ABSTRACT
Background: Sildenafil causes vasodilatation by relaxing the smooth muscles of blood vessels. This enhances endometrial development, the health of which is indispensable for implantation and embryonic and fetal development. Aim: To assess the role of Sildenafil when used in ovulation induction cycles with Clomiphene Citrate (CC) with reference to Endometrial Thickness (ET), follicular development, Pregnancy rates and Side Effects. Materials and methods: In this prospective comparative study on 80 infertile women, we randomly divided them into two groups. In group A with 40 patients, ovulation induction with CC was given and in group B with 40 patients oral Sildenafil Citrate 25mg – BD, was added from Day 8 up to hCG trigger, in the CC induced cycle. A transvaginal ultrasound was done on Day 13 to assess follicular growth and ET. A urine β-hCG on Day 30 was done to detect pregnancy. Patients were followed up for 8 weeks to monitor miscarriages, ectopics and multi foetal gestation. Results: Mean ET at the time of hCG trigger was 9.64 in the Sildenafil group compared to 8.47 in group A without Sildenafil (p value 0.01). 65% of the patients in group B conceived with 3 cycles of ovulation induction compared to 42.5% who conceived in group A (p value 0.04). The mean of total number of follicles greater than 18 mm at hCG trigger was 1.62 and 1.91 in group A and B respectively (p – 0.09). Side Effects were significantly higher in group B with sildenafil compared to group A with CC alone (p – 0.006). L. Pranathi Reddy, Y. Madhavi, Mohammed Ismail Khan. Role of Sildenafil in ovulation induction – A comparative study of outcomes with Sildenafil in ovulation induction cycles with Clomiphene Citrate. IAIM, 2016; 3(12): 26-32. Page 27 Conclusions: As our study shows that use of Sildenafil improves ET and rates of conception, we recommend the routine use of Sildenafil in ovulation induction protocols.
ABSTRACT
Drug-induced Acute Kidney Injury (AKI) constitutes an important cause of acute renal failure and chronic kidney disease in present day clinical practice. Drug-induced acute renal failure (ARF) accounted for 20% of all ARF in an Indian study. The incidence and prevalence of chronic kidney disease (CKD) has dramatically increasing worldwide. Progression of AKI from mild or moderate to end stage may be prevented by selecting potentially effective therapies, if it is detected in very early stage. But early detection of AKI is often difficult due to paucity of early predictive noninvasive biomarkers. Development of omics technology has led to the identification of several urinary protein biomarkers and transcriptional biomarkers, which enable earlier detection of kidney injury. Urinary protein biomarkers have great benefit due to the easy or non-invasive availability of urine and many showing good predictive power. Several urinary protein biomarkers have been identified and have demonstrated superiority in detecting kidney injury in comparison to conventional parameters like serum creatinine (SCr), blood urea nitrogen (BUN) etc. These promising experimental biomarker of kidney damage require further confirmation of its use in routine clinical use.
ABSTRACT
Background: Ossicular morphology and morphometric considerations play cornerstone importance in reconstructive surgeries. An attempt is made to have an insight into such morphological variations and evaluate the morphometric values of malleus in south Indian population through cadaveric dissection. Materials and methods: 25 human head specimens taken from the dissection hall, after removal of brain and duramater, subarcuate fossa and arcuate eminance of the petrous part of the temporal bone were chipped off with help of fine edged chissel and hammer. With help of bone cutter the tegmen tympani forming the remaining roof was removed, till the middle ear cavity and three ossicles are properly exposed and identified. Results: Malleus height ranged from 6.94 mm to 7.78 mm on both sides with average of 7.37mm on right and 7.51 mm on left. Weight ranged from 16.85 mg to 19.25 mg with average of 18 mg on right side and 18.52 mg on left both side. Length and weight of left malleus bones were statistically more than their right counterparts. Conclusions: Morphologically malleus showed lesser variations in comparison to stapes. The left sided malleus dominated the right sided ones in both length and weight.
ABSTRACT
Though there are studies to show protective effect of glutathione against neurotoxicity and nephrotoxicity, the present study was designed to investigate the cardio protective effect of glutathione against isoproterenol induced myocardial infarction in rats by demonstrating the changes in serum cardiac markers, antioxidant enzymes and ECG changes. Wistar male rats were randomly divided into four groups namely control (GI), glutathione (GII), isoproterenol (GIII) and glutathione + isoproterenol treated (GIV). Glutathione treated group-received glutathione (200 mg/kg body wt) orally for 30 days. Myocardial infarction was induced in rats by isoproterenol administration (100mg/kg) subcutaneously (sc) at an interval of 24 hrs on 31st and 32nd day cardiac marker enzymes, ECG, lipid peroxidation and antioxidant enzymes were assessed 24 hrs after the last dose of isoproterenol. Isoproterenol showed changes in ECG pattern, increase in serum level of cardiac marker, increased lipid per oxidation and decreased antioxidant defense system in heart. Glutathione pretreatment brings almost all the parameters to near normal level in isoproterenolinduced myocardial infarction in rats. The present study revealed that glutathione ameliorates cardiac damage in isoproterenol induced myocardial infarction in rats due to potent antioxidant, free radical scavenging effect, myocardial adaptation at cellular and organ levels.
ABSTRACT
Background: The incidence of ischemic heart disease (IHD) has markedly increased in India over the past few years. Considering the variations in racial, dietary and lifestyle patterns in our population, it is essential to study the biology of coronary atherosclerosis in our patients. Vulnerable plaques have a large number of foam cells, extracellular lipid, thin fibrous caps and clusters of inflammatory cells and are more prone to rupture. These plaques are nourished by the microvessels arising from the vasa vasorum of the blood vessels and by lumen-derived microvessels through the fibrous cap. This autopsy study was designed to analyse the coronary arterial tree in cases of sudden cardiac death, classify coronary atherosclerotic plaques and to assess the factors contributing to vulnerability of the plaques including inflammation, calcification and microvascular density. Materials and Methods: Seven cases of sudden cardiac death were included in the study. The hearts were perfusion-fixed and the coronary arteries along with their main branches were dissected and studied. The location of the plaques, type of plaques, presence of inflammation and calcification were assessed. The cap thickness and microvessel density per 1000um 2 were assessed. The statistical significance was estimated. Results and Conclusions: Extensive high-grade coronary atherosclerotic disease was seen in all sudden cardiac death cases. Majority of the plaques were vulnerable. High-grade inflammation was seen in most of the vulnerable and ruptured plaques. All the ruptured plaques were uncalcified indicating that calcification probably stabilizes the plaques and protects against rupture. Increased microvessel density was noted in ruptured plaques compared to vulnerable plaques. However, it was not statistically significant.
ABSTRACT
Primary broad ligament carcinomas unassociated with either uterine or ovarian disease are extremely rare. This case report deals with such a rare occurrence of primary broad ligament carcinoma of the serous papillary type with foci of transitional differentiation in a 40 yr old woman with a clinical diagnosis of multiple fibroids of uterus. The highlight of this case is that besides being a rare tumor occurring in an unusual site such as the broad ligament the papillary serous carcinoma reported here also has a unique feature of transitional cell differentiation.