A study on safety and feasibility of caesarean myomectomy: at a private institute

Background: Myomectomy at the time of caesarean delivery is controversial because of the risk of intractable hemorrhage and increased postoperative morbidity. The incidence of myoma associated with pregnancy is reported at 0.3-5%, with a majority of myomas not requiring surgical intervention during pregnancy or delivery. Recent studies consider it to be safe in selected patients and thus allow women to have a better obstetric outcome in future pregnancies, and to avoid hysterectomy. It relieves symptoms associated with fibroids and negates the need for later surgery or sonographic follow-ups for the fibroid after delivery.Methods: We performed a prospective cohort study of 15 patients with myomas who underwent myomectomy at the time of Caesarean section at MGM Hospital between January 2016 and December 2016. In a predesigned proforma, patient’s details such as age, parity, antenatal course, gestational age at delivery, type of Caesarean section, size and location of the fibroids, blood loss, postoperative morbidity and perinatal outcome were noted.Results: The incidence of hemorrhage in the study group was 20%. There was no significant increase in the incidence of postpartum fever (6.6%), operating time (50 min), and length of postpartum stay (5.6 days). No patient required hysterectomy. Size of fibroid did not appear to affect the incidence of hemorrhage, although intramural myomas were more associated with hemorrhage.Conclusions: This study shows that myomectomy during caesarean section is a safe procedure and is not associated with major intraoperative and postoperative complications

Diagnostic hystero-laparoscopy in work-up of female infertility

Background: Infertility is a growing concern of the society. In many cases the exact cause of infertility may not be elucidated, whether it is tubal, ovarian, uterine, or a combination of factors. This paper aims to understand the role of diagnostic hystero-laparoscopy in evaluation of cases of infertility.Methods: This prospective study included 200 infertile women and it was conducted at department of Obstetrics and Gynaecology, MGM Hospital, during the period between January 2016 to December 2016. All the infertile patients either with primary or secondary infertility were included after thorough evaluation.Results: Out of 200 cases, 118(59%) patients had primary infertility and 82(41%) had secondary infertility. While laparoscopy detected abnormalities in 49% of the cases, significant hysteroscopy findings were noted in only 23.5% of cases. The most common laparoscopic abnormalities were endometriosis (32%) and unilateral tubal lockage (24%). On hysteroscopy, periosteal adhesions were the commonest abnormality in both the groups.Conclusions: Diagnostic hystero-laparoscopy is a safe and cost-effective method and should be considered when there are abnormal HSG results, a past history of pelvic infection, pelvic surgery and /or unexplained secondary infertility during management of infertile couple. Evaluation of certain significant and correctable tubo-peritoneal and intrauterine pathologies which are usually missed by other imaging modalities, can be diagnosed as well as managed in some cases by hystero-laparoscopy

Machining and Tribological Characterisation of Uncoated and Coated Carbide Inserts while Turning Tungsten Heavy Alloy

Tungsten heavy alloys are high density alloys containing 80 to 98 wt.% tungsten and the balance is a matrix made of relatively low melting elements such as copper, nickel and iron. These alloys are used as radiation shields, CG adjusters and also in armour piercing ammunition. Machining these alloys to close tolerances and finish leads to excessive tool wear, surface damage and hence proves to be a challenging task. This study focuses on turning operation carried out under dry and wet cutting conditions using three different commercially available cemented carbide inserts. Three different feed rates have been used at a constant depth of cut and cutting speed. The best possible cemented carbide tooling solution for machining tungsten heavy alloys has been determined based on the surface finish obtained, chip geometry, cutting forces, and machining temperature. The observations made during machining are correlated to the tribological behavior of the inserts and the alloy with the help of pin-on disc tests. Coated cemented carbide inserts provide surface roughness values lower than 1 µm under finish turning conditions. On the other hand, PVD coated inserts give consistently better results over different feed rates and are found to experience lower tool wear for the specific cutting conditions. Analytical tool wear model suggests better tool life for the PVD coated insert

Huge yolk sac tumor in an adolescent girl: a case report

Germ cell tumours form a minority of all malignancies of the ovary. The common age group affected by yolk sac tumours is 11 to 24 years. Here, we present a case of yolk sac tumour in a 13-year-old girl who came with complaints of abdominal pain, distension and acute febrile illness. Fertility sparing surgery (Unilateral salpingo-oophorectomy) was done while the contra lateral ovary and uterus was conserved followed by combination chemotherapy postoperatively. As pprognosis of yolk sac tumours is highly stage-dependent, an early diagnosis can result in a drastic difference in the final outcome of the treatment of this highly aggressive disease. Besides the rarity of the tumour, the importance of the fact, that a vigilant and informed clinician can make an early and timely diagnosis of this condition even in girls of such a young age and make a drastic difference in the final outcome of the treatment, compels us to present this case

Interleukin-33 contributes to both M1 and M2 chemokine marker expression in human macrophages

Abstract Background Interleukin-33 is a member of the IL-1 cytokine family whose functions are mediated and modulated by the ST2 receptor. IL-33-ST2 expression and interactions have been explored in mouse macrophages but little is known about the effect of IL-33 on human macrophages. The expression of ST2 transcript and protein levels, and IL-33-mediated effects on M1 (i.e. classical activation) and M2 (i.e. alternative activation) chemokine marker expression in human bone marrow-derived macrophages were examined. Results Human macrophages constitutively expressed the membrane-associated (i.e. ST2L) and the soluble (i.e. sST2) ST2 receptors. M2 (IL-4 + IL-13) skewing stimuli markedly increased the expression of ST2L, but neither polarizing cytokine treatment promoted the release of sST2 from these cells. When added to naïve macrophages alone, IL-33 directly enhanced the expression of CCL3. In combination with LPS, IL-33 blocked the expression of the M2 chemokine marker CCL18, but did not alter CCL3 expression in these naive cells. The addition of IL-33 to M1 macrophages markedly increased the expression of CCL18 above that detected in untreated M1 macrophages. Similarly, alternatively activated human macrophages treated with IL-33 exhibited enhanced expression of CCL18 and the M2 marker mannose receptor above that detected in M2 macrophages alone. Conclusions Together, these data suggest that primary responses to IL-33 in bone marrow derived human macrophages favors M1 chemokine generation while its addition to polarized human macrophages promotes or amplifies M2 chemokine expression.http://deepblue.lib.umich.edu/bitstream/2027.42/78250/1/1471-2172-11-52.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78250/2/1471-2172-11-52.pdfPeer Reviewe

An Efficient Synthesis of Highly Substituted Indanones and Chalcones Promoted By Superacid

Superacid promoted one-pot method was developed for the efficient synthesis of indanones. This process enabled the formation of dual C-C bond between aryl isopropyl ketones and benzaldehydes. Interestingly, when the reaction was performed between acetophenones and benzaldehydes, it was impeded after the aldol condensation and furnished the corresponding chalcones

Turning product design into public service

Thesis (S.B.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 2010.Statement of responsibility on t.p. reads: Laura E. Aust, Zachary W. Rose, Ariadne G. Smith, Amrita Saigal. Each student submitted a title page and vita. Cataloged from PDF version of thesis.Includes bibliographical references (p. 87-89 ([i.e. p. [99]-[101])).Every mechanical engineering student at MIT takes the same courses: 2.009 being one of them. In our capstone product design course at MIT, most students glean an incredible amount from their teams, mentors, and projects, then focus their efforts on slightly more pressing issues, such as graduating and finding jobs and grad school. But what if the project you found was bigger than just a course, and had the potential of improving the lives of those less fortunate than you? The Komera project creates affordable sanitary protection for women in developing countries from the locally available and all-natural fiber from banana plants. In doing so, the initiative not only empowers girls by allowing them to attend school during their periods, but also creates employment and income within their communities. Our first initial iterations of the machine to fabricate pads were created in 2.009. Previous mechanical solutions to this problem are inefficient and labor-intensive. With our prototype, we seek to reduce the labor involved and increase pad output by twofold. However, we didn't want out work to stop there. Over the course of the semester, we continued to expand the Komera project twofold: by working on the mechanical design of the product and by expanding our scope to transform the product into a public service initiative. This thesis discusses the trials and tribulations of both directions. We explore the differences and challenges in designing for the developing world within a 1 st-world product design context - paying attention to manufacturing, materials, cost, and usability. We also offer a guide through the creation of an initiative: how we took a product and turned it into an IDEAS-winning public service project. It has been an incredibly rewarding experience for us, and we hope that we can inspire others to work on international development products as well.by Laura E. Aust ... [et al.].S.B

Regulation of eosinophilia and allergic airway inflammation by the glycan-binding protein galectin-1

Galectin-1 (Gal-1), a glycan-binding protein with broad antiinflammatory activities, functions as a proresolving mediator in autoimmune and chronic inflammatory disorders. However, its role in allergic airway inflammation has not yet been elucidated. We evaluated the effects of Gal-1 on eosinophil function and its role in a mouse model of allergic asthma. Allergen exposure resulted in airway recruitment of Gal-1-expressing inflammatory cells, including eosinophils, as well as increased Gal-1 in extracellular spaces in the lungs. In vitro, extracellular Gal-1 exerted divergent effects on eosinophils that were N-glycan- And dose-dependent. At concentrations ≤0.25 μM, Gal-1 increased eosinophil adhesion to vascular cell adhesion molecule-1, caused redistribution of integrin CD49d to the periphery and cell clustering, but inhibited ERK(1/2) activation and eotaxin-1-induced migration. Exposure to concentrations ≥1 μM resulted in ERK(1/2)- dependent apoptosis and disruption of the F- Actin cytoskeleton. At lower concentrations, Gal-1 did not alter expression of adhesion molecules (CD49d, CD18, CD11a, CD11b, L-selectin) or of the chemokine receptor CCR3, but decreased CD49d and CCR3 was observed in eosinophils treated with higher concentrations of this lectin. In vivo, allergen-challenged Gal-1-deficient mice exhibited increased recruitment of eosinophils and CD3+ T lymphocytes in the airways as well as elevated peripheral blood and bone marrow eosinophils relative to corresponding WT mice. Further, these mice had an increased propensity to develop airway hyperresponsiveness and displayed significantly elevated levels of TNF-α in lung tissue. This study suggests that Gal-1 can limit eosinophil recruitment to allergic airways and suppresses airway inflammation by inhibiting cell migration and promoting eosinophil apoptosis.Fil: Ge, Xiao Na. University of Minnesota; Estados UnidosFil: Ha, Sung Gil. University of Minnesota; Estados UnidosFil: Greenberg, Yana G.. University of Minnesota; Estados UnidosFil: Rao, Amrita. University of Minnesota; Estados UnidosFil: Bastan, Idil. University of Minnesota; Estados UnidosFil: Blidner, Ada Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Rao, Savita P.. University of Minnesota; Estados UnidosFil: Rabinovich, Gabriel Adrián. Universidad de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Sriramarao, P.. University of Minnesota; Estados Unido