Necrotising myometrial granulomas leading to postpartal hemorrhage: an extremely unusual presentation

Granulomas exclusively involving the myometrium are rare pathological finding and those presenting with atonic post-partum hemorrhage have never been reported. Here we present a case of myometrial granulomas presenting with atonic postpartum hemorrhage (PPH) with no evidence of granulomatous inflammation elsewhere in the body. There was also no history of instrumentation or biopsy of the uterine cavity in the past

Fibroma with minor sex cord elements – an incidental finding in a normal sized ovary A case report with literature review

Ovarian fibroma with minor sex cord element is a rare neoplasm. Microscopically it is composed of predominantly fibromatous or a thecomatous tumor containing scattered minor sex cord elements in less than 10% of the tumor area

Office hysteroscopy prior to ART cycle-analysis and outcome at a private IVF clinic setup in Surat, Gujarat, India

Background: Hysteroscopy is a gold standard test for assessing the uterine cavity. The presence of uterine pathology may negatively affect the chance of implantation .This study investigated the use of routine office hysteroscopy and correction of any intrauterine pathologies prior to starting IVF cycle on treatment outcome in women seeking IVF treatment for primary infertility and recurrent implantation failure.Methods: This was a retrospective study of 100 women who attended our infertility clinic from July 2016 to December 2016 and who were willing for office hysteroscopy. The main outcomes measured were clinical pregnancy rates achieved in the index IVF cycle, multiple pregnancy rate, ectopic pregnancy rate, miscarriage rate and failure rate.Results: Of the 100 patients who participated in the study, 75 patients conceived, 25 patients failed to conceive. 80.64% patients with normal findings on diagnostic hysteroscopy conceived after the procedure, 58.33% patients conceived after polypectomy, 68.42% conceived after septal resection, 71.42% conceived after adhesiolysis, 50% conceived after lateral metroplasty and 73.07% of recurrent implantation failure conceived after local endometrial injury was done on hysteroscopy.Conclusions: Hysteroscopy in infertile women prior to their IVF cycle when performed atleast 3 months in advance could improve treatment outcome

Laboratory investigation and core flood demonstration of enhanced biogenic methane generation from lignite

Over the last several decades, coalbed methane (CBM) has emerged as an important energy source in developing nations like India as well as worldwide and is expected to play a significant role in the energy portfolio of the future. The current scenario of rapid exhaustion of fossil fuels is leading to the need to explore alternative and efficient fuel resources. The present study demonstrates enhanced methane production per gram of lignite (lowest-rank coal). Optimization of the bioconversion of lignite to methane revealed 55°C temperature and 1.5 g/L NaCl concentration as ambient conditions for the process. A scale-up study in the optimized condition showed 2,800 mM methane production per 25 g of lignite in anaerobic conditions. Further, Fourier transform Infrared (FTIR) and Gas Chromatography Mass Spectrometry (GCMS) analysis showed bioconversion of lignite into simpler intermediate substrates required for methane production. The results highlighted that the bacterial action first converts lignite into volatile fatty acids, which subsequently get converted into methane. Further, the exploration of indigenous microbial consortia in Tharad well (THAA) mainly comprises the order Methanosarcinales and Methanomicrobiales. The pathogenicity of the microbial consortium THAA was declared safe for use in mice via the oral route by The Energy and Resources Institute (TERI), India. The study demonstrated the development of indigenous consortia (TERI THAA), which can potentially enhance methane production from the lowest coal grade under extreme conditions in Indian coal beds

Pseudogaucher cells obscuring multiple myeloma: a case report

Gaucher-like or pseudo-Gaucher cells have been noted in a variety of conditions including acute lymphoblastic leukemia, Hodgkin's disease, thalassemia, and multiple myeloma. They have an eccentric, lobulated nucleus, foamy cytoplasm but lack the tubular inclusions seen in Gaucher cells. The pseudo-Gaucher cells have distinct appearances on electron microscopy which distinguish them from true Gaucher cells

Thermodynamic analysis of solar powered trigeneration arrangement for cooling, power and drinking water generation

Solar-driven trigeneration system is a most sustainable energy production technique. It produces valuable energy in the forms of heating, cooling, and power generation. Therefore, it meets the energy demands of a residential complex or of smallscale industries. This paper presents a solar-driven trigeneration system for power, cooling, and freshwater generation through a unit of humidification dehumidification desalination under various thermodynamic criteria. The trigeneration system consists of a parabolic trough collector, a storage tank, an organic Rankine cycle for power generation, a vapor absorption refrigeration system for producing a cooling effect, and a humidification and dehumidification desalination unit for producing fresh water. The average work output for the R-123 fluid was 2866.6 kJ, whereas for R-134a it was 2883.275 kJ. The present study had an average production of freshwater of about 157 kg per day from the proposed trigeneration system

Use of simplified claustrophobia questionnaire in predicting adherence to positive airway pressure (PAP) therapy in obstructive sleep apnea (OSA) patients

TITLE: Use of simplified claustrophobia questionnaire in predicting adherence to continuous positive airway pressure (CPAP) in obstructive sleep apnea (OSA) patients. Introduction: Claustrophobia could affect adherence to CPAP in sleep apnea patients. High score in a claustrophobia questionnaire containing 12 restriction and 14 suffocation items was associated to poor CPAP adherence in previous research. The restriction and suffocation items were equivalent on predicting CPAP adherence which allowed to limit the survey to only the suffocation questionnaire. The goal of this study is to find the predictability of CPAP adherence for each question of the suffocation questionnaire. Methods: We performed a prospective chart review of 114 patients with newly diagnosed OSA using home sleep apnea testing (HSAT). On initial consultation, patients were provided with a suffocation claustrophobia questionnaire. Patients’ demographics, home sleep study data and objective adherence data were collected within the first 3 months of usage.Results: Items 2 (OR =1.67, p-value = 0.049), 3 (OR=1.60, p-value = 0.021), and 13 (OR= 1.52, p-value = 0.056) are most promising in association with non-adherence. Results indicate that higher scores on item 2 is associated with higher odds of non-adherence to CPAP. Specifically, each point increase on item 2 was associated with a 67% increase in odds of non-adherence. However, these items alone do not show a large effect in providing accurate classification of adherence. Of these items, item 3 had the lower rate of missing data, suggesting that it may be the most patient-friendly item. Conclusions: Based on these results, the 3 questions with highest predictability for CPAP adherence will be studied in the clinical arena to address feasibility and predictability.https://scholarlycommons.henryford.com/merf2019clinres/1013/thumbnail.jp

Lymph Node Cytology: Morphology and Beyond!

Fine needle aspiration cytology (FNAC), being minimally invasive, rapid, cost-effective provides a valuable first-line diagnostic tool in the evaluation of lymphadenopathies both benign and malignant. Various ancillary techniques namely immunocytochemistry, flow cytometry, cell blocks, and molecular studies further improve the diagnostic accuracy of FNACs. Targeted FNAC under ultrasound guidance optimizes cellular yield in palpable and non-palpable lymphadenopathies. FNAC proves to be indispensable at establishing tissue diagnosis in cases when surgical excision is unfeasible, as in elderly patients with comorbidities or in metastatic settings. Nevertheless, lymph node FNAC represents a daunting task owing to the multitude of benign and malignant causes of lymphadenopathy. To aid categorization and better communication to the clinician, an emphasis on classification and reporting of lymph node cytopathology using Sydney system is laid upon

How Sleep Affects Recovery and Performance in Basketball: A Systematic Review

Background: Sleep is considered an essential component related to physiological and psychological recovery in athletes and particularly in basketball, given the impact of condensed travel and game schedules on player health and performance. Objective: The aim of this systematic review is to examine studies published to date on sleep and basketball performance. Methodology: All scientific articles that reported a relationship between sleep and its possible impact on performance in basketball are included. The research processes followed the PRISMA criteria, and the relevant articles were extracted (PubMed, WOS, Scopus) as of December 31, 2021. Results: Twenty-eight articles were selected for inclusion and data extraction, with 27 demonstrating that sleep is a vital component in the recovery of basketball players and their corresponding on-court performance. Three central themes that we identified: (1) the quality and extension of sleep (the better quality and more extension of sleep, better performance and lower probability of injury); (2) influence of the players circadian rhythm (tTravel and game scheduling do not currently facilitate or take this into account); and (3) higher training loads and/or increased stress may jeopardize a subsequent good night's sleep, which should be taken into account when scheduling practices and workouts. Conclusion: The current systematic review regarding sleep and basketball performance and highlights that there is a strong relationship between both variables. Collectively, the evidence supports the critical influence of sleep on player recovery and basketball performance and risk for injury

Culture-independent assessment of the indigenous microbial diversity of Raniganj coal bed methane block, Durgapur

It is widely acknowledged that conventional mining and extraction techniques have left many parts of the world with depleting coal reserves. A sustainable method for improving the recovery of natural gas from coalbeds involves enhancing the production of biogenic methane in coal mines. By taking a culture-independent approach, the diversity of the microbial community present in the formation water of an Indian reservoir was examined using 16S rRNA gene amplification in order to study the potential of microbial-enhanced coal bed methane (CBM) production from the deep thermogenic wells at a depth of 800–1200 m. Physicochemical characterization of formation water and coal samples was performed with the aim of understanding the in situ reservoir conditions that are most favorable for microbial CBM production. Microbial community analysis of formation water showed that bacteria were more abundant than archaea. Proteobacteria, Firmicutes, and Bacteroidetes were found as the most prevalent phyla in all the samples. These phyla play a crucial role in providing substrate for the process of methanogenesis by performing fermentative, hydrolytic, and syntrophic functions. Considerable variation in the abundance of microbial genera was observed amongst the selected CBM wells, potentially due to variable local geochemical conditions within the reservoir. The results of our study provide insights into the impact of geochemical factors on microbial distribution within the reservoir. Further, the study demonstrates lab-scale enhancement in methane production through nutrient amendment. It also focuses on understanding the microbial diversity of the Raniganj coalbed methane block using amplicon sequencing and further recognizing the potential of biogenic methane enhancement through microbial stimulation. The findings of the study will help as a reference for better strategization and implementation of on-site microbial stimulation for enhanced biogenic methane production in the future