Effectiveness of different plant extracts against Galleria mellonella larvae in laboratory

The present investigation was undertaken to study the effectiveness of different plant extracts against Galleria mellonella larvae in laboratory. Acetone prepared extracts of leaves, stem, seed, root, husk of thirteen medicinal and healthy plants were used to examine their effects on the mortality of the greater wax moth Galleria mellonella larvae in laboratory.  Results revealed that only six plant extracts prepared with leaves and stem cause mortality of wax moth. Larval mortality was highest (93.33%) with husk prepared extract of P. psyllium followed by leaf prepared extract of H. sativum (80%), Raphanus sativus (73.33%), Linum usitatissimum (66.66%) Cucurbita moschata (46.66%) and Vicia sativa (46.66%). The larval mortality with stem/root/seed prepared extract was recorded highest in Hordeum sativum (73.33%) followed by Raphanus sativus (80%), Cucurbita moschata (60%)  Linum usitatissimum (53.33%) and Vicia sativa (40%) and found significant difference with the control (0.00%). There was no mortality of larvae was found in control and other remaining plant extract. Irrespective of the different plants, highest per cent mortality (52.22%) of wax moth larvae by stem/seed/ root prepared extract followed by leaf extract (48.66). Therefore, the plant extract of different plants were found effective against Galleria mellonella larvae

Role of selective progesterone receptor modulators in the treatment of symptomatic uterine fibroids

Background: Uterine leiomyomas are benign tumours of smooth muscle cells and fibrous tissue that develop within the wall of the uterus. Objective of this study was to compare efficacy and safety of Mifepristone and Ulipristal acetate in the treatment of symptomatic uterine fibroids.Methods: The present randomized comparative prospective study was conducted among 120 non-pregnant and non-lactating females of age 25-50 years with symptomatic fibroids reported in the department of obstetrics and gynecology, Chhatrapati Shivaji Subharti Hospital, Meerut, Uttar Pradesh for a duration of 2 years from September 2017 to July 2019.The selected subjects were divided into two treatment arms i.e. Group 1: ulipristal acetate: 5 mg OD for 3 months and Group 2: mifepristone: 25 mg OD for 3 months. Detailed history of the patient, general physical examination and systemic examination was done followed by per abdomen examination, per speculum and per vaginal examination. A blood examination, USG (pelvis), Pap smear and endometrial biopsy was done. Subjects visited the hospital at visit 1, visit 2, visit 3, visit 4, visit 5 and visit 6 for 6 months.Results: In both the groups, maximum subjects were in the age group of 36-40 years, followed by 41-50 years. When mean PBAC score at first, second, third, fourth and fifth visit was compared statistically among ulipristal acetate and mifepristone group, it was found to be statistically significant. Uterine pain was reduced more in mifepristone group as compared to ulipristal acetate group at all the different intervals. Size was reduced more in mifepristone group as compared to ulipristal acetate group at all the different intervals.Conclusions: Authors conclude from this study that mifepristone should be preferred over ulipristal acetate for treatment of symptomatic fibroids

Study of anemia in hypothyroid pregnant patients

Background: Hypothyroidism and anemia in pregnancy causes significantly high maternal and fetal morbidity and mortality. Aim of this study was to determine the prevalence of anemia, grade and type of anemia in hypothyroid pregnant patients.Methods: This prospective study was conducted at department of obstetrics and gynecology, CSSH, Meerut, Uttar Pradesh over a period of 2 years from August 2017 to August 2019. Patients who attended the OPD during the study period were included in the study according the inclusion criteria and were studied for the clinical profile, obstetric history and detailed examination. Investigations were done including hemoglobin, blood grouping, urine routine, HbsAg, Anti-HCV, HIV, RBS and serum TSH. The women with raised serum TSH, indicating hypothyroidism, test for free T3, free T4 and anti-TPO was done, and the hypothyroid females with anemia were further investigated with GBP for the type of anemia, data evaluated with adequate statistical analysis.Results: A total 223 patients, enrolled in the study, prevalence of anemia in hypothyroid patients was 69.95%. Most patients with overt hypothyroidism had mild anemia 26 (68.4%), while in sub-clinical hypothyroid patients’ group most of the patients had moderate anemia. In the overt hypothyroid and subclinical hypothyroid group dimorphic anemia was the most prevalent form of anemia with 52.6% and 74.6% respectively.Conclusions: Prevalence of anemia in hypothyroid pregnant patients is 69.95%. Dimorphic anemia is most prevalent; hence it is important to study anemia in antenatal patients with hypothyroidism and appropriate strategies should be used to prevent and treat anemia

Comparison of ease of insertion, visibility of strings and continuation rate of post-partum intrauterine copper device insertion by long inserter versus with the help of Kelly’s forceps

Background: The objective of the study was to compare ease of insertion, visibility of strings and continuation rate of post-partum intrauterine copper devices (PPIUCD) insertion by long inserter versus with the help of Kelly’s forceps.Methods: 100 women were enrolled in our study which was conducted in department of obstetrics and gynecology, Subharti medical college and Chattrapati Shivaji Subharti hospital (CSSH), Meerut over a period of 2 years between November 2018 and August 2020. In study comparison was done on insertion technique of PPIUCD.Results: High fundal placement was achieved with long inserter. There was no perforation and decreased infection rate among the users with no increase in incidence of side effects and expulsion. Among 50 insertion, 1 woman (2%) had partial expulsion, 2 women (4%) had complete expulsion and 1 woman (2%) got PPIUCD removed on request. Providers reported 100% easier technique. 96% satisfaction among the users.Conclusions: The dedicated long inserter PPIUCD was found to be safe, with high acceptability among the participants and providers. Study revealed the reduced risk of infection and expulsion, providers also reported increased convenience in insertion compared to standard PPIUCD insertion techniques

Prevalence and complications of hypothyroidism during pregnancy in western Uttar Pradesh

Background: This study was designed to know the prevalence of hypothyroidism during pregnancy in western part of Uttar Pradesh and its potential complications. A prospective and comparative clinical study to know prevalence of thyroid disorder in pregnancy and pregnancy outcome was done.Methods: Eight Hundred eighty seven pregnant cases from Department of Obstetrics and Gynaecology, Chattrapati Shivaji Subharti Hospital, Meerut were enrolled in the study from the year 2018 to 2020. Detailed history and physical examination was done. Thyroid Function test (FT3, FT4, TSH and Anti-TPO) were performed after the confirmation of pregnancy. Patients were followed up during entire pregnancy. Thirty seven patients dropped out from the study.Results: In this study, prevalence of thyroid disorder was 27.28% which was high when compared to other regions in India and in other parts of Asia. Subclinical hypothyroidism and Overt hypothyroidism was 16.57% and 10.71% respectively. Subclinical hypothyroidism was more prevalent and hidden, leading to the poor obstetrical outcome and fetal complications. Rate of miscarriage was high in overt hypothyroid patients.Conclusions: Due to the immense impact that the maternal thyroid disorder has on maternal and fetal outcome, prompt identification of thyroid disorders and timely initiation of treatment is essential. Thus, universal screening of pregnant women for thyroid disorder should be considered especially in a country like India where there is a high prevalence of undiagnosed thyroid disorder

Neonatal and fetal effects of antithyroid peroxidase positivity in hypothyroidism in pregnancy - A hospital-based prospective analytical study

Objectives: The objectives of this study were to evaluate the fetal and neonatal outcomes for pregnant women with autoimmune hypothyroidism and to compare them to hypothyroid and euthyroid women. Methods: A total of 309 women were included in the study. 159 hypothyroid women were categorized as “Cases” and 150 euthyroid women were “Controls.” Serum thyroid-stimulating hormone (TSH) was done for all women, and in hypothyroid women, antithyroid peroxidase (TPO) was also done for the mothers. Cases were subdivided on the basis of anti-TPO positivity. Fetal and neonatal complications were noted in all three groups along with basic parameters such as baby weight and Apgar scores. Meconium aspiration, neonatal intensive care unit (NICU) admission, jaundice, intrauterine growth retardation, intrauterine death (IUD), low or very low birth weight, congenital anomalies, hypothyroidism in the newborn, and neonatal death were the parameters noted. Testing of the babies was done with serum TSH on day of life 3 and serum bilirubin whenever clinically jaundice was suspected. The study period was 2 years. Results: Hypothyroidism is significantly associated with an increased risk of IUD (p=0.038), NICU admissions in babies (p=0.004), neonatal jaundice (p=0.027), low or very low birth weight babies (p=0.0003), congenital anomalies in the babies (p=0.026), and neonatal deaths (p=0.007). Anti-TPO positivity is significantly associated with increased risk of IUD (p=0.044) and hypothyroidism in the newborn of hypothyroid mothers (p=0.045). Conclusions: Anti-TPO positivity and hypothyroidism are both significantly associated with certain fetal complications such as IUD, neonatal jaundice, increased NICU admissions, and hypothyroidism in the newborn. Mothers with hypothyroidism who are TPO positive have a higher risk of neonatal mortality and morbidity, although small. Hence, screening should be done in all hypothyroid women in pregnancy and their babies. Universal screening with serum TSH is recommended in pregnancy and in the newborn on day 3 of life

Study of the frequency of female genital tract infection using cartridge based nucleic acid amplification test

Background: The aim of the study was to study the frequency of female genital tract infection using cartridge based nucleic acid amplification test (CBNAAT), to study the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CBNAAT.Methods: This prospective observational study was conducted among 100 patients as per inclusion criteria with genital tract infection in Swami Vivekanand Subharti University, Meerut over a period of two years. Investigations including ZN staining for acid fast bacillus (AFB), endometrial sampling for histopathology, CBNAAT and BACTEC culture were sent.Results: In a study of 100 patients’ histopathological examination detected tuberculosis in 2% patients while CBNAAT detected tuberculosis in 5% patients. Tubercle bacilli was found in 3% women on AFB stain while in only 1%-woman genital tuberculosis was diagnosed by BACTEC culture.Conclusions: Female genital tuberculosis is detected most frequently when a woman presents with unexplained infertility. Newer technologies allow genital tuberculosis to be identified at an earlier stage and enable us to provide treatment. CBNAAT being a sensitive test picked up more cases than histopathology, culture, AFB stain. Hence CBNAAT should be widely used for early detection of female genital tuberculosis

Psycho sexual profile of perimenopausal and post-menopausal women visiting a tertiary care centre

Background: The objective was to study the psychosexual profile of perimenopausal and postmenopausal females visiting a tertiary care centre.Methods: The present study was carried out in the Obstetrics and Gynecological Department of Subharti Medical College and Hospital from July 2013 to June 2015.A questionnaire was made including the questions regarding the various symptoms and problems encountered by both peri and postmenopausal females. A detailed interaction in the form of history and examination was done on a total of 220 patients which included both type of females. They were then given a questionnaire which they filled it by themselves or with assistance from our side. The females in both the groups were then analysed on the presence or absence of a particular symptom and whether the difference was statistically significant or not and the data was analysed using Chi square test.Results: The study showed varied symptoms in both the type of females be it Perimenopausal or post-menopausal. The vasomotor and the psychological symptoms were more common in the perimenopausal females whereas the physical and sexual symptoms were more common in post-menopausal females. Variations from this pattern were also found. The mean age of menopause was found to be 48.3 years with only 1.81% females above 70 years.Conclusions: The perimenopausal and postmenopausal females do undergo many physiological as well as psychological changes that surely affects their social, personal as well as sexual life. Thus they require a lot of care and support and adequate evaluation so that they can be treated well.

Impact of levonorgestrel intrauterine system on metabolic parameters

Background: Hormonal contraceptive is suggested to affect parameters like body mass index, body weight, blood pressure (BP), blood sugar, lipid protein, and liver function test (LFT) but effect of LNG-IUS on those parameters is still uncertain. The aim of the present study was to study the effects of LNG-IUS on the metabolic parameters.Methods: Sixty women who opted for LNG-IUS for various indications were included in the study. Lipid profile, liver function tests (LFT), glucose levels [fasting and post prandial (PP)], and hemoglobin (Hb) were tested. Bimanual genital examination and transvaginal-ultrasonography was done prior to LNG-IUS insertion. Any problems observed were recorded. The subjects were re-evaluated after 6 and 9 months on their subsequent visits. Data were analyzed using paired “t” test. P value of <0.05 was considered statistically significant.Results: Mean age of the patients was 35.5±6.79 years. Maximum number 50 (83.3%) had abnormal uterine bleeding (ovulatory dysfunction, endometrial, iatrogenic, not yet classified) [AUB (OEIN)]. Mean pictorial blood loss assessment chart (PBAC) score of patients was 164.7±56.72 and mean Hb level 11.15±1.75g/dL. LNG-IUS showed no significant adverse effects on anthropometric parameters at 6- and 9-month follow-up. Significant change was seen in total cholesterol (TC), very low-density lipoprotein (VLDL) and high density lipoproteins (HDL) values at follow-up (p<0.0001).Conclusions: In conclusion, amongst Asian population, the LNG-IUS does not have any adverse effects on metabolic parameters, TGs, LDL and blood sugar levels

Role of LNG-IUS in adenomyosis in reproductive age group women: a prospective interventional study

Background: The objective of the present study was to observe the efficacy of LNG-IUS in the treatment of heavy menstrual bleeding and dysmenorrhoea associated with adenomyosis.Methods: LNG-IUS was inserted in forty women between 20-50 years of age presenting with heavy menstrual bleeding and dysmenorrhoea associated with adenomyosis diagnosed on transvaginal ultrasonography and followed up after 1 month, 3 months and 6 months of insertion. Subjective assessment of menstrual blood loss was done by pictorial blood loss assessment chart and dysmenorrhoea was assessed on the basis of universal pain assessment tool and side effects were noted at each visit.Results: Mean patients’ age was between 31-40 years (72.5%) and the follow up duration was 6 months. Significant improvements in dysmenorrhea, HMB and haemoglobin levels were observed. There was no significant change in the uterine volume. The most common side effect was prolonged vaginal spotting (n=26, 65%) and pain abdomen (n=13, 32.5%). LNG-IUS expulsion was observed in 1 patient (n=1, 2.5%). 3 patients underwent hysterectomy (n=3, 7.5%). The overall success rate of LNG-IUS was 82.5%.Conclusions: The LNG-IUS appears to be an effective method in alleviating dysmenorrhoea and heavy menstrual bleeding associated with adenomyosis during 6 months of study. It may be a valuable long-term alternative for the treatment of adenomyosis in young and perimenopausal women and it is a good strategy to reduce the number of hysterectomies in women with adenomyosis