Incidental finding of thoracic outlet syndrome in a case of right tubal ruptured ectopic pregnancy

A 30-year-old woman, (multigravida) suffering from lower abdominal pain and slight vaginal bleeding was transferred to our hospital. She came with a pelvic ultrasound report. The provisional diagnosis of right tubal ectopic pregnancy was made. A laparotomy was carried out. Intraoperatively, blood pressure in both the arms were taken which revealed different blood pressure in different arms. A diagnosis of thoracic outlet syndrome was made. No postoperative complications were observed.

Correlation of ultrasound, hysteroscopic and endometrial histopathology findings in patients with post-menopausal bleeding

Background: To study endometrial changes by hysteroscopy and ultrasonography in women presenting with postmenopausal bleeding and correlate it with histopathological endometrial findings.Methods: This was prospective observational study carried out in the Department of Obstetrics and Gynaecology at Lokmanya Tilak Municipal Medical College and General Hospital. The materials for the present study included patients diagnosed with postmenopausal bleeding visited to a Municipal Tertiary care centre and teaching institute in between January 2019 to June 2020. Total 51 eligible patients were evaluated.Results: In this study, on TVS examination, maximum patients 45.10% were having endometrial thickness in between 6-12mm. On hysteroscopy, 35.29% of the patients were having atrophic endometrium which was the most common finding followed by Endometrial Hyperplasia in 29.41% patients. The most common histopathological finding was atrophic endometrium in 41.18% patients followed by endometrial hyperplasia in 23.53% patients. In TVS, lowest sensitivity and lowest specificity was in case of Atrophic Endometrium and highest sensitivity and highest specificity was in case of fibroid. In Hysteroscopy, lowest sensitivity was in case of carcinoma and lowest specificity was in case of Endometrial Hyperplasia and highest sensitivity was in case of fibroid and highest specificity was in case of fibroid and carcinoma.Conclusions: Hence from this study, hysteroscopy is found to be an easy, safe, alternative and effective means to investigate postmenopausal women with a thickened endometrium found on TVS. Hysteroscopy guided biopsy in postmenopausal women with uterine bleeding decreases the risk of false negative histopathological report which is more commonly found in blind dilatation and curettage. This is also a useful method of visualizing the uterine cavity pathologies.

Impact of COVID-19 infection on maternal near miss cases in tertiary care centre

Background: The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has exposed vulnerable populations to a health crisis. Since the beginning of the severe acute respiratory syndrome (SARS-CoV-2) or COVID-19 outbreak, it has been argued whether pregnant women are at increased risk of severe infection.1 The objective of this study was to summarize the effect of COVID-19 on maternal near miss cases.Methods: This single-centre prospective observational study, included all consecutive pregnant women with COVID-19 infection admitted to Lokmanya Tilak Municipal Medical College and General Hospital (Mumbai, India), a tertiary referral hospital, from 1 April 2020, to 20 December 2020. In this study, a total of 46 patients were included in near miss cases, who required ICU admission with severe morbidity. Of these, 8 patients were COVID-19 positive and remaining 38 patients were included in control group (COVID-19 negative). The course of each of their stay in ward was noted and findings were compared in both the groups. Results: During their course in ICU it was found that 6 COVID-19 patients had maternal death representing 75% and 12 non-COVID-19 patients had maternal death representing 31.57%.  Conclusions: The mortality rate from the above results concludes that in this study mortality appeared to be higher in COVID-19 infection. Multi-centre retrospective analysis with larger population size is required in order for this to be statistically significant

Survey on common practice in management of preeclampsia by obstetricians

Background: Approximately 72,000 pregnant women all over the world die every year due to direct or indirect complications related to eclampsia and severe preeclampsia. Incidence of hypertensive disorders in pregnancy in India is found to be 10.08% as per the data collected by the National Eclampsia Registry (NER). Here we present the results of a survey conducted among obstetricians in India to know the common practices in the management of pre-eclampsia followed in our country.Methods: Observational study of survey which was conducted for the period of 1 month from 22nd May 2020 to 22nd June 2020. Questionnaire was prepared on surveyheart.com and sent to obstetricians via Social media platforms to the members of FOGSI. all answers 'collected' and results were prepared from given answers. The survey was answered online by 289 obstetricians.Results: For mild to moderate pre-eclampsia Labetalol is still first line antihypertensive agent being used by many of the obstetricians. In our study also we found out Tab Labetalol 100mg BD is the most preferred type (278, 96.19%) of first line anti-hypertensive in cases of pre-eclampsia followed by Cap Nifedipine 5mg QID and Tab Amlodipine 5mg OD respectively.Conclusions: Comprehensive educational efforts and skill building modules are need of hour to keep every practicing obstetrician regarding recent advances in standard practice protocols.With close monitoring of all cases and well selected anti-hypertensive treatment, it is possible to achieve favourable outcomes for the mother and the baby

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Are female sex workers able to negotiate condom use with male clients? The case of mobile FSWs in four high HIV prevalence states of India

Introduction: Condom promotion among female sex workers (FSWs) is a key intervention in India’s National AIDS Control Program. However, there is limited understanding of how FSWs negotiate condom use with male clients, particularly in the context of their mobility for sex work. The objective of this study is to examine the factors associated with the mobile FSWs’ability to refuse unsafe sex and successfully negotiate condom use with unwilling male clients. Methods: Data for 5498 mobile FSWs from a cross-sectional survey conducted in 22 districts of four states in southern India were analyzed. Questions assessed FSWs’ ability to refuse clients unprotected sex, convince unwilling clients for condom use and negotiate condom use in a new location. Logistic regression models were constructed to examine the association between socio-demographics, economic vulnerability, sex work practice, and program exposure and condom negotiation ability. Results: A majority of FSWs (60%) reported the ability to refuse clients for unprotected sex, but less than one-fifth reported the ability to successfully convince an unwilling client to use a condom or to negotiate condom use in a new site. Younger and older mobile FSWs compared to those who were in the middle age group, those with longer sex work experience, with an income source other than sex work, with program exposure and who purchased condoms for use, reported the ability to refuse unprotected sex, to successfully negotiate condom use with unwilling clients and to do so at new sites. Conclusion: FSWs need to be empowered to not only refuse unprotected sex but also to be able to motivate and convince unwilling clients for condom use, including those in new locations. In addition to focusing on condom promotion, interventions must address the factors that impact FSWs’ ability to negotiate condom use

Degree of male mobility as a risk factor for HIV in high in-migration districts of Maharashtra, India

Background: Mobile males are vulnerable to HIV and are potential bridge for HIV transmission to their sex partners, including spouses. To understand how mobility accentuates vulnerability to HIV, we assessed the association of degree of male mobility with paid sex, alcohol use and condom use at all places visited by migrants in past two years. Methods: A cross-sectional survey was done among male migrant workers [n = 2991] in five high in-migration districts of Maharashtra in India during 2007–08. Results: Multivariate logistic regression analysis revealed that higher mobility [moving 3+ places in the past two years] was associated with “sexual debut” in paid sex [3.7% Vs 6.9%, AOR = 1.70, p \u3c 0.001] and having sex with sex worker at the current place of destination [8.7% Vs 16.9%, AOR = 2.10, p \u3c 0.001], at the previous place of destination [7.2% Vs 15.1%, AOR = 2.05, p \u3c 0.001], and at the place of origin [0.6% Vs 1.6%, AOR = 2.31, p \u3c 0.001]. However, higher mobility was associated with unpaid sex with non-marital female partners [28.4% Vs 37.2%, AOR = 1.48, p \u3c 0.001] and less consistent condom use at the current place [26.6% Vs 23.4%, AOR = 0.45, p \u3c 0.05] as well as at place of origin [12.2% Vs 7.2%, AOR = 0.48, p \u3c 0.01]. In addition, alcohol use prior to sex was more among more mobile migrants relative to less mobile migrants at current place [6.1% Vs 11.2%, AOR = 1.82, p \u3c 0.001] and previous place [7.0% Vs 13.0%, AOR = 1.77, p \u3c 0.001] of destination. Conclusion: Findings suggest that compared to the less mobile, highly mobile men report higher HIV risk behaviours: paid sex, alcohol use prior to paid sex and inconsistent condom use, at all locations along the routes of mobility. Interventions need to target men who are highly mobile along the routes of mobility and not at destination sites alone

Unadjusted percent and adjusted odds ratios predicting female sex workers’ ability to negotiate condom use and to refuse unsafe sex by socio-demographic and behavioral characteristics as the predictor variables, India.

1<p>OR: Odds Ratio. CI: Confidence Interval.</p

Female sex workers’ socio-demographic characteristics by age, India.

<p>Female sex workers’ socio-demographic characteristics by age, India.</p