Unicornuate uterus with rudimentary horn, gynaecological and reproductive outcome

Congenital malformations of the female genital tract occur in about 8-10% of all women. The unicornuate uterus is a result of partial or complete agenesis of one of the paired Mullerian ducts. It could be a true unicornuate uterus or along with a rudimentary horn, which may be functional. When the rudimentary functional horn is non-communicating, most patients become symptomatic after menarche or present with pregnancy related problems. Three clinical presentations of unicornuate uterus with non-communicating rudimentary horn encountered in last one year are described. The first case was of unruptured rudimentary horn pregnancy of 11-12 weeks. Second case had rudimentary horn removed as an adolescent due to intractable pain, but later main uterus harboured an uneventful pregnancy. Case three had two early abortions, followed by term caesarean section for fetal distress. With advent of ultrasonography and other imaging techniques, the diagnosis and management of unicornuate uterus and its variations is possible. The functional rudimentary horn if symptomatic must be removed along with ipsilateral tube. A unicornuate uterus is associated with obstetric problems and such women should be considered as high risk pregnancy

FORMULATION AND CHARACTERISATION OF MELOXICAM LOADED EMULGEL FOR TOPICAL APPLICATION

Objective: The aim of the research work is to formulate emulgel of Meloxicam for topical application.Methods: The method used for preparation of microemulsion was water titration method with Oleic acid as oil phase, Tween 20 as surfactant and PEG 400 as co-surfactant and its concentrations were fixed based on Pseudoternary phase diagrams. The optimized emulsion formulation was incorporated into the gel matrix that is Carbopol981 NF and Carbopol 974 P NF.Results: The prepared emulsions were characterized for globule size, drug content, zeta potential and the emulgel for physical appearance, drug content, pH, viscosity, spreadability, extrudability and in vitro drug release studies. The optimized emulsion formulations E1 and F1 showed globule size of 176 nm and 128 nm respectively and the emulgel formulation M2F1 with 1.5% Carbopol 981 and optimized F1 emulsion formulation showed in vitro drug release of 89.934% at the end of 8 h. The optimized formulation showed no skin irritation when compared with standard irritant 0.8% of Formalin. The optimized formulation showed better anti-inflammatory effect when compared with marketed formulation.Conclusion: Meloxicam was proven to be a suitable candidate for formulating emulgel for topical delivery to achieve better patient compliance.Â

Intraoperative contralateral extradural hematoma during evacuation of traumatic acute extradural hematoma

Introduction: Extradural hematomas (EDHs) accounts for approximately 2% of patients following head trauma and 5-15% of patients with fatal head injuries. When indicated, the standard surgical management consists of evacuation of the hematoma via craniotomy. Intraoperative development of acute extradural hematoma (AEDH) on the contralateral side following evacuation of acute extradural hematoma is uncommon and very few cases have been reported. Case report: We report a case of 28 year-old-male who suffered from a severe head injury following assault and diagnosed as acute extradural hematoma over right fronto-parietal region with midline shift towards left. Patient underwent emergency craniotomy with acute EDH evacuation. Following evacuation of acute EDH the duramater was tense which was unusual finding. With anticipation of underling acute SDH small durotomy was done, but there were no sub dural hematoma. Bone flap were repositioned and closure were done. Patient was shifted for NCCT head from OT, which revealed 2.7cm acute EDH over left frantoparietal region. Patient was again shifted back to OT and left frontoparietal craniotomy with evacuation of hematoma was done. Postoperative NCCT head was satisfactory. However, the patient remained severely disabled. Conclusion: Formation of contralateral EDH after AEDH surgery is a rare but potentially dangerous complication. A high degree of suspicion should be kept for contralateral extradural hematoma if during surgery there is tense duramater following AEDH evacuation. We would advise urgent NCCT head especially if a fracture is demonstrated on the preoperative CT scan on contralateral side. This would save some invaluable time, which may help in changing the outcome in some of the patients

Estimation of leakage power and delay in CMOS circuits using parametric variation

SummaryWith the advent of deep-submicron technologies, leakage power dissipation is a major concern for scaling down portable devices that have burst-mode type integrated circuits. In this paper leakage reduction technique HTLCT (High Threshold Leakage Control Transistor) is discussed. Using high threshold transistors at the place of low threshold leakage control transistors, result in more leakage power reduction as compared to LCT (leakage control transistor) technique but at the scarifies of area and delay. Further, analysis of effect of parametric variation on leakage current and propagation delay in CMOS circuits is performed. It is found that the leakage power dissipation increases with increasing temperature, supply voltage and aspect ratio. However, opposite pattern is noticed for the propagation delay. Leakage power dissipation for LCT NAND gate increases up to 14.32%, 6.43% and 36.21% and delay decreases by 22.5%, 42% and 9% for variation of temperature, supply voltage and aspect ratio. Maximum peak of equivalent output noise is obtained as 127.531nV/Sqrt(Hz) at 400mHz

NBS1 promotes the endonuclease of the MRE11-RAD50 complex by sensing CtIP phosphorylation

DNA end resection initiates DNA break repair by homologous recombination. MRE11-RAD50-NBS1 and phosphorylated CtIP perform the first resection step by MRE11-catalyzed endonucleolytic DNA cleavage. Human NBS1, more than its Xrs2 homologue from Saccharomyces cerevisiae, is crucial for this process, highlighting complex mechanisms that regulate the MRE11 nuclease in high eukaryotes. Using a reconstituted system, we show here that NBS1, through its FHA and BRCT domains, functions as a sensor of CtIP phosphorylation. NBS1 then activates the MRE11-RAD50 nuclease through direct physical interactions with MRE11. In absence of NBS1, MRE11-RAD50 exhibits a weaker nuclease activity, which requires CtIP but not strictly its phosphorylation. This identifies at least two mechanisms by which CtIP promotes MRE11: a phosphorylation-dependent mode through NBS1, and a phosphorylation-independent mode without NBS1. In support, we show that limited DNA end resection in absence of the FHA and BRCT domains of NBS1 occurs in vivo. Collectively, our data suggest that NBS1 restricts the MRE11- RAD50 nuclease to S-G2 phase when CtIP is extensively phosphorylated. This defines mechanisms that regulate the MRE11 nuclease in DNA metabolism

Bronchiectasis in India:results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry

BACKGROUND: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India. METHODS: The Indian bronchiectasis registry is a multicentre, prospective, observational cohort study. Adult patients ( 6518 years) with CT-confirmed bronchiectasis were enrolled from 31 centres across India. Patients with bronchiectasis due to cystic fibrosis or traction bronchiectasis associated with another respiratory disorder were excluded. Data were collected at baseline (recruitment) with follow-up visits taking place once per year. Comprehensive clinical data were collected through the European Multicentre Bronchiectasis Audit and Research Collaboration registry platform. Underlying aetiology of bronchiectasis, as well as treatment and risk factors for bronchiectasis were analysed in the Indian bronchiectasis registry. Comparisons of demographics were made with published European and US registries, and quality of care was benchmarked against the 2017 European Respiratory Society guidelines. FINDINGS: From June 1, 2015, to Sept 1, 2017, 2195 patients were enrolled. Marked differences were observed between India, Europe, and the USA. Patients in India were younger (median age 56 years [IQR 41-66] vs the European and US registries; p<0\ub70001]) and more likely to be men (1249 [56\ub79%] of 2195). Previous tuberculosis (780 [35\ub75%] of 2195) was the most frequent underlying cause of bronchiectasis and Pseudomonas aeruginosa was the most common organism in sputum culture (301 [13\ub77%]) in India. Risk factors for exacerbations included being of the male sex (adjusted incidence rate ratio 1\ub717, 95% CI 1\ub703-1\ub732; p=0\ub7015), P aeruginosa infection (1\ub729, 1\ub710-1\ub750; p=0\ub7001), a history of pulmonary tuberculosis (1\ub720, 1\ub707-1\ub734; p=0\ub7002), modified Medical Research Council Dyspnoea score (1\ub732, 1\ub725-1\ub739; p<0\ub70001), daily sputum production (1\ub716, 1\ub703-1\ub730; p=0\ub7013), and radiological severity of disease (1\ub703, 1\ub701-1\ub704; p<0\ub70001). Low adherence to guideline-recommended care was observed; only 388 patients were tested for allergic bronchopulmonary aspergillosis and 82 patients had been tested for immunoglobulins. INTERPRETATION: Patients with bronchiectasis in India have more severe disease and have distinct characteristics from those reported in other countries. This study provides a benchmark to improve quality of care for patients with bronchiectasis in India. FUNDING: EU/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis Consortium, European Respiratory Society, and the British Lung Foundation

NBS1 promotes the endonuclease activity of the MRE11-RAD50 complex by sensing CtIP phosphorylation

DNA end resection initiates DNA double-strand break repair by homologous recombination. MRE11-RAD50-NBS1 and phosphorylated CtIP perform the first resection step via MRE11-catalyzed endonucleolytic DNA cleavage. Human NBS1, more than its homologue Xrs2 in Saccharomyces cerevisiae, is crucial for this process, highlighting complex mechanisms that regulate the MRE11 nuclease in higher eukaryotes. Using a reconstituted system, we show here that NBS1, through its FHA and BRCT domains, functions as a sensor of CtIP phosphorylation. NBS1 then activates the MRE11-RAD50 nuclease through direct physical interactions with MRE11. In the absence of NBS1, MRE11-RAD50 exhibits a weaker nuclease activity, which requires CtIP but not strictly its phosphorylation. This identifies at least two mechanisms by which CtIP augments MRE11: a phosphorylation-dependent mode through NBS1 and a phosphorylation-independent mode without NBS1. In support, we show that limited DNA end resection occurs in vivo in the absence of the FHA and BRCT domains of NBS1. Collectively, our data suggest that NBS1 restricts the MRE11-RAD50 nuclease to S-G2 phase when CtIP is extensively phosphorylated. This defines mechanisms that regulate the MRE11 nuclease in DNA metabolism

Estimation of leakage power and delay in CMOS circuits using parametric variation

With the advent of deep-submicron technologies, leakage power dissipation is a major concern for scaling down portable devices that have burst-mode type integrated circuits. In this paper leakage reduction technique HTLCT (High Threshold Leakage Control Transistor) is discussed. Using high threshold transistors at the place of low threshold leakage control transistors, result in more leakage power reduction as compared to LCT (leakage control transistor) technique but at the scarifies of area and delay. Further, analysis of effect of parametric variation on leakage current and propagation delay in CMOS circuits is performed. It is found that the leakage power dissipation increases with increasing temperature, supply voltage and aspect ratio. However, opposite pattern is noticed for the propagation delay. Leakage power dissipation for LCT NAND gate increases up to 14.32%, 6.43% and 36.21% and delay decreases by 22.5%, 42% and 9% for variation of temperature, supply voltage and aspect ratio. Maximum peak of equivalent output noise is obtained as 127.531 nV/Sqrt(Hz) at 400 mHz