Study of thyroid hormone profile in women presenting with abnormal uterine bleeding attending gynaecology out patient department, tertiary care centre Raipur

Background: Menstrual disorders pose a huge burden on genecology OPD, accounting for 10-30% of attendance. Women with HMB have a significant impact on physical, emotional, social, professional and family perspectives which leads to decrease in work productivity. Thyroid gland is closely linked with the process of ovarian maturation and endometrial hyperplasia, its dysfunction also causes abnormal uterine bleeding (AUB).Methods: This was an observational cross-sectional study performed at Pt J. N. M. medical college associated with Dr. B.R.A.M. hospital Raipur (C.G.) between 1st January 2020 to 31st December 2020. Total 100 cases between 18-45 years of age with AUB were included routine investigations and ultrasonography done.Results: Majority of AUB cases belong to the more than 39 years (46%), 41% were multiparous. The 20% cases of AUB have hypothyroidism, 2% have subclinical hypothyroidism, 7% have hyperthyroidism. Commonest pattern of bleeding was heavy menstrual bleeding (52%). They 37% cases had leiomyoma of uterus, 17% cases had adenomyosis, and 14% cases had ovulatory dysfunction. The 12 cases having hypothyroidism and 3 cases having hyperthyroidism presented with heavy and prolonged bleeding.Conclusions: There is significant increase in thyroid disorders in cases with AUB as compared to general population. More than one fourth of cases of AUB were having thyroid disorder. Hypothyroidism is 3 times more common than hyperthyroidism. It is suggested that women of any age having AUB should be offered thyroid profile test to detect thyroid disorders. Early detection can provide early diagnosis and treatment.

Encryption and Secure Transmission of Telemedicinal Image in Watermarking using DWT HAAR Wavelet Algorithm

This is a result paper .In this paper, watermarking using DWT Haar wavelet algorithm is used.In this papera patient brain image which is to be transmitted using telemedicine is encrypted and the records of patient brain condition is hidden along with patients document and is transmitted along the channel which can not be decrypted by any unauthorized section. The main aim of this paper is to hide the patient information along with the image and to encrypt and transmit the data along with images and to protect it from different kind of attacks and noise that mainly take place in channels. The purpose of using watermarking is that watermarking does not influence the diagnosis to be made by reducing the visual clarity of medical images. Watermarking is implemented here using DWT haar wavelet and the process include complete copyright protection. Experimental result show high imperceptibility where there is no noticeable change in the watermarked image and original image and the patients records is also hidden along with the image which is to be transmitted along the channel that cannot be hacked or attacked by any unauthorized section. The robustness of watermarking scheme is analysed by means of performance evaluation of peak signal to noise ratio (PSNR) DOI: 10.17762/ijritcc2321-8169.150516

Maternal and neonatal outcome in pregnant women undergone induction of labor at Muhimbili National Hospital, Dar Es Salaam, Tanzania

Introduction Labor induction is a common obstetric intervention aimed at initiating labor when spontaneous onset is delayed or deemed necessary for maternal or fetal well-being. Despite its widespread use, the practice’s impact on maternal and neonatal outcomes remains a subject of ongoing research and debate. This study aims to evaluate the maternal and neonatal outcomes associated with labor induction in a tertiary hospital setting in Tanzania. Methodology A descriptive analytical cross-sectional study was conducted over a seven-month period from January 2021 to July 2021 at Muhimbili National Hospital in Dar es Salaam, Tanzania. A total of 120 pregnant women who underwent labor induction during this period were included in the analysis. Data on maternal demographics, obstetric characteristics, indications for induction, methods of induction, labor outcomes, and neonatal outcomes were collected from medical records and analyzed descriptively. Results Among 4773 deliveries during the study period, 120 women underwent labor induction, accounting for 120 (2.5%) of all deliveries. The most common indications for induction were postdate pregnancy 60 (50%), hypertensive disorders of pregnancy 38 (31.7%), and premature rupture of membranes 22 (17.5%). The majority of induced women 74 (61.7%) delivered vaginally, with 46 (38.3%) undergoing cesarean section. Maternal complications were minimal, with the most common being failed induction of labor 17 (14.2%). Neonatal outcomes were generally positive, with 120 (100%) of neonates having Apgar scores of 7 or higher at five minutes, although 10 (8.3%) required admission to the neonatal ward for further care. Conclusion Labor induction at Muhimbili National Hospital demonstrated favorable maternal and neonatal outcomes, with low rates of maternal complications and positive neonatal Apgar scores. Postdate pregnancy emerged as the most common indication for induction. While the study highlights the benefits of labor induction, its retrospective nature and single-center setting limit the generalizability of findings. Prospective studies with larger sample sizes are warranted to validate these findings and inform evidence-based obstetric practices

Severe primary hypothyroidism leading to life threatening heavy menstrual bleeding: a case report

Thyroid disorders are one of the leading causes of abnormal uterine bleeding in women of all age groups and in India its prevalence in women is about 26%. Sequelae of thyroid disorders may vary from infrequent menstrual cycle, light menstrual bleeding to even a very severe life threatening heavy menstrual bleeding leading to anemia &shock. It occurs due to anovulation, endometrial hyperplasia and coagulation defects. Thyroid screening is important while investigating all cases of AUB. A 18 year old girl was brought to Dr. Bhim Rao Ambedkar Memorial Hospital Raipur with very severe anemia (Hb: 1.1gm/dl) and grade IV hemorrhagic shock (BP 50/30mm of Hg) but surprisingly pulse rate was normal (80bpm). Her peripheries were cold and clammy. SpO2 -80% on room air, she had facial puffiness and grade III pitting edema over her hands and feet. Her TSH was very high >100 µIU/ml with decreased (T4 - 0.678µg/dl, T3 - 0.359 µg/ml) suggestive of severe primary Hypothyroidism. USG was suggestive of bulky uterus with 14 mm endometrial thickness. Her shock was managed and tablet norethisterone, tranexamic acid, levothyroxine and iron supplements started. Severe hypothyroidism can cause life threatening uterine bleeding. This case is of peculiar interest because of profound hypothyroidism associated with hemorrhagic shock. Early recognition and proper management is important to prevent hazardous complications

Bilateral tubal ectopic gestation: Complication in a patient with previous ectopic pregnancy, rare case report

Introduction: Ectopic pregnancy results of implantation of conceptus outside of endometrial cavity. It remains an important cause of maternal mortality. Spontaneous bilateral tubal pregnancies are the rare form of ectopic and are considered spontaneous when no fertility treatments are involved. Case findings: A 31-year-old nulliparous woman presented at the Family Medicine Clinic with complaints of non- specific mild lower abdominal pain for 3 days and amenorrhea for 5 weeks. Transvaginal Ultrasound showed bilateral unruptured adnexa pregnancies. The trial of medical therapy was done without success and later lap- arotomy salpingostomy was done. One year later patient was able to conceive and delivery well by cesareans section. Discussion: Bilateral ectopic pregnancy is a unique from of twin pregnancy frequently occurring with assisted reproductive technology rather than spontaneous pregnancy. Diagnosis of bilateral ectopic pregnancy is often challenging as the clinical symptoms and signs may not be indicative of bilateral involvement. Laboratory test with βhcg levels cannot suggestive if is unilateral or bilateral nature and sonographers may be falsely reassured if they are not careful and satisfied with visualization of ectopic gestation on one side. Laparoscopic salpingostomy or salpingectomy is the gold standard treatment modality for bilateral tubal ectopic pregnancy although lapa- rotomy may be indicated in unstable patient. Conclusion and recommendation: Therefore, any women in childbearing age presenting with clinical features of acute lower abdominal pain should be considered to have potential ectopic gestation

Disease-Modifying Antirheumatic Diets: The New Treatment Modalities for Rheumatoid Arthritis

Autoimmune responses need to be identified and managed promptly to avoid deleterious consequences. Autoimmune diseases, such as rheumatoid arthritis (RA), are debilitating and can lead to a compromised quality of life for patients. Autoimmune disease severity is directly related to sex (females are more prone to the diseases), as well as age, the environment, and genetic factors. Though many of these triggers cannot be avoided, disease onset and progression can be delayed, managed, and to some extent avoided altogether by dietary interventions. Certain food and dietary components have been observed to have anti-inflammatory properties and can thus be included in a patient’s diet to reduce disease symptoms. This review will assess dietary components with regard to RA, including those that are frequently observed to be different in patients with RA in comparison to healthy individuals. The authors conclude that assessment of the nutritional status of a patient, including the deficiency of vitamins or other nutrients and energy requirements, should be recorded and a dietary regimen should be designed accordingly for a better therapeutic response

Characterization, speciation and antimicrobial resistance pattern of Enterococcus species isolated from clinical specimens at a rural tertiary care hospital

Background: Enterococci have attracted much attention in recent years due to their increased recognition as a cause of nosocomial infection. They exhibit vancomycin resistance with increasing frequency so that determination of antimicrobial susceptibility pattern is necessary. Aim of present study is to determine the prevalence and susceptibility pattern of Enterococci in rural tertiary care hospital.Methods: Total of 100 Enterococcus isolated from various clinical samples were identified and speciated by Vitek®2 compact system (BIOMERIEUX). Antibiotic susceptibility was determined by modified Kirby Bauer disc diffusion method. Results were interpreted as per CLSI guidelines and vancomycin MIC was determined by E-test method.Results: Out of 100 Enterococcus strains 47 were E. faecalis, 51 were E. faecium, 02 were E. gallinarum and 01 was E. cassaliflavus. Resistance to penicillin, ampicillin, ciprofloxacin, elevated level gentamycin and high-level streptomycin were observed. All isolates were sensitive to linezolid and teicoplanin, 6% strains showed vancomycin resistance by E-test.Conclusions: High rate of resistance to penicillin, ciprofloxacin and aminoglycosides is observed and emergence of VRE has further worsened this situation. So, there is an urgent need for more rational use of antimicrobials and infection control

Gene Editing and Systems Biology Tools for Pesticide Bioremediation: A Review

Bioremediation is the degradation potential of microorganisms to dissimilate the complex chemical compounds from the surrounding environment. The genetics and biochemistry of biodegradation processes in datasets opened the way of systems biology. Systemic biology aid the study of interacting parts involved in the system. The significant keys of system biology are biodegradation network, computational biology, and omics approaches. Biodegradation network consists of all the databases and datasets which aid in assisting the degradation and deterioration potential of microorganisms for bioremediation processes. This review deciphers the bio-degradation network, i.e., the databases and datasets (UM-BBD, PAN, PTID, etc.) aiding in assisting the degradation and deterioration potential of microorganisms for bioremediation processes, computational biology and multi omics approaches like metagenomics, genomics, transcriptomics, proteomics, and metabolomics for the efficient functional gene mining and their validation for bioremediation experiments. Besides, the present review also describes the gene editing tools like CRISPR Cas, TALEN, and ZFNs which can possibly make design microbe with functional gene of interest for degradation of particular recalcitrant for improved bioremediation

“Do not detach the placenta from my baby\u27s cord” - Lotus birth case series from Tanzania tertiary hospital

Introduction: Lotus birth is seldom practiced, with its prevalence being not well documented. There is no clear existing guideline or pathway for this practice. Safety in delivery as well as caring for newborn and her mother is of paramount importance. Hence, clarity for Lotus delivery in any set up is indispensable. Cases findings: We have described on case series approach to women who opted to delivery without detachment of placenta. We have described delivery characteristics, neonatal clinical course, cord, and placenta manage- ment. In year 2022 at our center, we have received two cases of lotus delivery. Conclusion and recommendation: Lotus birth is a new way of delivery in our country despite of low prevalence, it is indispensable for all cadres that deal with delivering mothers to be aware for better outcomes. It has been noted that, the risk for neonatal infection increases with this practice

Alternative strategies for microbial remediation of pollutants via synthetic biology

Bioremediation is the degradation potential of microorganisms to dissimilate the complex chemical compounds from the surrounding environment. The genetics and biochemistry of biodegradation processes in datasets opened the way of systems biology. Systemic biology aid the study of interacting parts involved in the system. The significant keys of system biology are biodegradation network, computational biology, and omics approaches. Biodegradation network consists of all the databases and datasets which aid in assisting the degradation and deterioration potential of microorganisms for bioremediation processes. This review deciphers the biodegradation network, i.e., the databases and datasets (UM-BBD, PAN, PTID, etc.) aiding in assisting the degradation and deterioration potential of microorganisms for bioremediation processes, computational biology and multi omics approaches like metagenomics, genomics, transcriptomics, proteomics, and metabolomics for the efficient functional gene mining and their validation for bioremediation experiments. Besides, the present review also describes the gene editing tools like CRISPR Cas, TALEN, and ZFNs which can possibly make design microbe with functional gene of interest for degradation of particular recalcitrant for improved bioremediatio