Effects of Menopause on Sexual Function in Indian Women: A McCoy's Questionnaire-Based Assessment.

BACKGROUND: Menopause is associated with physical, physiological, psychological changes and may lead to sexual dysfunction (SD) effecting woman's health and well-being. Scientific research in the area of female sexuality in India is scant. Therefore, this study aimed to investigate female sexual function at perimenopause and menopause and determine the association between sociodemographic and physiological factors with sexual function. MATERIALS AND METHODS: This was a cross-sectional hospital-based study carried out in perimenopausal and menopausal women. Study participant's details were collected by gynecologists and clinical research professionals following the participant's informed consent. The case report and McCoy female sexuality questionnaire were used. The association between sociodemographic status and sexual function was determined. Data were summarized using descriptive statistics for portraying profile of the participants and t-test for comparison. RESULTS: A total of 129 women in the menopausal (SD - 3.26) and 112 in the premenopausal group (SD - 6.01) were enrolled. The sociodemographic parameters did not significantly affect the sexual function scores in both groups. In terms of vaginal atrophy, a significant increase in urgency was noted in the postmenopause group. The general domain of sexual function was significantly lower in menopausal than and perimenopausal with a P < 0.001. Looking at individual domains of sexual function, for sexual interest, satisfaction, vaginal lubrication, and orgasm, the mean value of perimenopausal participants was significantly higher when compared to menopausal women; for a primary partner domain, no significant differences between the two groups were noted. CONCLUSION: Overall, the sociodemographic profile did not impact sexual function in this study. Compared with menopausal women, perimenopausal women showed better, more complete sexual function based on McCoy's score except partner-related domain that is constant from perimenopause to menopause in a monogamous relationship.

Assessment of the perceived quality of life of successful kidney transplant recipients and their donors pre- and post-transplantation.

BACKGROUND: With advanced medical technology, quality of life (QOL) has assumed immense importance. In India, there has been scant research on the QOL of patients with stage 5 chronic kidney disease and their respective donors who make transplantation possible. METHODS: We assessed and compared the QOL of successful kidney transplant recipients (n = 30) and their living-related donors (n = 30) before and after kidney transplantation. RESULTS: For recipients, on the interview schedule the post-transplant QOL score (M = 1528.23, SD = 48.50) was higher than the pretransplant QOL score (M = 1075.80, SD = 95.34; P < .01). On the KDQOL SF 1.3, the physical and mental composite median QOL scores were significantly higher (P < .01) in the post-transplant (49.68, 61.43) than the pretransplant period (29.51, 34.09). For donors, on the interview schedule, the overall post-donation QOL score (M = 463.63, SD = 1.61) was higher than the predonation QOL score (M = 437.07, SD = 8.14; P < .01). On the KDQOL SF 1.3, the mental composite median post-donation QOL score (60.70) was higher than the predonation score (59.84; P < .01). CONCLUSION: Kidney transplantation/donation improved the QOL of patients and donors.

Disseminated histoplamosis.

A case of disseminated histoplasmosis in a 45-year-old male patient with acquired immunodeficiency syndrome (AIDS) from Pune is reported. The patient presented with high-grade fever and pain in hypochondrium. Clinical signs were pallor and hepatosplenomegaly. Bone marrow and splenic aspirate revealed numerous intracellular oval shaped yeast forms. Histoplasma capsulatum was isolated from the bone marrow and splenic aspirate. H. capsulatum infection is an opportunistic infection usually reported from patient with AIDS in areas endemic for H. capsulatum. The present case highlights the fact that histoplasmosis could be an emerging opportunistic infection in India.

Sero surveillance of leptospirosis among sewer workers in Pune.

Leptospirosis is an important occupational disease affecting people coming in contact with animals and their discharges. The occurrence of infection in ones workplaces is linked to the environment to which the worker is exposed and the adaptability of the organism in that working environment. Rodents usually abound in underground sewers and are carriers of leptospira. The urine of rodents and other animals present in that area is likely to contaminate these sewers. Leptospira are excreted in the urine of infected animals. Thus sewer workers are at a potential risk of leptospirosis. The prevalence of leptospirosis in these workers could thus indirectly predict the presence of the disease in animals in a particular geographical niche. Total seventy-eight sewer workers from 5 different municipal wards in Pune were examined to find out the evidence of past infection with leptospira using microagglutination test (MAT). The prevalence rate was found to be 16.6%. The serovars to which antibodies were detected include autumnalis (38.4%), pyrogenes (23.0%), canicola (15.3%) and pomona (15.3%). Evidence of leptospiral infection was found to be maximum in sewer workers in the areas of the city that were infested with rodents and stray animals.

Postnatal development and testosterone dependence of a rat epididymal protein identified by neonatal tolerization.

A rat epididymal protein of 27 kDa was identified using neonatal tolerization. This study reports the production and characterization of a polyclonal antiserum to this protein. ELISA was used to demonstrate that this antiserum reacts strongly with epididymal sperm proteins, but has little or no reactivity with testicular proteins. Western blot analysis revealed that this polyclonal antiserum recognized a 27 kDa protein extracted from the corpus epididymidis as well as from spermatozoa from the corpus and cauda epididymides, and immunostaining revealed the presence of the protein in the corpus to cauda epididymides. Stronger reactivity was observed in the supranuclear region and stereocilla of principal cells of the corpus epididymidis and in the luminal content of the corpus and cauda epididymides. The testicular section showed no reactivity. Treatment with the antiserum resulted in time- and dose-dependent agglutination of rat spermatozoa. By indirect immunofluorescence, the antiserum localized proteins in the mid-piece region of rat spermatozoa. Studies were carried out to determine the age at which the protein first became apparent during postnatal development. The protein was expressed from day 40 onwards, as demonstrated by western blot analysis. The androgen regulation of this protein was ascertained by castration and supplementation studies. Expression of this protein showed a decline starting at day 14 after castration and by day 21 the protein was absent; however, androgen replacement resulted in the reappearance of the protein. The results of these studies indicate that the protein identified is specific to the epididymis, and is regulated by development and androgens. The importance of epididymis-specific proteins that are regulated by androgens in sperm maturation is discussed, and the need to ascertain the sequence of the protein and clone the cognate gene is indicated.

Common infecting leptospiral serovars in and around Pune, Maharashtra.

Leptospirosis is a disease with protean manifestations. The present study was conducted in Pune to examine the possibility of leptospiral infection among a group of patients with fever of undetermined origin and to identify the common infecting serovars. Serological evidence of leptospirosis was found in 22 of the 118 (18.6%) patients with the help of microagglutination test (MAT) using a battery of 9 antigens. The serovars responsible for infection included autumnalis in eight cases, copenhageni in six, pomona in three, grippotyphosa in two and australis, batavia and canicola in one case each. Thus, there appears to be a focus of leptospirosis in and around Pune with autumnalis and copenhagni as the common infecting serovars.

Evaluation of clinical criteria for the diagnosis of leptospirosis.

OBJECTIVES: Leptospirosis has a wide range of clinical presentation and therefore, clinical suspicion of the infection is often difficult. The objective of this study is to find out the usefulness of the clinical and epidemiological criteria in the diagnosis of leptospirosis and its comparison with microagglutination test (MAT). METHODS: A total of 118 patients with undiagnosed fever of more than seven days duration were included in the study. Their clinical presentation was scored on the basis of a clinical criteria. Sera of the patients were tested for antibodies against leptospira with the help of microagglutination test using a battery of antigens. The usefulness of the criteria was evaluated and compared with microagglutination test. RESULTS: A total of 44 out of 118 (37.28%) patients could be provisionally diagnosed as cases of leptospirosis on the basis of the clinical criteria. Eighteen of these 44 (40.9%) patients had serological evidence of leptospirosis. The criteria had a sensitivity of 81.81%, specificity of 72.91%, a positive predictive value of 40.9% and a negative predictive value of 94.59% when compared with microagglutination test. CONCLUSIONS: The criteria had a moderate sensitivity and specificity. Considering the non-specific signs and symptoms of this infection, the positive predictive value is significantly high. The criteria has a high negative predictive value and this would help the clinicians exclude the diagnosis of leptospirosis with precision.

Contaminated antiseptics--an unnecessary hospital hazard.

A total of 284 antiseptic solutions were studied to check for their sterility. The overall antiseptic contamination rate was 15.14%. 14.85% of freshly prepared antiseptics were contaminated. Here, the problem could be attributed to inadequate precautions while preparing the antiseptics. 15.3% of the in-use antiseptics were contaminated. This could be due to improper handling. Non-fermenters (45.45%), Pseudomonas aeruginosa (30.30%) and Klebsiella spp. (22.72%) were the commonest organisms recovered from the antiseptics. In 44.44% of patients, the isolates obtained from the catheterised urine in the same wards matched with the isolates from antiseptics of that ward. Antiseptic solutions have to be regularly monitored. If they are found to be contaminated, they should be discarded immediately and replaced by fresh sterile antiseptics otherwise instead of preventing infection, antiseptics will become a source of hospital-acquired infection.

Incorporation of Galpha(z)-specific sequence at the carboxyl terminus increases the promiscuity of galpha(16) toward G(i)-coupled receptors.

Although the promiscuous nature of G(16) allows it to interact with numerous G protein-coupled receptors, several G(i)-linked receptors are incapable of activating phospholipase C via G(16). A series of chimeras between Galpha(16) and Galpha(z) were constructed and assayed for their ability to mediate receptor-induced stimulation of phospholipase C. Two Galpha(16/z) chimeras harboring 25 or 44 Galpha(z)-specific sequences at their C termini (named 16z25 and 16z44) were capable of responding to 14 different G(i)-coupled receptors tested, including those that were either unable to associate with Galpha(16) (melatonin Mel1c) or activate Galpha(16) weakly (micro-opioid and type 1 somatostatin). Agonist-induced stimulation of phospholipase C was more efficiently mediated (higher maximal and lower EC(50) value) by 16z44 than by Galpha(16). Both 16z25 and 16z44 were also coupled to G(s)- and G(q)-linked receptors. Incorporation of Galpha(z) sequence at the N terminus of Galpha(16) did not further enhance the ability of the chimeras to interact with G(i)-coupled receptors. Expression of the various chimeras was verified by immunodetection and functional analysis of their constitutively activated mutants. These results show that the incorporation of alpha4/beta6 and alpha5 regions of Galpha(z) into a Galpha(16) backbone can improve the recognition of G(i)-coupled receptors. Galpha(16/z) chimeras with expanded capability to interact with G(i)-linked receptors may be used to link orphan receptors to the stimulation of phospholipase C.

Leptospirosis in the causation of hepato-renal syndrome in and around Pune.

Fifty cases of hepato-renal dysfunction of unknown etiology were studied over a two-year period. Urine samples were examined microscopically and cultured for Leptospira. Serum samples were examined for antibodies against Leptospira by the Macroscopic slide agglutination test (MSAT). Seventeen out of fifty patients (34%) showed evidence of Leptospiral infection by at least two diagnostic techniques used. 15/17 i.e. 88.2% were positive by dark ground microscopy, 7/17 were diagnosed by culture technique and 16/17 i.e. 94% were confirmed by serology. There was a good correlation between Microscopic agglutination test (MAT) and MSAT. Thus Leptospires seem to play a major role in the causation of hepato-renal dysfunction in and around Pune, Maharashtra.

GalphaL1 (Galpha14) couples the opioid receptor-like1 receptor to stimulation of phospholipase C.

In most tissues and cells the opioid receptor-like (ORL1) receptor regulates effectors primarily through the pertussis toxin (PTX)-sensitive guanine nucleotide-binding regulatory proteins (G proteins) Gi/Go. Many Gi-coupled receptors possess additional capability to interact with one or more PTX-insensitive G proteins. Using the betagamma-induced stimulation of type 2 adenylyl cyclase as a readout, we screened the ability of ORL1 receptor to interact with a panel of PTX-insensitive G proteins. In the presence of PTX, activation of the ORL1 receptor resulted in the stimulation of type 2 adenylyl cyclase only in HEK 293 cells coexpressing the alpha subunit of Gz, G12, G14, or G16, but not in cells coexpressing G11, G13, or Gq. Coupling to both Gz and G16 was expected because close relatives of the ORL1 receptor, the opioid receptors, are known to couple productively to these G proteins. ORL1 receptor coupling to either G12 or G14 has not been demonstrated. As predicted by the type 2 adenylyl cyclase assays, activation of the ORL1 receptor resulted in the formation of inositol phosphates in COS-7 cells transiently cotransfected with Galpha14. The ORL1 receptor-mediated stimulation of phospholipase C was found to be Galpha14 dependent, agonist dose dependent, ligand selective, and PTX insensitive. We conclude that G14 can link the ORL1 receptor to regulation of phopholipase C.

Chimeric Galpha(q) mutants harboring the last five carboxy-terminal residues of Galpha(i2) or Galpha(o) are resistant to pertussis toxin-catalyzed ADP-ribosylation.

Three widely-used Galpha(q) chimeras harboring the last five residues of Galpha(i), Galpha(o) and Galpha(z) (qi5, qo5 and qz5) were examined for their ability to serve as substrates for pertussis toxin (PTX)-catalyzed ADP-ribosylation. In COS-7 cells coexpressing one of the three opioid receptors (mu, delta, and kappa) and a Galpha(q) chimera, agonist-induced stimulation of phosphoinositide-specific phospholipase C (PI-PLC) was largely insensitive to PTX treatment. Only the qi5-mediated stimulation of PI-PLC by kappa-opioids was partially inhibited by PTX. In betagamma-release assays, PTX treatment did not affect the ability of opioid receptors to activate these chimeras. [32P]ADP-ribosylation labeled Galpha(i/o) but not qi5 or qo5, although the expression of these chimeras was confirmed by immunodetection. Thus, Galpha(q) chimeras with a Galpha(i/o)-like tail are insensitive to PTX treatment.