Multiple lipoleiomyoma of the uterine cervix in premenopausal woman: a case report

Leiomyoma is a most frequently occurring benign mesenchymal tumor of monoclonal origin arising from the smooth muscle cells of the uterus. There are different subtypes of leiomyoma based on their morphological features. Lipoleiomyoma is a rare distinct variant of leiomyoma with a heterogenous cut surface comprising soft yellow areas of fatty tissue intermixed with firm rubbery areas of smooth muscle tissue. We report a case of a 35-year-old multipara premenopausal woman who presented with abdominal distension and chronic pelvic pain. Clinical examination gave an initial impression of a teratoma. Multiple large heterogenic cervical masses of varying sizes were noted on ultrasonography. Histopathological examination of the surgical resection specimen revealed multiple mature lipoleiomyomas. This case report is unique due to its occurrence in premenopausal women and its location in the cervix

Interplay of pericentromeric genome organization and chromatin landscape regulates the expression of Drosophila melanogaster heterochromatic genes.

BACKGROUND: Transcription of genes residing within constitutive heterochromatin is paradoxical to the tenets of epigenetic code. The regulatory mechanisms of Drosophila melanogaster heterochromatic gene transcription remain largely unknown. Emerging evidence suggests that genome organization and transcriptional regulation are inter-linked. However, the pericentromeric genome organization is relatively less studied. Therefore, we sought to characterize the pericentromeric genome organization and understand how this organization along with the pericentromeric factors influences heterochromatic gene expression. RESULTS: Here, we characterized the pericentromeric genome organization in Drosophila melanogaster using 5C sequencing. Heterochromatic topologically associating domains (Het TADs) correlate with distinct epigenomic domains of active and repressed heterochromatic genes at the pericentromeres. These genes are known to depend on the heterochromatic landscape for their expression. However, HP1a or Su(var)3-9 RNAi has minimal effects on heterochromatic gene expression, despite causing significant changes in the global Het TAD organization. Probing further into this observation, we report the role of two other chromatin proteins enriched at the pericentromeres-dMES-4 and dADD1 in regulating the expression of a subset of heterochromatic genes. CONCLUSIONS: Distinct pericentromeric genome organization and chromatin landscapes maintained by the interplay of heterochromatic factors (HP1a, H3K9me3, dMES-4 and dADD1) are sufficient to support heterochromatic gene expression despite the loss of global Het TAD structure. These findings open new avenues for future investigations into the mechanisms of heterochromatic gene expression

First Trimester Screening by Ultrasonographic Markers For Prediction of Preeclampsia

Aim- To correlate association of ultrasonographic markers in antenatal patients with subsequent development of preeclampsia Material Method - 131 pregnant women, in first trimester of pregnancy were investigated for their uterine artery Doppler and  placental volume. These patients were followed up till term for the development of preeclampsia. Results: Out of 131 antenatal cases 20.61% developed preeclampsia. Uterine artery Pulsatility index >95th percentile(>2.3) with mean 2.08±0.43(p value 0.0001) predicted pre eclampsia with sensitivity of 51.85% with specificity of 95.19%. Similarly Resistance index of Uterine artery >95th  percentile(>0.8) with mean 0.771±0.084(p value 0.018) predicted pre eclampsia with sensitivity of 48.15% and specificity of 87.50% . Placental Quotient <10th percentile (<0.81) with mean 0.89 (p value 0.0001)predicted pre eclampsia with sensitivity of 40.74% and specificity of 96%.On combining all three ultrasonographic parameters the sensitivity for prediction of preeclampsia was increased to 70.37% with specificity of 86.54%  with PPV of 36.74% % and NPV of 96.34% %. Conclusion: Maternal ultrasonographic markers like Uterine artery PI, RI, Placental Quotient levels vary between normal pregnancies and those that subsequently developed preeclampsia. Thus our study concludes that  first trimester screening with ultrasonographic markershave high sensitivity, specificity and negative predictive value in detection of preeclampsia

Clarithromycin: overview and its current clinical utility in the treatment of respiratory tract infections

Upper respiratory tract infection (URTI) is a common reason for medical consultation all over the world. Streptococcus A (Strep A) and other infections can cause sore throat as well as pharyngitis or tonsillitis. It may also result in post-infection sequelae, including acute post-streptococcal glomerulonephritis, acute rheumatic fever, and rheumatic heart disease.  As a result, there is a need for an antibiotic that is effective, easy to administer, has a favorable sensitivity pattern, and preferably has some additional pharmacodynamic properties that complement the basic antibacterial profile. Clarithromycin is a macrolide antibacterial agent with broad-spectrum activity against respiratory pathogens. It is especially active against atypical Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella spp. It is well absorbed and stable at gastric pH. It is metabolized by the cytochrome P450 enzymes and forms 14-hydroxy clarithromycin, which is more active than the parent compound, especially against Hemophilus influenzae. It acts by preventing protein synthesis by binding to the 50S subunit of bacterial ribosomes. In dosages of 500 to 1000 mg/day for 5 to 14 days, clarithromycin is effective in the treatment of community-acquired upper and lower respiratory tract infections in hospital and community settings. It exerts significant anti-inflammatory, immunomodulatory, and post-antibiotic effects. It provides a viable option for the treatment of community-acquired respiratory tract infections, in both children and adults.  

Local Anesthetic Systemic Toxicity

Local anesthetics are used very often in medicine and dentistry. They have few adverse effects, but the increased use of these drugs has resulted in a higher incidence of local and systemic anesthetic toxicity (LAST). From the initial symptoms to the deleterious effects on cardiac and the central nervous system, LAST is an important consequence of which we should be aware. LAST is known since the introduction and use of local anesthetics; it was originally associated with seizures and respiratory failure. However, in the 1970s, side effects on the heart were also identified, as the fatal cardiac toxicity associated with bupivacaine was discovered in healthy patients. Prevention and safe administration of regional anesthesia remains primary factors in the avoidance of the toxicity of these drugs. When a patient has LAST, treatment should be started immediately to reduce seizures. If there is cardiac arrest, follow ACLS guidelines. Intravenous lipids improve cardiac conduction, contractility and coronary perfusion by removing liposoluble local anesthetic from cardiac tissue

Symmetry of solutions to singular fractional elliptic equations and applications

In this article, we study the symmetry of positive solutions to a class of singular semilinear elliptic equations whose prototype is \begin{align*} (P) \quad \left\lbrace \begin{array}{ll} (-\Delta )^{s}u = \frac{1}{u^\delta } + f(u), \; u>0\quad & \text{ in }\Omega ; \\ u=0 & \text{ in } \mathbb{R}^n\setminus \Omega ,\\ \end{array} \right. \end{align*} where $00$, $f(u)$ is a locally Lipschitz function. We prove that classical solutions are radial and radially decreasing (see Theorem 1). The proof uses the moving plane method adapted to the non local setting. We then give two applications of this main result: Theorem 2 establishes the uniform apriori bound for classical solutions in case of polynomial growth nonlinearities whereas Theorem 3 ensures in case of exponential growth nonlinearities the convergence of large solutions with unbounded energy to a singular solution

Symmetry of solutions to singular fractional elliptic equations and applications

In this article, we study the symmetry of positive solutions to a class of singular semilinear elliptic equations whose prototype is \begin{align*} (P) \quad \left\lbrace \begin{array}{ll} (-\Delta )^{s}u = \frac{1}{u^\delta } + f(u), \; u>0\quad & \text{ in }\Omega ; \\ u=0 & \text{ in } \mathbb{R}^n\setminus \Omega ,\\ \end{array} \right. \end{align*} where $00$, $f(u)$ is a locally Lipschitz function. We prove that classical solutions are radial and radially decreasing (see Theorem 1). The proof uses the moving plane method adapted to the non local setting. We then give two applications of this main result: Theorem 2 establishes the uniform apriori bound for classical solutions in case of polynomial growth nonlinearities whereas Theorem 3 ensures in case of exponential growth nonlinearities the convergence of large solutions with unbounded energy to a singular solution

Study of prescribing pattern of drugs used in the treatment of bronchial asthma at tertiary care hospital of northern India

Background: Asthma is a chronic inflammatory disease requiring long term treatment. For an effective control of asthma symptoms background knowledge of the prescribing pattern of anti-asthmatic drugs is a must.Methods: A prospective, observational study was conducted in the Department of Respiratory Medicine OPD, King George's Medical University, Lucknow. 114 patients of asthma were recruited for the study. A case report form was filled from patient’s prescription containing the demographic details of the patients, presenting complaints, investigations and drugs prescribed along with their dose, duration, frequency, route of administration.Results: 114 patients’ prescriptions were assessed which showed average number of drugs per prescription - 3.22. 42.8% and 50% of the drugs were prescribed in accordance with World Health Organization model list of essential medicines and National list of essential medicines. Short acting β2 agonist (salbutamol), 61.4% was the most commonly and frequently prescribed single anti asthmatic drug. Combination of inhaled corticosteroid and long acting β2 agonist, 86.8% was the most commonly prescribed fixed dose combination anti asthmatic drug. Inhalational route (75%) was the most preferred one over oral route (25%).Conclusions: Asthma being a chronic disease requires prolonged treatment which imposes economic burden on the patients. Judicious prescription of drugs not only improves the patient clinically but also removes the unnecessary burden. Data obtained from these studies can be used as a guide to make future decisions regarding standard prescription

Correlation and path-analysis for morpho-economic traits and chemical constituents of essential oil in Corn mint (Mentha arvensis L.) accessions.

Mentha arvensis L. which belongs to Lamiaceae family and it is also know as cornmint or japanese mint.The plant as been used for medicinal and aromatic purpose since from ancient time. The present study was planned to estimate the variability among morpho-economic traits, to estimate magnitude of association between essential oil yield and its contributing traits and to determine the direct and indirect effects of various agro-morphic traits on essential oil yield. Experimental materials consist of twenty-nine accessions, which were evaluated for two consecutive years (2016-2017 and 2017-2018) in a randomized complete-block design (RCBD) with two replications. Data were collected on agro-morphic traits and essential oil yield. The results revealed that, the plant height was ranged from 72 cm (MASP-20) to 31cm (MASP-2), herb yield per plot was ranged from 1.83 kg/plot (MASP-13) to 4.36 kg/plot (MASP-12), and essential oil yield was varied from 0.118 kg/plot (MASP-1) to 0.698 kg/plot (MASP-12).The menthol percent was varied from 0.13% (MASP-15) to 73.19 % (MASP-24),menthyl acetate 25.52% (MASP-29) to 0.030% (MASP-18), pulegone 0 % to 75.00% (MASP-22), and limonene was varied from 0.24 %(MASP-29) to 24.89% (MASP-27).The significant and positive association was noticed between essential oil yield and herb yield per plot (0.82**; ** = significant at 1% probability level) and number of branches per plant (0.26*; *= significant at 5% probability level). Among the chemical constituents of essential oil, Limonene percent was positively and significantly correlated with pulegone percent. The path coefficient analysis revealed that herb yield per plot had the highest direct effect on essential oil yield (0.8104). Plant height, number of branches per plant, and herb yield per plot can be used as a selection criterion during selection to develop a high yielding menthol mint chemotypes.