Missing IUCD strings: an analysis

Background: Missing IUCD strings, i.e.  IUCD strings that are not visible at the external cervical os, are a commonly encountered problem and needs to be analysed.Methods: IUCD users coming for routine checkup (follow-up / renewal / removal) or with any complaints related to IUCD or gynecological complaints or referred from other health center and found to be having missing threads were included in the study. Complaints by woman, obstetric history, details of IUCD insertion, USG imaging reports were recorded. Removal of IUCD was done if indicated or if the woman desired so, by simple OPD procedure and if required in operation theatre.Results: Out of 324 IUCD users who were examined in OPD, missing IUCD threads were found in 69.  About half of them were asymptomatic. AUB was the commonest symptom. 82.6% women had IUCD in situ on USG. Displacement was seen in 10.14%, embedment in 4.35%. Expulsion was seen in 4.35% women. Removal was done in only 29 women. Removal was done by simple OPD procedure in 24 women, as minor OT procedure in 3. Only 1 required hysteroscopic removal. Commonest cause of missing threads was found to be broken, detached or severed strings.Conclusions: As most of these women with missed IUCD strings, IUCD was found to be in situ on ultrasound imaging; hence, these women need counselling regarding continuation of using IUCD.  If required, removal can be done as an OPD procedure

Hypertensive disorders of pregnancy: a clinical study in a rural tertiary care centre of western Uttar Pradesh, India

Background: The aim of study was to find out the frequency and clinical outcome in hypertensive disorder of pregnancy (HDP) in a rural tertiary care centre. Hypertensive disorder of pregnancy is a commonest medical disorder which constitutes about 12-22% of all pregnancies and it is a major cause of maternal morbidity as well as mortality world wide.Methods: It is a retrospective hospital-based study to find out the clinical outcome in different hypertensive disorder of pregnancy in a rural tertiary care centre of western Uttar Pradesh.Results: Present study showed the prevalence of HDP was 4.01% among the study population. Most of the patients were primipara ,unbooked and less than 25 years of age. The most common HDP was mild preeclampsia  and HELLP was its commonest  complication.Conclusions: Hypertensive disorder of pregnancy (HDP) is still a major cause of maternal mortality and morbidity. Authors intend to aware the pregnant women regarding high risk factors of pregnancy and motivate them for regular antenatal care so that  complications of  hypertensive disorders can be  managed timely

Association of serum beta-hCG and urine albumin-creatinine ratio with hypertensive disorders during pregnancy

Background: Preeclampsia with or without severe symptoms, chronic hypertension with or without superimposed pre-eclampsia/eclampsia, gestational hypertension, HELLP syndrome, or eclampsia all pose a significant risk of morbidity for both the mother and the unborn child. The aim of this study was to investigate if the albumin-to-creatinine ratio in urine spots and the serum beta-hCG level correlate with the hypertensive illness of pregnancy.” Method: “The current inquiry was conducted during the months of October 2020 and August 2022 at the obstetrics and gynaecology department of Subharti medical college in Meerut, Uttar Pradesh. The study was not open to women who were more than 20 weeks pregnant, had gestational diabetes mellitus, had more than one pregnancy, had chronic hypertension, chronic renal disease, chronic liver disease, cardiac disease, systemic lupus erythematosus, or haematological illnesses. We measured the levels of serum beta hCG and the urine albumin-creatinine ratio, and we compared them between the groups.” Results:  After ensuring that each participant had given their informed permission, the trial comprised a total of 200 patients. In the hypertensive group of the participants in the study, 31% were between the ages of 21 and 35, and 29% were less than 20 years old. With increased beta hCG and UACR, there was a higher incidence of hypertensive retinopathy, acute renal failure, DIC, and PPH among the patients, as well as the poorest fetal outcomes. (p<0.05) Conclusions: The presence of a substantial relationship between hypertensive diseases and raised levels of beta-hCG during pregnancy, as well as a greater ratio of urine albumin to creatinine.  There is a considerable increase in the incidence of fetal growth retardation, preterm, and mortality occurring within the uterus among mothers who have higher levels of beta-hCG and urine ACR

Estimation of the excess lifetime cancer risk from radon exposure in some buildings of Kufa Technical Institute, Iraq

A number of international health organizations consider the exposure to residential radon as the second main cause of lung cancer after cigarette smoking. It was found that there is no database on radon concentrations for the Kufa Technical Institute buildings in the literature. This therefore triggers a special need for radon measurement in some Kufa Technical Institute buildings. This study aims to investigate the indoor radon levels inside the Kufa Technical Institute buildings for the first time using different radon measurement methods such as active (RAD-7) and passive (LR-115 Type II) methods. Seventy eight of Solid-State Nuclear Track Detectors (SSNTDs) LR-115 Type II were distributed at four buildings within the study area. The LR-115 Type II detectors were exposed in the study area for three months period. In parallel to the latter, seventy two active measurements were conducted using RAD-7 in the same buildings for correlation investigation purposes between the two kinds of measurements (i.e. passive and active).The results demonstrate that the radon concentrations were generally low, ranging from 38.4 to 77.2 Bq/m3, with a mean value of 50 Bq/m3. The mean of the equilibrium equivalent radon concentration and annual effective dose were assessed to be 19.9 Bq/m3 and 1.2 mS/y, respectively; the excess lifetime lung cancer risk was approximately 11.6 per million personal. A high correlation was found between the methods of measurements (i.e. LR-115 Type II and RAD-7), R2 = 0.99 which is significant at P < 0.001. The results of this work revealed that the Radon concentration was below the action level set by the United States Environmental Protection Agency of 148 Bq/m3. This therefore indicates that no radiological health hazard exists. However, the relatively high concentrations in some classrooms can be addressed by the natural ventilation or the classrooms being supplied with suction fans

A case report on serous cyst fibroadenoma of ovary

A 16-year-old unmarried female patient presented to the Subharti hospital with a lump in her abdomen that had been there for one year. For the previous two months, there had been abdominal pain. Constipation, intermittent fever, and vomiting were all present. A mass of around 25×25 cm (approximately) was found on per-abdominal examination, which was firm in consistency, non-tender, afebrile to touch with smooth borders, and restricted mobility. On the basis of the above mentioned examination and investigation, a diagnosis of ovarian cyst with typhoid immunoglobulin G (IgG) and immunoglobulin M (IgM) positive, dengue IgG with hepatitis B surface antigen (HbsAg) positive was made

Presentation of acute pulmonary edema in severe pre-eclamptic pregnant women: a case report

Pulmonary edema refers to an excessive accumulation of fluid in the pulmonary interstitial and alveolar spaces. It may occur in low risk pregnancies but one very important predisposing factor is association with pre-eclampsia. Acute pulmonary edema during pregnancy is very rare and occurs in 0.08% pregnancies. About 3% of severe pre-eclamptic patients develop acute pulmonary edema. Several risk factors have been identified: preeclampsia or eclampsia, use of tocolytic therapy, severe infection, cardiac disease, iatrogenic fluid overload, and multiple gestations. This case examines one such presentation and reviews some of the diagnostic possibilities

Structure of N-acetylglucosamine-1-phosphate uridyltransferase (GlmU) from Mycobacterium tuberculosis in a cubic space group

The structure of M. tuberculosis N-acetylglucosamine-1-phosphate uridyltransferase (GlmU) was determined by the molecular-replacement method to 3.4 Å resolution in space group I432 and was refined to a final R work and R free of 0.285 and 0.321, respectively

Improved ECG watermarking technique using curvelet transform

Hiding data in electrocardiogram signals are a big challenge due to the embedded information that can hamper the accuracy of disease detection. On the other hand, hiding data into ECG signals provides more security for, and authenticity of, the patient\u27s data. Some recent studies used non-blind watermarking techniques to embed patient information and data of a patient into ECG signals. However, these techniques are not robust against attacks with noise and show a low performance in terms of parameters such as peak signal to noise ratio (PSNR), normalized correlation (NC), mean square error (MSE), percentage residual difference (PRD), bit error rate (BER), structure similarity index measure (SSIM). In this study, an improved blind ECG-watermarking technique is proposed to embed the information of the patient\u27s data into the ECG signals using curvelet transform. The Euclidean distance between every two curvelet coefficients was computed to cluster the curvelet coefficients and after this, data were embedded into the selected clusters. This was an improvement not only in terms of extracting a hidden message from the watermarked ECG signals, but also robust against image-processing attacks. Performance metrics of SSIM, NC, PSNR and BER were used to measure the superiority of presented work. KL divergence and PRD were also used to reveal data hiding in curvelet coefficients of ECG without disturbing the original signal. The simulation results also demonstrated that the clustering method in the curvelet domain provided the best performance-even when the hidden messages were large size

Global lockdown: An effective safeguard in responding to the threat of COVID-19

Rationale, aims, and objectives: The recent outbreak of coronavirus (COVID-19) has infected around 1,560,000 individuals till 10th April 2020, which has resulted in 95,000 deaths globally. While no vaccine or anti-viral drugs for COVID-19 are available, lockdown acts as a protective public health measures to reduce human interaction and lower transmission. The study aims to explore the impact of delayed planning or lack of planning for the lockdown and inadequate implementation of the lockdown, on the transmission rate of COVID-19. Method: Epidemiological data on the incidence and mortality of COVID-19 cases as reported by public health authorities were accessed from six countries based on total number of infected cases, viz., (United States of America (USA) and Italy (more than 100,000 cases); United Kingdom (UK), and France (50,000 to 100,000 cases), and India and Russia (6,000 to 10,000 cases).The Bayesian inferential technique was used to observe the changes (three points) in pattern of number of cases on different duration of exposure (in days)in these selected countries one month after WHO declaration about COVID-19 as a global pandemic. Results: On comparing the pattern of transmission rates observed in these six countries at posterior estimated change points, it is found that partial implementation of lockdown (in the USA), delayed planning in lockdown (Russia, UK and France), and inadequate implementation of the lockdown (in India and Italy) were responsible to the spread of infections. Conclusions: In order to control the spreading of COVID-19, like other national and international laws, lockdown must be implemented and enforced. It is suggested that on-time or adequate implementation of lockdown is a step towards social distancing and to control the spread of this pandemic

Relative contribution of susceptibility weighted imaging, compared to conventional MRI, in the detection of common bile-duct calculi

PURPOSEWe aimed to evaluate the relative contribution of susceptibility weighted imaging (SWI) in the detection of common bile-duct (CBD) stones in comparison to the conventional MRI protocol containing magnetic resonance cholangiopancreatography (MRCP), balanced turbo field echo (BTFE), and T2-weighted spin-echo imaging techniques.METHODSMRI data containing MRCP, BTFE, T2-weighted imaging, and abdominal SWI were independently evaluated by 2 sets of experienced radiologists in 44 patients with confirmed CBD stones. Endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound where available, was used as the reference gold standard. Evaluation was performed for the visualization of CBD stones in each of the MRI techniques. Relative contribution of SWI was classified into one of four categories for each case: (1) no contribution to CBD stone visualization; (2) same as conventional techniques; (3) improved diagnostic confidence; and (4) critical for diagnosis. Stone size was also assessed.RESULTSInter-rater agreement coefficient for CBD stone visualization was found to be “good” in MRCP (0.77), “very good” in SWI (0.94) and BTFE (0.84), and moderate in T2-weighted imaging (0.54). CBD stones were visualized with SWI in 86.4% and 82%, with MRCP in 70.5% and 70.5% cases, with BTFE in 73% and 61.4% cases, with T2-weighted imaging in 45.5% and 52.3% cases by reviewers 1 and 2, respectively. SWI did not contribute to CBD stone visualization in 2.3% (1/44); was the same as conventional techniques in 31.8% (14/44) cases; improved diagnostic confidence in 34.1%; and was critical for diagnosis in 20.5% cases.CONCLUSIONSWI has the potential to serve as a strong adjunct to conventional MRI protocols used for CBD stone evaluation with very small scan-time penalty