Effect of single-dose methotrexate injection to prevent neoplastic changes in high risk complete hydatidiform mole: A randomised control trial.

Background: Complete hydatidiform mole affects women in their reproductive age. About 15-20% develops persistent molar gestational trophoblastic neoplasia (GTN), which is linked with delayed (beyond 56 days) normalization of serum ßHCG after surgical evacuation. Objective: The objective of the article is to shorten the duration of normalization time of ßHCG with single-dose methotrexate injection in women with high risk complete hydatidiform mole (CHM) after suction evacuation. Methods: Total 76 women with CHM were randomized into intervention and control groups. In the intervention arm (n = 34) women received single dose 100 mg intramuscular methotrexate injection post evacuation and the control group (n = 42) had standard care. Surveillance was done in both groups at two weeks intervals for next six months and duration of normalization of ßHCG level was recorded. Results: Total 94.7% women completed follow-up. Mean of normalization time was significantly lower in the intervention group compared to controls (9.7 weeks versus 14.7 week; P < 0.01). Time to event curve showed significantly earlier cumulative normalization time for the intervention group. Conclusion: Single-dose 100 mg methotrexate injection is a low-cost, simple intervention to help one out of three women with CHM with high-risk features to achieve normalization of ßHCG within 56 days. This might be helpful for people in resource-poor countries where adherence to prolonged surveillance is poor.

Magnitude of Mental Morbidity and Its Correlates with Special Reference to Household Food Insecurity among Adult Slum Dwellers of Bankura, India: A Cross-Sectional Survey.

BACKGROUND: Mental disorders cause considerable morbidity and disability, and there is ample evidence that mental disorders are positively associated with household food insecurity. METHODS: A cross-sectional survey was conducted for a period of 2 months at Bakultala slum of Bankura town involving 152 people of ≥18 and ≤60 years of age selected using simple random sampling technique to estimate the prevalence of mental disorders and to find out its correlates. Information pertaining to socio-demographics and household food security (HHFS) and " potential psychiatric case" were collected through a house to house interview of the head of the household, using predesigned questionnaire, Bengali version of self-reporting questionnaire, and 6-item household food security scale (HFSS). RESULTS: In total, 45% of the study participants belonged to food unsecured households. Overall, 21% of the respondents were identified as "potential psychiatric case," which was found to be associated with higher age, illiteracy, divorcee female, and people living in households without food security. CONCLUSION: Study results reflecting high prevalence (21%) of "potential psychiatric case" with various correlates such as age, sex, education, marital status, and HHFS among the slum dweller of Bankura town may be helpful in formulating policies for combating mental health morbidities.

Clinicopathologic profile of non-Hodgkin's lymphoma in a rural medical college.

A prospective study was done at North Bengal Medical College, Sushrutanagar, Darjeeling, West Bengal over a period of two years. All patients diagnosed as non-Hodgkin's lymphoma were analysed for clinical presentation, classified according to the Working Formulation and staged according to Ann Arbor staging system. A lower median age (39.94 years) of onset and higher male to female ratio (3.22:1) as compared to western countries were observed. We found neck swelling was the commonest presenting symptom (65.79%) and peripheral lymphadenopathy was the commonest sign (94.74%). "B symptoms" were noted in 63.16% cases. Cervical lymph nodes were commonly involved (78.95%), followed by axillary (55.26%). Thoracic lymph nodes were enlarged in 31.58% cases and abdominal lymph nodes in 18.42% cases. We found diffuse mixed variant was the commonest (31.58%) followed by diffuse large cell (18.42%). At presentation most of the cases were of intermediate grade (55.26%) and in stage III (44.74%). We conclude that there is a distinct geographical pattern of non-Hodgkin's lymphoma in respect of age, sex, grade and stage of the disease which is distinctly different from those of western countries.

Unusual branching pattern of facial artery and a short review.

A detailed knowledge of the facial blood supply is necessary in planning of different types of orofacial surgeries. However abnormal pattern of facial blood supply may modify the result of the treatment, if it is not predicted in advance. Here we report two rare cases of unusual presentation of facial blood supply and the clinical implications of such findings, correlating with the previous studies.