A CASE OF OBSTRUCTED LEFT DIAPHRAGMATIC HERNIA

Diaphragmatic hernia is protrusion of abdominal viscera into the chest cavity. Most commonly seen due to congenital defects in the diaphragm, hence causing herniation of abdominal contents including stomach, bowel, pancreas, omentum. Acquired diaphragmatic hernia can be secondary to injury to diaphragm. Patient presents with respiratory distress, due to reduced lung expansion. Early correlation with radiological scans is required for appropriate timely management, to prevent further deterioration of condition

Comparative evaluation of the efficacy and safety of ormeloxifene and norethisterone in dysfunctional uterine bleeding

Background: Dysfunctional Uterine Bleeding (DUB) is the most common cause of abnormal uterine bleeding and is a major indication for referral to gynecological clinics. There are very few studies comparing the effect of ormeloxifene and progesterone in DUB. The objective of the study was to assess the efficacy and safety of Ormeloxifene in DUB and compare it with Norethisterone.Methods: Hundred women presenting with DUB were randomly allocated to 2 equal groups, Group-A, which received 60mg ormeloxifene twice a week for 12 weeks followed by 60mg once a week for next 12 weeks and Group-B, which received 5mg norethisterone twice daily for 21 days for 6 cycles. The primary outcomes were reduction in menstrual blood loss [measured by fall in PBAC (Pictorial Blood loss Assessment Chart) score and subjective assessment], rise in hemoglobin level and decrease in endometrial thickness.Results: The reduction in mean PBAC score with ormeloxifene (216 to 88) was significantly more than with norethisterone (262 to 162) at 3 months (p<0.01). The rise in hemoglobin concentration and fall in endometrial thickness were also significantly more with ormeloxifene than norethisterone (7.52g% to 9.2g% vs. 7.48g% to 8.4g%, p<0.05, and 12.12mm to 9.46mm vs. 12.05mm to 10.7mm, p<0.05, respectively). Further improvement at 6 months was much more with ormeloxifene. No major side effects were reported in any group.Conclusions: Both drugs are effective in treating DUB, but ormeloxifene is superior to norethisterone in reducing menstrual blood loss.

Fertility management in Kallmann syndrome: a step towards optimization

Kallmann syndrome (KS) is a genetic disorder with an incidence of one per 50,000 women. It is associated with hypogonadotropic hypogonadism and anosmia/hyposmia. An important aspect of managing KS is to achieve successful pregnancy. We hereby present a case series of three patients with KS who successfully conceived with human menopausal gonadotropin (HMG) induction. One patient achieved pregnancy with ovulation induction, second with fresh embryo transfer and the third with frozen embryo transfer. Two of these three women delivered at term and both babies were doing well at one year of follow up. Both received cyclical hormone therapy (HT) since adolescence. The third patient received HT only for six months before starting ovulation induction. She conceived twice but miscarried at both occasions. At times, it may be challenging to attain fertility in Kallmann syndrome but with persistent efforts results are usually rewarding. It is important to diagnose KS and start hormone therapy at appropriate time so that satisfactory fertility outcome can be achieved

Dermatoglyphics: A Marker of Periodontal Disease

Dermatoglyphics is the scientific study of fingerprint patterns.&nbsp;Fingerprints are formed in early embryonic life, during the 10th&nbsp;to 16th weeks of intrauterine life and remain permanent during&nbsp;the whole life. Dermatoglyphics can be used as a diagnostic&nbsp;tool of genetically and nongenetically determined diseases.&nbsp;Thus, it can be used not only in the field of medicine but also in&nbsp;dentistry for the early identification or prediction of oral lesions&nbsp;and diseases. Hence the present paper reviews the application&nbsp;of dermatoglyphics in dentistry along with the advantages,&nbsp;limitations, and patterns of dermatoglyphics

Clinical efficacy of clonidine versus nalbuphine as intrathecal adjuvants to 0.5% hyperbaric bupivacaine for subarachnoid block during gynaecological procedures: a double blind study

Background: Regional anesthesia techniques for gynaecological procedures are on increasing trends due to their advantage of postoperative analgesia owing to intrathecal adjuvants. The present study was aimed to comparatively evaluate the clinical efficacy of clonidine with nalbuphine when co-administered intrathecally with 0.5% hyperbaric bupivacaine for gynaecological procedures.Methods: Regional anesthesia techniques for gynaecological procedures are on increasing trends due to their advantage of postoperative analgesia owing to intrathecal adjuvants. The present study was aimed to comparatively evaluate the clinical efficacy of clonidine with nalbuphine when co-administered intrathecally with 0.5% hyperbaric bupivacaine for gynaecological procedures.Results: The onset of sensory block was earlier in patients of Group BN (3.91±2.25 min vs 4.30±0.87 min, p=0.039). The onset of motor block was also earlier in patients of Group BN (p=0.042). The time to first rescue analgesia in patients receiving intrathecal clonidine was significantly delayed (283±14.18 min vs 231.50±26.18 min, p=0.001). Intraoperative hemodynamic changes were comparable and none of the patient suffered from respiratory depression, shivering, nausea or vomiting.Conclusions: Intrathecal clonidine as adjuvant to bupivacaine provided was clinically more effective than nalbuphine for prolonging the duration of analgesia for gynaecological procedures

Endometrial histopathology patterns in women with abnormal uterine bleeding

Background: Abnormal uterine bleeding is the most common gynaecological condition for which many women seek medical opinion. Evaluation of these women requires careful investigation into the cause and nature of bleeding with a main focus to exclude organic pathology, especially genital malignancies. Endometrial biopsy is one such intervention which is of immense value in categorizing the conditions. Aims and objectives of current study were to analyse endometrial histology patterns in women with AUB.Methods: This was a retrospective study conducted on women with AUB who presented in the gynae OPD during the study period of one year and had endometrial biopsy as part of evaluation. Women between with AUB were included in the study after excluding pregnancy related bleeding. Detailed clinical history, examination findings, investigations and endometrial histopathology was noted.Results: A total of 97 women with AUB who had undergone dilatation and curettage with endometrial biopsy were studied. Majority of women were in age group of 40-45 years and heavy menstrual bleeding was the commonest complaint, AUB (P) 17% and AUB (L) 39%, accounted for most of the clinical presentations. Endometrial histology showed varied patterns 27 % had secretory endometrium, 11% proliferative endometrium. There were 7 cases of endometrial hyperplasia without atypia and three cases of endometrial malignancy. Conclusions: Histopathological evaluation of endometrium is the cornerstone of management of abnormal uterine bleeding. Endometrial patterns obtained can be useful in ruling out malignancy and help in formulating further management

Role of Click Chemistry in Organic Synthesis

Click chemistry involves highly efficient organic reactions of two or more highly functionalized chemical entities under eco-benign conditions for the synthesis of different heterocycles. Several organic reactions such as nucleophilic ring-opening reactions, cyclo-additions, nucleophilic addition reactions, thiol-ene reactions, Diels Alder reactions, etc. are included in click reactions. These reactions have very important features i.e. high functional group tolerance, formation of a single product, high atom economy, high yielding, no need for column purification, etc. It also possesses several applications in drug discovery, supramolecular chemistry, material science, nanotechnology, etc. Being highly significant and valuable, we have elaborated on several aspects of click reactions in organic synthesis in this chapter. Recent advancements in the field of organic synthesis using click chemistry approach have been deliberated by citing last five years articles

Synthesis of Bioactive Chlorinated 10H-Phenothiazines, Sulfones, Ribofuranosides and their Antimicrobial activity

Heterocyclic Chemistry is a vast thrust area for researchers. Various publications on biologically active phenothiazines and their ribofuranosides in recent years have aroused the interest of scientists in the synthesis and biological activity of these heterocycles. This article reports synthesis of some new prospective bioactive 10H-phenothiazines, their sulfones and ribofuranosides that have shown significant antimicrobial activity against some selected strains of fungi, Gram positive and gram negative bacteria and lead us to develop a possibly potent class of antimicrobial agents. 10H-phenothiazines were prepared via Smiles rearrangement. Their sulfones and ribofuranosides were prepared by oxidation with 30% hydrogen peroxide in glacial acetic acid and reaction with b-D-ribofuranose-1-acetate-2,3,5-tribenzoate (sugar) respectively