A case of perforation of rectum due to self-administered enema in a pregnant woman

A 23 year old primigravida at 35 weeks gestation presented with pain abdomen, fever and dissension of abdomen. Initially patient was managed conservatively at peripheral centre for two days and then reported to our hospital. An ultrasound done which shows collection inside peritoneal cavity and perforation was suspected. Decision of laparotomy was done. First caesarean section was done and a single live male baby born weighing 2.4 kg born. Then on exploration a small perforation in rectum was found and it was repaired by surgeon. But they found two more perforations and colostomy was done. On taking detailed history patient told that she-herself administered enema because of constipation. In post op period patient expired because of septicemia and ARDS

A case of bladder diverticulum simulating ovarian cyst during pregnancy

33 year old female G3P2+0 at 32 weeks of gestation was admitted in labour room with the complain of pain abdomen and difficulty in passing urine. On examination vitals were stable. Abdominal examination there was cystic swelling in suprapubic region extending up to umbilical region. Uterus was 32 week size. Report of USG from peripheral centre showed ovarian cyst. We made a provisional diagnosis of twisted ovarian cyst. Exploratory laparotomy was done there was no ovarian cyst and bladder diverticulum was present. Urologist called and first he aspirated fluid and it was urine. Then while separating the swelling from uterus bladder opened and resected the diverticulum. Bladder was sutured. Abdomen was closed. Patient went into preterm labour and delivered vaginally single live female of 2.1 kg weight. Postoperative period was uneventful. Patient was lost in follow up

Successful outcome of pregnancy in RHD with severe MS, severe pulmonary artery hypertension, moderate MR/TR/AR and mild AR

Rheumatic heart disease with severe Pulmonary Arterial Hypertension (PAH) in pregnancy is a grave situation, present with high maternal morbidity and mortality. In this case report, we describe our successful management of such a case which was even more difficult in combination with sever mitral stenosis, severe pulmonary artery hypertension and mild to moderate MR/TR. This patient got her diagnosis late in pregnancy, beyond the time at which a therapeutic termination could not have been performed

Successful outcome in a patient with glioma of brain with twin pregnancy

We present a case of glioma in pregnant female with twin pregnancy. Gliomas during pregnancy are rare. Gliomas during pregnancy pose a risk to maternal and fetal life. The benefit-to-risk ratio should be carefully evaluated and discussed prior to get marriage and pregnancy. In present case, patient had non-specific symptom like seizure and no any focal neurological deficit, Caesarean Section (CS) was done at term with multidisciplinary group, including a neurosurgeon, obstetrician, anesthesiologist and neonatologist. She has been followed up to the present date and remains in good health

Spontaneous unscarred fundal rupture after normal vaginal delivery

Uterine rupture is one of the most dangerous obstetric situation carrying an increased risk of maternal and perinatal morbidity and mortality, associated with poorly managed labour. The incidence of spontaneous rupture of unscarred uterus is around 1 in 8000 to 1 in 15000 deliveries. We report this unusual case of spontaneous unscarred fundal rupture after normal vaginal delivery. This case under reference developed shock soon after delivery and was explored due to suspected intraperitoneal hemorrhage. This case is being reported to emphasis the need for proper post-delivery monitoring not only to diagnose post-partum hemorrhage but also to suspect uterine rupture as a cause of unexplained shock developing after delivery inspite of all resuscitative measures. Although unexpected in a woman with an unscarred uterus, rupture should be considered as a possible cause of unusual pain or hypotension in the mother. The most effective way to reduce the number of morbidity and mortality would be to prevent unwanted pregnancies by informed and effective use of contraception

Application of turmeric dye in the coating of Triphala guggle ayurvedic tablet

The aim of present work was to extract a yellow colour dye from turmeric rhizome (Curcuma longa) and to use it in the coating of triphala guggle ayurvedic (abbreviated as TGA) tablets. For coating of the TGA tablets the work was completed into two parts- in the first part extraction of dye from turmeric rhizome was carried out and in the second part extracted dye was used to coat the TGA-tablets. The dye extract was used in two forms for dyeing the tablets - firstly as liquid turmeric dye extract (LTDE) and secondly as powdered turmeric dye extract (PTDE). The optimum extraction conditions were settled after studying the effect of solvent, stirring time and temperature on the extraction of dye. The solvents used are water, ethanol and water- ethanol mixture. It was observed that the optimum extraction conditions for turmeric dye extraction were 600c and 75 min stirring time with ethanol as solvent but from industrial point of view it is more economical to use ethanol–water (1:1) mixture for extraction. The extracted LTDE and PTDE were used to coat the TGA tablets. The results showed that the tablet coated with LTDE faded just in 30 days while PTDE coated tablets remained stable up to 40 days. Thus, present coating was suitable for coating the TGA tablets but the environmental factors like temperature and humidity influenced the stability of the coating a lot. The suitability of coating was studied by determining some physico- chemical parameters like average weight, diameter, thickness, friability, disintegration time and loss on drying of LTDE and PTDE coated tablets. The results were within the permissible limit of Indian Pharmacopea and other pharmacopeia. Therefore, coating of tablets with LTDE and PTDE both were found to be suitable for coating the TGA tablet

A survey of awareness of Pap smear and cervical cancer vaccine among women at tertiary care centre in Eastern Uttar Pradesh India

Background: Cervical cancer is very common in developing countries. In Uttar Pradesh the literacy rate of women is low as compared to other states of India. Poverty is very high. Most women report with advance stage of cervical cancer. It can be prevented by early screening with Pap smear. Aim of our study is to know about the awareness of Pap smear and cervical cancer vaccine among women attending a tertiary hospital in Eastern part of Uttar Pradesh India.Methods: A questionnaire based study is done on 1500 patients attending the OPD and admitted in ward over a period of one year.Results: To our surprise only 12.06% women were aware of Pap screening test. Only 6.13% women were aware of cervical cancer vaccine. The awareness about both Pap test and cervical cancer vaccine was present in only 5.2% only. The education of the women and socioeconomic status also play an important role. The awareness among rural women was significantly less as compared to urban women.Conclusions: The awareness about Pap test and cervical cancer vaccine was very low specially in women staying in rural area. So if we really wanted to reduce cervical cancer then we have to increase the awareness among women by media, camps etc

An Innovative Approach for Online Food Order Management System

Restaurants are one of the favorite premises. An online food ordering is a integrated process in fast food Restaurants to offer choice of food from menu, cooked and served or packaged hot to satisfy customer to immediately make orders on their ownselves. Customers can also call the restaurant to pack in advance or to deliver the food item but sometimes restaurants run out of certain items. The existing system lacks the feature to use Remote GPS tracker such that restaurant managers are auto updated about the location of the customer before reaching the restaurant. We propose a complete system to easily manage online menu where items update as per the availability of food and prices. The Customer views the products, register and place the order. The system administrator adds and manages user accounts and the Manager manages product and orders. The Kitchen meal deliverable deals with pending deliveries .The proposed system is developed using Android platform which is open source software and built in data connection modules. It also decreases labour rates to replace mobile phones to book order and table unlike employees who come to take order and payments .In advent of food consumption problems like obesity, overeating etc. ,he proposed system will show food items with nutrition based searches showing ingredients of the food items

Four years’ maternal mortality updates of a high referral burden teaching hospital of Eastern Uttar Pradesh, India

Background: Maternal mortality is still a major challenge in developing countries but in our hospital, it touches the extreme height of MMR. The target of the study is to assess the cause of maternal mortality at Sir Sunder Lal Hospital, Banaras Hindu University, Varanasi, India.Methods: Data collection was done from the patient maternal mortality records of hospital between 2013 to 2016. Study comprises only maternal mortality cases. Total 165 maternal deaths were included in this study.Results: Maternal mortality ratio is extremely high as compare to other studies. In an increasing trend, in the year 2015 MMR was highest. Moreover, we found direct causes accounted 77.5% of total maternal deaths Hypertensive disorders and eclampsia is the most frequent cause of deaths which represented 33.3%. We found a trend of increased MMR with Increased unbooked cases. 21.2% of total dead women couldn’t get beds in ICU because of not vacancy of beds and 18.8% of total women died due to non-affordability of ICU expenses.Conclusions: Our hospital is a high burden referral apex centre of eastern Utter Pradesh in India which experience mostly referred cases from the periphery. PPH and hypertensive disorder are two major causes which lead to deaths. Cardiovascular dysfunction is most accounted for deaths. Mostly patients were needed ventilatory support to survive but lack of separate ICU and improper antenatal visits leads to MMR higher. However, many other factors like ill-literacy, poor transportation, poor referral note, poor socio-demographic status should be dealt to incline the MMR.

Spectacle adherence and barriers towards spectacle wear among primary school going children

Background: The aim of the study was to assess the spectacle adherence and barriers towards spectacle wear among primary school going children in the west UP. Methods: A cross-sectional, descriptive questionnaire-based study was conducted among the primary school going children in rural area of west UP. Spectacle was provided after the comprehensive eye examination, free of cost to the children those who required. An uninformed visit was planned after 3 months of initial examination to assess the compliance of spectacle wear and non-compliant subjects were questioned about the reasons for not wearing spectacle. Results: This study consists of total 158 children. In this study, majority of participants 88.61% were myopic having low degree of myopia being more common. Compliance rate towards the spectacle wear was high in males as compared to female children. Compliance rate was significantly varied with the age of participants. Myopic patients show more compliance than the hyperopic patients, it was insignificant while considering the severity of refractive error. The main cause for non-compliance towards spectacle was the cosmetic blemish. Conclusions: It has been found that the compliance rate towards the spectacle wear was not good enough even after distributing the spectacle free of cost to the children. Various factors including cosmetic blemish, parents and children perception for wearing spectacle and difficulties experienced by the children while wearing glasses were responsible for the non-compliance. The compliance rate can be increased by providing the education and training and Counselling to school teachers, children and their parents regarding the eye health