Retrospective clinicopathological analysis of scar endometriosis and its surgical management

Background: Scar endometriosis is a rare form of extrapelvic endometriosis. It is defined as presence of endometrial glands and stroma in the abdominal wall. They have a variable clinical presentation and present to various doctors. Abdominal mass along with cyclical pain is pathognomic of scar endometriosis. Objective was to analyse the clinical presentation and surgical outcomes of scar endometriosis.Methods: It was a retrospective observational study. We have collected records of 28 patients of scar endometriosis managed at GEM Hospital over a period of 3 years. Patients demographic features, previous surgery, clinical findings, surgical findings, association with pelvic endometriosis as noted on diagnostic laparoscopy, need for mesh,  recurrence rate on follow up were noted.Results: Mean age of patients was 32.1 years. History of previous caesarean surgery/hysterotomy was present in all patients. Major clinical presentation was cyclical pain. MRI or USG was done and abdominal wall lesions were demonstrated in all cases. Diagnostic laparoscopy was done in 26 of these patients and showed associated endometriosis in 9 patients. Plane of endometriosis was found to be subcutaneous for 9 cases, sheath in 7 and muscular in 12 cases. HPE was proven in all cases.Conclusions: Scar endometriosis is rare. High index of suspicion is needed for diagnosis, especially in cases of previous caesarean sections. MRI and USG are useful tools for diagnosis. Complete wide local excision of scar endometriosis is the primary modality of treatment. Diagnostic laparoscopy along with the procedure is helpful in diagnosing associated pelvic endometriosis

Laparoscopic management of early stage primary fallopian tube carcinoma

Primary fallopian tube cancer (PFTC) is a rare malignancy with an incidence of 0.14-1.8% of all genital malignancies. Presentationsof fallopian tube cancer are mostly nonspecific and include abdominal pain, profuse watery or serosanguinous discharge. Here, wepresent the case of a 51-year-old patient with FIGO stage 1A PFTC. It was diagnosed as hematosalpinx intraoperatively, during totallaparoscopic hysterectomy and diagnosed as PFTC on histopathology. Further management was by laparoscopic staging. A high indexof suspicion is needed in peri and postmenopausal women who present with unexplained uterine bleeding, profuse discharge, pelvicpain, adnexal mass or abnormal pap smear

An Improved Chaotic Grey Wolf Optimization Algorithm (CGWO)

Grey Wolf Optimization (GWO) is a new type of swarm-based technique for dealing with realistic engineering design constraints and unconstrained problems in the field of metaheuristic research. Swarm-based techniques are a type of population-based algorithm inspired by nature that can produce low-cost, quick, and dependable solutions to a wider variety of complications. It is the best choice when it can achieve faster convergence by avoiding local optima trapping. This work incorporates chaos theory with the standard GWO to improve the algorithm's performance due to the ergodicity of chaos. The proposed methodology is referred to as Chaos-GWO (CGWO). The CGWO improves the search space's exploration and exploitation abilities while avoiding local optima trapping. Using different benchmark functions, five distinct chaotic map functions are examined, and the best chaotic map is considered to have great mobility and ergodicity characteristics. The results demonstrated that the best performance comes from using the suitable chaotic map function, and that CGWO can clearly outperform standard GWO

The Epidemiology of Herpes Simplex Virus Type-2 Infection among Pregnant Women in Rural Mysore Taluk, India

To assess the prevalence and determinants of herpes simplex virus type 2 (HSV-2) infections among pregnant women attending mobile antenatal health clinic in rural villages in Mysore Taluk, India. Methods. Between January and September 2009, 487 women from 52 villages participated in this study. Each participant consented to provide a blood sample for HSV-2 and HIV testing and underwent an interviewer-administered questionnaire. Results. HSV-2 prevalence was 6.7% (95% confidence interval (CI) 4.4–9.0), and one woman tested positive for HIV.The median age of women was 20 years and 99% of women reported having a single lifetime sex partner.Women whose sex partner traveled away from home had 2.68 (CI: 1.13–6.34) times the odds of being HSV-2 seropositive compared to women whose sex partner did not travel. Having experienced genital lesions was also associated with HSV-2 infection ( value = 0.08). Conclusion.The 6.7% HSV-2 prevalence was similar to results obtained in studies among pregnant women in other parts of India. It appeared that most women in this study contracted HSV-2 from their spouses and few regularly used condoms. This finding highlights the need for public health policies to increase awareness and education about prevention methods among women and men living in rural India

APTAMER: A REVIEW ON IT’S IN VITRO SELECTION AND DRUG DELIVERY SYSTEM

In recent year, Aptamer has been one of the key tools in the field of advanced drug delivery systems. Aptamer are oligonucleotides or peptides that bind to a specific target molecule. In this review we summarize the major differences between the antibody and an Aptamer along with the different methodology of the In vitro selection of the Aptamer by using SELEX (Systematic evolution of ligands by exponential enrichment) technique. SELEX is a technique which has a based biosensor and some of the novel drug delivery system. The article referred in this review was referred from the above said source was in the range of 1990-2020 y. Primary contents is searched from science direct, springer nature, scopus indexed journals. The resources are downloaded from google scholar, peer-reviewed published literature from scientific journals and books

Performance of BVBlue Rapid Test in Detecting Bacterial Vaginosis among Women in Mysore, India

Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge in reproductive age women. It is associated with increased susceptibility to HIV/STI and adverse birth outcomes. Diagnosis of BV in resource-poor settings like India is challenging. With little laboratory infrastructure there is a need for objective point-of-care diagnostic tests. Vaginal swabs were collected from women 18 years and older, with a vaginal pH \u3e 4.5 attending a reproductive health clinic. BV was diagnosed with Amsel’s criteria, Nugent scores, and the OSOM BVBlue test. Study personnel were blinded to test results. There were 347 participants enrolled between August 2009 and January 2010. BV prevalence was 45.1% (95% confidence interval (CI): 41.5%–52.8%) according to Nugent score. When compared with Nugent score, the sensitivity, specificity, positive predictive value, negative predictive value for Amsel’s criteria and BVBlue were 61.9%, 88.3%, 81.5%, 73.7% and 38.1%, 92.7%, 82.1%, 63.9%, respectively. Combined with a “whiff” test, the performance of BVBlue increased sensitivity to 64.4% and negative predictive value to 73.8%. Despite the good specificity, poor sensitivity limits the usefulness of the BVBlue as a screening test in this population. There is a need to examine the usefulness of this test in other Indian populations

Imunoprofilaksa kunića protiv krpelja Rhipicephalus haemaphysaloides uporabom pročišćenoga antigena srednjega crijeva od 35 kDa.

A 35 kDa midgut polypeptide of Rhipicephalus haemaphysaloides was isolated for the first time by immunoaffinity chromatography using immunoglobulin ligands from rabbits immunized with 35 kDa midgut polypeptide. An experimental immunization study was conducted on 12 New Zealand white rabbits using affinity purified 35 kDa midgut antigen (Aff - RhGM 35 kDa Ag) with Freund’s adjuvant. The humoral immune response was evaluated by ELISA. After tick challenge, reduction in the number, mass and oviposition capacity of engorged females was observed in the tick population that had fed on immunized animals. The results indicated a high efficacy of 83.3%, demonstrating the efficiency of the immune response elicited by 35 kDa midgut antigen to control the tick Rhipicephalus haemaphysaloides.Polipeptid od 35 kDa podrijetlom iz srednjega crijeva krpelja Rhipicephalus haemaphysaloides prvi put je izdvojen postupkom imunoafinitetne kromatografije rabeći imunoglobulinske ligande dobivene imunizacijom kunića. Ukupno 12 bijelih novozelandskih kunića bilo je pokusno imunizirano ubrizgavanjem pročišćenoga antigena pomiješanog s Freundovim adjuvansom. Humoralni odgovor bio je određen imunoenzimnim testom. Nakon izazivačke infestacije imuniziranih kunića uočene su značajne razlike u odnosu na kontrolnu skupinu. U imuniziranih kunića ustanovljen je manji broj krpelja, njihova manja težina te smanjena plodnost nasisanih ženki. Rezultati su pokazali učinkovitost od 83,3% što pokazuje da je imunosni odgovor na antigen srednjega crijeva od 35 kDa potaknuo dovoljan imunosni odgovor za kontrolu infestacije krpeljom Rhipicephalus haemaphysaloides

Identification of culturable vaginal Lactobacillus species among reproductive age women in Mysore, India

A healthy vaginal environment is predominated by certain Lactobacillus species, which lead to the prevention of infections of the reproductive tract. This study examined the characteristics of cultivable Lactobacillus species in both healthy women and women with bacterial vaginosis (BV). Between November 2011 and September 2013, 139 women attending a women\u27s clinic in Mysore, India, were evaluated for BV in a cross-sectional study. BV was diagnosed using Amsel\u27s criteria: homogeneous vaginal discharge, vaginal pH \u3e4.5, production of amines, and presence of “clue” cells. Those with three or more of the characteristics were considered to have BV. Vaginal swabs were then cultured in Rogosa agar and de Man-Rogosa-Sharpe broth. Gram-positive lactobacilli generating 600–800 bp amplicons by16 sRNA were further characterized by sequencing. Cultivable vaginal samples were obtained from 132 women (94.9 %). According to the Amsel criteria, 83 women (62.1 %) were healthy, and 49 (37.1 %) had BV. Eleven different Lactobacillus species were isolated from 47 women. The common lactobacilli species found in this sample included L. crispatus (39.6 %), L. gasseri (45.8 %), and L. jensenii (14.6 %). Lactobacilli were isolated from 39 healthy women and eight with BV. L. gasseri was cultured from 18.8 % of healthy women and 6.1 % with BV. The presence of L. reuteri was significantly associated with normal vaginal microbiota (P-value = 0.026). These results further our understanding of vaginal lactobacilli colonization and richness in this particular population. Our findings showed that lactobacilli species present in the vaginas of healthy women in India do not differ from those reported from other countries

Implementing and sustaining a mobile medical clinic for prenatal care and sexually transmitted infection prevention in rural Mysore, India

Background In rural India, mobile medical clinics are useful models for delivering health promotion, education, and care. Mobile medical clinics use fewer providers for larger catchment areas compared to traditional clinic models in resource limited settings, which is especially useful in areas with shortages of healthcare providers and a wide geographical distribution of patients. Methods From 2008 to 2011, we built infrastructure to implement a mobile clinic system to educate rural communities about maternal child health, train community health workers in common safe birthing procedures, and provide comprehensive antenatal care, prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV), and testing for specific infections in a large rural catchment area of pregnant women in rural Mysore. This was done using two mobile clinics and one walk-in clinic. Women were tested for HIV, hepatitis B, syphilis, and bacterial vaginosis along with random blood sugar, urine albumin, and anemia. Sociodemographic information, medical, and obstetric history were collected using interviewer-administered questionnaires in the local language, Kannada. Data were entered in Microsoft Excel and analyzed using Stata SE 14.1. Results During the program period, nearly 700 community workers and 100 health care providers were trained; educational sessions were delivered to over 15,000 men and women and integrated antenatal care and HIV/sexually transmitted infection testing was offered to 3545 pregnant women. There were 22 (0.6%) cases of HIV, 19 (0.5%) cases of hepatitis B, 2 (0.1%) cases of syphilis, and 250 (7.1%) cases of BV, which were identified and treated. Additionally, 1755 (49.5%) cases of moderate to severe anemia and 154 (4.3%) cases of hypertension were identified and treated among the pregnant women tested. Conclusions Patient-centered mobile medical clinics are feasible, successful, and acceptable models that can be used to provide quality healthcare to pregnant women in rural and hard-to-reach settings. The high numbers of pregnant women attending mobile medical clinics show that integrated antenatal care with PMTCT services were acceptable and utilized. The program also developed and trained health professionals who continue to remain in those communities

Size at birth and cognitive function among rural adolescents:a life course epidemiology study protocol of the Kisalaya cohort in Mysuru, South India

Introduction: It is proven that adverse intrauterine environment results in 'early life programming,' alterations in metabolism and physiological development of the fetus, often termed as 'Developmental Origins of Health and Disease' (DOHaD) resulting in a smaller size at birth, greater non-communicable diseases (NCD) risk factors during childhood and adolescence, and cardiometabolic disorders in adulthood. Nevertheless, very few studies have examined the relationship between DOHaD programming and cognition. This study aims to examine if impaired prenatal growth indicated by birth weight is associated with cognition among adolescents in the Kisalaya cohort, a rural birth cohort in South India, thus providing newer insights into DOHaD programming for adolescent mental health in a low-income and middle-income country setting.Methods and analysis: Kisalaya cohort was established in 2008, to provide integrated antenatal care and HIV testing using mobile clinics to improve maternal and child health outcomes. This cohort included pregnant women residing in 144 villages of Mysuru Taluk (rural) who received antenatal care through mobile clinics and delivered their children between 2008 and 2011. Data related to mother-infant dyads for all pregnant women who received care in the Kisalaya programme are available for this study. Presently, children born to women who received care through Kisalaya are adolescents between 10 and 12 years. At this point, information would be collected on sociodemographic data and assessments of mental health, stressful life events, cognition, vision, speech, language, hearing and anthropometric measures would be done and relevant maternal data and child data, available from the cohort would be retracted for analysis. We plan to retrace as many adolescents as possible out of 1544 adolescents who are currently available for study excluding twins, abortions, stillbirths and postdelivery deaths. Analyses will be extended to construct a life course pathway for cognition using structural equation modelling.</p