Cesarean scar ectopic with ruptured corpus luteal cyst: a rare case report

Incidence of caesarean scar pregnancy (CSP) is increasing because of a rising number of caesarean sections. Prompt diagnosis of the condition is required to reduce associated morbidity. A high index of suspicion is required for women with a suggestive history of CSP. Ultrasound scan is the diagnostic tool of choice. Management options include medical, surgical and interventional radiology. Appropriate patient selection is important for optimal results. Major haemorrhage and hysterectomy are the main risks associated with CSP. Therefore, adequate counselling and availability of surgical expertise and blood transfusion should be part of a comprehensive management strategy. We are reporting a rare case of G3P2L1 with previous two lower caesarean deliveries diagnosed with caesarean scar ectopic based on clinical and ultrasound finding came with acute pain in abdomen with haemodynamically unstable with intraoperative finding s/o unruptured c scar pregnancy along with ruptured corpus luteal cyst leading to severe intra-abdominal bleeding. C-scar ectopic and corpus luteal cyst confirmed on histopathology

Comparative study of misoprostol sublingually and dinoprostone gel intracervically for cervical ripening and induction of labor

Background: Both Prostaglandin E1 and E2 analog are being used for cervical ripening. The aims of study was to compare the efficacy and safety profile of sublingual misoprostol (PGE2) and intracervical dinoprostone (PGE1) for cervical ripening and induction of labor.Methods: One hundred women with single live fetus and with gestational age of more than 37 weeks admitted for induction of labor were recruited for the study. Patients were randomized to receive either 25μg of misoprostol sublingually or dinaprostone gel (0.5mg) intracervically.Results: There was shorter induction to active phase, induction to delivery time intervals and less requirement of oxytocin augmentation in misoprostol group than dinoprostone gel group. Incidence of tachysystole was higher in misoprostol group than dinoprostone gel group (22% vs 10%) however this was not statistically significant. Mode of delivery, maternal and neonatal complications were similar in both the groups.Conclusions: Use of misoprostol in lower dose is a safe and cost-effective method for cervical ripening and induction of labor

Twin-twin transfusion syndrome: revisited

Twin to twin transfusion syndrome is a very rare disorder complicating monozygotic monochorionic pregnancy. Here we are reporting a case of Twin to twin transfusion syndrome in 20 year old primigravida woman. Amnioreduction was planned as a treatment option. However patient underwent premature labor and deliver male twins both of which died later on

PREMATURE GRAYING OF HAIRS IN PATIENTS OF SCHIZOPHRENIA SPECTRUM DISORDER, AN INCIDENTAL FINDING OR SOME ASSOCIATION BETWEEN THESE TWO ENTITIES: A CASE SERIES.

Introduction: Healthy hair is a sign of general well-being and youth. This case series addresses the unique occurrence of premature graying of hair (PGH) in patients diagnosed with schizophrenia spectrum disorder. PGH is perceived as a prominent sign of aging, driven by oxidative stress, which may indicate underlying systemic oxidative stress and be associated with various progressive systemic illnesses, including neuropsychiatric disorders. Case Presentation:  In this case series, 14 young individuals (aged 18-25 years) exhibited heterogeneous behavioral symptoms suggestive of schizophrenia spectrum disorder alongside premature graying of hair. Behavioral symptoms included social withdrawal, unprovoked anger outbursts, auditory hallucinations, and significant socio-occupational dysfunction. Additionally, some cases had a family history of psychotic disorders or past medical conditions such as seizure disorders. Result: Patients were diagnosed with schizophrenia spectrum disorder by a dermatologist after excluding other cutaneous and systemic causes of graying. Behavioral changes varied in duration but commonly led to socio-occupational dysfunction, prompting medical attention. The onset of PGH ranged from simultaneous to before or after the behavioral disturbances, suggesting a possible timeline of progression linked to oxidative stress. Conclusion: Oxidative stress appears to be a common factor in both schizophrenia spectrum disorder and premature graying of hair, potentially serving as an early indicator of schizophrenia. Early intervention targeting oxidative stress and inflammatory markers, along with current therapeutic measures, may improve prognosis. Premature graying of hair could be considered a red flag for future schizophrenia transition, warranting further research to validate this association and explore preventive measures

SELF NANO EMULSIFYING DRUG DELIVERY SYSTEM OF RAMIPRIL: FORMULATION AND IN VITRO EVALUATION

Objective: The primary goal of the present work was to formulate and evaluate self-nano emulsifying drug delivery systems (SNEDDS) of ramipril in order to improve the solubility of this highly lipophilic antihypertensive drug.Methods: SNEDDS are generally liquid form preparations obtained by homogeneously mixing drug substance with oils, surfactants and co-surfactants using cyclomixer. Based on solubility studies Capmul PG8 NF, Gelucire 44/14 and Transcutol P were selected as oil, surfactant and co-surfactant respectively in order to prepare SNEDDS. Nine different SNEDDS formulations were prepared and subjected to various evaluation tests in order to obtain optimized SNEDDS formulation.Results: The SNEDDS formulations with 16.5-24.75 % of oil, 24.75-68.75 % of surfactant and 12.375-41.25 % of co-surfactant formed thermodynamically stable emulsion with droplet size ranging from 22.6-188.8 nm. Finally, out of 9 different SNEDDS formulations, SN9 formulation was optimized containing 16.5 % of oil, 68.75 % of surfactant and 13.75 % of co-surfactant as it formed a thermodynamically stable emulsion with least globule size (22.6 nm) and without any drug precipitation or phase separation.Conclusion: Finally, stable, optimized SNEDDS formulation of ramipril was successfully prepared that showed significant improvement in the rate of dissolution of ramipril.Keywords: Self nano emulsifying drug delivery system (SNEDDS), Ramipril, Emulsification time, Ternary phase diagram, Simulated Gastric Fluid (SGF)

Constacyclic and Linear Complementary Dual Codes Over Fq + uFq

This article discusses linear complementary dual (LCD) codes over ℜ = Fq+uFq(u2=1) where q is a power of an odd prime p. Authors come up with a new Gray map from ℜn to F2nq and define a new class of codes obtained as the gray image of constacyclic codes over .ℜ Further, we extend the study over Euclidean and Hermitian LCD codes and establish a relation between reversible cyclic codes and Euclidean LCD cyclic codes over ℜ. Finally, an application of LCD codes in multisecret sharing scheme is given

Oxidant and solvent stable alkaline protease from Aspergillus flavus and its characterization

The increase in agricultural practices has necessitated the judicious use of agricultural wastes into value added products. In this study, an  extracellular, organic solvent and oxidant stable, serine protease wasproduced by Aspergillus flavus MTCC 9952 under solid state fermentation. Maximum protease yield was obtained when the strain was grown under wheat bran and corn cob mixture (1:1) incubated for 48 h at pH 9.0 and temperature 37°C with 50% of initial moisture content. The partially purified enzyme showed wide range of pH optima (8.0-12.0) and pH stability (7.0-12.0), whereas, optimum temperature was 40°C and was stable over a wide range of temperature 30-45°C. The protease was extremely stable towards several organic solvents. The enzyme retained 80% of its original activity in the presence of non ionic and ionic surfactants and 100% with 10% H2O2 after 1 h of incubation at 30°C. In addition, the enzyme showed excellent compatibility with some commercial powder detergents. The compatibility of our protease with several detergents, oxidants and organic solvents suggests its possible use in detergent industry and peptide synthesis.Key words: Alkaline protease, solid state fermentation, PMSF, organic solvent

To evaluate the efficacy and safety of intravenous bolus versus intravenous infusion of iron sucrose in pregnant women with severe iron deficiency anemia

Background: Objective of present study was to evaluate the efficacy and safety of intravenous bolus iron sucrose for iron deficiency anemia during pregnancy during second and third trimester women presenting at S.N. medical college, Agra.Methods: It was a prospective controlled trial and study was carried out in Department of Obstetrics and Gynecology, S.N. medical college, Agra in the year 2014-2016. 100Pregnant women with proved iron deficiency anemia having hemoglobin between 4-9gm/dl was included in this study. Total Iron deficit was calculated by standard formula. Target haemoglobin was 11gm/dl. Iron sucrose was administered by intravenous bolus and intravenous infusion techniques. Hemoglobin was repeated at 2 weeks, 4 weeks and 8 weeks after the last dose of intravenous iron sucroseResults: In Group A (bolus group n=50) 22 women had gestational age >24-28weeks and 20 women gestational age >18-24 weeks, with Mean gestational age of 24.36±3.78 weeks. In Group B (infusion group n=50) most of the patients 24 (48%) had gestational age >24-28 weeks, 18 (36%) had gestational age >18-24 weeks, with Mean gestational age of 24.94±3.51 weeks. Target hemoglobin was achieved in group A in all 50 (100%) cases and in group B in 49 (98%) cases. There were no allergic reactions.Conclusions: This study showed a significant improvement in the hemoglobin of the patients after receiving intravenous bolus and intravenous infusion of iron sucrose. Patients achieved the target hemoglobin of 11gm/dl. Both therapies are safe, effective and faster acting for the treatment of iron deficiency anaemia during pregnancy. The bolus push technique is more convenient to women and care provider, less time consuming as well as cost effective

Child Drawing: A Projective Tool for Dental Anxiety Assessment

INTRODUCTION: Assessment of child’s anxiety is important in order to determine the success of dental treatment. Drawing, a nonverbal, self-report, projective and non-invasive technique may prove be helpful and needs to be explored in order to access anxiety in children requiring dental treatment.AIM: To investigate the applicability of children’s drawings as an indicator to measure their level of anxiety.MATERIALS & METHOD: A cross-sectional study was conducted in a total of hundred children between age group of 4-6 years. Children were asked to draw dental operatory on A4 sheet and colour it with basic set of 12 colours. The drawing was scored using Child Drawing: Hospital (projective scale) scale and the results were compared with pulse oximeter readings (physiological parameter) and Venham Picture Test scorings.RESULTS: Child Drawing: Hospital scale scoring had a positive correlation with pulse oximeter reading (involuntary) (p-value = 0.125) and a negative correlation with Venham picture test (p-value = 0.140).CONCLUSION: Drawing may be statistically significant projective tool significant to assess child anxiety in dental setting