Correlation of oxidative stress and serum gonadotropins in female infertility - A cross sectional study in a tertiary care hospital in Eastern Zone of India

Background: Infertility is a very important issue to family and society. Oxidative stress (OS) may affect ovulation, fertilization, embryo development, and implantation resulting in infertility in women. Gonadotropins are required for follicle development and estrogen production, hence low levels of these hormones may result infertility. Aim and Objectives: Our aim was to study OS and serum gonadotropins level in infertile women and to study whether the OS has any effect on gonadotropins level in infertile women. Materials and Methods: It is a hospital-based cross-sectional study. The study group included 50 infertile women in the age of 20–45 years. Age-matched 50 women without a history of infertility were selected as control. Serum samples were collected on the third day of the menstrual cycle and assayed for carbonylation of serum protein, a marker of OS by Levine’s method and Serum Follicle-stimulating hormone and luteinizing hormone by Chemiluminescence Immunoassay method in ADVIA, Centaur CP (SIEMENS) autoanalyzer. Statistical analysis of data was done by SPSS software. P < 0.05 was considered statistically significant. Results: From our study, we observed that OS was significantly high in infertile women than control (P < 0.05). Serum gonadotropins levels were significantly low in infertile women than control (P < 0.05). Our study shows significant negative correlations between OS and serum gonadotropins level in infertile women (P < 0.001). Conclusion: It can be concluded that both OS and low serum gonadotropin levels may be etiological factors for infertility in women. Oxidative can cause infertility by direct effect on reproduction physiology as well as by lowering gonadotropin level. So OS and serum gonadotropin levels can be emphasized in case of treatment of female infertility.

Plasmablastic lymphoma in HIV patients: Experience at a tertiary care hospital in eastern India.

BACKGROUND: Plasmablastic lymphoma (PBL), a rare non‑Hodgkin’s lymphoma (NHL) variant specifically associated with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), expresses well‑differentiated plasma cell markers like CD138, bright CD38, and MUM1; but not conventional B‑cell markers. It occurs at unusual sites like oral cavity and orbit, and has poor survival rates. AIMS: This study serves as a review of a clinical experience with six HIV patients with PBL and observes the spectrum of clinical presentations, histopathologies, and 1‑year outcomes in PBL patients. MATERIALS AND METHODS: This review of six PBL patients was conducted at a tertiary care hospital in eastern India using relevant radiological, histopathogical, and immunohistological studies. RESULTS: Incidence of PBL among HIV patients was 0.58% (6/1,028). Mean CD4 count at presentation was 125.5 ± 71.1 cells/μL. Sites of involvement included pleura, lung parenchyma, suprarenal gland, pelvic cavity, and retroorbital space (one each). Immunohistopathology of biopsied sample in each patient revealed PBL (positive plasma cell markers MUM‑1/ IRF4, CD38, and CD138/syndecan; and negative of B‑cell markers CD3, CD20, and CD30). Three (60%) were positive for Epstein Barr virus (EBV) immunoglobulin G (IgG). Five surviving patients received CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) regimen and attained partial remission (PR) after six cycles. Subsequently, three patients were started on EPOCH (etoposide, cyclophosphamide, doxorubicin, vincristine, prednisone) therapy; two attained near total regression after 6 months (four cycles). Overall, four patients remained alive with good quality of life at the end of 1 year of follow‑up. CONCLUSION: PBL in HIV occurs at unusual sites with varying aggressivity. This study is too small to comment on the long‑term outcomes of PBL in HIV; however, coadministration of antiretroviral therapy (ART) with standard chemotherapy may improve survival.

Scleredema of Buschke: a rare post-streptococcal complication.

A 19-year male presented with acute onset, gradually progressive symmetric indurations involving the skin over the face, neck, shoulders and upper part of chest following an upper respiratory tract infection. Detailed history and examination did not reveal evidence of Raynauds' phenomenon, nail changes, digital ulcers, pigmentation or any systemic involvement. Autoantibodies for systemic sclerosis were absent. Histopathology of skin biopsy documented scleredema. Antistreptolysin O (ASO) titer was elevated. We diagnosed a case of Scleredema adultorum of Buschke following a streptococcal throat infection. We report this case to highlight the importance of clinically differentiating this relatively benign, self-limiting disorder from systemic sclerosis.

Massive recurrent hemorrhage due to duodenal diverticulum--role of tattooing and suture plication.

We report a 79-year-old lady with massive recurrent GI bleeding from a duodenal diverticulum arising at the mesenteric border. We used tattooing during endoscopy as a method for identifying the bleeding source at surgery. The diverticulum was treated with suture plication.

Observations of hepatic encephalopathy profile in a tertiary care centre.

A study was conducted among 67 patients presenting with hepatic encephalopathy to establish the aetiological diagnosis and record the incidence of acute and chronic liver diseases. They all had undergone thorough clinical and laboratory evaluation. The factor precipitating encephalopathy was also identified. Among 67 patients 19 (28.4%) had acute liver disease and 48 (71.6%) had chronic liver disease. Majority of patients had grade 2 encephalopathy at presentation. Among the acute cases most common aetiology was acute viral hepatitis due to hepatitis B and E viruses whereas alcoholic liver disease was the most frequent cause of chronic liver disease. The most common precipitating factor was gastro-intestinal haemorrhage.

Pancreatic carcinoma: report of two cases presenting with unusual metastases.

We report two patients with adenocarcinoma of the body and tail of the pancreas who presented with features localized to the metastatic sites. A 67-year-old gentleman presented with right groin mass due to spermatic cord metastasis and later developed duodenal obstruction; the other gentleman was 69 years old and presented with change of bowel habit as a result of pelvic/pararectal metastasis.

Glycaemic consequences of HIV and highly active antiretroviral therapy: a pilot study and review of literature.

The metabolic consequences of HIV and AIDS are accentuated in the setting of highly active antiretroviral therapy. Peripheral lipodystrophy, central adiposity, hyperlipidaemia, insulin resistance and diabetes mellitus are frequent associations of protease inhibitor containing highly active antiretroviral therapy regimens. Ninety patients aged 25-50 years (males 52, females 38), seropositive for HIV 1 and 2 or both were selected to see the glycaemic profiles in asymptomatic early HIV disease with CD4 counts > 100/microl and to compare this with the glycaemic profile of (a) advanced HIV disease (CD4 counts < 200/microl), not on highly active antiretroviral therapy and (b) advanced HIV disease (CD4 counts < 200/microl), on uninterrupted non-protease inhibitor highly active antiretroviral therapy > 6 months. All the patients were grouped into 3: (1) Group A: CD4 counts > 500/microl (n=37), highly active antiretroviral therapy naive, (2) group B: CD4 counts < 200/microl (n=21), not on highly active antiretroviral therapy, and (3) group C: CD4 counts < 200/microl, receiving uninterrupted non-protease inhibitor based highly active antiretroviral therapy for > 6 months (n=32). The fasting blood glucose, glycosylated Hb (HbA1c) levels, were measured in all the patients in 3 groups and significance of difference between means was calculated among various groups. Body weight and waist-hip ratio were also measured. The results were analysed and compared with other studies.

Insulin in type 2 diabetes: promises to keep.

The concept which has evolved in the management of type 2 diabetes mellitus is early insulin therapy. In type 2 diabetes mellitus first phase insulin response is grossly impaired on eventually absent, overburdening phase 2 responses which obviously fail to compensate in the long run. Perpetuation of the age old practice to continue OHA while almost all beta-cells are exhausted is only buying time for starting insulin. Preservation of beta-cell function by early insulin therapy yields two important benefits: (1) Better glycaemic control at lower medication dose and (2) relative freedom from hypoglycaemia because of well preserved glucagon response. To ensure and to translate the proper action of insulin in the target organs we are now talking about designer insulins which are basically insulin analogues (short and long acting). So type 2 diabetes is a growing menace and is responsible for severe morbidity, mortality and poor quality of life. Good glycaemic control from the very beginning of diabetes has shown to favourably influence all of these and is accepted as a cardinal goal of proper diabetes care.

Diarrhea management among under fives.

This study was conducted to assess the magnitude of the problem of diarrhea and time of initiation of its management in under five children of different socio economic status, in an urban area of West Bengal. Overall prevalence of diarrhea was 31.67%, highest in lower socio economic class (41%). Prevalence was higher in the girls, though not significant. Acute watery diarrhea was most common (58.9%), followed by dysentery (24. 2 %) and persistent diarrhea (16.9%). Persistent type was inversely proportional to socioeconomic status. Majority of mothers administered fluids or sought treatments within six hours in the middle socioeconomic class but beyond six hours in lower socioeconomic group (P < 0.001). Percentage of children where doctors' advice was implemented within 12 hours was inversely proportional to socio economic status (P <0.001).

ANCA-negative limited Wegener's granulomatosis.

A 26-year-old man presented with epistaxis, nasal obstruction and a subcutaneous swelling over the left malar region with radiological evidence of a mass in the right nasal cavity. Histology of the lesions showed necrotizing granuloma with evidence of vasculitis. There was no other systemic involvement and the patient was ANCA-negative. Excellent response to systemic steroid and cyclophosphamide therapy was noted.

Mycetoma caused by a new red grain mycetoma agent in two members of a family.

An 18-year-old woman from rural West Bengal was affected with mycetoma involving her neck, back, and chest. After an interval of eight years, her younger brother developed mycetoma on his left arm. No history of trauma or immune deficiency was present in either case. By microscopic examination of sinus-discharged materials from both the cases, identical rusty red, hard grains were demonstrated. Soluble red pigment-producing colonies grew in Sabouraud dextrose-agar medium. Isolates were positive for casein hydrolysis and negative for hydrolysis test of xanthine, hypoxanthine, tyrosine, and nitrate reduction. Thus it differed from the only known red grain mycetoma agent, Actinomadura pelletieri and was provisionally identified as Actinomadura vinacea. Familial affection in mycetoma, that too caused by a new agent, is reported here for its uniqueness.

Sequence-based structural signatures of genome evolution.

Among the multitude of methods available for the study of origin and evolution of various life forms on Earth, the phylogenetic approach, i.e. the delineation of natural genetic relatedness amongst different groups of organisms, has been of particular interest to evolutionary biologists. An approach towards analysing phylogeny is the comparison of genome sequences of extant organisms by a variety of computational techniques. These studies rely mostly on the similarity or dissimilarity in global character of the genome in terms of sequence, without any consideration to its structure. In this work, we report a potentially new methodology towards elucidation of molecular phylogeny. The approach considers a structural parameter of the genome, namely its flexibility, and uses it to compare the small subunit ribosomal ribonucleic acid (SSU rRNA) gene from a cross-section of species. We find that the flexibility pattern of the genome is strikingly similar in organisms that are closer in evolutionary distance than the ones that are separated. This method of comparison thus might be utilised in constructing phylogenetic trees from flexibility patterns derived from nucleotide sequence.

Identification of human proteins using the linguist's tools.

The symbolic sequences of the exons that make human proteins are subjected to methods of statistical linguistics. The ideas developed for the natural languages by G. K. Zipf, when applied to these sequences, show significant promise. In particular, we argue, the Zipf's exponent differentiates, and hence, identifies disparate human sequences.

Knowledge and attitude in relation to HIV/AIDS among in-service nurses of Calcutta.

Seventy-five senior nurses attending a workshop were surveyed with questionnaires and using two separate scales, their knowledge about transmission and precautionary measures, and their general attitude towards HIV/AIDS as well as willingness for patient-care were assessed. The nurses showed a satisfactory level of knowledge (mean percentage score 74.3), but misconceptions regarding disinfection and precautionary measures were present; 33% had overall negative attitudes and 24% unwilling to provide care for HIV-infected patients. Knowledge and attitude were positively correlated (r = .32). Knowledge deficits of some aspects of infection leading to fear of contagion and judgemental outlook towards HIV infection might lead to negative attitude impeding proper care. It is suggested that continuous in-service training be instituted to dispel misconceptions and to develop favourable and non-discriminatory attitude.

Isolation and cloning of Bacillus thuringiensis var Kurstaki HD73 toxin gene and construction of a chimaeric gene for expression in plants.

Necessity for the production of transgenic crop plants of India, capable of expression of insecticidal Bt protein in plant to combat lepidopteran pest damage has been strongly felt. Bacillus thuringiensis Kurstaki HD73 crystal protein coded by CryIA(c)73 gene has been found to be sufficiently effective against the major pests of jute and chickpea. An attempt to isolate the gene and make its use in a chimaeric gene construct for expression in plant was carried out. The plasmid CryIA(c)73 gene was cloned and tailored at the 3' end. The expression of the truncated gene was monitored in the minicell systems of E. coli. The entomocidal property was found to be fully retained by the gene product. Deletion of the nucleotides at the 5' end was carried out and chimaeric gene construct of cryIA(c)73 was made in such a way that it was fused in frame with GUS gene under the control of the caMV 35S promoter with Nos polyadenylated terminus. Such a chimaeric gene construct was used as the passenger of a Ti plasmid derived plant vector with kanamycin gene (NPTII) as the additional plant marker. Transformation through infection of tobacco and mustard plant cells in culture was carried out. Plants regenerated from the transformed cells showed the presence of GUS gene indicating the expression of the cloned fused gene. Also, Northern analysis established the presence of cryIA(c)73 gene transcripts in the transgenic plants.