Ovarian tumours: a study of 282 cases

Histologically 282 ovarian tumours were studied, of these 212 (75.2%) were benign, 8 (2.8%) of borderline malignancy and 62 (21.9%) were malignant. The tumours were classified according to WHO classification. Epithelial tumours were the commonest variety constituting 70.9% of all the ovarian tumours followed by germ cell tumours (21.2%), sex cord stromal tumours (6.7%) and metastatic tumours (0.7%). Among the individual tumours, serous tumours (42.9%) were the commonest, followed by mucinous tumours (25.5%), teratomas (17%), granulosa cell tumours (6.7%), dysgerminomas (2.48%) and endodermal sinus tumours (1.77%). Two cases (0.7%) of endometrioid carcinomas and one case (0.35%) of clear cell carcinoma were encountered. Ovarian tumours were found to occur in the age range of 8 months to 74 years. Peak incidence was between 21 and 40 years age group.     

Marsupialization of intramyocardial left anterior descending artery: a novel approach for easy access during revascularization

The left anterior descending (LAD) artery is the most important vessel bypassed during coronary revascularization procedures. This artery usually runs a superficial course, making it easy for localization and grafting. However, many times it takes a course deep in the myocardium or is embedded in thick epicardial fat, which results in technical challenges to the surgeon for localization and grafting. So far, many techniques are described for overcoming these problems, but all require cardiopulmonary bypass (CPB), and in fact, intramyocardial LAD is considered a relative contraindication for off-pump coronary artery bypass grafting (OPCAB). In the present era of enhanced interest in OPCAB, these techniques are not as helpful as they are for conventional CABG with CPB. Here, we describe a novel approach of marsupialization of the LAD for revascularization of intramyocardial LAD that is useful for off-pump as well as conventional revascularization procedures and makes grafting simple and reproducible.     

Primary orbital NHL--a rare entity, diagnosed on FNAC

Primary Orbital NHL is a rare, malignant neoplasm of the orbit. FNAC is particularly useful for patients with such non-resectable, deep seated retroorbital tumors which are difficult to biopsy and in whom a firm cytologic diagnosis is vital to guide further treatment, such as radiotherapy and chemotherapy. A case of 70 years old female is described in the present article.     

Early pregnancy loss in Belagavi,Karnataka, India 2014–2017: a prospective population-based observational study in a low-resource setting

Background

The prevalence of early pregnancy loss through miscarriage and medically terminated pregnancy (MTP) is largely unknown due to lack of early registration of pregnancies in most regions, and especially in low- and middle-income countries. Understanding the rates of early pregnancy loss as well as the characteristics of pregnant women who experience miscarriage or MTP can assist in better planning of reproductive health needs of women.

Methods

A prospective, population-based study was conducted in Belagavi District, south India. Using an active surveillance system of women of childbearing age, all women were enrolled as soon as possible during pregnancy. We evaluated rates and risk factors of miscarriage and MTP between 6 and 20 weeks gestation as well as rates of stillbirth and neonatal death. A hypothetical cohort of 1000 women pregnant at 6 weeks was created to demonstrate the impact of miscarriage and MTP on pregnancy outcome.

Results

A total of 30,166 women enrolled from 2014 to 2017 were included in this analysis. The rate of miscarriage per 1000 ongoing pregnancies between 6 and 8 weeks was 115.3, between 8 and 12 weeks the miscarriage rate was 101.9 per 1000 ongoing pregnancies and between 12 and 20 weeks the miscarriage rate was 60.3 per 1000 ongoing pregnancies. For those periods, the MTP rate was 40.2, 45.4, and 48.3 per 1000 ongoing pregnancies respectively. The stillbirth rate was 26/1000 and the neonatal mortality rate was 24/1000. The majority of miscarriages (96.6%) were unattended and occurred at home. The majority of MTPs occurred in a hospital and with a physician in attendance (69.6%), while 20.7% of MTPs occurred outside a health facility. Women who experienced a miscarriage were older and had a higher level of education but were less likely to be anemic than those with an ongoing pregnancy at 20 weeks. Women with MTP were older, had a higher level of education, higher parity, and higher BMI, compared to those with an ongoing pregnancy, but these results were not consistent across gestational age periods.

Conclusions

Of women with an ongoing pregnancy at 6 weeks, about 60% will have a living infant at 28 days of age. Two thirds of the losses will be spontaneous miscarriages and one third will be secondary to a MTP. High maternal age and education were the risk factors associated with miscarriage and MTP.

Trial registration

The trial is registered at clinicaltrials.gov. ClinicalTrial.gov Trial Registration: NCT01073475.

     

MRI abnormalities of the anterior temporal lobe: a new indicator of congenital cytomegalovirus infection

Abnormalities of the anterior part of the temporal lobe (abnormal and swollen white matter, cysts, and focal enlargement of the anterior part of the inferior horn- either alone or more often in combination) suggest congenital cytomegalovirus (CMV) infection. This is not widely known. These can be seen in neonatal period and they continue to persist in later life.     

Movement Assessment of Infants as a Predictor of One Year Neuromotor Outcome in Very Low Birth Weight Infants

Objective  

To predict neuromotor outcome in Very Low Birth Weight infants at 1 year using Movement Assessment of Infants scale at 4 and 8 months of corrected age.     

Distal carotid perfusion in combined carotid endarterectomy and OP-CABG

An alternative method of maintaining carotid perfusion during combined carotid endarterectomy and off-pump coronary artery bypass grafting involves insertion of a cannula in the ascending aorta after a median sternotomy. This cannula is connected to a perfusion cannula, the distal end of which is inserted into the carotid artery beyond the carotid arteriotomy. This technique of aortico-carotid shunting and carotid perfusion was utilized in nine patients who underwent successful combined carotid endarterectomy and off-pump coronary artery bypass grafting.     

Idiopathic giant cell myocarditis--a case report and review of literature

Idiopathic giant cell myocarditis (IGCM) is a rare clinicopathological entity which is usually known to cause in more than half the cases sudden death. The histological features are characteristic with a central area of myocardial necrosis and a rich cellular infiltration of lymphocytes with a few eosinophils, plasma cells, macrophages and multinucleated giant cells. We hereby report a case of IGCM in a 72 year old male with history of sudden death. This case is being presented for its rarity and a review of literature is made.