Comparison of clinical outcomes in clomiphene citrate resistant infertile polycystic ovarian syndrome women after treatment with laparoscopic ovarian drilling (LOD) versus gonadotropins

Background: Infertility is the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year. Objective of present study was to compare the clinical outcome of laparoscopic ovarian drilling with gonadotropin ovulation induction in patients with clomiphene resistant Polycystic Ovarian Syndrome.Methods: Present study was a comparative interventional study conducted at the Institute of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, New Delhi for a period of one and a half year. We enrolled 40 clomiphene citrate resistant infertile PCOS women who were undergoing treatment for infertility, after taking written informed consent. The women were randomly divided into two equal groups: one for LOD (laparoscopic ovarian drilling) (group A) and other for gonadotropins (group B).Results: Out of 20, 16 women (80%) in group A ovulated with clomiphene citrate and 18 women (90%) ovulated in group B. Pregnancy was the second major outcome and 4 women (20%) in group A with clomiphene citrate got pregnant and 9 women (45%) got pregnant in group B.Conclusions: Out of 20, 16 women (80%) in group A ovulated with clomiphene citrate and 18 women (90%) ovulated in group B. Pregnancy was the second major outcome and 4 women (20%) in group A with clomiphene citrate got pregnant and 9 women (45%) got pregnant in group B. The treatment option can be selected and tailored according to the individual needs and desires of the patient

Comparative study of the effectiveness of two different dosage of sublingual misoprostal for cervical ripening before hysteroscopy

Background: Hysteroscopy a minimally invasive approach for evaluating uterine cavity, and has become an indispensable diagnostic and therapeutic procedure. The main limiting factor while performing office hysteroscopy is the level of pain or discomfort encountered during the procedure. The pain is attributed mainly to the difficulty in entering the internal cervical os with the hysteroscope and while distending uterine cavity. It could be reduced if cervix is ripened before the procedure. The purpose of this prospective observational study was to compare the effectiveness, adverse effects and surgery-related complications associated with two different doses of sublingual Misoprostol (100 and 200 µg) given 2-4 hours before hysteroscopy.Methods: A randomised comparative study was conducted in the department of Obstetrics and Gynaecology of ABVIMS and Dr. RML hospital New Delhi, from 1st November, 2018 to 31st March, 2020. One hundred and twenty women, fulfilling inclusion criteria were subjected to hysteroscopy. Women received either 100 µg (Group I) or 200 µg (Group II) of sublingual Misoprostol 2-4 hours prior to hysteroscopy. The primary outcome of the study was cervical dilatation as measured by the largest number of Hegar dilator that could be inserted without resistance at the beginning of procedure. The largest dilator that negotiated cervical canal without resistance at the beginning of procedure was recorded as the baseline cervical width. The secondary outcomes were subjective assessment of the surgeon of the ease of dilatation of cervix and adverse effects of drug (i.e. vaginal bleeding, shivering, fever and pain as measured on visual analog scale).Results: The mean baseline cervical width as measured by first Hegar dilator that could be passed through the cervical canal without resistance was 6.6±0.62 mm in group I and 6.94±1.21 mm in group II respectively                    (p value=0.016). Adverse effects like vaginal bleeding, shivering was more in group II compared to group I. No statistically significant difference was found between group I and II with regards to visual analog scale.Conclusions: 100 µg Misoprostol can be used for cervical ripening prior to hysteroscopy with minimal adverse effects

Occupational COVID-19 exposure among health care workers in obstetric unit in a Central Government Hospital in India: initial experience

Background: Health care workers (HCW) are the frontline warriors who are at a high risk of acquiring the COVID-19. HCW in obstetrical department are at high-risk due to their close proximity with the patient for examination, giving treatment and in delivery. The objectives of this study were to evaluate the positivity rate of COVID-19 in the initial 3 months of pandemic in health care personnel working in obstetric unit in a tertiary care hospital.Methods: Prospective cohort study was conducted in department of obstetrics and gynecology at tertiary care hospital in Delhi from 10 April to 10 June 2020. Predesigned questionnaire was used to record data of HCWs exposed to COVID-19 patients.Results: In a period of 3 months (April-June 2020), 152 health care workers were exposed to 30 COVID-19 patients.  Out of this, 10 HCW were found to be positive on testing, showing a positivity rate of 6.58%. Positivity ratio was 6:3:1 among nurses, auxiliary workers and doctors respectively. Labor room was area of high infection as 80% of HCW were infected in the labor room .80% HCW acquired infection during patient care in hospital and 20% were infected in contact with asymptomatic COVID-19 positive HCW.Conclusions: Positivity rate in obstetric department is comparable to that of general population. Appropriate infection prevention measures like use of PPE, handwashing and maintain safe distance from the patient is the key to prevention of infection. Gloves and N95 masks have been shown to provide superior protection as compared to triple layer masks. Nursing staff and auxiliary workers should be reinforced the importance of use of PPE, hand hygiene and physical distancing

Yolk sac tumor, a rare and challenging ovarian malignancy: case report

Yolk sac tumors (YST) are rare and rapidly developing neoplasm presenting in young females. They are second most common germ cell tumor after dysgerminomas. Fertility preservation is an important concern in treatment of patients of YST. We present a case of 22 years nulliparous female with rapidly evolving abdominal mass. The patient underwent fertility preserving surgery with four cycles of post operative bleomycin etoposide and paclitaxel (BEP) chemotherapy and is fairly doing well. BEP chemotherapy has successfully improved the treatment outcomes of YST patients

Comparison of clinical outcomes in clomiphene citrate resistant infertile polycystic ovarian syndrome women after treatment with laparoscopic ovarian drilling (LOD) versus gonadotropins

Background: Infertility is the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year. Objective of present study was to compare the clinical outcome of laparoscopic ovarian drilling with gonadotropin ovulation induction in patients with clomiphene resistant Polycystic Ovarian Syndrome.Methods: Present study was a comparative interventional study conducted at the Institute of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, New Delhi for a period of one and a half year. We enrolled 40 clomiphene citrate resistant infertile PCOS women who were undergoing treatment for infertility, after taking written informed consent. The women were randomly divided into two equal groups: one for LOD (laparoscopic ovarian drilling) (group A) and other for gonadotropins (group B).Results: Out of 20, 16 women (80%) in group A ovulated with clomiphene citrate and 18 women (90%) ovulated in group B. Pregnancy was the second major outcome and 4 women (20%) in group A with clomiphene citrate got pregnant and 9 women (45%) got pregnant in group B.Conclusions: Out of 20, 16 women (80%) in group A ovulated with clomiphene citrate and 18 women (90%) ovulated in group B. Pregnancy was the second major outcome and 4 women (20%) in group A with clomiphene citrate got pregnant and 9 women (45%) got pregnant in group B. The treatment option can be selected and tailored according to the individual needs and desires of the patient

In Silico Characterization and Functional Validation of Cell Wall Modification Genes Imparting Waterlogging Tolerance in Maize

Cell wall modification (CWM) promotes the formation of aerenchyma in roots under waterlogging conditions as an adaptive mechanism. Lysigenous aerenchyma formation in roots improves oxygen transfer in plants, which highlights the importance of CWM as a focal point in waterlogging stress tolerance. We investigated the structural and functional compositions of CWM genes and their expression patterns under waterlogging conditions in maize. Cell wall modification genes were identified for 3 known waterlogging-responsive cis -acting regulatory elements, namely, GC motif, anaerobic response elements, and G-box, and 2 unnamed elements. Structural motifs mapped in CWM genes were represented in genes regulating waterlogging stress-tolerant pathways, including fermentation, glycolysis, programmed cell death, and reactive oxygen species signaling. The highly aligned regions of characterized and uncharacterized CWM proteins revealed common structural domains amongst them. Membrane spanning regions present in the protein structures revealed transmembrane activity of CWM proteins in the plant cell wall. Cell wall modification proteins had interacted with ethylene-responsive pathway regulating genes (E3 ubiquitin ligases RNG finger and F-box) in a maize protein-protein interaction network. Cell wall modification genes had also coexpressed with energy metabolism, programmed cell death, and reactive oxygen species signaling, regulating genes in a single coexpression cluster. These configurations of CWM genes can be used to modify the protein expression in maize under waterlogging stress condition. Our study established the importance of CWM genes in waterlogging tolerance, and these genes can be used as candidates in introgression breeding and genome editing experiments to impart tolerance in maize hybrids

RNAseq revealed the important gene pathways controlling adaptive mechanisms under waterlogged stress in maize

Abstract Waterlogging causes yield penalty in maize-growing countries of subtropical regions. Transcriptome analysis of the roots of a tolerant inbred HKI1105 using RNA sequencing revealed 21,364 differentially expressed genes (DEGs) under waterlogged stress condition. These 21,364 DEGs are known to regulate important pathways including energy-production, programmed cell death (PCD), aerenchyma formation, and ethylene responsiveness. High up-regulation of invertase (49-fold) and hexokinase (36-fold) in roots explained the ATP requirement in waterlogging condition. Also, high up-regulation of expansins (42-fold), plant aspartic protease A3 (19-fold), polygalacturonases (16-fold), respiratory burst oxidase homolog (12-fold), and hydrolases (11-fold) explained the PCD of root cortical cells followed by the formation of aerenchyma tissue during waterlogging stress. We hypothesized that the oxygen transfer in waterlogged roots is promoted by a cross-talk of fermentative, metabolic, and glycolytic pathways that generate ATPs for PCD and aerenchyma formation in root cortical cells. SNPs were mapped to the DEGs regulating aerenchyma formation (12), ethylene-responsive factors (11), and glycolysis (4) under stress. RNAseq derived SNPs can be used in selection approaches to breed tolerant hybrids. Overall, this investigation provided significant evidence of genes operating in the adaptive traits such as ethylene production and aerenchyma formation to cope-up the waterlogging stress

Identification of Key Regulatory Pathways of Basidiocarp Formation in Pleurotus spp. Using Modeling, Simulation and System Biology Studies

Pleurotus (Oyster mushroom) is an important cultivated edible mushroom across the world. It has several therapeutic effects as it contains various useful bio-molecules. The cultivation and crop management of these basidiomycete fungi depends on many extrinsic and intrinsic factors such as substrate composition, growing environment, enzymatic properties, and the genetic makeup, etc. Moreover, for efficient crop production, a comprehensive understanding of the fundamental properties viz. intrinsic–extrinsic factors and genotype-environment interaction analysis is required. The present study explores the basidiocarp formation biology in Pleurotus mushroom using an in silico response to the environmental factors and involvement of the major regulatory genes. The predictive model developed in this study indicates involvement of the key regulatory pathways in the pinhead to fruit body development process. Notably, the major regulatory pathways involved in the conversion of mycelium aggregation to pinhead formation and White Collar protein (PoWC1) binding flavin-chromophore (FAD) to activate respiratory enzymes. Overall, cell differentiation and higher expression of respiratory enzymes are the two important steps for basidiocarp formation. PoWC1 and pofst genes were participate in the structural changes process. Besides this, the PoWC1 gene is also involved in the respiratory requirement, while the OLYA6 gene is the triggering point of fruiting. The findings of the present study could be utilized to understand the detailed mechanism associated with the basidiocarp formation and to cultivate mushrooms at a sustainable level