Microperforate hymen is incomplete canalization of hymen before birth. It is a rare entity with about 20 cases reported as of now. A, 16-year-old girl, presented to Gynaecology OPD of our hospital with complaints of heavy menstrual bleeding, foul smelling discharge per vaginum and acute pain abdomen for 3 days. She attained menarche at 12 years of age. On examination, abdomen was soft and tenderness was present in suprapubic area. On local examination, hymen was intact and apparently looked imperforate. On per rectal examination, a cystic mass was felt above the anal verge bulging through the anterior rectal wall. Abdominal, trans perineal ultrasound and MRI pelvis was done and possibility of imperforate hymen was made. Under anaesthesia, a syringe- needle was put through the apparent imperforate hymen and 50 ml of pus was drained. Hymenectomy was done. Diagnosis of microperforate hymen with pyocolpos was made. At the time of follow up after 15 days, patient was fine with healthy suture line. Our case is unique in many ways, first its delayed presentation, second the presentation of microperforate hymen with pyocolpos that was managed successfully surgically.

Background: The current outbreak of COVID-19 caused by SARS-CoV-2 raised fundamental public health concerns as its emergence has been marked the third introduction of a highly pathogenic coronavirus into the human population after SARS-CoV and MERS-CoV in the twenty-first century. Recent advancement of SARS-CoV-2 infection revealed mechanism of immune evasion during the pathogenesis. Hence, this study reviewed available literature on epidemiology of SARS-CoV-2, viral pathogenesis, host immune response to the infection and potential vaccine trial for the treatment of the infection. Methods: Systematic review technique was used for this study. Results: This study provides an immunological insight into the SARS-CoV-2 infection for better understating of the virus and as well as the strategies for use in combating the disease. Conclusion This predictive view may help in designing an immune intervention or preventive vaccine for COVID-19 in the near future.

Introduction: Antibody-mediated rejection (AMR) is the most serious cause of renal allograft loss. Most of the acute AMR attacks occur within the first week post-transplant. Subject: In this case report, we present a case of AMR that occurred five months post-transplant in association with acute oral viral infection. This patient had history of bone marrow hypoplasia two months following onset of hemodialysis and was maintained on cyclosporine and prednisolone beside switch to hirudin as anticoagulant. During that period, she also received 6 units of whole blood till she underwent kidney transplant after 2 years on dialysis. The post-transplant course was uneventful till the patient developed severe acute herpetic gingivastomatitis 5 months post-transplant that was associated with abrupt rise of renal chemistry. Biopsy proven AMR showed resistance to treatment with plasma exchange [PE] and Intravenous immunoglobulins. The patient was readmitted to regular hemodialysis unit for 2 months together with minimization of immunosuppressive treatment. Outcome: During routine follow-up investigations, kidney function tests became near to the pre-rejection levels. We discontinued dialysis and re-administered the initial immunosuppressive regimen. Conclusion: This is the first reported case of AMR in association with acute Herpes simplex infection that shows delayed spontaneous recovery.

Background: Elevated HBA1C level is predictive for cardiovascular disease and mortality in diabetic & also in non-diabetic patients. Aim of our study was to evaluate correlation between HBA1c on admission and short term mortality in non-diabetic patients with ST elevated myocardial infarction. Methods: 266 non-diabetic patients presenting with STEMI (within 48 hours) were included in our study. Data regarding patient characteristics were collected over 7 months. All-cause mortality data collected prospectively up to 6 months. Results: Mean HBA1C was 5.69±0.65 for the study population. HBA1C quartiles (<5, 5.1-5.5, 5.6-6, 6.1-6.4) has shown increased 6 months mortality (3%, 4.8%, 1.7%, 15.1% respectively P=0.004) with increased values. Multivariate regression analysis has shown HBA1C>6 as an independent predictor of 6 month mortality. Conclusion: A significant correlation exists between HBA1C on admission in non-diabetic patients with STEMI and 6 month all-cause mortality.

Background: Thrombolytic therapy is one of the effective treatments for ST-segment elevation myocardial infarction. The most common complication of thrombolytic therapy is hemorrhage. Thromboembolism caused by thrombolytic therapy is exceedingly rare in clinical practice. However, we report a case of cerebral infarction caused by thrombolytic therapy for acute myocardial infarction. Case Report: A 70-year-old man complained of burning sensation under the xiphoid process for 7 years and sudden chest pain for 3 hours. He was diagnosed with acute anterior ST-segment elevation myocardial infarction. Thrombolytic therapy was carried out immediately, but the patient developed cerebral infarction 3 hours after thrombolysis. CONCLUSION: The common complication of thrombolytic therapy is cerebral hemorrhage or gastrointestinal hemorrhage, but the possibility of cerebral infarction should also be taken into account when patients have neurological symptoms.