Performance Evaluation of Optical CDMA Transmission System

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Suspecting the unsuspected in a large adnexal mass in a postmenopausal woman

Adnexal mass in postmenopausal woman is a diagnostic challenge. Due to the age, concern for malignancy is always there. At times however, despite the usual investigations, diagnosis remains elusive till histopathology report is at hand. To add to the enigma, ovarian masses in postmenopausal woman may remain silent till quite large and even among those which are symptomatic a predictable presentation may not be there. A careful clinical examination with a high degree of suspicion of clinical variants is thus recommended while dealing with ovarian tumors in postmenopausal women.

Predictive and prognostic significance of placental growth factor in pregnant women at high-risk for development of preeclampsia

Background: The study aimed to assess the predictive and prognostic role of placental growth factor (PlGF) in high-risk antenatal women for development of preeclampsia (PE). Methods: In this observational cohort study, antenatal women with gestation age from 20 to 32 weeks with high risk for development of PE were included. Serum PlGF was estimated by sandwich ELISA technique. A p-value of less than .05 was considered significant. Results: A total of 286 high-risk women were analysed for development of PE and obstetric outcomes. Of these 97/286 (34%) developed PE and 62/286 (21.7%) had abnormal PlGF value ( 100 pg/ml). Among the women with abnormal PIGF, 48 (77.4%) developed PE and out of 224 women with normal PIGF level, 49 (21.9%) developed PE resulting in a significant (p<0.001) odds ratio of 12.2 (95% CI: 6.0-25.9). For prediction of PE, a sensitivity and specificity of more than 75% at a cut-off value of <204.5 pg/ml was observed by ROC curve analysis. For prediction of preterm delivery (<34 weeks), a sensitivity and specificity of 65% was observed at a cut-off value of PlGF 191.7 pg/ml. Obstetric complications like eclampsia, preterm births (<34 weeks), neonate with low 5-minute APGAR score, low birth weight, fetal growth restriction, still-births and neonatal intensive care unit admissions all were significantly higher in abnormal PlGF group compared with normal PlGF group (p<0.05). Conclusions: Serum PlGF levels can provide valuable information for the prediction of PE and preterm births and abnormal PlGF values showed a significant association with adverse obstetrical outcomes

Role of pelvic and para-aortic lymphadenectomy in epithelial ovarian cancers

Background: Lymphadenectomy in epithelial ovarian cancers has remained a controversial subject. Lack of robust evidence on survival benefits and surgical morbidity associated questions its role in the era of adjuvant chemotherapy. The present study assessed pelvic and para-aortic lymph node removal in epithelial ovarian cancer in Indian women and tried to find clinicopathological correlation of nodal involvement and postoperative implications of lymphadenectomy.Methods: Thirty patients with diagnosis of epithelial ovarian cancer posted for primary debulking surgery were recruited and underwent staging laparotomy along with pelvic and para-aortic lymphadenectomy. Nodal involvement was confirmed on histopathology and various parameters which could predict nodal metastasis were assessed. Patients were followed up for 12 months post-surgery.Results: Nodal yield was ten for pelvic and four for paraaortic nodes. Pelvic node involvement was seen in 26.6% (8/30) of the patients and para-aortic in 15% (3/20) of the patients. Serous histology, higher grade, stage 3 and above, positive peritoneal cytology, omental involvement showed a higher lymph node involvement though not statistically significant. Para-aortic lymphadenectomy was associated with increased operating time, blood loss and longer hospital stay.Conclusions: Lymphadenectomy increases morbidity and decision should be based on predictors of nodal involvement

Feasibility of laparoscopy in management of ectopic pregnancy: experience from a tertiary care hospital

Background: Ectopic pregnancy is an important cause of maternal morbidity and mortality. For surgical management, laparoscopy is preferred option. In developing world for ruptured ectopic pregnancy laparotomy is done at most of places. In this study we have assessed feasibility of laparoscopic management in both ruptured and unruptured ectopic pregnancy.Methods: A prospective study, conducted over period of 1 year from July 2014 to July 2015 in Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi. In 110 patients of ectopic pregnancy parameters studied were age and parity, symptoms, risk factors, diagnostic methods, site of ectopic, management and its outcome. Primary objective was to evaluate management outcome of ectopic pregnancy and to assess feasibility of laparoscopy in ectopic pregnancy. Ruptured ectopic pregnancy with massive hemoperitoneum were analyzed separately. Secondary objective was to study demographic characters and risk factors of ectopic pregnancy.Results: Surgical management was required in 93.6% patients, out of which 86.4% were managed laparoscopically. Unruptured ectopic pregnancy was managed successfully by laparoscopy in 96.6% (29/30) patients. Ectopic was ruptured in 73 (66.3%) cases, laparoscopy was attempted in 91.7% (67/73). In 10.4% (7/67) patients laparoscopy had to be converted to laparotomy and it was successful in 89.5%. Out of 16 patients with massive hemoperitoneum, 12(75%) were managed laparoscopically. There was no mortality.Conclusions: In most of cases laparoscopy is safe and successful. Laparoscopy is feasible in ruptured ectopic cases including selected cases with massive hemoperitoneum thus avoiding unnecessary laparotomy and associated morbidity. Timely diagnosis and management prevents mortality

Preparation and <em>in vitro</em> Characterisation of Solid Dispersion Floating Tablet by Effervescent Control Release Technique with Improved Floating Capabilities

In this research, an effort has been done for the development of effervescent controlled release floating tablet (ECRFT) from solid dispersions (SDs) of diclofenac sodium (DS) for upsurge the solubility and dissolution rate. ECRFT of DS was prepared by using SDs of DS and its SDs prepared with PEG as carrier using thermal method (simple fusion). SDs of DS was formulated in many ratios (1:1, 1:2, 1:3 and 1:4). Prepared SDs were optimised for its solubility, % drug content and % dissolution studies. Tablets were formulated by using optimised SDs products and all formulation was evaluated for various parameters. A clear rise in dissolution rate was detected with entirely SD, amid that the optimised SD (SD4) was considered for ECRFT. Among all the tablet formulations, its F3 formulation was better in all the terms of pre-compression and post-compression parameters. It had all the qualities of a good ECRFT, based on this F3 formulation was selected as the best formulation. Data of in vitro release were fitted in several kinetics models to explain release mechanism. The F3 formulation shows zero order release. From this study, we can conclude that ECRFT containing SDs of DS can be successfully used for achieving better therapeutic objective

Linkages between oral commensal bacteria and atherosclerotic plaques in coronary artery disease patients

Coronary artery disease is an inflammatory disorder characterized by narrowing of coronary arteries due to atherosclerotic plaque formation. To date, the accumulated epidemiological evidence supports an association between oral bacterial diseases and coronary artery disease, but has failed to prove a causal link between the two. Due to the recent surge in microbial identification and analyses techniques, a number of bacteria have been independently found in atherosclerotic plaque samples from coronary artery disease patients. In this study, we present meta-analysis from published studies that have independently investigated the presence of bacteria within atherosclerotic plaque samples in coronary artery disease patients. Data were collated from 63 studies covering 1791 patients spread over a decade. Our analysis confirms the presence of 23 oral commensal bacteria, either individually or in co-existence, within atherosclerotic plaques in patients undergoing carotid endarterectomy, catheter-based atherectomy, or similar procedures. Of these 23 bacteria, 5 (Campylobacter rectus, Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia, Prevotella nigrescens) are unique to coronary plaques, while the other 18 are additionally present in non-cardiac organs, and associate with over 30 non-cardiac disorders. We have cataloged the wide spectrum of proteins secreted by above atherosclerotic plaque-associated bacteria, and discuss their possible roles during microbial migration via the bloodstream. We also highlight the prevalence of specific poly-microbial communities within atherosclerotic plaques. This work provides a resource whose immediate implication is the necessity to systematically catalog landscapes of atherosclerotic plaque-associated oral commensal bacteria in human patient populations

Isoniazid resistance among rifampicin-susceptible Mycobacterium tuberculosis isolates from tuberculosis patients

AbstractObjective/BackgroundWith the introduction of novel molecular techniques that rely on rifampicin (RIF) susceptibility, resistance to isoniazid (INH) or other first-line drugs remains undetected. Such patients are prescribed first-line antituberculosis therapy and are on RIF monodrug therapy during the continuation phase, which may lead to therapeutic failure and emergence of multidrug resistance. We aimed to study INH resistance among RIF-susceptible Mycobacterium tuberculosis (MTB) isolates from retreatment patients.MethodsThe Drug Susceptibility Testing data for four first-line drugs (streptomycin [SM], INH, RIF, and ethambutol [EMB]) using BACTEC MGIT 960 (Becton Dickinson, Franklin 124 Lakes, NJ ,USA) and for two drugs (INH and RIF) using line probe assay was analyzed retrospectively at the Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases (New Delhi, India).ResultsWe analyzed 4910 drug susceptibility results performed using the BACTEC MGIT960 liquid culture system from 2009 to 2015. We found that 969 (19.7%) isolates were sensitive to all four first-line drugs, 3941 (80.3%) isolates were resistant to one or more drugs, and 3041 (61.9%) isolates were resistant to both RIF and INH with or without resistance to any other drug (multidrug resistant). Monodrug resistance to SM and EMB was observed in 94 (1.9%) and 8 (0.16%) isolates, respectively. RIF resistance without INH resistance was observed in 22 (0.44%) isolates. There were 776 isolates sensitive to RIF, but resistant to INH. Among these, INH resistance with EMB and/or SM was observed in 367 (7.47%) isolates, whereas 409 (8.3%) isolates were resistant to INH alone. The results of line probe assay from 2012 to 2015 were also analyzed, and the resistance to INH alone among all isolates with valid results was found to be 9.32% (1462/15,676). More than 75% of these isolates harbor mutations in the kat G gene associated with high-level resistance.ConclusionINH resistance among RIF-susceptible isolates was present in 10–15% of the total cases. Among these cases, the use of RIF susceptibility alone will fail to detect INH resistance. Since higher rates of failure, relapse, or acquired resistance are linked with INH resistance, rollout of techniques focusing on RIF resistance must, therefore, be accompanied by strict monitoring for better management of patients