Relationship and effect of duration of first stage of labor on second stage

Background: Objective: To evaluate the relationship and effect of first stage of labor on second stage.Methods: It was a prospective, observational study. A total of 132 subjects with cephalic presentation at or from 4 cm dilatation with or without intact membrane were included in the study. Women with more than 4 cm dilation were excluded from the study. The duration and complications of second stage were correlated with the duration of first stage.Results: Out of 132 subjects, duration of labor was less than 3 hours in 79 subjects of which 52 (65.8%) had shorter (less than 30 minutes) second stage. The duration of first stage was between 6 and 9 hours in 10 subjects of which 9 (90% had longer (more than 30 minutes) second stage and 4 subjects had first stage lasting more than 9 hours of which 3 (75%) had second stage lasting more than 1 hour. These findings were statistically significant (P = 0.001). As the duration of first stage increased the incidence of instrumental delivery was also increased however this was statistically not significant.Conclusions: As the duration of first stage increases the duration of second stage and the incidence of instrumental/caesarean delivery increases

Successful maternal and fetal outcome in patients with Takayasu arteritis: two case reports of Type I and Type IV in stage 2

Takayasu's arteritis, is a rare, chronic, idiopathic, inflammatory disease of the large arteries, primarily involves the aorta, its main branches as well as the coronary and pulmonary arteries. It is mostly seen among women with child bearing age group (80%). During pregnancy, the increased intravascular volume impair circulation and exacerbate aortic regurgitation, hypertension, and congestive heart failure. Hypertension is one of the serious complication that can develop, leading to intrauterine growth restriction, maternal heart failure, and fetal haemorrhage and during postpartum period

Epithelioid leiomyosarcoma: a rare uterine cancer

A uterine epithelioid leiomyosarcoma is a rare malignant tumour that arises from the smooth muscle lining the walls of the uterus. The exact cause of leiomyosarcoma, including uterine leiomyosarcoma accounting for 5 to 10% is unknown. Leiomyosarcoma is the most common subtype of uterine sarcoma, accounts for 1-2% of uterine malignancies. Malignancy should be suspected in menopausal women with tumour growth who are not on hormonal replacement therapy. A 64-year-old female had attained menopause 16 year back and developed postmenopausal bleeding since 2 months, with palpable mass, of 16 weeks size. Ultrasonography showed whorled mass lesions, endometrium and myometrium could not be seen separately. Uterus with both ovaries removed. Intra-operative findings showed 16 weeks uterine mass with size 15×10.5×10cm and weight 1kg with intramural fibroid. Necrotic and haemorrhagic areas with degenerative changes seen on cut section suggestive of malignancy. Histopathology and immunohistochemistry reported epithelioid leiomyosarcoma

Pelvic schwannoma mimicking as an adnexal mass

Schwannoma (neurilemmomas), a peripheral nerve sheath tumour generally occurs on the head and neck region, their pelvic occurrence is much rare. Retroperitoneal schwannomas are the rarest of all retroperitoneal tumours. We report a 45 year woman with a schwannoma in the retro peritoneum that was preoperatively diagnosed as an adnexal mass

Sonographic assessment of fetal head deflexion using occiput: spine angle measured during first stage of labour and its role in predicting the mode of delivery among nulliparous women

Background: The attitude of the fetal head during labour significantly influences the progress and outcome of delivery and is mainly diagnosed by vaginal examination during labour. The aim of the study was to quantify the extent of deflexion of the fetal head by measuring the fetal occiput spine angle (OSA) through transabdominal ultrasonography in the first stage of labour and to determine whether the fetal OSA can predict the mode of delivery.Methods: We conducted a prospective observational study on 145 nulliparous uncomplicated singleton pregnant women without occiput-posterior position of the fetus during active labour. The OSA was measured as the angle between the two tangential lines to the occipital bone and the vertebral body of the first cervical spine, during active labour and monitored until delivery. Intra- and interobserver reproducibility of the OSA measurement and the correlation between the OSA and mode of delivery were also evaluated.Results: For the study population, the mean value of the OSA measured in the active phase of the first stage was 124.2±11.5⁰. The OSA measurement showed excellent intraobserver agreement (r = 0.82; 95% confidence interval [95% CI] 0.70-0.80) and fair-to-good interobserver agreement (r = 0.62; 95% CI 0.51-0.71).  The mean OSA was significantly less for the group of patients who required conversion to cesarean section due to labour arrest (n=32) as compared to those who had vaginal delivery (n=113) (116.25±9.2⁰ versus 126.53±11.1⁰, P<0.01). An OSA of ≥121° was associated with vaginal delivery in 80.5% (91/113) of women, whereas 87.5% (28/32) of the women who delivered by cesarean section had an OSA <121⁰.Conclusions: Measurement of the OSA, by sonography is feasible, reproducible and an objective tool to assess the degree of fetal head deflexion during labour and to predict the mode of delivery

Synthesis, Spectral Characterization and Antimicrobial Studies of Co(II) Complexes with Tetradentate Schiff bases Derived from Ortho-Phthalaldehyde

A series of cobalt (II) complexes have been synthesized with Schiff bases derived from ortho-phthalaldehyde and various amines in aqueous methanol solution. The newly synthesized Schiff bases and their Co (II) complexes have been characterized  by elemental analysis, magnetic susceptibility, thermal, conductance measurements, mass, IR, electronic, 1H,13C-NMR spectral techniques. These ligands act as tetradentate species and coordinate to the metal center through the different potential donor atoms such as N, O and S. The probable octahedral structures have been assigned to these complexes. All the synthesized Schiff base ligands and Co(II) metal complexes have also been screened for their antimicrobial activities and metal complexes found to be more active than respective Schiff-base ligands

Digital Pathology in Healthcare: Current Trends and Future Perspective

Diagnosing a disease requires observing the affected tissues and drawing conclusions based on specific known features. Conventionally, a pathologist would diagnose the sample manually by placing it on a glass slide and viewing it under the microscope. These microscopes existed 400 years ago, but over the years, there have been modifications aimed at digitizing every possible diagnostic test. One of the major advantages of digitizing the process is the reduced time consumption for acquiring, processing, and analyzing the slides. Another positive aspect is the reduction in subjectivity achieved by utilizing artificial intelligence (AI) algorithms to classify and diagnose specific diseases. This is achieved by attaching a digital camera to the microscope, which captures images of the glass slides for subsequent processing and diagnosis. There has been a lot of research in this field, but its implementation has been hindered by challenges such as interoperability and high-resolution data, resulting in large file sizes. Various applications for whole slide imaging, such as disease diagnosis techniques, whole slide imaging (WSI) scanners, digital slide scanners, the Internet of Things (IoT), and AI, have been explored in this study. This paper reviews the trends and evolution of microscopes leading to present-day digital pathology scanners, with a major focus on one of the digital techniques, which is whole slide imaging. It also explores various areas where AI has been integrated into whole-slide imaging

Direct observation of nanometer-scale pinning sites in (Nd0.33_{0.33},Eu0.20_{0.20},Gd0.47_{0.47})Ba2_2Cu3_3O7−δ_{7-\delta} single crystals

We report on the observation of self-organized stripe-like structures on the as-grown surface and in the bulk of (Nd,Eu,Gd)Ba$_2$Cu$_3$O$_y$ single crystals. The periodicity of the stripes on the surface lies between 500 and 800 nm. These are possibly the growth steps of the crystal. Transmission electron microscopy investigations revealed stripes of periodicity in the range of 20 to 40 nm in the bulk. From electron back scattered diffraction investigations, no crystallographic misorientation due to the nanostripes has been found. Scanning tunneling spectroscopic experiments revealed nonsuperconducting regions, running along twin directions, which presumably constitute strong pinning sites.Comment: 4 pages, 5 Figure

Role of magnetic resonance imaging in distinguishing fungal from nonfungal multiple brain abscesses

AbstractCladophialophora bantiana is a neurotropic dematiaceous fungus known for affecting immunocompromised and immunocompetent hosts. We report a case of 24year old immunocompetent male presenting with headache, fever and vomiting. MRI was suggestive of multiple fungal brain abscesses. He underwent total excision of abscesses. Pus culture was suggestive of brain abscess caused by C. bantiana. We report a culture proven case of C. bantiana emphasizing on specific MRI features which are critical in differentiating fungal from nonfungal brain abscesses