Hysteroscopy versus transvaginal ultrasonography: finding the better modality for evaluation of postmenopausal bleeding

Background: The most common cause of postmenopausal bleeding is benign pathology, but likelihood of malignancy must be promptly excluded. As excision of localized lesion has higher disease-free survival rate and lower morbidity as opposed to treatment for regional-stage disease. Commonly employed blind dilatation and curettage followed by histopathology is the current standard. A screening method with high sensitivity and specificity can help to prevent the invasive procedure and can also improve the accuracy of the biopsy. The objective of the present study was to study and compare the diagnostic accuracy of hysteroscopy and transvaginal ultrasonography in diagnosis of postmenopausal bleeding.Methods: 80 female patients with complaints of postmenopausal bleeding were enrolled and followed up for a period of 10 months. Each patient underwent transvaginal ultrasonography and hysteroscopy followed by endometrial biopsy. Result were analyzed to find sensitivity, specificity, accuracy, PPV and NPV taking histopathological diagnosis as gold standard.Results: Authors found that in 40 patients (50%), the cause of post-menopausal bleeding was caused atrophic endometrium followed by endometrial hyperplasia seen in 14 patients (17.5%). Hysteroscopy had higher overall sensitivity, specificity, NPV and accuracy as compared to transvaginal ultrasonography. Hysteroscopy was found to be highly accurate in diagnosing endometrial carcinoma (100%) and endometrial polyps (100%). However, both methods showed similar accuracy (97.5%) in diagnosis of proliferative endometrium and hyperplasia.Conclusions: Hysteroscopy is comparable to histopathology and superior to transvaginal sonography in the diagnosis of intrauterine causes for postmenopausal bleeding, it also offers the possibility of visualizing macroscopic or focal intra-uterine abnormalities

Do sub-groups of butterflies display different elevational distribution patterns in the Eastern Himalaya, India?

Understanding the pattern of biodiversity along environmental gradients helps in identifying diversity hotspot areas that can be prioritized for conservation. While the elevational distribution of several taxa has been studied, responses of the sub-groups within a taxon to elevation and its associated factors are not properly understood. Here we study species richness and butterfly density along an elevation gradient in Sikkim, Eastern Himalaya, India and explore the underlying causes of the patterns. We sampled butterflies using a fixed-width point count method in 16 elevational bands (150–200 m intervals), between a range of 300 and 3300 m a.s.l. We categorized butterflies into various sub-groups based on family, range size, biogeographic affinity, and host-plant specialization. We recorded 3603 individuals and 253 species of butterflies after the completion of 1860 point counts. Overall, species richness in the majority of the sub-groups (except for Riodinidae and Palearctic species) declines with elevation, as does the density of almost all the sub-groups. From a selection of environmental factors, annual actual evapotranspiration has the strongest effect on the species richness pattern of butterflies as well as on the density of the overall butterfly community, especially the Lycaenidae family. The richness and density of butterfly groups display varied responses to the richness and density of trees and shrubs. The conducive climatic conditions and diverse habitats in the lower valleys of the Eastern Himalaya support a high diversity of butterflies (with majority of small range species) and thus warrants conservation attention.publishedVersio

THE BIRDS OF SIKKIM: AN ANALYSIS OF ELEVATIONAL DISTRIBUTION, ENDEMISM AND THREATS

ABSTRACT 2 ikkim, a small state (geographical area 7096 km ) located in the northeast part of India, is a paradise for ornithologists. Many explorers and scientists including famous ornithologist Salim Ali visited Sikkim for study S purpose. Most of the publications are based on taxonomy and systematics except a few recent ecological studies. We generated a database of birds of Sikkim based on literature and field studies during 2003-2006 with special reference to elevational distribution, endemism and threat. The state was divided into six zones based on vegetation types and altitudes. Generated database of birds of Sikkim shows a total of 574 species belonging to 253 genera and 55 families under 16 avian orders. Along the elevation gradient, species richness followed unimodal pattern with maximum species at mid-elevation zone. The number of habitat specialist (species occurring in single elevation zone) are more in the lowest and highest zones. A high turnover of species was observed along the elevation gradient with a few species showing wider distribution range. Ten eastern Himalayan endemic species are reported to occur in Sikkim. Of the total species, 17 are threatened (1 Endangered, 3 Critically Endangered and 13 Vulnerable) and 10 near threatened bird species. It is suggested that further study on birds of Sikkim should focus on ecology and habitat requirements of individual species especially of rare, threatened and endemics

Capillary haemangioma of fallopian tube: a rare but dangerous incidental finding

Haemangiomas are tumors of vascular origin. They are frequently observed in soft tissue and skin. Vascular tumors of female pelvic organs are extremely rare. Although, majority of these lesions are detected incidentally, they can mimic various benign and malignant lesions clinically and radiologically. Fallopian tube capillary haemangioma is very rare benign neoplasm. Only one case of capillary haemangioma of fallopian tube has been reported. A 44-year-old female with menorrhagia, underwent hysterectomy with bilateral salpingoopherectomy. Both the fallopian tubes were grossly unremarkable. Microscopic examination revealed a well circumscribed vascular neoplasm, consistent with capillary haemangioma, CD34 immunostaining highlighted the vascular endothelium.  Although benign in nature, haemangioma of the fallopian tube can present with complications. Rupture of the haemangioma can be lethal when present with hemoperitoneum

Otpornost bakterija Escherichia coli i Pseudomonas aeruginosa na karbapenem u antilope (Antilope cervicapra) i leoparda (Panthera pardus) iz zatočeništva u Indiji

The study aimed to investigate the occurrence of carbapenem resistant E. coli and P. aeruginosa in apparently healthy, captive blackbucks and leopards of India. Faecal samples of blackbucks (n = 7) and leopards (n = 7) were processed to isolate carbapenem resistant E. coli (CRE) and P. aeruginosa (CRP). Forty (leopards n = 26; blackbuck n = 14) E. coli and two P. aeruginosa (blackbuck n = 2) samples were isolated from the faecal samples (n = 14). Eleven carbapenem resistant isolates were recovered, of which 10 were CRE and one was CRP. The minimum inhibitory concentration (MIC) was determined for meropenem for carbapenem resistant isolates and was between 8 and 64 μg/mL. All the CRE and CRP were phenotypically multidrug resistant, and six CRE were extended-spectrum beta- lactamases (ESBL) producers. On genotypic screening, seven CRE and one CRP were positive for the blaNDM carbapenemase gene. Efflux pump-mediated carbapenem resistance was noticed in four CRE isolates (36.4%, 4/11). Of the six ESBL producing CRE, four isolates carried blaCTX-M-1 genes. The CRE isolates also harbored blaTEM-1, blaAmpC, qnrA, qnrB, qnrS, tetA, tetB and sul1 resistance genes. On Shiga toxin virulence screening, Stx1, Stx2 genes were detected in two and one isolates, respectively. Plasmid typing of CRE revealed that the blaNDM genes were carried on an Incl1 plasmid. The plasmid multilocus sequence typing (pMLST) of the isolates showed the Sequence Type (ST) 297. The occurrence of carbapenem resistance bacteria in captive wildlife should be a major public health priority.Cilj rada bio je istražiti slučajeve otpornosti bakterija E. coli i P. aeruginosa na karbapenem u zdravih antilopa i leoparda iz zatočeništva u Indiji. Uzorci izmeta antilopa (n = 7) i leoparda (n = 7) obrađeni su kako bi se izolirale bakterije E. coli (CRE) i P. aeruginosa (CRP) otporne na karbapenem. Iz uzoraka izmeta (n = 14) dobiveno je 40 izolata (leopard n = 26, antilopa n = 14) E. coli i 2 izolata P. aeruginosa (antilopa n = 2). Pronađeno je 11 izolata otpornih na karbapenem, od kojih je 10 E. coli i 1 P. aeruginosa. Određena je minimalna inhibicijska koncentracija (MIK) za meropenem za izolate otporne na karbapenem, od 8 za E. coli i 64 μg/mL za P. aeruginosa. Svi izolati E. coli i P. aeruginosa fenotipski su bili otporni na širok spektar lijekova, a 6 izolata E. coli proizvodilo je beta- laktamaze širokog spektra (ESBL). Genotipskim probirom 7 izolata E. coli i 1 izolat P. aeruginosa bili su pozitivni na karbapenemaza gen blaNDM. Otpornost na karbapenem putem efluks pumpe zabilježena je u 4 izolata E. coli (36,4 %, 4/11). Od 6 ESBL producirajućih CRE, 4 izolata nosila su gen blaCTX-M-1. Izolati E. coli također su sadržavali blaTEM-1, blaAmpC, qnrA, qnrB, qnrS, tetA, tetB i sul1 gene otpornosti. Pretragom na šiga-toksin, Stx1 i Stx2 geni utvrđeni su u dva odnosno jednom izolatu. Tipiziranje plazmida CRE otkrilo je prisutnost blaNDM gena na Incl1 plazmidu. Multilokusno tipiziranje sekvencija plazmida (pMLST) izolata otkrilo je sekvenciju tipa (ST) 297. Pojava otpornosti bakterija na karbapenem u divljih životinja iz zatočeništva trebala bi biti javnozdravstveni prioritet

Zirconium modified pomegranate peel for efficient removal of arsenite from water

We developed a novel biosorbent based on zirconium-modified pomegranate peel (SPP@Zr) for efficient arsenic (As(III)) removal from water. SEM, EDX, XRD, and FTIR were used to characterize the prepared biosorbent. The batch adsorption method was used to evaluate the adsorption viability of biosorbents for the removal of As(III) from water. The EDX analysis of saponified pomegranate peels (SPP) before and after Zr (IV) loading demonstrated that ion exchange was the preferred metal loading technique. As (III) adsorption is very pH-dependent, with the maximum adsorption occurring at pH 8.0. The maximum As(III) adsorption capacity of SPP@Zr was found to be 82.0 mg/g. According to isotherm and kinetic modeling studies, the experimental results fitted well with the Langmuir isotherm and pseudo-second-order kinetic modeling. The spent biosorbent may be easily regenerated and reused using an alkaline solution. Hence, SPP@Zr is proving to be a promising biosorbent for uptake of As (III) from water. BIBECHANA 19 (2022)1-1

Zirconium modified pomegranate peel for efficient removal of arsenite from water

We developed a novel biosorbent based on zirconium-modified pomegranate peel (SPP@Zr) for efficient arsenic (As(III)) removal from water. SEM, EDX, XRD, and FTIR were used to characterize the prepared biosorbent. The batch adsorption method was used to evaluate the adsorption viability of biosorbents for the removal of As(III) from water. The EDX analysis of saponified pomegranate peels (SPP) before and after Zr (IV) loading demonstrated that ion exchange was the preferred metal loading technique. As (III) adsorption is very pH-dependent, with the maximum adsorption occurring at pH 8.0. The maximum As(III) adsorption capacity of SPP@Zr was found to be 82.0 mg/g. According to isotherm and kinetic modeling studies, the experimental results fitted well with the Langmuir isotherm and pseudo-second-order kinetic modeling. The spent biosorbent may be easily regenerated and reused using an alkaline solution. Hence, SPP@Zr is proving to be a promising biosorbent for uptake of As (III) from water. BIBECHANA 19 (2022)1-1

Molekularna karakterizacija iz psa izdvojenog izolata bakterije Escherichia coli koji proizvodi prošireni spektrum beta-laktamaza i New Delhi metalo-beta-laktamazu-1 (blaNDM1) - prikaz slučaja

In this article, we report the molecular characterization of extensively drug resistant (XDR), extended spectrum, class C beta-lactamases and NDM-1 carbapenemase producing E. coli, isolated from the scrotal fluid of a 3-year-old male dog. In an antibiotic susceptibility test the E. coli isolate was susceptible only to tigecycline and resistant to all clinically applicable antibiotics tested in the study. The minimum inhibitory concentration (MIC) of meropenem, cefotaxime and cefepime was 256, 128 and 64 µg/mL, respectively. On genotypic screening by PCR, the isolate was positive for blaNDM, blaCTX-M, blaAmpC, blaTEM and sul1 genes. The isolate was a ESBL, AmpC and metalo beta-lactamase producer. On molecular pathotyping, the isolate harbored the Shiga toxin producing gene (Stx2). The extensively drug resistant, carbapenem resistant and ESBL producing E. coli constitutes a major public health concern, since there is a great chance of dissemination of resistance genes to humans due to the close association of humans and companion animals. To the best of our knowledge, this is the first report of blaNDM1 isolated from a dog in India.U radu se izvješćuje o molekularnoj karakterizaciji bakterije E. coli izdvojene iz skrotalne tekućine psa, iznimno otporne na antibiotike širokog spektra, koja proizvodi klasu C beta-laktamaza i NDM-1 karbapenemazu. Pas je bio u dobi od od tri godine. Izolat E. coli bio je osjetljiv samo na tigeciklin, a otporan na sve antibiotike primjenjivane u kliničkoj praksi. Minimalna inhibicijska koncentracija (MIC) za meropenem iznosila je 256, cefotaksim 128 i cefepim 64 µg/mL. Pretragom genotipa lančanom reakcijom polimerazom izolat je bio pozitivan na gene blaNDM, blaCTX-M, blaAmpC, blaTEM i sul1. Proizvodio je ESBL, AmpC i metalo-beta-laktamazu. Molekularnom patotipizacijom dokazano je da posjeduje gen za shiga-toksin (Stx2). E. coli otporna na karbapenem, koja proizvodi beta-laktamaze širokog spektra, velika je prijetnja za javno zdravstvo s obzirom na to da postoji velika mogućnost prijenosa E. coli s genom za rezistenciju na ljude u bliskom dodiru s kućnim ljubimcima. Ovo je prvo izvješće o blaNDM1 dokazanom u psa u Indiji