Digital Gangrene Associated with Scrub Typhus: A Case Series.

Rickettsial diseases cover a broad spectrum of illnesses. Scrub typhus is present worldwide, and Orientia tsutsugamushi is the causative agent of this chigger mite-borne infectious illness. Infections exhibit a range of severity, from mild illness to the more severe manifestation of multiorgan failure. We report three cases of scrub fever (55-year-old female, 63-year-old female, and 29-year-old male), all cases developed focal or pan-digital gangrene. All cases were successfully treated by administering doxycycline and additional supportive measures. Digital gangrene is uncommon in scrub typhus. Clinical suspension for early diagnosis and appropriate treatment may avoid further complications.

Spontaneous Intracranial Hemorrhage and Acute Respiratory Distress Syndrome Associated with Dengue: A Case Report.

BACKGROUND: Dengue is a major health burden worldwide, notably in tropical and subtropical countries, with symptoms ranging from asymptomatic infection to severe hemorrhagic or shock syndrome. The clinical and biochemical profile of dengue has been shown in the literature to be expanding as more atypical signs have been added over the past few decades. Most dengue-related symptoms are typically mild to moderate and self-limited. However, intracranial hemorrhage and acute respiratory distress syndrome in severe dengue is an event that has been encountered uncommonly. CASE PRESENTATION: A 30-year-old female presented with complaints of fever, headache, cough, and altered sensorium. Later, she was diagnosed with severe dengue fever complicated by dengue hemorrhagic fever, which manifested as subarachnoid and subdural bleeding and acute respiratory distress syndrome. She was managed conservatively with a positive outcome. CONCLUSION: Atypical manifestation, though rare, should be kept in mind while dealing with severe dengue patients, as early detection based on anticipated risk factors and timely treatment have the potential to save lives.

Impact of secondary infections on dengue presentation: A cross-sectional study in a tertiary care hospital in Uttar Pradesh, India.

BACKGROUND: Recently, a wide range variety of manifestations, including a self­limiting to severe illness, has been increasingly reported in dengue. Few studies attract attention to severe dengue, mainly observed in secondary infection. With this background, this study aims to provide a comprehensive overview to differentiate primary from secondary dengue using serology (IgG) and the possible association of severity of illness in secondary dengue. METHODS: Present retrospective cross-sectional study was conducted at a North Indian tertiary care center from September 2021 to January 2022. Clinical data of confirmed dengue patients from the medicine department were collected and assigned as primary and secondary dengue. RESULTS: Of the 220 dengue patients, 22 (10 %) had secondary dengue infection. Hemorrhagic manifestations were reported in 58/220 (26.4 %) cases while 7/22 (31.8 %) in secondary dengue. Prevalent hemorrhagic manifestations in secondary dengue include purpura (27.3 %), vaginal bleeding (4.5 %), melaena (9.1 %), and epistaxis (4.5 %). In addition, 42 (19.1 %) patients had pancytopenia, and 8 (36.6 %) cases were of secondary dengue. Hepatic dysfunction was noted in 164 (74.5 %) cases. Notably, all secondary dengue cases (22;100 %) had hepatic dysfunction and severe in 9 (40.9 %) cases. In addition, in secondary dengue patients, evidence of plasma leakages such as hypoproteinemia 7 (31.8 %) and ascites (35 %) were statistically more frequent. Overall, two deaths (0.9 %) were reported, and were one in each group. CONCLUSIONS: Many parameters, including hemorrhagic manifestation (melaena), hematological characteristic (pancytopenia), evidence of plasma leakage (hypoproteinemia and ascites), gastrointestinal (GB wall thickening and hepatic dysfunction) and reduction in mean hemoglobin and platelet count were found to be statistically significant in secondary dengue infection. Additionally, early classification of secondary dengue may help to anticipate its severity and allow for early strategic intervention/management to lower morbidity and mortality.

Massive Splenomegaly with Pancytopenia in an Adult: Gaucher's Disease.

INTRODUCTION: Gaucher's disease (GD) is a rare lysosomal storage disease. It is characterized by the deposition of glucocerebroside in cells of the macrophage-monocyte system. GD presents a broad clinical expression, including hematologic abnormalities (such as pancytopenia), massive hepatosplenomegaly, diffuse infiltrative pulmonary disease, renal involvement in the form of nephropathy and glomerulonephritis, skeletal involvement in the form of bone pain, bony infarct, osteopenia, and pathological fracture. Based on the presence or absence of neurologic involvement, it is differentiated into type 1, type 2, and type 3. Gaucher's disease type 1 is the most common form, having the nonneuropathic form and carrying autosomal recessive traits. Gaucher's disease affects all racial and ethnic groups, while type 1 GD is most prevalent among Ashkenazi Jews. CASE PRESENTATION: A 20-year-old female was admitted to the medicine department with complaints of generalized weakness and easy fatigability, menorrhagia, and a dragging sensation in the abdomen. On clinical evaluation, she had bone marrow failure syndrome features along with massive splenomegaly. Later, she was confirmed with Gaucher disease type 1 disease by clinical and investigation (low ß-glucosidase level) evaluation. CONCLUSION: This case emphasizes keeping a differential diagnosis of glycogen storage disorder while evaluating a case of unexplained pancytopenia with massive splenomegaly in adulthood for an extended period. Currently, enzyme replacement therapy and substrate reduction therapy are the mainstay therapeutic options for GD.

Clinical Dilemma, Bernard Soulier Syndrome versus Immune Thrombocytopenic Purpura: A Case Report.

BACKGROUND: Bernard Soulier Syndrome (BSS) is a rare autosomal recessive disorder due to deficiency or dysfunction of the glycoprotein GPIb-V-IX complex on the platelet surface. It is also known as hemorrhagiparous thrombocytic dystrophy or congenital hemorrhagiparous thrombocytic dystrophy. The patient usually presents with severe and prolonged bleeding along with characteristics of giant blood platelets and low platelet counts. Manifestations of BSS include epistaxis, gum bleeding, purpuric rashes, menorrhagia, rarely melena, and hematemesis. On the other hand, immune thrombocytopenic purpura (ITP) is an acquired autoimmune disorder in which there is accelerated platelet destruction and reduced platelet production. Isolated thrombocytopenia without fever, lymphadenopathy, and organomegaly usually lead to the diagnosis of immune thrombocytopenia. CASE PRESENTATION: A 20 years old female presented with complaints of recurrent episodes of epistaxis since childhood and menorrhagia during menarche. She was misdiagnosed as ITP elsewhere. Later, based on thorough clinical examination and investigation, the diagnosis was confirmed as BSS. CONCLUSION: BSS should always be taken in the differential diagnosis of ITP, especially when persistent, refractory, and treated unsuccessfully with steroids or splenectomy.

Adenovirus Meningoencephalitis and Neurocysticercosis Co-infection: First Case from India.

BACKGROUND: Adenovirus generally causes upper and lower respiratory tract infections. It is common in children and occasionally in adults. Neurological involvement is rare, which may be mild aseptic meningitis to potentially fatal acute necrotizing encephalopathy. Recently, viruses have been reported increasingly to cause CNS infections. Viral aetiology typically varies with age. CASE PRESENTATION: Here, we report an unusual adenovirus meningoencephalitis with a co-infection of neurocysticercosis in an immunocompetent adult patient. An 18-year-old healthy female student was admitted with fever and headache for 11 days and progressive altered behaviour for 5 days, followed by altered sensorium for 3 days. This variable and unusual presentation of adenoviral infection involving CNS provoked diagnostic difficulties, but with the help of advanced diagnostics, especially molecular, exact aetiology was detected. Even with the neurocysticercosis infection in this patient, the outcome was not adversely affected. CONCLUSION: This unusual co-infection with a successful outcome is the first case of this type in literature.

Recurrent hypokalemic paralysis in hypothyroidism.

Hypothyroidism, a commonly encountered thyroid disorder, usually manifests with readily recognizable typical features. However, an unusual presentation of a classic thyroid disorder may hinder accurate diagnosis in certain instances. One such rare initial presentation of hypothyroidism is recurrent hypokalemic paralysis, and existing reports in the literature are sparse. It has been more commonly reported in thyrotoxicosis. We report the case details and clinical outcomes of two middle-aged individuals (a 34-year-old male and a 37-year-old female) with recurrent episodes of hypokalemic paralysis. Their clinical examination revealed pure motor hyporeflexia quadriparesis with hypotonia and diminished deep tendon reflexes without any autonomic dysfunction. They had no significant previous medical history. Biochemical findings revealed hypokalemia in both cases (1.4 and 1.9 mEq/L, respectively) with elevated levels of thyroid­stimulating hormone and thyroid­related antibodies in both individuals, thus, confirming the diagnosis of autoimmune hypothyroidism. Immediate treatment with intravenous and oral potassium correction helped in the recovery. Thyroxine supplementation was considered a follow-up treatment, and for a one-year follow-up period there were no complaints of limb weakness reported in both individual.

Recurrent Nausea and Vomiting with Weight Loss Associated with Hypothyroidism: Fact or Myth.

BACKGROUND: Hypothyroidism is a commonly encountered endocrine disorder presenting in various clinical settings. It usually presents with classic manifestations, which are readily recognized and, therefore, easy to diagnose. However, occasionally, patients present with unusual symptoms, which becomes a challenge to diagnose. Thyroid dysfunction affects many body organs, including the gut and viscera. Studies show that intestinal motility might be affected by multiple factors, such as neuromuscular dysfunction, myopathy, or alterations in hormone receptors. CASE PRESENTATION: Here, we present the first case of a 21-year-old female student who had complaints of recurrent nausea, vomiting, loose stool, abdominal pain, and weight loss. In the second case, a 25-year-old male student presented with recurrent nausea, vomiting, loose stool, and weight loss. Their unremarkable blood routines and gastrointestinal-specific investigations failed to ascertain the diagnosis. Later, primary hypothyroidism was established by typical biochemical abnormalities. CONCLUSION: Thyroxine replacement treatment successfully resolved the presenting symptoms and normalized biochemical reports.

COVID-19 Associated Pancytopenia (CAP): A Clinical Impact.

BACKGROUND: SARS-CoV-2 infection has mild and asymptomatic to critical clinical course affecting mainly the lungs. Few case reports of COVID-19-associated pancytopenia are reported, but a series of 18 cases is not described in the literature to date. AIMS AND OBJECTIVES: This study aimed to investigate pancytopenia in COVID-19 and its correlation with severity and to explore the detailed clinical and biochemical information in COVID-19- associated pancytopenia. This study also highlights pancytopenia's rarity and prognostic value among COVID-19 patients. MATERIALS AND METHODS: This was a retrospective observational study conducted in a tertiary care centre at a level 3 COVID care facility that included adults of either sex having positive RT PCR for COVID-19 from October 2020 to May 2021. Data were collected from the online outpatient department and hospitalized patients. RESULTS: A total of 18 cases were included in the study; 13 were males (72.2%). The mean age was calculated as 48.56 years. Cases were categorized as severe 13 (72.2%) and non-severe 5 (27.8%) disease on the first day of pancytopenia. The most common presentations were fever 18 (100%) and cough 18 (100%), followed by generalized weakness 16 (88.9%), breathlessness 15 (83.3%), and diarrhoea 10 (55.6%). One case died in the severe disease group. The mean of haemoglobin, leukocyte count, and platelets in severe vs non-severe disease were calculated as 8.59 vs 8.74, 2339 vs 2578, and 77769 vs 88600, respectively. CONCLUSION: Pancytopenia was more prevalent in severe disease and age group 40-60 years. CAP was most likely due to secondary bone marrow suppression. It has no prognostic value for disease outcomes.

Disseminated Cryptococcosis in Idiopathic CD4+ Lymphocytopenia.

INTRODUCTION: Idiopathic CD4+ Lymphocytopenia (ICL) is a rare entity grouped in non- HIV-related syndromes. ICL is characterized by a marked low CD4 T cell count of <300 cells/mm3 with ambiguous natural history and prognosis. In addition, cryptococcal and nontuberculous mycobacterial infections are reported as known opportunistic infections. Therefore, management turns around vigilant follow-up and treatment of the current clinical scenario of these patients. CASE PRESENTATION: Here, a 55-year-old lady was referred with a history of diffuse headache and intermittent fever for two months, projectile vomiting, and altered mental status for five days. Nonpruritic maculopapular rashes and diffuse desquamation of the skin were noted. She had no significant previous medical history. Based on clinical findings and investigations, she was diagnosed with ICL having disseminated cryptococcosis. Unfortunately, the patient did not undergo specific treatment as she was recognized late, and unfortunately, she died. CONCLUSION: It is of paramount importance to recognize the clinical entity as early as possible to start appropriate treatment, which may positively impact the outcome. Therefore, the clinician must be aware of disseminated cryptococcosis associated with non-HIV states.

COVID-19 Associated Acute Pancreatitis: A Case Series from India.

INTRODUCTION: Initially, COVID-19 was typically concerned with respiratory symptoms and had a mild and asymptomatic to critical clinical course. Over time, many atypical presentations related to cardiac, hepatic, gastrointestinal, renal, musculoskeletal, and neurological features have been reported in COVID-19. CASE PRESENTATION: We present three confirmed cases of COVID-19, who developed acute pancreatitis without any other obvious discernible cause. One middle-aged 48-years old male was presented with severe abdominal pain with mild symptoms of COVID-19, who was later diagnosed with acute pancreatitis with a positive outcome. Another 40-year-old male, hospitalized due to moderate COVID-19, developed acute pancreatitis and was managed successfully. The third 58-year-old patient with control diabetes and severe COVID-19 developed acute necrotizing pancreatitis. Unfortunately, he succumbed due to multiorgan failure while on the mechanical ventilator. CONCLUSION: Acute pancreatitis is uncommon in COVID-19. Although, it should be kept as a highindex clinical suspicion if abdominal pain is reported. Early diagnosis and prompt management can significantly impact the patient's outcome.

Parotid gland swelling as an initial presentation of Multiple Myeloma: a case report.

INTRODUCTION: Parotid swellings are commonly encountered in ENT Clinics, the cause of which could range from neural conditions, endocrine problems, vitamin deficiencies, and sialadenitis, which may even be a manifestation of an underlying systemic disease. Multiple myeloma represents a clonal proliferation of plasma cells and is a condition in which a parotid swelling might be present, although very uncommon. CASE PRESENTATION: We report a case of 60-year-old female presented with unilateral parotid swelling, which led to a diagnosis of multiple myeloma based on the investigations. CONCLUSION: Various imaging modalities are currently available to assess the extent of the swelling and evaluate the soft tissue and osseous involvement. The clinician must have a rigorous insight into the several clinical manifestations and the sites of involvement of the different conditions to make a proper diagnosis.

Development of Advanced Artificial Intelligence and IoT Automation in the Crisis of COVID-19 Detection.

Internet of Things (IoT) is a successful area for many industries and academia domains, particularly healthcare is one of the application areas that uses IoT sensors and devices for monitoring. IoT transition replaces contemporary health services with scientific and socioeconomic viewpoints. Since the epidemic began, diverse scientific organizations have been making accelerated efforts to use a wide range of tools to tackle this global challenge and the founders of IoT analytics. Artificial intelligence (AI) plays a key role in measuring, assessing, and diagnosing the risk. It could be used to predict the number of alternate incidents, recovered instances, and casualties, also used for forecasting cases. Within the COVID-19 background, IoT technologies are used to minimize COVID-19 exposure to others by prenatal screening, patient monitoring, and postpatient incident response in specified procedures. In this study, the importance of IoT technology and artificial intelligence in COVID-19 is explored, and the 3 important steps discussed such as the evaluation of networks, implementations, and IoT industries to battle COVID-19, including early detection, quarantine times, and postrecovery activities, are reviewed. In this study, how IoT handles the COVID-19 pandemic at a new level of healthcare is investigated. In this research, the long short-term memory (LSTM) with recurrent neural network (RNN) is used for diagnosis purpose and in particular, its important architecture for the analysis of cough and breathing acoustic characteristics. In comparison with both coughing and respiratory samples, our findings indicate poor accuracy of the voice test.

Elusive Primary in Low Grade Mucoepidermoid Carcinoma: Dilemma of Chronology and Terminology.

Salivary gland tumours constitute an uncommon and diverse group of neoplasms that vary considerably in their histology and biologic behaviour. As per Globocon 2018, salivary gland malignancy account for 0.3% of all cancer cases and 0.2% of all cancer deaths worldwide, reflecting the rarity of these neoplasms. Mucoepidermoid carcinoma (MEC) is a common malignant tumour of major and minor salivary gland, which comprises about 10% of all salivary gland neoplasms and approximately 35% of malignant salivary gland neoplasms. While three fourth of cases of MEC arise in the parotid, they account for a large proportion of salivary gland neoplasms occurring in minor salivary glands. Appending to the uncommonness, unusual presentations like MEC arising in heterotopic rests of salivary gland tissue in intraparotid or extraparotid lymph nodes, and MEC arising in lingual tonsils have been reported. Such diversity of clinical presentation may present a diagnostic challenge. In this continuum, we report a rare and unique case of low grade mucoepidermoid carcinoma of minor salivary gland, which primarily presented as cervical lymph node metastasis, three years before the primary intraoral lesion occurred.

Crumpled B, F Co-doped graphene nanosheets for the fabrication of all-solid-state flexible supercapacitors.

Crumpled B, F co-doped graphene nanosheets (BFGO) have been synthesized using supercritical water as the solvent in a short reaction time of 1 h and were demonstrated for the fabrication of all-solid-state flexible supercapacitors (ASFS). As-synthesized BFGO delivered high specific capacitance with an NaVO3/H2SO4 electrolyte (832 F g-1). Moreover, the fabricated ASFS showed excellent energy and power densities of 24 W h kg-1 and 800 W kg-1 at 1 A g-1, respectively.

Utility of nested polymerase chain reaction for fungus in detecting clinically suspected patients of invasive fungal infections and its clinical correlation and comparison with fungal culture.

AIMS AND OBJECTIVES: The aim and objective of this study is to detect invasive fungal infections (IFIs) early and with more sensitivity by the nested polymerase chain reaction (PCR) for fungus as compared to fungal culture in clinically suspected patients and also explore its correlation in reference to age, duration of symptoms, immunocompromised status, and other risk factors predisposing to IFIs. MATERIALS AND METHODS: In this cross-sectional study, 50 suspected patients admitted in medical acute care unit/intensive care unit (ACU/ICU) of Sir Sunderlal Hospital, Banaras Hindu University, Varanasi, India, comprised the study. All cases were selected based on the predefined inclusion and exclusion criteria. A detailed history, clinical examination, and all required investigations were done in all suspected patients. Blood samples were taken for nested-PCR for fungus and culture. Nested PCR was performed on extracted DNA form samples collected from all participants under the study. RESULTS: Our study comprised of 50 suspected immunocompromised patients of IFIs. Among the participants under the study, the most common risk factor was diabetes mellitus (28% cases). Nearly two-thirds (60%) of the cases were 50 years or more. Around 70% of the cases had a history of illness more than 2 weeks. Nested PCR for fungus came out to be positive in 21/50 patients (42%); however, fungal culture was positive in none. Among the admitted patient in ACU/ICU, 75% were neutropenic. CONCLUSIONS: IFIs are more common in immunocompromised individuals, patients with comorbidities, long history of symptoms, and elderly population. Nested PCR for fungus has a high sensitivity (as compared to the fungal culture), and also they are rapid in giving the results. Thus, nested PCR for fungus can be used in a cost-effective manner for the early and reliable diagnosis of clinically suspected IFIs.

A comprehensive review of epilepsy in the Arab world.

PURPOSE: We conducted a comprehensive review of the epidemiology of epilepsy in the Arab world. METHODS: Epidemiological literature about epilepsy from 22 countries of the Arab League was searched in French and English using several keywords (specific and wider) and combinations, individually for each country. The search was conducted on Google first and then on PubMed. The results are presented as counts, proportions, and medians along with 95% confidence intervals (CI). Unpaired t-test with unequal variance and regressions were performed, altogether and individually, for lifetime and active epilepsy prevalence as well as incidence. RESULTS: Google provided 21 prevalence, four camp and nine incidence estimates while PubMed provided ten such estimates; none of them was identified by Google. No epidemiological data about epilepsy was found from 10/22 countries. Excluding pediatric studies, 13 prevalence estimates from six countries were identified. Including pediatric studies, 21 estimates from nine countries were found. Median lifetime and active epilepsy prevalence were 7.5/1000 (95% CI 2.6-12.3, range 1.9-12.9) and 4.4/1000 (95% CI 2.1-9.3, range 2.1-9.3), respectively, excluding pediatric studies (1984-2014, N=244081). Median incidence was 56.0/100,000 (n=9, N=122484, 95% CI 13.7-147.9, range 10.4-190). CONCLUSION: The fact that no epidemiological data about epilepsy is available in the public domain for almost one half of all Arab countries offers opportunities for future research. This thorough review of existing literature demonstrates a prevalence of epilepsy three times higher than previously reported for this region. The median incidence is similar to other regions of the world, e.g. North America. Google yielded additional valuable sources not indexed in PubMed and provided pertinent references more quickly.

Clinicopathological studies of gastrointestinal tract disorders in sheep with parasitic infection.

AIM: This study was envisaged to elucidate the parasitological aspects of gastrointestinal tract (GIT) disorders of sheep. MATERIALS AND METHODS: Fecal, blood and serum samples collected from 31 sheep/lambs of Sheep Breeding Farm, Lala Lajpat Rai University of Veterinary & Animal Sciences, Hisar. RESULTS: Of 25 cases, strongyle eggs (12 cases, 48%) were a major infection, followed by Strongyloides spp. (8 cases, 32%) and Moniezia spp. (5 case, 20%). In one case, massive infection of strongyle particularly Haemonchus contortus and Moniezia spp. was observed. All these animals were found negative for hemoprotozoan parasites in blood smear examination. Hematological studies revealed that significantly decreased values of hemoglobin (Hb), packed cell volume (PCV) and total erythrocytic count (TEC). Absolute leukocytic count revealed significant leukocytosis due to neutrophilia, lymphocytosis, monocytosis and eosinophilia. Serum biochemical profiles of diarrheic sheep/lambs in present study were significant decrease in values of total protein, serum globulin, glucose where as significant increase in the albumin: Globulin ratio, aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), alkaline phosphatise (ALKP) and bilirubin. CONCLUSIONS: From the present study, it is reasonable to conclude that major parasitic infection of sheep/lamb observed was strongyle, followed by Strongyloides spp. and Moniezia spp. Hemato-biochemical studies revealed significant leukocytosis and increase in AST, ALT, ALKP and bilirubin.

Doppler sonography for evaluation of hemodynamic characteristics of fetal umbilicus in Beetal goats.

AIM: The objective of this study was to evaluate the hemodynamic characteristics of umbilical vessels in healthy pregnant Beetal goats. MATERIALS AND METHODS: Doppler examinations were performed from day 20 to 120 of gestation, twice in week from day 20 to 60 and once in week from day 60 to 120 of gestation on six goats. RESULTS: Free floating umbilical cord was identified on day 39 of gestation. The umbilical cord waveform was characterized by the simultaneous presence of arterial and venous flow. The pattern of blood flow in the umbilical artery was represented as saw tooth pattern above the baseline. Pattern of blood flow in umbilical vein was flat and wavy in nature; presented below the baseline. Peak systolic velocity (PSV) increased significantly from day 39 to 67 and further between 98 and 120 days of gestation (p<0.05), but there was no significant increase or decrease in end-diastolic velocity (EDV). Pulsatility index (PI) value was increased significantly during 42 to 48 days of gestation and decreased significantly from 98 to 105 days of gestation. On other days, there was no significant increase or decrease. Value of resistance index (RI) was more stable than PI values as there was no significant increase or decrease in RI value. CONCLUSIONS: From the present study, it is reasonable to conclude that the normal blood flow parameters like PI, RI, PSV and EDV during gestation might be helpful in assessment of antenatal development of fetus in the goat. This work provides the basis for further contribution in diagnosing and monitoring high-risk pregnancy in this species.

Two-dimensional and three-dimensional ultrasonography for pregnancy diagnosis and antenatal fetal development in Beetal goats.

AIM: The objective of this study was to compare two-dimensional (2D) and three-dimensional (3D) study of the pregnant uterus and antenatal development of the fetus. MATERIALS AND METHODS: 2D and 3D ultrasound were performed from day 20 to 120 of gestation, twice in week from day 20 to 60 and once in week from day 60 to 120 of gestation on six goats. The ultrasonographic images were obtained using Toshiba, Nemio-XG (Japan) 3D ultrasound machine. RESULTS: On the 20(th) day of gestation, earliest diagnosis of pregnancy was done. First 3D ultrasonographic image of the conceptus, through transabdominal approach, was obtained on day 24. On 39(th) day, clear pictures of conceptus, amniotic membrane, and umbilicus were seen. On 76(th) day of gestation, internal organs of fetus viz heart, kidney, liver, urinary bladder, and stomach were seen both in 2D and 3D images. 3D imaging showed better details of uterine structures and internal organs of the fetus. CONCLUSIONS: Comparing 3D images with 2D images, it is concluded that 2D was better in visualizing fluid while 3D images were better to view details of attachment of fetus with endometrium.