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Biomedical subjects

A Kriplani

Publications and source records attributed to A Kriplani.

At least 37 records · Page 2Linked to original sources

Idiopathic origin of meconium peritonitis.

A 26-year-old, gravida 3 presented at 31 weeks of gestation with polyhydramnios. On ultrasound there was marked foetal ascitis with unilateral hydrocele. Patient delivered a 3.15 kg, large-for-date baby at 33 weeks and 3 days of gestation. On basis of clinical, radiological and sonographic features, diagnosis of meconium peritonitis was made. Ascitic tapping was done. Surgery was withheld, as there were no signs of intestinal obstruction. DNA testing for cystic fibrosis was negative. Baby did not deteriorate so he was discharged. Baby was doing well on 2 months follow up. Hydrocele and ascitis were resolving. Rarely meconium peritonitis may occur without an underlying cause when peritonitis may be innocuous and intervention may not be required.

Adult↗

Twin pregnancy following gonadotrophin therapy in a patient with Sheehan's syndrome.

A case of Sheehan's syndrome presented with secondary amenorrhea and was put on L-thyroxine, prednisolone and cyclical estrogen and progestin. Ovulation induction with gonadotrophins and intrauterine insemination with husband's semen resulted in a twin pregnancy. Antepartum course was complicated by bronchial asthma, gestational diabetes and pregnancy-induced hypertension. Cesarian section was done at 34 weeks gestation for preterm rupture of membranes and breech presentation. Both babies and their mother were doing well at 6 months of follow-up.

Adult↗

Hernia uterus inguinale in a 46,XX female. A case report.

BACKGROUND: Hernia uterus inguinale, a rare congenital anomaly, is usually found in hermophrodites. CASE: A case of lateral fusion defect associated with müllerian duct development in a young woman with primary amenorrhea and normal karyotype occurred. In our patient, bilateral müllerian duct systems were rudimentary and failed to fuse in the midline. The left horn of the uterus and ipsilateral ovary lay in the left inguinal canal. The right horn of the uterus, along with the tube and ovary, was intraabdominal. CONCLUSION: In the operative management of this rare anomaly, care must be taken to preserve and reposition the ovary in the abdominal cavity.

Adult↗

Rare delivery complication caused by an undiagnosed uterine septum.

The role of a uterine septum, and thus, metroplasty in an infertile woman is a debatable issue. A rare complication of fetal malpresentation and impaction in the uterine cavity due to undiagnosed uterine septum in a 24-year-old primigravida who conceived after 3 years of primary infertility is reported. This case highlights that uterine anomalies should be looked for in patients with infertility and reproductive failures, and should be corrected before conception by metroplasty in order to improve reproductive outcome.

Adult↗

Partial perforation of bladder by multiload.

A rare case of partial perforation of the wall of the bladder by an intrauterine contraceptive device (IUCD) in a puerperal woman and its subsequent laparoscopic removal is described. Cystoscopy revealed an intact bladder mucosa with the IUCD lying submucosally. This case demonstrates that an IUCD embedded in the wall of the bladder, whose mucosa is intact, can be safely removed through a laparoscope without resorting to laparotomy.

Adult↗

Graves' Disease during pregnancy--results of antithyroid drug therapy.

AIM OF STUDY: To assess the maternal and fetal outcome of pregnancies in thyrotoxic women. METHOD: Thyrotoxic women who conceived while on treatment or who conceived within two years after stopping treatment, were recruited into the study. The antithyroid drugs (PTU and methimazole) dosage were adjusted to keep T3 and T4 within the upper normal range for these women. Cord blood and baby's blood (between days 4 and 10) were assayed for T3, T4 and TSH. RESULTS: Thirteen women (16 pregnancies) required antithyroid drugs during pregnancy. The drug dosage remained the same during pregnancy in 8 women while it was increased in 5 women and reduced in 3 women. One woman who was in remission at the time of conception remained euthyroid throughout her pregnancy. There were 14 spontaneous vaginal deliveries and 3 Caesarean sections. One baby had a small VSD while no other congenital malformations or perinatal death occurred. CONCLUSIONS: Drug therapy can adequately control thyrotoxicosis during pregnancy and improve maternal and fetal outcome.

Adult↗

Preterm labor and accidental hemorrhage after disopyramide therapy in pregnancy. A case report.

BACKGROUND: Treatment of arrhythmias during pregnancy is complicated by concerns about the safety of antiarrhythmic therapy. This is the first case report of preterm labor and abruptio placentae following the administration of disopyramide during pregnancy. CASE: A 26-year-old woman, gravida 2, para 1, was diagnosed as having Wolff-Parkinson-White syndrome during the third trimester of pregnancy. Recurrent episodes of supra-ventricular tachycardia were refractory to medical therapy and required repeated direct current cardioversion. Administration of disopyramide led to the initiation of painful uterine contractions and accidental hemorrhage. CONCLUSION: Caution must be exercised during the use of disopyramide during pregnancy, and intensive monitoring should be instituted to avoid adverse maternal and fetal effects.

Abruptio Placentae↗

Retrieval of lost Copper-T from the rectum.

A case of lost Copper-T lying partly in the rectal lumen and its removal through the rectal route is described. This case emphasises the importance of rectal examination in the case of lost intra-uterine contraceptive device (IUCD) and highlights the possibility of safe retrieval of an IUCD through the rectal route even when it is partly embedded in the rectal wall.

Adult↗

Biochemical hemodynamic and hematological changes during transcervical resection of the endometrium using 1.5% glycine as the irrigating solution.

OBJECTIVE: To study fluid absorption during transcervical resection of the endometrium (TCRE) and its effect on the biochemical, hemodynamic and hematological alterations so that life threatening complications of fluid overload may be prevented. METHOD: Intraoperative fluid (1.5% glycine) absorption in 46 women undergoing TCRE was studied and correlated using biochemical parameters (serum sodium, potassium, total proteins, creatinine and blood urea), hemodynamic parameters (pulse rate, blood pressure, oxygen saturation and end tidal CO2) and hematological parameters. Twenty five of these patients had received danazol (800 mg/day) for six weeks prior to TCRE. RESULT: The mean glycine deficit during TCRE was found to be 474.45 ml, with a mean total inflow of 3802.17 ml. Amongst all of the parameters, only serum sodium levels were found to be significantly inversely correlated with the glycine deficit. No case of hyponatremia occurred below a deficit of 1000 ml. Severe hyponatremia was reported in three cases (6.4%) and all three had a glycine deficit of more than 1000 ml. No case of pulmonary edema was noted. The mean glycine deficit was significantly lower (P=0.007) and the duration of procedure significantly shorter (P=0.0009) in the patients who had received danazol. None of the patients in the danazol group had fluid absorption of more than 1000 ml. CONCLUSION: Close monitoring of fluid inflow and outflow should be done during TCRE. Above a deficit of 1000 ml, serum sodium should be measured to detect significant hyponatremia. The use of danazol for endometrial preparation also reduces the mean amount of fluid absorbed.

Blood Proteins↗

Laparoscopic gonadectomy in male pseudohermaphrodites.

OBJECTIVE: To study patients of male pseudohermaphroditism and establish the laparoscopic approach for gonadectomy in these cases. STUDY DESIGN: Seven phenotypic females with XY karyotype were evaluated through a diagnostic protocol which included clinical, cytogenetic, hormonal, endoscopic and histologic evaluation. The gonads were then removed by laparoscopic surgery. RESULTS: The seven patients included three patients of pure gonadal dysgenesis, two patients of testicular feminization and one patient each of mixed gonadal dysgenesis and dysgenetic male pseudohermaphroditism. Two of the seven patients (28.57%) had gonadal neoplasias on histopathology-one dysgerminoma and one occult seminoma. In all of these patients, removal of the gonads was accomplished laparoscopically. No complications occurred during any of the surgeries. CONCLUSION: Due to the reduced morbidity, shorter hospital stay and safety, laparoscopic gonadectomy can be considered the treatment of choice for the removal of gonads in male pseudohermaphrodites in the hands of experienced laparoscopic surgeons.

Adolescent↗

Mosaic partial trisomy of chromosome 5 (q33-q ter) associated with fetal polycystic kidneys.

A case of de novo mosaic partial trisomy of chromosome 5 (q33-q ter) in a stillborn male fetus with bilateral polycystic kidneys, and atrial septal defect, is reported. Fetal cord blood sampling was carried out at 25 weeks of gestation because of bilateral polycystic kidneys with severe oligohydramnios observed on ultrasound examination of the fetus. The family history was notable for the presence of similar phenotypic abnormality in the mother and sibling. However, no chromosomal abnormality was detected in other family members. Significance of this rare chromosomal abnormality and its association with congenital malformations in the fetus and in the family is being discussed.

Chromosomes, Human, Pair 5↗

Etiology and management of monoamniotic twin discordant for anencephaly.

A case of monoamniotic monochorionic (MAMC) female twins, with one twin being anencephalic, and the co-twin being normal, is reported. Twin to twin transfusion syndrome was also noted. The reasons for anencephaly in association with monozygotic (MZ) twinning are discussed. The management of such a case is presented.

Amnion↗

Uterovaginal prolapse associated with rectal prolapse.

A case of combined genital prolapse and rectal prolapse in a 55-year-old multipara is reported. The mixed prolapse was treated by vaginal hysterectomy with pelvic floor repair and laparoscopic rectopexy at the same sitting. The feasibility of combined treatment of genital prolapse by the vaginal route and of rectal prolapse by laparoscopic rectopexy is emphasized.

Feasibility Studies↗