The effect of letrozole vs clomiphene citrate for ovulation induction in patients of infertility with polycystic ovarian syndrome

Background: The overall prevalence of primary infertility in India is 3.9% to 16.8%. PCOS being a recognized cause of infertility, affects 8 to 13% of all reproductive-age women. Clomiphene citrate (CC) is most commonly used as first line drug for ovulation induction. CC is selective estrogen receptor modulator (SERM) and has adverse effect on cervical mucus and endometrial receptivity resulting in low pregnancy rates. Letrozole an aromatase inhibitor is considered as better alternative drug due to its benefits over CC. Thus, the aim of the present study is to assess the effect of letrozole and clomiphene citrate for ovulation induction in women with PCOS and compare the pregnancy rates. Methods: This is a hospital based randomized controlled study conducted on 89 patients at Armed forces medical college in western Maharashtra from June 2019 to May 22. Women with infertility due to PCOS attending OPD/IPD who fulfilled the inclusion criteria were included in the study. The subjects were divided into two groups through computer generated randomization and Group A of 45 subjects received letrozole for ovulation induction while Group B with 44 subjects received clomiphene citrate (CC). Data was analyzed and comparison among the study groups was done with the help of unpaired t test or Mann-Whitney test. Results: The number of mature follicles after treatment was significantly greater in clomiphene citrate group (1.59 ± 1.04) as compared to letrozole (1.02 ± 0.76). However, there was statistically significant greater mono ovulation with letrozole (55.2% vs 40.3%, p=0.03). After ovulation induction, the mean endometrial thickness was significantly greater in letrozole group as compared to CC (9.85±2.32 mm vs. 8.45±1.53 mm; p<0.05). Ovulation rate with letrozole was 42.5% vs 32.5% and pregnancy rate was letrozole 20% vs CC 7.5% which was statistically significant (p<0.05). Conclusions: Letrozole is a better drug for ovulation induction in women with PCOS with an ovulatory cycles as pregnancy rates are higher and lesser chance of multiple pregnancy

Facial Skin Disease Detection using Image Processing

Busy lifestyle, modernization, increasing pollution and unhealthy diet have led to problems which people are neglecting. Not drinking enough water, stress and hormonal changes are causing problems to skin. Causes may be situational or genetic. Few skin conditions are minor while others can be life-threatening. The skin is the largest organ of the body and is composed of water, proteins, fats and minerals. Problems appear on outer layer of the skin that is epidermis. Skin diseases are considered to be the fourth most common cause of human illness. Skin diseases are observed to increase with age and were seen frequently in both men and women. Skin disorders can be temporary or permanent. Skin diseases have an impact on individual, family and social life caused by inadequate self-treatment which may also induce psychological problems. In recent years, use of computer technologies is becoming practically universal for both personal and professional issues. Facial skin problem identification and recognition has evolved to a great extent over the years. Detection of skin diseases is done using Convolution Neural Network (CNN) and image processing methods. CNN yields better performance in terms of accuracy, precision and results than the existing conventional methods. Image processing uses digital computer to process the images through an algorithm. We focus on features like skin tone, skin texture and color. We present a brief review about various facial skin problems providing more insight about the effective models and algorithms used

Passblot: A Highly Scalable Graphical One Time Password System

ABSTRACT User authentication is necessary to secure the data and process on Internet and in digital device

Study of Prescribing Pattern, Identification of Drug Related Problems and Therapeutic Intervention in Cardio Vascular Diseases (CVD) Patients

Cardiovascular disease (CVD) is a disorder of heart and blood vessels. CVD is one of the major causes of deaths in India, which contributed around 30 to 40%. The aim of the study was to study the prescribing pattern of drugs, identification of drug related problems and therapeutic intervention in CVD patients. A hospital based prospective and observational study was carried out for a period of nine months in a south Indian tertiary care hospital. Among 120 selected patients, 79 were male  (65.83%) and 41 were female  (34.16%), more number of patients (35) were between the age group of 55-64 (29.16%) of which 27 were males & 8 were females, and very less number of patients (6) were between the age group 85-94 (5%) of which all the 6 were male. Hypertension is the most commonest and dominant disorder, which affected 47(39.16%) patients, in which 30 were male (25%) and 17 were female (14.16%). Most common risk factor is HTN followed with smoking and diabetes of 45 patients (37.5%). The most often prescribed pattern adopted in CVD is Dual therapy, it is most frequently used therapy 50 (41.66%) and quadruple therapy is less frequently 6(6.5%) used. The diuretics and calcium channel blocker combination were maximally prescribed class of drugs as a dual therapy. A total of 47 drug-drug interactions were found, among 12 were major, 15 were moderate and 20 were minor interactions. Clinical pharmacist has intervened with the help of other health care professionals in order to reduce the risk factor and minimise the drug-drug interactions. The study provides the benefits of presence of clinical pharmacist in a hospital setting, in order to prevent the medication related errors and provide the expertise pharmacotherapy opinion in CVD patients, which improves the patient compliance.  Hence study justifies a need of active collaboration between clinical pharmacist, physician and other health care professionals for the better management of CVD patients. Keywords: Prescribing Pattern; Cardio Vascular Diseases; Drug Related Problems; Therapeutic Intervention

Comparative Expression Profile of miRNA and mRNA in Primary Peripheral Blood Mononuclear Cells Infected with Human Immunodeficiency Virus (HIV-1)

Host cells respond to exogenous infectious agents such as viruses, including HIV-1. Studies have evaluated the changes associated with virus infection at the transcriptional and translational levels of the cellular genes involved in specific pathways. While this approach is useful, in our view it provides only a partial view of genome-wide changes. Recently, technological advances in the expression profiling at the microRNA (miRNA) and mRNA levels have made it possible to evaluate the changes in the components of multiple pathways. To understand the role of miRNA and its interplay with host cellular gene expression (mRNA) during HIV-1 infection, we performed a comparative global miRNA and mRNA microarray using human PBMCs infected with HIV-1. The PBMCs were derived from multiple donors and were infected with virus generated from the molecular clone pNL4-3. The results showed that HIV-1 infection led to altered regulation of 21 miRNAs and 444 mRNA more than 2-fold, with a statistical significance of p<0.05. Furthermore, the differentially regulated miRNA and mRNA were shown to be associated with host cellular pathways involved in cell cycle/proliferation, apoptosis, T-cell signaling, and immune activation. We also observed a number of inverse correlations of miRNA and mRNA expression in infected PBMCs, further confirming the interrelationship between miRNA and mRNA regulation during HIV-1 infection. These results for the first time provide evidence that the miRNA profile could be an early indicator of host cellular dysfunction induced by HIV-1

Neuronal apoptosis by HIV-1 Vpr: contribution of proinflammatory molecular networks from infected target cells

Background: Human immunodeficiency virus type 1 (HIV-1) induces neuronal dysfunction through host cellular factors and viral proteins including viral protein R (Vpr) released from infected macrophages/microglia. Vpr is important for infection of terminally differentiated cells such as macrophages. The objective of this study was to assess the effect of Vpr in the context of infectious virus particles on neuronal death through proinflammatory cytokines released from macrophages.Methods: Monocyte-derived macrophages (MDM) were infected with either HIV-1 wild type (HIV-1wt), Vpr deleted mutant (HIV-1{increment}Vpr) or mock. Cell lysates and culture supernatants from MDMs were analyzed for the expression and release of proinflammatory cytokines by quantitative reverse transcription-PCR and enzyme-linked immunosorbent assay respectively. Mitogen-activated protein kinases (MAPK) were analyzed in activated MDMs by western blots. Further, the effect of Vpr on neuronal apoptosis was examined using primary neurons exposed to culture supernatants from HIV-1wt, HIV-1{increment}Vpr or mock-infected MDMs by Annexin-V staining, MTT and Caspase - Glo® 3/7 assays. The role of interleukin (IL)-1β, IL-8 and tumor necrosis factor (TNF)-α on neuronal apoptosis was also evaluated in the presence or absence of neutralizing antibodies against these cytokines.Results: HIV-1{increment}Vpr-infected MDMs exhibited reduced infection over time and specifically a significant downregulation of IL-1β, IL-8 and TNF-α at the transcriptional and/or protein levels compared to HIV-1wt-infected cultures. This downregulation was due to impaired activation of p38 and stress-activated protein kinase (SAPK)/c-Jun N-terminal kinase (JNK) in HIV-1{increment}Vpr-infected MDMs. The association of SAPK/JNK and p38 to IL-1β and IL-8 production was confirmed by blocking MAPKs that prevented the elevation of IL-1β and IL-8 in HIV-1wt more than in HIV-1{increment}Vpr-infected cultures. Supernatants from HIV-1{increment}Vpr-infected MDMs containing lower concentrations of IL-1β, IL-8 and TNF-α as well as viral proteins showed a reduced neurotoxicity compared to HIV-1wt-infected MDM supernatants. Reduction of neuronal death in the presence of anti-IL-1β and anti-IL-8 antibodies only in HIV-1wt-infected culture implies that the effect of Vpr on neuronal death is in part mediated through released proinflammatory factors.Conclusion: Collectively, these results demonstrate the ability of HIV-1{increment}Vpr to restrict neuronal apoptosis through dysregulation of multiple proinflammatory cytokines in the infected target cells either directly or indirectly by suppressing viral replication. © 2012 Guha et al.; licensee BioMed Central Ltd

Failure in Clay Brick Masonry with Soft Brick under Compression: Experimental Investigation and Numerical Simulation

An experimental investigation of compressive failure in masonry made of soft clay bricks is presented. The research attempts to address the concern of strong/stiff mortars available in the market today in combination with poor quality burnt clay bricks available in India. Masonry assemblages are tested to evaluate the influence of the relative strength of mortar on the observed damage evolution and compressive failure. Damage evolution associated with the formation and propagation of vertical splitting cracks during the compressive load response of masonry assemblages in the stack bonded arrangement are studied using a full-field optical technique based on digital image correlation. The stress state in the composite material produces tension in the mortar and confined compression in brick. Using image correlation clear evidence of the crack forming in the mortar and propagating into the brick is established. Failure is produced by vertical splitting and the number of cracks depend upon the tensile strength of the mortar relative to the brick and the number of head joints. Head joints act as stress risers, leading to high tensile stress

Physico-Chemical Studies on the Effect of Preservatives in Storage of ABC Juice

&lt;p&gt;Consuming the fruit and vegetable juices are considered as a simple and easy method to gain maximum health benefits. Preserving the nutritive value of these juices is important during their storage. So, preservatives and additives are used to increase their shelf life, along with ensuring the product safety. In this study, three kinds of natural preservatives were used to preserve a juice blend obtained from apple, carrot and beetroot under ambient room temperature and refrigerated conditions. The samples were examined every day for any changes in physical parameters and after 7 days, an aliquot of juice was studied for its chemical properties. The sample with lemon juice as preservative and stored under ambient room temperature had no contamination with least amount of reducing sugars and total proteins. Hence, the results observed in this preliminary study corroborate the usage of lemon juice as an effective natural preservative for preserving juice blend of apple, beetroot and carrot.&lt;/p&gt;&lt;p&gt;Keywords:- ABC Juice, Lemon Juice, Natural Preservative, Storage.&lt;/p&gt

A Comparative study on depression and its factors among First year and Final year M.B.B.S students of S.B.K.S.M.I. & R.C, Piparia

Introduction:Mental health has been holed up behind a blind of disgrace and segregation for a really long time. Not only do 56 million Indians (4.5% of India's populace) experience the ill effects of depression as of now, another 38 million Indians experience the ill effects of nervousness issue and anxiety disorders.Objective:1.To find prevalence of depression among medical students of S.B.K.S.M.I &amp; R.C. 2. To find out risk factors associated with depression among study population.3. Compare those risk factors among a first year and final year students of S.B.K.S.M.I &amp; R.C.Methods:ThisCross sectional study was conducted among First year and Final year students of S.B.K.S.M.I. &amp; R.C. piparia, Total 150 students in first year batch and 98 students in final year MBBS batch, All students (112 from first year &amp; 63 from final year) present on the day of data collection were included in study.After obtaining the permission from ethical committee to conduct study and after taking permission from the higher authority for data collection at medical college, we started data collection. Data was collected in two questionnaires. Questionnaire one on personal Data and factors associated with mental health and second questionnaire on Zung Depression Scale to assess the level of depression symptoms.Results:Out of 112 first year students, 48 were female participants and 64 were male participants while Out of 63 final year students, 21 were female participants and 42 were male participants. Out of total 112 first year MBBS students 84 (75%), 26 (23.21%), 2, (1.78%) and 0 (0%)&nbsp; were having Normal Range (25-49), Mildly Depressed (50-59), Moderately Depressed (60-69) &amp; Severely Depressed (70 &amp; above) Zung Depression scale score respectively.&nbsp; Out of total 63 final year MBBS students 44 (69.84%), 17 (26.98), 2 (3.12%) &amp; 0 (0%) were having Normal Range (25-49), Mildly Depressed (50-59), Moderately Depressed (60-69) &amp; Severely Depressed (70 &amp; above) Zung Depression scale score respectively. Yates' χ2 was used as a test of significant to find out association. We found that there is no statistical significance on prevalence of depression between first year and final year student. (p = 0.978)Discussion:Symptoms suggestive of depression were found in 24.99% (Mild 23.21%) (Moderate 1.78%) of first year Medical students and 30.1 (26.98% &amp; Moderate 3.12%) of final year Medical students which do not corresponds with prevalence rates found in other developing countries. Prevalence found in this this study is somewhat lower than other comparative studies conducted in developing and developed world