Hepatic adenoma-an unusual case report

A 70-year-old female visited to tertiary care hospital with complains of abdominal pain on and off for 2 years. Pain gradually increased and was associated with vomiting. Patient is a known case of hypertension and diabetes mellitus. The patient`s complete blood count was normal with increased coagulation profile. Provisional clinical diagnosis was fibronodular variant of hepatocellular carcinoma. Computed tomography scan suggestive of fibronodular hyperplasia. Specimen received in pathology department, which on gross examination showed well circumscribed, well encapsulated tumour with variegated appearance. Histopathological diagnosis of Hepatic adenoma was made

Placental polyp after normal vaginal delivery: a rare diagnostic dilemma

Placental polyp is retained placental tissue within the endometrial cavity, which forms a nidus for inflammation and bleeding. Placental polyp is a rare entity with an incidence of less than 0.25% of all pregnancies as reported. Here, we report a case of 23-year-old P2L2 woman with complaints of intermittent vaginal bleeding since her recent normal vaginal delivery, 1.5 months back. A polypoid mass (51×41 mm) with abundant vascularity was detected as retained products of placenta (RPOC) within the endometrial cavity by imaging studies. A combination of polypoidal mass within the endometrial cavity with normal beta human chorionic gonadotropin (hCG) of <2.0 mIU/ml raising the suspicion of retained products of placenta or trophoblastic neoplasms. After yielding an unsatisfactory biopsy containing only fibrin deposition, total hysterectomy was performed due to profuse bleeding during biopsy. The uterus specimen showed slight globular enlargement with presence of a red-coloured polypoid mass within the endometrial cavity with rough outer surface and fragile consistency. The histological specimen of the protruding lesion, from the exaggerated placental implantation site, showed intermediate trophoblastic cells infiltrated into the myometrium, which might lead to the diagnosis of placental polyp. However, since placental polyp and uterine arteriovenous malformation have similar clinical characteristics, it is important to accurately identify and differentiate between them to ensure optimal treatment therapy. Definite diagnosis is ultimately made by histopathological examination. We report here a case that is suggestive of either a placental polyp or uterine arteriovenous malformation and will discuss the differential diagnoses and treatments for both diseases, based on a literature review

Seasonal Variability in Fine Particulate Matter Water Content and Estimated pH over a Coastal Region in the Northeast Arabian Sea

The acidity of atmospheric particles can promote specific chemical processes that result in the production of extra condensed phases from lesser volatile species (secondary fine particulate matter), change the optical and water absorption characteristics of particles, and enhance trace metal solubility that can function as essential nutrients in nutrient-limited environments. In this study, we present an estimated pH of fine particulate matter (FPM) through a thermodynamic model and assess its temporal variability over a coastal location in the northeast Arabian Sea. Here, we have used the chemical composition of FPM (PM2.5) collected during the period between 2017–2019. Chemical composition data showed large variability in water-soluble ionic concentrations (WSIC; range: 2.3–39.9 μg m−3) with higher and lower average values during the winter and summer months, respectively. SO42− ions were predominant among anions, while NH4+ was a major contributor among cations throughout the season. The estimated pH of FPM from the forward and reverse modes exhibits a moderate correlation for winter and summer samples. The estimated pH of FPM is largely regulated by SO42− content and strongly depends on the relative ambient humidity, particularly in the forward mode. Major sources of FPM assessed based on Positive matrix factorization (PMF) and air-mass back trajectory analyses demonstrate the dominance of natural sources (sea salt and dust) during summer months, anthropogenic sources in winter months and mixed sources during the post-monsoon season

Asia–Pacific association for study of liver guidelines on management of ascites in liver disease

The development of ascites is a landmark event in the natural history of cirrhosis. This guidance statement by the Asia–Pacific Association for Study of Liver (APASL) provides an evidence-based approach to managing ascites and its complications in patients with chronic liver disease. These guidelines extensively review the differential diagnosis, diagnostic evaluation, and management of ascites, hyponatremia, hepatic hydrothorax and hepatorenal syndrome (HRS) in patients with cirrhosis and acute-on-chronic liver failure (ACLF). A panel of international experts was invited to formulate the guidelines. The opinions of the experts were collected using two sets of Delphi questionnaires. Then, an online meeting of all the experts was held to discuss the evidence and formulate the final recommendations by consensus. The guidelines were developed using the GRADE system for analysing the level of evidence and strength of recommendation (Table 1). All authors have gone through the guidance document and endorse the same.In this document, we have also covered the grey areas which have been underexplored in previous guidelines and some of the issues which are relatively peculiar to the Asia–Pacific region. Given the high burden of tuberculosis in some of the countries of the Asia–Pacific region, mixed ascites is not uncommon in these patients with liver disease. We discuss the diagnostic approach to mixed ascites and the role of ascitic fluid adenosine deaminase (ADA) and other tests for tuberculosis. In addition, many countries in the Asia–Pacific region are low-middle-income countries, and financial constraints are an essential barrier to liver transplants and other costly therapies like albumin. Hence, we have discussed the role of low-dose albumin in the prevention of paracentesis-induced circulatory dysfunction (PICD) after large-volume paracentesis (LVP) and the prevention of acute kidney injury (AKI) in patients with spontaneous bacterial peritonitis (SBP). We have also reviewed the current evidence of outpatient albumin in managing patients with ascites and have made practical recommendations. We also highlight the timing of albumin infusion concerning LVP. To decrease adverse events and improve patient compliance with diuretic therapy, the guidelines emphasize initiating low-dose diuretics and gradually increasing the dose to the maximum tolerable dose. Non-alcoholic fatty liver disease (NAFLD), also referred to as Metabolic associated fatty liver disease (MAFLD) by some societies has become a significant cause of chronic liver disease worldwide [1]. Many patients with NAFLD/MAFLD related cirrhosis are on angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) when they present to a hepatologist or gastroenterologist with ascites. For the first time, we provide guidance statements regarding the use of these drugs in patients with cirrhosis and ascites. For refractory ascites, we have now defined renal dysfunction following the International Club of Ascites (ICA) recommendations on AKI. Lastly, we have highlighted the gaps in our knowledge and have provided directions for future research

Book of Abstracts of the 2nd International Conference on Applied Mathematics and Computational Sciences (ICAMCS-2022)

It is a great privilege for us to present the abstract book of ICAMCS-2022 to the authors and the delegates of the event. We hope that you will find it useful, valuable, aspiring, and inspiring. This book is a record of abstracts of the keynote talks, invited talks, and papers presented by the participants, which indicates the progress and state of development in research at the time of writing the research article. It is an invaluable asset to all researchers. The book provides a permanent record of this asset. Conference Title: 2nd International Conference on Applied Mathematics and Computational SciencesConference Acronym: ICAMCS-2022Conference Date: 12-14 October 2022Conference Organizers: DIT University, Dehradun, IndiaConference Mode: Online (Virtual

Abstracts of Scientifica 2022

This book contains the abstracts of the papers presented at Scientifica 2022, Organized by the Sancheti Institute College of Physiotherapy, Pune, Maharashtra, India, held on 12–13 March 2022. This conference helps bring researchers together across the globe on one platform to help benefit the young researchers. There were six invited talks from different fields of Physiotherapy and seven panel discussions including over thirty speakers across the globe which made the conference interesting due to the diversity of topics covered during the conference. Conference Title:  Scientifica 2022Conference Date: 12–13 March 2022Conference Location: Sancheti Institute College of PhysiotherapyConference Organizer: Sancheti Institute College of Physiotherapy, Pune, Maharashtra, Indi