Giant uterine leiomyoma: a case report with literature review

Uterine leiomyomas are one of the most common entities encountered in routine gynaecological practice; however, the giant uterine myomas are very rare and can often create a diagnostic dilemma and therapeutic challenge owing to their size, non-specific clinical presentation and degenerations. Here, in this article we review the literature on giant uterine leiomyomas and report one such case in a 38-year-old woman who presented with the complaints of vague abdominal lump, enlargement of abdomen, dysmenorrhea, lower abdominal and pelvic pain since last 2 years and a 6-month history of increased frequency of micturation. Physical examination and radiological investigations suggested a giant abdominopelvic mass, probably a uterine or an ovarian malignancy. An exploratory laparotomy was performed followed by total hysterectomy. Grossly, the specimen was a 15.2 kg uterine leiomyoma measuring 18x18x13 cm in size. Histologically, the benign leiomyoma showed cystic degeneration. The patient’s post-operative and follow-up period was uneventful

Editorial vol 16 iss 5

Editorial Vol 16 iss

A prospective study of efficacy and safety of mifepristone and vaginal misoprostol in termination of pregnancy up to 63 days of gestation

Background: Illegal abortion is still one of the important causes of maternal mortality in India accounting for approximately 13%. Medical Management of abortion is a non-surgical termination which does not require special facilities like operation theatre, hospital stay and thereby reduces complications associated with the same.Methods: It is a prospective study done in a Tertiary care Government Hospital over a span from Jan 2015 to April 2016. After patient selection as per inclusion criteria and written informed consent after evaluating patients were enrolled in the study. In first visit Tab. mifepristone 200 mg. orally was given and advised to take Tab. misoprostol 800 mcg. Vaginally after 48 hours at home. They were counselled for side effects and asked to report in case of excess bleeding, pain, fever or no bleed for 24 hours of misoprostol. After 7 days follow up was done to ensure completion of abortion. Any additional drugs required were noted. Contraceptive advice is also given during these visits.Results: In our study 60 cases were taken. Majority of women are between 20-29 years of age which is peak reproductive age. 61.1% women are of second parity. The success rate of medical methods is 96.6%, two cases out of 60 underwent surgical evacuation and one was lost to follow up. Most common adverse effect noted is abdominal cramps. No patient required hospitalization. Additional Misoprostol was required in 4 cases. This method is highly acceptable 95% cases as it is non invasive and preferred to adopt the same in future if needed.Conclusions: Patient participation, motivation, compliance, regular follow up visits, ability to record and report complications are the pillars on which the success of medical methods depends. Hence overall, it came out to be safe and effective method

Assessment Of Tree Species Diversity And Community Structure In District Sonipat, Haryana

The present study was carried out in Sonipat district of Haryana and aim of the study was to present the scenario of Phytosociological analysis and diversity of various tree species with respect to the importance value index (IVI) .From study area 31 families (28 dicots, 1 monocot, and 2 gymnosperms) representing 57 genera and 62 species have been documented. In terms of the number of species, the Fabaceae family has been dominating with 13 genera and 14 species, followed by the Moraceae (2 genera and 6 species). Diversity indices, such as the Simpson index of dominance (Cd) 0.022, the Shannon Wiener index (H') 3.95, and the Pielou index for equitability (E) 0.956 recorded for trees, are determined by observed parameters. Acacia nilotica found to be most common tree species in the district Sonipat with the highest value of IVI (12.8) and minimum value observed for Pithecellobium dulce (1.2). In tree species, 27 species showed random distribution while the remaining 35 species showed contagious distribution Present study data match  with  Raunkiaer  frequency  value,  indicates the distribution of tree species homogenous in nature. This study contributes to the appropriate knowledge of the tree species found in this region, which will helpful in the future planning of conservation initiatives

Towards Formalizing Adaptive Software Services

More and more complex, distributed and software-Intensive systems are built using independently developed services. Due to various reasons, such as changes in the execution environment, these systems may need to adapt their behavior. Although, adaptation at the system level has been extensively studied, developing adaptive services to start-with has not received any significant attention. This paper describes a framework for formalizing the concept of adaptation at the service level, leading to the "service adaptation by construction" approach. Hence, the proposed work will help software developers in identifying the important adaptation categories at the service level

The Impact of the Patient-Centered Medical Home on Health Disparities in Adults: A Systematic Review of the Evidence

Introduction: The objective of this study was to review the empirical evidence on Patient-Centered Medical Home (PCMH) impact on health disparities in adults. Methods: We searched PubMed, Scopus, and Google Scholar to identify studies on PCMH/health homes and health disparities published in English between January 1, 2009 and December 31, 2014. Articles met inclusion criteria if they investigated at least one component of PCMH or health homes in vulnerable populations, defined by PROGRESS-PLUS criteria, and reported differences in one of five clinical quality measures. Results: 964 articles were identified through database searching and subsequent snowballing. 60 articles underwent full text screening. Further review eliminated 56 studies. In the final 4 studies, PCMH interventions showed small improvements in health disparities. Discussion: The PCMH has been suggested as a model for improving health disparities. Given rapid implementation in underserved settings, stakeholders should better understand the impact of the PCMH on health disparities

Evaluation of pre induction scoring by clinical examination vs transvaginal sonography

Background: The aim of the study was to find out pre-induction cervical length by TV Sonography, determine Bishops score and to co-relate the obstetric outcome with these two variables.Methods: A study was done on 100 women with singleton pregnancies at 37-42 weeks of gestation, admitted for induction of labour in the Department of Obstetrics and Gynaecology at SGRDIMSR, Vallah, Amritsar, Punjab, India. All women underwent cervical assessment by both transvaginal ultrasound and Bishop Score and the outcome of labour induction was determined.Results: Of the 100 women, 53 women had vaginal delivery and 47 landed into LSCS. Bishop score < 6 and cervical length > 3 cm are cut off values of cervical unfavourablity. Successful induction was achieved among 87.5% and 78% women with favorable cervix according to Bishop Score and Cervical length respectively .Among the 92 and 50 women with unfavourable cervix according to Bishop score and cervical length, 48 (52.17%) and 14 (28%) had vaginal delivery respectively.Conclusions: Hence, cervical length by transvaginal ultrasound is a better predictor for the success of induction of labour as compared with assessment by Bishop Score alone

Pharmaceutical Applications of Xanthan Gum in Ophthalmic Delivery Systems

Introduction: Ophthalmic delivery system is one of the challenging domains of formulation and development due to tear dilutions, drug loss due to lacrimal drainage, limited volume and pre-corneal barriers. Several pharmaceutical technologies are exploited in order to counter the challenges posed by ocular route such as emulsions and suspensions. But all these technologies have stability issues which lead to their limited use.Background: Among polysaccharides, xanthan gum, a natural occurring biodegradable exopolysaccharide extracted from bacterium Xanthomonas campestris is widely accepted as one of the potential polysaccharide in ophthalmic delivery systems.Review Results: Xanthan gum is commonly used as an additive to various ophthalmic formulations due to its mucoadhesive property and imparting stability to various novel pharmaceutical technologies for ophthalmic. Xanthan gum also allows chemical modifications with various ligands which consequently allow controlled release, modified dissolution rate and viscoelasticity. Conclusion: In this review we are providing an insight over potential of pharmaceutical applications of xanthan gum. Also, we have discussed the scope of chemical modifications in xanthan gum with modified physicochemical properties

Opinion-Mining on Marglish and Devanagari Comments of YouTube Cookery Channels Using Parametric and Non-Parametric Learning Models

YouTube is a boon, and through it people can educate, entertain, and express themselves about various topics. YouTube India currently has millions of active users. As there are millions of active users it can be understood that the data present on the YouTube will be large. With India being a very diverse country, many people are multilingual. People express their opinions in a code-mix form. Code-mix form is the mixing of two or more languages. It has become a necessity to perform Sentiment Analysis on the code-mix languages as there is not much research on Indian code-mix language data. In this paper, Sentiment Analysis (SA) is carried out on the Marglish (Marathi + English) as well as Devanagari Marathi comments which are extracted from the YouTube API from top Marathi channels. Several machine-learning models are applied on the dataset along with 3 different vectorizing techniques. Multilayer Perceptron (MLP) with Count vectorizer provides the best accuracy of 62.68% on the Marglish dataset and Bernoulli Naïve Bayes along with the Count vectorizer, which gives accuracy of 60.60% on the Devanagari dataset. Multilayer Perceptron and Bernoulli Naïve Bayes are considered to be the best performing algorithms. 10-fold cross-validation and statistical testing was also carried out on the dataset to confirm the results

Rare Event of Intraoral Kinking of Endotracheal Tube Upon Prone Positioning in a Patient Undergoing Posterior Fossa Surgery

Prone position is commonly employed for many surgical procedures including neurosurgeries, spine surgeries, urological procedures, and in refractory ARDS patients. An endotracheal tube is a conduit to provide a secured airway to the patient. But in case of any equipment failure, it can cause catastrophic events. Intra-oral kinking is a rarer event. It can pose a major troubleshooting standstill owing to the inaccessible view of the kinked portion and the rarity of its occurrence to cross the clinician’s mind in the emergency scenario. We thus report this as the first such case of intraoral kinking against the soft palate in the prone position