPIV3) isolates was determined together with that of a prototype UK strain. All of the clinical isolates were from the Manchester area of the UK and were obtained in 1990. 1991 and 1993. The gene segment was amplified by the polymerase chain reaction using HPIVB-specific oligonucleotide primers. The nucleotide homology of the strains was high, around 99% and specific differences in the UK sequences when compared with that of the US prototype strain were identified. In addition, a number of isolate-specific differences were seen. No correlation was detected between the observed nucleotide mutations and the year of isolation, which supports the hypothesis that HPIV3 shows cocirculation of a heterogeneous population of viruses rather than varying with time in a linear fashion. However, the data suggested that geographically-defined genetic lineages of HPIV3 may exist

Development of a New RP-UPLC Method for the Determination of Rabeprazole Sodium in Pharmaceutical Formulation and Application in Dissolution Studies

Purpose: To develop a reverse phase ultra-performance liquid chromatographic (RP-UPLC) method for the estimation of rabeprazole sodium in tablet formulations.Methods: Chromatographic separation was achieved on a Waters Acquity BEH C18 (50 x 2.1 mm, particle size 1.7 μm) column using an isocratic method with mobile phase composed of acetonitrile and phosphate buffer (pH 7.4) in the ratio of 35:65 (v/v). The flow rate was 0.4 ml/min, temperature of the column was maintained at ambient, injection volume was 5 μL and detection was made at 280 nm. The run time was as short as 2 min. Comparison of system performance with conventional HPLC was made with respect to analysis time, efficiency and sensitivity.Results: The developed method was linear for rabeprazole sodium from 0.03 - 30 μg/ml and the linear regression obtained was > 0.999. Precision, evaluated by intra- and inter-day assay,s had relative standard deviation (R.S.D) values within 1.5 %. Recovery data were in the range 98.0 - 101.5 % with R.S.D. values < 1.5 %.Conclusion: The method is precise, accurate, linear, robust and fast. The short retention time of 1.49 min allows the analysis of a large number of samples in a short period of time and, therefore, should be cost-effective for routine analysis in the pharmaceutical industry.Keywords: Ultra performance liquid chromatography, Assay, Rabeprazole sodium, Validatio

A rare case report of total uterine rupture from cervix to fundus in an unmarried teenage pregnancy

Uterine rupture is an uncommon and a life threatening obstetric complication. It is mainly a result of delivery by untrained personnel. This is a catastrophic situation where there is a high mortality rate for both the mother and the baby and a nightmare for the obstetrician also. There are many cases of uterine trauma reported in which there may be scar dehiscence, scar rupture, uterine rupture,perforation, cervical injuries, colporrhexis etc.This case report is regarding an unusual and rare presentation of a 19 year old unmarried girl who landed in our institution-a case of total and complete uterine rupture extending from cervix to fundus, a peculiar presentation, a hazardous result of Youtube delivery by her boyfriend highlighted. A scenario where the maternal anatomy totally distorted due to the trauma. This patient managed by immediate resuscitation and uterus reconstructive surgery successfully. In spite of  the advice not to conceive for the next few years, patient turned back to us in the late trimester within the next year itself, again a big challenge. Both the mother and baby managed successfully .With this case report we emphasize the need for immediate intervention in case of suspected uterine rupture and the possibility of successful subsequent pregnancy highlighted

Investigating the VLSI Characterization of Parallel Signed Multipliers for RNS Applications Using FPGAs

Signed multiplication is a complex arithmetic operation, which is reflected in its relatively high signal propagation delay, high power dissipation, and large area requirement. High reliability applications such as Cryptography, Residue Number System (RNS) and Digital Signal Processing (DSP)2019;s effective performance is mainly depend on its arithmetic circuit's performance. Trend of using Residue Number System (RNS) instead of Constrain over-whelming Binary representation is promising technique in VLSI Systems and Multiplier is the basic building block of such systems. In this paper we have considered signed Modified Baugh Wooley Multiplier and Modified Booth Encoding (MBE) Multiplier logic for analysis and synthesized on best suited application platform. Analysis has taken account of Delay, Number of Logic Element requirements; Number of Signal Transition for particular sample input and its Power Consumption were analyzed for both Modified Baugh Wooley Multiplier and Modified Booth Encoding Multiplier. Analysis of Multiplier is described in Verilog HDL and Simulated using two different simulators namely Xilinx ISIM and Altera Quartus II. Then for comparative study, both multipliers are synthesized with Xilinx Virtex 7 XCV2000T-2FLG1925 and Altera Cyclone II EP2C35F672C6 and same parameter as discussed above are also evaluated. Booth Recoding provides overall advent of 9.691% in terms of area and approximately 43 % in terms of Delay compared to Modified Baugh Wooley Multiplier implemented using FPGA Technology

Retrospective analysis of conservatively treated thoracolumbar burst fracture

Background: Thoracolumbar burst fractures accounts for 10 to 40 percent of the spinal column fractures caries a significant morbidity and mortality. Vertebral fractures are usually followed by chronic pain, deformity, loss of height and crowding of internal organs. A combination of the above problems can adversely affect the self-esteem and ability to carry on the daily activities.The objective of the study was to find proportion of the conservatively treated thoracolumbar burst fracture and the factors associated with the final outcome of the treatment with the clinical, radiological evidences.Methods: In this study 36 patients with burst fracture of thoracolumbar spine without neurological deficit, treated conservatively from January 2015–August 2016 were included. The overall follow up period was 18 months. Various radiological parameters were taken in to consideration like Cobb angle, canal stenosis, sagittal alignment, and fragment displacement. Treatment outcome was evaluated by short form survey questionnaire (SF-36), Denis score for pain and work and the visual analogue scale (VAS).Results: The overall functional outcome in this study group 30.55% returned to the previous employment. 25% back to their previous job with restrictions.27.7% unable to return to the previous job but works fulltime in a new job. 16.7% unable to return to full time work. No one is completely disabled. The Cobb angle remains same or decreased in 53% and in 47% with minimum -8 maximum 5. The severe pain score was in 5.6% of cases. Conclusions: Proper selection of patients and their prior activities, social and educational background and future plans in addition to a thorough physical, neurological and spinal examination are mandatory to achieve satisfactory result