Role of Prostaglandins in Pathogenesis of Dysmenorrhea and Place of Mefenamic Acid and Dicyclomine in its Management

Despite being one of the most common gynecological issues faced by women of reproductive age, dysmenorrhea largely remains an ignored, underdiagnosed and untreated condition. It continues to be a public health issue and has a significant impact on the quality of life of the affected women in terms of inability to lead routine activities, absenteeism from academic activities or work and reduced social activities. Currently, existing evidence correlates and implicates the excessive synthesis of prostaglandins with the menstrual pain. Hence, treatment approaches that can inhibit prostaglandins\u27 production or already formed prostaglandins can provide relief in dysmenorrhea. In this review, the impact of dysmenorrhea on the quality of life of women, the role of prostaglandins in the pathogenesis of dysmenorrhea, and how nonsteroidal anti-inflammatory drugs (NSAIDs) like mefenamic acid can be safe and effective in managing dysmenorrhea are discussed

NLRP3 Inflammasome in the Pathogenesis of Dysmenorrhea and Role of Mefenamic Acid as its Inhibitor

While the role of prostaglandin as a trigger in dysmenorrhea is well known, not many are aware that inflammation and nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome are also implicated in primary dysmenorrhea (PD). Inhibition of NLRP3 inflammasome and inflammation pathways is an important approach to treating dysmenorrhea and also the symptoms of premenstrual syndrome. Mefenamic acid is an effective and selective inhibitor of the NLRP3 inflammasome, which can be considered the most important option for PD treatment owing to its action via various pathways. In this article, the authors have reviewed the role of inflammation and NLRP3 inflammasome in causing PD, how inhibitors of NLRP3 inflammasome can treat dysmenorrhea and the mechanism of action of mefenamic acid as NLRP3 inflammasome inhibitor and its role in PD

Prediction of efficacy of gonadotropin releasing hormone agonist trigger for final oocyte maturation through post-trigger 12-hour luteinizing hormone, follicle stimulating hormone and progesterone levels in COS: a prospective study

Background: Circulating levels of luteinizing hormone (LH), follicle stimulating hormone (FSH) and progesterone (P4) in serum after administration of gonadotropin releasing hormone agonist (GnRHa) trigger for final oocyte maturation are found to be predictive of oocyte maturity. This prospective study was conducted at a tertiary care centre to evaluate relationship between serum LH, FSH and P4 levels at 12-h post-trigger and oocyte maturity rate and to predict which hormone has maximum sensitivity and specificity for appropriate oocyte maturation.Methods: Women at risk of ovarian hyper-stimulation syndrome who underwent either autologous or donor IVF cycle treated with flexible GnRH antagonist protocol were taken as participants of the study. GnRHa as trigger for final oocyte maturation was given. After 12 hours of agonist trigger, blood sample was drawn to assess LH, FSH and P4 levels in serum. Continuous variables were expressed as mean±SD. Independent sample t test was used for continuous variables which were normally distributed and Mann-Whitney U test for data not normally distributed. Main outcome measures were number of oocytes retrieved, oocyte maturity rate, fertilization rate, cleavage rate and grade of embryos.Results: There was a statistically significant reduction in number of retrieved oocytes, maturity rate, fertilization rate and grade 1 embryos with a concentration of serum LH and P4 less than the cut off value (p < 0.05).Conclusions: Serum LH and P4 level less than the cut off value at 12-hour post-trigger with GnRHa is associated with a dramatically less oocyte maturity rate and fertilization rate

Peri conceptional association of the triad of hyperhomocsteinemia, hypothyroidism and impaired carbohydrate metabolism with recurrent pregnancy loss

Background: Recurrent pregnancy loss is a cause of great concern to the affected couple as well as the treating physician. We evaluated the periconceptional association of the triad of hyperhomocystienemia, hypothyroidism, and impaired carbohydrate metabolism with RPL and to identify the potential risk factors for RPL which are probably nutritional.Methods: Seven hundred ninety-six consecutive pregnancies with two or more abortions referring to our Infertility clinic were selected to be studied in a descriptive, prospective observational study in 2012-2014. All the pregnant women were subjected to routine blood tests/ examination/ imaging as per hospital protocols. All underwent TSH, FT4, GTT 75 gm (fasting and 2 h postprandial) as per routine antenatal workup. Additionally, fasting plasma homocysteine, antinuclear antibody, anti phospholipid antibody, anti- thyroid peroxidase antibody tests were performed for patients with RPL. All the patients were studied for the triad of hypothyroidism, hyperhomocysteinemia and impaired carbohydrate metabolism.Results: The incidence of RPL was found to be 5.65 %. Majority of women (51.1%) were in the age group 30-34 years. Majority of the women (55.6%) had 2 previous abortions. Majority of women (57.7%) had conceived normally. Majority of women (46.7%) had BMI<25. PCOS was reported in 28.9% women. HHcy, hypothyroidism and impaired carbohydrate metabolism was found in 78%, 73% and 73% women, respectively. The presence of two factors was reported in 60 to 65% women. 56% women reported the presence of the triad. About 7% of the patients underwent repeat abortion in second trimester of which 66.6% had the association of triad.Conclusions: Investigating these three factors in patients with RPL would help in early recognition, monitoring, and aggressive surveillance, which will help prevent obstetric complications. Simple nutritional correction may allow for better maternal and fetal programming and appropriate risk modulation

Impact of Innovations in Value Chain on Sorghum Farmers

The paper has studied the implementation of millets value chain pilot project under the NAIP to create demand for sorghum through diversification in farm production, procurement, ultimately aiming at economical benefits to both farmers and other stakeholders. This 4.5 years novel initiative is still in the mid-way. The study has reported that technological backstopping of sorghum cultivation with end-product specific improved cultivars has realized 51 per cent rise in incremental net income of Rs 16098/ha for the participating farmers (58 per cent rise in kharif and 44 per cent in rabi farmers). The inconvenience in the preparation of sorghum foods which has been the important reason for the decrease in its consumption, has been eliminated through development of convenient and ready-to-eat/cook foods. The factorization of the investment expenditure made per farmer (one acre of sorghum per participating farmer) has been worked out to be Rs 356 (equivalent of Rs 890/ha) in a season resulting in 51 per cent rise in incremental net income over baseline which is slightly higher in kharif sorghum than in rabi sorghum. The output pricing in kharif has helped in attaining these benefits. However, the benefit-cost ratio has worked out in favour of rabi sorghum farmers, i.e. 1:7.5 vis-à-vis kharif farmers BC ratio of 1: 4.2. The study has observed that linking up of the entire stakeholders through value addition throughout the value chain system would renew and uplift the diminishing sorghum area and production and its ultimate economical benefits to farmers and other stakeholders in the value chain.Agricultural and Food Policy,

Evaluation of road safety audit implementation on interurban expressway

The main aim of the road infrastructure development is to provide seamless travel with safety. At the same time, it is very much necessary to make sure that the developed roads are safe in operation. In this direction, the New Okhla Industrial Development Authority (NOIDA) has given due consideration to assess the safety scenario on the project corridor and hence conducted Road Safety Audit (RSA) of the Noida Expressway starting from 0.00 km to 20.00 km through an independent team of experts in the year 2013. The audit team recommended host of measures to improve the road geometrics and safety features to the authority which has been largely implemented by stakeholder. As it is known that Safety Audit (RSA) is a formal examination of the proposed or existing roads and road related areas from the perspective of all road users with the intention of identifying road safety deficiencies and areas of risk that could lead to road crashes. Subsequent to the implementation of the recommended RSA measures it is worthwhile to understand whether the recommended measures have facilitated in enhancing road safety by comparing road accidents. In this paper, analysis is carried out after two years to know how the countermeasures working on the field and up to which extend these are showing effect in reduction of crashes. Minimum of two-year accident data is required to calculate the reduction factors. To know the impact of safety features on road accidents by using CRF value will be used as measure to judge the road investments as the safety improvements are highly economical, to see the investments carried out on the safety implementation

PHYTOCHEMICAL, PHARMACOLOGICAL AND BIOLOGICAL PROFILES OF TRAGIA SPECIES (FAMILY: EUPHORBIACEAE)

Background: Tragia belongs to the family Euphorbiaceae which contains about 152 species. Interestingly, most of the earlier investigations have been done using only five Tragia species, namely, Tragia involucrata, Tragia cannabina, Tragia spathulata, Tragia plukenetii, and Tragia benthamii. The objective of the present review is to compile the phytochemical, pharmacological and biological studies of the selected five Tragia species reported in the literature. Methods: The reported data/information was retrieved mainly from the online databases of PubMed (MEDLINE), EMBASE and Botanical Survey of India. Results: The present review elaborated the phytochemical, pharmacological and biological properties of the selected five Tragia species obtained from recent literature. Conclusion: This review provides a basis for future investigation of Tragia species and, especially for those species that have not been explored for biological and pharmacological activities

Evaluation of Cartosat-1 Multi-Scale Digital Surface Modelling Over France

On 5 May 2005, the Indian Space Research Organization launched Cartosat-1, the eleventh satellite of its constellation, dedicated to the stereo viewing of the Earth's surface for terrain modeling and large-scale mapping, from the Satish Dhawan Space Centre (India). In early 2006, the Indian Space Research Organization started the Cartosat-1 Scientific Assessment Programme, jointly established with the International Society for Photogrammetry and Remote Sensing. Within this framework, this study evaluated the capabilities of digital surface modeling from Cartosat-1 stereo data for the French test sites of Mausanne les Alpilles and Salon de Provence. The investigation pointed out that for hilly territories it is possible to produce high-resolution digital surface models with a root mean square error less than 7.1 m and a linear error at 90% confidence level less than 9.5 m. The accuracy of the generated digital surface models also fulfilled the requirements of the French Reference 3D®, so Cartosat-1 data may be used to produce or update such kinds of products

Increases in intracellular calcium perturb blood–brain barrier via protein kinase C-alpha and apoptosis

An increase in intracellular calcium represents one of the early events during an ischaemic stroke. It triggers many downstream processes which promote the formation of brain oedema, the leading cause of death after an ischaemic stroke. As impairment of blood–brain barrier (BBB) accounts for much of oedema formation, the current study explored the impact of intracellular calcium on barrier integrity in relation to protein kinase C, caspase-3/7, plasminogen activators and the pro-oxidant enzyme NADPH oxidase. Human brain microvascular endothelial cells alone or in co-culture with human astrocytes were subjected to 4 h of oxygen–glucose deprivation alone or followed by 20 h of reperfusion (OGD ± R) in the absence or presence of inhibitors for urokinase plasminogen activator (amiloride), NADPH oxidase (apocynin), intracellular calcium (BAPTA-AM) and protein kinase C-α (RO-32-0432). Endothelial cells with protein kinase C-α knockdown, achieved by siRNA, were also exposed to the above conditions. BBB permeability was measured by transendothelial electrical resistance and Evan's blue-albumin and sodium fluorescein flux. Intracellular calcium and total superoxide anion levels, caspase-3/7, NADPH oxidase, plasminogen activator and protein kinase C activities, stress fibre formation, the rate of apoptosis and BBB permeability were increased by OGD ± R. Treatment with the specific inhibitors or knockdown of protein kinase C-α attenuated them. This study reveals successive increases in intracellular calcium levels and protein kinase C-α activity are key mechanisms in OGD ± R-mediated impairment of BBB. Furthermore inhibition of protein kinase C-α may be therapeutic in restoring BBB function by reducing the rate of cytoskeletal reorganisation, oxidative stress and apoptosis