Abnormal uterine bleeding in perimenopausal women: sonographic and histopathological correlation and evaluation of uterine endometrium

Background: The objectives of the study was to establish the role of histopathological diagnosis of uterine endometrial lesions in patients of AUB at perimenopausal age and to correlate the transvaginal sonographic (TVS) finding with histopathological examination.Methods: This prospective observational study was carried out over 1 and 1/2 years in the two apex level teaching hospitals in eastern India. A total of 197 women in the age group of 40-49 years and ≥50 years (up to 55 years) who presented with abnormal uterine bleeding were included in the study. After selecting the patient with eligibility criteria in the OPD, detailed clinical history, systemic and gynecological examinations and investigations were done as per proforma. TVS study of endometrial pattern and thickness was measured followed by dilatation and curettage (D and C) and HPE of the endometrial curetting was done.Results: Menorrhagia (44.67%) was the most common clinical finding. Mean endometrial thickness measured by TVS was 7.04±2.11 mm in proliferative phase and 10.25±1.27 mm in the secretory phase. Proliferative endometrium (37.06%) was the most frequent finding in HPE followed by secretory endometrium (20.3%). Hyperplasia of endometrium was noted in 27 cases (100%) at 12-15 mm of endometrial thickness on TVS whereas endometrial hyperplasia with and without atypia and endometrial carcinoma was noted in 25 cases (92.59%) at the same thickness of 12-15 mm of uterine endometrium on HPE. Endometrial hyperplasia and polyp both had sensitivity of 84.21% and 71.43% respectively on TVS as compared with histopathology.Conclusions: Increased endometrial thickness and echo pattern by TVS correlated well with abnormal endometrial tissue histopathology in perimenopausal women with AUB

Prediction of preeclampsia by a combination of maternal spot urinary protein-creatinine ratio and uterine artery doppler

Background: Preeclampsia (PE) is heterogeneous disorder. The aim of the study was to observe the role of a spot urinary protein - creatinine ratio (UPCR) and uterine artery doppler velocimetry measured between 20-24 weeks of gestation in prediction of preeclampsia.Methods: Prospective observational study conducted on 120 pregnant mothers with singleton pregnancy between 20-24 weeks of gestational age in two tertiary teaching hospitals in eastern India. A spot urinary protein creatinine ratio (UPCR) was determined in a mid- stream urine sample and estimation of protein was done by immunoturbidimetric micro albumin method and creatinine by modified Jaffe’s method. Doppler velocimetry was also determined at 20-24 weeks of gestation. A notch in uterine artery, unilateral or bilateral; or RI > 0.7 and PI of > 1.45 were considered to have an abnormal result. Women were followed-up and relationship between variables was assessed by Chi- square test.Results: Women who subsequently developed preeclampsia had significantly higher UPCR (median 44.8 mg/mmol) when compared with women of unaffected groups (median 26.6 mg/mmol). The optimum spot urinary UPCR to predict preeclampsia was 35.5 mg/mmol and the cut-off value >35.5 mg/mmol had a test sensitivity (80%), specificity (94.06%), PPV (66.76%) and NPV (96.94%).The area under curve (AUC) of spot UPCR in ROC curve was  0.949 (95% CI,0.891 - 1.000). For predicting preeclampsia, the mean uterine artery RI had to be >0.7 having sensitivity (60%), specificity (97.03%), PPV (75%) and NPV (94.23%). The area under curve (AUC) was 0.856 (95% CI, 0.742 - 0.971).Conclusions: Second trimester UA doppler is a useful screening test for prediction of preeclampsia. This test works best when combined with a spot UPCR and accuracy of both the methods for prediction of preeclampsia was 92.24%

Prevalence and predictors of metabolic syndrome with comparison of myoinositol and metformin in PCOS women

Background: The objective is to determine the prevalence of metabolic syndrome (MBS) and the effects of insulin sensitizers to improve the clinical and hormonal milieu for better reproductive outcome in PCOS women.Methods: This prospective cross-sectional study was conducted on 50 PCOS women and 50 age matched control to determine the prevalence of the MBS in two tertiary hospitals over one year. Diagnosis of PCOS was based on at least two of ESHRE/ASRM criteria and diagnosis of MBS was based on at least three of NCEPATPIII criteria. Patients already diagnosed as PCOS were treated with insulin sensitizers myoionositol and metformin which were compared.Results: The study revealed that the prevalence of MBS was 40 % (20/50) nearly 4-fold higher than that of control groups. Among PCOS women, the most prevalent MBS factors were high BMI (52%) and low serum HDL-C (42%). The least prevalent factor was high fasting serum glucose level (16%). The resumption of spontaneous regular menstrual cycle and pregnancy rate in infertile groups of PCOS patients with myoionositol and metformin were 61% vs. 26% and 50% vs.91% respectively. The myoionositol group did not require any extra ovulating agents for pregnancy, while 7 out of 11 patients in metfromin group needed clomiphen citrate for ovulation induction to achieve pregnancy.  With myoinositol there is significant reduction of weight, BMI, LH/FSH ratio and fasting insulin level; whereas metformin shows decrement of weight and BMI only.Conclusions: The prevalence of MBS in PCOS is nearly 4 times in present study and there is significant improvement of symptom profile, weight, BMI and change of hormonal pattern in myoinositol group

HELLP syndrome in eclampsia and its impact on maternal and foetal outcome: a study in a tertiary care centre of rural India

Background: Objective of current study was to determine the incidence of HELLP syndrome in patients with eclampsia and its impact on maternal and perinatal outcome.Methods: The prospective study was conducted in the department of obstetrics and gynaecology, Burdwan medical college, Burdwan on 727 eclamptic mothers, admitted from January 2012 to December 2013. Clinical data and detailed investigations including complete haemogram, liver function tests and relevant investigations for haemolysis were analysed. Statistical analysis was performed using student’s t-test and χ2 test where appropriate. All P values <0.05 were considered statistically significant.Results: The incidence of HELLP syndrome among the women of eclamptic mothers was 7.43% (54/727). Among 54 patients; abruptio placentae (12.96%), acute renal failure (11.11%) and cerebral haemorrhage (11.11%) were most frequent maternal complications followed by DIC (3.70%). Maternal and perinatal mortality in HELLP syndrome were 7.40% and 30.5% respectively. SGOT level was higher in complete HELLP and it is statistically significant when compared to incomplete variant (P <0.0004). Complete HELLP syndrome is at increased risk for serious complications when compared to incomplete variety.  Conclusions: Classification of HELLP syndrome cases according to the clinical and laboratory findings can help in the monitoring and treatment of the disease.to improve perinatal outcome without increasing maternal morbidity

An assessment of Information disclosures by Pharmaceutical Industry: Evidence from India

[EN] The information disclosed by the companies in their annual reports reveals much about company’s performance and prospects. Investors take the information as base for decision for investment. Under such circumstance, companies choose to disclose beyond what is mandatorily required. Theories like agency theory, capital need theory and signaling theory support the need of voluntary disclosure. This study is about investigating the extent of Voluntary disclosure in pharmaceutical sector of India which is 3rd in World in terms of Volume of Trade.Objective: To investigate the extent of voluntary disclosure practices prevailing in pharma sector of India, for the year 2010-11 to 2017-18.Significance of the study: This study aims to explore the corporate aspect of pharmaceutical sector. Any growing avenue is a potential opportunity for investors looking for parking their money to get adequate returns. Thus, Indian Pharma sector has come up in flying colors as an avenue for investors to place their money owing to its 100% FDI . Investors have been looking for more and more information from this sector to ensure the safety of funds. Thus the extent of disclosures is worth studying to place a suggestion for the policymakers to introduce the changes in the present set of disclosure practices in pharmaceutical sector.Research Methodology: To understand the extent of voluntary disclosure, a disclosure checklist is constructed and descriptive statistics are carved out to reach the results. The checklist consists of 55 items which are not mandatory by law. The checklist is based on dichotomous scale of ‘1’ and ‘0’ representing presence and absence of the checklist item respectively. The cross sectional analysis is carried out to investigate the year wise and company wise disclosure for eight years.Findings: Though the study observes an increasing trends in the disclosure scores, but the findings are alarming to state that the highest score attained by any company throughout the period of 8 years was 37 (out of 55) not even meeting 80% of the total checklist score. This shows that pharmaceutical sector is not so friendly at disclosures. The probable reasons for such startling results are discussed in the study.Khanna, R.; Chahal, BPS. (2019). An assessment of Information disclosures by Pharmaceutical Industry: Evidence from India. Multidisciplinary Journal for Education, Social and Technological Sciences. 6(2):147-174. https://doi.org/10.4995/muse.2019.11531SWORD14717462Accounting, F. (2014). Voluntary disclosure frequency and cost of debt : an analysis in the Tunisian context Dorra Talbi * Mohamed Ali Omri, 6(2). https://doi.org/10.1504/IJMFA.2014.064521Adam, T., and V. K. Goyal. "The Investment Opportunity Set and Its Proxy Variables." Journal of Financial Research 31.1 (2008): 41. Print. https://doi.org/10.1111/j.1475-6803.2008.00231.xAgarwal, S. P., Monem, R. M., & Ariff, M. (1996). Price to Book Ratio as a Valuation Model: An Empirical Investigation. Finance India, 10(2), 333-344. https://doi.org/10.1.1.570.3053AICPA (1994), "Improving Business Reporting-a Customer Focus:Meeting the Information Needs of Investors and Creditors", Comprehensive Report of the Special Committee on Financial Reporting (the Jenkins report),Barry, c., and s. Brown. "Differential Information and Security Market Equilibrium." Journal of Financial and Quantitative Analysis 20 (1985): 407-422. https://doi.org/10.2307/2330758Baumann, U., and E. Nier. 2003. "Market Discipline, Disclosure, and Moral Hazard in Banking." In Proceedings of the 2003 Conference on Bank Structure and Competition. Chicago: Federal Reserve Bank of ChicagoBertomeu, J., Beyer, A., & Dye, R. A. (2011). Capital structure, cost of capital, and voluntary disclosures. Accounting Review, 86(3), 857-886. https://doi.org/10.2308/accr.00000037Buzby, S.L. (1974a), "The Nature of Adequate Disclosure", Journal of Accountancy, April, pp. 3 8-47. Buzby, S.L. (1974b), "Selected Items of Information and their Disclosure in Annual Reports", Accounting Review, Vol. XLIX NO. 3 July, PP. 423-43 5. Buzby, S.L. (1975a), "The Boundaries of Adequate Disclosure", The Singapore Accountant, Vol. 10, pp. 83-91.Botosan, C.A. (1997). Disclosure level and the cost of equity capital, Accounting Review, 72, pp. 323-350. Botosan, C.A. (2006). Disclosure and the cost of capital: What do we know? Accounting and Business Research, International Accounting Policy Forum, pp. 31-40. https://doi.org/10.1080/00014788.2006.9730042Botosan, C.A. and M.A. Plumlee (2002), A Re-examination of Disclosure Level and the Expected Cost of Equity Capital, Journal of Accounting Research, vol. 40 (1), pp. 21-40. https://doi.org/10.1111/1475-679X.00037Cooke, T. E. (1989). Voluntary Corporate Disclosure by Swedish Companies. Journal of International Financial Management & Accounting, 1(2), 171-195. https://doi.org/10.1111/j.1467-646X.1989.tb00009.xCampbell, D., Shrives, P., & Saager, H.B. (2001). Voluntary disclosure of mission statements in corporate annual reports: signaling what and to whom?, Business and Society Review, 106(1), pp. 65-87. https://doi.org/10.1111/0045-3609.00102Cheynel, E. (2013). A theory of voluntary disclosure and cost of capital. Review of Accounting Studies, 18(4), 987-1020. https://doi.org/10.1007/s11142-013-9223-1Choi, F.D.S. (1973). Financial disclosure and entry to the European capital market, Journal of Accounting Research, 11(2), pp. 159-175. https://doi.org/10.2307/2490187David, P., J. P. O'Brien, and T. Yoshikawa. "The Implications of Debt Heterogeneity for R&D Investment and Firm Performance." The Academy of Management Journal 51.1 (2008): 165-81. Print https://doi.org/10.5465/amj.2008.30772877Determination of the weighted average cost of capital of UPC and. (2009), (October).Diamond, D., & Verrecchia, R. (1991). Disclosure, liquidity, and the cost of capital, The Journal of Finance, 46(4), pp. 1325-1355. https://doi.org/10.2307/2328861Forker, J. J. (1992), "Corporate Governance and Disclosure Quality", Accounting and Business Research, Vol. 22, No. 86, Spring, pp. 111-124.https://doi.org/10.1080/00014788.1992.9729426Francis, J., Nanda, D., & Olsson, P. (2008). Voluntary disclosure, earnings quality, and cost of capital. Journal of Accounting Research, 46(1), 53-99. https://doi.org/10.1111/j.1475-679X.2008.00267.xGray, S. J. with McSweeney, L. B. and Shaw, J. C. (1984), Information Disclosure and the Multinational Corporation, Chichester: John Wiley & Sons, Inc.Gelb David.S; Paul Zarowin (2002) "Corporate Disclosure Policy and the Informativeness of Stock Prices Review of Accounting Studies"; Mar 2002; ABI/INFORM Global pg. 33Haggard, K. S., Martin, X., & Pereira, R. (2008). Stock Price Informativeness ? Financial Management, 747-768. https://doi.org/10.1111/j.1755-053X.2008.00033.xHail, L., C. Leuz (2007), Capital Market Effect of Mandatory IFRS Reporting in the EU: Empirical Evidence, http://www.afm.nl https://doi.org/10.2139/ssrn.1511671Hassan Omaima A.G, Peter Romilly, Gianluigi Giorgioni, David Power : The value relevance of disclosure: Evidence from the emerging capital market of EgyptThe International Journal of Accounting, Volume 44, Issue 1, Pages 79-102Healy, Paul M. and Palepu, Krishna, Information Asymmetry, Corporate Disclosure and the Capital Markets: A Review of the Empirical Disclosure Literature (December 2000). JAE Rochester Conference April 2000. https://doi.org/10.2139/ssrn.258514Ibrahim, K. (2014). Firm Characteristics and Voluntary Segments Disclosure among the Largest Firms in Nigeria. International Journal of Trade, Economics and Finance, 5(4), 327-331. https://doi.org/10.7763/IJTEF.2014.V5.392Jensen, M.C., & Meckling, W.H. (1976). Theory of the firm: managerial behavior, agency costs and ownership structure, Journal of Financial Economics, 3(4), pp. 305-360. https://doi.org/10.1016/0304-405X(76)90026-XKristandl, G., & Bontis, N. (2007). The impact of voluntary disclosure on cost of equity capital estimates in a temporal setting. Journal of Intellectual Capital, 8(4), 577-594. https://doi.org/10.1108/14691930710830765Lang, M., & Lundholm, R. (1993). Cross-sectional determinants of analyst ratings of corporate disclosures, Journal of Accounting Research, 31(2), pp. 246-271. https://doi.org/10.2307/2491273Lang, M., & Lundholm, R. (1996). Corporate disclosure policy and analysts behaviour, The Accounting Review, 71, pp. 467-492.Lang, H.L., R.J. Lundholm (2000), Voluntary Disclosure and Equity Offerings: Reducing Information Assymetry or Hyping the Stock, Contemporary Accounting Research, vol. 17 (4), pp. 623-662. https://doi.org/10.1506/9N45-F0JX-AXVW-LBWJLeuz, c., and Verrecchia (2000) "The Economic Consequences of Increased Disclosure." Journal of Accounting Research (2000): 91-124. https://doi.org/10.2307/2672910Lindblom, C.K. (1994). The implications of organizational legitimacy for corporate social performance and disclosure, Critical Perspectives on Accounting Conference. New York.Magness, V. (2006). Strategic posture, financial performance and environmental disclosure: an empirical test of legitimacy theory, Accounting, Auditing and Accountability Journal, 19(4), pp. 540-563. https://doi.org/10.1108/09513570610679128Mangala, D. (2015). Disclosure through Annual Reports: A Study of Indian Corporate Sector. International Journal of Research in Management, Science & Technology, 3(2), 2321-3264. Retrieved from http://www.ijrmst.org/download/vol3no2/152.pdfMathew James (1999), "Perception about the Need for Innovations in Financial Reporting: A Survey", the Management Accountant, (May), pp. 373-375.Meek, G. K. and Gray, S. J. (1989), "Globalisation of Stock Market and Foreign Listing Requirement: Voluntary Disclosures by Continental European Companies Listed on the London Stock Exchange", Journal of International Business Studies, Vol. 20(2). https://doi.org/10.1057/palgrave.jibs.8490854Palepu K.G., P.M. Healy and V.L. Bernard (2004), Business Analysis and Valuation: Using Financial Statements, Mason, Thomson South WesternPankaj M Madhani (2008) "New Models for Financial Reporting in the 21st Century" in Corporate Disclosure: Concepts and Practices, The Icfai University PressPetrova, E., Georgakopoulos, G., Sotiropoulos, I., & Vasileiou, K. Z. (2012). Relationship between Cost of Equity Capital and Voluntary Corporate Disclosures. International Journal of Economics and Finance, 4(3), 83-96. https://doi.org/10.5539/ijef.v4n3p83Ross, S.A. (1977). The determination of financial structure: the incentive signaling approach, Bell Journal of Economics, 8(1), pp. 23-40. https://doi.org/10.2307/3003485Shahriari, M., Mesbahi, L., & Saeedi, S. M. (2015). Risk Free Rate in the Context of Indian Market (Vol. 1). Retrieved from www.ijariie.com547Schutter P. and V.O Connell (2006) "The Trend Toward Voluntary Corporate Disclosures" Management Accounting Quarterly, 7, no. 2 (Winter) 1-9.Shankar Tilak, "Making Corporate Reporting Practices More Communicative", Economic and Political Weekly, November 1972, pp.164-168.Singh, D.R. and Gupta, B.N., "Corporate financial disclosure in Indian Companies," Indian journal of Accounting (June and December 1977), pp. 21-37Singhvi, S. S. (1972), "Corporate Management's Inclination to Disclose Financial Information", Financial Analyst's Journal, July-August, pp. 66-73. Solomons, D. (1989), Guidelines for Financial Reporting Standards, London: The Institute of Chartered Accountants in England and Wales. https://doi.org/10.2469/faj.v28.n4.66Spero, L. L. (1979), The Extent and Causes of Voluntary Disclosure of Financial Information in Three European Capital Markets: An Exploratory Study, Unpublished Doctoral Dissertation, Harvard University.Spence, M. (1973). Job market signalling, Quarterly Journal of Economics, 87(3), pp. 355-374. https://doi.org/10.2307/1882010Verrecchia, R.(1990) "Information Quality and Discretionary Disclosure." Journal of Accounting and Economics 12 (1990): 365-380. https://doi.org/10.1016/0165-4101(90)90021-UWatson, A., Shrives, P., & Marston, C. (2002). Voluntary disclosure of accounting ratios in the UK, British Accounting Review, 34(4), pp. 289-313. https://doi.org/10.1006/bare.2002.021

Investigation of DNA damage response and apoptotic gene methylation pattern in sporadic breast tumors using high throughput quantitative DNA methylation analysis technology

<p>Abstract</p> <p>Background-</p> <p>Sporadic breast cancer like many other cancers is proposed to be a manifestation of abnormal genetic and epigenetic changes. For the past decade our laboratory has identified genes involved in DNA damage response (DDR), apoptosis and immunesurvelliance pathways to influence sporadic breast cancer risk in north Indian population. Further to enhance our knowledge at the epigenetic level, we performed DNA methylation study involving 17 gene promoter regions belonging to DNA damage response (DDR) and death receptor apoptotic pathway in 162 paired normal and cancerous breast tissues from 81 sporadic breast cancer patients, using a high throughput quantitative DNA methylation analysis technology.</p> <p>Results-</p> <p>The study identified five genes with statistically significant difference between normal and tumor tissues. Hypermethylation of <it>DR5 </it>(P = 0.001)<it>, DCR1 </it>(P = 0.00001)<it>, DCR2 </it>(P = 0.0000000005) and <it>BRCA2 </it>(P = 0.007) and hypomethylation of <it>DR4 </it>(P = 0.011) in sporadic breast tumor tissues suggested a weak/aberrant activation of the DDR/apoptotic pathway in breast tumorigenesis. Negative correlation was observed between methylation status and transcript expression levels for <it>TRAIL</it>, <it>DR4</it>, <it>CASP8</it>, <it>ATM</it>, <it>CHEK2</it>, <it>BRCA1 </it>and <it>BRCA2 </it>CpG sites. Categorization of the gene methylation with respect to the clinicopathological parameters showed an increase in aberrant methylation pattern in advanced tumors. These uncharacteristic methylation patterns corresponded with decreased death receptor apoptosis (P = 0.047) and DNA damage repair potential (P = 0.004) in advanced tumors. The observation of BRCA2 -26 G/A 5'UTR polymorphism concomitant with the presence of methylation in the promoter region was novel and emerged as a strong candidate for susceptibility to sporadic breast tumors.</p> <p>Conclusion-</p> <p>Our study indicates that methylation of DDR-apoptotic gene promoters in sporadic breast cancer is not a random phenomenon. Progressive epigenetic alterations in advancing tumors result in aberrant DDR-apoptotic pathway thereby promoting tumor development. We propose, since pathological epigenetic changes of the DDR-apoptotic genes are reversible modifications, these could further be targeted for therapeutic interventions.</p

Нормативно-правові аспекти дослідження витрат торговельних підприємств

У статті досліджено міжнародні та національні нормативно-правові акти, що розкривають суть та методологічні аспекти формування витрат підприємств у бухгалтерському і податковому обліку. (In the article are investigated standard-legal sources that open methodological aspects of formation of costs of the enterprises in the accounting and tax account.

Pubertal Development in Girls with Beta Thalassaemia and Assessment of the Adequacy of Chelation Therapy: A Quasi-experimental Study

Introduction: Beta thalassaemia is the most prevalent hereditary autosomal disorder, significantly impacting endocrine function during pubertal development. The pathology is rooted in the excessive deposition of iron in vital organs. If left untreated, this condition leads to serious morbidity and mortality. Hypogonadism stands as the most common endocrine complication. Aim: To observe pubertal development in girls with thalassaemia and evaluate the adequacy of chelation therapy in such patients by measuring levels of Follicle Stimulating Hormone (FSH), Luteinising Hormone (LH), oestrogen, and serum ferritin. Materials and Methods: A quasi-experimental study was conducted at the Thalassaemia Clinic at the Department of Obstetrics and Gynaecology, Burdwan Medical College, Purba Bardhaman, West Bengal, India involving 300 diagnosed Beta Thalassaemia Major (BTM) (case) patients aged 13 to 17 years over a period of one and a half years (January 2020 to June 2021). The girls in the study groups were sequentially enrolled from the Outpatient Department of the Thalassaemia Clinic after meeting inclusion and exclusion criteria. Demographic data, anthropometric measurements, and Sexual Maturity Rating (SMR) were recorded. Hormonal assays of serum FSH, LH, oestrogen, and serum ferritin levels were conducted. Thalassaemic girls with serum ferritin levels exceeding 500 ng/mL received chelation therapy. Serum ferritin levels were measured at two-month intervals for up to six months, with reassessment of serum FSH, LH, oestrogen, and ferritin levels at the end of the six-month period. Statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) version 27.0, Microsoft excel spreadsheet, and Epi Info 7. Results: A total of 190 (63.3%) of the thalassaemic girls were aged 13 to 15 years, with a mean Body Mass Index (BMI) of 22.5000±2.6100 kg/m2, and 74 of them (38.94%) experienced menarche in this age group. Out of 300 cases, 269 thalassaemic girls (89.6%) received chelation therapy, and 89 cases (33.09%) reached menarche after chelation therapy. A significant (p<0.0001) increase in mean LH and FSH levels was observed after chelation therapy. The mean ferritin level decreased from 3168.85 ng/mL to 2227.24 ng/mL following chelation therapy. Conclusion: Pubertal development failure is common in beta thalassaemic girls. Intervention in the form of adequate chelation therapy in girls with high serum ferritin levels yielded favourable outcomes, as evident from serum gonadotropin and oestrogen levels