Bilateral thecoma presenting as premenopausal hirsutism: Laproscopic removal

Hyperandrogenism is a common disorder among women in the reproductive age group. One of the rare causes for androgen excess is sex cord- stromal tumors of the ovary. These are usually unilateral. Here we report case of a 48 year old woman who presented with hyperandrogenism due to bilateral ovarian thecoma. Androgen levels normalized following resection of the tumor. This, to the best of our knowledge, is the first case of bilateral thecoma presenting as hirsutism in a premenopausal woman.

Constructed wetland as an ecotechnological tool for pollution treatment for conservation of Ganga river

With aim to develop an efficient and ecofriendly approach for on-site treatment of sewage, a sub-surface flow constructed wetland (CW) has been developed by raising potential aquatic macrophytes; Typha latifolia, Phragmites australis, Colocasia esculenta, Polygonum hydropiper, Alternanthera sessilis and Pistia stratoites in gravel as medium. Sewage treatment potential of CW was evaluated by varying retention time at three different stages of plant growth and stabilization. After 6 months, monitoring of fully established CW indicated reduction of 90%, 65%, 78%, 84%, 76% and 86% of BOD, TSS, TDS, NO3-N, PO4-P and NH4-N, respectively in comparison to inlet after 36 h of retention time. Sewage treatment through CW also resulted in reduction of heavy metal contents. Thus, CW proved an effective method for treatment of wastewater and may be developed along river Ganga stretch as an alternative technology. Treated water may be drained into river to check further deterioration of Ganga water quality.

Evaluation of antiemetic effect of intravenous palonosetron versus intravenous ondansetron in laparoscopic cholecystectomy: a randomized controlled trial

OBJECTIVES

Incidence of postoperative nausea and vomiting (PONV), without active intervention, following laparoscopic cholecystectomy is unacceptably high. We evaluated the effectiveness of intravenous (IV) palonosetron in counteracting PONV during the first 24 hrs following laparoscopic cholecystectomy, using ondansetron as the comparator drug.

MATERIALS AND METHODS

In a randomized, controlled, single blind, parallel group trial, single pre-induction IV doses of palonosetron (75 mcg) or ondansetron (4 mg) were administered to adult patients of either sex undergoing elective laparoscopic cholecystectomy. There were 49 subjects per group. The pre-anesthetic regimen, anesthesia procedure and laparoscopic technique were uniform. The primary effectiveness measure was total number of PONV episodes in the 24 hrs period following end of surgery. The frequencies of individual nausea, retching and vomiting episodes, visual analog scale (VAS) score for nausea at 2, 6 and 24 hrs, use of rescue antiemetic (metoclopramide), number of complete responders (no PONV or use of rescue in 24 hrs) and adverse events were secondary measures.

RESULTS

There was no statistically significant difference between the groups in primary outcome. Similarly, the frequencies of nausea, retching and vomiting episodes, when considered individually, did not show significant difference. Nausea score was comparable at all time points. With palonosetron, 14 subjects (28.6%) required rescue medication while 13 (26.5%) did so with ondansetron. The number of complete responders was 14 (28.6%) and 16 (32.7%), respectively. Adverse events were few and mild. QTc prolongation was not encountered.

CONCLUSION

Palonosetron is comparable to ondansetron for PONV prophylaxis in elective laparoscopic cholecystectomy when administered as single pre-induction dose.