Prediction of pregnancy in artificial reproductive techniques through evaluation of thickness, morphology and vascularity of endometrium

Background: Prediction of pregnancy in Artificial Reproductive Techniques through evaluation of thickness, morphology and vascularity of endometrium.Methods: Endometrial thickness, morphology and sub endometrial blood flow were assessed using trans-vaginal ultrasound on the day of HCG in 200 undergoing IVF/ICSI treatment in the period between October 2009 and December 2014. Statistical analysis was done.Results: There was no difference in the demographic features between pregnant and non-pregnant women. Overall, 80 patients conceived; 46 (57.5%) of them had blood flow in zone III and 30 (37.5%) in zone II. All patients achieved pregnancy had endometrial thickness >8 mm. There was no significant difference in Doppler indices between pregnant and non-pregnant women.Conclusions: When the endometrial thickness is <8 mm, and if there are non-triple endometrial line, pregnancy rate decreases and the absence of colour mapping of the endometrium and subendometrial areas means and absolute implantation failure or a significant decrease of the implantation rate. Conversely, the pregnancy rate increases when the vessels reach endometrium

Role of obstetric colour doppler studies in predicting perinatal outcome in pregnancy induced hypertension

Background: Pregnancy induced hypertension (PIH) is associated with adverse perinatal outcome. Multi vessel colour Doppler studies are useful in these cases for timely intervention. The aim of present study was to know the significance of umbilical, middle cerebral and uterine artery Doppler in PIH and to analyse their role in predicting perinatal outcome.Methods: This is a study of 150 pregnant women with pregnancy induced hypertension (PIH). These patients were evaluated with colour Doppler and were followed subsequently for any adverse perinatal outcome.Results: Out of 150 cases 70% of cases were found in 20-30 years age group. 98 cases had abnormal uterine artery Doppler indices accounting for 65.3%, while 52 cases had a normal Doppler index accounting for 34.3%. Out of 150 cases, 94 (64.6%) cases had abnormal middle cerebral artery. In our study 53 cases had abnormal umbilical artery Doppler indices accounting for 35.4%, while 97 cases had a normal Doppler index accounting for 64.6%. Out of 150 cases in our study 27 cases had Reversal of a wave in ductus venosus waveform that is in 18%. In this study total 5 cases (35.7%) of perinatal mortality were seen.Conclusions: The knowledge of various doppler parameters may help to improve pregnancy outcome and identification of PIH at earliest gestation age as compared to other antepartum test modalities

Abruptio placenta and its maternal and fetal outcome

Background: Abruptio placenta is one of the common cause of antepartum haemorrhage and is defined as premature separation of normally implanted placenta. It is more common in second half of pregnancy. Abruptio placenta is serious complication of pregnancy and causes high maternal and neonatal morbidity and mortality.Methods: This retrospective study of abruptio and its maternal and perinatal outcome was carried out between July 2016 and October 2017 at Rama Medical College Hospital and research centre.Results: Incidence of Abruptio placenta is 1.6%. It is most common in the women of age group 30-35 years. 75% of cases were associated with severe pre-eclampsia. Live births were 75% while stillbirths were 25%. PPH occurred in 30% of cases. DIC accounts for 25% of the complication.Conclusions: Abruptio placenta is life threatening complication of pregnancy and it is associated with poor maternal and fetal outcome if not managed appropriately. Hence early diagnosis and prompt resuscitative measures would prevent both perinatal and maternal mortality and morbidity

Fatigue Determination in Drivers Using Biomarkers and Subjective Assessment Tools

Fatigue is a condition of extreme tiredness, resulted from physical or mental stress due to prolonged monotonous and stressful work with/without sleep deprivation. It can originate centrally or peripherally due to a multitude of inducing factors like excessive physical activity, peer-pressure, undue stress, tight schedules etc. Fatigue in specific occupations like driving can be hazardous by increasing the risk of road traffic accidents. In case of drivers, it is recorded the most for the ones who drive for long distances, or drive heavy-vehicles or the ones who are seasoned drivers. The driver shows symptoms like sleepiness, loss of pleasure, slower reaction/reflex, pessimism, inattentiveness and irritation. According to WHO report, road traffic injuries are the 6th leading cause in India. And conferring to a study done by JP Research India, over a span of 2 years, fatigue was the leading cause contributing to 29% of the total accidents. But there is still no defined machinery to monitor a driver’s fatigue in real time. In order to get an estimate of physical fatigue in drivers, appropriate study is essential. In the current study, an attempt was made to quantify physical fatigue in healthy non-trained subjects during simulated driving session of 12 hours at a stretch. The goal was to observe and estimate the progress of fatigue in the subjects out of driving task. Briefly, 10 male healthy subjects with mean age of 25 ± 4 years were selected. During 12 hours of driving on the simulator, blood samples were collected at 6 hours intervals from each subject, for estimation of Serotonin, CK-MB and Lactic acid. The subjective feeling of stress and fatigue was evaluated in the participants using subjective assessment tools like Epworth Sleepiness Scale, Berlin Questionnaire and Beck Depression Inventory. All the biochemical parameters increased significantly as fatigue progressed. The subjective assessment scores also indicated the fatigue process & strongly correlated. The subjective assessment scores also indicated the fatigue progress and strongly correlated with the biochemical parameters

Biologische Studien an neuartigen peptidischen Vektoren für die transmembrane Aufnahme intrazellulärer Kontrastmittel zur molekularen Bildgebung

Noninvasive imaging techniques like MRI possess the prospective to observe molecular-genetic and cellular processes. But the exogenously administered molecular imaging agents are unable to reach their molecular and cellular targets as the lipid bilayer of the cell poses a formidable natural barrier. However, a unique class of peptides known as cell penetrating peptides or CPPs has the ability to traverse this barrier and convey cargo molecules attached to it across the cell membrane. Thus the combination of CPPs with MR/optical agents would permit the evaluation of cellular processes through the interaction of imaging probes with intracellular targets like proteins, mRNA or DNA. In the first part of the thesis, two mRNA targeting MR based contrast agents were designed using the most efficiently transporting derivative of HIV-1 Tat. In vitro cell free studies depicted their ability to selectively bind to complementary oligonucleotide sequence. The agents also showed a significant MR contrast enhancement in labeled cells. However, no specific enrichment was observed in transgenic target containing cells. Some reasons hypothesized to reason the lack of specificity of these agents were the high non-specific binding of the non-sense sequence or the low sensitivity of MRI. But the primary cause could be the entrapment of most of the compound in vesicles, thus, hindering their interaction with specific mRNA. The second part of the thesis was based on the search for a CPP that could efficiently deliver cargos into the cytosol permitting there interaction with cytosolic targets like mRNA, proteins, etc. Extensive Structure Activity Relationship (SAR) studies were carried out on a putative nuclear localization sequence derived from the main toxin in snake venom. CyLoP-1 was identified as a cysteine rich CPP with distinguished cytosolic diffusion as well as endosomal uptake at low concentrations. Further characterization of the biochemical properties and understanding of the unique intracellular localization of CyLoP-1 was performed. Our results indicate the involvement of two possible mechanisms. One is the endocytosis as reported for several other CPPs and the other could either be a direct delivery across membrane or a re-distribution after retrograde transport. Nevertheless, CyLoP-1 has potential for exploitation as a novel tool for cytosolic delivery of cargos.Nicht-invasive Bildgebungstechniken, wie die Magnetresonanztomograhie (MRT), bieten die Möglichkeit molekular-genetische und zelluläre Prozesse zu beobachten. Exogen verabreichte Substanzen für die Molekulare Bildgebung sind allerdings nicht in der Lage ihre molekularen und zellulären Ziele zu erreichen, da die Lipiddoppelschicht der Zellmembran eine effektive natürliche Barriere darstellt. Eine einzigartige Klasse von Peptiden, auch bekannt als zellpenetrierende Peptide (CPPs), haben aber die Eigenschaft diese Barriere zu überwinden und an sie gekoppelte Moleküle durch die Zellmembran zu transportieren. Im ersten Teil der Arbeit wurden zwei MR basierte Kontrastmittel entwickelt, die eine bestimmte mRNA einer Zelle als Zielstruktur haben. Dazu wurde das HIV-1 Tat Peptid als Transporter verwendet, da es am effizientesten in Zellen aufgenommen wurde. In zellfreien in vitro Assays konnte gezeigt werden, dass sie selektiv an eine komplementäre Oligonukleotidsequenz binden konnten. Diese Kontrastmittel induzierten ebenfalls eine signifikante Kontrasterhöhung in MR Bildern markierter Zellen. Es konnte allerdings keine signifikante Anreicherung in Zellen beobachtet werden, die die Ziel-mRNA enthielten. Gründe für die fehlende Spezifität könnten die hohe nicht-spezifische Bindung der non-sense Sequenz sein oder aber die niedrige Sensitivität der MRT. Der Hauptgrund liegt aber in der endosomalen Anreicherung der Kontrastmittel, die eine spezifische Wechselwirkung mit den Zielmolekülen im Zytosol verhindert. Der zweite Teil der Arbeit basierte daher auf der Suche nach neuartigen CPP, die effizient gekoppelte Moleküle ins Zytosol transportieren können, um eine bessere Wechselwirkung mit zytosolischen Zielmolekülen wie mRNA, Proteinen etc. zu ermöglichen. Eine intensive Struktur-Wirkungs-Studie wurde mit einer Peptidsequenz aus dem Hauptbestandteil des Giftes einer südamerikanischen Klapperschlange durchgeführt. Diese soll die Fähigkeit haben, Moleküle in den Zellkern zu transportieren. CyLoP-1 (CRWRWKCCKK) konnte als ein cysteinreiches CPP mit sowohl deutlicher zytosolischer Diffusion als auch endosomaler Aufnahme bereits bei niedrigen Konzentrationen identifizierte werden. Die weitere biochemische Charakterisierung wurde durchgeführt, um die einzigartige intrazelluläre Verteilung von CyLoP-1 besser zu verstehen. Unsere Ergebnisse deuten dabei darauf hin, dass zumindest zwei mögliche Mechanismen daran beteiligt sind. Zum einen handelt es sich um Endozytose, wie schon für viele andere CPP berichtet, und zum anderen entweder um eine direkte Aufnahme über die Zellmembran ins Zytosol oder eine Neuverteilung nach retrogradem Transport aus den Endosomen/Lysosomen heraus. CyLoP-1 hat das Potential als neuartiger Transporter für die zytosolische Anlieferung von Wirkstoffen genutzt zu werden

Fatigue Determination in Drivers Using Biomarkers and Subjective Assessment Tools

Fatigue is a condition of extreme tiredness, resulted from physical or mental stress due to prolonged monotonous and stressful work with/without sleep deprivation. It can originate centrally or peripherally due to a multitude of inducing factors like excessive physical activity, peer-pressure, undue stress, tight schedules etc. Fatigue in specific occupations like driving can be hazardous by increasing the risk of road traffic accidents. In case of drivers, it is recorded the most for the ones who drive for long distances, or drive heavy-vehicles or the ones who are seasoned drivers. The driver shows symptoms like sleepiness, loss of pleasure, slower reaction/reflex, pessimism, inattentiveness and irritation. According to WHO report, road traffic injuries are the 6th leading cause in India. And conferring to a study done by JP Research India, over a span of 2 years, fatigue was the leading cause contributing to 29% of the total accidents. But there is still no defined machinery to monitor a driver’s fatigue in real time. In order to get an estimate of physical fatigue in drivers, appropriate study is essential. In the current study, an attempt was made to quantify physical fatigue in healthy non-trained subjects during simulated driving session of 12 hours at a stretch. The goal was to observe and estimate the progress of fatigue in the subjects out of driving task. Briefly, 10 male healthy subjects with mean age of 25 ± 4 years were selected. During 12 hours of driving on the simulator, blood samples were collected at 6 hours intervals from each subject, for estimation of Serotonin, CK-MB and Lactic acid. The subjective feeling of stress and fatigue was evaluated in the participants using subjective assessment tools like Epworth Sleepiness Scale, Berlin Questionnaire and Beck Depression Inventory. All the biochemical parameters increased significantly as fatigue progressed. The subjective assessment scores also indicated the fatigue process & strongly correlated. The subjective assessment scores also indicated the fatigue progress and strongly correlated with the biochemical parameters

Obstetrical outcome of pregnancy complicated with first trimester bleeding and subchorionic hematoma

Background: First trimester bleeding complicates around 20-27% of pregnancy. Objective of this study was to evaluate and compare the feto-maternal and pregnancy outcome in patients presenting with live pregnancy complicated with first trimester bleeding and subchorionic hematoma with those without subchorionic hematoma.Methods: In this prospective observational study, based on ultrasonography, live pregnancies were categorized into two groups, first group having first trimester bleeding with subchorionic hematoma and second with first trimester bleeding only without any hematoma. They were evaluated for the end outcome of pregnancy in terms of abortion and continuation. Continued pregnancies were evaluated for antenatal complications, delivery and intrapartum events along with fetal outcomes.Results: Outcome of pregnancies presenting with first trimester bleeding in terms of abortion was similar in both the groups, 22.8% and 21.5% with hematoma and without hematoma respectively. Incidence of preeclampsia was 11.4% and Fetal growth restriction was 7% in pregnancies with first trimester bleeding with hematoma and was significantly higher than those without hematoma which was 3.07% for preeclampsia and 3% for fetal growth restriction. Incidence of antepartum haemorrhage was higher in hematoma group but the result was not statistically significant. 20% pregnancies with first trimester bleeding with hematoma had preterm deliveries, while it was 7.7% in pregnancies without hematoma and the difference was statistically significant. Low birth weight had occurred in 20% of babies in first group of patients while 4.6% in second group, difference being statistically significant.Conclusions: We found that live pregnancies with first trimester bleeding and subchorionic hematoma were associated with similar risk of miscarriage and antepartum haemorrhage while increased risk of preeclampsia, fetal growth restrictions, preterm birth, non-reassuring fetal heart pattern, caesarean delivery and low birth weight baby when compared to patients with first trimester bleeding without subchorionic hematoma. There was no difference in 5 minutes Apgar score and the NICU admission in both the groups

Histopathological classification of ovarian neoplasm: a retrospective study of 612 cases from a regional cancer centre, Odisha, India

Background: Ovarian cancer is the leading cause of cancer related death amongst women in India. Identification of histological types helps to predict tumor behaviour and further appropriate management. Aims and objectives is to study the histopathological parameters of ovarian tumor.Methods: This retrospective study was done on patients who presented ovarian mass and subsequently underwent surgery in a Regional Cancer Centre, Odisha, over a period of three years from January 2016 to December 2018.  All datas such as age, site, gross findings and histological tumor types were retrieved from pathology and analyzed using MS Excel worksheet.Results: A total 612 cases of ovarian tumor were included for study. Non-neoplastic to neoplastic tumor ratio was 1:7.74. Surface epithelial tumors comprised the majority of tumors, accounting for 452 cases (83.39%). Malignant lesions were predominant in this series 416 cases (76%). Majority of borderline tumors were of mucinous subtype 20 (76.92%). The Mean±SD ages of all benign comprising, borderline and malignant tumors were 47.4±11.9, 44.9±14.3 and 46.9±13, respectively. On the basis of two tired grading system, high grade malignant serous tumors were maximum, 226 (74.34%). Ovarian surface involvement, omental invasion, uterine invasion, LVSI, capsular invasion and pelvic lymph node involvement was observed in 146 (35.26%), 106 (25.6%), 12 (2.89%), 70 (16.9%), 6 (1.44%) and 12 (2.89%) respectively. According to the FIGO staging system, among primary malignant tumor, 58% patients were presented in late stage (III and IV).Conclusions: The high incidence of malignant ovarian tumor with late presentation was observed in our study. So, further study is warranted to elucidate the major factors in our population

Biocytin-Based Contrast Agents for Molecular Imaging: An Approach to Developing New In Vivo Neuroanatomical Tracers for MRI

One of the most striking characteristic of the brain is its profuse neuronal connectivity. Not surprisingly, the function of the nervous system critically depends on the spatiotemporal pattern of intercommunication between different regions of the brain. Both macro- and microscopic aspects of the wiring diagrams of brain circuits are relevant and need to be understood in order to cope with the complexity of the brain function. In this way, for instance, the long-range connections that carry the functional specification of cortical territories need to be studied together with the detailed microcircuits inside a cortical column. Moreover, the temporal dimension of these wiring diagrams must be investigated since neuronal networks are dynamic structures exhibiting context-dependent changes in synaptic weights (Canals et al., 2009) and numbers (Chklovskii et al., 2004). Investigations over the last decades strongly suggest that stimulus or task related neural activity is distributed over large parts of the brain, covering different cortical and sub-cortical areas. For a detailed understanding of brain function, it is of prime importance to understand the organization of the neuronal connections. To chart the anatomical connections between the various components of brain networks, the neuronal tract tracing technique has been proved to be very useful. Thus, experimental tools that allow the exploration of brain circuits at diverse organizational levels are mandatory for the understanding of brain intercommunication and information processing