Pregnancy in a diagnosed case of cauda equina syndrome and it’s management: a case report

As with many rare conditions, little is known about cauda equina syndrome (CES) and reproduction. Knowledge pertaining to complications during pregnancy and its management in a patient with diagnosed case of CES is even more scant. The information which we have is from attending on individual cases who presented with CES diagnosed during pregnancy. The following case report demonstrates pregnancy in a known case of CES, diagnosed after sustaining a burst fracture of lumbar vertebrae followed by surgical decompression at puberty. Patient conceived spontaneously with residual disease as symptoms of perineal numbness, sensory deficit in both lower limbs and persistent saddle hypoesthesia along with foot drop and gait abnormalities and presented at 30 weeks of gestation. CES is an unusual entity that appears in between 2-6% of all cases of disc herniation in the lumbar segment. Related post-traumatic presentations are extremely rare. Pregnancy exacerbates most problems associated with spinal cord injury. Autonomic dysreflexia may present as a complication in a case of pregnancy with CES which may be life threatening and requires immediate treatment. Antenatal management and complications of pregnancy in a diagnosed case of CES has not been documented till date

Silent primary ovarian ectopic pregnancy following ovulation induction: diagnostic dilemma

Early diagnosis of an ovarian pregnancy, of all the diagnoses relating to extrauterine gestations, is perhaps a diagnostic challenge faced by an obstetrician and a radiologist. About 0.5% of extrauterine implantations occur in the ovary. Recent studies have demonstrated infertility and Assisted reproductive techniques (ARTs), multiparity, use of intrauterine devices as risk factors for ovarian ectopic. Knowledge pertaining to ovulation induction and risk of ovarian ectopic is even more scant. In this article, we report a case report of ovarian pregnancy following ovulation induction with letrozole. Patient visited with history of missed menstrual period, mild abdominal pain and a weakly positive urine pregnancy test. Provisional diagnosis of right tubal ectopic was made. Diagnosis of ruptured ovarian ectopic was made on explorative laparoscopy which was later confirmed histopathologically. Patient had normal intra and post-operative course. An ovarian ectopic can present as a life-threatening condition and a high index of suspicion can prevent morbidity as well as mortality. Ovarian pregnancy in a primigravida with ovulation induction without an alarming sign, as in this case, is the rarest entity came across till date

The hidden uterus in Swyer syndrome with gonadoblastoma: a diagnostic dilemma

Disorders of sex development (DSD) comprise a rare group of disorders in which genotype and phenotype are discordant. In 46 XY DSD, also known as Swyer syndrome, patients present a complete female phenotype and the 46 XY karyotype is usually identified during investigation for primary amenorrhea and/or delayed puberty. The risk of developing a gonadal tumor can be as high as 30%-40%. A 27-year-old phenotypically female with the complaints of primary amenorrhea with a pelvic mass presented to our setup. The case was approached applying the role of clinical, radiological and laboratory analyses. The final diagnosis of Swyer syndrome with gonadoblastoma was made. Karyotyping was done which revealed 46 XY set of chromosomes. Her FSH and LH levels were found to be elevated. Patient was explained about streak gonads. After surgical resection of tumor and gonadectomy, HRT was started. Primary amenorrhea is a common diagnostic challenge, wherein there are numerous causes that need to be approached in a systematic manner. However, when a case with a pelvic lump or a solid pelvic mass presents to a clinician, the approach becomes difficult to justify amenorrhea and pelvic mass as a single entity

Parking Management System: A Review

In today?s transport related concerns, vehicle parking has become a major issue in urban areas. Lack of parking facilities and increased amount of vehicles, due to this, drivers who are searching for parking space keep roaming around the city in peak hours. This causes traffic, waste of time and money. To solve these problems, a Smart Parking Management System can be designed. Earlier many efforts were done on it, to reduce these problems, such as by presenting drivers with real-time description about vacancy of parking slots through the mobile application. To sense car and analyse the count of vacant slots, Ultrasonic sensors and Raspberry pi were castoff at the entrance of parking areas. Also there was an effort to activate an idea which uses the video surveillance camera for tracking those vacant locations, also Matrix Laboratory(MATLAB) to practice the computer vision techniques like background deletion and addition for the update of vacancy and occupancy of spots. Sensor circuits were also designed, which includes Radio Frequency Identification(RFID) tag, a mode of digital payment and a different theft management feature. A smart parking system was also designed which was grounded on the amalgamation of the technologies of Ultra High Frequency(UHF), RFID and Wireless Sensor Network, for the same purpose desired. A parking system was also developed for motorcycles as those are the majority mode of transportation in Taiwan, which includes management system that was based on the wide concept of RFID system, Visual Basic (VB) language and My Structured Query Language(MySQL) system. Likewise, a model came up with the concept of Internet of Things(IoT) and theft management facility, a sensor circuit and RFID tag. It could be accessed and monitored remotely through the application

Role of imaging modalities in diagnosis of silent caesarean scar ectopic pregnancy after ovulation induction: a case report

There has been an increased prevalence of ectopic pregnancies in the present scenario attributing to 1.5-2% of all pregnancies. Caesarean scar pregnancies are rare, occurring in approximately 1 in 2000 pregnancies, although the incidence is increasing. The increasing rate of caesarean scar ectopic pregnancies mirrors the increasing rate of caesarean delivery. Disruption of the endometrium and myometrium after caesarean delivery predisposes to improper implantation at the site of the prior hysterotomy. Without normal surrounding myometrium, untreated caesarean scar ectopic pregnancies can result in uterine rupture with severe maternal hemorrhage and death. Although ultrasound remains the primary imaging modality for this diagnosis, MRI may be useful in the setting of equivocal cases and also may aid in the detection of possible placental implantation or bladder wall invasion. An MRI may provide additional confirmation of the ultrasound findings and characterize the myometrial interface if the pregnancy is difficult to distinguish from other pregnancy complications such as a cervical ectopic pregnancy or consideration for expectant management of pregnancy is considered

Characterizing genomic alterations in cancer by complementary functional associations.

Systematic efforts to sequence the cancer genome have identified large numbers of mutations and copy number alterations in human cancers. However, elucidating the functional consequences of these variants, and their interactions to drive or maintain oncogenic states, remains a challenge in cancer research. We developed REVEALER, a computational method that identifies combinations of mutually exclusive genomic alterations correlated with functional phenotypes, such as the activation or gene dependency of oncogenic pathways or sensitivity to a drug treatment. We used REVEALER to uncover complementary genomic alterations associated with the transcriptional activation of β-catenin and NRF2, MEK-inhibitor sensitivity, and KRAS dependency. REVEALER successfully identified both known and new associations, demonstrating the power of combining functional profiles with extensive characterization of genomic alterations in cancer genomes