A retrospective study of the clinical features of 50 consecutive cases diagnosed to have adenomyosis by histopathology in hysterectomy specimens in a tertiary centre

Background: Adenomyosis is characterised by the presence of ectopic endometrium, both glands and stroma deep in myometrium. Myometrial weakness caused by previous surgery or pregnancies, genetic factors, and tamoxifen use has been proposed as some aetiological factors.Methods: Present study aims to study the clinical profile of patients who have histological evidence of adenomyosis in hysterectomy specimens. The records of consecutive patients who had undergone hysterectomy were analysed.Results: The commonest age group affected is 41-50 years and menorrhagia is the predominant symptom.  The preoperative diagnosis of adenomyosis remains poor at around 8%.Conclusions: The age of onset and clinical features of patients should serve as an index for suspecting adenomyosis

Prevalence of bacterial vaginosis among reproductive age group women in a tertiary care centre

Background: Vaginal discharge in reproductive age poses a serious problem in the developing countries. Bacterial vaginosis also known as non-specific vaginitis is the most common cause of vaginal infections, detecting the organism at an early stage and initiating a proper treatment is very difficult in our country due to lack of awareness and proper follow-up. The disease manifests in the form of vaginal discharge with or without itching. It has a strong association with preterm labor, preterm premature rupture of membranes and low birth weight in pregnancy. The objective of this study was to find out the prevalence of bacterial vaginosis among the reproductive age group women, in a tertiary care centre.Methods: A cross sectional study was conducted among 150 women of the reproductive age group in the department of obstetrics and gynaecology Sree Mookambika Institute of Medical Sciences over a period of one month October 2018 the diagnosis was made with history and nugents scoring system.Results: Out of the total 150 women enrolled in the study 74 had positive results, 50% of them were of the age group 26-30.Conclusions: The study shows us the high prevalence of bacterial vaginosis

A study on contraceptive use among married women of reproductive age group in a rural area of Tamilnadu, India

Background: India was the first country in the world to formulate the national family planning programme in the year 1952 with the objective of “reducing the birth rate to the extent necessary to stabilize the population at a level consistent with requirement of national economy. The objective of this study was to study contraceptive use among married women of reproductive age group in a rural area of Tamilnadu.Methods: A cross sectional study was conducted from December 2014 to January 2015 in Sree Mookambika institute of medical Sciences, Kulasekharam among the married women in eligible couples group attending the hospital. Sample size was calculated to be 84. Inclusion criteria: married couple with female in age group of 15 - 45 years and sexually active and having the ability to communicate in local language.Results: The mean age was 30.95 years (SD = 6.421). Formal education was received by 100% women. Majority are Christians (48.8%) followed by Hindu (46.4%) and Muslim (4.8%). Among the respondents (n = 84), 33.7%, 41.7%, 2.4% and 22.6% had parity of 1, 2, 3 or more and none respectively Most of the women (71.4%) belonged to middle class group. 94% of women were aware of sterilization. This study shows a significant association between number of children and contraception usage (p<0.05). As parity increases contraception usage rate increases. Similar association is seen between number of male children and contraception practice (0.006). Also acceptance for permanent method of family planning increased with increasing parity (0.00) and number of male children (0.04).Conclusions: The study reveals good knowledge and favorable attitude of rural couples towards contraception. Contraceptive knowledge and practice was influenced by exposure to family planning messages

तारली और मलबार सोल के स्टाँक पर बारिश का प्रभाव

कृपया पूरा लेखा पढ

Differential gene expression of NADPH oxidase (p22phox) and hemoxygenase-1 in patients with Type 2 diabetes and microangiopathy

Aims: While the downstream effects of increased reactive oxygen species (ROS) in the pathogenesis of diabetes were well studied, only a few studies have explored the cellular sources of ROS. We examined whether protection against oxidative stress is altered in patients with diabetes and microangiopathy by examining changes in NADPH oxidase (p22phox) and hemoxygenase‐1 (HO‐1) levels. Methods: NADPH oxidase (p22phox) and HO‐1 gene expression were probed by RT‐PCR using leucocytes from patients with Type 2 diabetes without (n = 19) and with microangiopathy (n = 20) and non‐diabetic subjects (n = 17). Levels of lipid peroxidation as measured by thiobarbituric reactive substances (TBARS) and protein carbonyl content (PCO) were determined by fluorimetric and spectrophotometric methods, respectively. Results: p22phox gene expression (mean ± se) was significantly (P < 0.05) higher in diabetic patients with (0.99 ± 0.04) and without microangiopathy (0.86 ± 0.05) compared with control subjects (0.66 ± 0.05). Consistent with the mRNA data, the p22phox protein expression and NADPH oxidase activity was also increased in cells from diabetic patients compared with control subjects. However, HO‐1 gene expression was significantly (P < 0.05) lower in patients with (0.73 ± 0.03) and without microangiopathy (0.85 ± 0.02) compared with control subjects (1.06 ± 0.03). The mean (± se) levels of TBARS were significantly (P < 0.05) higher in diabetic patients with (14.36 ± 1.3 nm/ml) and without microangiopathy (12.20 ± 1.3 nm/ml) compared with control subjects (8.58 ± 0.7 nm/ml). The protein carbonyl content was also significantly (P < 0.05) higher in diabetic patients with (1.02 ± 0.04 nmol/mg protein) and without microangiopathy (0.84 ± 0.06 nmol/mg protein) compared with control subjects (0.48 ± 0.02 nmol/mg protein). In diabetic subjects, increased p22phox gene expression was negatively correlated with HO‐1 and positively correlated with TBARS, PCO, HbA1c and diabetes duration. In contrast, HO‐1 gene expression was correlated negatively with p22phox, TBARS, PCO, HbA1c and diabetes duration. Conclusion: Our results indicate that increased oxidative damage is seen in Asian Indians with Type 2 diabetes and microangiopathy and is associated with increased NADPH oxidase (p22phox) and decreased HO‐1 gene expression

Teleophthalmology: A Model for Eye Care Delivery in Rural and Underserved Areas of India

Objectives. To describe the application of teleophthalmology in rural and underserved areas of India. Study Design. This paper describes the major teleophthalmology projects in India and its benefits. Results. Teleophthalmology is the use of telecommunication for electronic transfer of health-related data from rural and underserved areas of India to specialities in urban cities. The MDRF/WDF Rural Diabetes Project has proved to be very beneficial for improvement of quality health care in Tamilnadu and can be replicated at the national level. This community outreach programme using telemedicine facilities has increased awareness of eye diseases, improved access to specialized health care, helped in local community empowerment, and provided employment opportunities. Early detection of sight threatening disorders by teleophthalmology and prompt treatment can help decrease visual impairment. Conclusion. Teleophthalmology can be a very effective model for improving eye care delivery system in rural and underserved areas of India

Reentrant phase transitions of DNA-surfactant complexes

Complexes of double-stranded DNA with the cationic surfactant cetyltrimethylammonium bromide have been studied using small angle X-ray diffraction at varying concentrations of DNA and the cosurfactant hexanol. At low DNA concentrations, an intercalated hexagonal (HIc)→lamellar (Lαc)→inverted hexagonal (HIIc) transformation is found on increasing hexanol content. The HIIc structure is converted into Lαc on adding more DNA. Further increase in hexanol content leads to a phase separation in the surfactant solution, and a reentrant Lαc→HIIc→Lαc transition is observed as DNA concentration is increased. Such structural transformations of DNA-surfactant complexes, driven by DNA concentration, have not been reported until now

Structures of some surfactant-polyelectrolyte complexes

Structures of complexes formed in aqueous solutions by some anionic polyelectrolytes (double and single stranded (ds and ss) DNA, poly(vinyl sulfonate) (PVS), and poly(styrene sulfonate) (PSS)) with a cationic surfactant system consisting of cetyltrimethylammonium bromide (CTAB) and sodium 3-hydroxy-2-naphthoate (SHN) have been determined using small angle X-ray diffraction. All complexes are found to have a two-dimensional (2-D) hexagonal structure at low SHN concentrations. Analysis of the diffraction data shows that the ds DNA-CTAB complex has an intercalated structure, with each DNA strand surrounded by three cylindrical micelles. On increasing SHN concentration, DNA-CTAB-SHN complexes exhibit a hexagonal-to-lamellar transition, whereas PVS complexes show a hexagonal → centered rectangular → lamellar transition. PSS complexes show yet another sequence of structures. These results indicate the significant influence of the chemical nature of the polyelectrolyte on the structure of the complexes

A study of obstetric and fetal outcome of placenta previa in scarred and unscarred uterus

Background: This study was conducted to study the maternal and fetal outcome in case of placenta previa in a scarred and unscarred uterus.Methods: This was 10 months’ prospective study conducted in Sree Mookambika Institute of Medical Science, Kulasekharam in the year between January 2021 to October 2021, among the cases of placenta previa with scarred and unscarred uterus. During the study period out of 1882 deliveries 20 cases of placenta previa beyond 28 weeks of gestation were reported. These cases were divided into two groups, scarred uterus (group A) and unscarred uterus (group B).Results: Incidence of placenta previa in scarred uterus (A) was higher than in unscarred uterus (B). Postpartum haemorrhage was seen in 25% of cases malpresentation was found in 55% of cases among which 5 cases in scarred group and in 6 cases in unscarred. Caesarean hysterectomy was performed in 1 case in scarred uterus. Neonatal intensive care unit was required for 15% of babies born to mother with placenta previa.Conclusions: The risk of placenta previa increases with increase in number of previous caesarean section, increased parity and advanced maternal age. Postpartum hemorrhage and blood transfusion are not uncommon in both group. Planned management at a tertiary care centre is obligatory. Mode of delivery is by emergency LSCS in case of bleeding per vaginum or elective LSCS

Oxidative DNA damage and augmentation of poly(ADP-ribose) polymerase/nuclear factor-kappa B signaling in patients with Type 2 diabetes and microangiopathy

Although oxidative stress and the subsequent DNA damage is one of the obligatory signals for poly(ADP-ribose) polymerase (PARP) activation and nuclear factor-kappa B (NFκB) alterations, these molecular aspects have not been collectively examined in epidemiological and clinical settings. Therefore, this study attempts to assess the oxidative DNA damage and its downstream effector signals in peripheral blood lymphocytes from Type 2 diabetes subjects without and with microangiopathy along with age-matched non-diabetic subjects. The basal DNA damage, lipid peroxidation and protein carbonyl content were significantly (p < 0.05) higher in patients with and without microangiopathy compared to control subjects. Formamido Pyrimidine Glycosylase (FPG)-sensitive DNA strand breaks which represents reliable indicator of oxidative DNA damage were also significantly (p < 0.001) higher in diabetic patients with (19.41 ± 2.5) and without microangiopathy (16.53 ± 2.0) compared to control subjects (1.38 ± 0.85). Oxidative DNA damage was significantly correlated to poor glycemic control. PARP mRNA expression and PARP activity were significantly (p < 0.05) increased in cells from diabetic patients with (0.31 ± 0.03 densitometry units; 0.22 ± 0.02 PARP units/mg protein, respectively) and without (0.35 ± 0.02; 0.42 ± 0.05) microangiopathy compared to control (0.19 ± 0.02; 0.11 ± 0.02) subjects. Diabetic subjects with and without microangiopathy exhibited a significantly (p < 0.05) higher (80%) NFκB binding activity compared to control subjects. In diabetic patients, FPG-sensitive DNA strand breaks correlated positively with PARP gene expression, PARP activity and NFκB binding activity. This study provides a comprehensive molecular evidence for increased oxidative stress and genomic instability in Type 2 diabetic subjects even prior to vascular pathology and hence reveals a window of opportunity for early therapeutic intervention