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Menstruation is a normal physiological phenomenon, but sometimes the abnormalities and pain associated with it can severely affect the daily routine of women and may create a stressful environment for them. The objective of this study was to conduct a comparative evaluation of the pattern of menstruation, lifestyle and the outlook toward menstruation among undergraduate female medical and nursing students.It was a descriptive cross-sectional study conducted among the undergraduate medical and nursing students of a tertiary care Institute. A semi-structured questionnaire was used to collect the data. Of the 400 students approached, 188 completed the questionnaire.The mean age of the participants was 21.23 ± 1.47 years. The mean age of menarche was 12.65 ± 1.24 years among the medical students and 13.69 ± 1.38 years among the nursing students (Despite having a medical background and knowledge about the physiology of menstruation, medical and nursing students do carry certain myths regarding menstruation which are being carried forward in society. Small roleplays in the OPD (Outpatient Department) area and public awareness lectures should be planned. They will not only develop confidence and better understanding among the students but also create social awareness.

Children are considered as an important asset for any country and their health as one of the important indicators of a healthy country. There are several factors affecting children's health and anemia is one of them. Globally around 1.62 billion people are affected by it, which corresponds to 24.8% of the population, with the highest prevalence of anemia (47.4%) among preschool-aged children.The present study was conducted to estimate the prevalence of anemia among toddlers (12-36 months) and to determine the associated factors.A cross-sectional study was carried out among toddlers (12-36 months) in the urban field practice area of Pt. B.D. Sharma PGIMS, Rohtak. A total of 170 toddlers were enrolled in the study and their mothers were interviewed using a semi-structured pretested questionnaire. Hb was estimated by Sahli's acid hematin method. The data were analyzed using SPSS software version 20.In the present study, more than half (55.9%) participants were girls and 44.1% were boys. The overall prevalence of anemia was found to be 62.4%, with mild, moderate, and severe anemia being 41.8%, 17.7%, and 2.9%, respectively. The children with regular intake of iron supplementation were found to be 6.625 times likely to be nonanemic as compared to those with no supplementation.Every endeavor should be made to combat the anemia in children through multisectoral and multipronged approach such as nutritional education of mothers, growth monitoring, nutritional supplementation, etc.

In the year 1928, Arthur Eddington, a British physicist, first introduced the word “time’s arrow” to physics. He believed that the arrow of time is vividly recognized by consciousness and insisted that the reversal of this arrow would render the physical world nonsensical. It is widely known that the laws of physics remain unchanged under the combination C, P, and T and that the laws of physics do not change with the flow of time but that is not the case under the operation T alone. This paper focuses on mainly three arrows of time, the thermodynamic arrow of time, the psychological arrow of time, and the cosmological arrow of time and discusses the reversal of the arrow of time and its implications.

Aerosol optical depth (AOD) and Ångström exponent (AE) are observed to be important parameters in understanding the status of ambient aerosol concentration over a particular location and depend not only upon the local but also on the large-scale dynamics of the atmosphere. The present article analyses the AOD and AE parameters retrieved with Moderate Resolution Imaging Spectrometer (MODIS) and Multi-angle Imaging Spectro-Radiometer (MISR) instruments onboard satellites, for the upper (Chamoli) and foothill (Dehradun) regions of Garhwal Himalaya in Uttarakhand, India, from 2006 to 2015. Aerosol properties are investigated at monthly, seasonal, and annual scales. The monthly mean values of MODIS-derived AOD and AE were observed to be 0.18 (± 0.14) and 1.05 (± 0.43) respectively over the Dehradun region. The seasonal maximums in AOD with MODIS and MISR were observed as 0.23 ± 0.06 and 0.29 ± 0.07 respectively in the pre-monsoon season, and the minimum values (0.099 ± 0.02) were observed in the post-monsoon season, over the Dehradun region. In contrast, in the Chamoli region, the maximum AOD (MODIS) was 0.21 ± 0.06 observed in the monsoon season and the minimum was 0.036 ± 0.007 in the post-monsoon season. Over a decade, the AE for Chamoli and Dehradun was found to vary from 0.07 to 0.17 and from 0.14 to 0.20 respectively. The median AE for Chamoli and Dehradun was found to be 1.49 and 1.47 respectively, marking the dominance of fine mode particles of anthropogenic origin. Observations show the presence of dust and polluted dust resulting from the long-range transport from the west. The comparison of AOD values from the two sensors shows a significant correlation (0.73) with slightly higher values from MISR over the year. The results obtained are important in understanding the climatic implications due to the atmospheric aerosols over the abovementioned Himalayan region of Uttarakhand, India.

Garcin’s Syndrome is a rare pathology involving multiple cranial nerves in the setting of invasive mucormycosis, usually in immunocompromised patients. Owing to its extremely high mortality rate, clinician should have a high suspicion for diagnosis. This article presents a rare case of Rhino-Orbito-Cerebral Mucormycosis with Garcin’s syndrome in a 33-years old male along with a discussion of previously reported cases. The case is discussed in light of scant contemporary literature on the cited subject. A thorough search using the keywords Garcin's Syndrome, Invasive Mucormycosis, Rhino-orbital, Rhino-cerebral mucormycosis, was conducted on Pubmed/MEDLINE, Google scholar, LILACS, medRxiv and Google. A total of six reported cases found in international literature published between 2000 and 2020 were reviewed and analyzed. Garcin’s Syndrome is associated with a high mortality rate. In our review, of the total seven patients, only three survived, bringing the collective mortality to 42.85%. Patients had multiple cranial nerve involvement leading to long term sequelae. Our case showed the unique finding of VIII nerve involvement. Early intervention helped in patient survival and better functional outcome. This literature review highlights the distinct clinical nature of the presentation of disease and the importance of prompt diagnosis and early management in the reversal of complications in an otherwise potentially fatal disease.

Stem cells are undifferentiated cells that can self-renew and differentiate into diverse types of mature and functional cells while maintaining their original identity. This profound potential of stem cells has been thoroughly investigated for its significance in regenerative medicine and has laid the foundation for cell-based therapies. Regenerative medicine is rapidly progressing in healthcare with the prospect of repair and restoration of specific organs or tissue injuries or chronic disease conditions where the body's regenerative process is not sufficient to heal. In this review, the recent advances in stem cell-based therapies in regenerative medicine are discussed, emphasizing mesenchymal stem cell-based therapies as these cells have been extensively studied for clinical use. Recent applications of artificial intelligence algorithms in stem cell-based therapies, their limitation, and future prospects are highlighted.

In modern nanotechnology, the synthesis of metal nanoparticles via a green route has been gaining much attention due to their widespread applications in many sectors. Among the various metal nanoparticles, gold nanoparticles (AuNPs) have been used in biomedical applications due to their unique optical, electrical, and photo-thermal properties. The syntheses of nanoparticles using conventional methods (including physical and chemical methods) have become obsolete due to high cost and use of toxic chemicals. Hence, there is a need to develop alternative, economical, and environmentally safe approaches to assemble nanoparticles. Since the last decade, the biological synthesis of metal nanoparticles employing bacterial cultures has emerged as a hopeful approach. Apart from synthesis, it is highly essential to elucidate molecular mechanisms in the bacteriogenic synthesis of nanoparticles for controlled size, shape, and dispersity. Therefore, in this article, we have emphasized the different mechanisms that have drawn on the bacteriogenic synthesis of AuNPs and their applications in various fields.

For the development of green technologies in materials synthesis, the aspect of nanotechnology considered as an important technology. The mycogenic biosynthesis of nanoparticles is an ecologically nontoxic method as compared to other methods (physical and chemical). Due to their nanoscale structures, these nanoparticles have a wide range of applications in various fields like targeted drug delivery, gene therapy, cancer treatment, DNA analysis, antibacterial agents, enhancing reaction rates, biosensors, magnetic resonance imaging, and separation science. The nanoparticles can be metallic, oxide, sulfide, and other types. The main advantage of biosynthesis of nanomaterial is to decrease energy consumption, hazardous waste production, and greenhouse gas. The microorganisms like bacteria and fungi are the biological agents with promising potential for the biosynthesis of nanoparticles. Fungi have more ability to synthesize ecologically clean metallic nanoparticles. Most of the study reported that fungi are moderately more suitable for large-scale bioproduction of the nanoparticles by producing large amounts of extracellular enzymes. Most of the fungal species Aspergillus fumigates, A. flavus, A. terreus, Fusarium oxysporum, Trichoderma viride, etc., have been studied for intracellular or extracellular nanoparticle synthesis. The fungi-like protein engineering, metabolic engineering, synthetic biology, systems biology, and downstream processing can be used for the production of nanoparticles at the large scale.

Currently, the world is facing water quality crisis resulting from land use changes, industrialization, agricultural practices, sewerage, and poor wastewater management practices. Wastewater comprises a combination of one or more of domestic effluent, industrial effluent, agricultural runoff, and water from commercial establishment and institution including hospitals. Untreated wastewater released into the environment can cause health and environmental problem and can have an economic impact. Wastewater treatment process is used worldwide for removal of existing contamination before reuse or disposal into the environment. In this article, various wastewater treatment techniques, basic fundamentals, and their consequent pollutants removal are discussed briefly.

Transverse vaginal septum is one of the variants of Mullerian duct anomaly, caused as a result of defective fusion or recanalisation of vaginal and Mullerian organs. At an early age, it commonly presents as primary amenorrhea along with cyclical abdominal pain while later on usually it presents as dyspareunia and infertility. Our 22-year-old patient presented with secondary amenorrhea. It is very unusual for a transverse vaginal septum to cause secondary amenorrhea. MRI and clinical examination raised the suspicion of transverse vaginal septum causing secondary amenorrhea. She attained regular menstrual cycle after septum excision. The proposed theory behind it is obliteration of microperforated transverse vaginal septum because of menstrual blood and cell debris. Thus, a rare possibility of transverse vaginal septum should also be considered as a differential diagnosis of secondary amenorrhea.

Objective To determine the incidence of accidentally diagnosed genital malignancies in women undergoing gynecological surgeries for pathologies presumed to be benign. Methods Data of all women who underwent hysterectomy for benign indications were retrieved from hospital records. A total of 628 cases of hysterectomy and 35 cases of myomectomy were included. The final histopathology was accessed through the computer records, and the total number of genital tract malignancies was included. Results The incidence of occult uterine, ovarian, and cervical malignancies in women undergoing hysterectomy was 0.47%, 0.31%, and 0.15%, respectively. The incidence of uterine corpus malignancies in women undergoing myomectomy was 2.8%, and 3 cases of smooth muscle tumor of uncertain malignant potential (STUMP) were also identified. Endometrial stromal sarcomas were the most common pathology among uterine malignancies, followed by leiomyosarcoma and endometrial adenocarcinoma. Conclusion Postoperative diagnosis of malignancies in women undergoing surgery for benign indications poses great challenges to the treating surgeon. Occult malignancies must be ruled out by thorough preoperative assessment, especially in some subsets of women. Morcellation is an inevitable technique and complement to laparoscopic surgeries, although little chances of malignancy spread is related to its use. Nevertheless, thorough preoperative investigations and always ensuring contained morcellation can minimize these chances.

Objective(s) Current evidence suggests that endometrial injury improves clinical pregnancy rate while having no effect on miscarriages in women undergoing IVF/ICSI. However, there is no substantial evidence to advocate the use of endometrial injury to benefit the outcomes of IUI treatment. Additionally, there is no clear consensus about the ideal timing, underlying mechanism and optimum intensity of endometrial injury required. The study examines the effect of intentional endometrial injury/scratch in the early proliferative phase of stimulated cycle on reproductive outcomes (clinical and ongoing pregnancy rates and miscarriage occurrence) of intra-uterine insemination treatment (IUI). Study design, size, duration This prospective, randomized control interventional study was conducted in a tertiary level teaching institution from April 2018 to February 2020. 150 eligible couples requiring IUI treatment who agreed to participate were randomly allocated on 1:1 basis to either control or intervention group. The trial participants received up to 3 cycles ovulation induction with clomiphene citrate and intra-uterine insemination. In addition, women in intervention group were subjected to endometrial scratch injury on day 6-7 of their stimulated cycle. 154 cycles in control arm and 128 cycles in intervention group were analyzed for clinical pregnancy, miscarriages and pain experienced by the women during endometrial scratch injury using the statistical package SPSS (version 21). Result Similar cumulative clinical pregnancy rates (12.5% Vs 13.6%, RR 1.21, 95% CI 0.44-3.37, p = 0.713), biochemical pregnancy rates (17.1% vs 22.9%, RR 1.43, CI 0.59-3.47, p = 0.421) and ongoing pregnancy rates (10.93% Vs 11.47%, RR 1.05, CI 0.35-3.21, p = 924) were observed in control and intervention arms. Likewise, the relative risk of miscarriage occurrence in the intervention arm was 1.32 (95% CI 0.39-4.32, p = 1.000) which was not statistically different from control group. Mean pain score of 6.93 on numerical pain rating scale was experienced by women whilst having endometrial scratch injury. Conclusions There is insufficient evidence to defend the use of endometrial scratch injury in intra-uterine insemination treatment, as it is moderately painful and have uncertain beneficial influence on reproductive outcomes.

The understanding of ovarian malignancy pathogenesis has greatly increased with identification of varied genomic mutation profiles, which directs the clinical behavior of the tumors. The present case describes the rare subtype of pure transitional cell carcinoma which is no more included in the newer World Health Organization (WHO) classification as the WHO labels it as a type of high-grade serous ovarian cancer with transitional cell differentiation, although in our case no serous component was identified. Hence, with revised classification of ovarian malignancies, it is important to report all rare subtypes in order to understand their biology and behavior.

Cervical dysgenesis is a rare cause of obstructive amenorrhoea. We are presenting a case of a 15-year-old girl presented with primary amenorrhoea diagnosed with cervical dysgenesis with left ectopic kidney and endometriosis. The patient underwent laparoscopy followed by exploratory laparotomy with total abdominal hysterectomy with left salpingectomy followed by neovaginal creation and right ureteric D-J stenting and vaginal mould insertion. Cervical agenesis treatment should aim at the re-establishment of patency of the outflow tract. A fistulous tract with stent placement has been done in some cases but eventually, hysterectomy is required in view of recurrent and severe pelvic infection is a common problem. Ovarian function can be preserved if a hysterectomy is performed timely.

Giant cervical polyps are rarely seen nowadays in routine day-to-day practice and are defined as a polyp with a size >4 cm. Giant cervical polyps protruding outside the vaginal canal causing diagnostic dilemma are rarely encountered in gynecologic practice. They masquerade as uterine inversion, prolapse, or cervical malignancy. Only a few cases have been reported in the literature. We hereby report a case of giant polyp of anterior lip of the cervix occurring in a multiparous woman and presented with something coming out per vagina. Histopathology of it came out to be angiomyomatous polyp (vascular leiomyoma) of the cervix that itself is a rare entity.

Background: The indications for paediatric tracheostomies have had a significant change world over during last few decades. Emergency management of paediatric airway by tracheostomy has its own share of complications which need fair amount of expertise to manage.Methods: We carried out a retrospective study at a tertiary care centre in rural area of Haryana and analysed the available data of last 5 years (2017-2021) for determining various indications of paediatric tracheostomies and complications encountered during or after the surgery.Results: The study included 65 paediatric patients (Conclusions: High number of paediatric tracheostomies and sheer presence of diphtheria in this rural area of Haryana suggests that there is dire need of proper immunisation coverage and an active participation at community level.

Struma ovarii is a variant of mature cystic teratoma, with predominant thyroid element. Confirmatory diagnosis is by histopathology. It may mimic as ovarian malignancy in some. It may be associated with ascites in minority; even CA-125 has been found to be raised in some cases. We here report three cases – two operated for suspected ovarian malignancy in a postmenopausal female and one case operated for persistent benign ovarian cyst with raised CA-125 in a young female. In all histopathological diagnosis was a benign struma ovarii. It is difficult to diagnose these cases preoperatively as there are no specific clinical, radiological or serum markers for these rare tumors in the absence of thyroid biology abnormality. Most cases are diagnosed on histopathology. These benign tumors many times require extensive staging laparotomy for suspected ovarian malignancy in the absence of preoperative diagnosis. Prognosis is good for these tumors. Subtle radiological signs and a clinical suspicion can avoid extensive staging laprotomies in these patients.

Arrestin-related domain-containing protein-3 (ARRDC3) is one of 6 mammalian arrestins, which suppresses metastasis by inducing degradation of phosphorylated β2-adrenergic receptor (β2 AR) and integrin β4 (ITG β4). Our previous studies demonstrated that expression of ARRDC3 is epigentically silenced in Triple Negative Breast Cancer (TNBC) cells, and the forced expression of ARRDC3 significantly reduced the invasive potential of TNBC cells. In the current study, we found that Selective Inhibitors of Nuclear Export (SINE) compounds (KPT-185 and selinexor (KPT-330)) restore ARRDC3 expression in TNBC cell lines (MDA-MB-231 and MDA-MB-468) at both the mRNA and protein level in a dose and time course dependent manner. SINE compounds inhibit the proliferation, pro-invasive migration and anchorage independent growth of the TNBC cells by restoring ARRDC3 expression. We found that ARRDC3 expression is lower in TNBC cell lines than those of luminal breast cancer cell lines, and inversely correlated with IC50s of selinexor. Analysis of tissue microarray confirmed that ARRDC3 expression in patient samples is significantly lower in the majority of TNBC tumors relative to normal tissue. In vivo, selinexor inhibited the tumor growth of MDA-MB-231 xenografts by nearly 100% compared with vehicle treated animals. Furthermore, immunohistochemical analysis of TNBC tumors from selinexor treated mice revealed increased ARRDC3 expression versus vehicle treated animals. Our results suggest that restoration of ARRDC3 expression is an important antineoplastic mechanism of SINE compounds in TNBC, and therefore selinexor could be an effective treatment option for breast tumors with down-regulated ARRDC3.

Gossypiboma is an uncommon but avoidable condition, which is mostly asymptomatic initially and difficult to diagnose but can cause serious postoperative complications. It is a mass lesion due to surgical sponge or swab if retained in the body after the surgery. Gossypiboma has a vague presentation, and it is difficult to diagnose. In patients with a prior history of surgery having soft-tissue masses or localized pain abdomen, gossypiboma should be included in the differential diagnosis. We are reporting a case of a 33-year-old woman referred to our center with a complaint of vague abdominal pain, mild distension for the past 7 days, and discharge from the stitch line for the past 1 day. After investigation, diagnosis of gossypiboma was made and an exploratory laparotomy was performed to remove the retained surgical mop.

Objectives: Lead is one of the most toxic heavy metal prevalent in the environment, which affects almost all major organs including heart, brain, intestines, kidneys as well as reproductive organs. It has been known that serum iron deficiency is associated with increased serum lead levels as lead is a particularly pernicious element to iron metabolism. Lead is also known to freely cross the placenta too; hence, this study was planned to determine any association between antenatal iron deficiency anemia (IDA), raised blood lead levels (BPb), and adverse pregnancy outcomes. Materials and Methods: This was an observational study done on 99 antenatal women with IDA and 41 nonanemic antenatal women. Lead levels were assessed in these 140 antenatal women and they were followed for adverse pregnancy outcomes. Chi-square test was used to find a difference in quantitative variables and Pearson's correlation test was used to assess association between BPb and hemoglobin levels. Results: We found that in 11 out of 99 (11.11%) women with IDA, BPb levels were high as compared to high BPb levels in only 1 out of 41 (2.4%) women without IDA and the high BPb levels ranged from 4 μg/dl–16.9 μg/dl with a mean BPb of 8.1 μg/dl. The difference in BPb among anemic and nonanemic antenatal women was significant (P < 0.05) and there was a negative dose effect relationship between BPb levels and hemoglobin levels. This difference in antenatal outcomes among women with and without high BPb levels was also significant with increased incidence of pre-eclampsia, FGR, and preterm deliveries in women with raised BPb levels. The incidence of NICU admission was also higher in the neonates of mothers with high BPb levels. Conclusions: We propose screening of high-risk women based on their social, occupational, environmental, and personal factors, with serum lead levels in the preconception period itself. All public and personal measures must be taken to reduce lead consumption and exposure in the preconception and antenatal period.

Yolk sac tumours of the ovary are rare and highly malignant germ cell tumours, which comprise of only 10%–15% of all malignant germ cell tumours. They have various clinical presentations most common being subacute pelvic pain and feeling of lump but sometimes high-grade fever can be one of the rare presentations. Here, we present a case report of a 26-year-old nulliparous woman with 36 weeks gravid uterus size advanced stage yolk sac tumour of one ovary with fever as main clinical presentation and overt hypothyroidism. We did staging laparotomy with total abdominal hysterectomy with bilateral salpingo-oophorectomy and omentectomy with multiple peritoneal biopsies. Postoperatively, we had started adjuvant chemotherapy. Since yolk sac tumours are highly aggressive tumours as they rapidly increase in size, their early diagnosis and appropriate surgical management is required particularly in young women where fertility sparing surgery is possible in early stage with good prognosis.

In this paper, the daily solar radiation and meteorological parameters such as temperature, dew point temperature, relative humidity, rainfall and wind speed were analyzed for the period of one year (2014) data-set for Dehradun, India. The maximum values of temperature, wind speed and relative humidity, ranging from 35∼39 °C, 3∼4 m/s and 55∼70 % were found in monsoon months. The maximum value of rainfall (46.30 mm) was recorded on 21 June 2014. The statistical parameters such as standard deviation, kurtosis and skewness were calculated to check the normality of used data set. Regression and correlation analysis was also used to model the relationship between daily solar radiation and meteorological parameters.

Objectives To find out correlation between cervical cytology, and colposcopy in diagnosing premalignant lesions of cervix. To find out correlation in colposcopy and histopathology in detecting premalignant lesion of cervix. Methods A retrospective study was carried out in OBGYN department over a period of 2 years. Data were retrieved from the departmental records and hospital information system. Inclusion criteria screen positives who underwent colposcopy and directed biopsy between the age of 21–70 years. Exclusion criteria Screen positives who did not have colposcopy or where biopsy were not done were excluded. Pregnant women were excluded. These cases were then analysed for sensitivity and specificity in detecting premalignant lesion taking histopathology as gold standard Results Total of 122 cases were retrieved who fulfilled inclusion criteria, 2 cases were excluded as the biopsy report was inconclusive. Good correlation was observed between colposcopy and histopathology with a sensitivity of 90% and specificity of 98.7%. Cervical cytology and colposcopy showed poor specificity of 58%, and cytology and histopathology had specificity of 62%. Discordance between cytology and colposcopy was seen in 35% of cases. Conclusions Cervical cytology has a poor specificity for detecting premalignant lesion of cervix as compared to colposcopy and histopathology. A well done colposcopy aids significantly in targeting the tissue precisely for identifying premalignant lesion.

With the advancement in agricultural practices, use of various chemicals for better yield is posing huge threat to the society. These chemical containing variable amounts of heavy metals are the key players that have become threat to plants and human beings. The discharge of various harmful environmental pollutants from different industrial sectors has created a challenge for environmentalists and scientists concerning the sustainable development of mankind. Particularly in plants, heavy metals are essential for its growth and development, but when the concentration of each heavy metal crosses, its threshold concentration becomes harmful for plants itself. These heavy metals possess specific density of more than 5 g/cm3 (Cr-7.2, Co-8.9, Ni-8.7, Cu-8.9, Zn-7.1, Mo-10.2, Cd-8.2 etc.). Various survey studies reveals intense exposure of heavy metals still continues in different parts of the world though its ill-effects are well documented. Some of the well-known heavy metals include arsenic, cadmium, copper, lead, nickel, zinc, etc., all of which cause risks for the environment and human health. Considering heavy metals as potential threat to different life forms, it has become an important and interesting issue since last few decades. This chapter attempts to review different strategies for remediating heavy metal contamination with the plants and microorganisms. An attempt has also been made to review and promote the sustainable development with the involvement of phytoremediation and micro-remediation technologies.

Background: Children 1-3 years of age are most vulnerable to the vicious cycles of malnutrition, disease/infection and resultant disability all of which influence the present condition of a child at the microlevel and the future human resource development of the nation at the macrolevel.Methods: Urban field practice area attached to the department of community medicine, Pt. B. D Sharma PGIMS, Rohtak being served by 14 anganwadi centres out of which 8 anganwadi centres were selected randomly. From each selected anganwadi centre, 22 children of 1-3 years of age group were selected by simple random sampling, thus, a sample of 176 children were included in the study.Results: Overall prevalence of undernutrition in our study was found as follows: wasted 14.1%; underweight 20.0%; stunted 24.1%. Inverse relation between prevalence of undernutrition and educational status of mother was observed. Children who were >3 in birth order had high prevalence of wasting, stunting and underweight. Children with low birth weight were having higher percentages of wasting, stunting, and underweight. Children who took supplementary nutrition regularly from AWC were less likely to be undernourished.Conclusions: Every endeavor should be made to combat the outcomes of undernutrition through multipronged approach such as growth monitoring, nutritional supplementation etc., Also, present study findings reinforce the importance of proper infant and child feeding practices and appropriate maternal care in prevention of childhood undernutrition.

Background: Chronic rhinosinusitis (CRS) is defined as inflammation of the nasal cavity and paranasal sinuses. Azithromycin, a macrolide antibiotic, a well-established class of anti-bacterial agents, which also have anti-inflammatory properties. The present study was designed to compare the role of azithromycin with surgical management in patients with chronic-rhinosinusitis.Methods: The study population included 60 adult patients with symptomatic CRS refractory to 3 weeks of medical therapy. The patients were divided in two groups with 30 patients in each group. One group of patients received oral Azithromycin as main treatment for 12 weeks while the other group of patients underwent sinonasal surgery. Symptom scoring and endoscopic scoring were done previous to the treatment and at 1 month and 3-month follow-ups.Results: A good subjective as well as objective outcome in terms of symptom improvement was obtained with in patients with chronic rhinosinusitis with Surgical intervention as compared to those patients who received long term oral Azithromycin.Conclusions: We advocate that patients suffering from chronic sinonasal disease should be initially targeted with maximal medical therapy using an oral macrolide for at least 3 months. After this patient should be assessed and surgery considered in those cases refractory to medical therapy.

Background: The aim of this study was to compare the outcomes of pregnancies complicated by isolated oligohydramnios with the low risk pregnancies with normal amniotic fluid volume.Methods: The present study is a retrospective cohort study of singleton pregnancies diagnosed with Isolated oligohydramnios (AFI≤5) in their third trimester (N=35). Pregnancy outcome was compared with a matched control group of low risk pregnancies with amniotic fluid volume >5 (N=30).Results: The overall incidence of Isolated oligohydramnios was 0.7-0.8%. In oligohydramnios group, significant association were found in null-parity (60% vs 23.33%, p-value

Utero-ovarian ligament fibroids are among the rarest sites for extrauterine leiomyomas. Broad ligament fibroids are relatively common. They can be either asymptomatic or present with chronic pelvic pain and pressure symptoms. They can be confused with an ovarian mass, broad ligament cyst or a pedunculated fibroid. There are high chances of missing it clinically. Ultrasonography, magnetic resonance imaging (MRI) and computed tomography scan are the imaging techniques used to diagnose such conditions, MRI being the most accurate in ruling out other broad ligament masses with suspected ovarian, tubal or isolated broad ligament cyst. Here is a rare case report of a pedunculated extrauterine leiomyoma with its origin in the utero-ovarian ligament.

Several DNA minor groove binders exhibit numerous therapeutic applications. The crystal structure demonstrating 2,5-bis[4-(N-cyclobutyldiaminomethyl)phenyl]furan binding within the minor groove of DNA has been reported by Simpson et al (2000 Bioorg. Med. Chem. Lett. 10 2593). In the present study, computational investigations on the title compound have been carried out which comprise geometry optimization, HOMO-LUMO, dipole moment, Molecular electrostatic potential(MEP), thermodynamic parameters, and IR assignments using the B3LYP/6-31G** method. The true minimum was long-established by the nonappearance of negative wavenumbers. A comparison of optimized parameters with crystallographic structure demonstrates slight variations in the conformations of the cyclobutyl groups. A small HOMO-LUMO gap indicates the high chemical reactivity and inter molecule charge transferability. The vibrational spectra of the molecule calculated in 400–3800 cm−1 region, reproduce reliable IR assignments. Bearing in mind the high pharmaceutical significance of minor groove binders and a variety of flexible options accessible for lead optimization will be a bountiful ground for the development of drugs targeting minor grooves.

Authors report a unique case of 46XX gonadal dysgenesis, with dysgerminoma in one ovary and other streak ovary with hilar nests of leydig cells. It is exceptionally rare to find dysgerminoma in a dysgenetic gonad with no Y chromosome and so is the presence of leydig cells in the contralateral streak ovary in a patient with 46XX pure gonadal dysgenesis.