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Biomedical subjects

Krishna Sangwan

Publications and source records attributed to Krishna Sangwan.

At least 19 recordsLinked to original sources

Multiple bladder calculi: a rare cause of irreducible uterine prolapse.

BACKGROUND: A vesical calculus in a prolapsed cystocele is rare. OBJECTIVE: To highlight bladder calculi as a cause of irreducible uterine prolapse. CASE REPORT: A case of irreducible total uterine prolapse caused by multiple vesical calculi is presented. Bladder stones were removed through vaginal cystolithotomy followed by vaginal hysterectomy. CONCLUSION: In cases of acute irreducible pelvic organ prolapse, the possibility of bladder stones should be kept in mind and X-ray pelvis including the prolapsed mass should be done to confirm the diagnosis.

Female↗

Destructive operations in modern obstetrics.

This is a retrospective study carried out over a period of 7 years at a tertiary care hospital to evaluate the indications, types and complications of destructive operations. During this period, 51 destructive operations were performed on women with obstructed labor and intrauterine fetal death. The most common operation performed was craniotomy (68.62%) followed by decapitation (19.60%), evisceration (7.84%) and cleidotomy (3.92%). The most common indication was cephalopelvic disproportion (31.25%). Out of 53 babies delivered (one triplet delivery), two were grossly malformed and 49.05% babies had birth weight between 3.0 kg and 4.0 kg and 9.43% were macrosomic. A total of 45.09% women had complications like atonic PPH, vaginal and perineal tears, puerperal sepsis and urinary tract infection. However, there was no maternal death. It is felt that for the women who belong to poor socio-economic status and have poor compliance and who present late in labor with features of obstruction, intrauterine sepsis and fetal death, destructive operation is still a good option.

Adult↗

Antenatal diagnosis of twin-reversed arterial perfusion sequence (acardiac amorphous) in a triplet pregnancy: case report.

Acardiac twinning is the most extreme form of twin-twin transfusion syndrome occurring in monzygotic twin pregnancies with monochorionic placentation. A case of acardiac amorphous foetus, occurring in association with spontaneously conceived triplet pregnancy, diagnosed on ultrasound in early second trimester is described and its antenatal management and brief review of literature discussed.

Abnormalities, Severe Teratoid↗

Recent onset neurofibromatosis complicating eclampsia with maternal death: a case report.

Neurofibromatosis in pregnancy has been associated with poor perinatal outcome. A 30-year-old multigravida developed peripheral lesions of neurofibromatosis during the third month of pregnancy. She had eclampsia complicated with fatal left-sided massive intracerebral haemorrhage detected on computed tomography at 8.5 months gestation. Investigations were suggestive of HELLP syndrome. A still-born male baby was delivered. In spite of all supportive measures the patient died on the third postpartum day. We conclude that recent onset neurofibromatosis in current pregnancy should be considered as a predictor of potentially adverse maternal and fetal outcome and such pregnancies be managed in tertiary level referral centre.

Adult↗

Effect of oestrogen replacement therapy on serum lipid profile.

BACKGROUND: Oestrogen deficiency in postmenopausal women alters the lipid metabolism unfavourably. AIM: To evaluate the effects of oral and transdermal oestrogen replacement therapy (ORT) on serum lipid profile. METHODS: Ninety hysterectomised and oophorectomised women were randomised into three equal groups (no hormones; oral conjugated equine oestrogen, 0.625 mg/day; transdermal oestradiol patches, 50 microg/day). Serum concentrations of total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol and triglycerides were determined at the baseline and after 3 and 6 months of therapy. Student's t-test was used for statistical evaluation. RESULTS: Most of the hysterectomised women had abnormal serum lipid profile, especially HDL cholesterol levels (less than 40 mg/dL in 87%). A significant decline in the levels of serum cholesterol (total) as well as LDL and a significant increase in HDL cholesterol levels were observed following ORT by both modes, the response being comparatively rapid with oral route. After 3 and 6 months, the number of cases with HDL cholesterol levels above 40 mg/dL increased from initial 13 to 63% and 87% (oral) and 30 and 60% (transdermal), respectively. Serum triglyceride levels declined significantly with transdermal therapy but increased with oral ORT. CONCLUSIONS: Oestrogen replacement therapy either via oral or transdermal route has a beneficial effect on serum lipid profile of menopausal women. Whereas the oral route is more effective in increasing HDL cholesterol levels, the transdermal route is better for reducing the serum triglyceride level; hence, the latter should be the route of choice in women with high serum triglyceride levels.

Adult↗

324 cases of misplaced IUCD--a 5-year study.

Copper-T remains the mainstay of family planning measures in developing countries but is associated with serious complications like bleeding, perforation and migration to adjacent organs or omentum. Patients with misplaced intrauterine contraceptive device (IUCD) may present with pregnancy or lost strings or may remain asymptomatic for years. In our series of 324 cases with misplaced IUCD1; in 258 (79.93%) cases copper-T was found in the uterine cavity and in 47 cases (14.51%) it was removed from cervical canal. In only 18 cases (5.56%), it was translocated and of these 66.67% were inserted at primary health centres. Laparoscopic retrieval was successful in 61.11% cases. Endoscopy thus helps in the localization and retrieval of misplaced IUCDs. A regular follow up of IUCDs for visible threads would help in earlier detection of misplaced IUCDs. Proper training of paramedical staff is mandatory in developing countries to provide safe and better family planning services.

Adult↗

Long retained intravaginal foreign body: a case report.

Recurrent vaginal discharge in children may be due to variety of causes. Intravaginal foreign body retained for long duration can be a diagnostic dilemma. This report presents the case of a girl who had an intravaginal foreign body for over four years duration. Recurrent, unremitting, foul-smelling, bloody vaginal discharge in a child should alert the clinician to the possibility of a retained vaginal foreign body.

Child↗