Emergency cervical cerclage and pregnancy outcomes

Background: To evaluate the effectiveness and safety of emergency cervical cerclage in women who presented with advanced cervical changes such as cervical dilatation and bulging foetal membranes.Methods: This is a retrospective study on all women treated with cervical cerclage presented in the late second trimester with advanced cervical dilatation (2 to 4cms) for whom emergency cervical cerclage by McDonald technique.Results: Out of the 24 patients for whom emergency cervical cerclage was performed, three patients had spontaneous abortion after cervical cerclage, two had PROM and eight of these patients had term delivery. Twenty-one fetus were live born after the period of viability. Nine of these babies were admitted to NICU and 50 percent of the neonates required only regular perinatal care.Conclusions: Post emergency cervical cerclage, the outcome in terms of prolongation of pregnancy, live births and neonatal survival is better

Assessment of Physical Disability and Nutritional Status among elderly in a Rural Population in South India

INTRODUCTION : The world population is graying and the longevity which has been looked upon as The result of technological advancement is now being looked as a bane by many Societies. As a result of the decrease in mortality and fertility rates at varying Levels across the world, there was an increase in life expectancy, which resulted In more people living to enter the old age.(1) According to World Health Organization (WHO) the population of elderly across the world was steadily rising From 200 million in 1950 to 350 million in 1975 and is expected to be 1100 million By 2025, which will be 15 percent of the total world population. OBJECTIVES : To determine the prevalence of physical disability among elderly in a rural population. To identify the common type of disability among elderly in the above mentioned population. To determine the nutritional status of elderly in the same population. To identify the factors associated with physical disability and poor Nutrition. METHODS : A cross sectional study was conducted among elderly of age 60 years and above was conducted in Kaniyambadi block of Vellore district which was the service of Christian medical college Vellore, community medicine department. A sample size of 340 was calculated assuming a prevalence of mild disability as 27 percent, based on a study conducted in south India, with an absolute precision of 7, design effect of 2 and anticipated non responsiveness of 5 percent. Using cluster sampling method 17 clusters of size 20 were selected based on probability proportional to size (PPS). Within each cluster elderly were chosen using simple random sampling. A semi structured self administered questionnaire was used which included basic demographic details, Mini nutritional assessment (MNA) scale and Barthel index. Blood samples were collected for testing hemoglobin and serum albumin levels. Data was entered using the software epi info and was analyzed using SPSS Version 17. RESULTS : The prevalence of physical disability was 20.6 percent (95% CI 16.2- 25.0). According to the MNA scale nobody is malnourished. Disability is more in the age group 75 years and above (OR= 2.266 (1.276- 4.024), (p= 0.005) and among women (OR 2.814 (1.311- 6.041) (p= 0.004). There is no malnutrition among the elderly according the MNA scale. The prevalence of those who are at risk of malnutrition is 10.9 percent (95% CI 7.52- 14.28). Using BMI classification (revised by Ministry of health, India, WHO classification for Asia) the percentage of those who are malnourished is 62.1 percent of which 18.3 percent are under nourished, 16.8 percent are overweight and 27.1 percent are obese. The undernutrition according to the BMI has statistically significant association between gender (OR= 1.805 (1.021- 3.189) (p= 0.042) and ses (OR= 2.378 (1.251- 4.521) (p= 0.008). The total prevalence of anemia among the study population was very high, 38.2 percent (95% CI 33.0- 43.4) thus coming under the WHO classification of moderate to severe public health significance. Anemia among women is 38.7 percent and among men is 37.7 percent. Anemia is more in the age group 75 years and above as compared to 60 to 69 year age group (OR= 2.399 (1.177- 4.889) (p=0.016)

Coconut (Cocos nucifera) Inflorescence Sap Nutritional Characteristics and Health Effects

Coconut is widely known as the tree of life. Every part of the tree is useful and therefore, coconut palm is an important economic crop of the local people. Neera is the exudate obtained from the unopened inflorescence of coconut palm (Cocos nucifera). It is healthy and therapeutic drink since it is rich in Vitamin C, has more food calories than milk, fights diabetes, cancer, electrolyte deficiency and even hair fall. Neera is rich in minerals and vitamins and it contains glucamic acid necessary for protein synthesis. It aids in digestion health. Neera contains vitamins (A and C), which have anti - oxidant properties thereby preventing damage or death of cells. Neera contains acids nicotinic acid and riboflavin and also can be consumed by people suffering from diabetes since it has a low glycemic index and a low glycemic load. In the study discuss about chemical composition including total sugar, reducing sugar, ethanol and vitamins

Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival

Background. Ex vivo perfusion is used in our unit for kidneys donated after cardiac death (DCD). Perfusion flow index (PFI), resistance, and perfusate glutathione S-transferase (GST) can be measured to assess graft viability. We assessed whether measurements taken during perfusion could predict long-term outcome after transplantation. Methods. All DCD kidney transplants performed from 2002 to 2014 were included in this study. The exclusion criteria were: incomplete data, kidneys not machine perfused, kidneys perfused in continuous mode, and dual transplantation. There were 155 kidney transplantations included in the final analysis. Demographic data, ischemia times, donor hypertension, graft function, survival and machine perfusion parameters after 3 hours were analyzed. Each perfusion parameter was divided into 3 groups as high, medium, and low. Estimated glomerular filtration rate was calculated at 12 months and then yearly after transplantation. Results. There was a significant association between graft survival and PFI and GST (P values, .020 and .022, respectively). PFI was the only independent parameter to predict graft survival. Conclusions. A low PFI during ex vivo hypothermic perfusion is associated with inferior graft survival after DCD kidney transplantation. We propose that PFI is a measure of the health of the graft vasculature and that a low PFI indicates vascular disease and therefore predicts a worse long-term outcome

A classic triphasic pleomorphic adenoma of nasal cavity mimicking as malignancy: a rare case report

Pleomorphic adenoma (PA) is the most common benign tumor of major salivary glands and intra nasal PA is unusual which may be misdiagnosed as malignancy. A 65-year-old female presented with unilateral nasal bleeding and nasal obstruction in right nasal cavity for 6 months. Local examination showed polypoid mass which surgically excised. HPE showed classic triphasic component of epithelial, myoepithelial with cartilaginous stromal elements and pathological diagnosis of PA made. High cellularity of tumor and predominant squamous epithelial component with keratin pearl created diagnostic confusion of malignancy and it confirmed by immune-histochemistry using p63 to demonstrate presence of myoepithelial component. Highlighted this case report for its unusual location and rare triphasic component of tumor tissue with keratin pearl formation which mimic as malignancy

Changing trends in oral cancer

Context: No study highlighting the incidence of oral squamous cell carcinoma (OSCC) in young adults has been reported from North Kerala until now. Aims: To study the cases of OSCC reported at our institution, with emphasis on the clinicopathologic variables in young adults. Settings and Design: This was a retrospective study of OSCC cases reported from 2002 to 2007. Materials and Methods: Data of oral cancer cases reported between 2002 and 2007 were retrieved from the records. The cases in patients below 40 years of age formed a separate study group. The data obtained was tabulated and comparisons drawn on the observed variables between the two groups. Results: Results showed a high incidence of OSCC among young adults. The demographic and anatomic location of these cases showed significant variations from cases of oral cancer in older patients. In addition, a significant number of these cases failed to show any relation with the commonly implicated etiologic agents of oral cancer. Conclusion : The findings of our study indicate a high incidence of oral cancer among young adults in our region. The tongue is the most common site in these cases with a significant number showing no possible etiological factors

Changing trends in oral cancer

Context: No study highlighting the incidence of oral squamous cell carcinoma (OSCC) in young adults has been reported from North Kerala until now. Aims: To study the cases of OSCC reported at our institution, with emphasis on the clinicopathologic variables in young adults. Settings and Design: This was a retrospective study of OSCC cases reported from 2002 to 2007. Materials and Methods: Data of oral cancer cases reported between 2002 and 2007 were retrieved from the records. The cases in patients below 40 years of age formed a separate study group. The data obtained was tabulated and comparisons drawn on the observed variables between the two groups. Results: Results showed a high incidence of OSCC among young adults. The demographic and anatomic location of these cases showed significant variations from cases of oral cancer in older patients. In addition, a significant number of these cases failed to show any relation with the commonly implicated etiologic agents of oral cancer. Conclusion : The findings of our study indicate a high incidence of oral cancer among young adults in our region. The tongue is the most common site in these cases with a significant number showing no possible etiological factors

Acute sleep restriction increases dietary intake in preschool‐age children

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/136000/1/jsr12450_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/136000/2/jsr12450.pd

Nefroblastom u kuje - prikaz slučaja.

A nine year old, intact female German shepherd dog was presented with the complaint of melena. The dog was anorectic, lethargic and cachectic. Physical examination and radiography revealed the presence of a large mid-dorsal intra-abdominal mass. Laboratory findings and diagnostic ultrasound marked the suspicious involvement of the right kidney. Renal neoplasm was suspected and an exploratory celiotomy was done. The mass was spread over the sublumbar region and was found to have originated from the right kidney. Excision of the tumor mass, along with unilateral nephrectomy, was done and the surgical recovery was uneventful. Histopathological examination led to the diagnosis of stage ΙΙΙ renal nephroblastoma with unfavorable histology. The potential clinical and pathological manifestations of canine renal nephroblastoma in an adult dog have been documented.Opisan je nefroblastom devetogodišnje njemačke ovčarke s melenom. Kuja je bila anoreksična, letargična i kahektična. Fizikalnom pretragom i radiografijom u kuje je ustanovljena velika masa u srednjem dorzalnom dijelu trbuha. Laboratorijskom i ultrazvučnom pretragom ustanovljene su promjene na desnom bubregu. Postavljena je sumnja na pojavu novotvorine na bubregu te je učinjena dijagnostička celiotomija. Masa se proširila na podslabinsko područje, a potjecala je od desnog bubrega. Tumorska masa bila je uklonjena kirurški s unilateralnom nefrektomijom. Patohistološkom pretragom postavljena je dijagnoza nefroblastoma III. stupnja s nepovoljnim histološkim nalazom. U radu je opisano kliničko i patološko očitivanje nefroblastoma u odrasle kuje