Changing trends in technique of hysterectomy in abnormal uterine bleeding: a comparison between non descent vaginal hysterectomy versus laparoscopic assisted vaginal hysterectomy

 Background: Hysterectomy is the commonest gynaecological surgery over the world. However, in India there is a huge lack in data regarding this surgery. The common indications are abnormal uterine bleeding (AUB), prolapse, pelvic inflammatory disease (PID) and pelvic pain. This study focuses on pros and cons of different routes of hysterectomy to decide a better approach of management. Aims and objective of the study were to compare non descent vaginal hysterectomy (NDVH) to laparoscopic assisted vaginal hysterectomy (LAVH) to determine better route of hysterectomy.Methods: A randomized prospective observational study conducted in Hind Institute of Medical Science, Barabanki over a period of 2 years on perimenopausal women undergoing hysterectomy for AUB for benign pathology. 100 patients were selected for the study and randomly divided in 2 groups NDVH and LAVH. Preoperative investigations, intra-operative and postoperative complications were compared.Results: The mean duration of surgery was found to be significantly less in NDVH group 71.24 minutes as compared to LAVH group 103.1 minutes. (p value <0.001). Number of patients requiring Blood transfusion during or after surgery was higher in LAVH group (21) than in NDVH (15) (p value <0.05) suggesting more blood loss in LAVH. Patients undergoing NDVH were having significant less postoperative pain visual analogue score 3.8 as compared to 5.4 in LAVH group (p value <0.001) .5 patients in LAVH group were having postoperative abdomen discomfort as compared to only 1 in NDVH group (p value <0.05).Conclusions: NDVH supersedes LAVH being faster, less expensive, less blood loss and cosmetically scarless surgery. However, LAVH should be kept in mind if there is associated adnexal pathology

Histopathological evaluation of abnormal uterine bleeding with immunohistochemical study of significant estrogen receptor expression in endometrium of women with different age groups

Background: Abnormal uterine bleeding is symptom, not disease. Bleeding per vaginum is labelled to be pathological when there is constant irregularity in pattern and flow of bleeding, altered duration or increased amount of menstrual blood. Histopathological examination of endometrium biopsies remains a gold standard diagnostic tool. Methods: A prospective study was done on 150 patients presenting with AUB over the period January 2022 to December 2022 in the department of pathology, Hind institute of medical sciences, Sitapur, Uttar Pradesh, India. The sections were stained with hematoxylin and eosin and special stain estrogen receptor was used. Results: Majority of the patients were seen in the perimenopausal age group and most common complaint was menorrhagia in 73 patients (48%). The commonest pathology observed in our study was proliferative phase endometrium in 48 patients (32%). Most of the endometrial carcinoma (4%) were presented after the age of 50 years. The association between histopathological patterns and estrogen receptor category were found to be statistically significant as the p&lt;0.05. Conclusions: Disease burden on a global scale is witnessed by women affected by AUB thus having a detrimental impact. Accurate diagnosis of AUB in women over the age of 35yrs is important to rule out preneoplastic lesions and malignancies so that surgical interventions can be avoided by initiating proper medical management. Comparing the hyperplastic and neoplastic endometrium to that of the proliferative phase, ER expression was lower. Endometrial carcinoma with advanced stage often lacks the expression of the receptors

Public Health concern for a Nipah Virus disease

Nipah virus (NiV) is a pathogenic paramyxovirus that has been responsible for sporadic outbreaks of respiratory and encephalitic disease in tropical countries. Elevated case mortality rate has also been connected with recent outbreaks in India (Kerala), Malaysia and Bangladesh. The virus generally infects animals like pigs and bats, but they do not show any symptoms of NiV.&nbsp; The mortality rate in NiV infected humans is more as compared to other mammals. The patient usually shows no symptoms to headache fever, cough, dyspnea, confusion and more consequences lead to a coma. Although there are no drugs or vaccines available against this severe disease, precaution and awareness reduce the risk of NiV-infection. This review will be helpful to save the life of people and decrease death by the NiV-infection outbreak. Keywords:&nbsp; &nbsp;Diagnosis, Henipavirus, Nipah virus, Prevention and treatmen

Association of SUMOlation Pathway Genes With Stroke in a Genome-wide Association Study in India

OBJECTIVE: To undertake a genome-wide association study (GWAS) to identify genetic variants for stroke in an Indian population. METHODS: In a hospital-based case-control study, 8 teaching hospitals in India recruited 4,088 participants, including 1,609 stroke cases. Imputed genetic variants were tested for association with stroke subtypes using both single-marker and gene-based tests. Association with vascular risk factors was performed with logistic regression. Various databases were searched for replication, functional annotation, and association with related traits. Status of candidate genes previously reported in the Indian population was also checked. RESULTS: Associations of vascular risk factors with stroke were similar to previous reports and show modifiable risk factors such as hypertension, smoking, and alcohol consumption as having the highest effect. Single-marker–based association revealed 2 loci for cardioembolic stroke (1p21 and 16q24), 2 for small vessel disease stroke (3p26 and 16p13), and 4 for hemorrhagic stroke (3q24, 5q33, 6q13, and 19q13) at p < 5 × 10(−8). The index single nucleotide polymorphism of 1p21 is an expression quantitative trait locus (p(lowest) = 1.74 × 10(−58)) for RWDD3 involved in SUMOylation and is associated with platelet distribution width (1.15 × 10(−9)) and 18-carbon fatty acid metabolism (p = 7.36 × 10(−12)). In gene-based analysis, we identified 3 genes (SLC17A2, FAM73A, and OR52L1) at p < 2.7 × 10(−6). Eleven of 32 candidate gene loci studied in an Indian population replicated (p < 0.05), and 21 of 32 loci identified through previous GWAS replicated according to directionality of effect. CONCLUSIONS: This GWAS of stroke in an Indian population identified novel loci and replicated previously known loci. Genetic variants in the SUMOylation pathway, which has been implicated in brain ischemia, were identified for association with stroke

The hypoxic cancer secretome induces pre-metastatic bone lesions through lysyl oxidase

Tumour metastasis is a complex process involving reciprocal interplay between cancer cells and host stroma at both primary and secondary sites, and is strongly influenced by microenvironmental factors such as hypoxia. Tumour-secreted proteins play a crucial role in these interactions and present strategic therapeutic potential. Metastasis of breast cancer to the bone affects approximately 85% of patients with advanced disease and renders them largely untreatable. Specifically, osteolytic bone lesions, where bone is destroyed, lead to debilitating skeletal complications and increased patient morbidity and mortality. The molecular interactions governing the early events of osteolytic lesion formation are currently unclear. Here we show hypoxia to be specifically associated with bone relapse in patients with oestrogen-receptor negative breast cancer. Global quantitative analysis of the hypoxic secretome identified lysyl oxidase (LOX) as significantly associated with bone-tropism and relapse. High expression of LOX in primary breast tumours or systemic delivery of LOX leads to osteolytic lesion formation whereas silencing or inhibition of LOX activity abrogates tumour-driven osteolytic lesion formation. We identify LOX as a novel regulator of NFATc1-driven osteoclastogenesis,independent of RANK ligand, which disrupts normal bone homeostasisleading to the formation of focal pre-metastatic lesions. We show that these lesions subsequently provide a platform for circulating tumour cells to colonize and form bone metastases. Our study identifies a novel mechanism of regulation of bone homeostasis and metastasis, opening up opportunities for novel therapeutic intervention with important clinical implications

Common variants in CLDN2 and MORC4 genes confer disease susceptibility in patients with chronic pancreatitis

A recent Genome-wide Association Study (GWAS) identified association with variants in X-linked CLDN2 and MORC4 and PRSS1-PRSS2 loci with Chronic Pancreatitis (CP) in North American patients of European ancestry. We selected 9 variants from the reported GWAS and replicated the association with CP in Indian patients by genotyping 1807 unrelated Indians of Indo-European ethnicity, including 519 patients with CP and 1288 controls. The etiology of CP was idiopathic in 83.62% and alcoholic in 16.38% of 519 patients. Our study confirmed a significant association of 2 variants in CLDN2 gene (rs4409525—OR 1.71, P = 1.38 x 10-09; rs12008279—OR 1.56, P = 1.53 x 10-04) and 2 variants in MORC4 gene (rs12688220—OR 1.72, P = 9.20 x 10-09; rs6622126—OR 1.75, P = 4.04x10-05) in Indian patients with CP. We also found significant association at PRSS1-PRSS2 locus (OR 0.60; P = 9.92 x 10-06) and SAMD12-TNFRSF11B (OR 0.49, 95% CI [0.31–0.78], P = 0.0027). A variant in the gene MORC4 (rs12688220) showed significant interaction with alcohol (OR for homozygous and heterozygous risk allele -14.62 and 1.51 respectively, P = 0.0068) suggesting gene-environment interaction. A combined analysis of the genes CLDN2 and MORC4 based on an effective risk allele score revealed a higher percentage of individuals homozygous for the risk allele in CP cases with 5.09 fold enhanced risk in individuals with 7 or more effective risk alleles compared with individuals with 3 or less risk alleles (P = 1.88 x 10-14). Genetic variants in CLDN2 and MORC4 genes were associated with CP in Indian patients

Azimuthal anisotropy of charged jet production in root s(NN)=2.76 TeV Pb-Pb collisions

We present measurements of the azimuthal dependence of charged jet production in central and semi-central root s(NN) = 2.76 TeV Pb-Pb collisions with respect to the second harmonic event plane, quantified as nu(ch)(2) (jet). Jet finding is performed employing the anti-k(T) algorithm with a resolution parameter R = 0.2 using charged tracks from the ALICE tracking system. The contribution of the azimuthal anisotropy of the underlying event is taken into account event-by-event. The remaining (statistical) region-to-region fluctuations are removed on an ensemble basis by unfolding the jet spectra for different event plane orientations independently. Significant non-zero nu(ch)(2) (jet) is observed in semi-central collisions (30-50% centrality) for 20 <p(T)(ch) (jet) <90 GeV/c. The azimuthal dependence of the charged jet production is similar to the dependence observed for jets comprising both charged and neutral fragments, and compatible with measurements of the nu(2) of single charged particles at high p(T). Good agreement between the data and predictions from JEWEL, an event generator simulating parton shower evolution in the presence of a dense QCD medium, is found in semi-central collisions. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe