Effects of calcium-vitamin D and metformin on the menstrual cycle and ovulation in polycystic ovary syndrome patients in a tertiary care teaching hospital

Background: Polycystic ovary syndrome (PCOS) is a heterogeneous hormonal disorder of reproductive aged women characterized by chronic anovulation, irregular menstrual cycles and hyperandrogenism. The present study aimed to investigate the effects of metformin and calcium-vitamin D on follicular maturation and regularity of menstrual cycles in patients with PCOS.Methods: A prospective, open-label, multiple arms, randomized clinical trial. Group 1 participants received 1,000 mg of calcium and 400 IU of vitamin D per day, orally, group 2 participants received 1,500 mg of metformin per day, orally and group 3 participants received combination of above drugs. The patients were treated for 3 months and followed up for a further 3 months. Menses regularity, number of dominant follicles (≥14 mm) and pregnancy rates were compared among the three groups.Results: A total of sixty infertile women with PCOS were recruited. Calcium-vitamin D plus metformin treated patients showed highest percentage improvement (50%) menstrual regularity as compared to other two groups (p<0.001) also showed significant follicular response (p<0.014). Calcium-vitamin D plus metformin treated group showed better follicular response in the second and third month of follow-up and 30% of women showed high quality dominant large (≥14 mm) follicles at the end of follow-up period.Conclusions: Calcium-vitamin D plus metformin combination is more effective in terms of follicle maturation and restoring menstrual disturbances as compared to individual drug treatment

Intraoperative findings in primary caesarean section for non-reassuring fetal status and its correlation with cardiotocography

Background: Cardiotocography plays an important role in diagnosing nonreassuring fetal status during labour, which is a leading cause for caesarean section among primigravida. These abnormal cardiotocographic traces may or may not translate into intraoperative findings of meconium stained liquor or low APGAR at birth. Hence a study is warranted to understand their correlation, thereby demonstrating the utility of cardiotocography in diagnosing nonreassuring fetal status. The objective of the study was to assess the correlation of intraoperative findings and neonatal outcome in primigravida undergoing emergency caesarean section for nonreassuring fetal status with cardiotocography.Methods: A retrospective analysis of 104 case records of primigravida undergoing emergency caesarean section for fetal distress at Department of Obstetrics and Gynecology, Apollo Institute of Medical Sciences and Research, Hyderabad, was done. Their CTG traces were correlated with their intraoperative findings such as meconium stained liquor; nuchal cord and APGAR score at birth.Results: Out of these 104 primigravida who underwent emergency caesarean section for nonreassuring fetal status, 63.4% had CTG with decelerations-Non reactive, 28% had a CTG trace with persistent decreased variability while 7.6% had a reactive CTG with meconium stained liquor. Among patients with CTG trace showing decelerations 54.5% had meconium stained liquor, 28.7% had cord around the neck and 43.9% had low APGAR scores at birth. Among the group of patients with decreased variability 63.4% had meconium stained liquor, 30% had cord around the neck and 30% had low APGAR scores at birth. There were 8 patients who had reactive CTG with meconium stained liquor, among them only 3 had low APGAR scores.Conclusions: Cardiotocography positively correlates with meconium stained liquor and APGAR scores at birth, but not with the presence of nuchal cord. Hence, judicious interpretation of CTG and introduction of another noninvasive, cost effective and acceptable test to detect non reassuring fetal status is warranted to prevent unnecessary caesarean sections

Life-cycle of the Pea Crab, Pinnotheres vicajii Chhapgar, infesting the clam, Paphia malabarica

Various crab stages commencing with the invasive stage to adult stages of male and female in the lile cycle of Pinnotheres vicajii infesting the edible clam, Paphia malabarica, occurring in the Mandovi estuary of Goa have been described. Except the adult male and female the rest of the stages have been described here for the first time in this species. Zoeae larvae liberated from the eggs carried by ovigerous females are characterized by the presence of 3 spines on the carapace. Comparison of these larvae with those of other species has been attempted. Planktonic zoea larvae in the estuary occur almost throughout the year with 2 peak periods in MayJune and December-January, coinciding with high salinity conditions of waters. Egg counts of 12 ovigerous females of different sizes show a minimum of 611 and a maximum of 3800 with an average of 1853 eggs. An attempt has been made to study the host-symbiont relationship. No signflcant damage has been noticed on the soft parts of the host and there is no marked difference in the meat weight - whole weight relationships of the infested and non-infested clams. However, a slight decrease has been noticed in the averages of meat weights of infested clams in the bigger whole weight groups

Diophantine equations with balancing-like sequences associated to Brocard-Ramanujan-type problem

In this paper, we deal with the Brocard-Ramanujan-type equations (A_{n_1}A_{n_2}cdots A_{n_k}pm 1=A_m) or (G_m) or (G_m^2) where ({A_n}_{ngeq0}) and ({G_m}_{mgeq 0}) are either balancing-like sequences or associated balancing-like sequences

Evolution to Big Data Analytics Techniques and Challenging Issues in Data Mining With Big Data

Big Data is another term used to recognize the datasets that because of their enormous size and multifaceted nature. Big Data are currently quickly growing in all science and engineering domains, including physical, natural and biomedical sciences. Big Data mining is the capacity of separating helpful information from these huge datasets or floods of data, that because of its volume, changeability, and velocity, it was impractical before to do it. The Big Data challenge is getting one of the most energizing open doors for the following years. In the present time of digitization, we take a shot at the variety of data. Colossal measure of data will be prepared by Google, Microsoft and Amazon. Regular routine these organization prepared huge measure of data. In such way we have to require some approach to adjust the innovation in with the end goal that every one of the data will be prepared adequately. Big Data is a developing concept that depicts imaginative systems and innovations to break down enormous volume of complex datasets that are exponentially produced from different sources and with different rates. Data mining procedures are giving extraordinary guide in the region of Big Data examination, since managing Big Data are big difficulties for the applications. Big Data examination is the capacity of removing valuable information from such colossal datasets. This paper exhibits a writing survey that incorporate the significance, difficulties and applications of Big Data in different fields and the various methodologies utilized for Big Data Analysis utilizing Data Mining procedures. The discoveries of this audit give important information to the analysts about the primary patterns in research and examination of Big Data utilizing diverse investigation domains. This examination paper incorporates the information about what is big data, Data mining, Data mining with big data, Challenging issues and its related work

Prevalence of pregnancy induced thyroid disorders, diabetes and hypertension in a tertiary care teaching hospital: an observational study

Background: Pregnancy induced thyroid disorders, gestational diabetes mellitus (GDM) and gestational hypertension are common problems in women with gestational period. Published literate shows wide range of prevalence in pregnancy induced disorders in other states of India, and as of now the exact prevalence in our study population is not studied. Hence, there present study was aimed to know the prevalence of pregnancy induced disorders in pregnant women in South Indian population.Methods: A total of 120 subjects were followed-up at the time of recruitment to entire gestational period. Standard guidelines were followed for the assessment of thyroid hormone levels, glucose tolerance test (OGTT) and blood pressure values at different intervals and positions. Apart from detailed clinical history has been taken and routine basic and obstetrical investigations were done.Results: Prevalence of thyroid dysfunction (15.0%), gestational diabetes mellitus (11.7%) and gestational hypertension (9.2%) was reported in the present study population. Subclinical hypothyroidism was highest prevalence amount thyroid disorders. Gestational diabetes subjects have mean blood glucose levels of 230.68±17.48 mg/dL with OGTT test. Gestational hypertensive patients had SBP of 152.4±10.8 and DBP of 96.6±6.4; pre-hypertensive subjects had SBP of 134.2±5.48 and DBP of 6.8±4.6 respectively.Conclusions: Our study findings were slightly higher than normal prevalence’s which are reported earlier by various authors. We suggested that early screening, diagnosis and treatment are warranted for the prevention of maternal and fetal complications in Indian population.

VEDANADHYAYA - A CLINICAL APPROACH TO PEDIATRIC EXAMINATION IN KASHYAPA SAMHITA

Kashyapa Samhita is a book of pediatrics having main focus on the health and well-being of children and their pathological manifestations. The most revered source book available on Kaumarbhritya, is presented in the form of compilations of the preaching of Acharya Kashyapa by his disciple Vridhha Jivaka. The Kashyapa samhita available today is actually one fourth or even less than what it would have been in its original form. Fortunately we have Vedanadhyaya where in 32 pediatric illnesses are described. The text is divided in various sections (Sthanas) of which Vedanadhyaya is twenty fifth chapters in Sutra Sthana. Acharya Kashyapa has provided us a strong diagnostic tool which is useful in day to day practice of pediatrics. He undoubtedly laid the foundation stone of clinical pediatrics. Vedanadhyaya concerns the symptomalogy of various diseases in children and serves as a great guidance for pediatric examination and diagnosis as children are unable to narrate their symptoms themselves. So the present article reviews the original text of the chapter and critically analyses it in light of contemporary medical science

Cytomorphological changes in breast carcinomas, after neoadjuvant chemotherapy: a study of twenty cases

Background: Neoadjuvant chemotherapy administered pre-operatively is the standard of care therapy for locally advanced breast cancers, mainly for clinical down staging. The histopathological evaluation of tumor response is the gold standard. Aims: To study the morphological changes induced with neoadjuvant chemotherapy in breast carcinoma and assess the response or non-response of cancers to systemic therapy, based on a web based calculation script at www.mdanderson.org/breastcancer_RCB and also evaluated basing on NSABP-B18 system.Methods: 20 cases of radical mastectomies in locally advanced breast carcinomas with neoadjuvant chemotherapy are studied.Results: All the cases are female breast cancers. Macroscopically, the size of the tumor bed ranges from 10 mm to 90 mm in maximum dimension. The morphological changes: Tumor cellularity, cytomorphological changes. In the present study 20% of cases are pCR/RCB 0, 40% are pNR/RCB III cases and 40% are pPR/RCB I & II (i.e. pCR- pathological complete response, pNR-pathological no response, pPR-pathological partial response, RCB-Residual Cancer Burden).   Conclusions: The spectrum of changes observed in the tumor bed is coagulative necrosis, hyalinisation, dystrophic calcification and intense mononuclear inflammatory cell collections, cytoplasmic vacuolization and bizarre nuclei.  Quantification of the residual disease by RCB system and to categorize the residual disease is important, to predict the disease-free relapse rate.

Issues in Delivering Morbidity Management for Lymphatic Filariasis Elimination: A Study in Pondicherry, South India

Lymphatic filariasis is a vector borne parasitic disease causing long term disability. The Global Programme to Eliminate Lymphatic Filariasis aims to achieve its objective through two strategies; Mass Drug Administration (MDA) to interrupt transmission and Morbidity Management (MM) to manage disability for those already affected. MDA is going on in full swing in endemic areas; but MM is lagging behind. An exploratory study was conducted in Pondicherry through focus group discussions to find out whether there are delivery issues if any, in the MM programme and get suggestions from end users. The study results show that MM has not received the same attention as MDA and there are shortcomings in the delivery mechanism of the programme. The importance of these findings are discussed and suggestions given for improving the programme