Tuberculosis (TB) of the genital tract commonly occurs secondary to a primary lesion. The mode of spread is via the lymphatics, the haematogenous route or less commonly by a peritoneal spread. The fallopian tubes are the first targets, followed by the pelvic organs. Isolated cases of TB which occur in a unilateral fallopian tube are rare, particularly with it as a primary site. The aim of this study was to report a rare case of TB of the left fallopian tube in a post menopausal lady with no positive history, clinical or laboratory finding to suggest it to be a secondary focus. As the pre-operative diagnosis was that of a right ovarian neoplasm, the patient underwent staging laparotomy. TB of the left fallopian tube was diagnosed, as there were numerous typical granulomata throughout the fallopian tube.

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Purpose The present study aimed to assess the role of adipocytokines as predictive markers of gestational diabetes mellitus (GDM). We undertook this study to explore the association of adiponectin, resistin, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) and insulin resistance in the development of GDM. Methods This longitudinal descriptive study was done in the Medical College Hospital, involving the departments of Biochemistry and Gynecology. The study subjects were pregnant women with normal body mass index. They were recruited at 12-14 weeks of gestation, The healthy pregnant women were selected and were followed at 24-28 weeks for screening of GDM. The participants were categorized as healthy and GDM based on oral glucose tolerance test results. Blood samples were collected on both the occasions at 12-14 weeks and 24-28 weeks. The serum samples were analyzed for levels of insulin, adiponectin, resistin, IL-6 and TNF-alpha. Insulin resistance (HOMA-IR) was calculated from serum insulin and plasma glucose values. ResultsThe levels of HOMA-IR, resistin, IL-6 and TNF-alpha were significantly higher and level of adiponectin was significantly lower in GDM subjects in comparison to healthy pregnant women, when compared both at 12 weeks and 24 weeks. The levels of resistin, IL-6 and TNF-alpha were significantly higher and level of adiponectin was lower at 24 weeks in comparison to 12 weeks, in the healthy pregnant women as well as those with GDM . Conclusions Significant difference in the levels of adipocytokines between the healthy and GDM pregnant women suggest potential clinical application of these molecules as biomarkers of GDM. The increase or decrease in the levels of adipocytokines during the course of pregnancy in GDM subjects suggests their role in GDM and potential use as predictive markers.

Knowledge, attitudes and practices of medical ethics among 297 undergraduate medical interns of four medical colleges from eastern part of India were assessed using a self administered structured questionnaire. Questions on source of medical ethics, codes and guidelines were set to assess the knowledge of medical ethics while importance of ethics, autonomy, justice and confidentiality were used as questions to assess attitudes towards medical ethics. Practices of medical ethics, however, were assessed by questions on frequency of ethical dilemma, research ethics etc. Out of 297, 259 interns (87.2%) responded. 106 interns (40.9%) said that sources of knowing medical ethics are lectures and/or seminars. Others told either through own reading (20.6%), training (19.8%) or during doing work (18.7%). In code & guidelines, all interns knew Hippocratic Oath but 52.3% interns were aware of Indian Council of Medical Research's code of ethics. 87.6% interns admitted importance of ethics in their work but 22.5% interns believed that consent is required only during operation and not at the time of taking blood. In practice of ethics 52.5% interns told that ethical dilemma comes once in a month. 12.4% interns, however, told that they faced ethical dilemma in their daily work. Regarding application of consent form in human research, 58.1% interns knew about informed consent. 100% interns had no clear cut idea about ethical issue on end-of-life. Implementation of teaching on medical ethics seems to be important in undergraduate medical curriculum in this study zone.

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