ABSTRACT
Background: : Judicious use of hysteroscopy to manage abnormal uterine bleeding (AUB) adds a new dimension in handling this perplexing problem. Hysteroscopy combined with histological examination is the new “Gold Standard” for evaluating a case of abnormal uterine bleeding Objectives: To study Diagnostic accuracy of hysteroscopy in relation to histopathology in patients with abnormal uterine bleeding Methods: A hospital based diagnostic accuracy study was carried out among 100 women with abnormal uterine bleeding. All patients underwent the procedure of hysteroscopy. Samples were collected in all patients for histopathology confirmation of the hysteroscopy findings. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were calculated for hysteroscopy in comparison to gold standard histopathology. Results: Majority of the women belonged to 40-49 years (41%). Majority (37%) reported after one year of occurrence of the symptoms. Majority (54%) had menorrhagia. Hysteroscopy was found to be having good sensitivity and specificity in comparison to gold standard histopathology. Sensitivity=97.7%; specificity=78.5%, positive predictive value=78.1%; negative predictive value=97.7%; diagnostic accuracy=87% for hysteroscopy in comparison to histopathology. Conclusion: Hysteroscopy is simple to perform and provides direct visualization of the uterus cavity and the endo-cervical canal. In abnormal uterine bleeding, quick and safe diagnosis is possible by hysteroscopy. In cases of endometrial polyp and sub mucous myoma which are pedunculated structures, diagnostic accuracy is greater with hysteroscopy and can be treated during the procedure itself. Thus, Hysteroscopic guided biopsy and histopathology is considered as new “Gold Standard” in diagnosis and often treatment of abnormal uterine bleeding.
ABSTRACT
Background: Urinary Incontinence is often underreported, undiagnosed and untreated. Though the prevalence increases with age it can occur even in younger age women. Validated questionnaires are available to establish the association of risk factors and diagnose the type of incontinence. Objective: To study risk factors and the impact of Urinary Incontinence on quality of life in women. Methods: Descriptive Cross-Sectional study was carried out among 230 women with symptoms of urinary incontinence. ICIQ-FLUTS a brief and psychometrically robust patient-completed questionnaire for evaluating female lower urinary tract symptoms and impact on quality of life (QoL) was used. The data was analysed using proportions. Results: Most commonly affected age group was 41-50 years (42%). Storage phase symptoms were seen in 78.6% women, and Incontinence was seen in 36.08% women. Stress incontinence was commonest (55.65%) with an average bothersome score of 3.1/10. Moderate to severe degree of Stress Incontinence with a score >5/10 was seen in 15.65% of women. Frequency incontinence was seen in 33.47% of respondents. Average bothersome score of stress and urge incontinence was 3.1/10. They showed as average score of 1.36 and 1.44 respectively. Nocturia was commonest symptom in storage phase symptoms (78.69%). Urgency and Frequency was noted in 55.65% and 50.43% of women respectively. Intermittency was the commonest in voiding phase symptoms seen in 19.56% with an average score of 1.44/4. Conclusion: Stress urinary incontinence was the most common type of urinary incontinence. Urinary incontinency significantly affected the quality of life of women.
ABSTRACT
L-Glutaminase, an amidohydrolase enzyme has been a choice of interest in the treatment of lymphoblastic leukaemia. The present study reports production, purification and characterization of extracellular glutaminase enzyme from Actinomycetes. Screening was performed for twenty Actinomycetes isolates from soil; one isolate (Isolate 2) was finally selected based on the activity of glutaminase (32.5 U/ml).The isolate was identified as Streptomyces sp. Effect of physicochemical factors namely temperature, pH, NaCl concentration, and supplementary carbon & nitrogen sources on the production of L-glutaminase from the Streptomyces sp. was carried out. The enzyme production was found to be optimum with glucose as carbon source (33 U/ml), L-glutamine as nitrogen source (33.1 U/ml), at 7 pH (32.8 U/ml), temperature 30oC (32.4 U/ml) and for 0.1% NaCl concentration (32.5 U/ml). The L-glutaminase produced from Streptomyces sp. was purified by ammonium sulphate precipitation, dialysis method and ion exchange chromatography. After the purification of the enzyme by ion exchange chromatography, it has been purified 46-fold from cell-free extract and yield was 3.25%. Characterization of extracellular L-glutaminase showed that the enzyme shown optimal activity at temperature of 30°C, pH 7, at 2% NaCl and for 0.04M substrate and the Km value was calculated to be 2.8mM and Vmax was 7.57 U/ml. The molecular weight of enzyme as determined by sodium dodecyl sulphate polyacrylamide electrophoresis (SDS-PAGE) was found to be 50 kDa.