Pap smear in antenatal women: a valuable opportunity for screening and awareness

Background: Pregnancy creates an important opportunity to screen the cervix for neoplastic and infectious diseases and to spread awareness. A pap smear is simple, cost effective and safe in pregnancy. In low resource countries, this may be the only opportunity when the woman visits a health centre.  It also helps identify and treat infections that could hamper the pregnancy outcome. Objective of the study is to determine the awareness of pap smear as a cervical cancer screening test in antenatal women; to determine the incidence of cervical neoplasia and premalignant lesions of the cervix in antenatal women.Methods: A cross-sectional study was carried out between November 2018 to April 2019. Inclusion criteria were pregnant women in the first trimester. Exclusion criteria were pregnancy greater than 12 weeks, symptoms of vaginal infection, history of sexual intercourse or vaginal medication or bleeding in the last 48 hours or a normal pap smear in the last 3 years. The reporting was done as per Bethesda 2014.Results: 308 women underwent a pap smear in their 1st trimester. 94% were satisfactory smears and 3(0.9%) an abnormal smear (2 LSIL and 1 ASCUS). 31.2% had inflammatory smears. Only 15 women were aware of pap smear as a test for cancer cervix screening and all these women were graduates and above. No women had ever had a pap smear test in the past. One fifth of women studied had 1 or more risk factor the commonest being early age at first intercourse.Conclusions: The antenatal period should be utilized as an opportunity to screen women for cancer cervix

MOLECULAR DOCKING OF ANTITRYPANOSOMAL INHIBITORS FROM EUCALYPTUS TERETICORNIS FOR SLEEPING SICKNESS

Objectives: This study aims to investigate the antitrypanosomal inhibitors of Eucalyptus tereticornis for sleeping sickness through molecular docking and studies on Absorption distribution metabolism excursion and toxicology (ADMET). Methods: In silico molecular docking in ArgusLab software and ADMET analysis in AdmetSAR software was performed for the antitrypanosomal inhibitors of E. tereticornis for sleeping sickness. Results: Interactions were studied for the ten proteins responsible for sleeping sickness with the 50 antitrypanosomal inhibitors of E. tereticornis. Docking was performed to see the interaction and the best binding energy of compounds with the proteins involved in sleeping sickness. The docking scores were highest for betulonic acid with −15.66 kcal/mol followed by euglobal with −12.24 kcal/mol, B-pinene with −10.313 kcal/mol, A-pinene with −10.3418 kcal/mol, and the least docking score for P-cymene with −10.6045 kcal/mol. Docking results showed that only betulonic acid and euglobal showed that hydrogen bond interaction was as b-pinene, a-pinene, and p-cymene yielded no hydrogen bond interactions so we will be taking the former docking results for further studies. The best docking result was shown by betulonic acid with trypanothione reductase giving binding energy of −15.66 kcal/mol with hydrogen bond interaction of 2.9, so this result was taken for further analysis. Conclusion: The results of the compound extracted from E. tereticornis will become physiological relevant only when (i) the pure compounds of this plant is available in large quantities; (ii) the Eucalyptus is biochemically stabilized to avoid degradation and enhance absorption in the gastrointestinal tract; and (iii) special delivery methods for this drug to reach the areas of treatment. In this work, the efficacy of E. tereticornis to act against trypanosomal protein was initiated and thus further research in this process would help us to take full advantage of the remedial effects of the compounds extracted from this plant

Comparative evaluation of colposcopy, cytology and histopathology for diagnosis of cervical lesions

Background: Cervical cancer is the fourth most frequent cancer globally in women with an estimated 570,000 new cases and 311,000 deaths in 2018 representing 6.6% of all female cancers. To correlate the cytology, colposcopy and histopathology of cervical lesions in patients attending gynaecology OPD in a tertiary care centre, Ghaziabad.Methods: 208 women were enrolled from Gynaecology OPD of Santosh Medical College and Hospital, Ghaziabad, irrespective of their chief complaints. Women aged 19-80 years were included in the study group. Those with pregnancy and already diagnosed or treated with CIN, Cervical cancer or Cervical HPV infection were excluded from the study. PAP-smear was taken for all the patients followed by colposcopy without waiting for PAP-smear report. Cervical biopsy was taken from patients with abnormal colposcopic findings (90 patients).Results: Majority of women were in age group 30-39 years. 37.5% had unhealthy, 21.6% had hypertrophied cervix and only 9.1% had normal cervix. It was found that PAP -smear has a sensitivity of 33.33%, specificity of 92.59%, accuracy of 68.89%, positive predictive value of 75% and negative predictive value of 67.57%. Test parameters calculated for colposcopy revealed that it has sensitivity of 73.33%, specificity of 92%, PPV of 64.7%, NPV of 94.52% and accuracy of 88.89%.Conclusions: The results from the current study conclude that it is better to use cytology and colposcopy together as part of routine screening for cervical cancer rather than pap smear alone in order to detect maximum number of lesions

Beliefs regarding SARS-COV-2 vaccine in patients with transfusion-dependent thalassemia

Background: SARS-CoV-2 vaccination drive generated varying responses in the general public. This study aimed to assess the vaccination acceptance amongst patients with thalassemia and to elucidate their beliefs regarding SARS-CoV-2 vaccines.Methods: A prospective observational study was done involving thalassemia patients above the age of 18 years in the thalassemia day care center of our hospital.Results: The study assessed 145 patients with a male to female ratio of 1.5:1 and a mean age of 25.6±6 years. Seventy-six (52.4%) of the study population had already been vaccinated with the first dose, 25.5% (n=37) were willing to get vaccinated, however, 22% were vaccine-hesitant. Vaccine hesitancy was 25.5% in males compared to 16.9% in females. The fear of adverse effects to the vaccine is a major deterrent to the vaccination. Patients considered themselves at high risk of COVID-19 disease and adverse effects of the SARS-CoV-2 vaccine.Conclusions: Vaccine hesitancy was observed in 22% of patients. A significantly higher proportion of these patients considered vaccines unsafe and ineffective. Public sharing of safety and efficacy data may help in improving trust in the vaccine.

Acid Peptic Disease among Patients with Acute Abdomen Visiting the Department of Emergency Medicine in a Tertiary Care Centre

Introduction: Acid peptic disease is caused by excessive acid secretion or weakened mucosal defense. Symptoms include epigastric pain, bloating, and nausea. Factors like gastric acid, Helicobacter pylori infection, alcohol consumption, smoking, and stress contribute to peptic ulcers. Imbalances between offensive and defensive factors can lead to ulcers. Acid-related disorders impact the quality of life and mortality. Accurate diagnosis and prompt treatment are vital. This study aimed to find out the prevalence of acid peptic disease among patients with acute abdomen in the Department of Emergency Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted from 2 April 2022 and 2 April 2023 among the patients presented in the Department of Emergency Medicine in a tertiary care centre. Ethical approval was obtained from the Institutional Review Committee. All patients presenting with acute abdominal pain in the Emergency Department were included in the study. Patients not giving consent were excluded from the study. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of the 400 patients with acute abdomen, the prevalence of acid peptic disease was found to be 87 (21.75%) (17.71-25.79, 95% Confidence Interval). Conclusions: The prevalence of acid peptic disease among patients with acute abdomen was found to be lower than in other studies performed in similar settings

CD40 gene polymorphism and its expression in children with Kawasaki disease from North India: a preliminary case–control study and meta-analysis

IntroductionCD40 gene single-nucleotide polymorphisms (SNPs) have been associated with susceptibility and development of coronary artery abnormalities (CAAs) in children with Kawasaki disease (KD) in Japanese, Chinese, and Taiwanese populations. However, data on SNPs of the CD40 gene in patients with KD from the Indian subcontinent are not available. We studied the CD40 gene polymorphisms and its expression in children with KD from North India.MethodsSNPs of the CD40 gene (rs4810485, rs1535045) were studied using Sanger sequencing. CD40 expression was studied by flow cytometry. Meta-analysis was carried out to assess the role of both SNPs of the CD40 gene in KD. GRADEpro GDT software (v.3.2) was used to assess the “certainty of evidence.”ResultsForty-one patients with KD and 41 age-, sex-matched febrile controls were enrolled. However, none of the alleles and genotypes of the CD40 gene were found to be associated with KD. CD40 expression was higher in KD and in KD with CAAs compared to controls, but it failed to reach statistical significance. In a meta-analysis, the T allele of rs153045 was found to be significantly associated with KD (OR = 1.28; 95% confidence interval (: 1.09–1.50; p = 0.002). The GRADE of evidence for this outcome, however, is of “ very low certainty.”ConclusionThe present study found no association between SNPs (rs4810485 and rs153045) and susceptibility to KD. This could be a reflection of a modest sample size. CD40 expression was higher in KD and in KD with CAAs. In the meta-analysis, the T allele of rs153045 was significantly associated with KD. Our study confirms a significant genetic heterogeneity in KD among different ethnicities

Effect of stem structural characteristics and cell wall components related to stem lodging resistance in a newly identified mutant of hexaploid wheat (Triticum aestivum L.)

In wheat, lodging is affected by anatomical and chemical characteristics of the stem cell wall. Plant characteristics determining the stem strength were measured in lodging tolerant mutant (PMW-2016-1) developed through mutation breeding utilizing hexaploid wheat cultivar, DPW-621-50. Various anatomical features, chemical composition, and mechanical strength of the culms of newly developed lodging-tolerant mutant (PMW-2016-1) and parent (DPW-621-50), were examined by light microscopy, the Klason method, prostate tester coupled with a Universal Tensile Machine, and Fourier Transform Infrared Spectroscopy. Significant changes in the anatomical features, including the outer radius of the stem, stem wall thickness, and the proportions of various tissues, and vascular bundles were noticed. Chemical analysis revealed that the lignin level in the PMW-2016-1 mutant was higher and exhibited superiority in stem strength compared to the DPW-621-50 parent line. The force (N) required to break the internodes of mutant PMW 2016-1 was higher than that of DPW-621-50. The results suggested that the outer stem radius, stem wall thickness, the proportion of sclerenchyma tissues, the number of large vascular bundles, and lignin content are important factors that affect the mechanical strength of wheat stems, which can be the key parameters for the selection of varieties having higher lodging tolerance. Preliminary studies on the newly identified mutant PMW-2016-1 suggested that this mutant may possess higher lodging tolerance because it has a higher stem strength than DPW-621-50 and can be used as a donor parent for the development of lodging-tolerant wheat varieties

Surface charge on chitosan/cellulose nanowhiskers composite via functionalized and untreated carbon nanotube

Improvement in chitosan (CS) was achieved by solution casting using cellulose nanowhiskers (CNWs) and multiwall carbon nanotubes (MWCNTs) to synthesize CS/CNW functionalized/treated MWCNTs (CS/CNWs/f-MWCNTs) and CS/CNW untreated MWCNTs (CS/CNWs/Un-MWCNTs) nanocomposite films. A comparison between effects of f-MWCNTs and Un-MWCNTs on CS/CNWs matrix have been studied with respect to change in their physical and mechanical properties. The surface morphology, chemical composition, mechanical properties and temperature decomposition of CS/CNWs/f-MWCNTs and CS/CNW/Un-MWCNTs nanocomposite films were characterized by Energy Dispersion Spectroscopy (EDS), Field Emission Scanning Electron Microscope (FESEM), Fourier-Transform Infrared Spectroscopy (FTIR) and Thermogravimetric Analysis (TGA). FESEM has shown that f-MWCNTs and Un-MWCNTs were well dispersed in CS/CNWs structure. Decrease in film ductility was observed with addition of Un-MWCNTs or f-MWCNTs. Moreover, Tensile strength (TS) and Young's modulus (YM) were increased with f-MWCNTs and seemed to be decreased in case of Un-MWCNTs. However, a decrease in elongation at break (EB) has experienced with addition of f-MWCNTs and Un-MWCNTs. Furthermore, thermal stability of chitosan composites presented a delay or prevention from degradation of CS/CNWs due to the strong interactions. Such modification in chitosan can improve its mechanical and surface properties. Hence, chitosan derived composites could achieve more applicability in packaging, medicinal and environmental applications