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Byline: Alvee. Saluja, Kallur. Saraswathy, Sunil. Thakur, Shubhalaxmi. Margekar, Ankit. Goyal, Rajinder. Dhamija Background: Endothelial nitric oxide synthase (eNOS) is an enzymatic marker whose genetic polymorphism might predispose to acute [...]

Introduction: Endometrial cancer is a hormone-dependent malignancy, and sex steroid hormones play a crucial role in its pathogenesis. Recent studies have demonstrated that microRNAs (miRNAs) can regulate the expression of sex steroid hormone receptors and modulate hormone signaling pathways. Our aim is to provide an overview of the current understanding of the role of miRNAs in endometrial cancer regulated by sex steroid hormone pathways. Methods: A thorough literature search was carried out in the PubMed database. The articles published from 2018 to the present were included. Keywords related to miRNAs, endometrial cancer, and sex steroid hormones were used in the search. Results: Dysregulation of miRNAs has been linked to abnormal sex steroid hormone signaling and the development of endometrial cancer. Various miRNAs have been identified as modulators of estrogen and progesterone receptor expression, and the miRNA expression profile has been shown to be a predictor of response to hormone therapy. Additionally, specific miRNAs have been implicated in the regulation of genes involved in hormone-related signaling pathways, such as the PI3K/Akt/mTOR and MAPK/ERK pathways. Conclusion: The regulation of sex steroid hormones by miRNAs is a promising area of research in endometrial cancer. Future studies should focus on elucidating the functional roles of specific miRNAs in sex steroid hormone signaling and identifying novel miRNA targets for hormone therapy in endometrial cancer management. [ABSTRACT FROM AUTHOR]

BACKGROUND: The use of drain in primary total knee replacement (TKR) started with the belief that it prevents hematoma formation and infection. The fear of infection made this practice an essential step that enjoyed a long journey. However, in recent years, majority of evidence-based studies have not only been failed to provide substantial benefits of the drain but also have proven this a counterproductive step. OBJECTIVE: The purpose of our study is to assess the outcome of performing primary TKR without the use of a drain. METHODOLOGY: After meeting inclusion and exclusion criteria, a prospective observational study was conducted on 186 patients (191 knees) who underwent primary cemented total knee arthroplasty without the use of drain from September 2018 to March 2020 and were followed up for one year. Surgery was performed under tourniquet, bleeders were electro cauterized, and injection tranexamic acid was used to control bleeding. A good preoperative screening for foci of infection, tight glycemic control for diabetics, part preparation, prophylactic antibiotics, and gentle handling of soft tissue was ensured to control infection. Deep vein thrombosis prophylaxis was instituted after risk stratification. Ambulation and physiotherapy were started as per protocol. The clinical parameters such as pain score and range of motion (ROM) were measured by a physiotherapist. Postoperative hemoglobin (Post Op Hb) and requirement of dressing change/reinforcement were monitored by the ward nurse. Aspiration of the knee if required was done by the treating surgeon. RESULTS: Post Op Hb drop was insignificant and none of the patients required blood transfusion. Tense arthrocoele, requiring rescue analgesia, were found in 5(2.6%) patients which responded well with knee aspiration. There was significant improvement (P < 00001) in pain score and the targeted ROM were achieved in 3 weeks' postoperative. Although ecchymosis was a common finding (20.4%), it did not require special attention. Blisters developed in six patients which were managed by antibiotic-impregnated paraffin dressing. Wound healing was not delayed in any patient. None of the patients acquired infection. CONCLUSION: Performing primary TKR without drain is a safe practice to exercise as it neither increases the risk of infection nor poses a significant threat of blood loss and blood transfusion. The presence of arthrocoele in postoperative period does not compromise short term clinical and functional outcomes. The incidence of developing tense hemarthrosis is very less and if aspirated, relieves patient's discomfort and aborts the surgeon's fear of infection. Moreover, not only the cost of drain and utilization of workforce is saved but the question of caring for the drain and its complications also ends. [ABSTRACT FROM AUTHOR]

Unilateral spinal anesthesia (USpA) is a technique used to restrict the effect of the spinal block on the operative side. 10-15 degrees reverse Trendelenburg position has been used to control the height of the spinal block using hyperbaric drugs. We aimed to study the effect of the 10-degree reverse Trendelenburg position on the quality of block and hemodynamic stability in unilateral spinal anesthesia in this hospital-based, double-blind, randomized clinical trial. 60 patients of both sexes between 20-60 years of age, undergoing below-knee orthopedic surgeries, were randomized into 2 groups. In both groups, spinal anesthesia was given with 2 mL bupivacaine heavy (0.5%), and the lateral position was maintained for 10 mins. Group 2 patients were kept in a 10-degree reverse Trendelenburg position throughout the surgery. The hemodynamic parameters and block characteristics of the two groups were compared using Epi Info statistical software. The onset of sensory block was faster in Group 1 (recumbent) compared to Group 2 (reverse Trendelenburg). The two-segment regression time was longer in the second group. In group 2, 73.3% of patients reached a level at T8 or below T8, compared to 46.7% in Group 1. The duration of sensory block and anesthesia was longer in Group 2. We conclude that reverse Trendelenburg of 10 degrees immediately after spinal anesthesia significantly limits the level of sensory block and prolongs the duration of unilateral spinal anesthesia. [ABSTRACT FROM AUTHOR]

Introduction: Almost every cesarean delivery is done under spinal anesthesia because of ease of doing, rapid onset, avoids maternal and fetal risk of general anesthesia, promotes early recovery. Major complication especially in young women undergoing LSCS under spinal anesthesia is post dural puncture headache (PDPH) which is caused by cerebrospinal fluid leakage. There is wide variation in reported incidence of PDPH (0.3% to 40 %) after spinal anesthesia being affected by various procedure and non procedure related risk factors like age, gender, needle size and type, numbers of spinal attempts and previous history of PDPH. Methods: Prospective cohort study was conducted in 335 patients posted for caesarean section under spinal anesthesia from January 2019 to September 2019 in medical College situated in rural India. Spinal anesthesia was given by 26 G Quincke spinal needle. All patients were evaluated for incidence and severity of PDPH from post operative day 1 to day 5. Result: Incidence of PDPH was 11.4% in this study. Majority of patients (62.5%) were having mild pain. All patients reported PDPH with 72 hours. Conclusion: Body mass index (BMI), h/o PDPH, multiple attempts for successful spinal anesthesia did not have any significant association with PDPH in our study. [ABSTRACT FROM AUTHOR]

Oxidative stress, due to reactive oxygen species (ROS) or free radicals, can increase cardiovascular risk factors (CRFs). Lifestyle, environment, and genetics are the primary reasons for ROS generation. The role of genetics in the causation of CRFs mediated by ROS is still elusive. The present study aimed to determine the prevalence of null genotypes of oxidative stress genes (GSTM1 and GSTT1) and cardiovascular risk factors (CRFs) in an urban population. The association of GSTM1 & GSTT1 null genotypes with CRFs was also assessed in this study. A total of 40 participants (permanent residents of Chandigarh, India) were recruited. Anthropometric and physiological data were collected along with blood samples. Biochemical and molecular analysis were performed on all the collected blood samples. More than 90% of the participants had high blood pressure (HBP), 70% had obesity (OBS), and 40% had postprandial hyperglycemia (PPH). The null-genotype of GSTM1 and GSTT1 exhibited 47.50% and 7.50% of participants, respectively. GSTM1 and GSTT1 null genotypes were higher in males than females (50% vs 42.9% and 7.7% vs 7.1%). Agewise distribution showed that the absence of GSTM1 genotype was more in older participants (56.5% vs 35.3%) while GSTT1 genotype was more absent in younger participants (11.8 % vs 4.3%). Participants with null genotypes had trends of high CRFs, but only diastolic blood pressure (DBP) was significantly high. Although, mean arterial pressure (MAP) was also on the verge of significance. Odd ratio analysis showed a 2.383-fold risk of hyperglycemia in participants with either null genotypes. The present study concluded that studied participants are at greater risk of cardiovascular diseases due to high trends of CRFs. High CRFs may be related to the null genotype of GSTM1 and GSTT1 in the urban environment. Further studies with a bigger sample size are warranted to establish the results of the present study. [ABSTRACT FROM AUTHOR]

Despite India has a high incidence of cervical cancer, there aren't enough large-scale population-based investigations on the prevalence and genotype distribution of the Human Papilloma Virus (HPV). Out of the several high-risk types, HPV-16 and HPV-18 are primarily responsible for the bulk of cancers linked to the virus. The present study investigates the genotype distribution of HPV-16 and HPV-18 with respect to cervical cytology among the women of the Barak Valley, Assam, Northeast India. A total of 80 women were enrolled in the study. After the enrolment of the participants, cervicovaginal smears were collected and processed for (a) HPV genotyping and (b) cytological analysis. HPV DNA detection was done with consensus primers MY09/11, followed by the detection of HPV-16 and HPV-18 with typespecific primers. Liquid Based Cytology (LBC) test was performed, and cytological grading was done. Overall HPV prevalence was 17.5% (14/80) using MY09/11 HPV consensus primers. HPV-16 is found to be the most prevalent single infection (8.75%, 7/80), followed by HPV-18 (6.25%, 5/80). Where co-infection with HPV types 16+18 is found to be 2.5% (2/80). In cytological analysis, a total of 10% (8/80) show abnormal lesions in various cytological categories. The distribution of abnormal cytological lesions is CIN1 (6.25%, 5/80), CIN2 (2.5%, 2/80), and CIN3 (1.25%, 1/80). When HPV infection was checked across different cytological categories, 87.5% (6/8) of abnormal cytological lesions were HPV positive. The present study found that overall HPV infection is high among the women of the Barak Valley Northeast India. Awareness about the virus, information on available screening methods, and vaccination may play a decisive role in reducing the infection rate. [ABSTRACT FROM AUTHOR]