Abnormal vaginal discharge in reproductive age group women with special implication to antifungal susceptibility of candida species

Introduction And Background: Vaginal discharge is a common complaint in reproductive age group women2. Vaginal discharge is one of the common reasons in women of reproductive age group seeking gynecological consultation. It is the second most common clinical problem after menstrual disorders. Globally, it is estimated that one in ten women will present with vaginal discharge in the course of one year and approximately, ten million office visits each year are attributed to vaginal discharge complaints. The prevalence of vaginal discharge in India is estimated to be 30%3. Ÿ Abnormal vaginal discharge predisposes to significant morbidity to the women in the form of pelvic inflammatory disease, infertility, endometriosis, cuff cellulitis, urethral syndrome, pregnancy loss, and preterm labour.5 Ÿ Certain conditions such as prolonged use of combined oral contraceptive, pregnancy, malnutrition, diabetes, neutropenia, prolonged antibiotic therapy, candida become pathogenic and causes candidiasis.8 Ÿ Isolation, identification, characterization, and susceptibility of candida species became critical management of fungal infections.9 Need For The Study: The study was done to emphasize the role of laboratory investigations in patients with vaginitis, as presumptive clinical diagnosis alone can lead to false interpretation and treatment mismanagement. TheMethods: present study is a cross sectional observational study conducted from January 2019 to February 2020 for about a period of one year among 300 women aged 15-49 years with vaginal discharge attending gynecology OPD, Government Maternity Hospital, Tirupati. This study included 300 subjects with a mean age of 30.4 ± 7.26 years. Nearly halfResults: of (49.33%) our study population was aged between 25 to 34years, a majority (47%) of women had bacterial vaginosis, followed by Candida in 39.33%, trichomonas vaginalis in 14.33%, mixed infections in 6.67% and 6% with no organisms. Among Candida species, 48.31% of participants had candida albicans, 23.73% had candida tropicalis, 19.49% had candida krusei, and 8.47% had candida glabrata, and of them 38.33% participants had voriconazole sensitivity, 32.33% participants had ketoconazole sensitivity, 26% participants had clotrimazole sensitivity, and 21.33% participants had fluconazole sensitivity. Among 118 candida infected 106 (89.83%) participants came for follow-up, of which symptoms subsided in 90 (84.91%) participants. In conclusion, our study with 300 women patients complaining ofConclusion: vaginal discharge found a majority of them belonging to the sexually active age group. Vaginal discharge was more prevalent in lower economic status and rural areas. Bacterial vaginosis was the most common and frequent etiology, followed by Candida. TV was the least common etiology for vaginal discharge

Evaluation of induction of labour in a tertiary care hospital

Background: The objective is to evaluate the preferred methods for labor induction, including incidence of caesarean section, operative and normal vaginal delivery rate, need for oxytocin augmentation, and Apgar score at 1 and 5 min.Methods: This was a hospital-based study carried out in 110 inductions of labour during the study period. misoprostol 50 mcg was inserted in posterior fornix of vaginal in cases with PROM and intracervical 0.5 mg Dinoprostone for other causes in whom induction was decided. Maternal and neonatal outcomes were observed. collected data were analyzed using SPSS and MS excel.Results: Most preferred methods of induction of labour were observed to be Dinoprostone and Misoprostol, augmentation was done by oxytocin. normal delivery rate was 54% in Dinoprostone gel and 58.3% in misoprostol group. Caesarean and operative vaginal delivery rates were 42.8%, 3% in Dinoprostone gel group and 33.3%, 8.3% respectively in misoprostol group. Mean Apgar scores were observed to be similar in both methods of induction at 1st and 5th minutes.Conclusions: It was found that misoprostol had higher percentage of normal and operative vaginal delivery and need for oxytocin augmentation than Dinoprostone. Neonatal outcome as predicted by Apgar score were similar in both groups.

A guise of osteosarcoma: Chondroblastoma-like.

Osteosarcoma (OS) is a rare tumor arising from immature bone forming cells or through neoplastic differentiation of other immature mesenchymal cells into osteoblasts. Chondroblastoma-like OS is one of the rare forms of OS to be seen in jaw bones. Aggressive clinical behavior, osteolytic areas in the radiograph and histological presentation of chondroblastoma such as cells with grooved nuclei, typical chicken-wire calcification along with areas of tumor osteoid, implied the diagnosis as chondroblastoma-like OS. Use of reticulin stain further confirmed the diagnosis. A case of chondroblastoma-like OS is reported, emphasizing the importance of early diagnosis of aggressive jaw lesions with the help of routine radiography, histopathology, and special stains.

Oncocytic and clear cell areas in a solid pseudopapillary tumor of the pancreas: a case report

Solid pseudopapillary tumor [SPT] of pancreas is a rare, distinct, low-grade malignant neoplasm. Variable areas like clear cell foci can exist in this tumor, which can easily mislead the pathologist. Diagnosis of the same is important to distinguish from other clear cell lesions in the pancreas. Oncocytoid differentiation is rarer still and can raise doubts about the diagnosis, especially on trucut biopsies. Herein, we discuss a case of SPT of the pancreas exhibiting variable cellular morphology, of which very few cases have been reported in world literature

Immunohistochemical phospho tensin tumor suppressor gene staining patterns in endometrial hyperplasias: A 2-year study.

Background: Endometrial carcinoma is a common neoplasm associated with the female genital tract with considerable morbidity.Eendometrial hyperplasias have been widely regarded as precursor lesions. It is of importance to the pathologist to identify the subset of hyperplasias or the associated factor which could be a possible forerunner of malignancy. Phospho tensin gene (PTEN) has gained importance as one of the factors responsible. Aim: To determine the variability in PTEN expression patterns in different types of endometrial hyperplasias. Settings and Design: The study was undertaken on samples received at the Department of Pathology from 2005 to 2007. Materials and Methods: One hundred samples with 76 showing hyperplasias of different types formed the core "study group" with simple hyperplasia without atypia predominating. The rest belonged to the control groups. PTEN intensity and percentage positivity, variability in patterns of glandular and stromal expression, the number and type of PTEN null glands in different types of hyperplasia were evaluated. Statistical analyses used were Fisher's exact test based on Monte Carlo test and chi-square test. Results: Complex hyperplasia was associated with a reduction in number of strongly PTEN positive glands, with an increase in null glands, seen in clusters. Co-existing atypia was associated with the weakest staining and in fewer glands. Conclusions: PTEN expression in endometrial hyperplasias can be used as an early warning of heightened cancer risk and a potential target for preventive treatment. However, extensive research is needed along this line to conclusively establish its effectiveness.

Antioxidant potential of Coriandrum sativum L. seed extract.

The seeds of C. sativum are used as a traditional drug for the treatment of diabetes. The antioxidant and free-radical-scavenging property of seeds in vitro was studied and also investigated whether the administration of seeds curtails oxidative stress in the kidney of streptozotocin-induced diabetic rats. Incorporation of seed powder in the diet led to marked lowering of blood glucose and a rise in the levels of insulin in diabetic rats. A parallel beneficial effect was observed on oxidant –antioxidant balance in the kidney. Addition of coriander seed powder not only inhibited the process of peroxidative damage but also significantly reactivated the antioxidant enzymes and antioxidant levels in diabetic rats. The total polyphenolic content of the seeds was found to be 12.2 gallic acid equivalents (GAE)/g while total flavanoid content was found to be 12.6 quercetin equivalents/g. The seeds also showed scavenging activity against superoxides and hydroxyl radicals in a concentration -dependent manner. Maximum free radical-scavenging action and free radical reducing power of coriander seed extract was observed at a concentration of 50 g GAE. Islet histology structures showed degeneration of pancreatic islets in diabetic rats which was also reduced in diabetic rats treated with seed powder. These results show that C. sativum seeds not only possess antihyperglycemic properties but antioxidative properties also. Increased dietary intake of coriander seeds decrease the oxidative burden in diabetes mellitus.

Fabrication and in- vitro permeation studies of indomethacin-ficus carica fruit mucilage patches.

The main objective of the present study was to develop matrix-moderated transdermal systems of Indomethacin using various proportions of Ficus carica fruit mucilage. Physical evaluation was performed such as moisture content, moisture uptake, tensile strength, flatness and folding endurance. In-vitro permeation studies were performed in a Keshary-Chien diffusion cell. The matrix-type transdermal systems were prepared using Indomethacin with Ficus carica fruit mucilage by the solvent evaporation technique. The interactions between Indomethacin and Ficus carica fruit mucilage were performed. The transdermal patches were subjected to various physicochemical parameters viz., mechanical properties, permeation studies and skin irritation studies. The prepared patches possessed satisfactory pre-formulary and formulary characteristics. In vitro permeation studies were performed using a Keshary-Chien diffusion cell across hairless Albino rat skin. The non-ionic surfactants Span 80, Glycerin, Propylene glycol in the formulation played a role as permeability enhancer. The patches were seemingly free of potentially hazardous skin irritation. The experimental results shows that the release of drug from the patch delayed in controlled manner as the proportion of Ficus carica increased. It was concluded that Indomethacin can be developed as a transdermal patches with Ficus carica fruit mucilage.

Dual acting oral floating matrix tablets of ranitidine hydrochloride.

The main purpose of this work was to prepare floating matrix drug delivery system of Ranitidine. Floating matrix tablets of Ranitidine were developed to prolong gastric residence time and increase its bioavailability. Rapid gastrointestinal transit could result in incomplete drug release from the drug delivery system above the absorption zone leading to diminished efficacy of the administered dose. Floating matrix tablets containing 100 mg Ranitidine were developed using different effervescent salts and polymer combinations. The tablets were prepared by direct compression technique, using polymers such as hydroxyl propyl methyl cellulose (HPMC K4M), Carbopol 934 in combination. Sodium bicarbonate, citric acid, calcium carbonate was incorporated as a gas-generating agent. The effects of sodium bicarbonate on drug release profile and floating properties were investigated. The formulation was optimized on the basis of acceptable tablet properties, floating lag time, total duration of floating and in vitro drug release. The formulated tablets with optimum hardness, uniform thickness, consistent weight uniformity and low friability. The results of dissolution studies, floating lag time indicated that formulations F4 exhibited good and controlled drug release. Applying the linear regression analysis and model fitting showed the selected formulation F4 showed diffusion coupled with erosion drug release mechanism, followed first order kinetics. Optimized floating matrix tablets F4 showed no change in physical appearance, drug content, or in dissolution pattern after storage at 250C/ relative humidity 65% and 40°C / relative humidity 75% for a period of 3 months.

Novel approach in formulation and evaluation of mouth dissolving tablets of ondansetron hydrochloride.

Mouth dissolving drug delivery systems has number of advantage viz., faster onset of action, elegance, ease of administration, ease of manufacturing, ease of storage and transport. A novel attempt has been made to develop mouth dissolving tablets of Ondansetron hydrochloride by including clove oil as flavor and local anesthetic on taste buds. The tablets were prepared by direct compression technique. The formulated tablets were evaluated for Pre formulation and post formulation parameters and they were found to be saatisfactory. Direct compression method was employed for making mouth dissolving tablets. The formulated mouth dissolving tablets possessed good drug releasing property, good mouth feel and improved drug availability with better patient compliance.

Malignant melanoma of the mandibular gingiva: A rare occurrence.

Primary mucosal malignant melanoma of the oral cavity is a rare tumor. It accounts for only 0.2-8% of all malignant melanomas. This malignancy commonly affects male subjects and is more frequently seen on the hard palate and maxillary gingiva. The peak age for diagnosis of oral melanoma is between 55 and 65 years. A biopsy is required to establish a diagnosis. Ablative surgery with tumor-free margins remains the treatment of choice. It has a much poorer prognosis than its counterpart on the skin. Here, we present a case of malignant melanoma of the mandibular lingual gingiva in a 55-year-old male patient. Immunohistochemistry and special stains were conducted for confirmatory diagnosis.

Insulin sensitizing actions of fenugreek seed polyphenols, quercetin & metformin in a rat model.

Background & objectives: Plant polyphenols have been known to exert anti-diabetic action and promote insulin action. The present study was carried out to compare the effects of administration of fenugreek seed polyphenolic extract (FPEt), quercetin and metformin (a positive control) in an acquired model of insulin resistance (IR). Methods: Adult male Wistar rats divided into seven groups (n=12). IR was induced in groups (groups 2, 3, 4 and 5) by feeding a high fructose diet (FRU) (60 g/100 g diet) for 60 days. From day 16, FRU rats were administered either FPEt (200 mg/kg bw) (group 3), quercetin (50mg/kg bw) (group 4) or metformin (50 mg/kg bw) (group 5) for the next 45 days. Group 1 served as normal control while groups 6 and 7 served as FPEt and quercetin controls respectively. Oral glucose tolerance test (OGTT) was done on day 59 to assess glucose tolerance. At the end of 60 days, the levels of glucose, insulin, triglycerides (TG) and free fatty acids (FFA) were measured in the blood and the activities of insulin-inducible and suppressible enzymes in cytosolic and mitochondrial fractions of liver and skeletal muscle. The extent of tyrosine phosphorylation of proteins in response to insulin was determined by assaying protein tyrosine kinase (PTK) and protein tyrosine phosphatase (PTP) in liver. Results: Fructose caused increased levels of glucose, insulin, TG and FFA, alterations in insulin sensitivity indices, enzyme activities and reduced glycogen content. Higher PTP activity and lower PTK activity suggest reduced tyrosine phosphorylation status. Administration of FPEt or quercetin improved insulin sensitivity and tyrosine phosphorylation in fructose-fed animals and the effect was comparable with that of metformin. Interpretation & conclusions: Our findings indicated that FPEt and quercetin improved insulin signaling and sensitivity and thereby promoted the cellular actions of insulin in this model.

Polymorphic fibro-osseous lesion of the bone: a case report with review of literature.

A polymorphic fibro-osseous lesion of the bone is a benign fibro-osseous lesion of the bone with a marked predilection for the proximal femur and characterized by a complex mixture of histological elements. We present one such case of a 35-year-old female with spontaneous onset of pain in the left hip for 3 months and trauma sustained a year ago. An examination revealed tenderness with painful movements over the anterior aspect of the left hip joint and trochanter. A clinico-radiological differential diagnosis of simple bone cyst or fibrous dysplasia was entertained. A microscopic examination of the lesion with clinico-radiologic correlation led to the diagnosis of a polymorphic fibro-osseous lesion. This is a genuine clinico-pathologic entity that is usually asymptomatic with a rare history of trauma or hip pain. It has a distinctive histopathological picture with a better prognosis than its mimics.

Periductal stromal sarcoma of breast with lipoblast-like cells: a case report with review of literature.

The specialized mesenchyme of the breast is the seat of neoplasms with distinct morphology, though with considerable overlap due to the ever increasing number of variants. This article seeks to describe the morphologic features of one such rare neoplasm. A 35-year-old female patient presented with a breast lump that was subsequently excised. Morphological assessment and immunohistochemistry were performed and a diagnosis of periductal stromal sarcoma with lipoblast-like cells (pseudolipoblasts), was made. Being an unusual finding in a rare entity of intermediate grade, it has to be considered, before rendering a diagnosis of a malignant, higher-grade neoplasm.

Evaluation of in vitro antioxidant activity of Indian bay leaf, Cinnamomum tamala (Buch. -Ham.) T. Nees & Eberm using rat brain synaptosomes as model system.

The study investigated the perturbation of oxidant-antioxidant balance in brain synaptosomes of diabetic rats and determined the antioxidant and free radical-scavenging property of the Indian bay leaf. Brain synaptosomes were isolated from control and streptozotocin-induced diabetic animals and oxidative stress parameters were assayed. A methanolic extract of bay leaf (BLE) was tested for the polyphenolic content and antioxidant activity by in vitro assays. A significant increase in the levels of lipids and lipid peroxidation products and a decline in antioxidant potential were observed in diabetic rat brain synaptosomes. The total polyphenolic content of BLE was found to be 6.7 mg gallic acid equivalents (GAE)/100g. BLE displayed scavenging activity against superoxide and hydroxyl radicals in a concentration-dependent manner. Further, BLE showed inhibition of Fe(2+)-ascorbate induced lipid peroxidation in both control and diabetic rat brain synaptosomes. Maximum inhibition of lipid peroxidation, radical scavenging action and reducing power of BLE were observed at a concentration of 220 microg GAE. These effects of BLE in vitro were comparable with that of butylated hydroxyl toluene (BHT), a synthetic antioxidant. It can be concluded that synaptosomes from diabetic rats are susceptible to oxidative damage and the positive effects of bay leaf in vitro, could be attributed to the presence of antioxidant phytochemicals.

Taurine prevents collagen abnormalities in high fructose-fed rats.

BACKGROUND & OBJECTIVE: Accumulation of collagen and changes in its physiochemical properties contribute to the development of secondary complications of diabetes. We undertook this study to see the effects of taurine on the content and characteristics of collagen from tail tendon of rats fed with high fructose diet. METHODS: The rats were divided into four groups of six each: control group (CON), taurine-supplemented control group (CON+TAU), taurine supplemented (FRU+TAU) and not supplemented fructose-fed group (FRU). The physico-chemical properties of collagen isolated from the tail tendon were studied. RESULTS: Fructose administration caused accumulation of collagen in tail tendon. Enhanced glycation and advanced glycation end products (AGE)-linked fluorescence together with alterations in aldehyde content, solubility pattern, susceptibility to denaturing agents and shrinkage temperature were observed in fructose-fed rats. Elevated b component of type I collagen was evidenced from the SDS gel pattern of collagen from the fructose-fed rats. Simultaneous administration of taurine alleviated these changes. INTERPRETATION & CONCLUSION: Taurine administration to fructose-rats had a positive influence on both quantitative and qualitative properties of collagen. The results of the present study suggested a role for the action of taurine in delaying diabetic complications and the possible use of taurine as an adjuvant therapeutic measure in the management of diabetes and its complications.

Multiple myeloma with amyloidosis presenting with recurrent gastrointestinal bleeding.

We report a 45-year-old woman who presented with hematemesis. Endoscopy showed nodular lesions and ulcers in the gastric antrum; histology of the lesions showed amyloidosis. The patient had received melphalan and prednisolone for multiple myeloma 5 years earlier.

Lipoic acid restores antioxidant system in tissues of hyperinsulinaemic rats.

BACKGROUND & OBJECTIVES: Feeding rats with high fructose induces insulin resistance, hyperinsulinaemia, elevation of blood glucose level and impaired glucose tolerance. Oxidative stress plays a vital role in pathology associated with insulin resistance. The present study was to investigate the effects of alpha-lipoic acid (LA) on the oxidant-antioxidant balance in liver and kidney of high fructose-fed rats. METHODS: Male Wistar rats (170-180 g) were divided into six groups. The control group received diet containing starch; the fructose group was given a high fructose diet (>60% of total calories); the third and fourth groups were given fructose diet and administered with two different doses of lipoic acid as low dose (35 mg/kg body weight) and high dose (70 mg/kg bw) intraperitoneally using olive oil as vehicle; the fifth group received control diet and was administered with lipoic acid (70 mg/kg bw); the sixth group received the control diet and olive oil. The rats were maintained in their respective dietary regimen for 20 days. Lipid peroxidation indices and antioxidant status in liver and kidney were quantitated. RESULTS: The rats fed fructose showed increased levels of lipid hydroperoxides, thiobarbituric acid reactive substances (TBARS), conjugated dienes, and impaired antioxidant defence potential as evidenced by a decrease in the levels of non-enzymatic and enzymatic antioxidants. Treatment with LA to the fructose-fed rats mitigated these alterations and LA was effective uniformly at both the closes. Increased lipid peroxidation and inadequate antioxidant system are observed in the high dose fructose-fed rats. INTERPRETATION & CONCLUSION: LA administration restored the antioxidant potential and lowered lipid peroxidation. These findings strengthen the utility of LA in the management of insulin resistance and associated pathology.

Response of liver antioxidant system to taurine in rats fed high fructose diet.

Fructose-fed rats were more susceptible to peroxidative damage as measured by thiobarbituric acid reactive species. The concentrations of lipid peroxides, diene conjugates, lipofuscin and hydroperoxides were significantly higher. The levels of enzymic antioxidants such as vitamin C, vitamin E and glutathione and activities of antioxidant enzymes were significantly lower in fructose-fed rats. When these rats received taurine in drinking water, peroxidative damage was minimal in both plasma and liver. Taurine was effective in inducing the antioxidant potential in fructose-fed rats. Increased peroxidative damage in liver is likely to be associated with fructose dependent pathology, which could be reduced by taurine by enhancing the antioxidant potential.

Restoration on tissue antioxidants by fenugreek seeds (Trigonella Foenum Graecum) in alloxan-diabetic rats.

The influence of fenugreek seed powder supplementation in the diet on lipid peroxidation and antioxidant status was studied in normal and alloxan-diabetic rats. The protective effect of the aqueous extract of the seeds on the activity of calcium-dependent adenosinetriphosphatase (Ca2+ ATPase) in liver homogenate in the presence of Fe2+/ascorbate in vitro was also investigated. Normal and diabetic rats were provided with a diet supplemented with fenugreek seed powder for 30 days at a dosage of 2 g/kg body weight. The diabetic rats exhibited enhanced lipid peroxidation and increased susceptibility to oxidative stress associated with depletion of antioxidants in liver, kidney and pancreas. However, treatment with fenugreek seed powder normalised the alterations. In normal rats supplementation resulted in increased antioxidant status with reduction in peroxidation. Ca2+ ATPase activity in liver was protected by the aqueous extract to nearly 80% of the initial activity. The findings suggest that the soluble portion of the seeds could be responsible for the antioxidant property.

Effect of training on lipid peroxidation, thiol status and antioxidant enzymes in tissues of rats.

The effect of training on lipid peroxidation, thiol-status and certain antioxidant enzymes of glutathione system was studied in blood and tissues such as liver and skeletal muscle of rats. Exercise training was given by subjecting the rats to treadmill running. Training for a period of 6 weeks resulted in increased lipid peroxidation (P < 0.001) as indicated by thiobarbituric acid test and conjugated diene measurement in liver and muscle. Thiol levels (total and non-protein) were reduced. However, glutathione level in blood was increased and blood lipid peroxides were unaltered as a result of training compared to sedentary controls. Adaptive increases in three antioxidant enzyme activities were observed. The study indicates that training induces adaptation in the glutathione system.