A clinical study to compare drain versus no drain in post cesarean section

Background: Cesarean section is one of the commonest hospital based surgical procedure in obstetric mainly done to facilitate delivery in case where vaginal delivery is either not feasible or poses undue risk to mother, baby or both. The most common complications of CS are superficial surgical site complications including sepsis, seroma formation and breakdown.Methods: A prospective study done on 100 patients admitted in labour room of Department of Obstetrics and Gynaecology, Kamla Raja Hospital, G.R.M.C., Gwalior between November 2015 to March 2016. Study divided into two groups: group I, including women who had no subcutaneous drain left and group II, including women who had a subcutaneous drain left before closure of the skin; Each group has 50 patients. The study included term pregnant women with pre-operative Hb >9 gm%, BMI >30 kg/m2 and were taken for emergency cesarean sections (for cephaloppelvic disproportion, fetal distress, abnormal presentations) with no intraoperative complications (hemorrhage, blood transfusion).Results: VAS median grade in patients without drain was G3 (46%), followed by G2 (28%), G4 (14%). VAS median grade in with drain group was G2 (68%), followed by G1 (24%) and then G3 (08%). Wound infection was noted in 4 (08%) patients in both the groups. Both groups were administered same group of intravenous antibiotics for 5 days. The mean hospital stay in patients without drain were 9.4 days and patients with drain were 8.2 days. The mean haemoglobin in patient with drain was 8.6 gm% and patients without drain was 9.4 gm%. Wound seroma in 13 cases and superficial breakdown in 4 cases in non-drain group versus 5 cases and 2 cases in drain group respectively. There is significant difference in postoperative pain and non-significant difference in postoperative fever.Conclusions: Patients in with drain group have reduced rates of wound seroma, postoperative pain, shorter hospital stay, but there is insignificant benefit regarding post-operative fever, superficial SSI, wound breakdown and hemoglobin concentration

Study of correlation of ultrasonography with surgical evaluation of adnexal masses: a prospective study

Background: Adnexal masses are one of the most common pathologies among women of all age groups. Ovarian tumors, alone, represent two thirds of these cases. Malignant ovarian tumors are the fourth most common cause of death in women. Accurate diagnosis is required foremost for proper treatment and management of the patients.Methods: A prospective study done on 100 patients with adnexal masses presenting to Department of Obstetrics and Gynecology at Kamla Raja Hospital, G.R.M.C, Gwalior from February 2015 to August 2016. Firstly, the cases were studied by ultrasonography then intraoperatively and simultaneous sampling for HPE done. The study included women with clinical symptoms of pain abdomen/ discomfort, bleeding per vaginum, abdominal mass was subjected to ultrasonography, diagnosed with adnexal mass. 100 indicated patients were taken for surgery and intraoperative tissue and fluid samples were taken and sent for HPE.Results: No discordance found regarding laterality of adnexal masses between ultrasonographical findings and surgical findings. 69% cases were devoid of any septation/locules/nodules. Most common pathology found to be ectopic pregnancy. Most common benign ovarian mass encountered was serous cystadenoma (31.1%) and malignant mass was serous adenocarcinoma (12.7%). Apart from 13 malignant adnexal masses, 2 adnexal masses had malignant changes found on histopathological examination. 11 cases were found to be of advanced stage on surgical findings, which then confirmed by HPE.Conclusions: There is positive correlation between ultrasonographical and surgerical evaluation of adnexal masses. Correlation of the lesion’s location and appearance at imaging with the surgical findings will aid in the detection of potential pathology reporting errors

Cataloguing the bacterial diversity in the active ectomycorrhizal zone of Astraeus from a dry deciduous forest of Shorea

The plant microbiome has been considered one of the most researched areas of microbial biodiversity, yet very little information is available on the microbial communities prevailing in the mushroom's ectomycorrhizosphere. Ectomycorrhizal symbioses often result in the formation of a favourable niche which enables the thriving of various microbial symbionts where these symbionts endorse functions, such as quorum sensing, biofilm formation, volatile microbial compound (VOC) production, regulation of microbial gene expression, symbiosis and virulence. The identification of hidden uncultured microbial communities around the active ectomycorrhizal zone of Astraeus from dry deciduous sal forest of Jharkhand, India was carried out using MinION Oxford Nanopore sequencing of 16S rRNA amplicons genes. High richness of Operational Taxonomic Units (1,905 OTUs) was observed. We recorded 25 distinct phyla. Proteobacteria (36%) was the most abundant phylum, followed by Firmicutes (28%), Actinobacteria (10%) and Bacteroidetes (6%), whereas Gammaproteobacteria was the most abundant class of bacterial communities in the active ectomycorrhizal zone. The ectomycorrhizosphere soil has abundant phosphate-solubilising bacteria (PSB). This is the first report of the ectomycorrhizosphere microbiome associated with Astraeus