A case report on advanced undiagnosed secondary abdominal pregnancy

Abdominal pregnancy is a rare form of ectopic pregnancy that involves implantation within the peritoneal cavity, exclusive of fallopian tubes, ovaries, broad ligament and cervix. Secondary abdominal pregnancy results from implantation of blastocyst into peritoneal cavity that was originally located elsewhere. It is associated with high maternal and fetal morbidity and mortality. Here, we have discussed about a 32 year old second gravida para one post caesarean section (last CS 2 years back) at 24+ weeks of gestation with rupture uterus with advanced secondary abdominal pregnancy with intrauterine death. Exploratory laparotomy with repair of rupture uterus with bilateral tubectomy was done

Study on epidemiology of endometriosis in North East India

Background: Endometriosis is the presence of endometrial glands and/or stroma outside the uterus, predominantly in   reproductive age. The prevalence is around 10% in women of reproductive age and is caused by combination of multiple genetic and environmental factors. Characterization of endometriosis can be learnt from epidemiological factors of the patients which influence on disease development and thus helpful in clinical diagnosis. Histological pictures after surgery may vary considerably and sometimes over diagnosis of the disease is not uncommon. The purpose of the study was to study the epidemiology of endometriosis in North East population of India and correlation of clinical and histopathological diagnosis. Methods: It was a hospital based observational descriptive study carried out in Department of Obstetrics and Gynecology, AMCH, Dibrugarh, Assam, India.  Detailed history and clinical presentations were elicited and relevant investigations were done. Operative findings and biopsy reports were correlated. All the findings were tabulated and statistically analyzed. Results: Women in age group 30-39 years (48.31%) with mean BMI of 24.44±4.06 kg/m2, nulliparous (31.46%) or para 1(33.71%) formed the majority of study population. Majority had early age at menarche (11.45±1.24), irregular cycles, shorter cycle length, longer duration of flow. Majority (79.78%) had dysmenorrhea followed by dyspareunia (59.55%). Only 62.92% had biopsy proven endometriosis. Conclusions: Epidemiological factors and clinical presentations guide in diagnosing endometriosis and should be given importance. Clinical diagnosis of endometriosis may not always correlate with histopathologic diagnosis and many other pathologies mimic endometriosis

The effect of comorbidities of preeclampsia and eclampsia on maternal and fetal outcome

Background: The aim of this study is to comparatively assess the maternal and fetal outcome in preeclampsia and eclampsia patients with and without comorbidities. The objectives are to assess the comorbidities associated with preeclampsia and eclampsia cases and to find out the effects of the comorbidities of preeclampsia and eclampsia on maternal and fetal outcome. Methods:380 patients who had attended antenatal OPD and emergency labour room of Assam medical college and hospital, Dibrugarh during June 2020 to July 2021 with preeclampsia and eclampsia were selected for present study. Based on relevant history, clinical and laboratory findings, these patients were further evaluated for associated comorbidities. The cases were distributed in the respective comorbidity group. Then the outcome of the mother and the baby were analyzed till the day of discharge in patients without comorbidities and with comorbidities and the same was compared. Results: The eventful maternal (44.1%) and fetal (50.92%) outcome was more in preeclampsia and eclampsia patients with comorbidities than in patients without comorbidities which is statistically significant, (p value=0.029), (p value=0.009) respectively. Conclusions: The effect of preeclampsia and eclampsia itself would adversely affect the pregnancy outcome and the effect is worse when associated with comorbidities. Appropriate prenatal counselling and optimization of the comorbidities is critical for women who are planning pregnancy

Waste polyethylene terephthalate as an aggregate in concrete

This paper reports the strength behaviour of concrete containing three types of recycled polyethylene terephthalate (PET) aggregate. Results are also analysed to determine the PET-aggregate's effect on the relationship between the flexural and splitting tensile strengths and compressive strength and to know whether the relationships between compressive strength and other strength characteristics given in European design codes are applicable to concrete made with PET-aggregates. The compressive strength development of concrete containing all types of PET-aggregate behaves like in conventional concrete, though the incorporation of any type of PET-aggregate significantly lowers the compressive strength of the resulting concrete. The PET-aggregate incorporation improves the toughness behaviour of the resulting concrete. This behaviour is dependent on PET-aggregate's shape and is maximised for concrete containing coarse, flaky PET-aggregate. The splitting tensile and flexural strength characteristics are proportional to the loss in compressive strength of concrete containing plastic aggregates

Recycled Aggregate in ConcreteUse of Industrial, Construction and Demolition Waste /

XI, 445 p. 225 illus., 21 illus. in color.online

Perspective of the doctors in a new medical college of North-East India regarding the National list of essential medicines.: Doctors perspective regarding the National list of essential medicines in a medical college of North-East India .

Background:The WHO model list of essential medicines is issued by the WHO to serve as a guide for all the countries for development of their respective list of essential medicines depending on their requirements.In addition to national list some countries also have provisional or state lists and institutional EML by keeping in view of certain conditions such as availability of medicines, affordability, treatment of facilities, personnel, and genetic, demographic and environmental factors.The condition that the patients present with in tertiary care hospital in North East India will not be entirely similar to those presenting in a hospital in North India or elsewhere. Aims and Objective: To collate the perspective of doctors regarding NLEM and thus assessing the factors affecting adaptation and implementation of NLEM at the state/institution level. Materials and method: This is a cross-sectional questionnaire-based study conducted among the doctors of Tomo Riba Institute of Health and Medical Sciences, which is a new Medical college and a tertiary care hospital in Naharlagun, Arunachal Pradesh. The study was carried out for a period of 6 months.The participants were explained the purpose of study and requested to fill the questionnaire and return immediately.Data analysis was performed using simple statistical methods like percentages and proportions Results: A total of 73 participants responded to the questionnaire. Out of which 63% of the study participants were aware of NLEM while 37% were unaware of the term NLEM.Only 17.8% of the doctors are satisfied that the drugs in the latest NLEM suffice most of the medical conditions they come across in their daily practices. Only about 39.7% of the doctors prescribed frequently the drugs from the NLEM list in their routine practice. Majority(61.6%) of them agree that there should be a separate essential drug list supplementary to the WHO list in every tertiary care medical college. Conclusion:The concept of NLEM offers the most cost-effective solution to healthcare needs. The selection of the medicines in the list or a separate state or institutional list according to the need of the regional population can cater most of the healthcare needs

Seasonal Variation in Epistaxis in Upper Assam Region: A Cross-sectional Study

Introduction: Epistaxis whether spontaneous or acquired is one of the most common ENT emergencies. Its management can be challenging depending on the origin of bleeding and presence of precipitating factors. Aim: To find out the seasonal variation in epistaxis according to age, gender, region and aetiological factor. Materials and Methods: This cross-sectional study was conducted from June 2019 to June 2020 in a tertiary care centre in Upper Assam. In this study, the seasons were divided according to weather atlas as follows: Winter- December, January, and February; Spring- March and April; Summer- May and June; Rainy season- July, August and September; and Autumn- October and November. Outcome was to find the seasonal variation in epistaxis according to age, gender, region and aetiological factor. The data collected was tabulated in Microsoft Excel Worksheet and the categorical variables were summarised as proportions and percentages. Results: Out of 313 patients, 221 (70.6%) were males and 92 (29.4%) were females. High male preponderance with male to female ratio of 2.4:1 was noticed. Maximum number of patients were seen in month of October 66 cases (21%). Minimum male patients were seen in month of June 2020 (0.6%) 2 cases and minimum number of female patients were seen in the month of February and April (0.3%). Conclusion: The major cause of epistaxis in this region is hypertension, therefore peripheral health facility should be ready for giving treatment

Umbilical Cord Blood Culture as an Aid to the Diagnosis of Early Onset Neonatal Sepsis: A Cross-sectional Study

Introduction: Neonatal sepsis is one of the leading causes of neonatal morbidity and mortality globally, accounting for an estimated neonatal mortality rate of 23.9 per 1000 live births. Due to overlapping signs and symptoms, a specific diagnosis of sepsis poses a diagnostic challenge. Blood collected from a peripheral vein for sepsis screening and blood culture remains the gold standard for diagnosing neonatal sepsis. The umbilical cord is still not routinely used as a site for collecting blood for sepsis screening and blood culture. Aim: To determine the diagnostic efficacy of Umbilical Cord Blood Culture (UCBC) compared to Peripheral Venous Blood Culture (PVBC) in Early Onset Neonatal Sepsis (EONS). Materials and Methods: This cross-sectional observational study was conducted at the Neonatology Unit, Department of Paediatrics, Assam Medical College and Hospital (AMCH), Dibrugarh, Assam, India, involving 110 neonates with two or more risk factors for EONS over a one-year period (August 2021-July 2022). Umbilical cord blood and peripheral venous blood were collected and cultured, and the neonates were monitored throughout their hospital stay. Statistical significance was determined using the Chi-square test for categorical variables and the t-test for continuous variables (with a p-value <0.05 considered statistically significant). The validity of UCBC for diagnosing early neonatal sepsis was assessed based on sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV). Results: The mean gestational age was 34.95±3.314 weeks and mean birth weight was 2.08±0.790 grams. Of the 110 high-risk neonates, sepsis screening was positive in 67 (61%), while UCBC and PVBC were positive in 19 (17.3%) and 10 (9.09%), respectively. Acinetobacter was the most common organism found in both cultures. The sensitivity and specificity of sepsis screening were 100% and 47.25% compared to UCBC and 90% and 42% compared to PVBC. In comparison to PVBC, UCBC demonstrated a sensitivity and specificity of 70% and 88%, with a diagnostic accuracy of 86.36%. Conclusion: The UCBC exhibits good diagnostic accuracy for diagnosing EONS and can be utilised due to it being a painless and technically less challenging method of blood sampling, with high sensitivity and specificity

Pre-treatment of municipal solid waste incineration (MSWI) bottom ash for utilisation in cement mortar

© 2015 Elsevier Ltd. All rights reserved. The removal of elemental aluminium, sulphate and harmful organics from two types of MSWI ash samples, the sand sized (0.1-2 mm) fraction of MSWI bottom ash from a grate furnace (SF), and boiler and fly ash from a fluidized bed incinerator (BFA), were done to use as fine aggregates in preparation of cement mortar. Results indicate that the chemical treatment by 0.25 M Na2CO3 solution can dissolve the Al and the sulphate bearing minerals from the BFA and therefore enhance its quality to use as a fine aggregate in cement mortar preparation. On the other hand, heat treatment at about 675 °C before Na2CO3 treatment is necessary to improve the quality of SF for using as a fine aggregate. The compressive strengths of mortars improve significantly due to the partial replacement of sand by heat and Na2CO3 treated ash samples. The proposed treatment methods slightly change the toxic element leaching behaviours of the ash samples. The concentrations of toxic elements in the leachates generated from the treated ash samples as well as the leachates generated from the mortars containing these ash samples are well within the regulatory limits.status: publishe