A rare case of acute non-puerperal uterine inversion due to large leiomyoma in COVID pandemic: challenges in clinical diagnosis and management

Non puerperal uterine inversion is a very rare clinical scenario with very few gynaecologist actually managing it in their lifetime. Acute variety of non-puerperal inversion is even rarer and thus possess diagnostic and management challenges. Case study of a rare case of a 45 years old female who was admitted for an elective surgery and had sudden acute inversion of uterus which was clinically diagnosed. Patient was managed by debulking of tumour which turned out to be large leiomyoma, followed by total abdominal hysterectomy. Rarity of the disease, atypical symptoms and less clinical exposure to such cases pose diagnostic as well as surgical challenges as in our case

Effectiveness of evidence based regimen for medical abortion over conventional methods

Background: Medical abortion is a means of medical termination of pregnancy by drugs alone. This can be done upto 63 days using mifepristone and misoprostol tablets. For the conventional method, patient has to come to the hospital 3 times. In our study we reduced the interval between the drugs there by reducing the number of hospital visits. The objectives were to study the reduction of induction abortion interval following administration of evidence based regimen and to compare the proportion of patients developing complications in both the groups.Methods: It was a comparative study conducted at Department of Obstetrics and Gynecology, Govermnent MedicalCollege Kottayam, Kerala, India from May 2015 to November 2015.Results: The mean induction abortion interval in experimental group was 14.3 hours and in control group, it was 60.4 hours which was found to be statistically significant. Only 3 patients (7%) of experimental group had side effects whereas 12 patients. (17.4%) had side effects in the control group. Major side effects encountered were severe abdominal pain and severe bleeding per vaginum. Evidence based  regimen consist of administration of mifepristone 200mg and vaginal misoprostol 600µg 6 hours later for termination of pregnancy up to 63 days could reduce the induction abortion interval by 46 hours and had less side effects.Conclusions: As it reduces the induction abortion Interval and complications we feel that the evidence based regimen for Medical Termination of Pregnancy is superior to the FDA approved regimen

Sea truth data collection: estimation of diffuse attenuation coefficient in ocean colour mapping

Phytoplankton pigments in the ocean waters are the prime synthesisers in marine food chain which in turn terminate as pelagic or benthic nekton. They perform about half of the total global photosynthesis and compr is ethe upper consumption and production. These are the substances that have definite spectral characteristics and thereby govern the ocean colour

A persistent eddy in the Central Arabian Sea: potential trophic significance

Arabian Sea is an area of strong currents, complicated flow patterns with several eddies and semi annually reversing monsoon winds. This paper deals with a cold eddy highly rich in phytoplankton in the Central Arabian Sea, centered around: 14° 25' N and 69° 20' E during January - March 1998. The eddy was about 100 km in diameter with a depth of about 4000 m and maximum chlorophyll-a concentration was 1 mg m−3 compared with 0.2 mg m−3 in the surrounding areas. Average optical depth of the area was 12 m. The occurrence of the eddy and the related oceanographic variables were inferred from SeaWiFS derived chlorophyll-a (Chl-a), NOAA Pathfinder AVHRR derived sea surface temperature, sea surface height from TOPEX altimeter and collateral information. The cold eddy formation is probably due to longshore density variation in the ocean. Due to negative sea level anomalies, associated surface divergence and upwelling process, the region of cold eddy is known to be highly productive. The cold eddy in the same location was observed during January 2000. The persistence of the eddy for more then a month indicates that this area is a rich forage ground for tuna fishery

Seasonal trends in the fishery resources off Gujarat: Salient observation using NOAA AVHRR

438-442Thermal features delineated on the sea surface temperature (SST) images were used as a tracer to select probable fishing grounds. This paper deals with the steps involved in fishery forecast like generation of SST images, identification of potential grounds/s, dissemination and some results based on the analysis of feed-back received from the Fisheries Terminal Division (FTD), Veraval, Gujarat State, India. Catch per unit effort (CPUE) was computed for three commercially important species i.e. prawns, squids, ribbon fish. The CPUE was also compared with features representing the prevailing hydrographic condition observed on the SST image/s. An interannual comparison showed a distinct pattern of high and low during various seasons. An increase of about 38% in notified ground i.e. area of forecast, was observed as compared to unnotified ground

Ultrasound guided peritubal infiltration of 0.25% Bupivacaine versus 0.25% Ropivacaine for postoperative pain relief after percutaneous nephrolithotomy: A prospective double blind randomized study

Background and Aim: Percutaneous nephrolithotomy (PCNL) is a common for managing renal calculi. Pain in the initial post operatie period is relieved by infiltration of local anaesthetic around the nephrostomy tract.We aimed to compare the analgesic efficacy of bupivacaine and ropivacaine. Methods: A total of 100 adult patients undergoing elective PCNL- under balanced general anaesthesia were randomly divided into bupivacaine group (Group B) and ropivacaine group (Group R). After completion of procedure, 23G spinal needle was inserted at 6 and 12 O′clock position under ultrasonic guidance up to renal capsule along the nephrostomy tube. A volume of 10 ml of either 0.25% bupivacaine or 0.25% ropivacaine solution was infiltrated in each tract while withdrawing the needle. Post-operative pain was assessed using visual analogue scale (VAS) and dynamic visual analogue scale (D-VAS) for initial 24 h. Intravenous tramadol was given as rescue analgesia when VAS >4. Time to first rescue analgesic, number of doses and total amount of tramadol required in initial 24 h and side-effects were noted. Results: Visual analogue scale and D-VAS at 6 h and 8 h in Group B was significantly higher than Group R. Mean time to first rescue analgesia in Group R was significantly longer than Group B. Mean number of doses of tramadol and total consumption of tramadol in 24 h was less in Group R, though not statistically significant. Conclusion: Peritubal infiltration of 0.25% ropivacaine infiltration along the nephrostomy tract is more effective than 0.25% bupivacaine in alleviating initial post-operative pain after PCNL

Mental health problems among health-care workers during the COVID-19 pandemic

Introduction: As the pandemic of COVID-19 stretches, its wings across the different parts of the world over the past few months, it is very likely that mental health problems increase, particularly among the health-care workers who have higher risk of exposure to the disease and also to sufferings of the people affected with the disease. Objective: To assess the prevalence and factors associated with depression, anxiety, and stress among health-care workers from Kerala during the COVID-19 pandemic. Materials and Methods: A cross-sectional study among 544 health-care workers from Kerala was conducted by a self-administered online questionnaire in Google Forms by chain referral sampling with Depression, Anxiety, and Stress Scale-21 scale during initial phase of the COVID-19 pandemic. The tests of significance used were Mann–Whitney U-tests and Kruskal–Wallis tests. Odds ratios and 95% confidence interval are estimated. Results: During the early pandemic period, 9.7% of health-care workers had mild depression and 13.3% had moderate-to-severe depression. While 4% had mild anxiety and 3.5% had moderate-to-severe anxiety, about 6.8% had mild stress and 6.4% had moderate-to-severe stress. The anxiety symptoms were significantly higher among nurses compared to doctors. Emotional and social support from higher health authorities is a significant protective factor against stress and depression. Frontline workers have 84% higher risk to have depression. Conclusions: Frontline health-care workers who are directly involved in the screening, diagnosis, treatment, and care for patients with COVID-19 are at higher risk of experiencing poor mental health outcomes. Emotional and social support from higher health authorities is a significant protective factor against depression and stress among health-care workers