Double coin in esophagus at same location and same alignment - a rare occurrence: a case report

Coin is the most common foreign body swallowed by pediatric age group. The multiple coin swallowing is extremely rare and very few cases had been reported in English literature. Most of them were present at different site and had different alignment in the esophagus. The location of the coin (trachea vs. esophagus) is commonly determined by the alignment of the coin on radiographic studies. A 4-year-girl was presented to us with history of coin ingestions one day back without any respiratory distress. On radiological study there was suspicion of two coins on same location and alignment. The diagnosis was confirmed after removal. The both coin was removed successfully by esophagoscopy. Unexpected second foreign bodies in pediatric esophageal coin ingestions are rare and it is mandatory to do post operative radiography after removal to exclude duplex coin or tracheal coin. We are presenting this case because of its rarity, difficulty in diagnosis especially when proper history is not available

Duplication cyst of pyloroduodenal canal: a rare cause of neonatal gastric outlet obstruction: a case report

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Efficacy of limonene nano coatings on post-harvest shelf life of strawberries

Strawberries are highly demanded fruits because of their color, nutritional values and appearance. The aim of this study was to develop and characterize alginate and limonene liposomes as edible coating materials and to determine their efficacy in shelf life extension and maintaining quality parameters of ‘Chandler’ strawberries. Alginate solution (1.5% w/v) and Limonene liposomes prepared from 80% lecithin and 20% PDA were used as edible coating materials. Fungal decay percentage, total yeast and mold counts, headspace atmosphere analysis, total soluble solids, pH, titratable acidity, total anthocyanin content and total phenolics were analyzed to assess fruit quality during 14 days at 4 °C of storage. Days of storage was found to be significant in maintaining the quality of the strawberries. Among the coating types, limonene liposomes were found to be significantly more effective in maintaining the lower concentration of carbon dioxide (CO2), lower the change in pH (3.9), and had higher total anthocyanin (43.85) content during storage than those without a liposomal coating. Thus, limonene liposomes were found to be useful for extending the shelf life and maintaining quality of strawberry fruits

A hospital based cross sectional study of critical care management of eclampsia patients in a tertiary care hospital

Introduction: Preeclampsia is a pregnancy specific hypertensive syndrome associated with significant morbidity and mortality in mother and baby. Preeclampsia-eclampsia needs intensive care antepartum, intrapartum as well as postpartum for successful pregnancy outcome. Preeclampsia leads to multiorgan system involvement if appropriate timing of delivery is delayed. Materials and Methods: The present study was a hospital based cross sectional study done in the Department of Obstetrics and Gynecology, Mahatma Gandhi Memorial Medical College and Hospital Jamshedpur, Jharkhand over a period of one year from January 2020 to December 2020. For each eligible patients for the study, information in socio-demographic characteristics (age, parity, booking/referral status, marital status, educational status and place of delivery), gestational age at the time of identification of complications, indication for ICU admission and timing of admission to ICU (antepartum or postpartum) were collected on a data collection sheet. Results: During the study period, there were a total of 9907 obstetric admission and 7365 live births. Out of 174 eclampsia patients, 72 patients were admitted to the obstetric ICU, giving an ICU admission rate of 4.8/1000 live births. The mean maternal age of the patients was 25.4+5.8 years (range 18-29 years). Out of 72 patients, 30 patients (41.3%) were nulliparous and 60.5% were uneducated. A total 1.97% (3 patients) were booked and 98.03% (69 patients) were unbooked referred emergencies. The average duration of ICU stay was 5.4+3.1 days. Conclusion: Early referral of eclampsia patients or at risk patients to a tertiary care centre may help to reduce maternal morbidity and mortality. Early diagnosis and prompt treatment through a multidisciplinary team in an ICU setting can prevent complications and reduce morbidity and mortality

A descriptive study of maternal near miss cases in tertiary care center

Introduction: Maternal near miss (MNM) case is defined as “a woman who nearly died but survived a complication that occurred during pregnancy, childbirth, or within 42 days of termination of pregnancy. Maternal mortality is one of the important indicators used for the measurement of maternal health. Improvement of maternal health is one of the millennium development goals (MDG), MDG 5 with Target 5 A that calls for the reduction of maternal mortality ratio by three quarters between 1990 and 2015. Materials and Methods: The study was conducted in the Department of Obstetrics and Gynecology, Mahatma Gandhi Memorial Medical College and Hospital Jamshedpur, Jharkhand which is a tertiary care centre and serves as a referral centre for other Primary Health Centre and District hospitals of Jharkhand. Cases of severe obstetric morbidity were identified during daily morning meetings, where all the new admission in the last 24 hour and serious inpatient cases were discussed. All the cases were followed during their hospital stay till their discharge or death. Results: During the 12 months of the study period, 10000 deliveries at the institution and 240 women were identified as near-miss obstetrical cases by five factor scoring system. The prevalence of near-miss case in this study was 2.4%. Near-miss per 1000 delivery was 24%. Maternal death to near miss ratio was 1:7.2. The leading causes of maternal near miss were hemorrhage (42.5%) and hypertensive disorder of pregnancy (23.5%) The morbidity was high in unbooked cases. Conclusion: Lesson can be learned from cases of near-miss which can serve as a useful tool in reducing maternal mortality ratio. Need for development of an effective audit system for maternal care which includes both near-miss obstetric morbidity and mortality is felt

Pseudotumor of the urinary bladder in a child: A case report and review of the literature

Inflammatory pseudotumors (IPTs) are rare, nonepithelial tumors of the urinary bladder that are benign. They are very difficult to distinguish from sarcomas or carcinomas of the urinary bladder in children. Conservative surgical management by either transurethral resection or partial cystectomy is the treatment of choice. We report here a rare case of juvenile urinary bladder IPT that we managed by right partial cystectomy with right ureteric reimplantation because of involvement of the right ureteric orifice. On account of histological similarity of IPT to malignant urinary bladder tumors, it is mandatory to require definite diagnosis and long-term close follow up