Serum estradiol level and postmenopausal symptoms in surgical and natural menopause

Background: Menopause whether it occurs naturally or surgically is characterized by the reduced production of hormones by the ovaries. The study aimed at comparing the serum estradiol levels and postmenopausal symptoms in women with surgical and natural menopause.Methods: 50 women each of natural and surgical menopause were enrolled. Five ml of fasting blood sample was collected from each patient in both the groups by venepuncture in a plain tube, which was centrifuged and was analyzed for serum estradiol levels by chemiluminescence method. Levels of serum estradiol hormone for both the groups were compiled and the mean and standard deviation was calculated. Postmenopausal symptoms were also compared among two groups. Chi square and fisher exact test were used to analyze the qualitative data and t test were used to analyze the quantitative data.Results: The mean level of serum estradiol in women with surgical menopause was found to be 20.49 + 3.16 pg/ml while that in natural menopause, was 27.41 + 5.08pg/ml. The difference in mean estradiol level between the two groups was found to be statistically significant (p value <0.0001). Hot flushes and mood swings were observed in more number of women with surgical menopause.Conclusions: The statistically significant lower levels of serum estradiol in surgical menopausal group may be a reason behind increased presence of menopausal symptoms in this group. Thus, the women in this group may benefit from hormone replacement therapy, improving their quality of life, however further studies are needed to establish this role

A case of atypical leiomyoma mimicking as endometrial cancer

Atypical leiomyoma or leiomyoma with bizarre nucleus is diagnosed on histopathological examination characterized by severe cytological atypia in the form of nuclear enlargement, multi nucleation, hyperchromasia, coarse chromatin and prominent nuclei. These tumours do not have typical features of necrosis or mitotic figures to characterize them as leiomyosarcoma. There are 2% risk of these tumours to convert to leiomyosarcoma. 50-year P3L3A1 postmenopausal for past 6 years presented to gynaecology outpatient department (GOPD) with complains of pain in lower abdomen for past 1 year. Patient was examined and investigated. On clinical examination there was no apparent finding. On radiological examination a well-defined hypoechoic lesion of 6.4×5.7 cm2 was found arising from uterus. Contrast enhanced computed tomography (CECT) abdomen showed heterogenous mass involving endometrium and myometrium likely neoplastic. Total abdominal hysterectomy with bilateral salpingoophrectomy was done. Histopathological examination (HPE) report revealed features of atypical leiomyoma. Patient is under follow up in GOPD

4-[(4-Methyl­benz­yl)amino]-3-[(4-methyl­benz­yl)imino­meth­yl]-2H-chromen-2-one

The title compound, C26H24N2O2, was prepared from the reaction of 4-chloro-3-formyl­coumarin with p-methyl­benzyl­amine. Even though there are no strong and specific inter­actions in the crystal structure, the translationally related mol­ecules form chains along the b axis. The coumarin moieties are stacked through π–π inter­actions [centroid–centroid distance = 3.5275 (7) Å], forming layers perpendicular to the stacking direction

Head injury at a tertiary referral centre in the Eastern Region of Nepal

Background: The purpose of this epidemiologic study was to determine the pattern and characteristics of head injuries and to establish an epidemiologic data bank for designing preventive strategies for head injuries in the eastern region of Nepal.Patients and Methods: This retrospective review was done at B.P.Koirala institute of Health Sciences, Dharan, Nepal. All the patients with head injury admitted to the Department of Surgery between the periods January 2005 to December 2005 were included in the study.Results: The study population consisted of 334 patients who sustained head injuries. Their ages ranged from 1 to 88 with a mean age of 28.53 years. The majority (66.3%), were young adults in the 2nd to 5th decades The male to female sex ratio was 2.6:1. Road traffic crushes were the most common cause (43.4%) followed by fall from heights (30.8%). X-ray of skull showed lesions in 114 cases (49.8%) such as depressed fracture (11.4%) and linear fracture (24.0%). Common lesions on CT scan included cerebral contusion (21.6%), extradural haematoma (20.9%), linear fracture (23.8%), subarachnoid haemorrhage (18.5%) and pnemocephalus (11.2%). Forty patients (12.0%) sustained moderate head injury. There were 15 deaths. One patient had associated intra-abdominal injury (splenic rupture) and two patient sustained pulmonary trauma and succumbed to haemothorax and aspiration.Conclusion: A clearer understanding of the patterns of head injuries will assist health care providers to plan and manage the treatment of traumatic facial injuries. Such epidemiological information can also be used to guide the future funding of public health programs geared toward prevention

ANTIOXIDANT AND ANTIPROLIFERATIVE POTENTIALS OF MARINE ACTINOMYCETES

Objective: The aim of present studyis to isolate and characterize a novel actinomycetes strain from marine sediments collected at Kakinada coast. To evaluate antioxidant and antiproliferative activities of the crude methanolic extract of isolated actinomycetes.Methods: Actinomycetes was isolated from marine sediments collected at Kakinada coast using starch casein agar. Morphological, biochemical and molecular characterization was performed and the crude methanolic extract was used for determination of in vitro antioxidant activity and antiproliferative activity against MDA-MB 231 breast cancer cells.Results: The crude methanolic extract exhibited significant antioxidant activity with IC­50­ value in the range of 30-46 µg/ml in different radical scavenging assays. Moreover, the extract showed concentration dependent cytotoxicity against triple negative breast cancer cell line, MDA-MB 231 with IC50 of 42.5µg/ml. The extract also inhibited cell proliferation with IC50 value 44.1 µg/ml probably by arresting cell cycle at S phase. The antioxidant activity of the extract was strongly correlated with cytotoxic and antiproliferative activity.Conclusion: The isolated marine actinomycetes can be the potential source of antioxidants with the anticancer property

DEVELOPMENT OF STABILITY INDICATING RP-HPLC METHOD FOR THE SIMULTANEOUS ESTIMATION OF AMBROXOL HYDROCHLORIDE AND LEVOCETIRIZINE DIHYDROCHLORIDE

A simple, precise and accurate method has been developed for simultaneous estimation of Ambroxol hydrochloride and Levocetirizine dihydrochloride. The proposed RP-HPLC method utilises Enable C18 G column (250 x 4.6mm, 5m), mobile phase consisting of Phosphate buffer pH 3.0: Methanol in the ratio of 20:80 (v/v) and UV detection at 236nm using a photodiode array detector. ambroxol hydrochloride and levocetirizine dihydrochloride were exposed to acidic, alkali, oxidative, thermal and photolytic stress conditions and the stressed samples were analysed by the proposed method. Peak homogeneity data of ambroxol hydrochloride and levocetirizine dihydrochloride in the stressed samples demonstrated the specificity of the method for their estimation in presence of degradants. The described method was linear over a range of 15 45 g/mL for ambroxol hydrochloride and 1 3 g/mL for levocetirizine dihydrochloride respectively. The method validation data showed excellent results for accuracy, precision, linearity, specificity, limit of detection, limit of quantification and robustness. The present method can be successfully used for routine quality control and stability studies

The Epidemiology of Hypoxemic Pneumonia among Young Infants in Malawi

We describe hypoxemic pneumonia prevalence in outpatient and inpatient settings, in-hospital mortality, and clinical guideline performance for identifying hypoxemia in young infants in Malawi. In this retrospective analysis of a prospective cohort study, we investigate infants younger than 2 months participating in pneumonia surveillance at seven hospitals and 18 outpatient health centers in Malawi between 2011 and 2014. Logistic regression, multiple imputations with chained equations, and pattern mixture modeling were used to determine the association between peripheral oxyhemoglobin saturation (SpO2) levels and hospital mortality. We describe referral recommendations based on clinical characteristics and SpO2 distributions. Among 1,879 analyzed cases, SpO2 < 90% was more prevalent among outpatient health center cases than that among hospitalized cases (22.6% versus 13.5%, 95% CI: 17.6–28.4% and 12.0–15.3%, respectively). A larger proportion of hospitalized infants had signs of respiratory distress than infants at health centers (67.7% versus 56.6%, P < 0.001) and the signs were higher in male versus female infants (56.7% versus 40.6%, P < 0.001). An SpO2 of 90–92% and < 90% was associated with similarly increased odds of in-hospital mortality (adjusted odds ratio [aOR]: 4.3 and 4.4, 95% CI: 1.7–11.1 and 1.8–10.5, respectively). Unrecorded, or unobtainable, SpO2 was highly associated with mortality (n = 127, aOR: 18.1; 95% CI: 7.6–42.8). Four of 22 (18%) infants at health centers who did not meet clinical referral criteria had an SpO2 ≤ 92%. Clinicians should consider hospital referral in young infants with SpO2 ≤ 92%. Infants with unobtainable SpO2 readings should be considered a high-risk group, and hospital referral of these cases may be appropriate