Spontaneous evisceration is a very rare and potentially fatal complication of abdominal-wall incisional hernia. Here the authors present a case report of spontaneous evisceration in an incisional hernia in a 45-year-old female patient. Management of the condition using prosthetic mesh repair risks mesh infection, while the use of non-prosthetic repair risks recurrence of the hernia due to the absence of stout natural tissues. Use of a biological mesh for the condition seems quite plausible. Thorough saline washes of the eviscerated organ; excision of redundant/unhealthy skin and strict adherence to the fundamental principles of hernia repair is desired in managing the condition.
Background: Caesarean Section (C.S.) delivery rate is steadily increasing worldwide, including India. It is difficult to determine the optimum categorisation of C.S. Robson system is most widely accepted classification worldwide. The objective of the present study is to analyze the incidence of deliveries and caesarean section rate according to Robson’s criteria at SRMS-IMS, Bareilly, Uttar Pradesh.Methods: The record of total women admitted in labour unit from June 2017 to May 2018 were analyzed based on their age, parity, gestation age, mode of delivery and group they belong according to Robson’s classification.Results: Among 2560 women who delivered during the study period, 1030(40.23%) had caesarean section. Out of the total caesarean section 55.15% had primary caesarean section while repeat section were done in 44.85%. The most frequent indication for primary caesarean were fetal compromise and failure to progress while for repeat caesarean scar tenderness was the frequent indication. Robson’s group V had maximum caesarean section rate followed by group I. Breech presentation contributed to 11.55% to overall caesarean sections.Conclusions: In present study group V, I, II were found to be major contributors to overall caesarean section rates. Modifiable factor for reducing caesarean rate would be to improve successful induction of labour which would decrease primary caesarean rate hence the chance of repeat section.
Porins are highly conserved bacterial outer membrane proteins having β barrel structure and are majorly involved in the selective transport of charged molecules across the membrane. Despite having huge contributions in the pathogenesis of many gram-negative bacteria, their role remains elusive in salmonellosis. In this study, we have characterized the pathogenic role of porins majorly found on the outer membrane of Salmonella Typhimurium (such as OmpA, OmpC, OmpD, and OmpF) paying the utmost importance to OmpA. The outer membrane protein A (OmpA) of Salmonella Typhimurium has shown a multifaceted role in our study. We have observed that deletion of ompA from wildtype Salmonella has made it more prone to phagocytosis and weakly proliferative in macrophages. Whereas, in epithelial cells STM ΔompA was found to be invasion deficient and hyper-proliferative. The poor colocalization of STM ΔompA with LAMP-1 confirmed impaired stability of SCV membrane around the intracellular bacteria, which further resulted in the release of the knockout strain to the cytosol of macrophage where it is bombarded with reactive nitrogen intermediates (RNI). The cytosolic localization of STM ΔompA was found to be responsible for the downregulation of SPI-2 encoded virulent factor SpiC which is required for suppressing the activity of iNOS. The reduced recruitment of nitrotyrosine on wildtype Salmonella staying in the cytosol of macrophage by ectopically expressing Listeriolysin O (LLO) strongly proves the pro-bacterial role of OmpA against host nitrosative stress. The time-dependent increase in 405/ 488 ratio of STM ΔompA pQE60-Grx1-roGFP2 exposed to in vitro acidified nitrite suggested RNI dependent redox burst which further answered the reason for its enhanced sensitivity towards nitrosative stress. Our study further demonstrated loss of integrity and enhanced porosity in the bacterial outer membrane in absence of OmpA. The enhanced porosity of the bacterial outer membrane was further attributed to the upregulated expression of larger porins namely ompC, ompD, and ompF. In comparison with STM ΔompA ΔompC and ΔompA ΔompF, the enhanced uptake of nitrite and greater recruitment of nitrotyrosine on intracellular STM ΔompA ΔompD demonstrate the involvement of OmpC and OmpF in the entry of excess nitrite in ompA deficient bacteria.
To study cervical cytology and cervicovaginal infection in antenatal women.Objectives: To find out by pap smear for inflammatory, atypical squamous cells of undetermined significance (ASCUS), atypical glandular cells of undetermined significance (AGUS) and premalignant lesions in antenatal women.• To find out cervicovaginal infection by wet mount among antenatal women.• Correlation of cervical cytology with cervicovaginal infection.Materials and methods: Five hundred antenatal women, irrespective of gestational age, were enrolled as subjects in this prospective clinical study for blood investigations, wet mount examination of cervical discharge and pap smear.Results: Out of 500 smears, 385 women were having inflammatory smears out of which 301 were having bacterial vaginosis followed by 89 vaginal candidiasis followed by 12 were having trichomoniasis, in which 339 had a preterm delivery. Conclusion:Antenatal visits are a potential opportunity to perform screening by Pap smear and wet mount study to prevent preterm labor and improve perinatal mortality.
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