Obstetric hysterectomy, still a life saving tool in modern day obstetrics: a five year study

Background: Objective of current study was to study the indications and maternal outcome of emergency obstetric hysterectomy and its role in reduction of maternal morbidity and mortality in complicated obstetric cases.Methods: A prospective study of the cases of emergency obstetric hysterectomy performed over a period of five years from 2009 to 2013 was done.Results: During the study period, 105 emergency obstetric hysterectomies were performed giving an incidence of 0.54% .The incidence of hysterectomy following vaginal delivery was 0.54% and that of caesarean hysterectomy was 2.08%. It was most common in the age group 26-35 years (66.66%) and in women of parity 3-4 (71.42%).Rupture uterus was the most common indication accounting for 59.04% cases followed by Atonic PPH (18.09%). Febrile illness and wound infection were the two most common co-morbidities. Maternal mortality was 5.71%.Conclusions: Emergency obstetric hysterectomy is potentially a life saving procedure which every obstetrician must be familiar with in cases of catastrophic rupture uterus and intractable haemorrhage. With the help of prostaglandins, modern policies of active management of labor, timely performance of caesarean section, internal iliac artery ligation, compression sutures etc. obstetric hysterectomy should be made a more rare procedure

Visual inspection with acetic acid for cervical cancer screening in a tertiary health care centre

Background: Cervical cancer is one of the most prevalent malignant neoplasms among women in developing countries. Invasive cervical cancer is preceded by a long premalignant phase known as cervical intraepithelial neoplasia (CIN). The goal of cervical cancer screening is the detection and treatment of precancereous lesions before cancer develops. The objective of the study was to assess visual inspection with acetic acid (VIA) as a screening tool for use in a well-equipped health center , to evaluate VIA as an alternative or adjunct to the Papanicolaou (Pap) smear, and to determine if VIA can play a role in settings other than low resource ones.Methods: This was a prospective study of 1520 asymptomatic women, carried out in 2014-2015. The study was performed at a tertiary care center equipped with the latest-generation technology and highly trained oncologists. The women underwent a complete clinical evaluation, including a Pap smear and VIA. Participants with any positive test were referred for colposcopy and biopsy.Results: More women tested positive by VIA than on the Pap smear (6.9% vs. 4.2%; P =0.0001). There were 27 women with histologic cervical intraepithelial neoplasia grade 1 (CIN1); of these, 12 were detected by Pap and 15 by VIA (P = 0.4). A diagnosis of CIN 2 or 3 (CIN2–3) was confirmed in a total of 11 cases; Pap detected 4 of the cases and VIA 9 of the cases (P = 0.06). The positive predictive value for detection of CIN 2+ was 8.5% for VIA and 6.2% for Pap (P = 0.5). Most importantly, while only 2.8% of patients with a positive VIA were lost to follow-up before colposcopy that was true for 26.5% of the women with a positive Pap smear (P < 0.0001).Conclusions: VIA is useful for detection of precursor lesions of cervical cancer not only in low-resource settings but also in well-equipped health centers and cancer centers. In these non low-resource settings, VIA has a positive predictive value comparable to the conventional Pap smear, but it is more likely to achieve earlier diagnosis, follow-up, and treatment than cytology based screening

IL2 Inducible T-cell Kinase, a Novel Therapeutic Target in Melanoma

Interleukin-2 inducible T-cell kinase (ITK) promoter CpG sites are hypomethylated in melanomas compared to nevi. The expression of ITK in melanomas, however, has not been established and requires elucidation

Monitoring land use/land cover change and high-altitude vegetation trends along with their climatic controls across the Central and Eastern Himalayas

Monitoring the spatial pattern of vegetation growth trends is important in the Central and Eastern Himalayas as many ecosystems in the Himalayas are sensitive to climatic change. The human-induced land use/land cover (LULC) changes are the potential driving forces for changes in ecosystems. This study employed MODIS (MCD12Q1) product to quantify the spatial pattern of LULC from 2001 to 2019. The long-term vegetation datasets (NDVI3g) (1982-2015) were utilized to estimate vegetation trends and climatic variables (e.g., precipitation, soil moisture, temperature, solar radiation) trends. The Mann-Kendall (τ) test and Theil-Sen’s slope were deployed for computing trends over vegetation (e.g., forests, shrublands, savannas, croplands, and grassland). The results showed a prominent large-scale greening trend of croplands (77% of area) and forests including shrublands, savannas, and grassland (42% of area), mostly across the Central (Nepal) Himalayas. The browning trends of forests were also evident, especially over the Eastern Himalaya (Bhutan). The greening trends of vegetation were mainly associated with climatic factors like precipitation and soil moisture, and the corresponding correlation coefficients (r) were 0.69 and 0.28, respectively at p-value ̼ 0.001. Additionally, temperature control on vegetation was found at higher elevation zones of the Central and Eastern Himalayas (r = 0.93, p-value ̼ 0.001), whereas browning trends of vegetation occurred due to temperature-induced moisture stress along with the decreasing trends of solar radiation, and a profound impact was seen over Bhutan. Human-induced land-use change (e.g., shifting cultivation, deforestation) was also attributed to declining vegetation growth since an increase in built-up area was noticed that mainly replaced the croplands and barren land over the study regions. Therefore, the quantification of vegetation trends is important for understanding and managing agriculture and forests ecosystems located in the high-altitude zone, and attention from ecologists and policymakers is required to monitor and manage vegetation in the Himalayas

Pattern of sexually transmitted infections and reproductive tract infections in women of reproductive age group attending sexually transmitted infections clinic at a tertiary care hospital

Background: Sexually transmitted infections are public health problems, which significantly increase the risk of HIV transmission. A proper understanding of pattern of STIs in different socio demographical areas is important for proper planning of STI control. Reproductive tract infection is caused by sexually transmitted disease and other routes and they are being recognized as a serious public health problem. RTIs cause suffering to both men and women, but their consequences are far more devastating and widespread among women. To describe socio demographic factors related to reproductive tract infections in females of reproductive age group attending STI clinic at obstetrics and gynecology department, GSVM medical college Kanpur.Methods: A cross sectional study was carried out at STI clinic of Department of Obstetrics and Gynecology from 1 January 15-31 December 2016. Data on variables like age, socioeconomic status, habitat, marital status was collected and all symptomatic and asymptomatic women were counselled for examination and investigations and were given syndromic treatment.Results: Out of the 4963 women surveyed, 69% were married, 76% belong to 25-35 age group. Laboratory diagnosed RTI were HIV 1.52%, candidiasis 14.65%, chlamydial infections 27.32%, PID 31.50%, syphilis 0.02%. After syndromic management, prevalence of RTI has significantly reducedConclusions: Syndromic treatment and health education can definitely reduce STIs and RTIs

Proteomics insights into the fungal-mediated bioremediation of environmental contaminants

As anthropogenic activities continue to introduce various contaminants into the environment, the need for effective monitoring and bioremediation strategies is critical. Fungi, with their diverse enzymatic arsenal, offer promising solutions for the biotransformation of many pollutants. While conventional research reports on ligninolytic, oxidoreductive, and cytochrome P450 (CYP) enzymes, the vast potential of fungi, with approximately 10 345 protein sequences per species, remains largely untapped. This review describes recent advancements in fungal proteomics instruments as well as software and highlights their detoxification mechanisms and biochemical pathways. Additionally, it highlights lesser-known fungal enzymes with potential applications in environmental biotechnology. By reviewing the benefits and challenges associated with proteomics tools, we hope to summarize and promote the studies of fungi and fungal proteins relevant in the environment