Efficacy of SEVISTA (Ormeloxifene) in treatment of mastalgia and fibrocystic breast disease

Background: Mastalgia and fibrocystic breast disease is common in women. Ormeloxifene (SEVISTA) is a weak oestrogen receptor (ER) agonist, a strong ER antagonist (SERA) and therefore a selective ER modulator (SERM) used in the treatment of the disease. Aim of study was to see the efficacy of ormeloxifene in women with pain in breast associated with or without fibrocystic breast disease.Methods: This was a randomized control trial of oral ormeloxifene 30 mg alternate day for 3 month in patients of 20 – 50 years old with breast pain and fibrocystic (without cancer). The pain was accessed by visual analogue scale and nodularity grade on a 5 – point.Results: Total 203 patients were completed the study. The mean age was 32.8 ± 8.35 years. The mean pain level was continuously decrease over 5 visit (5.8 to 0.86) and there was significant improvement was observed in the nodularity grades i.e. at beginning of treatment 1 and 2 nodularity were seen in 62 (30.5%) patients where as grades 3, 4 and 5 were seen in 141(69.5%) and at the end of six month it was 188 (92.6%) patients had grades 1 and 2 and only 15 (7.4%) had grade 3, 4 and 5 nodularity.Conclusion: SEVISTA (Ormeloxifene) showed significant efficacy for the treatment of mastalgia and fibrocystic breast disease

Comparison between bipolar vessel sealer (LigaSure vessel sealer) and harmonic scalpel in total laparoscopic hysterectomy

Background: The aim of the present study was to compare the use of bipolar Vessel Sealer with Harmonic Scalpel (HS) during total laparoscopic hysterectomy with respect to estimated blood loss and related postoperative complications.Methods: A retrospective study was conducted in the Jeevan Jyoti hospital and Guru Gobind Singh Memorial Vanadana Women’s hospital, Allahabad, U.P., India. Two forty two patients were enrolled who underwent total laparoscopic hysterectomy and were randomized into two homogenous groups: bipolar vessel sealer and harmonic scalpel.Results: Estimated blood loss was significantly less in bipolar vessel sealer when compared with harmonic scalpel. No significant difference was observed in postoperative complications.Conclusions: The bipolar vessel sealer is a reliable and safe tool for reducing intraoperative blood loss in patients undergoing total laparoscopic hysterectomy. More randomized studies need to be done to confirm the advantages of this technique.

Cesarean scar pregnancy: clinicians challenge

A case of caesarean scar ectopic pregnancy managed diagnosed early on transvaginal ultrasound and managed successfully by sequential approach of methotrexate and hysteroscopic removal preserving the woman’s fertility is discussed below. Ectopic pregnancy i.e. implantation of the blastocyst outside the endometrium of the uterine cavity occurs in 1.9% of reported pregnancies

Prenatal diagnosis of congenital megalourethra: a rare anomaly

Congenital megalourethra is a rare urogenital malformation characterised by pathological elongation and dilatation of penile urethra. It is a form of functional obstructive uropathy which is associated with significant urological and sexual dysfunction secondary to hypoplasia or absence of corpora cavernosa and spongiosa. We report a case of megalourethra in one of the dichorionic diamniotic twin diagnosed prenatally in a young primigravida. Initial ultrasound report suggested two different diagnoses i.e. omphalocoele and gastroschisis. Later, diagnosis of congenital megalourethra was made on detailed ultrasound examination by our fetal medicine consultant. Postnatal gross and ultrasonographic examination confirmed the prenatal diagnosis. In the present case report, we have emphasized proper perineal anatomical ultrasound examination which revealed a megalourethra. Although this anomaly is not lethal in isolation, but it has worse prognosis in presence of other associated structural anomalies. This anomaly also raises the controversy regarding disclosure of sex of foetus in countries like India where sex disclosure is prohibited by law. As this condition typically affects male foetuses and significantly affects sexual function, it may be necessary to reveal fetal sex for appropriate counselling and prognostication to prospective parents. Ethical dilemma arises for practising clinicians while dealing with isolated forms of megalourethra whether to offer termination of pregnancy on the grounds of having significant impact on sexual life due to erectile dysfunction. Anorectal malformation is often associated with megalourethra, although suspected in the present case, can be difficult to identify antenatally prior to 20 weeks (the time limit up to which legal termination can be performed in India). These issues have been highlighted in the present report

Variable Immunogenic Potential of Wheat: Prospective for Selection of Innocuous Varieties for Celiac Disease Patients via in vitro Approach

Celiac Disease (CD) is a multifactorial, autoimmune enteropathy activated by cereal proteins in genetically predisposed individuals carrying HLA DQ2/8 genes. A heterogenous gene combination of the cereal prolamins is documented in different wheat genotypes, which is suggestive of their variable immunogenic potential. In the current study, four wheat varieties (C591, C273, 9D, and K78) identified via in silico analysis were analyzed for immunogenicity by measuring T-cell proliferation rate and levels of inflammatory cytokines (Interferon-γ and Tumor Necrosis Factor-α). Peripheral Blood Mononuclear Cells and biopsy derived T-cell lines isolated from four CD patients in complete remission and two controls were stimulated and cultured in the presence of tissue transglutaminase activated pepsin-trypsin (PT) digest of total gliadin extract from test varieties. The immunogenicity was compared with PBW 621, one of the widely cultivated wheat varieties. Phytohaemagglutinin-p was taken as positive control, along with unstimulated cells as negative control. Rate of cell proliferation (0.318, 0.482; 0.369, 0.337), concentration of IFN- γ (107.4, 99.2; 117.9, 99.7 pg/ml), and TNF- α (453.8, 514.2; 463.8, 514.2 pg/ml) was minimum in cultures supplemented with wheat antigen from C273, when compared with other test varieties and unstimulated cells. Significant difference in toxicity levels among different wheat genotypes to stimulate celiac mucosal T-cells and PBMC's was observed; where C273 manifested least immunogenic response amongst the test varieties analyzed

Multidisciplinary Perspectives Towards Building a Digitally Competent Society

Используемые программы Adobe AcrobatМир претерпевает трансформацию, поскольку технологии проникают в каждую экосистему. Следовательно, существует необходимость развивать цифровые навыки более высокого порядка, чтобы обеспечить возможность трудоустройства, поскольку профессионалам необходимо развивать цифровые компетенции, чтобы оставаться конкурентоспособными в текущей рабочей среде. Кроме того, предприятия также должны продолжать обновлять свои цифровые методы, чтобы оставаться актуальными. В книге «Многодисциплинарные перспективы построения общества, компетентного в цифровых технологиях», исследуются междисциплинарные перспективы построения общества, более компетентного в цифровых технологиях, рассматриваются новые бизнес-модели и необходимость для организаций и отдельных лиц развивать правильное мышление для внедрения цифровизации, а также обсуждается, как социальный капитал может стать ключевым фактором в развитии цифрового общества. создание совершенно новой цифровой социальной структуры. Этот справочный материал, охватывающий такие темы,The world is undergoing a transformation as technology enters every ecosystem. Subsequently, there is a need to develop higher-order digital skills to ensure one's employability as professionals need to build digital competencies to remain competitive in the current work environment. Additionally, businesses must also continue to update their digital practices in order to remain relevant. Multidisciplinary Perspectives Towards Building a Digitally Competent Society explores multidisciplinary perspectives towards building a more digitally competent society, considers new business models and the need for organizations and individuals to develop the right mindset to embrace digitalization, and discusses how social capital can become a key driver in crafting a whole new digitally competent social fabric. Covering topics such as technological transformation, social media, and corporate social responsibility, this reference work is ideal for corporate practitioners, business owners, policymakers, scholars, researc

Prenatal diagnosis of congenital megalourethra: a rare anomaly

Congenital megalourethra is a rare urogenital malformation characterised by pathological elongation and dilatation of penile urethra. It is a form of functional obstructive uropathy which is associated with significant urological and sexual dysfunction secondary to hypoplasia or absence of corpora cavernosa and spongiosa. We report a case of megalourethra in one of the dichorionic diamniotic twin diagnosed prenatally in a young primigravida. Initial ultrasound report suggested two different diagnoses i.e. omphalocoele and gastroschisis. Later, diagnosis of congenital megalourethra was made on detailed ultrasound examination by our fetal medicine consultant. Postnatal gross and ultrasonographic examination confirmed the prenatal diagnosis. In the present case report, we have emphasized proper perineal anatomical ultrasound examination which revealed a megalourethra. Although this anomaly is not lethal in isolation, but it has worse prognosis in presence of other associated structural anomalies. This anomaly also raises the controversy regarding disclosure of sex of foetus in countries like India where sex disclosure is prohibited by law. As this condition typically affects male foetuses and significantly affects sexual function, it may be necessary to reveal fetal sex for appropriate counselling and prognostication to prospective parents. Ethical dilemma arises for practising clinicians while dealing with isolated forms of megalourethra whether to offer termination of pregnancy on the grounds of having significant impact on sexual life due to erectile dysfunction. Anorectal malformation is often associated with megalourethra, although suspected in the present case, can be difficult to identify antenatally prior to 20 weeks (the time limit up to which legal termination can be performed in India). These issues have been highlighted in the present report