A prospective study on postmenopausal bleeding-causes and its diagnosis using transvaginal ultrasound and hysteroscopy

Background: Postmenopausal bleeding (PMB) is considered a red flag symptom and warrants further examination and evaluation. Trans-vaginalsonography (TVS) can be used reliably to diagnose fibroids, polyps and thickened endometrium. Hysteroscopy is considered “gold standard” for evaluating endometrial cavity. It provides direct visualization of endometrial cavity. It can have both diagnostic as well as operative purpose however, it is not cost effective, an invasive procedure and requires anesthesia and expertise. Present study was designed and carried out to study aetiology and prevalence of PMB in Central India as well as to evaluate the efficacy of TVS and hysteroscopy in diagnosis of different endometrial pathologies in patients with PMB.Methods: This prospective study included 82 post-menopausal women with PMB who attended the gynaecological clinic from December, 2019 to December, 2020 at Motherhood hospital, Indore, India after ethical clearance. A detailed history, examination followed by transvaginal sonography was made. Hysteroscopy was then performed, and biopsy was obtained in all patients. Hysteroscopic and sonographic images were then analyzed and conformed with the histopathologic diagnosis.Results: Most common endometrial pathology was atrophic endometrium followed by endometrial polyp and hyperplasia. Endometrial carcinoma was observed in (3.66%) females. Other findings in cases of secretory, proliferative endometrium and endometritis accounted for 6.09%. The diagnostic accuracy of ET by TVS at a cut-off point of 5 mm was 94% with sensitivity 89.3%, specificity 100%, PPV 100% and NPV 88%. The diagnostic accuracy of hysteroscopy was 98% with sensitivity 96.4%, specificity 100%, PPV 100% and NPV 95.7%.Conclusions: TVS with ET measurement should first line investigation in the evaluation of women with PMB with suspected endometrial pathology because of cost effectiveness, easy accessibility and non-invasive method of diagnosis. Although hysteroscopy is more specific and sensitive, in poor resource settings it should be limited to cases with illdefined endometrial lining, recurrent/ persistent bleeding and cases with endometrial thickness greater than 5 mm irrespective of endometrial echotexture

The interaction surface of a bacterial transcription elongation factor required for complex formation with an antiterminator during transcription antitermination

The bacterial transcription elongation factor, NusA, functions as an antiterminator when it is bound to the lambdoid phage derived antiterminator protein, N. The mode of N-NusA interaction is unknown, knowledge of which is essential to understand the antitermination process. It was reported earlier that in the absence of the transcription Elongation Complex (EC), N interacts with the C-terminal AR1 domain of NusA. However, the functional significance of this interaction is obscure. Here we identified mutations in NusA N terminus (NTD) specifically defective for N-mediated antitermination. These are located at a convex surface of the NusA-NTD, situated opposite its concave RNA polymerase (RNAP) binding surface. These NusA mutants disrupt the N-nut site interactions on the nascent RNA emerging out of a stalled EC. In the N/NusA-modified EC, a Cys-53 (S53C) from the convex surface of the NusA-NTD forms a specific disulfide (S-S) bridge with a Cys-39 (S39C) of the NusA binding region of the N protein. We conclude that when bound to the EC, the N interaction surface of NusA shifts from the AR1 domain to its NTD domain. This occurred due to a massive away-movement of the adjacent AR2 domain of NusA upon binding to the EC. We propose that the close proximity of this altered N-interaction site of NusA to its RNAP binding surface, enables N to influence the NusA-RNAP interaction during transcription antitermination that in turn facilitates the conversion of NusA into an antiterminator

Biomedical waste segregation and their management in urban area of Gorakhpur: A survey for long term approach

Biomedical waste (BMW) generated from medical centers have become a serious health threat worldwide including India. Unsegregated and insensitive disposal of BMW can become a source of spreading serious diseases not only for hepatitis, tuberculosis, HIV but also the recent pandemic of COVID-19 among their handlers and society. Our investigation was carried out to assess the waste handling, their segregation, disposal and treatment system of hospital BMW in the various medical institutes’ established in Gorakhpur city. The study was conducted in accordance with the questionnaire as per guidelines of “BMW Management Rules, 2016” amended in 2018. We have found that almost 27 Metric tons of BMW were generated monthly by seven hospitals; in which, medical centers with the name of BRDMC generated 164.7 followed by NSCBDH, GSGC, DWH, LCH, REH and MMNH produced 33.8, 29.9, 20.7, 10.3, 7.9 and 4.3 quintals of wastes, respectively. They also generated 20.74%, 35.78%, 9.8%, 32.3%, 12.7%, 41.3% and 28.6% per day hazardous wastes in the above sequence of hospitals in comparison to non-hazardous wastes. A yellow colour container waste (a potential source of infection) was higher among the hospitals of BRDMC, GSGC, DWH and MMNC; whereas, red colour containers wastes (recyclable contaminated waste) was higher among NSCBDH, LCH and REH, respectively. Our surveyed hospitals produce approximately 10-40% of hazardous wastes daily. Proper guidelines of segregation and treatment are an essential component for reducing the risk of BMW generated infections. Continuous training and fixing the responsibility of medical staffs are the key criteria's for reducing the chance of contamination and per unit BMW generation

RIDDHI (HABENARIA INTERMEDIA D. WEAR): SIGNIFICANCE AND VERSATILITY IN VARIOUS ANCIENT AYURVEDIC NIGHNATU SCRIPTURES

In Ayurveda treatment combines products derived from plants, animal, mineral, etc. Amongst all types of Ayurvedic preparations plant-based preparations play a significant and important role in the Ayurvedic healing process. Healing with medicinal plants is as old as mankind itself. We have been using medicinal plants since extremely long time. The use of plant based medicinal products and supplements have increased tremendously over the past three decades. Ṛddhi is an important member of Aṣṭavarga group of plants. Traditionally it is used in many herbal preparations for its rejuvenating and health promoting properties. Polyherbal formulation containing tubers of this herb possess properties viz. full of vital energy, high in antioxidants, and boosting immunity. The demand of this herb is increasing day by day but due to scarcity of this plant in wild, unaware about authentic botanical source, non-existing cultivation practices there is widespread problem of adulteration or substitution with other plants. So by taking into account the above situation this systematic review has conducted to find out authentic botanical source of Ṛddhi

Comparative larval biology of three Macrobrachium species under controlled conditions

Three large sized Macrobrachium species-. viz. Macrobrachium rosenbergi;, M malcolmsonii and M gangelicum are available in Indian riverine systems. The study on the seed production and growout of these species are being carried out to develop technologies for commercial application. Hence, the knowledge on comparative larval biology of the three species is extremely important to give a new line for developing hatchery technology for large-scale seed production in different agro-climatic conditions. The present communication deals with comparative study of larval growth and seed production of the three larger species

Burden, maternal risk factors, and fetal outcomes in twin pregnancies: a retrospective observational study

Background: Twin pregnancies present significant challenges for obstetricians worldwide. Although they account for a relatively small percentage of global births, their occurrence varies across different regions. The increasing utilization of assisted reproduction techniques and the advancing maternal age contribute to the growing incidence of twin pregnancies. As a result, it is essential to understand the implications and risks associated with multiple gestations. The objective was to determine the burden of twin pregnancies, identify maternal risk factors, assess fetal outcomes, and explore potential associations between these factors. Methods: Data were collected from hospital records, including information on maternal age, parity, method of conception, gestational age, pregestational body mass index (BMI), and family history. Maternal and fetal complications, mode of delivery, and high-risk conditions in the fetuses were documented. Statistical analysis was performed using the Fisher-exact test. Results: The study included 78 twin pregnancies. The majority of women (78.2%) fell within the age range of 21-30 years. The majority of women (70.5%) had a normal pregestational BMI. Preterm births occurred in 24.3% of twin pregnancies. Hypertensive disorders (24.0%) and foetal malpresentation (38.0%) were common indications for cesarean section. Fetal complications included intrauterine growth restriction (11.5%), birth weight discordance (25.0%), early neonatal deaths (14.7%), and low APGAR scores (16.0%). Conclusions: Twin pregnancies present challenges due to the increased risks of maternal complications, preterm birth, and adverse fetal outcomes. The study emphasizes the need for careful management and monitoring of twin pregnancies to improve outcomes

Lead palladium titanate : a room temperature nanoscale multiferroic thin film

The authors acknowledge the financial support from the Department of Defense, USA (DoD Grant No. FA9550-16-1-0295).The discovery of single-phase multiferroic materials and the understanding of coupling mechanisms between their spin and polarization is important from the point of view of next generation logic and memory devices. Herein we report the fabrication, dielectric, ferroelectric, piezo-response force microscopy, and magnetization measurements of Pd-substituted room-temperature magnetoelectric multiferroic PbPd0.3Ti0.7O3 (PbPdT) thin films. Highly oriented PbPdT thin films were deposited on {(LaAlO3)0.3(Sr2AlTaO6)0.7} (LSAT) substrates in oxygen atmosphere using pulsed laser deposition technique. X-ray diffraction studies revealed that the films had tetragonal phase with (001) orientation. Surface morphology studies using atomic force and scanning electron microscopy suggest a smooth and homogeneous distribution of grains on the film surface with roughness ~2 nm. A large dielectric constant of ~1700 and a low-loss tangent value of ~0.3 at 10 kHz were obtained at room temperature. Temperature dependent dielectric measurements carried out on Pt/PbPdT/La0.7Sr0.3MnO3 (LSMO) metal-dielectric-metal capacitors suggest a ferroelectric to paraelectric transition above 670 K. The measured polarization hysteresis loops at room temperature were attributed to its ferroelectric behavior. From a Tauc plot of (αhν)2 versus energy, the direct band gap Eg of PbPdT thin films was calculated as 3 eV. Ferroelectric piezoelectric nature of the films was confirmed from a strong domain switching response revealed from piezo-response force microscopy. A well-saturated magnetization M-H loop with remanent magnetization of 3.5 emu/cm3 was observed at room temperature, and it retains ferromagnetic ordering in the temperature range 5–395 K. Origin of the magnetization could be traced to the mixed oxidation states of Pd2+/Pd4+ dispersed in polar PbTiO3 matrix, as revealed by our x-ray photoelectron spectroscopic results. These results suggest that PbPdT thin films are multiferroic (ferroelectric-ferromagnetic) at room temperature.Publisher PDFPeer reviewe

ADVERSE DRUG REACTION MONITORING AMONG HYPERTENSIVE PATIENTS OF TERTIARY CARE CENTER OF NORTH INDIA RELATED TO ANTIHYPERTENSIVE DRUGS

Objective: The objective of the study was to monitor the adverse drug reactions (A.D.Rs.) associated with antihypertensive drugs. Methods: All patients coming to the department with blood pressure systolic above 120 mmHg and diastolic above 90 mmHg and prescribed hypertensives will be screened for the study. Results and Discussion: A total of 136 patients were observed during the study. Out of 136 patients, 23 (17%) A.D.Rs. were recorded. A study conducted by Ramesh et al. in the Indian capital reports that 22.3% of the patients experienced A.D.Rs. Conclusion: Furthermore, any appearance of A.D.Rs. due to side effects of the drugs or due to bad control and patients non-compliance, it was treated mainly by decreasing the doses of the drugs, switching them to another active substance from the same pharmacological group, or by adding more active substances from different pharmacological groups in lower dosages to achieve the B.P goals