Role of ormeloxifene in the management of dysfunctional uterine bleeding: a prospective study

Background: Menorrhagia is an important healthcare problem and most common indication for hysterectomies worldwide. This study was carried out to assess the efficacy, safety and acceptability of Ormeloxifene in the medical management of Dysfunction uterine bleeding (DUB).Methods: For the study 50 women aged 27-48 years who attended the outpatient gynecology department in a tertiary care hospital with complaint of heavy menstrual flow were recruited. Ormeloxifene (60 mg) was given orally twice a week for first 12 weeks and then once a week for up to next 12 weeks. The primary outcome measures were reduction in menstrual blood loss which was measured by fall in PBAC (Pictorial blood assessment chart) score, rise in hemoglobin level and reduction in endometrial thickness.Results: The reduction in mean PBAC score at the end of 12th week was found to be statistically significant (P<0.001). There was also significant decrease in the mean endometrial thickness (P<0.001) after treatment with Ormeloxifene when compared to mean baseline value. The difference in mean hemoglobin level is 1.96 gm/dl between baseline and post treatment level was found to be statistically significant (P<0.001). No major adverse effects were experienced by patients in this study.Conclusions: Ormeloxifene is very effective and safe alternative in the management of dysfunction uterine bleeding. It has a good patient acceptability and compliance due to its minimal side effects, low cost and simple dosa

Assessment of the efficacy of glyceryl trinitrate patch as a tocolytic

Background: Preterm labor is defined as onset of delivery after the age of gestational viability (20-28 weeks) and prior to 37 weeks. Preterm birth complicated 5-10% of all births and accounts for 75% of perinatal deaths. Several drugs are now available to delay delivery in spontaneous preterm labour. Delaying the delivery for at least 24-48 hr for lung maturity of fetus is the primary goal. Glyceryl trinitrate has less maternal side effects.Methods: The study included 100 women who were admitted in view of preterm labour with gestational age between 28-36 weeks and were given trans dermal nitroglycerin therapy for arrest of preterm labour.Results: The efficacy of nitroglycerine patch to arrest preterm labour was studied. 88 patients were successfully progressed for more than 48 hours with minimum prolongation of 3 days and maximum prolongation of 65 days and average prolongation of 26 days of pregnancy.Conclusions: Glyceryl trinitrate patch as a tocolytic is very effective. This drug has a good patient acceptability and compliance due to its minimal side effects, low cost and simple dosage schedule

Targeting and Readout Strategies for Fast Optical Neural Control In Vitro and In Vivo

Major obstacles faced by neuroscientists in attempting to unravel the complexity of brain function include both the heterogeneity of brain tissue (with a multitude of cell types present in vivo) and the high speed of brain information processing (with behaviorally relevant millisecond-scale electrical activity patterns). To address different aspects of these technical constraints, genetically targetable neural modulation tools have been developed by a number of groups (Zemelman et al., 2002; Banghart et al., 2004; Karpova et al., 2005; Lima and Miesenbock, 2005; Thompson et al., 2005; Chambers et al., 2006; Tan et al., 2006; Gorostiza et al., 2007; Lerchner et al., 2007; Szobota et al., 2007). One approach recently brought to neurobiology, combining both high speed and genetic targeting, is based on a family of fast light-responsive microbial opsins including halorhodopsins (e.g., NpHR) and channelrhodopsins (e.g., ChR2) (for review, see Zhang et al., 2007b). These microbial opsins are single-component transmembrane conductance regulators encompassing light sensitivity and fast membrane potential control within a single open reading frame, which can be used to achieve fast bidirectional control of specific cell types even in freely moving animals (Adamantidis et al., 2007; Zhang et al., 2007a). Although the basic functioning of these tools has been reviewed previously (Zhang et al., 2007b), here we describe a collection of targeting and readout strategies designed for rapid and flexible application of the microbial opsin system, and provide pointers to the relevant literature. Combinations of these multiple levels of targeting and readout define an evolving toolbox that may open up new possibilities for basic neuroscience investigation

Optical Deconstruction of Parkinsonian Neural Circuitry

Deep brain stimulation (DBS) is a therapeutic option for intractable neurological and psychiatric disorders, including Parkinson's disease and major depression. Because of the heterogeneity of brain tissues where electrodes are placed, it has been challenging to elucidate the relevant target cell types or underlying mechanisms of DBS. We used optogenetics and solid-state optics to systematically drive or inhibit an array of distinct circuit elements in freely moving parkinsonian rodents and found that therapeutic effects within the subthalamic nucleus can be accounted for by direct selective stimulation of afferent axons projecting to this region. In addition to providing insight into DBS mechanisms, these results demonstrate an optical approach for dissection of disease circuitry and define the technological toolbox needed for systematic deconstruction of disease circuits by selectively controlling individual components

Community acquired pneumonia: risk factors associated with mortality in a tertiary care hospitalized patients

OBJECTIVE: To evaluate risk factors associated with mortality in patients hospitalized with CommunityAcquired Pneumonia (CAP) from a developing country. METHODS: An observational study was conducted on adult patients admitted with a diagnosis of CAP from January 2002 to August 2003 at Aga Khan University hospital, Karachi, Pakistan. Clinical records were reviewed for demographic characteristics, clinical and laboratory features, hospital course, and risk factors associated with mortality. RESULTS: A total of 329 patients (187 males) were admitted with CAP. Two-third of patients had underlying co-morbid medical illnesses. Complications developed in 15.7% cases and the overall mortality rate was 11%. Risk factors were identified on initial clinical assessment, laboratory and radiological features and during hospital course. On admission elevated blood urea, new onset of confusion, abnormal liver function test, low serum albumin, cardiomegaly and presence of underlying malignancy were strongly associated with increased mortality. Failure to respond to therapy was associated with a high risk of mortality as depicted by complication during hospital stay (Odds Ratio = 23.3, 95% Confidence Interval = 10.3-52.8), need for mechanical ventilation (OR = 17.1, 95% CI = 7.4-39.8) and need for intensive care unit (OR = 9, 95% CI = 4.2-19.3). CONCLUSIONS: Abnormal liver function test, low albumin and presence of cardiomegaly were more significant mortality risk factors than age, respiratory rate and blood pressure. Elevated blood urea and confusion remain strong risk factors on admission. Failure of response to therapy and onset of complications heralded a high risk of death

Eccrine porocarcinoma and Bowen\u27s disease with fatal metastasis to the lung

The term eccrine porocarcinoma was introduced by Mishima and Morioka in 1969 for the malignant counterpart of eccrine poroma. We report an uncommon and a rare case of an invasive adnexal carcinoma like porocarcinoma coexisting with Bowen\u27s disease with extremely rapid progression, metastatic spread to the lungs, leading to death in weeks

Fiscal Year 2005

P'P' (PKPPKP) are P waves that travel from a hypocenter through the Earth's core, reflect from the free surface and travel back through the core to a recording station on the surface. Here we report the observations of hitherto unobserved near-podal P'P' waves (at epicentral distance &lt; 10{sup o}) and very prominent precursors preceding the main energy by as much as 60 s. We interpret these precursors as a back-scattered energy from previously undocumented horizontally connected small-scale heterogeneity in the upper mantle beneath the oceans in a zone between 150 and 220 km depth beneath the Earth's surface. From these observations, we identify a frequency dependence of attenuation quality factor Q in the lithosphere through forward modeling of the observed amplitude spectra of the main and back-scattered P'P' waves. In addition, we did not find that travel times corresponding to very polar paths through the centermost inner core with respect to the rotation axis of Earth are anomalously advanced, which argues for isotropic or at best --weakly-anisotropic center of Earth in the direction parallel with the rotation axis. More systematic sampling near Earth's center and characterization of anisotropy in Earth's center will be a subject of future research efforts

Role of ormeloxifene in the management of dysfunctional uterine bleeding: a prospective study

Background: Menorrhagia is an important healthcare problem and most common indication for hysterectomies worldwide. This study was carried out to assess the efficacy, safety and acceptability of Ormeloxifene in the medical management of Dysfunction uterine bleeding (DUB).Methods: For the study 50 women aged 27-48 years who attended the outpatient gynecology department in a tertiary care hospital with complaint of heavy menstrual flow were recruited. Ormeloxifene (60 mg) was given orally twice a week for first 12 weeks and then once a week for up to next 12 weeks. The primary outcome measures were reduction in menstrual blood loss which was measured by fall in PBAC (Pictorial blood assessment chart) score, rise in hemoglobin level and reduction in endometrial thickness.Results: The reduction in mean PBAC score at the end of 12th week was found to be statistically significant (P&lt;0.001). There was also significant decrease in the mean endometrial thickness (P&lt;0.001) after treatment with Ormeloxifene when compared to mean baseline value. The difference in mean hemoglobin level is 1.96 gm/dl between baseline and post treatment level was found to be statistically significant (P&lt;0.001). No major adverse effects were experienced by patients in this study.Conclusions: Ormeloxifene is very effective and safe alternative in the management of dysfunction uterine bleeding. It has a good patient acceptability and compliance due to its minimal side effects, low cost and simple dosa