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Neurodegenerative disorders present with progressive and irreversible degeneration of the neurons. Alzheimer's disease (AD) is one of the most common neurodegenerative disorders affecting 50 million people worldwide (2017), expected to be doubled every 20 years. Primarily affected by age, AD is the cause for old-age dementia, progressive memory loss, dysfunctional thoughts, confusion, cognitive impairment and personality changes. Neuroglia formerly understood as "glue" of the brain neurons consists of macroglia (astrocytes and oligodendrocyte), microglia and progenitors NG2-glia, and constitute a large fraction of the mammalian brain. The primary functions of glial cells are to provide neurons with metabolic and structural support in the healthy brain; however, they attain a "reactive" state from the "resting" state upon challenged with a pathological insult such as a neurodegenerative cascade. Failure or defects in their homoeostatic functions (i.e. concentration of ions, neurotransmitters) ultimately jeopardize neurons with excitotoxicity and oxidative stress. Moreover, the most common clinical outcome of AD is the cognitive impairment and memory loss, which are attributed mainly by the accumulation of Aβ. Failure of glial cells to remove the Aβ toxic proteins accelerates the AD progression. The rapidly emerging proteomic techniques such as mass spectrometry (MS), cross-linking mass spectrometry, hydrogen deuterium trade mass spectrometry, protein foot printing and 2-DGE combined with LC-MS/MS present wide array of possibilities for the identification of differentially expressed proteins in AD.

The intricate physiology of many Central Nervous System (CNS) disorders points towards oxidative damages of neurons. Various studies have established that oxidative stress is a big threat to integrity of neurons. All the sections of central nervous system are exposed to free radicals and charged species formed during oxidative degradation of catecholamines and polyunsaturated fatty acids which are present abundantly in CNS. By products of other biochemical reactions also contribute to oxidative stress in central nervous system. If these charged species are not counter neutralized by antioxidants, it leads to neurodegenerative disorders like Alzheimer's disease, Parkinson's disease, Amyotropic lateral sclerosis, Multiple sclerosis, Spinal cord injury, Schizophrenia etc. The level of charged species and free radicals is found to be higher in neurodegenerative diseases than normal physiological condition and it is related to oxidative damages to neuronal cells. In many of such cases, use of antioxidants decreases oxidative stress and contribute to neuroprotection. This review intends to compile approach of managing oxidative stress in various neurodegenerative disorders. The perspective of this review is to study antioxidants and their role in neuroprotection.

Rheumatoid Arthritis (RA), one of the leading causes of disability due to progressive autoimmune destruction of synovial joints, affects ∼1% of the global population. Standard therapy helps in reducing inflammation and delaying the progression of RA but is limited by non-responsiveness on long-term use and several side-effects. The conventional nanocarriers (CNCs), to some extent, minimize toxicity associated with free drug administration while improving the therapeutic efficacy. However, the uncontrolled release of the encapsulated drug even at off-targeted organs limits the application of CNCs. To overcome these challenges, trigger-responsive engineered nanocarriers (ENCs) have been recently explored for RA treatment. Unlike CNCs, ENCs enable precise control over on-demand drug release due to endogenous triggers in arthritic paws like pH, enzyme level, oxidative stress, or exogenously applied triggers like near-infrared light, magnetic field, ultrasonic waves, etc. As the trigger is selectively applied to the inflamed joint, it potentially reduces toxicity at off-target locations. Moreover, ENCs have been strategically coupled with imaging probe(s) for simultaneous monitoring of ENCs inside the body and facilitate an 'image-guided-co-trigger' for site-specific action in arthritic paws. In this review, the progress made in recently emerging 'trigger-responsive' and 'image-guided theranostics' ENCs for RA treatment has been explored with emphasis on the design strategies, mechanism, current status, challenges, and translational perspectives.

Cancer is considered the most deadly disease impacting the different countries of the world. A classic hallmark of cancer is the rapid transformation of normal cells into rapidly and uncontrollably dividing abnormal cells that invade adjoining tissues and organs in a process termed metastasis. According to WHO reports, as of 2018, the leading cause of death in cancer with a global estimate of around 9.6 million and one out of every six cases of death is due to cancer worldwide. The factors resulting in the cancer are physical, chemical, and biological carcinogens. The number of risk factors plays a significant role in cancer like food contaminants, medical drugs, reproductive and hormonal factors, natural, medical, industrial sources, immunosuppression, and genetic susceptibility. Thus, for cancer management, surgery, radiotherapy, chemotherapy, essential medicines, and psychological services are used. Nowadays, advanced techniques are available to detect cancer, including ultrasonography, computed tomography (CT), conventional X-rays, scanning, and magnetic resonance imaging. In addition to this, positron emission tomography and single-photon emission CT are the two often used nuclear imaging techniques used for cancer imaging in recent years. The advanced techniques available for treatment are CART-cell therapy, gene therapy, immunotherapeutic vaccines, adoptive cell transfer therapy, and genetically modified poliovirus therapy. Hence, the chapter deals with cancer, its types, carcinogens responsible for cancer, cause, risk factors, detection, and prevention techniques for cancer. It also explained the treatments available currently for the management of cancer.

Purpose To describe endogenous endophthalmitis in the setting of Covid-19 pneumonia post recovery. Methods Retrospective review of five patients of endogenous endophthalmitis following Covid-19 disease done. Results All five cases had received systemic corticosteroid for a mean duration of 7 days during severe Covid-19 treatment. Decrease vision was presenting symptom between 1 and 31 days following Covid-19 recovery. All patients had presumed fungal endogenous endophthalmitis based on clinical profile. Four out of five patients subjected to pars plana vitrectomy had microbiologically proven aspergillus species endogenous endophthalmitis on vitreous fluid assessment; two cases each of aspergillus niger and aspergillus fumigates. Four eyes underwent pars plana vitrectomy with silicone oil injection had shown satisfactory anatomical outcome with control of the infection; however, no significant visual gain achieved. Conclusion We reported five cases of aspergillus endogenous endophthalmitis in Covid-19 recovered patients to document the likely presentation of this rising entity and avoid misdiagnosis.

The 10/66 dementia protocol was developed as a language and culture-fair instrument to estimate the prevalence of dementia in non-English speaking communities. The aim of this study was to validate the 10/66 dementia protocol in elders of Indian ethnicity born in the Fiji Islands (Fijian-Indian) living in New Zealand. To our knowledge, this is the first time a dementia diagnostic tool has been evaluated in the Fijian-Indian population in New Zealand. We translated and adapted the 10/66 dementia protocol for use in in Fijian-Indian people. Individuals (age ≥ 65) who self-identified as Fijian-Indian and had either been assessed for dementia at a local memory service (13 cases, eight controls) or had participated in a concurrent dementia prevalence feasibility study (eight controls) participated. The sensitivity, specificity, positive predictive value, and Youden’s index were obtained by comparing the 10/66 diagnosis and its sub-components against the clinical diagnosis (reference standard). The 10/66 diagnosis had a sensitivity of 92.3% (95% CI 70.3–99.5), specificity of 93.8% (95% CI 75.3–99.6), positive predictive value of 92.3% (95% CI 70.3–99.5), and negative predictive value of 93.8% (95% CI 75.3–99.6). The study results show that the Fijian-Indian 10/66 dementia protocol has adequate discriminatory abilities to diagnose dementia in our sample. This instrument would be suitable for future dementia population-based studies in the Fijian-Indian population living in Aotearoa/New Zealand or the Fiji-Islands.

Breast cancer (BC) is a second common malignancy in female globally. Hence, identification of novel therapeutic agents is extremely important. Molecular docking and MD simulation are the important tools in the process of drug discovery for searching the potential hits. The structure-based drug designing technique also reveals the information about ligands behavior in computational environment. Docking tools help in visualization and analysis of protein-ligand complex at atomic level. Molecular dynamics shows the stability of the molecules in the receptor cavity in the simulated environment. In this research work, we have screened potent phytochemicals against the BC. We docked the phytochemicals and examined the binding affinities of ligands towards the EGFR, HER2, estrogen and NF

Retinal cavernous hemangiomas is a rare vascular tumor, isolated and non-progressive. This tumor is incidentally diagnosed on fundus examination and visual impairment can be rare presentation from vitreous hemorrhage, pre-retinal traction, hyphema, or macular scarring. The tumor has typical appearance of grape-like clusters of dilated vascular sacs with variable surface gliosis. Characteristic imaging findings aids in diagnosis. Newly emerged imaging tool is optical coherence tomography angiography (OCT A) which obtains high-resolution visualization of retinal vasculature in non-invasive fashion. In the present case report, we analyzed various diagnostic tool available for retinal cavernous hemangiomas; illustrating on the OCT A features.

Proboscis lateralis (PL) is a rare congenital malformation of the craniofacial structure with varied clinical associations. None of the studies documented a discrete review of ophthalmic presentations in PL. The principal aim of the present study is to explore the ophthalmic manifestations of PL. The ancillary goal is to derive a relationship between congenital deformity in PL and various ophthalmic anomalies. Databases were searched in order to obtain articles related to PL. A qualitative systematic analysis of 100 subjects was performed. In PL, eyelid coloboma (32.6%) is the most common ocular feature, followed by hypertelorism (25.3%), iris coloboma (22.4%), lacrimal system abnormality (20.7%), malpositioned eyebrow (14.4%) and retinochoroidal coloboma (12.9%). Sinonasal deformity is the most common systemic abnormality, detected in 87.9% of cases of PL, as compared with central nervous system involvement (56.2%) and other anomalies. The analysis showed a strong significant association between brain abnormalities and hypertelorism (p=0.000) and between brain abnormalities and micro-ophthalmia/anophthalmia (p=0.000). Statistically significant association was noted between cumulative ocular abnormalities and cumulative systemic abnormalities (p=0.001). The present study on PL reviewed the salient features of this rare congenital disorder. The study outcome provides a new aspect to concomitant ocular abnormalities. This study supports the view that other congenital anomalies in cases of PL had significant influence on certain ophthalmic anomalies.

Background Tetranectin concentration has been identified as a biomarker of several types of metastatic and malignant cancers. The role of tetranectin has also be seen in some neurological disorders. We aimed to estimate the plasma tetranectin concentration in different groups of people with epilepsy (PWE) followed-up for a year. As a secondary objective, the clinical and social characteristics were also correlated with the tetranectin levels. Methods We enrolled 90 subjects grouped as Newly-diagnosed epilepsy (NDE), Drug-effective epilepsy (DEE), and Drug-refractory epilepsy (DRE) and an age-gender matched control group (n = 30). The plasma samples were collected thrice at the six-month interval and were analysed for the tetranectin concentration using S-ELISA. Results The mean plasma tetranectin levels at the baseline test were significantly lower for the DEE (6.294 ± 0.806) and DRE (7.572 ± 0.545) groups compared with control group (9.71 ± 0.628) but not the NDE group (8.651 ± 0.859 vs. 9.71 ± 0.628; p > 0.05). On a year of follow-up, the tetranectin levels for the NDE group significantly decreased (p < 0.001) matching with that of the DEE and DRE group. Multivariate linear regression analysis showed that gender (p = 0.035) in the DRE group and seizure type (p = 0.040) and diet (p = 0.046) for the NDE group were significantly correlated. Conclusion The plasma tetranectin level in PWE significantly decreased as the disease progressed irrespective of the stage of epilepsy. Thus, tetranectin could be considered as a potential progressive biomarker for epilepsy. The study outcome suggests further investigation for the possible link of tetranectin levels with clinical and social parameters.

Present study was undertaken to study the association between sickle cell anemia (SCA) and glucose-6-phosphate dehydrogenase (G6PD) deficiency from Sahu and Kurmi population of Durg and Rajnandgaon district of Chhattisgarh, India.A random sampling of 1749 individuals was done. SCA and G6PD deficiency was detected by slide test followed by electrophoresis and Enzymatic reaction indicated by change in colour respectively. Further the samples were subjected to analyze glutathione-S-transferase (GST) i.e. GSTM1 and GSTT1 gene polymorphism, variance of G6PD among G6PD deficient samples by PCR-RFLP. Oxidative stress and DNA damage by comet assay was also analyzed.Present finding indicates positive correlation between SCA and G6PD deficiency in Durg and Rajnandgaon district [Durg: (r = 0.92; HbAS-G6PDd and r = 0.56; HbSS-G6PDd) Rajnandgaon: (r = 0.63; HbAS-G6PDd and r = 0.86; HbSS-G6PDd)]. Significant changes (P 0.05) in antioxidant enzymatic parameters were observed in HbSS and G6PD with sickle positive individual. Assessment of DNA damage by Comet assay considering Head DNA percent, Tail DNA percent, Tail length and Tail moment also showed significant changes (P 0.05) within all concerned parameters in HbSS and G6PD with sickle positive individual. Analysis of GST gene polymorphism showed that frequency of individuals carrying the GSTM1 null genotype was higher in HbAS (60%) and the frequency of individual carrying the GSTT1 null genotype was found higher in HbSS (66.6%). G6PD variants analysis also confirmed the presence of highest percentage of mutation among G6PD deficient population as compared to control and a positive correlation was observed between G6PD deficiency and mutant variants of G6PD gene [Rajnandgaon: (r = 0.67; G6PDd-Mahidol mutated and r = 0.90; G6PDd-Union mutated) Durg: (r = 0.91; G6PDd-Mahidol mutated and r = 0.01; G6PDd-Union mutated)] .Thus present finding indicates positive correlation between SCA and G6PD deficiency in Chhattisgarh, India.

To determine the clinical features, treatment, and visual outcome in ocular toxocariasis.A total of 16 cases diagnosed as ocular toxocariasis clinically and/or serologically were analyzed retrospectively.The mean age of the patients was 22.6 years. Cases were categorized into three clinical types with peripheral granuloma (43.7%) as the most common presentation. Of the patients, 10 (62.5%) had positive serum ELISA for T. canis; five (31.2%) received combination treatment with anthelmintic and corticosteroid, and eight (50%) patients had vitreous surgery. The visual outcome in eyes which underwent surgery was better, however the difference in medically and surgically treated groups was insignificant (p = 0.11). There was also no difference in visual outcome among the three clinical groups (p = 0.20).Ocular toxocariasis has a varied presentation spectrum. Serum ELISA for T. canis aids in diagnosis. The difference in visual outcome among clinical and treatment groups was insignificant. However, in general, ocular toxocariasis resulted in a poor visual outcome.

Background Epilepsy is the most common neurological disorder which requires chronic treatment. This has prominent impact on the quality of life of the patient and their caregivers. This study was planned to assess and correlate the quality of life in epilepsy (QOLIE) in these two groups, in India. Material and methods A total of 160 subjects with definite diagnosis of epilepsy according to ILAE and their caregivers were included in the study. The QOLIE 31 and SF 36 proforma were used as assessing instruments for subjects and caregivers respectively. Results Factors such as early age of onset of epilepsy, lesser duration of epilepsy, increased interval between seizures in subjects on monotherapy, socioeconomic and educational status had better quality of life (QOL) in subjects than age, gender, marital and employment status. On the other hand for caregivers following factors-age, gender, relation with the subjects and socioeconomic status had influenced the QOL. The QOL of the caregivers was directly proportional proportional to the QOL of their respective subject. Conclusion This study reaffirms the findings of the previous studies that key to improving quality of life of people with epilepsy, are good control of seizure and reducing side effects (by minimizing antiepileptic drugs) along with holistic care. Caregivers QOL is also proportionally affected by subjects QOL and it is seen to have adverse outcomes when the caregiver is female (mother or wife), elderly, of low socioeconomic status and when subject has poor seizure control.

Background & objectives : Wilson's disease (WD) is an autosomal recessive disorder caused by mutations in ATP7B, a copper transporter gene, leading to hepatic and neuropsychiatric manifestations due to copper accumulation. If diagnosed early, WD patients can be managed by medicines reducing morbidity and mortality. Diagnosis of this disease requires a combination of tests and at times is inconclusive due to overlap of the symptoms with other disorders. Genetic testing is the preferred alternative in such cases particularly for individuals with a family history. Use of DNA microarray for detecting mutations in ATP7B gene is gaining popularity because of the advantages it offers in terms of throughput and sensitivity. This study attempts to establish the quality analysis procedures for microarray based diagnosis of Wilson's disease. Methods: A home-made microarrayer was used to print oligonucleotide based low-density microarrays for addressing 62 mutations causing Wilson's disease reported from Indian population. Inter- and intra- array comparisons were used to study quality of the arrays. The arrays were validated by using mutant samples generated by site directed mutagenesis. Results: The hybridization reaction were found to be consistent across the surface of a given microarray. Our results have shown that 52 °C post-hybridization wash yields better reproducibility across experiments compared to 42 °C. Our arrays have shown > 80 per cent sensitivity in detecting these 62 mutations. Interpretation & conclusions: The present results demonstrate the design and evaluation of a low-density microarray for the detection of 62 mutations in ATP7B gene, and show that a microarray based approach can be cost-effective for detecting a large number of mutations simultaneously. This study also provides information on some of the important parameters required for microarray based diagnosis of genetic disorders.

The aims of this study were to characterize a lamotrigine-resistant kindled model of epilepsy in mice, to study the anticonvulsant effect of carbamazepine (CBZ) and valproic acid (VPA), and to probe into the mechanism for resistance. Swiss albino mice were kindled by a subconvulsive dose of pentylenetetrazole (PTZ, 30 mg/kg, i.p., every other day for 6 weeks). The mice were pre-treated (30 min.) either with a low dose of LTG (5 mg/kg, i.p.) or with vehicle, and the seizures were scored. The acute treatment with LTG (15 mg/kg, i.p.) on the last day blocked seizure in the vehicle-treated group, but the LTG pre-treated group showed resistance. This resistance was extended to CBZ, but not to VPA. The resistant model was successfully replicated in mice with less kindling development time (6 weeks versus 9 weeks 5 days in rats). A highly significant decrease in the level of histamine (p 0.001) was found, and there were also decreases in serotonin, GABA and AChE levels (p 0.05). A significantly low level of histamine correlates with drug resistance and indicates involvement of the H1/H3 receptors. It is suggested that the selective action on voltage-gated Na(+) and Ca(2+) channels could explain the differences in the sensitivity of CBZ and VPA.

Spillover of lipoprotein lipase-generated fatty acids from chylomicrons into the plasma free fatty acid (FFA) pool is an important source of FFA and reflects inefficiency in dietary fat storage. We measured spillover in 13 people with type 2 diabetes using infusions of a [3H]triolein-labeled lipid emulsion and [U-13C]oleate during continuous feeding, before and after weight loss. Body fat was measured with dual energy X-ray absorptiometry and computed tomography. Participants lost ∼14% of body weight. There was an ∼38% decrease in meal-suppressed FFA concentration (P < 0.0001) and an ∼23% decrease in oleate flux (P = 0.007). Fractional spillover did not change (P = NS). At baseline, there was a strong negative correlation between spillover and leg fat (r = −0.79, P = 0.001) and a positive correlation with the trunk-to-leg fat ratio (R = 0.56, P = 0.047). These correlations disappeared after weight loss. Baseline leg fat (R = −0.61, P = 0.027) but not trunk fat (R = −0.27, P = 0.38) negatively predicted decreases in spillover with weight loss. These results indicate that spillover, a measure of inefficiency in dietary fat storage, is inversely associated with lower body fat in type 2 diabetes.

Objectives To evaluate the effect of low-dose mifepristone (25 mg) on symptomatic myoma in perimenoapausal women. Study design Prospective observational clinical trial. Materials and methods Ninety-three perimenopausal women of age 35 to 50 years having symptomatic myoma were selected from gynecology outpatient department and given 25 mg mifepristone once daily continuously for 3 months. Baseline uterine size, uterine volume, myoma size, volume, their number, position, characteristics, hemoglobin and blood parameters, were taken and followed monthly for 6 months. Bleeding and pain scores were checked on monthly visits. Change in above parameters were tabulated during the first 3 months treatment phase and then next 3 months post-treatment phase for analysis. Statistical analysis Done by calculating mean, standard deviation, standard error and percentage distribution of variables. Results Menorrhagia was the commonest symptom which led patients to report to hospital. Mean uterine volume reduced to 63.69% of baseline, mean dominant myoma volume reduced to 53.62% and hemoglobin level raised to 137% after complete treatment of 3 months. Changes persisted in next 3 months post-treatment follow-up, while hysterectomy was required in 10 (12.2%) cases. Conclusion Three months treatment of 25 mg mifepristone effectively controls bleeding, reduces the uterine and myoma volume and thus can avoid blood transfusion and hysterectomy in a lot of symptomatic myoma cases. How to cite this article Seth S, Singh E, Mathur AS, Gupta G, Nagrath A. Low-dose Mifepristone (25 mg) in Treatment of Uterine Myoma in Perimenopausal Women. J South Asian Feder Menopause Soc 2013;1(1):34-37.

In Brief Severe hypoglycemia characterized by neuroglycopenic symptoms is a recently described and relatively uncommon complication of gastric bypass surgery. It occurs several months to years after surgery and may be distinct from the more commonly encountered dumping syndrome that occurs early in the postoperative course and usually improves with time. Nesidioblastosis has been proposed as a possible underlying mechanism for late postoperative hypoglycemia. This syndrome is distinct from noninsulinoma pancreatogenous hypoglycemia and likely has a multifactorial etiology. It responds variably to nutrition and pharmacological interventions. Partial pancreatectomy and reversal of the bypass have sometimes been used to ameliorate symptoms.

Plasma cell dyscrasias are a group of clinically and biochemically diverse disorders of unknown etiology, characterized by the disproportionate proliferation of one or more clones of B cells, and the presence of a structurally and electrophoretically homogeneous (monoclonal) immunoglobulin or polypeptide subunit in serum or urine. The role of splenectomy in the management of plasma cell dyscrasias has not been well defined. Using MEDLINE, the authors searched the English-language published literature from the year 1970 through September 2005 to determine the indications for splenectomy in plasma cell dyscrasias. A review of the literature in humans and animals supported the idea that the spleen provides a special microenvironment favorable for homing or differentiation of IgM producing B cells, and splenectomy can, at times, lead to remission in Waldenström's macroglobulinemia. The other reported reasons for splenectomy in plasma cell dyscrasias are hypersplenism-related pancytopenia, control of splenic plasmacytomas, and management of a splenic abscess. Splenic infiltration in primary amyloidosis can be an indication for splenectomy, where removal of a large spleen can also reverse an acquired factor X deficiency. Thus, the spleen can be considered a potential target organ for management of plasma cell dyscrasias, and therapeutic success has been achieved with removal of this organ. However, splenectomy can be a potentially morbid procedure in patients with plasma cell dyscrasias, and major postoperative complications include infection, hemorrhage, and thrombosis.

Tuberculosis is the leading cause of death worldwide with India leading the count (World Health Organization report 2016). We present a case of right submandibular swelling and tuberculous periapical granuloma associated with carious mandibular 2nd molar adjacent to partially impacted third molar in a 35-year-old female patient. Histopathology report of periapical specimen revealed tuberculous granulomatous pathology that correlated with the histopathology report of submandibular lymph node on the same side of face. The lesion healed uneventfully with expert medical consultation. The patient was followed up for 13 months.

A Complex Case of Herniated Gravid Uterus Rupture with Placenta Accreta A 35 year old woman from rural India, with a prior history of caesarean delivery, presented to the emergency room in hypovolemic shock at 34 weeks’ gestation, with an unusual protrusion of the infra-umbilical portion of the anterior abdominal wall. The lower abdominal bulge turned out to be the ruptured gravid uterus with the intact amniotic sac (amniocele) herniating through the anterior abdominal wall incisional hernia.

Cardiac amyloidosis, the primary determinant of prognosis in systemic amyloidoses, is characterized by infiltration of myocardium by amyloid protein resulting in cardiomyopathy and conduction disturbances. Cardiac involvement is primarily encountered in immunoglobulin (AL) and transthyretin-associated (hereditary/familial and senile) amyloidoses. Although the latter variants could be indolent, untreated AL amyloidosis with clinical cardiac involvement is a rapidly fatal disease. The management decisions of cardiac amyloidosis are based on the underlying cause. Although treatment of senile systemic amyloidosis is largely supportive, the therapeutic approaches for AL amyloidosis include chemotherapy, autologous stem cell transplantation, and, rarely, cardiac transplantation. The familial variant is potentially curable with a liver ± cardiac transplantation. This narrative review outlines a practical approach to these challenging diagnoses in the face of rapidly evolving management strategies.

Objectives: To evaluate the effect of Mifepristone (25 mg) on symptomatic myoma in perimenopausal women. Study Design: Open label clinical trial. Materials and Methods: Ninety three perimenopausal women of age 35-50 years having symptomatic myoma were selected from Gynecology OPD and given 25 mg Mifepristone once daily continuously for three months. Variables as; baseline uterine size, uterine volume, myoma size, volume, their number, position, characteristics, hemoglobin and blood parameters, were taken and followed monthly for six months. Bleeding and pain scores were checked on monthly visits. Changes in above parameters were tabulated during the first three months treatment phase and then next three post-treatment phase for analysis. Statistical Analysis: Was done by calculating mean, standard deviation, standard error and percentage distribution of variables. Results: Menorrhagia was the most common symptom which led patients to report to hospital. Mean uterine volume reduced to 63.69% of baseline, Mean dominant Myoma volume reduced to 53.62% and hemoglobin level raised to 137% after complete three months of treatment. Changes persisted in next three months post-treatment follow-up, while hysterectomy was required in 10 (12.2%) cases. Conclusion: Three months treatment of 25 mg Mifepristone effectively controls bleeding, reduces the uterine and myoma volume and thus can avoid blood transfusion and hysterectomy in a lot of symptomatic myoma cases.

Objective To determine the baseline information about the knowledge of cervical cancer and explore attitude and practice of Pap smear screening among staff nurses. Methods A pretested structured self administered questionnaire based survey was done on 205 staff nurses working in Rural Institute of Medical Sciences & Research, Saifai, Etawah, containing mostly recognition and some recall type questions about demographics, knowledge about cervical cancer, its risk factors, screening techniques, attitudes towards cervical cancer screening and its practices. Results In this study, 74% knew that Pap smear is used for detection of cervical cancer, but only 59% knew that it can detect both cancerous as well as precancerous lesions of the cervix. Only 18% of the respondents knew about human papillomavirus vaccine. A 47% of respondents had never taken a Pap smear; 63% never referred patients for the screening. Most nurses (79%) thought that a speculum examination and Pap smear are procedures to be performed by the doctors. Among all the respondents, only 11% had ever undergone a Pap smear on themselves. Conclusion Despite knowledge of the gravity of cervical cancer and prevention by screening, attitudes and practices towards screening were negative.