Neglected vaginal pessary

Vaginal pessary may be opted for management of uterine prolapse as a safe option, but to avoid complications regular follow-up is a must. We are reporting a case of neglected vaginal pessary in a 72 year old female which got embedded in vaginal mucosa and required excision of vaginal band for its removal

Potential of Biochar as Cost Effective Adsorbent in Removal of Heavy Metals Ions From Aqueous Phase: A Mini Review

Due to industrialization and increasing population, wastewater treatment has become a big challenge. There are numerous techniques such as ion-exchange, adsorption, membrane filtration, coagulation, flocculation, floating and electrochemical approach developed for the remediation of contaminants from wastewater. But, now it is necessary to develop an approach which should has high efficiency, less expensive and environmental friendly, so that limitation of existing techniques can be overcome. Recent developments of biochar have attracted the researchers into this area. Different methods are discovered to synthesized biochar for the removal of pollutants from wastewater. In this review, biochar are elaborated and critically discussed which have reported for the removal of metallic pollutants present in waste water

Radiation and mass transfer effects on MHD flow through porous medium past an exponentially accelerated inclined plate with variable temperature

AbstractAn analysis of unsteady MHD free convection flow, heat and mass transfer past an exponentially accelerated inclined plate embedded in a saturated porous medium with uniform permeability, variable temperature and concentration has been carried out. The novelty of the present study was to analyze the effect of angle of inclination on the flow phenomena in the presence of heat source/sink and destructive reaction. The Laplace transformation method has been used to solve the governing equations. The effects of the material parameters, magnetic field and the permeability of the porous medium are discussed. From the present analysis it is reported that the presence of magnetic field and porous medium prevents the flow reversal. Angle of inclination and heat source sustains a retarding effect on velocity. The present study has an immediate application in understanding the drag experienced at the heated/cooled and inclined surfaces in a seepage flow

Correlation of lateral placental location with development of preeclampsia

Background: Preeclampsia is a complex clinical syndrome which involves multiple organ systems and remains the principle cause of maternal and perinatal morbidity and mortality. Preeclampsia is a disease of trophoblastic tissue. Placental abnormality is one of the initial events in patients who are destined to develop pregnancy induced hypertension subsequently. Objective of this study was to evaluate the association of laterally located placenta on ultrasound with development of preeclampsia.Methods: This prospective observational study was conducted on 200 antenatal women with singleton pregnancy at 18-24 weeks of gestation who attended antenatal clinic of obstetrics and gynaecology, PGIMS Rohtak from October 2017 to October 2018. Detailed antenatal transabdominal ultrasound along with placental location was done between 18-24 weeks of gestation in women who fitted into inclusion criteria. All the antenatal women belonged to 18-24 weeks of gestation were included in the study except those women with chronic hypertension, diabetes mellitus, renal disease, severe anaemia, thyrotoxicosis, low lying placenta, previous history of preeclampsia or eclampsia.Results: Out of 200 antenatal women, 84 had lateral placenta while 116 had central placenta. Out of these 84 women who had lateral placenta, 55 women (65.5%) developed preeclampsia and out of 116 (58%) women who had central placenta, 28 women (24.1%) developed preeclampsia.Conclusions: From the above study, we concluded that women with laterally located placenta by ultrasound at 18-24 weeks of gestation have greater risk of developing preeclampsia

Maternal complications in twin pregnancy; recent trends: a study at a tertiary care referral institute in Northern India

Background: This study aims to determine the maternal complications in twin pregnancy in North Indian population at tertiary institute.Methods: This was a retrospective cohort review of multiple pregnancies after 20 weeks gestation at a tertiary teaching hospital (2011-2015). Maternal data was collected from the labor room delivery data entry register and patient’s admission file. Patients with diabetes mellitus and chronic hypertension were excluded from the study.Results: Out of 19539 births during this period, 432 were twin pregnancies with an incidence of 22/1000 birth. Most of them were 282 (65.4%) were referred patients. Eighty seven percent patients were in the age group of 21-30 years and primigravida contributed to 45.7% of total patients. Maternal complications noticed were as preterm deliveries in 304 (70%), anaemia in 259(60%) patients, preterm rupture of membranes in 120 (39.4%) patients, hypertensive disorders of pregnancy in 122(28.3%) patients, cholestasis of pregnancy in 24(5.5%) of patients, hypothyroidism in 22(5.1%) of patients, antepartum hemorrhage (APH) in 20(4.6%) and gestational diabetes mallitus (GDM) in 08(1.8%) of patients. Among postpartum complications, atonic postpartum haemorrhage (PPH) was observed in 44 (10.2%) and maternal mortality happened in 02(0.46%) cases.Conclusions: This study reveals higher percentage of, preterm labor, anaemia, and gestational hypertension than other studies. More number of intensive care unit should be established in high prevalence areas to prevent perinatal mortality due to prematurity. Treatment of anaemia requires more aggressive approach by considering intravenous iron whenever compliance is in doubt. Frequent antenatal care is required for early diagnosis of these complications to prevent maternal and fetal morbidity

Relationship of Personal Hygiene and BMI with OHI-S Scores among Primary School Children in a District in North India

INTRODUCTION: Malnutrition, among children can lead to various morbidities, and some of its consequences can be fatal. AIM: To assess Hygiene with Nutrition & Morbidity among school children in district Ambala, Haryana, India. MATERIALS AND METHOD: Data was collected through a health check-up program for primary school children studying in class I and class III (aged only between 6-9 years) using a pre-tested and pre-designed questionnaire, weighing scale, measuring tape and dental screening instruments. The investigators were duly standardized and concerned instruments were duly calibrated. No names and personal information was collected and before the student was sent for examination, his I-card was removed. Data cleaned and analyzed using SPSS version 22.0. Shapiro wilk-test for data normalcy revealed a parametric distribution of the data and hence, the student’s t-test and multiple logistic regression were applied. RESULTS: The study included 216 males and 106 females, and the maximum unfavourable score (unclean hands, feet and skin) was observed in 40.1% of the children. Difference between favourable and unfavourable scores with OHI-S ≤2 was found to be 65.3% (p=0.02) and maximum students (68.9%), reported having a good favourable OHI-S score (p=0.01). It was observed that maximum males (43.1%) and females (48.1%) belonged to the “Normal” category of BMI, while lesser females (6.7%) were overweight in comparison to their male counterparts. Multivariate logistic regression revealed that OHI-S scores were significantly associated with BMI status (p=0.05) of the children, indicating that children with higher BMI scores have a tendency to have “fair” and “poor” OHI-S scores. CONCLUSION: Based on the results, appropriate measures can be undertaken to ensure that schools as well as healthcare professionals undertake more stringent measures to educate parents, children as well as teachers regarding the relationship between poor oral health and increased BMI values

Metastatic Bilateral Malignant Ovarian Tumors Associated with Pregnancy

SummaryObjectiveKrukenberg tumors in pregnancy are extremely rare. Only three cases have been reported, two of which were diagnosed postpartum.Case ReportA 20-year-old, primigravida with bilateral malignant ovarian tumors, who received no prior antenatal care, was presented with intestinal obstruction at 5 months' gestation. Pregnancy was preserved, and bilateral oophorectomy, omentectomy with resection of sigmoid colon growth, and colostomy were performed. The patient aborted spontaneously and postoperatively, and was treated with adjuvant chemotherapy.ConclusionBecause platinum-based chemotherapy can be safely given during pregnancy, hysterectomy can be avoided in cases of bilateral malignant ovarian tumors if the uterus is not grossly involved, so allowing preservation of an existing pregnancy

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Radiation and mass transfer effects on MHD flow through porous medium past an exponentially accelerated inclined plate with variable temperature

An analysis of unsteady MHD free convection flow, heat and mass transfer past an exponentially accelerated inclined plate embedded in a saturated porous medium with uniform permeability, variable temperature and concentration has been carried out. The novelty of the present study was to analyze the effect of angle of inclination on the flow phenomena in the presence of heat source/sink and destructive reaction. The Laplace transformation method has been used to solve the governing equations. The effects of the material parameters, magnetic field and the permeability of the porous medium are discussed. From the present analysis it is reported that the presence of magnetic field and porous medium prevents the flow reversal. Angle of inclination and heat source sustains a retarding effect on velocity. The present study has an immediate application in understanding the drag experienced at the heated/cooled and inclined surfaces in a seepage flow