Effects of letrozole on patients with symptomatic leiomyoma in the reproductive age women

Background: Uterine leiomyoma is a common indication for hysterectomy in India. An effective medical treatment option may reduce hysterectomy associated morbidity. This study was undertaken to evaluate the effect of the Letrozole on patients with symptomatic leiomyoma in the reproductive age women.Methods: Prospective interventional study was conducted on 50 women between 30-45 years of age with menstrual or pressure symptoms on the bowel or urinary system, and having no. Of myoma ≤4 and size of single myoma ≥2 cms in diameter. They received tablet letrozole 5mg/day for 3 month, and effect of the drug on myoma volume and symptomatology were studied. Beside these, effects on uterine volume, ovarian volume, endometrial thickness and side effects of letrozole of any were also studied.Results: Average reduction of myoma volume by 47.68% and uterine volume by 19.58% was seen. Haemoglobin concentration was significantly higher at the end of study. It increased from 9.56g/dl to 10.76g/dl and overall improvement in symptomatology score was observed. Ovarian volume increased significantly from baseline mean volume of 8.18±0.51cm³ to 19.3±0.84cm³ and no significant change in endometrial thickness was observed at the end of 3 month. Sweating, hot flushes, nausea and vomiting were the main adverse effects observed and were self limiting.Conclusions: Letrozole, the aromatase inhibitor resulted in significant volume reduction of the uterus-leiomyoma structure and was effective in controlling the more frequent symptoms of this disorder with fewer side effects

Alternate paradigm for intrinsic transcription termination in eubacteria

Intrinsic transcription terminators are functionally defined as sites that bring about termination in vitro with purified RNA polymerase alone. Based on studies in Escherichia coli, intrinsic termination requires a palindromic stretch followed by a trail of T (or U) residues in the coding strand. We have developed a highly efficient algorithm to identify hairpin potential sequences in bacterial genomes in order to build a general model for intrinsic transcription termination. The algorithm was applied to analyze the Mycobacterium tuberculosis genome. We find that hairpin potential sequences are concentrated in the immediate downstream of stop codons. However, most of these structures either lack the U trail entirely or have a mixed A/U trail reflecting an evolutionarily relaxed requirement for the U trail in the mycobacterial genome. Predicted atypical structures were shown to work efficiently as terminators both inside the mycobacterial cell and in vitro with purified RNA polymerase. The results are discussed in light of the kinetic competition models for transcription termination. The algorithm identifies >90% of experimentally tested terminators in bacteria and is an invaluable tool in identifying transcription units in whole genomes

A comparative study of low dose magnesium sulphate (Dhaka regime) and Pritchard regime for the management of impending eclampsia and eclampsia

Background: Eclampsia is a common obstetrical emergency though preventable, yet remains a leading cause of maternal and perinatal morbidity and mortality in the developing world. Pritchard regime is most widely used magnesium sulphate regime for control of eclamptic fits but its dose related toxicity is a major concern among Indian women with low BMI and at peripheral institutions where the patients monitoring is limited. The objective was to study the efficacy of low dose MgSO4 regime (Dhaka regime) for control of convulsions in eclampsia and prevention of convulsions in impending eclampsia, to assess the magnesium related toxicity and to analyze the maternal and perinatal outcomes as compared to standard Pritchard regime.Methods: This prospective study was carried out in the Department of obstetrics and Gynaecology at Patna Medical College and Hospital, Patna. Study was done on 80 patients of eclampsia and impending eclampsia. Patients were divided into two groups A and B. Group A (n=40) received low dose MgSO4 regime (Dhaka regime) and Group B (n=40) received standard Pritchard regime. Results were analysed using statistical package of social sciences (SPSS) 21.0. Statistical significance was set at p ≤0.05.Results: In the present study, convulsions were controlled in 95% of eclampsia cases with low dose magnesium sulphate (Dhaka) regime. Recurrence of convulsion was seen in both groups. None of the patients with impending eclampsia in both the groups developed the seizure during entire treatment period. Signs of impending MgSO4 toxicity and the mean amount of magnesium sulphate received was found more in Pritchard regime group (22.5gms in Group A and 39gms in Group B) and was statistically significant with p value <0.001. There were 3 maternal deaths in present study.Conclusions: Low dose magnesium sulphate is as effective as standard Pritchard regime in controlling the eclamptic fits and preventing its recurrence with comparable maternal and perinatal outcome and less chances of magnesium toxicity. This regimen may be more suitable for use in Indian women with low BMI and in resource poor settings where clinical monitoring is limited