Successful management of pregnancy in a non-communicating rudimentary horn of a unicornuate uterus

Pregnancy in a rudimentary horn pregnancy is a rare clinical condition. The usual consequence is rupture culminating in hypovolemic shock. We had a different scenario of unruptured rudimentary horn pregnancy which was detected following failed attempt of MTP. She underwent laparotomy and excision of rudimentary horn. Post-operative period was uneventful. We present this case not only because of rarity but also high index of suspicion is required to diagnose at an early stage before a devastating course

SOD1 Integrates Signals from Oxygen and Glucose to Repress Respiration

SummaryCu/Zn superoxide dismutase (SOD1) is an abundant enzyme that has been best studied as a regulator of antioxidant defense. Using the yeast Saccharomyces cerevisiae, we report that SOD1 transmits signals from oxygen and glucose to repress respiration. The mechanism involves SOD1-mediated stabilization of two casein kinase 1-gamma (CK1γ) homologs, Yck1p and Yck2p, required for respiratory repression. SOD1 binds a C-terminal degron we identified in Yck1p/Yck2p and promotes kinase stability by catalyzing superoxide conversion to peroxide. The effects of SOD1 on CK1γ stability are also observed with mammalian SOD1 and CK1γ and in a human cell line. Therefore, in a single circuit, oxygen, glucose, and reactive oxygen can repress respiration through SOD1/CK1γ signaling. Our data therefore may provide mechanistic insight into how rapidly proliferating cells and many cancers accomplish glucose-mediated repression of respiration in favor of aerobic glycolysis

Modelling Engineering Change Management in a New Product Development Supply Chain

The changes within a new product development (NPD) process are handled differently depending on the stage of the project. The changes during the initial stages of the project are addressed by design iterations, while the changes after the product design is complete are addressed using a formal engineering change management (ECM) process. The ECM process is a complex process, especially under a collaborative environment, where various independent entities work together for a common cause of product development. The interactions between the NPD and ECM processes have rarely been investigated in the research community. In this paper, we attempt to study the interactions between the various NPD and ECM process parameters by modelling the processes and simulated the model to understand the parameter interactions. The organisations in a supply chain have been characterised based on their interactions with the original equipment manufacturer (OEM) during the NPD process. The organisation process templates representing the NPD and ECM processes of each type of organisation in the supply chain have been modelled. The templates have been used to develop a simulation model representing the NPD and ECM processes for a supply chain. The process variables, such as processing rates, resources, resource composition, resource allocation priority, processing quality and phase overlap, have been included in the model. The results indicate that most of the variables and interactions among the variables have a significant influence on the NPD lead time. By identifying the status of the NPD process, the decision-makers can use these results to develop appropriate management policies to govern their product development projects

Evidence for CO2-rich fluids in rocks from the type charnockite area near Pallavaram, Tamil Nadu

Fluid inclusion and mineral chemistry data was presented for samples from the type charnockite area near Pallavaram (Tamil Nadu, India). The results indicate the presence of a dense CO2 fluid phase, but the data cannot distinguish between influx of this fluid from elsewhere or localized migration of CO2-rich fluids associated with dehydration melting

Clinical use of misoprostol for cervical ripening before transcervical procedures in non pregnant women: a randomized comparison of vaginal and sublingual administrations

Background: Endometrial sampling techniques like endometrial biopsy, Fractional curettage, Dilatation & curettage and hysteroscopy are the common gynaecological outpatient transcervical diagnostic procedures for various clinical conditions. Complications encountered during these procedures are often due to difficulties in cervical dilatation. The incidence of these complications can be reduced if cervix is ripened before the procedures. The aim of the present study was to evaluate the efficacy of 400mcg of misoprostol administered vaginally or sublingually for cervical ripening before transcervical gynaecological diagnostic procedures in both pre and post-menopausal women. Methods: Non pregnant pre and post-menopausal women scheduled for transcervical diagnostic procedures were assigned by computerized randomization to receive 400 mcg of misoprostol, administered either sublingually or vaginally 3-4 hours prior to the procedure. The primary outcome in this study was the pre procedural cervical width as measured by the largest number of Hegar dilators. The side effects related to misoprostol and complications associated with the procedure if any also noted.Results: Patients were randomized to receive sublingual (50) or vaginal (50) misoprostol. The two groups were comparable in terms of age, BMI (body mass index), parity, menopausal status and indications for diagnostic procedures. The mean cervical dilatation in sublingual group was 7.28 ± 2.21 mm and it was 6.57 ± 2.24 mm in vaginal group which was statistically similar among the groups. There were no complications associated with the procedure. Side effects were also comparable among the groups.Conclusion: Even though we found sublingual route is an effective alternate to vaginal administration of misoprostol for cervical ripening before transcervical diagnostic procedures like endometrial biopsy, fractional curettage and dilatational curettage in non pregnant pre and post-menopausal women especially when women feel uncomfortable with vaginal route. However, the optimal dose and time interval remains to be identified. It needs larger randomized control trials are required to prove clinical significance if any.

A Weakly Supervised Approach for Estimating Spatial Density Functions from High-Resolution Satellite Imagery

We propose a neural network component, the regional aggregation layer, that makes it possible to train a pixel-level density estimator using only coarse-grained density aggregates, which reflect the number of objects in an image region. Our approach is simple to use and does not require domain-specific assumptions about the nature of the density function. We evaluate our approach on several synthetic datasets. In addition, we use this approach to learn to estimate high-resolution population and housing density from satellite imagery. In all cases, we find that our approach results in better density estimates than a commonly used baseline. We also show how our housing density estimator can be used to classify buildings as residential or non-residential.Comment: 10 pages, 8 figures. ACM SIGSPATIAL 2018, Seattle, US

A review of cardiac tumors

The intention of the review is to highlight the clinical presentation and established surgical technique in the management of this relatively uncommon cardiac pathology. Intracardiac masses may be encountered by a cardiologist or cardiac surgeon, and a comprehensive knowledge of the various diagnostic modalities is therefore essential. More crucial are the likely probabilities, based on an amalgamation of the clinical features, echocardiographic and radiographic findings. If surgical management is undertaken, the intra-operative finding is ultimately correlated with the histopathological diagnosis. In the review, we emphasise the necessity of a multidisciplinary approach to management of these tumors. The cumulative experience of the various members of the team collectively enables increasingly accurate diagnoses to be made preoperatively, with appropriate surgical management carried out timeously

Radical irradiation for carcinoma of the prostate

Ninety-three patients treated by radical irradiation for stage A2, Band C1 carcinoma of the prostate between 1979 and 1988 at a joint radiotherapy service were reviewed. The average age was 63 years, 84% of the patients were white and on histological examination the tumours were well or moderately differentiated in 88% of cases. Treatment was with 5 fractions per week in 71% while the remainder received 3 - 4 fractions per week. At a median follow-up of 62 months, the 5-year survival rate was 83% and the relapse-free rate was 73% (life table). The most important prognostic factor was tumour grade. In patients with grade 1 and 2 tumours, the 5-year survival rate and relapse-free rate was 91% and 76% respectively, while the survival for grade 3 tumour was 60% and 22% respectively (P < 0,05 logrank). There was a suggestion that patients diagnosed by trans-rectal needle biopsy did better than those diagnosed by trans-urethral resection, but this was not statistically significant. Disease stage did not influence survival. The crude late complication rate was 10% but this was significantly related to the use of less than 5 fractions of radiation per week. A separate group of 13 patients with local disease who had had failed previous hormonal treatment were not analysed. Their 5-year survival rate was 19%, which is statistically significantly worse (P< 0,001 logrank)

An unusual presentation of a severely calcified subserous leiomyoma in a postmenopausal woman: a case report

We report a case of a 58-year-old postmenopausal woman presented with mass descending per vaginum with lower abdominal discomfort for last one year. Examination revealed second stage utero-vaginal prolapse according to Pelvic organ prolapsed quantification (POP-Q) system with a hard mobile mass of size 6x6 cm in pouch of Douglas. After workup, it was diagnosed as posterior subserosal calcified leiomyoma of FIGO (International Federation of Gynaecology and Obstetrics) class 6. Vaginal hysterectomy with pelvic floor repair was done and histopathological examination confirmed a calcified leiomyoma.

Adjuvant chemotherapy for stage I non-seminomatous testicular cancer

The International Society for Burns Injuries (ISBI) has published guidelines for the management of multiple or mass burns casualties, and recommends that 'each country has or should have a disaster planning system that addresses its own particular needs.' The need for a national burns disaster plan integrated with national and provincial disaster planning was discussed at the South African Burns Society Congress in 2009, but there was no real involvement in the disaster planning prior to the 2010 World Cup; the country would have been poorly prepared had there been a burns disaster during the event. This article identifies some of the lessons learnt and strategies derived from major burns disasters and burns disaster planning from other regions. Members of the South African Burns Society are undertaking an audit of burns care in South Africa to investigate the feasibility of a national burns disaster plan. This audit (which is still under way) also aims to identify weaknesses of burns care in South Africa and implement improvements where necessary