Evaluation of endometrium by transvaginal ultrasonography and hysteroscopy and its correlation with histopathology in perimenopausal women with abnormal uterine bleeding at tertiary rural centre

Background: Abnormal uterine bleeding is one of the commonest clinical presentation ac-counts for 33% gynaecological consultations and this proportion rises to 70% in perimenopausal and postmenopausal age group in any gynaecology clinic. The most probable etiology of abnormal uterine bleeding relates to the patients reproductive age. Various diagnostic techniques have been evolved over the periods to determine the etiology of abnormal uterine bleeding in perimenopausal women, but their accuracy has not been compared properly. The aim of study is to evaluate the endometrium by transvaginal ultrasonography and hysteroscopy and its correlation with histopathology in perimenopausal patients with abnormal uterine bleeding.Methods: Total 96 patients in perimenopausal age group, admitted with chief complaints of ab-normal uterine bleeding were included. All patients underwent transvaginal ultrasonography and hysteroscopy, followed by hysteroscopy guided biopsy and histopathological examination. Accuracy, sensitivity, specificity, positive predictive value and negative predictive value were calculated for both methods and compared, considering histopathological diagnosis as gold standard.Results: Mean age of patients was 44.05±3.29. Hysteroscopy has high accuracy, sensitivity, specificity, positive predictive value and negative predictive value than Transvaginal sonography for diagnosis of all endometrial and intrauterine pathologies.Conclusions: Hysteroscopy results are more consistent with the results of histopathology. Hysteroscopy and hysteroscopy guided biopsy has been proven as gold standard for endometrial evaluation of patients with abnormal uterine bleeding. TVS can be used as most cost effective first step investigation in cases of perimenopausal bleeding

Maternal and perinatal outcomes of rupture uterus at rural tertiary care institution: a retrospective study

Background: Rupture of the pregnant uterus is a life threatening, preventable obstetric complication associated with high maternal and fetal mortality and morbidity. The objective of this study was to determine the incidence, maternal and perinatal outcome of rupture uterus at a rural tertiary care institution.Methods: Retrospective study included all uterine rupture cases booked or unbooked in hospital over a period of 6 years from January 2009-December 2014. In all patient’s case files, labour room and theatre records were reviewed and analyzed. Uterine rupture cases were categorized into complete and incomplete. Complete rupture was defined as full thickness uterine wall defect and incomplete rupture as small uterine wall defect. Only complete uterine rupture cases were included in the study. Cases with uterine dehiscence or other partial defects of uterine wall were excluded.Results: Total of 57 cases of uterine rupture was managed during the 6 years study period. In this period there were a total of 28,607 deliveries, giving a ratio of 1:502 and incidence of uterine rupture was calculated to be 0.199%. There were 43 (75.4%) rupture in scarred and 14 (24.56%) rupture in unscarred uterus. Majority (52.63%) were in age group 21-30 years, 42.10% cases were in age group 31-40 years. Maximum (91.2%) patient were between paraity 1 and parity 4, at 36-40 weeks of gestational age. 89.5% unbooked, 59.6% of rupture were managed with scar repair, 36.84% had bilateral tubal ligation done along with scar repair. 40.3% underwent hysterectomy (subtotal 29.82% and total abdominal hysterectomy 10.52%). Commonest complication was anemia for which multiple transfusions were given. In 5.3% bladder repair was done. Maternal mortality due to rupture was 8.77%. Perinatal mortality was 85.9%.Conclusions: Incidence of rupture is very high in our rural tertiary center. Mortality and complications due to rupture can be decreased by regular antenatal visits, early referral, taking timely and active interventions and blood transfusions

Liver Transplantation for Cholestatic Liver Diseases in Adults

Liver transplantation (LT) is an established lifesaving therapy for patients with cholestatic liver diseases, including primary cholestatic diseases, namely primary sclerosing cholangitis and primary biliary cirrhosis, as well as secondary forms of cholestatic liver disease, including those with cholestatic complications of LT needing a retransplant. Patients with cholestatic liver diseases can be transplanted for complications of end-stage liver disease or for disease-specific symptoms before the onset of end-stage liver disease. These patients should be regularly assessed. Patient survival after LT for cholestatic liver diseases is generally better than for other indications

Influence of dietary ginger (<i>Zingiber officinales </i>Rosc) on antioxidant defense system in rat: Comparison with ascorbic acid

604-606Ginger (Z. officinale; 1% w/w) significantly lowered lipid peroxidation by maintaining the activities of the antioxidant enzymes—superoxide dismutase, catalase and glutathione peroxidase in rats. The blood glutathione content was significantly increased in ginger fed rats. Similar effects were also observed after natural antioxidant ascorbic acid (100mg/kg, body wt) treatment. The results indicate that ginger is comparatively as effective as ascorbic acid as an antioxidant

Alterations in immunoglobulins and cytokine levels in blood of malathion poisoning cases

209-211The excessive exposure and use of malathion, an organophosphate pesticide, has lead to deleterious effects on human health. Chronic exposure to organophosphates has been shown to suppress immune system in experimental animals. Therefore, in this study, we have investigated the immunoglobulins (IgG, IgM, IgE and IgA) and cytokines (IL-2, IL-4, IFN-ϒ and TNF-α) levels in blood of malathion poisoning cases, admitted in Guru Teg Bahadur Hospital (University of Delhi), Dilshad Garden, Delhi, India. All the seriously ill patients of malathion poisoning showed significant levels of residue (503-702 mg/L). While no significant changes were found in Igs levels in blood of malathion poisoning cases, there was a significant increase in IL-2, IL-4 and TNF-α levels in blood of malathion poisoning cases, and significant decrease in IFN-ϒ level, as compared to normal subjects. This study demonstrated altered levels of cytokines and interleukins in serum in response to malathion exposure

Antifungal activity of some Himalayan medicinal plants and cultivated ornamental species

Extracts of roots of Rumex nepalensis, Berberis aristata, Arnebia benthamii, bark of Taxus wallichiana, Juglans regia and petals of Jacquinia ruscifolia were tested for their antifungal activity against twelve different fungal pathogens. Ethanolic extracts of R. nepalensis and J. ruscifolia extracts showed a broad spectrum of activity

Human Acquired Aplastic Anemia Patients’ Bone-Marrow-Derived Mesenchymal Stem Cells Are Not Influenced by Hematopoietic Compartment and Maintain Stemness and Immune Properties

Background and Objective. Acquired aplastic anemia (aAA) is a bone marrow failure disorder characterized by pancytopenia and bone marrow aplasia. Bone marrow Mesenchymal Stem Cells (BM-MSCs) are an important component of BM microenvironment, associated with hematopoietic and immune homeostasis. Any alterations in BM microenvironment can disrupt the normal functioning and it needs to be assessed. Methods. In the current study, we investigated the morphological differences, proliferation capacity, population doubling time (PDT), surface marker profiling, trilineage differentiation potential, and immunosuppressive ability of BM Mesenchymal Stem Cells (BM-MSCs) from untreated aAA patients and in the same number of age- and gender-matched controls. Results. We observed similar morphology, proliferation capacity, phenotype, trilineage differentiation potential, and immunomodulatory properties of BM-MSCs in aAA patients and control subjects. Conclusion. Our results confirm that the basic and immunosuppressive properties of BM-MSCs from aAA patients do not differ from normal BM-MSCs. Our data suggest that BM-MSCs from aAA patients might not be involved in disease pathogenesis. However, owing to a smaller number of samples, it is not conclusive, and future studies with more exhaustive investigation at transcriptome level are warranted

Liver Transplantation for Cholestatic Liver Diseases in Adults

Liver transplantation (LT) is an established lifesaving therapy for patients with cholestatic liver diseases, including primary cholestatic diseases, namely primary sclerosing cholangitis (PSC) and primary biliary cirrhosis (PBC), as well as secondary forms of cholestatic liver disease, including those with cholestatic complications of LT needing a re-transplant. Patients with cholestatic liver diseases can be transplanted for either complications of end stage liver disease or for disease-specific symptoms prior to the onset of end stage liver disease. Patients with cholestatic liver disease need to be regularly assessed for symptoms, lab parameters, development of hepatobiliary tumors, and the status of concomitant IBD if present, including colon cancer screening. Patient survival after liver transplantation for cholestatic liver diseases is generally better than for other indications.(1