A case report on ACUM: a rare mullerian anomaly

Accessory and cavitated uterine mass (ACUM) is a rare, newly recognized mullerian anomaly. It is an accessory cavity lined by functional endometrium within an otherwise normal uterine cavity, in contrast to the other mullerian anomalies in which the uterus is malformed. It is often misdiagnosed as myoma, adenomyosis or adenomyoma. The entity needs expertise to diagnose as it is a rare but treatable cause of severe dysmenorrhea and chronic pelvic pain in young females with a wide range of differential diagnosis. A 30 years old female with history of one abortion 2 years back, came to infertility OPD with complaints of lower abdominal pain with severe dysmenorrhea, dyspareunia and inability to conceive since 2 years. Her menstrual cycle was regular with normal flow. USG pelvis showed subserosal fibroid of 4×3 cm in fundus region of uterus. On HSG, bilateral fallopian tubes were patent. MRI-pelvis revealed normal uterus with thick walled cavitatory lesion of size 4.1×3.6 cm with thick T2W hypointense wall similar to myometrium in continuation with right fundal wall of uterus containing blood products suggestive of ACUM. Both ovaries were normal, no obvious adnexal lesion/collection/free fluid noted in peritoneal cavity. Laparoscopy followed by laparotomy with excision of ACUM was performed. The MRI findings of an accessory cavitated uterine mass located below the attachment of round ligament with haemorrhagic contents, normal shaped uterus with normal bilateral tubes and ovaries should suggest the diagnosis of ACUM pre-operatively

Construction and Analysis of Protein–Protein Interaction of Therapeutic Phytoconstituents of Garlic (Allium sativum) Targeting Non-small Cell Lung Cancer Protein

Background: Advances in genomics and taxonomic literature reveal that lung cancer is a polygenic disease and expose the complexity of cancer-related genes and molecular mechanisms. Several chemically synthesized drugs are used in cancer treatment, but this is still a challenging task because of their lower efficacy and side effects. In recent years, phytochemicals have played a vital role in novel drug discovery; garlic was used in this study to treat lung cancer. This study aimed to determine the specific target, pharmacological, and molecular mechanisms of garlic phytoconstituents in lung cancer treatment. Methodology: Protein–protein interaction network and KEGG signaling pathway analysis of no small cell lung cancer and garlic phytoconstituents revealed that out of 68 targets of non-small cell lung cancer, 14 were targeted by garlic phytoconstituents. Results: Only 14 phytoconstituents of Allium sativum L. have regulatory effects on 14 targets of non-small cell lung cancer. Garlic phytoconstituents have an inhibitory effect on lung cancer progression by regulating highly enriched pathways in lung cancer, such as the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor resistance pathway. Conclusion: Some garlic phytoconstituents, such as allixin, ajoene, carvacrol, and some derivative of allicin have drug-like properties that target these targets and act by regulating different molecular pathways of cancer progression. The results of this study require further in vivo or experimental studies to confirm their value in lung cancer treatment and to identify the exact binding sites of the selected targets on which ligands can bind

Comparison of modified biophysical profile and Doppler ultrasound in prediction of perinatal outcome in high-risk pregnancies

Background: The objective of this present study was to compare MBPP and umbilical artery Doppler flow in high-risk pregnant women in prediction of perinatal outcome.Methods: A cohort study was done on 150 high-risk pregnant women over 16 months. Antenatal women with singleton pregnancy who delivered within 48 hours of performing MBPP and Doppler USG, with presence of ≥1 high-risk factor like pre-eclampsia/gestational HTN, BOH, post-dated pregnancy, FGR, GDM, maternal heart disease, anaemia, hypothyroidism and IHCP were included in the study. MBPP (NST and AFI) and umbilical artery Doppler was performed. Perinatal outcome was measured in terms of stillbirth/IUD, LBW, Apgar <7 at 5 minutes, admission to NICU, neonatal death within 48 hours of delivery, MSL and neonatal seizures within 24-48 hours. Quantitative variables were compared using independent t-test/Mann Whitney test. Qualitative variables were correlated using Chi square test/Fisher exact test. Sensitivity, specificity, NPV, PPV were calculated and p-value <0.05 was considered statistically significant. Data analysis was done using social sciences (SPSS) licensed version 21.0.Results: Majority belonged to the age group 21-25 years and were between 37-40 weeks of gestation. It was found that highest perinatal complications occurred in those with both abnormal MBPP and Doppler followed by those with only abnormal MBPP (p-value<0.0001).Conclusions: MBPP is a better predictor of perinatal outcome compared to umbilical artery Doppler USG in high-risk pregnant women. MBPP should be done in all high-risk pregnancies even if Doppler is normal. Both the tests must be performed in all high-risk pregnancies to improve perinatal outcome

Compartmentalized Metabolic Engineering for Artemisinin Biosynthesis and Effective Malaria Treatment by Oral Delivery of Plant Cells

Artemisinin is highly effective against drug-resistant malarial parasites, which affects nearly half of the global population and kills \u3e500 000 people each year. The primary cost of artemisinin is the very expensive process used to extract and purify the drug from Artemisia annua. Elimination of this apparently unnecessary step will make this potent antimalarial drug affordable to the global population living in endemic regions. Here we reported the oral delivery of a non-protein drug artemisinin biosynthesized (~0.8 mg/g dry weight) at clinically meaningful levels in tobacco by engineering two metabolic pathways targeted to three different cellular compartments (chloroplast, nucleus, and mitochondria). The doubly transgenic lines showed a three-fold enhancement of isopentenyl pyrophosphate, and targeting AACPR, DBR2, and CYP71AV1 to chloroplasts resulted in higher expression and an efficient photo-oxidation of dihydroartemisinic acid to artemisinin. Partially purified extracts from the leaves of transgenic tobacco plants inhibited in vitro growth progression of Plasmodium falciparum-infected red blood cells. Oral feeding of whole intact plant cells bioencapsulating the artemisinin reduced the parasitemia levels in challenged mice in comparison with commercial drug. Such novel synergistic approaches should facilitate low-cost production and delivery of artemisinin and other drugs through metabolic engineering of edible plants