Endometriosis is presence of functioning endometrial tissue outside the uterine cavity. Endometriosis can sometimes occur in a previous surgical scar. Scar endometriosis is rare and difficult to diagnose. It mostly follows obstetrical and gynecological surgeries. This condition is often confused with other surgical conditions. We are reporting two cases of scar endometriosis following cesarean section, which were misdiagnosed as stitch granuloma initially. Medical treatment was not helpful. Both the patients required wide surgical excision of the lesion. The pathogenesis, diagnosis and treatment of this condition are being discussed.

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BACKGROUND: Blood pressure (BP) measurement is a routine procedure but errors are frequently committed during BP recording. AIMS AND SETTINGS: The aim of the study was to look at the prevalent practices in the institute regarding BP recording. The study was conducted in the Medicine Department at Government Medical College, Chandigarh, a teaching institute for MBBS students. METHODS: A prospective, observational study was performed amongst the 80 doctors in a tertiary care hospital. All of them were observed by a single observer during the act of BP recording. The observer was well versed with the guidelines issued by British Hypertension Society (BHS) and the deviations from the standard set of guidelines issued by BHS were noted. The errors were defined as deviations from these guidelines. STATISTICAL METHODS: The results were recorded as percentage of doctors committing these errors. RESULTS: In our study, 90% used mercury type sphygmomanometer. Zero error of the apparatus, hand dominance was not noted by any one. Every one used the standard BP cuff for recording BP. 70% of them did not let the patient rest before recording BP. 80% did not remove the clothing from the arm. None of them recorded BP in both arms. In out patient setting, 80% recorded blood pressure in sitting position and 14% in supine position. In all the patients where BP was recorded in sitting position BP apparatus was below the level of heart and 20% did not have their arm supported. 60% did not use palpatory method for noticing systolic BP and 70% did not raise pressure 30-40 mm Hg above the systolic level before checking the BP by auscultation. 80% lowered the BP at a rate of more than 2 mm/s and 60% rounded off the BP to nearest 5-10 mm Hg. 70% recorded BP only once and 90% of the rest re inflated the cuff without completely deflating and allowing rest before a second reading was obtained. CONCLUSION: The practice of recording BP in our hospital varies from the standard guidelines issued by the BHS.

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Sarcoma-like mural nodule is a very rare occurrence in a mucinous tumour of the ovary. Two such nodules having morphologically benign features with osteoclastic giant cells, in the wall of mucinous cystadenoma are described. In addition, these nodules exhibited reactive vascular proliferations. The sarcoma-like nodules are associated with a favourable outcome and must be distinguished from other malignant nodules composed of sarcoma or anaplastic carcinoma that may also occur in the wall of mucinous ovarian tumours.

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RESEARCH QUESTIONS: How much human loss would have caused by the earthquake in Bhuj block? What is the environmental sanitation status? OBJECTIVES: (1) To assess human loss and injuries after the earthquake in Bhuj block.(2) To study the status of some relief activities.(3) To study the environmental sanitation status of the earthquake affected Bhuj block. STUDY DESIGN: Cross-sectional study. SETTINGS: Bhuj block. Participants: All villages excluding Bhuj city of Bhuj block. Statistical analysis: 0 Proportions, chi-square test, chi-square for trend. RESULTS: Survey was done in 144 villages; there were total 541 deaths with death rate of 3.18 per 1000 population. Death rate was significantly associated with distance of village from epicenter (chi-square for trend significant, P < 0.001). Among victims, majority were children 171 (45.4%) and women 107 (28.4%). Relief work was significantly associated with accessibility of village (P < 0.001) and few interior pockets were deprived of help. Total 56 (38.9%) villages were entirely dependent on water tanker for water supply and in 61 (42.4%) villages drinking water was used without chlorination. In 142 (98.6%) villages open-air defecation was practiced. Diseases such as URTIs, diarrheal diseases, fever and conjunctivitis were commonly observed in the field area.

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BACKGROUND: G-tolerance assessment is an essential element of both military pilot and pilot candidate evaluation. AIMS: Attempt at prediction of individual relaxed + Gz tolerance on the basis of head-up tilt (HUT) testing. SETTINGS AND DESIGN: In two stages, 20 healthy men at the mean age 21.5 years took part in this study. The first stage, a 45 min, HUT test was performed using the Westminster protocol. During the second stage each underwent a centrifuge evaluation in response to gradual onset rate profiles. METHODS AND MATERIAL: In each subject, heart rate (HR) and blood pressure (BP) before and at 2, 15 and 45 min of the tilt-test were recorded. The gravity-load centrifuge (GOR) studies were carried out [following the standard GOR programme, at 0.1 G/s rate of gravity load increase until the gravity load tolerance limit (loss of peripheral vision) was reached]. STATISTICAL ANALYSIS USED: Relationships between variables were explored using Kendall's tau-B correlation coefficient. The critical P-level was one-tailed 0.05. RESULTS: In four of 20 subjects (20%), vasovagal syncope occurred during the tilt test. G-level tolerance of this group (of +Gz accelerations) lay in the range from +4 to +8.1 Gz, (+5.72 ? 0.86 Gz average) and was comparable to the group without syncope. Loss of consciousness did not occur in any subjects during the centrifuge test. No statistically significant correlation was observed between HR and BP during tilt test and tolerance to +Gz accelerations. CONCLUSIONS: The result of tilt testing, carried out according to the Westminster protocol, was not useful in predicting individual tolerance to +Gz gravity loads.

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[FULL TEXT]  [PDF] [CITATIONS]  [PubMed]

[FULL TEXT]  [PDF] [CITATIONS]  [PubMed]