Clinico histopathological evaluation of abnormal uterine bleeding in women of reproductive and perimenopausal age group

Background: Abnormal uterine bleeding constitutes a significant proportion of cases attending gynaecology outpatient department. It affects woman’s physical, emotional, social and maternal well-being, and hence it demands adequate management. It is a multifactorial entity; presented in various patterns, signs and symptoms. The PALM COEIN classification is the most recent method of categorizing AUB (abnormal uterine bleeding) based on structural and non-structural causes. The treatment of AUB depends on age, parity, symptom severity, investigation findings and cause. Various invasive and non-invasive investigations including USG, endometrial biopsy and hysteroscopy helps find different causes. Whatever be the etiology endometrium gets affected; hence AUB is likely managed through hormonal preparations, LNG-IUS, endometrium ablation/resection and ultimately hysterectomy as the last resort.Methods: A retrospective study comprising 216 patients in the age group of 30-50 years with complaints of AUB were recorded as per a structured proforma at department of obstetrics and gynaecology, MGM MCH over a period of one year (January 2018-19). The results of investigations, ultrasound scans, endometrial biopsy and histopathology of hysterectomised specimens were correlated. The endometrial biopsy and histopathology of the specimens was done at department of pathology, MGM MCH.Results: The most common age group showing AUB lies under 35-40 years (40.2%) and 40-45 years (33.7%). Menorrhagia was found to be the most common symptom (66.2%). As per PALM COEIN classification, the most common type in our study was of AUB-L (33.7%) and the associated histopathological pattern was of secretory type (50.4%).Conclusions: The features and patterns of AUB differ according to the age of patient, affecting mostly women in perimenopausal and late reproductive age group. There are various modalities for its diagnosis and management and PALM COEIN classification helps better understand the disease etiology

Overview of Cancers and Impact of Music Therapy in Intervention: A Literature Review

Cancer is taken under consideration as a fatal disease. It’s caused by a spread of things including unhealthy lifestyles, pollution, stress, radiation exposure, infection, tobacco consumption, and unhealthy food choices. There are several varieties of cancer that affect the chassis and their growth varies depending on the type. Cancer could be a major reason for death after a heart condition. There are 10 million new cases of cancer and approximately 5 million deaths in 2020 were caused by cancer (World Health Organization, 2018)1, and deaths from cancer worldwide are projected to still rise to over 20 million by 2025 (Stewart and Wild. 2014)2. There are several intervention modes to treat cancer patients. Besides medical intervention, there are prominent psychosocial concerns that have a very noticeable impact on intervention in the case of cancer patients. Cancer treatment facilities in India have incorporated psychosocial services into cancer care by routinely assessing patients’ levels of distress. For that Music therapy can improve their quality of life by addressing the emotional, spiritual, and physical needs that will arise during this point. Furthermore, music therapy also can be applied to assist relationships throughout the grieving process by providing comfort, continuity, and opportunities for specific feelings of loss (Rossetti et al., 2017)3. Hence, there’s a greater need and justification for exploring the scope of using music therapy with cancer patients, especially in low-income countries, including Indi

Hearing Loss in Stroke Cases: A Literature Review

Stroke is the most common cause of neurological disability (MacDonald, Cockerell, Sander, & Shorvon, 2000) and about 1 in 3 stroke life survivors are functionally reliant on it after one year (Murray and Lopez 1996). The majority of stroke survivors need restoration (MacDonald et al., 2000), requiring them to be adequately informed of the prognosis, nature, and proposed treatment of their illness. Hearing plays an important role in effective communication between healthcare professionals and patients (Bensing, 2000), therefore hearing loss may restrict contribution in recuperation programs, leading to an inferior level of bodily performance (Landi et al., 2006). Both hemorrhagic and ischemic strokes may interrupt all stages of the hearing path and lead to hearing shortages that start acutely previously, throughout, or shortly after the occurrence of the stroke. Yet, hearing shortfalls after stroke have not been as lengthily investigated as visual shortfalls, possibly due to the potentially “invisible” nature of this loss compared to more noticeable symptoms (e.g., dysphasia or motor loss). Hearing impairment after stroke may be a vital unmet need for stroke patients and additional research into patterns, detection, prevalence, and treatment are compulsory. In SCA infarction, the ischemic lesion happens in the area where threads from the nucleus have already traversed, and therefore sensory hearing impairment is noticed in the contralateral sideways. There is clear evidence that PICA and AICA territory strokes may result in mixed cochlear/retro­ cochlear, and less frequently retro cochlear-only patterns of hearing impairment (H. Lee et al., 2002). Hearing impairment for both AICA and PICA infarcts is mostly one-sided. Stroke may affect all levels of the auditory pathway and lead to hearing reception and/or perception deficits. Sudden-onset hearing loss after stroke of the vertebra-basilar territory and/or low brainstem is one of the less frequent neurologic impairments, while cortical or central deafness is even rarer. However, studies of populations with stroke indicate that hearing loss is very common, while in the general population, a past history of stroke increases the likelihood of having hearing loss. Auditory-processing deficits after stroke are less well studied than hearing loss and possibly under documented. Auditory dysfunction may impact on patient communication and may even predict long-term patient outcome after stroke. Despite this, clinical guidelines for auditory assessments after stroke are rudimentary. This study reviews the available information of auditory function in patients with stroke. On the basis of the information available, it is suggested that screening the patient's hearing before the patient leaves the stroke ward with a short test and a minimum set of hearing-related questions and subsequently screening the patient's hearing needs with targeted questions at the chronic stage of stroke may be a cost-effective bare minimum assessment approach to addressing the hearing needs of this complex population

Inhibition of Mycobacterium tuberculosis MtrA response regulator by anticancer drugs via computational methods

Mycobacterium tuberculosis (MTB) causes TB disease and millions of deaths are reported every year. Drug resistance TB and its complex treatment is a big problem worldwide. The present  study aimed to design new and safer antitubercular compounds to tackle this serious threat. The unique drug target is the MtrAB Two-component regulatory system (2CRS) of mycobacteria. MtrAB system consists of MtrB sensor kinase (SK) and MtrA response regulator (RR). This system is essential in MTB and is involved in mycobacteria's proliferation. This important physiological process is operated by the phosphorylation of MtrB and then to MtrA. The phosphorylation mechanism triggers modulation in the expression of MtrA targets genes and helps perform appropriate function. This phenomenon depends on the active and inactive confirmation of MtrA, which involves a ligand (Metal ion complex e.g. Mg2+). In this study, anti-cancerous compounds were selected for the inhibition of MtrA. However, molecular docking exhibited binding affinity ranging from −10.8 to −4.7 kcal/mol, targeting the binding pocket of the selected Tuberculosis–MtrA protein (PDB ID: 5L8X). This energy difference between the native ligand and docked compounds showed that the six molecules: (Risperidone, 2-(benzofuran-2-yl)-6,7-dimethyl-4H-chromen-4-one, (2E)-1-(4-hydroxyphenyl)-3-(quinolin-4-yl)prop-2-en-1-one, Estradiol Cypionate, (2Z)-6-hydroxy-2-(3,4,5-trimethoxybenzylidene)-1-benzofuran-3(2H)-one, (2E)-3-(2,3-dihydro-1,4-benzodioxin-6-yl)-1-(3-hydroxyphenyl)prop-2-en-1-one) mentioned are more potent than the native ligand.These six molecules were first time reported as the inhibitor for MtrA of MtrAB Two-component regulatory system and can be utelize for further study

Even Degree Deficient Spline Interpolation

In this present paper we study the general even degree spline  i.e. the spline of degree 2m, where m is the positive integer, matches derivatives upto the order of m at the knots of uniform partition. Tarazi and Sallam[6], have been constructed an interpolating quartic spline with matching first and second derivative of a given function at the knots. A similar study was made by Tarazi and Karaballi [5], for even degree splines upto degree 10. Further, it was conjectured by Tarazi and Karaballi [5], that higher degree splines can be obtained in a similar way. They also raised a question for getting a proof for general degree splines. We provide a proof for general degree spline of degree 2m. Explicit formula for these splines are obtained. Error estimation to these splines in terms of Chebyshev norm is also represented by using the result due to Cirlet, Schults and Varga [2]. On combining the result of this paper and the result obtained by Kumar and Jha [4] with some modification we get deficient spline of general degree for approximation. The deficient splines are found useful because of the fact that, in this case we require less continuity requirements (see De Boor [3], P. 125). The restrictions of smoothness are compensated by considering additional interpolatory conditions

A Comparison of Nested PCR Assay with Conventional Techniques for Diagnosis of Intestinal Cryptosporidiosis in AIDS Cases from Northern India

Cryptosporidiosis is a very important opportunistic infection and is responsible for significant morbidity and mortality in HIV/AIDS patients. Although current laboratory methods are generally considered adequate to detect high concentrations of oocysts, they fail to detect cases of cryptosporidiosis in many immunocompromised patients. The present study was done to determine the diagnostic efficacy of modified Ziehl-Neelsen (ZN), antigen detection ELISA, and a nested PCR assay for detection of Cryptosporidium in 58 adult AIDS cases with diarrhea from the ART clinic of Lok Nayak Hospital, New Delhi. Cryptosporidium was detected in 17 (29.4%), 39 (67.3%), and 45 (77.5%) cases by modified ZN staining, antigen ELISA, and nested PCR assay, respectively. Taking nested PCR as the gold standard, specificity of both modified ZN staining and Cryptosporidium antigen detection ELISA was 100% while the sensitivity of the tests was 37.8% and 86.6%, respectively. PCR was more sensitive than the other two diagnostic modalities but required a more hands-on time per sample and was more expensive than microscopy. PCR, however, was very adaptable to batch analysis, reducing the costs considerably. This assay can therefore have considerable advantages in the treatment of immunosuppressed individuals like AIDS patients, allowing their early diagnosis and decreasing the morbidity and the mortality

Assessment of quality of life of type-2 diabetes mellitus patients in tertiary care teaching hospital in North India

Background: Quality of life (QoL) is a standard indicating a person’s life in better condition as compared to a diseased person or patient. Diabetes itself is not a dangerous disease if managed properly, but it becomes life-threatening after a certain time period because of the patient’s poor interest in disease management and treatment adherence. Diabetes mellitus is an endocrine system disorder that invokes lack of insulin secretion in the bloodstream. The study was conducted to assess the QoL of type-2 diabetes mellitus patients with QoL instrument.Methods: Questionnaire based cross-sectional, prospective study was conducted at Teerthanker Mahaveer Hospital, Moradabad, for a duration of 6 months from January - June 2019, on 196 patients of type-2 diabetes mellitus.Results: On an average 56.5% people have accepted that due to the diabetic condition their working proficiency is decreased. 80.3% of patients have accepted that they were facing problems due to diabetic symptoms. Similarly, 84% of patients have accepted that the ongoing treatment was quite expensive than their expectations. Finally, the last section of the patient’s emotional/mental satisfaction showed that 49.7% of patients were very satisfied with their family support while 13.7% of patients were not satisfied.Conclusions: QOL instrument for Indian diabetes patient’s instrument helped to evaluate the patient’s physical strength, psychological strength of the patient during disease condition, the response provided from the family members and relatives, the economical status of the patient and its effects on their living

LRRK2 and RIPK2 variants in the NOD 2-mediated signaling pathway are associated with susceptibility to Mycobacterium leprae in Indian populations

In recent years, genome wide association studies have discovered a large number of gene loci that play a functional role in innate and adaptive immune pathways associated with leprosy susceptibility. The immunological control of intracellular bacteria M. leprae is modulated by NOD2-mediated signaling of Th1 responses. In this study, we investigated 211 clinically classified leprosy patients and 230 ethnically matched controls in Indian population by genotyping four variants in NOD2 (rs9302752A/G), LRRK2 (rs1873613A/G), RIPK2 (rs40457A/G and rs42490G/A). The LRRK2 locus is associated with leprosy outcome. The LRRK2 rs1873613A minor allele and respective rs1873613AA genotypes were significantly associated with an increased risk whereas the LRRK2 rs1873613G major allele and rs1873613GG genotypes confer protection in paucibacillary and leprosy patients. The reconstructed GA haplotypes from RIPK2 rs40457A/G and rs42490G/A variants was observed to contribute towards increased risk whereas haplotypes AA was observed to confer protective role. Our results indicate that a possible shared mechanisms underlying the development of these two clinical forms of the disease as hypothesized. Our findings confirm and validates the role of gene variants involved in NOD2-mediated signalling pathways that play a role in immunological control of intracellular bacteria M. leprae

Epidemiology and antimicrobial resistance trends of Acinetobacter species in the United Arab Emirates: a retrospective analysis of 12 years of national AMR surveillance data

Introduction: Acinetobacter spp., in particular A. baumannii, are opportunistic pathogens linked to nosocomial pneumonia (particularly ventilator-associated pneumonia), central-line catheter-associated blood stream infections, meningitis, urinary tract infections, surgical-site infections, and other types of wound infections. A. baumannii is able to acquire or upregulate various resistance determinants, making it frequently multidrug-resistant, and contributing to increased mortality and morbidity. Data on the epidemiology, levels, and trends of antimicrobial resistance of Acinetobacter spp. in clinical settings is scarce in the Gulf Cooperation Council (GCC) and Middle East and North Africa (MENA) regions. Methods: A retrospective 12-year analysis of 17,564 non-duplicate diagnostic Acinetobacter spp. isolates from the United Arab Emirates (UAE) was conducted. Data was generated at 317 surveillance sites by routine patient care during 2010-2021, collected by trained personnel and reported by participating surveillance sites to the UAE National AMR Surveillance program. Data analysis was conducted with WHONET. Results: Species belonging to the A. calcoaceticus-baumannii complex were mostly reported (86.7%). They were most commonly isolated from urine (32.9%), sputum (29.0%), and soft tissue (25.1%). Resistance trends to antibiotics from different classes during the surveillance period showed a decreasing trend. Specifically, there was a significant decrease in resistance to imipenem, meropenem, and amikacin. Resistance was lowest among Acinetobacter species to both colistin and tigecycline. The percentages of multidrug-resistant (MDR) and possibly extensively drug-resistant (XDR) isolates was reduced by almost half between the beginning of the study in 2010 and its culmination in 2021. Carbapenem-resistant Acinetobacter spp. (CRAB) was associated with a higher mortality (RR: 5.7), a higher admission to ICU (RR 3.3), and an increased length of stay (LOS; 13 excess inpatient days per CRAB case), as compared to Carbapenem-susceptible Acinetobacter spp. Conclusion: Carbapenem-resistant Acinetobacter spp. are associated with poorer clinical outcomes, and higher associated costs, as compared to carbapenem-susceptible Acinetobacter spp. A decreasing trend of MDR Acinetobacter spp., as well as resistance to all antibiotic classes under surveillance was observed during 2010 to 2021. Further studies are needed to explore the reasons and underlying factors leading to this remarkable decrease of resistance over time