HPV-DNA testing for detecting precancerous lesions of cervix: how effective?

Background: Human Papilloma Virus has been found to be associated with cervical squamous cell carcinoma. Studies and reviews indicate that HPV testing is more sensitive than Pap smear for identifying cervical cancer and its precursors in population screening. Hybrid capture 2 assays detect high oncogenic risk viruses and can be used as primary screening tool for women older than 30 years.Methods: A detailed history followed by a thorough clinical and gynecological examination was carried out for women attending the gynecological O.P.D. HPV-DNA (HCT) samples were collected using a cytobrush. Suspicious lesions of the cervix were further subjected to colposcopy directed loop electrosurgical excision procedure (LEEP) and sent for histopathological examination in formalin. The results of HPV-DNA (HCT) and histopatholgical report were then correlated.Results: In this study, one hundred and sixty women were screened for HPV-DNA. Thirty-two women were found to be positive for HPV-DNA. They were further subjected to colposcopy directed large loop electrosurgical procedure. The positive patients were found to have either low-grade or high-grade cervical intraepithelial neoplasia.Conclusions: The use of HPV-DNA test may make it a viable alternative to cytological screening especially as a less frequent screening

Transgressing the Contours of Domesticity

Tracing the history of women, it becomes evident that all through the age-old practices, women have been expected of erasing their own identity in an environment where the male patriarch is the sole authority of the society. The society have targeted woman and made her understand that her ordeals are her destiny. Among a plethora of feminist writers, Yashpal has marked a niche in the literary world by unveiling the dreadful representation of women in the Indian society through his writings. His writings give an idea about his anxiety for the prejudices she faces in the Indian society. This paper proposes to highlight the retaliation of the female characters against gender discrimination by seeking an equal space and status for themselves. They break away from the conventional social norms, refuse to abide by the suffocating rules laid down by the traditionalist social order. His characters are customary born and brought up in a conventional milieu. Their consciousness to uphold the honour of the family does not stop them to unshackle themselves from the prejudiced value structure and annihilated cultural representation of gender in the pursuit of liberty and self-identity. The literary words of Yashpal voice the stubbornness of the women to not yield to the social norms and smash them completely. The paper elucidates how strongly they struggle to break away from subjugation and life of dilapidation

Sooner than later: a little effort may avert postpartum haemorrhage in patients with acute hepatitis E

Background: The incidence of postpartum hemorrhage (PPH) in pregnancies with hepatitis E varies from 14-42%. Management of labor and PPH in these women with acute liver injury makes it a real obstetric challenge due to associated coagulopathies and contraindication for many drugs. Prophylactic insertion of condom balloon tamponade along with active management of the third stage of labour (AMTSL) prevent primary PPH in these women. Simultaneous use of injection tranexemic acid further gives reliable results. The present study was conducted to study the effectiveness of condom balloon tamponade in preventing PPH in pregnant women with acute hepatitis E in labor.Methods: The present study was conducted in the Department of Obstetrics and Gynecology, Pt. Jawaharlal Nehru Medical (JNM) College and associated Dr. Bhim Rao Ambedkar Memorial (BRAM) Hospital, Raipur, Chhattisgarh over period of two year from September 2018 to September 2020.Results: During the study period 32 women presented with hepatitis E in labor. Condom balloon tamponade was inserted prophylactically in all hepatitis E virus (HEV) positive cases immediately after delivery of placenta along with vaginal packing, irrespective of amount of bleeding. Inspite of so many odds in the form of unscanned pregnancies, multiparity, multifetal gestation, abruption, intrauterine fetal death (IUFD), prolonged labor, deranged liver and coagulation profiles, anemia and thrombocytopenia, our study showed high effectiveness of prophylactic condom balloon tamponade by encountering only one case of PPH.Conclusions: Prophylactic condom balloon tamponade insertion just after the removal of placenta is promising in averting PPH

In-vitro sperm immobilization activity and biocompatibility study of NVD terpolymer

Background: Boronate derivatives have been used in affinity chromatography for separation of cells based on their glycoprotein content. Boronate containing polymers when used intravaginally before sexual intercourse could bind to the glycoproteins present on sperm cell surface and render them immobile, which potentially may work as female-controlled contraceptive. To study this hypothesis NVD terpolymer which contains boronic acid was studied on goat sperm and its biocompatibility was accessed on NIH3T3 fibroblast.Methods: Sperm motility study was carried out on goat sperm cells. The study was divided into two groups, test group (NVD terpolymer in simulated vaginal fluid) and negative control (simulated vaginal fluid only) performed using Sander-crammer assay. In the test group, the study was started from 0.1 % of the polymer solution, until the half of the sperms became non-motile as compared to normal control. The biocompatibility study was performed by culturing the NIH3T3 fibroblast with different concentrations of NVD polymer, followed by cell viability assay by performing 3-(4, 5-dimethylthiazol-2-Yl)-2, 5-diphenyltetrazolium bromide (MTT) assay at 6, 12 and 24 hour spectrophotometrically.Results: Sander-crammer assay resulted in significant (P-value < 0.05) decrease in motile sperm count in test group when compared to control. At 7.5 % concentration, the half of the sperms rendered immobile, and this was termed as effective concentration 50 (EC50). In-vitro biocompatibility study using NIH3T3 fibroblasts culture and MTT assay with cultured cells at 6, 12 and 24 hour, revealed that the polymer is biologically compatible as there were no significant change (P-value < 0.05) in the absorbance.Conclusions: Boronate containing polymer, such as NVD terpolymer has in-vitro sperm immobilizing activity in goat sperm model, with further research in this area could yield a potential female control contraceptive agent

Study of maternal and perinatal outcome in cases of a HELLP syndrome

Background: HELLP is an acronym which describes the presence of haemolysis, elevated liver enzymes, low platelet count during pregnancy. It is a life-threatening manifestation of pre-eclampsia. The incidence of HELLP syndrome is 0.5-0.9% of all pregnancies and 10-20% in cases of pre-eclampsia. The rationale of this study lied in the anticipation that knowledge of incidence of the HELLP Syndrome will incite the interest of medical fraternity handling various pregnancy related complication. The results may also imply that early detection of high-risk individuals by primary medical personnel and timely referral to a tertiary care centre will be helpful in improving maternal and perinatal outcomes. Aim of this study were to study the incidence of HELLP syndrome in patients with pre-eclampsia and to study maternal and perinatal outcome in pre-eclampsia patients complicated with HELLP syndrome. Methods: A prospective observational study of 400 admitted cases with more than 20 weeks of gestation having pre-eclampsia. Statistical analysis of the data done on IBM SPSS Statistics Version. Results: The incidence of HELLP syndrome in pre-eclampsia was found to be 9.25%. The major maternal complications were placental abruption (35.14%), acute renal failure (16.22%), eclampsia (5.4%), papilledema (5.41%), PRES (5.41%), DIC (5.41%), maternal mortality (8.11%) in cases of HELLP syndrome while low birth weight (48.64%) respiratory distress syndrome (35.14%), meconium aspiration syndrome (18.9%), IUD (10.81%), NICU admission (37.84%), NND (10.81%) were neonatal complications. Conclusions: HELLP syndrome in pre-eclampsia is associated with significant maternal and perinatal morbidity and mortality and early detection and prompt management is the key for a better maternal and perinatal outcome

Evaluation of maternal and fetal outcome in pregnancies complicated by jaundice-an observational study

Background: The spectrum of jaundice in pregnancy varies from a benign condition with good maternal and fetal outcome to a severe form resulting in liver failure and maternal and fetal mortality. Jaundice may complicate 3-5% of pregnancies. Present study was aimed to analyze the cause, course and impact of jaundice during pregnancy so as to have better understanding and hence better feto-maternal outcome. The present study aimed to analyze the various causes of hepatic dysfunction in pregnancy, maternal and fetal outcome in pregnancies complicated by jaundice and various hematological and liver function variables for predicting maternal and fetal outcome.Methods: The present study was an observational study conducted in the department of obstetrics and gynecology, Pt. JNM medical college and associated Dr. BRAM hospital, Raipur (CG) over period of 2 year from September 2018 to September 2020.Results: Total 0.72% pregnancies were complicated by jaundice. HELLP syndrome was the commonest cause of jaundice in pregnancy (36.7%), followed by viral hepatitis (32.7%). Hepatitis E was the most common type of viral hepatitis (91.8%). Hemolytic jaundice presented with best maternal outcome (maternal mortality rate 8.6%). Worst maternal outcome was seen in AFLP (maternal mortality rate 100%). Best fetal outcome was seen in viral hepatitis (live birth rate 67.6%), whereas worst noted with AFLP (fetal death rate 66.6%). Higher total serum bilirubin, higher serum AST, anemia and deranged INR had significant correlation with maternal mortality.Conclusions: HELLP syndrome and viral hepatitis are preventable causes of jaundice yet it contributed to significant proportion of maternal deaths in 26.5 and 18.5% cases respectively. AFLP is often under diagnosed and had a fulminant course in pregnancy causing maternal and fetal mortality

Effect of Methods and Catalysts on the One-pot Synthesis of Tetrahydropyridine Derivatives: A Mini-Review

As heterocyclic nitrogen molecules, tetrahydropyridines have been recognized as significant constituents of many natural and synthetic compounds, many of which have interesting biological and pharmacological properties. Tetrahydropyridines (THPs) play a pivotal role in synthesizing a range of remedial compounds. They have exhibited impressive curative efficacy for the treatment of numerous diseases. Due to this reason, they are attractive synthetic targets for organic chemists. Several techniques and schemes have been adopted for the synthesis of these molecules. Among these, multicomponent reactions (MCRs) are proved to be one of the best tools for achieving compounds containing complex diversity in a single step and production of their vast libraries. Along with this, the employment of various catalysts makes this technique more vibrant. This review article discussed different catalysts adopted in the synthesis of tetrahydropyridine derivatives via multicomponent reactions to provide information for the development of new-fangled processes aiming at less reaction time, better yield, and minimum side effects. DOI: http://dx.doi.org/10.17807/orbital.v13i4.158

Post caesarean scar endometriosis: reporting three cases

Scar endometriosis remains under diagnosed entity. A high index of suspicion is required for correct diagnosis. Complaints of pain, increase in size or bleeding from a mass post operatively that is cyclically associated with menstrual cycle is almost pathognomonic. Surgical excision remains the treatment of choice. We report three cases treated in our institute.

Formulation and Evaluation of Protein Bound Paclitaxel Nanoparticles for Injectable Suspension

Aims: The aim of present study is to develop Paclitaxel nanoparticles for injectable suspension, an anti-neoplastic drug formulation. Study design:  Mention the design of the study here. Place and Duration of Study: Sagar Institute of Research & Technology- Pharmacy, Ayodhya Bypass Road, Bhopal, between June 2017 and June2018. Methodology: The Human serum albumin (HSA) is the most abundant plasma protein in the human blood with a half-life of 19 days. It can reversibly bind hydrophobic drug substances, transport them in the body and release drugs at cell surface. The formulation is prepared by homogenization at high-pressure of paclitaxel in the presence of human serum albumin into a nanoparticle colloidal suspension. Paclitaxel nano particles have been stabilized by human albumin and maintain the average size of 100 nm Results: The particle size of the reconstituted solution is checked using the laser diffraction Technique the particle is White to yellow lyophilized after reconstitution the particle become homogeneous milky suspension without visible particulates. Reconstitution time NMT 25 minutes 20.45 sec. The assay was performed by HPLC and found to be 90.0% to 110.0% of label. The retention time of Paclitaxel peak obtained in sample corresponds to the respective standards obtained from standards the pH NLT 6.00 to NMT 8.00 Particle size NLT 100 nm – NMT 200 nm. Sterility test was comply as per USP <71> Conclusion: The nano-delivery systems could have the potential to be free of Cremophor EL and ethanol, enhance Paclitaxel solubility, improve Paclitaxel pharmacokinetic profiles in vivo, decrease its side effects, passively or actively target to tumor sites due to the EPR (Enhanced Permeability and Retention) effect and the use of targeting ligands, respectively, nanotechnology is a very active research area in both academic and industrial settings. Keywords: paclitaxel, Anti-cancer, nanotechnology, Injectable, Suspensio

Interplay of fission modes in mass distribution of light actinide nuclei 225,227Pa

Fission-fragment mass distributions were measured for 225,227Pa nuclei formed in fusion reactions of 19F + 206, 208Pb around fusion barrier energies. Mass-angle correlations do not indicate any quasi-fission like events in this bombarding energy range. Mass distributions were fitted by Gaussian distribution and mass variance extracted. At below-barrier energies, the mass variance was found to increase with decrease in energy for both nuclei. Results from present work were compared with existing data for induced fission of 224, 226Th and 228U around barrier energies. Enhancement in mass variance of 225, 227Pa nuclei at below-barrier energies shows evidence for presence of asymmetric fission events mixed with symmetric fission events. This is in agreement with the results of mass distributions of nearby nuclei 224, 226Th and 228U where two-mode fission process was observed. Two-mode feature of fission arises due to the shell effects changing the landscape of the potential energy surfaces at low excitation energies. The excitation-energy dependence of the mass variance gives strong evidence for survival of microscopic shell effects in fission of light actinide nuclei 225, 227Pa with initial excitation energy ~30 - 50 MeV