An increasing trend of bilateral tubal ectopic gestation reported over the past two decades: a case report and review of literature

Bilateral tubal ectopic pregnancies which are spontaneously conceived are of rare occurrences. Generally, they are diagnosed intra-operatively. There are no guidelines published till date for their management. There has been a reported increase in the incidence of such cases. We present a review of such cases reported over the last two decades and report a similar case which presented to our hospital with acute abdomen and USG suggested hemo-peritoneum with further intraoperative diagnosis of bilateral tubal ectopic managed by left salpingectomy and right salpingostom

A retrospective study of ectopic pregnancy at a tertiary care centre

Background: Ectopic pregnancy is a global problem and is the most common life-threatening emergency in early pregnancy leading to significant morbidity and fetal loss. It occurs in variable presentations. The rate of ectopic pregnancies has increased from 0.5% in 1970 to 2% today. The aim of this study was to determine the incidence, clinical presentation, risk factors, treatment, and morbidity and mortality associated with ectopic pregnancy.Methods: The present retrospective study was conducted over a period of three years in the department of obstetrics and gynecology at SMS and R, Greater Noida, UP from Feb 2014 to Jan 2017.A total of 80 patients with ectopic pregnancy were analyzed regarding clinical presentation, risk factors, operative findings and treatment modality.Results: Total number of 80 cases of ectopic pregnancies were admitted during this period against 2645 deliveries representing frequency of 3%. Majority of cases (43.75%) were in the age group of 25-29 years and 41.25% were gravida 4 and above. Risk factors were identifiable in 66.25% of cases. Previous abortion was the most common risk factor (31.25%). The classical triad of amenorrhea, pain abdomen and vaginal bleeding was present in 71.25% of cases. More than half of case (55%) had ruptured tubal pregnancy on admission. Unruptured tubal pregnancy was seen in 10% case. Interestingly we found one rare case of bilateral ectopic pregnancy. Salpingectomy by open method was the mainstay of treatment (86.25%).Conclusions: Ectopic pregnancy is still a major challenge in gynecological practice. In our country most of the cases present late after tubal rupture requiring radical surgical treatment. Early diagnosis and timely intervention in the form of medical treatment or conservative surgery not only reduces maternal morbidity but also preserves future fertility

Obstetrics ICU admissions: challenges faced at a tertiary referral centre

Background: Management of critically ill patients in obstetrics is a challenge owing to the changed physiology and unpredictability of the disease behaviour. Stratification strategy for early admission to obstetric ICU is imperative to reduce maternal morbidity and mortality. Due to lack of formal surveys regarding obstetrical ICU in our country, there is lack of precise national data on obstetrical ICU mortality. Aim of the present study was to estimate the obstetric ICU admission rate, to study the pattern of causative aetiology and to study the complications developed in ICU.Methods: The present study is a retrospective analytical study done in the Department of Obstetrics and Gynecology, from January 2015 to August 2017.Results: During the study period there were a total of 8466 obstetrical admissions, 2508 deliveries and 104 ICU admissions. Out of 104, analysis was done on 71 patients. Hypertensive disorders of the pregnancy were associated with maximum number of admissions (47.8%), followed by postpartum haemorrhage (12.6%). Maximum admissions were in postpartum period (63.4%). Anaemia was associated with 35.2% of the cases and it was closely followed by sepsis (28.2%). Mechanical ventilation was required for 30.9% of the patients.Conclusions: Hypertensive disorders of the pregnancy, haemorrhage and sepsis are the major risk factors for ICU admission in obstetric population

Microbial Composite in Trivalent Chromium Remediation from Effluents

Chromium (III) in the industrial effluents is considered hazardous due to oxidation and therefore its remediation by alternate methodology such as biosorption has recently gained importance. Though sorption of Cr(III) on algae and fungi have been studied, their applications as fungal-clay composite is not much investigated. Growth of A.niger with bentonite showed release of spores and development of full cells in <72h facilitating good metal uptake. In this study, Aspergillus niger and bentonite have been used to develop a composite sorbent and removal of Cr(III) from a model effluent solution of 100ppm Cr(III) was investigated. A maximum sorption of 85% Cr(III) was achieved with 1%(w/v) composite (1:6 ratio of biomass to bentonite) of <50µm size within a contact time of 5 min at 2.5pH and 35oC temperature. Increasing the pH up to 4.0 caused elevation in the degree of sorption. The composite was thus found to be effective sorbent to treat chromium (III) containing waste solutions

A Hybrid Linear Iterative Clustering and Bayes Classification-Based GrabCut Segmentation Scheme for Dynamic Detection of Cervical Cancer

Cervical cancer earlier detection remains indispensable for enhancing the survival rate probability among women patients worldwide. The early detection of cervical cancer is done relatively by using the Pap Smear cell Test. This method of detection is challenged by the degradation phenomenon within the image segmentation task that arises when the superpixel count is minimized. This paper introduces a Hybrid Linear Iterative Clustering and Bayes classification-based GrabCut Segmentation Technique (HLC-BC-GCST) for the dynamic detection of Cervical cancer. In this proposed HLC-BC-GCST approach, the Linear Iterative Clustering process is employed to cluster the potential features of the preprocessed image, which is then combined with GrabCut to prevent the issues that arise when the number of superpixels is minimized. In addition, the proposed HLC-BC-GCST scheme benefits of the advantages of the Gaussian mixture model (GMM) on the extracted features from the iterative clustering method, based on which the mapping is performed to describe the energy function. Then, Bayes classification is used for reconstructing the graph cut model from the extracted energy function derived from the GMM model-based Linear Iterative Clustering features for better computation and implementation. Finally, the boundary optimization method is utilized to considerably minimize the roughness of cervical cells, which contains the cytoplasm and nuclei regions, using the GrabCut algorithm to facilitate improved segmentation accuracy. The results of the proposed HLC-BC-GCST scheme are 6% better than the results obtained by other standard detection approaches of cervical cancer using graph cuts

Usage Pattern of Glimepiride/Metformin Fixed-dose Combination in Type 2 Diabetes Patients with CVD or at Risk of CVD: An Experience in Indian Setting

Background: Diabetes is associated with almost twofold increased risk of cardiovascular diseases (CVD). The present case-based questionnaire survey evaluated the treatment pattern and clinical experience of healthcare professionals in prescribing glimepiride/metformin fixed-dose combination (FDC) to type 2 diabetes mellitus (T2DM) patients with CVD or those patients who are at risk of CVD in the Indian settings. Material and methods: A retrospective, multicenter, observational, case-based questionnaire survey was conducted in Indian healthcare centers using medical records of patients having T2DM, with CVD or are at risk of CVD, who were prescribed any strength of glimepiride/metformin FDC. Data was collected from the patients’ medical records and was analyzed using statistical tests. Results: A total of 680 patients with T2DM with CVD or at risk of CVD were included in this study. Mean duration of diabetes in the patients was 5.7 ± 4.8 years. About 68.5% patients had hypertension, 47.9% had dyslipidemia, 25.4% had coronary artery disease (CAD), 3.6% had transient ischemic attack (TIA), 4.8% had peripheral arterial disease (PAD) and 2.9% had heart failure. Around 18.1% patients had CVD after diabetes was diagnosed, while 81.9% presented with cardiovascular (CV) issues at the time of diabetes diagnosis. All patients received glimepiride/metformin FDC as first-line therapy. About 68.2% patients on glimepiride/metformin FDC had blood pressure within optimal limits. A large proportion of patients had improvement in glycemic parameters. Weight change was noted in 18.4% of the patients overall. Of these, 59.2% had reduction in weight. There were no major adverse events and treatment efficacy and tolerability were reported as good to excellent for 94.6% and 92.9% patients, respectively. Conclusion: This case-based questionnaire survey demonstrates the usage pattern of various strengths of glimepiride/metformin FDC and the clinicians’ practice approach regarding early initiation of this combination in Indian patients with diabetes who have or are at risk of CVD

In-Situ Electro-Assembly of Redox-Based Glucose Sensors for Microfluidic Applications

Microfluidic models of the gastrointestinal (GI) tract, known as gut-on-a-chip devices, mimic the structural, absorptive, pathophysiological and microbial environment of the human gut. They have potential to revolutionize drug delivery testing and replace animal testing to improve efficacy. However, current models lack methods for quantitative assessment of molecular cues that determine biological function, limiting their ability to discern the efficacy of treatments on diseases. Team BioCHIPS developed a polydimethylsiloxane (PDMS) gut-on-a-chip model lined with Caco-2 intestinal epithelial cells, with the novel incorporation of catechol-chitosan biomolecular sensors. This is the first instance of in situ assembled biomolecular sensors that provide direct electrical connectivity and assessment of glucose level in real time. These sensors enable quantifying changes in the physiological conditions due to alterations in glucose concentration, to monitor effects of treatments on their respective GI diseases

Analyzing Job Aware Scheduling Algorithm in Hadoop for Heterogeneous Cluster

A scheduling algorithm is required to efficiently manage cluster resources in a Hadoop cluster, thereby to increase resource utilization and to reduce response time. The job aware scheduling algorithm schedules non-local map tasks of jobs based on job execution time, earliest deadline first or workload of the job. In this paper, we present the performance evaluation of the job aware scheduling algorithm using MapReduce WordCount benchmark. The experimental results are compared with matchmaking scheduling algorithm. The results show that the job aware scheduling algorithm reduces average waiting time and memory wastage considerably as compared to matchmaking algorithm