A case report on decidual cast

The mucous membrane lining of uterus is known as decidua once it is implanted with a fertilized egg. A decidual cast forms under the influence of hormones while preparing uterus for implantation and it can shed by taking the shape of uterus. It has well known association with ectopic pregnancy. Also it can occur with incomplete abortion as mentioned in this case report. Other conditions are use of progesterone, standard dose of oral contraceptive pills. Our patient 25 year unbooked gravida 3 parity 2 with 12 week period of gestation presented to emergency department with incomplete abortion with excessive bleeding and anaemia. She was shifted for surgical evacuation in which she passed decidual cast, a very rare finding. The histopathology report suggest retained product of conception with chorionic villi

Immediate postpartum intrauterine contraceptive device insertions in caesarean and vaginal deliveries: a comparative study

Background: Post-partum family planning is prevention of unintended and closely spaced pregnancies during first 12 months following childbirth. Postpartum IUCD is the best method of all as it is the safest, most effective, has no effect on breast feeding, reliable and with minimum complications.Methods: The cross-sectional study was conducted in AIMSR Bathinda on 400 postpartum patients. It was a prospective, observational study of women who received PPIUCD in our region.Results: Out of total 400, 58% had normal vaginal delivery and 42% had cesarean section. PPIUCD was done in all cases after applying exclusion criteria and the females were called for follow up.  53% cases who had cesarean and 47% of normal vaginal delivery turned up for follow up. Acceptance is more in multipara (20.7%) than in primi patients (13.7%). Almost 90% patients had good continuation rate. There were few problems faced by patients like irregular bleeding for first few months, pain lower abdomen, leucorrhea etc. which were removed by good counseling and some treatment like NSAIDs for bleeding.Conclusions: The acceptance of PPIUCD was high in present study in both types of females delivered by normal vaginal delivery or post LSCS but with good counseling efforts. It was safe and effective and had high retention rate when done at good timing by trained service provider that is within 10 minutes of placental delivery. So the need of time is creating awareness of public towards it and removing fear from minds, breaking taboos and myths.

Study of incidence of urinary tract infection during pregnancy and its effect on maternal and perinatal outcome

Background: Urinary tract infection is the commonest bacterial infection in pregnancy, especially in developing countries like India. It has several adverse outcomes not only in the mother but also in the fetus. This study aims to determine the incidence of UTI during pregnancy, the commonest micro-organism causing UTI, and to find out the impact of such infection on maternal and fetal outcomes.Methods: This observational study was carried out in the department of obstetrics and gynaecology Deen Dayal Upadhyay Hospital, New Delhi over a period of 10 months. A total of 196 pregnant women attending the outdoor hospital for ANC check-up without any medical disorder or previous adverse pregnancy outcomes were included in this study. Urine routine microscopy was done as a screening test for UTI. They were followed through their pregnancy and puerperium due to any pregnancy complication and perinatal outcome.Results: Incidence of urinary tract infection was 12.2%, of which 8.2% were asymptomatic and 4.08% were symptomatic. It was found that the incidence of UTI was highest in the age group of 18 to 25 years and also found that UTI was more common in the second (16.7%) and third (16.7%) trimester and lowest in the first trimester (5.7%). Women who had anaemia, pregnancy-induced hypertension, preterm labour, chorioamnionitis, perinatal mortality, and puerperal pyrexia had a high incidence of UTI than those who had not.Conclusions: From this study, we concluded that screening for UTI should be a part of routine antenatal care, and also there is a need to initiate an awareness program to educate women about UTI and their adverse fetomaternal outcome so that prompt and effective treatment can be done

A rare case of myiasis in a woman with genital prolapse

Myiasis is an infestation by dipterous larva that thrives on host’s living or necrotic tissue and cause massive tissue infection. We present a case of myiasis in a 65-year-old multiparous lady with procidentia. Her examination revealed a big excavatory ulcer on dependent part and cervix indwelled with maggots. About 40 to 50 such maggots were subsequently manually removed with a forceps. After conservative management, definitive surgical treatment for prolapsed uterus was done after healing of the ulcer, within three months. It is a very rare case as only a few reports have been previously published in literature

Study of significance of elevated maternal serum β-human chorionic gonadotropin (β-hCG) level in 16 to 20 weeks pregnant women as predictor of hypertensive disorder of pregnancy

Background: Hypertensive disorder of pregnancy affects both mother and fetus, leading their high morbidity and mortality and a major killer of women in developing country. The etiologic of preeclampsia is still not clear. It seems that placenta plays main role in path-physiology of preeclampsia, but there is strict relationship between hypertensive disorder of pregnancy and elevated β-hCG level, indicating there should be an abnormal placental secretary function in patients with severe preeclampsia.Methods: 245 patients were recruited from our institute (OPD) and Prospective analytical study was started with 16-20 weeks pregnant women. Cases were subjected to detailed history and thorough physical examination including baseline blood pressure. β-hCG measurement was done between 16-20 weeks and cases were followed at regular interval for the development of hypertensive disorder of pregnancy. Statistical testing was conducted with appropriate tests.Results: Total 245 women were enrolled in the study, only 208 were followed till delivery, 24 were developed hypertension. On analysis of data, maximum cases were younger, primigravida and of lower class. β-hCG levels (Mean ± SD) were also significantly higher (30100±16250 V/S 74700±23790; p<0.001) in subjects who later developed hypertension. Cut off value of β-hCG was 45755 mIU/ml, and analysis establishes validity of β-hCG as predictor of hypertensive disorder of pregnancy with sensitivity, specificity, positive and negative predictive value for β hCG were 87.5, 83.2, 70.4 and 83.7% respectively.Conclusions: Present study shows that elevated serum β-hCG in early second trimester can be considered as predictor of subsequent hypertensive disorder of pregnancy

Hydatid cyst of ovary: an unusual site

Discovering a hydatid cyst in pelvic region, especially as primary localization, is a rare event; as a matter of fact according to data provided by literature the incidence is between 0.2 and 2.25%. The ovarian involvement is often secondary to a cyst's dissemination localized in a different site. When possible the optimal treatment is represented by radical laparotomic cystectomy. We report a case of an old postmenopausal woman presented with intermittent dull aching pain with 16 weeks cystic pelvic mass which mimicked the ovarian malignancy even after imaging techniques. We treated the case with laprotomic cystectom

Numerical Study of Wind Loads on Y Plan-Shaped Tall Building Using CFD

The increase in the population is at an exponential rate, and the available land is in the form of irregular shapes. That is why irregular shapes are very commonly built. Wind load increases with respect to height, so wind load evolution is necessary for such high-rise structures. Wind forces majorly depend on the plan's cross-sectional shape. Therefore, for an irregular shape, an investigation is needed for tall buildings. This paper demonstrates a detailed study on velocity stream line, external pressure coefficients, pressure distribution on the surfaces of the building and the turbulence kinetic energy for the Y-shaped plan for tall buildings under wind excitation for wind incidence angles of 0o to 180o. k-  turbulence model is utilized to solve the problem using computational fluid dynamics techniques in ANSYS for terrain category II as per IS: 875 (Part3), 2015. Wind ward faces in all building models show positive pressure distribution, while the leeward faces are under the effect of negative pressure distribution. Wind load can be reduced on building models by modifying the corners, such as chamfering, rounding, and double recessed. The variation of pressure distribution on different faces of a "Y" plan shaped tall building for 0° and 180° is investigated using ANSYS CFX, and the pressure contours are plotted for all the faces of different "Y" shaped buildings to compute the effect of corner modification on pressure distribution. In this research, it was found that building models with rounded corners are highly efficient in resisting the wind load. Doi: 10.28991/CEJ-2022-08-02-06 Full Text: PD

Our needles in the haystack: An endodontist’s review and case reports

During root canal preparation procedures, the potential for instrument breakage is always present. This review focuses on basic principles involved in separated instrument retrieval, factors on which successful retrieval of the separated instrument depends on and various treatment options available for the same. A decision-making flowchart for the techniques to be used in the management of intracanal separated instruments is presented. Prognostic factors depending on the phase (that of chemo-mechanical preparation) of separation and pre-operative status of pulp are discussed. Few case reports that document cases with instrument separation that were successfully treated in our department are also presented

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe