Yolk sac tumor in an antenatal patient: a challenging case

Pregnancy complicated with adnexal masses is a very common occurrence. However, most of these adnexal masses encountered in pregnancy are benign in nature and are found incidentally during routine antenatal ultrasound. Malignant ovarian neoplasms account for 1%-8% of all persistent adnexal masses diagnosed during pregnancy. Yolk sac tumor (YST) complicating pregnancy is very rare and has no proper guidelines for its diagnosis and management hence causing a therapeutic dilemma for the clinicians. Therefore, an individualised approach is preferred in such cases. It is very important to report such cases for better understanding and management of these cases. Here we present a case report of a 23-year-old primigravida at 30 weeks gestation with yolk sac tumor of right ovary, surgical stage IIIc who responded well to fertility sparing surgery with cisplatin-based combination chemotherapy. She has no evidence of disease post treatment and has been put on regular follow up

A study for evaluation of two protocols comprising of clomiphene citrate, human menopausal gonadotropin with or without follicle stimulating hormone for ovulation induction in patients with infertility for intrauterine insemination

Background: To compare two protocols comprising of FSH/CC/HMG and CC/HMG for ovulation induction and IUI in women with infertility.Methods: 60 women with unexplained infertility were randomized using sequentially numbered opaque envelope method. Group A received inj FSH 150 units on day 2 of menstrual cycle and clomiphene citrate 100 mg from day 3-7, followed by injection HMG 150 units on day 9 of menstrual cycle. Group B received clomiphene citrate 100 mg from day 3-7, and HMG 150 units on day 7 and 9 of the menstrual cycle.  Ovulation triggered with hCG 5000 units when dominant follicle was 18mm. Single IUI was done 36-42 hours afterwards.Results: Pregnancy occurred in 3 out of 30 women in 116 cycles Group A (with FSH) with a pregnancy rate of 10 percent, and 2.8% per cycle. In group B (without FSH) pregnancy occurred in 3 out of 30 women in 117 cycles with pregnancy rate of 10 percent, and 2.6% per cycle. The number of follicles per cycle was 1.36 and follicle size was 18.57 mm in group A. While in Group B numbers of follicles per cycle were 1.22, with average size of 18.9mm. Mean endometrial thickness was 7.7mm in Group A and 6.37 in Group B (p=.01, significant). Mild OHSS was observed in one woman in Group B. No other side effects were observed in both the groups.Conclusions: The controlled ovarian stimulation regimes used in this study are equally effective, easy to administer, require less intensive monitoring and fewer medications, with little risk of OHSS and multiple gestation

Evolution of Drainage in Response to Brittle - Ductile Dynamics and Surface Processes in Kachchh Rift Basin, Western India

The eastern part of Kachchh Rift basin was reactivated after 2001 Bhuj earthquake of Mw 7.7 and continuous seismicity has been recorded since then. The northern part of Wagad upland also experienced moderate earthquakes Mw ≥ 5.7 in February 2006 and March 2007. These moderate to major Intraplate earthquakes provide a unique opportunity to study the effects and linkage between brittle-ductile dynamics, surface processes and drainage evolution. We presented a geomorphological analysis of the Wagad highland providing new constraints on the evolution of river network. The shallow to deeper nature of fault and their response to development of hydrological networks has been analyzed using seismic tomography. Based on surface drainage offset and seismic structures several E-W oriented faults controlling fluvial dynamics are identified. From seismic structures and drainage offset it is clear that the fluvial dynamics is controlled by shallower to deeper faults. The estimated attributes are well supported with seismic structures and focal mechanisms solutions. Based on fluvial offset and seismic structure analysis a new tectonic model has been proposed for WH. The tectonic model shows that the faults WH are well connected at deeper level and generated negative flower structures and significantly controlling surface fluvial dynamics

Artificial Light at Night: A Global Threat to Plant Biological Rhythms and Eco-Physiological Processes

Light is crucial environmental factor for primary resource and signalling in plants and provide optimum fitness under fluctuating environments from millions of year. However, due to urbanization, and human development activities lot of excess light generated in environment during night time and responsible for anthropogenic generated pollution (ALAN; artificial night light pollution). This pollution has cause for serious problem in plants as it affects their processes and functions which are under the control of light or diurnal cycle. Plant biorhythms mostly diurnal rhythms such as stomatal movements, photosynthetic activity, and many more metabolic processes are under the control of period of light and dark, which are crucially affected by artificial light at night. Similarly, the crucial plant processes such as pollination, flowering, and yield determining processes are controlled by the diurnal cycle and ALAN affects these processes and ultimately hampers the plant fitness and development. To keep in mind the effect of artificial light at night on plant biorhythm and eco-physiological processes, this chapter will focus on the status of global artificial night light pollution and the responsible factors. Further, we will explore the details mechanisms of plant biorhythm and eco-physiological processes under artificial light at night and how this mechanism can be a global threat. Then at the end we will focus on the ANLP reducing strategies such as new light policy, advanced lightening technology such as remote sensing and lightening utilisation optimisation

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Emulsomes: new lipidic carriers for drug delivery with special mention to brain drug transport

Abstract Background Emulsomes are a type of lipid-based nanoparticle that consists of a solid lipid core surrounded by a phospholipid bilayer and have shown promise as drug delivery systems for a variety of applications. The major advantageous aspect of employing lipid-based carriers is their ability to enhance the solubility and bioavailability of poorly water-soluble drugs, mandatorily in case of intranasal drug delivery. These structures have portrayed significant ability to encapsulate drug with poor water solubility and low oral bioavailability, further leading to a completely enhanced drug delivery systems for achieving stability and controlled release of drug. The selection of lipid components and their physiochemical properties can be tailored to optimize drug solubility, blood brain barrier permeability, and enhanced targeting. Main body of abstract Intranasal drug delivery systems offer several advantages over other routes of administration. Intranasal delivery of drugs can provide rapid and efficient absorption into the bloodstream, bypassing first-pass metabolism in the liver and potentially reducing the risk of systemic side effects. Nasal mucosa comprises of dense network of blood vessels, that allow much enhanced rapid drug absorption and direct systemic delivery once the medication is being insufflated through the nasal route. Emulsomes can be used to encapsulate a wide range of drugs, including hydrophobic compounds that are difficult to formulate using traditional delivery methods. By incorporating targeting ligands or other components into the emulsome structure, it is possible to create formulations that are highly selective for specific tissues or cells. The characterization parameters majorly particle size, zeta potential, and encapsulation efficiency play a significant role while demonstrating the effectiveness of emulsome formulation and further its nasal route of administration. Therefore, by assessing and evaluating the parameters, researchers could effectively gain insights into the quality, stability, and enhanced therapeutic effects of emulsome drug carrier, leading to impactful information which would help in future intranasal emulsome preparation preparations, optimization and ensuring the overall effectiveness of the drug delivery systems. Short conclusion This review discusses the idea of emulsomes drug delivery systems, reviews the effectiveness of emulsomes for the delivery of small molecules, and pays particular attention to its structural and formulation design including benefits of intranasal emulsome delivery with recent advancements, stability aspects, and various considerations related to drug delivery and comprising of future prospects

Valproate-induced hyperammonemic encephalopathy in an elderly patient with bipolar disorder

Hyperammonemia is a rare side effect of valproate, diagnosis of which requires a high level of clinical suspicion. We describe a case of 57-year-old man, suffering from bipolar affective disorder, who had multiple physical comorbidities (diabetes mellitus, benign prostatic hyperplasia, hydroureteronephrosis, and chronic kidney disease) and was on sodium valproate 1500 mg/day along with risperidone 6 mg/day, who developed delirium when the dose of sodium valproate was increased from 1500 mg/day to 2000 mg/day. In view of use of high doses of valproate, hyperammonemia was suspected, and on investigations, patient was found to have high ammonia levels (159 μmol/l). He was managed conservatively with stoppage of valproate and syrup lactulose. To conclude this case depicts that use of high doses of valproate can lead to hyperammonemia, especially among those with chronic medical illnesses