A comparison of hysterosalpingography and laparoscopy in the evaluation of tubal factors in female infertility

Background: WHO defines infertility as “failure to conceive after having regular, unprotected intercourse for one year. Factors responsible - male factors (20-30%), female factors (40-55%), combined male and female factors (10-40%) and unexplained infertility (10-20%). Amongst female factors, tubal factors are responsible for 25-30% of infertility. Hysterosalpingography and diagnostic laparoscopy with chromopertubation are widely used in the evaluation of tubal factors of infertility. The aim of this study was to compare findings of HSG and diagnostic laparoscopy with chromopertubation for tubal patency in infertile women.Methods: An observational study, done on a total of 125 females suffering from primary and secondary infertility who underwent HSG and then 97 patients who gave consent, underwent diagnostic laparoscopy with chromopertubation. The data was entered in MS excel spreadsheet and analysis was done using statistical package for social sciences (SPSS) version 21.0.Results: Primary infertility cases were more than secondary infertility cases. Mean age of patients was found to be 28.92±5.33 years. Most common tubal abnormality found on hysterosalpingography and chromopertubation was bilateral tubal block. Inter rater kappa agreement used and significant agreement found between hysterosalpingography and chromopertubation with kappa value of 0.612.Conclusions: From this study authors conclude that HSG and laparoscopy with chromopertubation are complimentary to each other. Laparoscopy helps in identification of tubal and non-tubal factors like intra-abdominal and pelvic adhesions, endometriosis etc. and simultaneously they can be treated while HSG helps in evaluation of tubal factors as well as of intra-uterine factors like synechiae, polyps etc.

Ormeloxifene versus combined oral contraceptive pills to control blood loss in cases of dysfunctional uterine bleeding

Background: Dysfunctional uterine bleeding is one of the most often encountered gynecologic problems causing anemia, reduced quality of life and unnecessary hysterectomies. A prospective study was conducted on women with DUB to study the effect of ormeloxifene versus combined oral contraceptive pills in controlling blood loss in them.Methods: 100 Women with DUB were enrolled randomly in three groups. After baseline assessment each patient in group A was treated with iron tablets, containing 100 mg elemental iron and folic acid 1.5 mg, for three months and were termed as control group. Group B patients were treated with ormeloxifene in dose of 60 mg twice a week for twelve weeks. Group C patients were treated with combined oral contraceptive pills for twenty- one days starting from third day of their LMP. The treatment was continued for three consecutive cycles. The efficacy of the studied drugs was analyzed by comparing the baseline and post treatment PBAC score, haemoglobin level and endometrial thickness, using appropriate statistical tests.Results: Ormeloxifene was more effective than only iron or combined oral contraceptive therapy in controlling menstrual blood loss (79.11% versus 58.57%). There was a reduction in endometrial thickness in group receiving ormeloxifene as well as in the group receiving combined oral contraceptive pills (p=0.486), however this was statistically not significant.Conclusions: Ormeloxifene was significantly better than combined OCP in reduction of menstrual blood flow in cases of DUB. It has better compliance and marked improvement in subjective symptoms as compared to OCP.

Gingival crevicular fluid resistin levels in chronic periodontitis with type 2 diabetes before and after non-surgical periodontal therapy: A clinico-biochemical study

Aim: Periodontitis and diabetes mellitus share a bidirectional relationship. Resistin is an adipocytokine shown to be associated with type 2 diabetes mellitus. Hence, the present study aims to estimate the effect of non-surgical periodontal therapy (NSPT) on GCF resistin levels in healthy individuals with gingivitis and well controlled diabetics with periodontitis, and correlate the same with HbA1c levels of the diabetic subjects. Materials and Methods: The present study was a comparative interventional trial set in Department of Periodontics, the Oxford Dental College, Bangalore. Forty subjects participated in the study and were divided into two groups; group I (healthy individuals with gingivitis) and group II (diabetic individuals with mild to moderate periodontitis). Periodontal parameters were assessed and GCF was collected and analysed for resistin before and 3 months after NSPT. Statistical Analysis: All the analysis was done using SPSS version 18. A P value of < 0.05 was considered statistically significant. Results: A significant difference was observed in GCF resistin concentrations between the two groups at baseline, wherein group II had significantly higher values. Following NSPT, there was a significant reduction in GCF resistin concentrations in both the groups, however intergroup comparison showed no difference in the amount of reduction. When all samples were analysed together, no significant correlation could be found between resistin and the parameters assessed. Conclusion: Resistin levels are increased in diabetes related periodontitis. However, post treatment a similar response can be seen between healthy and well controlled diabetics. Hence, resistin can be used as an inflammatory biomarker for diabetes related periodontal disease.

Occurrence And Resistance Profile Of Nonfermentative Gram-Negative Bacilli In A Tertiary Care Hospital - A Therapeutic Concern

Aim: To isolate, identify and characterize the prevalence of non- fermenting gram negative bacteria (NFGNB) along with their antimicrobial resistance pattern among the patients attending a tertiary care Hospital in Meerut. Materials and Methods: The isolates of NFGNB obtained from various samples were identified by standard bacteriological technique and VITEK® 2 system (Biomerieux , France) . Antimicrobial susceptibility test was carried out to assess the resistance profile both by Kirby Baeur disk diffusion method and VITEK® 2 system (Biomerieux , France) . Result: Atotal of 16,296 clinical samples from the indoor and outdoor patients were processed in the bacteriology laboratory. Isolation rate of nonfermenters was 7.82% (1274/16296). Pseudomonas spp. was the predominant isolate (66.56%) followed by Acinetobacter spp. (27.16%). Other isolated non-fermenters were Burkholderia cepacia complex (BCC)(1.57%), Stenotrophomonas maltophila (0.86%), Sphingomona spaucimobilis (0.71%), Achromobacter xylosoxidans (0.16%), Ochrobactrum anthropic (0.16%). Conclusion: NFGNB are emerging as important opportunistic pathogens and are mostly resistant to commonly used antimicrobials. Therefore early diagnosis and initiation of appropriate antibiotic therapy would help in efficient management of patients and result in reduction of morbidity and mortality caused by these multi drug resistant organisms.

A Review On Physiology Of Manasa (psyche) In Ayurveda

Mental health is given equal importance at various places in Ayurvedic texts. Ayurveda emphasizes that Sharira (body) and Sattva (mind) both interact with one another in all spheres of life. The Ayurvedic approach towards health and disease is entirely psychosomatic in its nature. Ayurveda greatly emphasizes on the phenomena of mind than that of the body. This can be expounded by the definition of health, the causes of disease, the approach to the examination of the patient, the concept of the psychosomatic constitution i.e. Prakruti, the regimen of mental and physical hygiene. Therefore it is imperative to understand about the physiology, functions and enactments of Mind i.e. Manasa in Ayurveda. This review article is based upon the fundamentals describing Manasa and its functions and physiology. It is very important to understand each and every aspect of Manas for an Ayurvedic scholar or physician for complete knowledge of human body and behavior.

Enteric coated HPMC capsules plugged with 5-FU loaded microsponges: a potential approach for treatment of colon cancer

The work was aimed at developing novel enteric coated HPMC capsules (ECHC) plugged with 5 Florouracil (5-FU) loaded Microsponges in combination with calcium pectinate beads. Modified quasi-emulsion solvent diffusion method was used to formulate microsponges based on 32 factorial design and the effects of independent variables (volume of organic solvent and Eudragit RS100 content) on the dependent variables (Particle size, %EE & % CDR) were determined. The optimized microsponges (F4) were characterized by SEM, PXRD, TGA and were plugged along with calcium pectinate beads in HPMC capsules and the HPMC capsules were further coated with enteric polymer Eudragit L 100 (Ed-L100) and/ or Eudrgit S 100 (Ed-S 100) in different proportions. In vitro release study of ECHC was performed in various release media sequentially SGF for 2 h, followed by SIF for the next 6 h and then in SCF (in the presence and absence of pectinase enzyme for further 16 h). Drug release was retarded on coating with EdS-100 in comparison to blend of EdS-100: EdL-100 coating. The percentage of 5-FU released at the end of 24 h from ECHC 3 was 97.83 ± 0.12% in the presence of pectinase whereas in control study it was 40.08 ± 0.02% drug. The optimized formulation was subjected to in vivo Roentgenographic studies in New Zealand white rabbits to analyze the in vivo behavior of the developed colon targeted capsules. Pharmacokinetic studies in New Zealand white rabbits were conducted to determine the extent of systemic exposure provided by the developed formulation in comparison to 5-FU aqueous solutions. Thus, enteric coated HPMC capsules plugged with 5-FU loaded microsponges and calcium pectinate beads proved to be promising dosage form for colon targeted drug delivery to treat colorectal cancer.

O trabalho teve como objetivo o desenvolvimento de novas cápsulas com revestimento entérico HPMC (ECHC) conectadas com microesponjas carregadas com fluoruracila (5-FU) em combinação com grânuos de pectinato de cálcio. O método de difusão de solvente modificado quasi-emulsão foi usado para formular microesponjas com base no planejamento fatorial 32 e determinaram-se os efeitos das variáveis independentes (volume de solvente orgânico e conteúdo Eudragit RS100) sobre as variáveis dependentes (tamanho de partícula, EE% e % CDR). As microesponjas otimizadas (F4) foram caracterizadas por SEM, PXRD, TGA e ligadas aos grânulos de pectinato de cálcio em cápsulas de HPMC e estas foram, ainda, revestidas com polímero entérico Eudragit L 100 (Ed-L100) e/ou Eudrgit S 100 (Ed S 100) em diferentes proporções. No estudo de liberação in vitro de ECHC foi realizada em vários meios de liberação sequencial SGF durante 2 h, seguido de SIF para as próximas 6 h, e, em seguida, em SCF (na presença e na ausência de enzima pectinase por mais 16 h). A liberação do fármaco foi retardada em revestimento com a EDS-100, em comparação com mistura de EDS-100: EDL-100, de revestimento. O percentual de 5-FU liberado de ECHC 3 ao final de 24 h foi 97,83 ± 0,12% em presença de pectinase, enquanto que para o controle foi de 40,08 ± 0,02% do fármaco. A formulação otimizada foi submetida a estudos Roentgenográficos in vivo, em coelhos brancos Nova Zelândia, para analisar o comportamento das cápsulas desenvolvidas direcionadas ao cólon. Os estudos de farmacocinética em coelhos brancos da Nova Zelândia foram conduzidos para determinar a extensão da exposição sistêmica propiciada pela formulação desenvolvida, em comparação com solução aquosa de 5-FU. Assim, cápsulas entéricas de HPMC revestidas e conectadas com microesponjas carregadas com 5-FU e grânulos de pectinato de cálcio se mostraram promissoras como formulação para liberação do fármaco no cólon no tratamento do câncer colorretal.