Efficacy and safety of ormeloxifene, a selective estrogen receptor modulator in management of dysfunctional uterine bleeding in perimenopausal patients: a prospective interventional study

Background: Dysfunctional uterine bleeding (DUB) is one of the most common menstrual disorder of women in any age group and is a diagnosis of exclusion. Medical management of menorrhagia is a difficult task as there are wide variations in the available drugs and a lot of different regimes are available. Present study evaluates efficacy and safety of ormeloxifene a selective estrogen receptor modulator (SERMs) in treatment of dysfunctional uterine bleeding in perimenopausal women. Methods: The study was conducted on 120 patients in the age group of 40-55 years who were treated with 60 mg ormeloxifene twice a week for first 12 weeks and once weekly for next 12 weeks. The primary outcome measures were menstrual blood loss (assessed by pictorial blood assessment chart score), hemoglobin concentration and endometrial thickness. The secondary outcome measures were aceptability and side effects of ormeloxifene. Results: 86.66% of women showed marked improvement in symptoms. Mean endometrial thickness decreased significantly from 9.825 mm to 6.25 mm after 6 months of treatment (p value <0.001). A significant decrease in median PBAC score (p value <0.001) was observed. Also, the mean haemoglobin level increased significantly from 8.03 g/dl to 9.60 g/dl (p value <0.001). Most common side effect reported was amenorrhoea (16%). 4% patient not relieved underwent hysterectomy. Conclusions: Ormeloxifene could be the drug of choice in patients with DUB. It is safe, cost-effective with manageable side effects. The therapy has facilitated compliance, tolerability and reduction of symptoms resulting in adherence towards the treatment

Effects of yoga in modifying blood pressure in patients of type 2 diabetes mellitus

Background: The incidence of diabetes mellitus is increasing with the increase in unhealthy dietary habits, physical inactivity and sedentary lifestyle. Hypertension complicated with diabetes further aggravates the problem. Yoga has been found to be helpful in delaying the progression and complications of the disease. The present study was undertaken with an aim to evaluate the effect of yoga in modifying blood pressure in patients of diabetes mellitus.Methods: Thirty patients of diabetes mellitus who were known case of hypertension were taken and their fasting and post-prandial blood glucose levels, systolic and diastolic blood pressure and waist circumference were analysed before and after ninety days of yoga in the department of physiology and biochemistry.Results: Systolic and diastolic blood pressure, waist circumference and fasting and post-prandial blood glucose level showed significant reduction (p value <0.05).Conclusions: This study emphasizes the importance of yoga in the control and management of type 2 diabetes mellitus and hypertension

Copper T (380 A) and risk of uterine perforation in lactating women: rural scenario

Background: Copper T 380 A is commonly used as PPIUCD as well as Interval contraception in rural areas of Chhattisgarh. Studies have reported that interval insertion of intrauterine device in women during their lactation period is associated with high risk of uterine perforation as compared to postpartum insertion similar as our study.Methods: 50 consecutive women were included, who came in family planning OPD of Chhattisgarh Institute of Medical Sciences (CIMS), a Government Medical College, with history of copper T insertion, during their lactation period, within one year of child birth. The copper T insertion was done by health workers at peripheral health centers with complains of pain lower abdomen, menstrual irregularities, missing thread, vaginal discharge, uterine perforation following Copper T 380 A insertion. Apart from patient’s characteristics such as age and parity etc. the method of detection of the perforation and details of management were analyzed.Results: There was one case of partial uterine perforation, one case of copper T lying in peritoneal cavity, two cases of expulsion and three cases had embedded copper T in the myometrium.Conclusions: The risk of perforation due to copper T 380A insertion in lactating women is slightly high, thus timing of insertion, proper counseling and providers training, which are vital factors for intrauterine device use during lactation period, should be considered seriously so as to minimize the complications

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

Synthesis of novel amino acid derivative of 7-AVCA

Abstract: In this study

Predictors of mortality in critically ill obstetric patients in a tertiary care intensive care unit: A prospective 18 months study

Introduction: Intensive care units (ICUs) receive obstetric patients with medical and surgical complications as well as obstetrical emergencies. These patients needing intensive care present an exclusive challenge both for the obstetrician as well as the intensivist. In developing countries such as India, due to scarcity of ICU resources, maternal morbidity and mortality of such patients is high. Objectives: The aim of our study was to examine the pattern of admission, prevalence, causes, and the outcomes of critically ill obstetric patients admitted to an Indian ICU and the factors affecting mortality. Materials and Methods: A prospective study of all obstetric patients (pregnant and within 6 weeks postpartum) admitted in a 48-bedded ICU of a tertiary care hospital over a period of 18 months from January 2015 to June 2016 was done. The data collected included demographics, obstetric and medical history, illness severity scores, organ failures, treatment given, the ICU stay, hospital stay, and outcomes. Results: A total of 48 obstetric patients were admitted in the ICU during the study period. Mean age was 29.27 ± 5.910 years, mean APACHE-II was 12.77 ± 7.553, and SOFA score was 6.36 ± 4.235. Postpartum hemorrhage was the commonest cause for ICU admission (23%). Of the study patients, 40% had sepsis, 33% had multiorgan failure, 48% required ventilator support, and 25% had need for vasopressors. Mortality of study patients was 8.3%. Average ICU stay was 6.6 days. APACHE-II, SOFA scores, ICU stay and hospital stay, and multiorgan failure are significant predictors of mortality in obstetric critically ill patients. Conclusion: APACHE-II, SOFA scores, and ICU stay are strong predictors of maternal mortality in ICU. APACHE-II and SOFA scores overpredict mortality in obstetric patients. Early assessment and intervention of critically ill obstetrical patients with a team approach involving obstetricians and intensivists is ideal. All obstetric residents should have a mandatory short ICU training

Insilico exploration of the potential inhibitory activity of DrugBank compounds against CDK7 kinase using structure-based virtual screening, molecular docking, and dynamics simulation approach

The CDK-activating complex (CAK), which includes CDK7, cyclin H, and the RING-finger protein (MAT1), drives cell cycle advancement via T-loop phosphorylation of cell cycle CDKs.The heterotrimeric CAK complex is a component of TFIIH, a generic transcription factor with dual functions in transcription and cell cycle control. CDK7 facilitates transcription by phosphorylating RNA polymerase II (Pol II) at active gene promoters. The “hallmark of cancer” has been attributed to cell cycle dysregulation, as well as aberrant transcriptions mediated by various pathways found in a variety of malignancies. Furthermore, clinical outcomes show that CDK7 levels are abundantly produced in many types of malignancies, implying that it may play a role in tissue maintenance. As a result, CDK7 is regarded as a malignant therapeutic target. Selective CDK7 inhibitors (CDK7i) have been found to work as anti-cancer medications. Drugs being repurposed for CDK7 kinase treatments is a viable strategy to swiftly uncover powerful therapeutic options for some of the most challenging forms of cancer. All of the DrugBank database chemicals, as well as the CDK7 kinase protein, were prepared, and Maestro (Schrödinger Suite) and GROMACS software suite were used to perform Docking, ADMET, MMGBSA, and MD simulation analyses. After screening the DrugBank molecules against CDK7 kinase, compounds including DB07075, DB07163, DB07025, DB01204, DB03916, DB02943, DB07812, and DB07959 were discovered to fit in the active site of the CDK7 kinase and demonstrate tight interactions. The top three docked compounds were tested, and the MD simulation revealed that they were stable with the target protein at 200 ns. As a result, these chemicals have the potential to be effective CDK7 Kinase inhibitors. As a final result, we present DB07075 (3-(5-[4-(aminomethyl)piperidin-1-yl]methyl-1H-indol-2-yl)-1H-indazole-6-carbonitrile) is a reversible inhibitor because it inactivates an enzyme through non-covalent, reversible interactions that could be a more promising inhibitor of CDK7 kinase by interacting with CDK7 kinase. This novel molecule, DB07075 has met all in silico criteria, necessitating further in vitro and in vivo research, especially in clinical trials

A comparative study of pain in patients planned for tooth extraction and dental implant insertion

Introduction: A variation in dental pain following tooth extraction and implant placement has been observed. The present study aimed to compare pain in patients undergoing tooth extraction and implant placement. Materials and Methods: Eighty-four patients underwent tooth extraction and implant placement in maxillary central incisor. Pain (VAS) was recorded at 24 h, 24 h, and 48 h. Results: The mean pain value (VAS) at 24 h post-operatively after tooth extraction was 6.1 and after implant insertion was 2.9. At 48 h after tooth extraction was 4.3 and after implant insertion was 1.1 and after 72 h after tooth extraction was 2.4 and after implant insertion was 0.27. A significant difference was observed between both procedures at different intervals of time (P < 0.05). Conclusion: The pain experienced by patients during dental implant insertion was comparatively less as compared to dental tooth extraction