Demographics and follow up of post partum intra-uterine copper device in tertiary hospital in Delhi, India

Background: Increasing unintended pregnancies in post partum females in our country warrants urgent attention towards prevalence and efficacy of contraceptives used. This study was done to determine the prevalence of PPIUCD and its follow up in patients attending tertiary hospital in New Delhi, India.Methods: Prospective study was carried in Department of Obstetrics and Gynecology, Dr. RML Hospital, New Delhi, India over a period of 1 year from July 2017 to July 2018. The awareness and prevalence of PPIUCD was assessed. At 6 week follow-up visit, women with PPIUCD were asked for symptoms of unusual vaginal discharge, irregular or heavy bleeding per vagina, and any expulsions if noticed. All the data was recorded and assessed.Results: Out of 1478 deliveries, 1372 were eligible for PPIUCD. 335 patients got PPIUCD inserted. 295 patients were followed as 40 patients were lost to follow up. 79.3% women did not have any complaints. 11.8%, 1% and 7.4% women had only heavy menstrual bleeding, only lower abdominal pain and both symptoms respectively. Spontaneous expulsion rate was noted in one patient (0.3%) at 6 weeks. IUCD removal was done in 4 patients who had complaints of pain and heavy menstrual bleeding not conservatively managed.Conclusions: PPIUCD insertion is a safe, convenient and effective method of contraception. The benefits of contraception immediately after delivery outweigh disadvantage of complications. Antenatal counseling and follow up in hospitals need to be strengthened to increase awareness and acceptability of PPIUCD

Fibrous dysplasia of maxilla: Report of two cases

Fibrous dysplasia (FD) is an idiopathic skeletal disorder in which the trabecular bone is replaced and distorted by poorly organized, structurally unsound fibro-osseous tissue. The lesion is classified into two forms: Monostotic (75-80%) and polyostotic. A distinct form of Polyostotic FD, known as McCune-Albright Syndrome, is accompanied by cutaneous pigmentation and sexual precocity, and this occurs almost exclusively in women. Typical radiographic appearance shows an expanded osseous lesion having poorly defined margins covered by a thin "eggshell" cortex and lacking periosteal new bone formation. Here, we are presenting two case reports of FD involving the maxilla

Encapsulation of Bacteriophage in Liposome Accentuates Its Entry in to Macrophage and Shields It from Neutralizing Antibodies

<div><p>Phage therapy has been a centre of attraction for biomedical scientists to treat infections caused by drug resistant strains. However, ability of phage to act only on extracellular bacteria and probability of interference by anti-phage antibodies <i>in vivo</i> is considered as a important limitation of bacteriophage therapy. To overcome these hurdles, liposome were used as delivery vehicle for phage in this study. Anti-phage antibodies were raised in mice and pooled serum was evaluated for its ability to neutralize free and liposome entrapped phage. Further, ability of phage and liposome-entrapped phage to enter mouse peritoneal macrophages and kill intracellular <i>Klebsiella pneumoniae</i> was compared. Also, an attempt to compare the efficacy of free phage and liposome entrapped phage, alone or in conjunction with amikacin in eradicating mature biofilm was made. The entrapment of phage in liposome provided 100% protection to phage from neutralizing antibody. On the contrary un-entrapped phage got neutralized within 3 h of its interaction with antibody. Compared to the inability of free phage to enter macrophages, the liposome were able to deliver entrapped phage inside macrophages and cause 94.6% killing of intracellular <i>K</i>. <i>pneumoniae</i>. Liposome entrapped phage showed synergistic activity along with amikacin to eradicate mature biofilm of <i>K</i>. <i>pneumoniae</i>. Our study reinforces the growing interest in using phage therapy as a means of targeting multidrug resistant bacterial infections as liposome entrapment of phage makes them highly effective <i>in vitro</i> as well as <i>in vivo</i> by overcoming the majority of the hurdles related to clinical use of phage.</p></div

Bacterial count (CFU/ml) on different days of incubation of a 7 day biofilm of <i>K</i>. <i>pnuemoniae</i> B5055 in a microtiter plate following treatment with plain liposomes (empty lipoosmes as control), antibiotic (amikacin at 40 μg/ml), non-entrapped phages (MOI = 1) and liposome entrapped phages (MOI = 1).

<p>All values represent the mean ± SEM, calculated from two independent experiments, each performed in duplicate on different occasions.</p

Comparison of effect of neutralizing antibodies on phage and liposome entrapped phage.

<p>Comparison of effect of neutralizing antibodies on phage and liposome entrapped phage.</p

Biodistribution of liposome entrapped phage and unentrapped phage in spleen of BALB/c mice (n = 3).

<p>All values represent the mean ± SEM, calculated from two independent experiments, each performed in duplicate on different occasions</p

Percent bacterial uptake and killing by mouse peritoneal macrophages at different time intervals.

<p>All values represent the mean ± SEM, calculated from two independent experiments, each performed in duplicate on different occasions. SEM represent the 95% confidence interval. Confidence interval is calculated as SEM * 3.18. Raw data is available in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0153777#pone.0153777.t002" target="_blank">Table 2</a>.</p

Bacterial count (CFU/ml) on different days of incubation of a 7 day biofilm of <i>K</i>. <i>pnuemoniae</i> B5055 in a microtiter plate following treatment with plain liposomes (empty lipoosmes as control), antibiotic (amikacin at 40 μg/ml), non-entrapped phages (MOI = 1) and liposome entrapped phages (MOI = 1).

<p>All values represent the mean ± SEM, calculated from two independent experiments, each performed in duplicate on different occasions.</p

Bacterial count (CFU/ml) on different days of incubation of a 7 day biofilm of <i>K</i>.<i>pneumoniae</i> following treatment with phage + antibiotic (P+A) and liposome entrapped bacteriophage + antibiotic (LP+A) in a microtiter plate.

<p>All values represent the mean ± SEM, calculated from two independent experiments, each performed in duplicate on different occasions. A- Amikacin (40 μg/ml), P- Phage, LP- Liposome entrapped phage.</p

Comparison of percent killing of intracellular bacteria when treated with phage and liposome entrapped phage.

<p>Comparison of percent killing of intracellular bacteria when treated with phage and liposome entrapped phage.</p