Comparison of metformin and N-acetylcysteine on metabolic parameters in women with polycystic ovarian syndrome

Background: Polycystic ovary syndrome (PCOS) is a common disease that affects up to 10% of women of reproductive age, in which hyperandrogenism (HA), enlarged cystic ovaries, and chronic anovulation often co-exist with obesity, dyslipidemia and insulin resistance (IR). There is a need for an alternative to metformin with minimal side effects to improve insulin sensitivity and correct dyslipidemia in PCOS patients.Methods: It was a prospective, Randomized controlled clinical trial. 116 PCOS patients, 58 each in two groups received either Metformin 500 mg TDS or N-acetylcysteine (NAC) 600 mg TDS for 3 months. Clinical and biochemical parameters contributing to metabolic syndrome (MS) and insulin resistance (fasting blood sugar (FBS), fasting insulin (FI), FBS:FI, HOMA-IR and QUICKI) were assessed at the start and end of the study. Results were compared between the two groups.Results: Both treatment modalities resulted in a significant reduction in number of cases with IR (p=0.001) and MS. Fasting hyperinsulinemia improved in 15 % (p=0.12) and 30% (p=0.001) of patients while 12% (p=0.23) and 18% (p=0.049) improvement was seen in FBS:FI in MET and NAC group respectively. Similarly, improvement in HOMA-IR was 12% (p=0.30) and 32% (p=0.001) in MET and NAC group which is significant with NAC. QUICKI and impaired glucose tolerance showed significant improvement in both the groups with a p-value of 0.04 and 0.006, 0.035 and 0.046 respectively. Significant reduction was seen in triglycerides (p=0.048) in NAC group.Conclusions: NAC is equally efficacious as metformin in improving parameters of insulin resistance and metabolic syndrome with minimal occasional side effects ensuring better compliance for a long-term therapy

A knowledge, attitude and practice study on awareness and acceptance of contraception in postpartum women in a tertiary care hospital

Background: India was the first country in the world to launch National Family Planning Programme in 1951. This was first step taken to stabilize population, but still lag behind in limiting family size and practicing contraceptive use. 55 million unintended pregnancies occur every year in developing countries due to no contraception use. 25 million pregnancies occur due to inconsistent or incorrect use of contraception method and contraception failure. The reason for promotion of family planning services to increase inter-pregnancy interval, birth spacing or to delay conception after birth by this method we can achieve optimum maternal and child outcome. This study was conducted to assess knowledge, awareness and acceptance about contraceptive methods during postpartum period.Methods: A prospective observational questionnaire based study in which 500 postpartum women belongs to 15 to 45 years age group was interviewed with informed verbal consent. This was KAP study regarding socio-demographic profile, awareness and acceptance of contraceptive method in postpartum period or during inter-pregnancy and factors affecting its use.Results: Statistical analysis of univariate and bivariate data done by using chi-square test and percentage (%). Out of 500 postpartum women, 46% women reported that they did not use any contraceptive method before. There was a significant association between contraceptive use with religion and education status (p=0.000, p=0.042 respectively). 62% obtained information from health professional (doctor/nurse), 23.8% obtained information from husband 44.4% of postpartum women implied that they would use contraceptive. Barrier method is the most preferred method (40.1%) of contraception.Conclusions: To improve maternal and child outcome, health professionals should be more focused to encourage effective and high quality contraceptive counseling during antenatal, intrapartum and postpartum period

Müllerian duct cyst misdiagnosed as ovarian cyst: a rare case report

The Müllerian duct cyst is a remnant of the caudal ends of the fused embryologic paramesonephric ducts (or Müllerian ducts). Preoperative distinction of ovarian cyst from a Müllerian duct cyst is important and is based on visualization of the ipsilateral ovary separate from the mass. Müllerian duct cysts may also be mistaken as paratubal, paraovarian or peritoneal inclusion cysts and hydrosalpinx. Thus, preoperative diagnosis of Müllerian cyst of the uterus can be very challenging. However, with increased awareness, preoperative diagnosis of this condition should be possible by sonography. Laparoscopy is useful as a minimally invasive treatment to diagnose as well as resect the cyst at the same time. We present a rare case of Müllerian duct cyst misdiagnosed as ovarian cyst pre-operatively and managed laparoscopically. A 32 year old multiparous female presented with the complaint of lump and dull aching pain in lower abdomen since three months. A cystic mobile mass measuring 6X7 cm with smooth surface which corresponded to 16 weeks gravid uterus size was palpated arising from pelvis. Her pelvic ultrasonography revealed a 7X7 cm unilocular thin walled simple cyst in right ovary suggestive of serous cystadenoma. Her CA-125 was 5.3 IU/ml. She was taken up for laparoscopic ovarian cystectomy. Intra-operatively, a 7X7 cm cyst was seen arising from right lateral wall of uterus. Histopathology showed the cyst wall features consistent with a Müllerian duct cyst

Role of Ionic & Non-ionic Surfactants in the Suppression of Polarographic Maxima of Ni(II)

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Early diagnosis of iniencephaly: a case report with review of literature

Iniencephaly is a rare and fatal neural tube defect characterized by retroflexion of fetal head with absent neck due to spinal defects. Herein, we describe a case of iniencephaly with a brief review of literature

Platelet transfusion in pregnancy: clinical profile and pregnancy outcome

Background: Thrombocytopenia, being second important hematological disorder of pregnancy can result in maternal and neonatal morbidity and mortality in some women. Some of these disorders are not associated with adverse pregnancy outcomes while in others it is associated with maternal and neonatal morbidity and mortality. So this study was conducted to evaluate the various causes of thrombocytopenia associated with platelet transfusion and its effect on maternal and neonatal outcome.Methods: It is a retrospective data analysis of 70 peripartum women admitted in a tertiary level hospital with thrombocytopenia, requiring platelet transfusion over a period of 9 months (January 2013 to September 2013). Patients were analyzed for the cause of thrombocytopenia, requirement of platelet transfusion, additional treatment, duration of hospital stay and maternal and neonatal morbidity and mortality.Results: In this study, pre-eclampsia and HELLP was present in 37.1% (n=26) of women requiring platelet transfusion while obstetrical hemorrhage (APH, PPH and Rupture uterus), combined iron deficiency anemia and infective causes accounted for 27.1% (n=19), 17.1% (n=12) and 15.7% (n=11) of women respectively. One case each of APLA and idiopathic thrombocytopenia was seen. 70% of women had to stay in hospital for more than 5 days. Four women expired and the incidence of morbidities was 73.1%. Prematurity was present in 41.1% neonates and three expired in nursery. Neonatal morbidity and mortality was not affected by maternal thrombocytopenia.Conclusions: Thrombocytopenia associated with pathological conditions like HELLP, dengue and malaria were associated with profound maternal and neonatal morbidity

PRODUCTION OF INDIAN CITRUS RINGSPOT VIRUS FREE PLANTS OF KINNOW EMPLOYING CHEMOTHERAPY COUPLED WITH SHOOT TIP GRAFTING

Indian citrus ringspot virus (ICRSV) is known to cause serious problem in Kinnow (Citrus nobilis Lour × C. deliciosa Tenora). This paper reports the elimination of ICRSV from Kinnow by chemotherapy coupled with shoot tip grafting under in vitro conditions. Nodal segments from infected mother plant (indexed by indirect ELISA and RT-PCR) were cultured on MS medium containing 2-iP (1mg/l) and malt extract (800 mg/l) along with different concentrations of five antiviral chemicals acycloguanosine, azidothymidine, 2,4-dioxohexahydro-1, 2,5-triazine (DHT), ribavirin and 2- thiouracil. Shoot tips of size 0.7 mm were excised from the sprouts of these nodal segments and grafted on to rough lemon (Citrus jambhiri) under aseptic conditions. The plantlets obtained from chemotherapy coupled with in vitro micrografting were indexed by indirect ELISA and RT-PCR after acclimatization. Maximum effect (37% virus elimination) was seen for ribavirin at 25 mg/l followed by 2-thiouracil at 25 mg/l (21.4%) and acyclguanosine at 25 mg/l (20.8%). Azidothymidine and DHT at the tested doses could not eliminate ICRSV. In the present study only those plants/plantlets were considered virus free, which showed negative reaction both with indirect ELISA and RT-PCR

Standardized observation of neighbourhood disorder: does it work in Canada?

<p>Abstract</p> <p>Background</p> <p>There is a growing body of evidence that where you live is important to your health. Despite numerous previous studies investigating the relationship between neighbourhood deprivation (and structure) and residents' health, the precise nature of this relationship remains unclear. Relatively few investigations have relied on direct observation of neighbourhoods, while those that have were developed primarily in US settings. Evaluation of the transferability of such tools to other contexts is an important first step before applying such instruments to the investigation of health and well-being. This study evaluated the performance of a systematic social observational (SSO) tool (adapted from previous studies of American and British neighbourhoods) in a Canadian urban context.</p> <p>Methods</p> <p>This was a mixed-methods study. Quantitative SSO ratings and qualitative descriptions of 176 block faces were obtained in six Toronto neighbourhoods (4 low-income, and 2 middle/high-income) by trained raters. Exploratory factor analysis was conducted with the quantitative SSO ratings. Content analysis consisted of independent coding of qualitative data by three members of the research team to yield common themes and categories.</p> <p>Results</p> <p>Factor analysis identified three factors (physical decay/disorder, social accessibility, recreational opportunities), but only 'physical decay/disorder' reflected previous findings in the literature. Qualitative results (based on raters' fieldwork experiences) revealed the tool's shortcomings in capturing important features of the neighbourhoods under study, and informed interpretation of the quantitative findings.</p> <p>Conclusions</p> <p>This study tested the performance of an SSO tool in a Canadian context, which is an important initial step before applying it to the study of health and disease. The tool demonstrated important shortcomings when applied to six diverse Toronto neighbourhoods. The study's analyses challenge previously held assumptions (e.g. social 'disorder') regarding neighbourhood social and built environments. For example, neighbourhood 'order' has traditionally been assumed to be synonymous with a certain degree of homogeneity, however the neighbourhoods under study were characterized by high degrees of heterogeneity and low levels of disorder. Heterogeneity was seen as an appealing feature of a block face. Employing qualitative techniques with SSO represents a unique contribution, enhancing both our understanding of the quantitative ratings obtained and of neighbourhood characteristics that are not currently captured by such instruments.</p

Perceptions of Medical Students on Research Curriculum: A Cross-sectional Study

Introduction: Medical colleges promote research by incorporating it into the curriculum, which enables students to acknowledge it as a career prospect. The aim of the study was to assess the perceptions of medical students on research curriculum. Methods: This cross-sectional study was conducted among 544 medical students (interns and post-graduates) at AIIMS Rishikesh in 2020. Data was collected thorough online self-administered questionnaire. A comparison between groups was made using the Mann-Whitney test or chi-square test p &lt; 0.05 was considered statistically significant. Results: Out of 544 participants, 218 (40.1%) responded with complete data. The total median score for the self-perceived ability of study participants regarding performing the research tasks differed significantly between interns and post-graduates [29.5 (24.0–34.2) vs 33 (25.2–39.7), p = 0.03]. They suggested that mandatory research projects, workshops, and training should be included in the curriculum. Conclusion: Feedback from medical students regarding the need for guided research projects, hands-on training, and inclusion of research methodology as a course in UG curriculum and provision of support in the form of incentives, academic credits, and motivation are well noted and guide the resource faculties to modify their teaching and student support programs