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Preeclampsia (PE) remains a leading cause of maternal morbidity and mortality all over the world. However, its aetiology and pathophysiology remain elusive. Platelet activating factor (PAF) is produced in response to oxidative stress and is a potent hypotensive agent. PAF acetylhydrolase (PAF-AH) inactivates PAF and is seen to decrease in normotensive women. The role of PAF-AH in preeclampsia has been in investigational literature, so far. The few studies done have shown a positive association of elevated levels of PAF-AH with preeclampsia. However, this marker has not been studied in the Indian population to-date and such studies are needed to elucidate the pathogenesis of this condition. Our study aimed to determine the PAF-AH activity by spectrophotometric assay in maternal plasma of 73 PE patients versus 73 normotensive controls and plasma PAF-AH mRNA expression to know the aberration of PAF-AH activity at the genetic level. Relative mRNA expression was calculated by Δ DCT method and a fold change was calculated by 2–ΔDCT. We found that the mean plasma PAF-AH activity levels among cases was significantly higher than the normotensive controls. However, the mRNA expression of the PAF-AH gene was similar between the cases and controls, as well as between severe and non-severe preeclampsia (true fold change =1). To conclude, PAF-AH appears to be increased in women with preeclampsia and hence may contribute to pathophysiology and severity. However, a larger sample size will be required to reiterate this association. Recently, PAF-AH inhibitors such as Darapladib has been tested as a therapeutic option in atherosclerosis. After studying the role of PAF-AH in the pathogenesis of PE, PAF-AH inhibitors may be used as a therapeutic tool in the future in PE. What is already known on this subject? Platelet activating factor (PAF) is produced in response to oxidative stress and is a potent hypotensive agent. PAF acetylhydrolase (PAF-AH) hydrolyses and inactivates PAF and is seen to decrease in normotensive women. The role of platelet activating factor-acetylhydrolase (PAF-AH) in preeclampsia has been investigational so far. Few studies done have shown a positive association of elevated levels of PAF-AH in preeclamptic women. What do the results of this study add? Our study aimed to determine the activity of PAF-AH in maternal plasma of PE patients versus normal pregnancy and plasma PAF-AH mRNA expression to know the aberration of PAF-AH activity at the level of the gene. We found that plasma PAF-AH activity among preeclamptics was significantly higher than in the controls with a possible role in early-onset preeclampsia (<32 weeks), in the Indian population. This marker has never been studied in this population earlier. The results of our study re-emphasised its role in the pathogenesis of preeclampsia. What are the implications of these findings for clinical practice and/or further research? Such studies are important to not only give us a greater understanding of the various pathways involved in this multifactorial dreaded condition, but can also offer us a marker for early identification of women at risk. Recently, PAF-AH inhibitors like Darapladib has been tested as a therapeutic option in atherosclerosis. After studying the role of PAF-AH in the pathogenesis of PE, PAF-AH inhibitors may be used as a therapeutic tool in the future in PE. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer is the fourth most common cancer in the world and the second leading cause of mortality in India atier breast cancer. Human papilloma virus (HPV) infection has been regarded as a key risk factor in cervical cancer, however it is not sufficient in the causation of the disease. Role of other cofactors like steroids and their receptors in the pathogenesis of carcinoma cervix is being studied extensively. Various in-vitro and some human studies have postulated a role of estrogen receptors in carcinoma cervix. Estrogen receptors (ER) were categorized into two subgroups (alpha and beta) atier the discovery of estrogen receptor beta in the mid-nineties. Studies show that ER alpha (ERa) and beta (ERß) have their own unique cell specific expression patierns and actions and may also have mutual antagonistic roles if present in the same tissue. Aim and Objectives: The aim of the research was to study and compare the expression of ER alpha and beta in ectocervix of healthy women and cervical cancer patients. Materials and Methods: One gram of cervical tissue was taken from 30 cervical cancer patients and 20 healthy women and subjected to immune histochemical analysis. The expression patiern of ER alpha and beta was studied in terms of number of women expressing the receptor and immunoreactivity scores and compared between healthy and cancerous cervix. Results: Ectocervical cells of both normal and cancerous cervix expressed both ER alpha (ERa) and beta (ERß) in their nuclei and only ER beta in their cytoplasm. Ninety percent of healthy women expressed ER alpha in the ectocervix compared to only 6.67% of cervical cancer patients (p=0.000). The mean immunoreactivity scores for ER alpha expression was also lower in cervical cancer patients (0.167±0.75) compared to healthy women (2.60±2.01) [p=0.000]. Conclusion: ER alpha and beta have different expression patierns in ectocervical cells. ER alpha is significantly down expressed while ER beta expression is retained or slightly increased in cervical cancer cells when compared to normal cervix. [ABSTRACT FROM AUTHOR]

Background: Illness severity scores commonly used in critical care settings are not considered appropriate in obstetric practice as they do not account for pregnancy physiology. A new illness severity score called the 'Sepsis in Obstetrics Score' (SOS) was introduced by Albright et al. for triaging patients with sepsis in pregnancy in an emergency department setting. Objectives: We aimed to determine whether this score could predict the need for critical care support using the presence of organ failure as the identification criteria. Severity and culture positivity in pregnancy-associated sepsis was also assessed. Materials and methods: All pregnant, postabortal and postpartum women with suspected sepsis were enrolled (as per systemic inflammatory response syndrome criteria) were enrolled. Severe pregnancy-associated sepsis was defined as dysfunction of one or more organs due to sepsis. The severity of pregnancy-associated sepsis was graded according to the number of organ failures. A SOS cut off of 6 was taken for statistical analysis. Results: Out of 100 women with pregnancy-associated sepsis, 'severe sepsis' was present in 58%. When the SOS test performance was compared with the severity of pregnancy-associated sepsis, it had sensitivity of 68.9% and specificity of 80.9%, positive predictive value of 83% and negative predictive value 65% to predict severe sepsis. The area under curve for the SOS detecting severe pregnancy-associated sepsis was 0.810. SOS predicted organ failure in pregnancy-associated sepsis and this was statistically significant for all organs involved. Culture positivity did not correlate with the SOS in our study. Conclusions: Sepsis in Obstetrics Score correlated well with organ failure in pregnancy-associated sepsis. It had a high positive predictive value (83%) for severe sepsis. [ABSTRACT FROM AUTHOR]