Vulvar myiasis: a rare case report

Myiasis is the parasitic infestation of dipterous larvae (maggots) in humans and other vertebrate animals. Maggots are commonly seen on exposed body parts but it is very rare to find on covered body parts like external genitalia. Diagnosis and treatment are simple. We hereby present a rare case of vulvar myiasis in a young unmarried girl living in rural area in conditions of poor hygiene.

Myxoedemic coma: an uncommon presentation of Sheehan syndrome

This is a rare case of a 35 year old multiparous female who presented with electrolyte abnormality, hyponatremia in a setting of seizure and moderate pallor. She had a significant past history of childbirth complicated with post-partum haemorrhage after which she developed secondary amenorrhoea and lactation failure. Workup showed suppressed levels of all pituitary hormones and was treated as myxoedemic coma. A diagnosis of Sheehan’s syndrome presenting as myxoedemic coma - a rare but emergency presentation was made

Chronic pelvic pain in women: comparative study between ultrasonography and laparoscopy as diagnostic tool

Background: Chronic pelvic pain is a major cause of morbidity among the reproductive age group women. The study on patients of chronic pelvic pain aimed to compare the diagnostic accuracy of ultrasonography and laparoscopy in these patientsMethods: The study was conducted on 100 patients of chronic pelvic pain attending the gynaecology outdoor and were subjected to thorough clinical examination followed by ultrasonography and laparoscopic examination.Results: Maximum number of cases of chronic pelvic pain belonged to 25-30 years, were parous with mean duration of pain of 15.2 months. The most common complaint was vaginal discharge (70%) followed by menstrual irregularity. On clinical examination, pelvic tenderness was observed in majority (60%) of cases. USG examination showed chronic pelvic inflammatory disease in 43% cases followed by myoma (8%), ovarian cyst (5%), endometriosis (6%), pelvic congestion (5%) and no abnormal pathology in 25% cases. On laparoscopic examination, chronic pelvic inflammatory disease was present in 47% cases followed by endometriosis (11%), pelvic congestion (8%), myoma (8%), adhesions (7%) while 13% cases showed normal findings.Conclusions: Laparoscopy is more effective than ultrasonography as a diagnostic tool in patients of chronic pelvic pain.

Knowledge, attitude and practices about cervical cancer screening among nursing staff in rural tertiary care center

Background: Cervical cancer is the second most common cancer among women worldwide.  The knowledge and attitude of nursing personnel towards cervical cancer screening can grossly influence the community. As the doctor to patient ratio is low in India, staff nurses if trained can act both as health educators and service providers. Objectives of the study were to determine the baseline information about the knowledge of cervical cancer and explore attitude and practice of Pap smear screening among staff nurses.Methods: In this cross-sectional study sample of 100 nurses was selected randomly out of the total 445 nurses employed in the hospital at a rural tertiary care centre from August 2016 to October 2016. A self-administered, structured, open ended and pretested questionnaire comprising of questions on the general characteristics, awareness, perceptions and actual practices of nursing personnel was used to gather information about cervical screening.Results: In this study, 82% knew that Pap smear can detect cancer. About 48% knew that it can present as post-menopausal bleeding and 32% of the respondents knew that HPV is a risk factor for cancer cervix, but only 30% knew about HPV vaccine and only 35% have ever been screened.Conclusions: The study showed that, knowledge about cancer cervix, screening and practice of Pap smear is low among nursing staff. There is an urgent need for integration of cervical cancer prevention issues in the nurses existing training curriculum

Comparative study of oral iron (ferrous sulphate) versus intravenous (iron sucrose) therapy in treating iron deficiency anaemia in puerperium

Background: Iron deficiency anaemia is one of the major morbidities during post-partum period. The aim of this study was to compare the efficacy, safety and compliance of intravenous iron sucrose complex with oral Iron therapy in treatment of postpartum anemia.Methods: 100 postpartum anaemic patients randomized into two groups. In Group I oral iron ferrous sulphate tablets twice daily and in group II 200 mg of iron sucrose on every alternate day up to total calculated dose for 6 weeks. Hemoglobin and serum ferritin were measured on day 0, 2 week and 6 weeks. The side effects in both groups were noted.Results: Majority of patients are multiparous, illiterate and belonged to low socioeconomic. Mean baseline hemoglobin in oral group (Group I) was 7.90±0.905 gm /dl and in i/v group (Group II) was 7.81±0.849 gm /dl. There was significant rise in hemoglobin and hematocrit in both groups after 2 weeks and 6 weeks. However, efficiency of iron sucrose was greater in between the groups (p value=0.0000). There was a rise in serum ferritin to 58.35±14.537μg/L from 8.30±1,461μg/L after 6 weeks in intravenous group with shorter duration of treatment indicating a high efficacy (p<0.001). Intravenous iron sucrose did not result in any serious adverse reactions.Conclusions: This study illustrates clearly that intravenous iron sucrose complex is safe, convenient and effective in postpartum anemic women as compared with oral ferrous sulphate

A comparative study between active and expectant management of premature rupture of membranes at term on fetomaternal and perinatal outcome in rural population

Background: Premature rupture of membranes at term (PROM) is defined as a spontaneous rupture of membranes after 37 completed weeks of gestation and before the onset of regular painful uterine contractions. PROM occurs in 5-10% of all pregnancies of which approximately 80% occur at term. The study aimed to compare the maternal and neonatal outcome in patients with term PROM receiving active induction versus expectant management.Methods: The present study was a prospective randomised controlled trial, conducted on 100 term antenatal women with PROM in the Department of Obstetrics and Gynaecology, UPUMS, Saifai from January 2016 to June 2017. 50 antenatal women received immediate induction with oral misoprostol while another 50 antenatal women were expectantly managed for 24 hours. The latency period, PROM delivery interval, maternal and neonatal outcome were compared and subjected to statistical analysis.Results: 42% of active management group and 30% of expectant management group had a latency period of 12-20 hours and results were found to be statistically significant (p value = 0.005). There was no statistically significant difference in the rate of caesarean section, maternal and neonatal morbidity in both the groups.Conclusions: Immediate labour induction in patients with term PROM resulted in significant shortening of latent period and PROM to delivery interval without any increase in caesarean section rate as compared to expectant management group

Cross sectional study for contraceptive practices in antenatal women at tertiary rural institute

Background: Objective of the study was to assess the awareness and acceptance for contraceptive practices amongst the women attending the routine antenatal outpatient services at our tertiary rural institute.Methods: It was a cross sectional study done in UP University of Medical Sciences (UPUMS) Saifai. Three hundred fifty (350) patients aged between 18 -40 years were enrolled in the study after written informed consent. A self structured pre formed questionnaire was provided regarding demographic profile, obstetric profile, contraceptive practices and reasons for not using any contraception. Then data were analysed statistically.Results: Majority of the women were between the age group of 30-35 years and had basic level of education. In our study 90% women were aware of one or more methods of contraception. 86.5% accepted the contraceptive practices and 81.43% followed the contraception. 81.43% used temporary methods of which OCPs, IUCDs, and Condoms were common.Conclusions: Majority of the women were between 30-35 years of age. 90% women knew about some method of contraception. 81.4% women followed the temporary method of contraception. Among non users the main reason for not using contraceptive method were mainly lack of knowledge and they wanted more children

Gestational diabetes mellitus: study of prevalence using criteria of diabetes in pregnancy study group in India and its impact on maternal and fetal outcome in a rural tertiary institute

Background: Gestational diabetes mellitus ((GDM) is defined as carbohydrate intolerance of varying degree of severity with onset or first recognition during pregnancy. GDM is associated with adverse fetomaternal outcome. Its early detection and management is essential for better perinatal outcome. The objective of the study was to assess the prevalence of gestational diabetes mellitus among pregnant women of western U.P. using diabetes in pregnancy study group in India (DIPSI) criteria and further assess its impact on fetomaternal outcome.Methods: This was a prospective study conducted at UP RIMS &amp; R, Saifai, Uttar Pradesh, India including 225 pregnant women between 24-28 weeks gestational age who attended the antenatal OPD from January 2014 to January 2015.All women were given 75 gm oral glucose irrespective of their meals. Women with blood sugar values &gt;140mg/dl were labeled as GDM and rest as control or non GDM group. All the GDM patients were followed up either with diet or insulin therapy till delivery to study fetomaternal outcome.Results: Out of 225 Women 22 women (9.7%) were diagnosed as having GDM and among risk factors, higher BMI was shown to be significant association (p&lt;0.05). There was also significant difference among birth weight and neonatal complications in GDM and NON-GDM group (P&lt;0.05).Conclusions: Due to high prevalence of GDM in India in our study we concluded that screening is very essential for all pregnant women even in low-risk group. As in our study which was done by single step method of DIPSI which was easy to performed, feasible for remote population. But more studies are needed to further conclude that DIPSI is sufficient for Indian population

Comparison of BACTEC MGIT with conventional methods for detection of Mycobacteria in clinically suspected patients of extra pulmonary tuberculosis in a tertiary care hospital

Background: Tuberculosis is an important public health problem in India and globally.  Extra pulmonary tuberculosis (EPTB) constitutes for approximately 15 to 20 per cent of all cases of tuberculosis in immunocompetent patients and accounts for more than 50 per cent of the cases in HIV- positive individuals. Main problem with the extra-pulmonary tuberculosis is the paucibacillary nature of the specimen, which makes the diagnosis difficult and delay the treatment. With this in background, this study aimed at the isolation of Mycobacteria from clinical specimens of patients suspected of extra pulmonary tuberculosis using BACTEC MGIT, Lowenstein Jensen (LJ) media and direct acid-fast bacilli smear examination.Methods: A total of 66 samples were processed for direct AFB smear examination, and culture on MGIT and LJ media. Acid fast staining of the specimens was done using the Ziehl-Neelsen method.Results: Among 66 specimens, MGIT gave a higher yield of mycobacteria (46.9%), lower contamination rate (3%) and shorter time to positive culture as compared to LJ media.Conclusions: MGIT gives higher yield and faster results

A wheat kinase and immune receptor form host-specificity barriers against the blast fungus

Since emerging in Brazil in 1985, wheat blast has spread throughout South America and recently appeared in Bangladesh and Zambia. Here we show that two wheat resistance genes, Rwt3 and Rwt4, acting as host-specificity barriers against non-Triticum blast pathotypes encode a nucleotide-binding leucine-rich repeat immune receptor and a tandem kinase, respectively. Molecular isolation of these genes will enable study of the molecular interaction between pathogen effector and host resistance genes