Untangling the emergency: fimbrial cyst in pregnancy

Torsion of uterine adnexa is a significant cause of acute pain abdomen, however isolated fimbrial cyst torsion without the involvement of the ipsilateral ovary is rarely reported. It is even rarer to occur during pregnancy, hence making its diagnosis a conundrum. Here is a case report of a 19 year primigravida with 18 weeks of gestation who presented with acute pain abdomen with investigations suspecting an ovarian torsion. However, on laparotomy, isolated right fimbrial cyst torsion was seen for which detorsion followed by right salpingectomy was done. Adnexal torsion is a surgical emergency requiring early intervention to salvage the tissues. An acute abdomen on the background of adnexal mass requires vigilant assessment and evaluation to ensure timely intervention and prevent further complications

THIRU ANBIL DIVYA DESAM THROUGH THE EYES OF THIRUMALISAI ALVAR

Thiru Anbil Divya Desam, located near Trichy, is celebrated as one of the 108 sacred abodes Divya Desams of Lord Vishnu. Dedicated to Sundararaja Perumal Temple (Vishnu) and Sundaravalli Thayar, this temple holds immense spiritual significance, immortalised through the hymns of Thirumalisai Alvar. In his compositions from the Naalayira Divya Prabandham, Thirumalisai Alvar vividly praises the Lord\u27s divine beauty, grace, and role as the protector of devotees. His verses reflect themes of surrender (Saranagathi), cosmic love, and the sanctity of the temple as a refuge for the faithful. The article explores Alvar’s poetic descriptions of the deity, his connection to the temple\u27s serene atmosphere, and his portrayal of the Lord as the liberator of souls. Additionally, it examines how his hymns influenced the temple’s rituals, festivals, and cultural legacy. Thirumalisai Alvar’s works continue to resonate with devotees, offering timeless spiritual insights and reaffirming Thiru Anbil’s prominence in the Vaishnavite tradition

Developmental Outcomes of Very Preterm Infants with Tracheostomies

Objectives To evaluate the neurodevelopmental outcomes of very preterm (<30 weeks) infants who underwent tracheostomy. Study design Retrospective cohort study from 16 centers of the NICHD Neonatal Research Network over 10 years (2001-2011). Infants who survived to at least 36 weeks (N=8,683), including 304 infants with tracheostomies, were studied. Primary outcome was death or neurodevelopmental impairment (NDI, a composite of one or more of: developmental delay, neurologic impairment, profound hearing loss, severe visual impairment) at a corrected age of 18-22 months. Outcomes were compared using multiple logistic regression. We assessed impact of timing, by comparing outcomes of infants who underwent tracheostomy before and after 120 days of life. Results Tracheostomies were associated with all neonatal morbidities examined, and with most adverse neurodevelopmental outcomes. Death or NDI occurred in 83% of infants with tracheostomies and 40% of those without [odds ratio (OR) adjusted for center 7.0 (95%CI, 5.2-9.5)]. After adjustment for potential confounders, odds of death or NDI remained higher [OR 3.3 (95%CI, 2.4-4.6)], but odds of death alone were lower [OR 0.4 (95%CI, 0.3-0.7)], among infants with tracheostomies. Death or NDI was lower in infants who received their tracheostomies before, rather than after, 120 days of life [adjusted OR 0.5 (95%CI, 0.3-0.9)]. Conclusions Tracheostomy in preterm infants is associated with adverse developmental outcomes, and cannot mitigate the significant risk associated with many complications of prematurity. These data may inform counseling about tracheostomy in this vulnerable population

Clinicopathological analysis of ovarian tumours: a 10 year retrospective study

Background: Ovarian tumors account for 30% of all cancers of female genital tract which represents the sixth most common cancer and fourth leading cause of death in women. The present study was done with an objective to determine the frequency and distribution of various ovarian tumors and to study their clinical and histopathological presentations.Methods: It is a retrospective observational study of patients with ovarian tumors subjected to surgery in the department of obstetrics and gynecology, SDM College of Medical Sciences and Hospital from January 2005 to December 2015.Results: There were 642 cases comprising of 77.7% of neoplastic lesions and 22.3% of non-neoplastic lesions. Majority of the ovarian tumors (83%) were seen in the age group of 20 to 50 years. Mean age for ovarian tumors was 38 years.  Among the neoplastic lesions 84% were benign, 14.2% were malignant and 1.8% were borderline tumors. Surface epithelial tumors were the commonest tumors (60.9%) followed by germ cell tumors (12.8%).  Serous cystadenoma was the most common benign tumors (47.1%) followed by mucinous cystadenoma (18.4%). Among the ovarian malignant tumors; serous cystadenocarcinoma was the most common (4.5%) followed by mucinous cystadenocarcinoma (2.6%). Chocolate cysts were the most common among the non-neoplastic lesions (36.4%).Conclusions: Ovarian neoplastic lesions were more common than non-neoplastic lesions. Benign ovarian tumors were common in reproductive age group.  The mean age of occurrence for ovarian tumor was 38 years. The most common neoplasm was surface epithelial tumors, of which serous tumors was the commonest. Chocolate cysts were the most frequently encountered histopathological finding among the non-neoplastic lesions

Utilization pattern of child health care services in the rural area of Surendranagar district: a community based cross sectional study

Background: Infant and child mortality continues to be a major public health problem all over the country. Despite the existence of national programmes for improving child health in India, child mortality and morbidity continue to be high. Utilization of child health care services is poor in the rural areas, causing significant impact on the health causing increased morbidity and mortality.Methods: It was a Community based Cross-sectional study carried out in the rural area of Surendranagar district through oral questionnaire method which was pre-designed and pretested. Data on demography, history of colostrum, initiation of breastfeeding, prelacteal feeds, exclusive breastfeeding, introduction of complementary feeding, immunization, respiratory infections etc. were collected, compiled and analyzed by applying appropriate tests using SPSS.Results: Out of 154 participants, 43.51% were offered breastfeeding within one hour of birth. Association was observed between initiation of breastfeeding, exclusive breastfeeding, time of introduction of complementary foods and duration of breastfeeding and utilization of health education services. Educational level of mothers and immunization status of the children had a significant statistical association. The overall prevalence of ARI was 31.82% & of Diarrhoea was 39.61%.Conclusions: A positive association was observed between nutritional status and utilization of nutritional services. Significant impact of health education services given during the antenatal period was observed on initiation of breastfeeding as well as exclusive breastfeeding. Although child services in India have been created, strengthened and expanded over the years, their performance in terms of utilization particularly in rural area is still limited

The uterine fibroid study: comparative study between total abdominal hysterectomy and laparoscopic assisted vaginal hysterectomy

ABSTRACT Background: To compare safety and efficacy of total abdominal hysterectomy (TAH) and laparoscopic assisted vaginal hysterectomy (LAVH) in uterine fibroid patients. Methods: It is a prospective observational study conducted at six major gynaecology hospitals located in Telangana State. The data was collected from November 2022 to April 2023 and all the safety and efficacy parameters were evaluated. The collected data entered in MS Excel and then analysed and statically evaluated by using GraphPad prism software. Internal consistency reliability Cronbach’s alpha was calculated. Results:  There were 200 patients 100 each of TAH and LAVH. LAVH is less painful, has a shorter length of hospital stay and quicker return to work than TAH. On average, LAVH operations took significantly longer than TAH operations (47.9±5.953 minutes, 117.6±26.174 minutes, p&lt;0.0001). The total length of hospital stay was significantly shorter after LAVH than after TAH (11.4±2.81 days, 2.66±0.95 days, p&lt;0.0001). Although the haemoglobin drop in TAH was significantly higher than LAVH (173.15±40.872 and 92.5±6.83, p&lt;0.0001), blood transfusions were more common in TAH (25 case versus 15 cases p=0.0306). The drug requirement to control pain during hospitalization after the two surgeries was not significantly different between the two groups. Fever was observed more often in the TAH group (P=0.01). Finally, Intra-operative and post-operative complications were lower in LAVH than TAH. Conclusions: LAVH is less painful, has a shorter length of hospital stay and quicker return to work than TAH. It has been concluded in present study that LAVH has become a major alternative to conventional abdominal hysterectomy with patient often opting laparoscopic approach for the result of cosmetic and faster recuperative reasons

Security Risk Assessment of Blockchain-Based Patient Health Record Systems

Blockchain technology is receiving greater attention for enhancing the security of patient records systems; however, it is not a panacea, as many security risks have been found in these healthcare applications. This study conducts a state-of-the-art analysis of emerging risks in blockchain-based patient health record systems, their severity level, impact, and the corresponding countermeasures against them. In addition, we conclude our observations and indicate how blockchain security vulnerabilities may develop in the future. This study aims to promote more research on blockchain security challenges by offering researchers insights into future security and privacy developments in blockchain-based patient health record systems

Development and Validation of Stability Indicating RP-HPLC Method for Estimation of Rilpivirine Hydrochloride in Tablet Dosage Form

A simple, sensitive, rapid and reproducible HPLC Method was developed and validated for estimation of Rilpivirine in the presence of degradation products generated from forced decomposition studies. The analysis was carried out on Hypersil BDS C18, 250 X 4.6mm, 5? column using a mixture of ammonium acetate Buffer (pH to 6.0 0.05) and Acetonitrile in the proportion 55:45 respectively as a mobile phase at a flow rate of 1.2 mL/minute. The wavelength selected for the analysis was 300 nm. The peak for Rilpivirine HCl was observed at 10.33 minute. A linear response was observed in the range of 12.5 - 62.5 ?g/mL with a correlation coefficient of 0.999. The method was validated for specificity, linearity, precision, accuracy and robustness. The obtained results were indicating that the method is selective in analysis of Rilpivirine in the presence of degradation products formed under various stress conditions

Synthesis and Piezoelectric Response of Cubic and Spherical LiNbO3 Nanocrystals

Methods have been developed for the shape-selective synthesis of ferroelectric LiNbO3 nanoparticles. Decomposition of the single-source precursor, LiNb(O-Et)6, in the absence of surfactants, can reproducibly lead to either cube- or sphere-like nanoparticles. X-Ray diffraction shows that the LiNbO3 nanoparticles are rhombohedral (R3c). Sample properties were examined by piezoresponse force microscopy (PFM) and Raman where both sets of nanoparticles exhibit ferroelectricity. The longitudinal piezoelectric coefficients, d33, varied with shape where the largest value was exhibited in the nanocubes (17 pm V21 for the cubes versus 12 pm V21 for spheres)

Adverse drug reaction risk assessment with prescribed renal risk drugs among hospitalized patients attending a teaching hospital in South India

Background: Renal impairment is the primary cause of mortality and morbid conditions in patients. Inappropriate drug use in patients who are with risk of renal damage causes harmful and deleterious effects. Adjusting doses based on renal function is necessary for renal risk drugs, primarily to avoid adverse reactions of medications. Aim of the present study was to assess the risk of incidence on ADRs with drugs lowering the renal function.Methods: This is a cross-sectional observational study conducted in General Medicine department. 230 Patients constituted the sample in the study. The study was conducted for a period of one year and prescriptions with renal risk drugs were evaluated. Changes in the renal functional tests were compared to the normal range and adverse drug responses were monitored.Results: A total of 230 patients who fulfilled the inclusion criteria were included in the study. The meanage of the study subjects were 50.9±15.2 respectively. 56.39% patients were men and 43.6% were women. Renal risk drugs included in the study are anti-hypertensive, antibiotics, and analgesics. Paracetamol (24.77%) followed by telmisartan (20.85%) are the predominantly prescribed renal risk drugs with high incidence of adverse drug reactions. Causality assessment by Naranjo ADR probability scale showed out of 211 ADRs, 51.6% were possible, 25.59% were doubtful, 21.8% were probable and 0.94% was definite.Conclusions: The current study signifies that patients under high risk of renal damage require continuous monitoring and optimized therapy for better disease management