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Palliative care is an integral component of comprehensive cancer care that offers reasonable symptom control and a decent quality of life beyond the chance for cure.[1][1] A 50-year-old postmenopausal woman was seen in the oncology clinic with a progressive lump in the right breast and ulceration

Introduction In this study, we have mainly focused on the molecular and biochemical aspects to know the cause of gall stone diseases in human. To know about these problems, there may be necessitating initiating interest in researchers of this field and to set up easily available tools and techniques. The screening of polymorphism with molecular approaches of P450 super family CYP7A1 gene was performed to explore its relation with gallstone diseases. Methods Total 300 samples (150 patients and 150 controls) were analyzed for the study. The polymorphisms were analyzed by PCR followed by RFLP with BsaI restriction enzyme. The lipid profile was estimated by using modified Roeschlau’s method. The cholesterol content in gall stones was determined with Liebermann-Burchard reaction method. Results The cholesterol content of recovered gallstones was found 98.86 ± 25.43 (% by weight). BMI and serum glucose were found higher in patients than in the control group: 30.84 ± 8.13 kg/m2 vs 28.61 ± 7.50 kg/m2 (P = 0.032), and 121.03 ± 15.11 mg/dL vs 104 ± 21.05 mg/dL (P = 0.001) respectively. Statistical analysis showed no significant differences in genotypic frequencies of gene CYP7A1 gene polymorphism between patients and controls. Frequencies of C allele (CYP7A1 gene polymorphism) in patients and controls were obtained 24.24% vs 26.46% (P = 0.621, OR = 0.89). Genotypic frequencies between patients and controls were found 59.42% vs 54.97% for AA; 30.25% vs 34.72% for CA; and 10.33% vs 10.31 for CC. Discussion In this study by using of multiple logistic regression analysis the results have indicated that CYP7A1 gene polymorphism may not play any significant role in gallstone disease.

The somatic component of seminiferous epithelium, the Sertoli cells (Sc) respond to Follicle stimulating hormone (FSH), and Testosterone (T) to produce factors which are necessary for germ cell (Gc) survival and differentiation. Infant Sc do not support spermatogenesis in spite of sufficient hormonal milieu, a situation similar to that found in male idiopathic infertility. Sc maturation during pubertal period involves expression of some genes which may be important for initiation of spermatogenesis. Analysis of differentially expressed genes, one by one, in infant and pubertal Sc might provide useful information about the regulation of spermatogenesis. DNA microarray based analysis of mRNA from 5-days (infant) and 12-days (pubertal) old rat Sc revealed increased expression of Nor-1 by pubertal Sc. NOR-1 is an orphan nuclear receptor involved in maintaining cellular homeostasis and disease. We generated transgenic mice using shRNA cloned under Pem (Rhox5) promoter which is activated at puberty in Sc. Such transgenic mice had reduced Nor-1 expression and increased Tgfβ1, Tgfβ3, and Smad3 expression. Moreover, an increase in β-catenin expression was observed in NOR-1 knockdown testes. High β-catenin in such transgenic mice was found to be associated with disruption of Sc maturation characterized by elevated expression of Anti Mullerian hormone, Cytokeratin 18, and Sox9. This disruption of Sc maturation resulted in Gc apoptosis. Such NOR-1 knockdown mice showed reduced sperm count and litter size. We report for the first time that NOR-1 plays a crucial role in regulating sperm count and male fertility.

Testicular Sertoli cells make a niche for the division and differentiation of germ cells. Sertoli cells respond to increased follicle-stimulating hormone (FSH) and testosterone (T) levels at the onset of puberty by producing paracrine factors which affect germ cells and trigger robust onset of spermatogenesis. Such paracrine support to germ cells is absent during infancy, despite Sertoli cells being exposed to high FSH and T within the infant testis. This situation is similar to certain cases of male idiopathic infertility where post-pubertal Sertoli cells fail to support germ cell division and differentiation in spite of endogenous or exogenous hormonal support. Defective Sertoli cells in such individuals may fail to express the full complement of their paracrine repertoire. Identification and supplementation with such factors may overcome Sertoli cells deficiencies and help trigger quantitatively and qualitatively normal differentiation of germ cells. To this end, we compared the transcriptome of FSH- and T-treated infant and pubertal monkey Sertoli cells by DNA microarray. Expression of Wnt3, a morphogen of the Wnt/β-catenin pathway, was higher in pubertal Sertoli cells relative to infant Sertoli cells. Transgenic mice were generated by us in which Wnt3 expression was curtailed specifically in post-pubertal Sertoli cells by shRNA. Subfertility and oligozoospermia were noticed in such animals with low Wnt3 expression in post-pubertal Sertoli cells along with diminished expression of Connexin43, a gap-junctional molecule essential for germ cell development. We report that the FSH- and T-targetedf Wnt3 governs Sertoli cell-mediated regulation of spermatogenesis and hence is crucial for fertility.

In response to various hormonal (follicle-stimulating hormone [FSH] and testosterone [T]) and biochemical inputs, testicular Sertoli cells (Sc) produce factors that regulate spermatogenesis. A number of FSH- and T-responsive Sc-specific genes, necessary for spermatogenesis, have been identified to date. However, the hormone-induced in vitro expression pattern of most of these genes is reported to be inconsistent at various time points in primary rat Sc cultures. As a matter of convenience, cultured Sc are constantly exposed to hormones for a few hours to days in the reported literature, although Sc are exposed to pulsatile FSH and T in vivo. The major aim of the present study is to evaluate the advantage, if any, of the in vitro administration of pulsatile hormone (FSH and T in combination) treatment on gene expression of cultured Sc as compared with that of constant hormone treatment. Pulsatile treatment (a 30-min hormonal exposure every 3 h) mimicking the in vivo condition reveals a more prominent effect of hormones in augmenting gene expression as compared with constant treatment. Our results indicate that the expressions of Stem cell factor (Scf, only responsive to FSH), Claudin11 (only responsive to T) and Transferrin (both FSH- and T-responsive) mRNAs are significantly higher at 12 h upon pulsatile treatment than upon constant hormonal treatment. Maximal expression of relevant genes because of pulsatile treatment with hormones suggests that this protocol provides a more suitable premise for assessing hormone-induced gene expression in isolated Sc than one involving constant exposure to hormones.

Background: India, with one of the world’s fastest growing populations, is a nation very much in need of contraceptive counselling. To assess the knowledge and attitude regarding family planning methods and contraceptive practices among women of reproductive age group.Methods: A cross-sectional study was performed in which 547 women in the reproductive age group i.e., 15-45 years, attending a tertiary care hospital in Mumbai were interviewed with predesigned validated questionnaire. A total of 547 women were interviewed using a semi-structured questionnaire from January 2016 to December 2016. The proforma included details such as socio-demographic features, questions related to knowledge, attitude and practices (KAP) regarding contraceptive use.Results: Out of 547 women interviewed, 498 (i.e. 91%) had displayed an awareness of family planning methods (permanent/temporary). Out of these 498 women, about 78% had procured the information from family and friends. 13% got their information through mass media. Only 9% of women had been counselled in detail by health personnel about the various contraceptive options available. Out of 547 women interviewed, 342 (62.5%) were using contraception. More than a third of these women (26.8%), resort to barrier contraception as a contraceptive method of choice for spacing and to prevent an unwanted pregnancy. Only 17% women used OC Pills as a contraceptive method though 66% women knew about them. Though 59.4% of the women knew about IUCDs only 3.5% were actually using IUCD. Most of the women were in the younger age group of 21-30years (62%) and already had one or two children.Conclusions: Ignorance regarding use and side effects various contraceptive methods is the reason for inadequate practice of family planning methods. There should be emphasis on focused awareness programs, based on bridging the knowledge gaps among the women in reproductive age group.

Background: The outcome of first trimester vaginal bleeding is a matter of debate. This study sought to determine the maternal and perinatal outcome in patients presenting with first trimester vaginal bleeding.Methods: This prospective observational study was done on 1007 women with first trimester vaginal bleeding at a tertiary care hospital in Mumbai over a period of one year. A detailed history was taken and USG was done to confirm diagnosis. All these patients were evaluated for the outcomes including threatened abortions, spontaneous, complete or incomplete abortions, sub-chorionic hematoma, Intra-uterine Fetal Demise, missed abortions, second and third trimester bleeding, Intra-uterine Growth Restriction, premature rupture of membranes and preterm deliveries.Results: Out of the 11835 confinements 1007 patients presented with first trimester vaginal bleeding. The incidence was highest (52.3%) in the age group of 21-30 years. 63.9% primigravidas presented with first trimester bleeding as compared to 36.1% of multigravidas. It was seen that 76.9% patients who presented before 6 weeks aborted whereas only 7% patients who presented after 10 weeks aborted. Out of the 163 patients that continued pregnancy after first trimester vaginal bleeding 1.8% had a second trimester abortion, 15.3% went into preterm labour 6.75% has premature rupture of membranes and 1.8% had antepartum hemorrhage.Conclusions: According to the results of present study, first trimester vaginal bleeding predicts auxiliary maternal and fetal complications. Also, as the clinical intermediation has an important role in continuance of pregnancy and in reducing the fetal complications precise management and planning by physician is important.

Background: Abnormal uterine bleeding (AUB) is a common gynecological problem associated with considerable morbidity and significantly affects the patients. The aim of the study was to analyze the histopathological patterns of endometrium in patients presenting with AUB and also to determine the incidence of AUB in various age groups.Methods: This is a retrospective study, conducted in the Department of Obstetrics and Gynaecology, in a tertiary care teaching hospital, Mumbai, India from March 2016 till date. All cases of AUB were included in the study. Data was entered in microsoft excel and managed in statistical package for the social sciences (SPSS) version 16. Analysis was done in the form of percentages and proportions and represented as tables where necessary.Results: A total of 120 cases were analyzed. Patients’ age ranged from 22-79 years. AUB was most common among the perimenopausal females (41-50years). The most common presenting symptom was heavy menstrual bleeding (53%). Dilatation and curettage (D&C) was performed in all cases and 96 underwent hysterectomy as final resort. Endometrial proliferative pattern was the most common histopathological finding and was seen in 27% patients, followed by endometrial hyperplasia in 13.5% patients, secretory endometrium (12.7%) and disordered proliferative endometrium were seen in 10.9% patients each. Malignancy was detected in 1.7% of cases and endometrial carcinoma was the most common lesion.Conclusions: Endometrial sampling is especially indicated in women above the age of 35 years to rule out malignancy and preneoplasia. Among the females with no organic pathology, normal physiological patterns with proliferative, secretory, and menstrual changes were observed. The most common endometrial pathology in this study was endometrial proliferation.