Homeologs of Brassica SOC1, a central regulator of flowering time, are differentially regulated due to partitioning of evolutionarily conserved transcription factor binding sites in promoters.

Evolution of Brassica genome post-polyploidization reveals asymmetrical genome fractionation and copy number variation. Herein, we describe the impact of promoter divergence among SUPPRESSOR OF OVEREXPRESSION OF CONSTANS1 (SOC1) homeologs on expression and function in Brassica spp. SOC1, a regulated floral pathway integrator, is conserved as 3 redundant homeologs in diploid Brassicas. Even with high sequence identity within coding regions (92.8-100%), the spatio-temporal expression patterns of 9 SOC1 homologs in B. juncea and B. nigra indicates regulatory divergence. While LF and MF2 SOC1 homeologs are upregulated during floral transition, MF1 is barely expressed. Also, MF2 homeolog levels do not decline post-flowering, unlike LF. To investigate the underlying source of divergence, we analyzed the sequence and phylogeny of all reported (22) and isolated (21) upstream regions of Brassica SOC1. Full length upstream regions (4712-19189 bp) reveal 5 ubiquitously conserved ancestral Blocks, harboring binding sites of 18 TFs (TFBSs) characterized in Arabidopsis thaliana. The orthologs of these TFBSs are differentially conserved among Brassica SOC1 homeologs, imparting expression divergence. No crucial TFBSs are exclusively lost from LF_SOC1 promoter, while MF1_SOC1 has lost NF-Y binding site crucial for SOC1 activation by CONSTANS. MF2_SOC1 homeologs have lost important TFBSs (SEP3, AP1 and SMZ), responsible for SOC1 repression post-flowering. BjuAALF_SOC1 promoter (proximal 2 kb) shows ubiquitous reporter expression in B. juncea cv. Varuna transgenics, while BjuAAMF1_SOC1 promoter shows absence of reporter expression, validating the impact of TFBS divergence. Conservation of the original primary protein sequence is discovered in B. rapa homeologs (46) of 18 TFs. Co-regulation pattern of these TFs appeared similar for B. rapa LF and MF2 SOC1 homeologs; MF1 shows significant variation. Strong regulatory association is recorded for AP1, AP2, SEP3, FLC and CONSTANS/NF-Y, highlighting their importance in homeolog-specific SOC1 regulation. Correlation of B. juncea AP1, AP2 and FLC expression with SOC1 homeologs also complies with the TFBS differences. We thus conclude that redundant SOC1 loci contribute differentially to cumulative expression of SOC1 due to divergent selection of ancestral TFBSs.

A Literature Review on Current and Proposed Technologies of Noninvasive Blood Pressure Measurement.

BACKGROUND: Noninvasive continuous blood pressure (BP) measurement has become an evolving topic in the field of remote healthcare. The classical noninvasive BP measurement techniques provide spontaneous values of systolic and diastolic BP. On the other hand, intrusive type BP measurement techniques provide continuous values of systolic and diastolic BP. However, these techniques are very painful, cannot be used for long-term monitoring, and are obtainable only in an intensive care unit environment. With the advancement of the remote healthcare industry, there is a growing demand for noninvasive continuous BP monitoring. OBJECTIVE: The objective of this research was to present a compact literature review on the various prospective approaches of noninvasive continuous BP measurement techniques. MATERIALS & METHODS: The most contemporary and advanced technologies on noninvasive continuous BP measurement are Tactile Sensing, Vascular Unloading Technique, Pulse Transit Time, Photoplethysmography, Ultrasound-based BP measurement, BP measurement from image processing, etc. The literature search based on these technologies was conducted in EMBASE, Web of Science, IEEE, PubMed, and Ovid MEDLINE databases. In this study, each selected approach was evaluated and characterized using the following criteria: (1) accuracy; (2) cost; (3) portability; (4) comfort and convenience of use; (5) clinical health and safety; and (6) ability to integrate with the remote healthcare system. RESULTS: A detailed technical analysis was done to determine the advantages and limitations of each technique in the context of the abovementioned parameters. It was observed that BP measurement, using photoplethysmography (using camera or sensor or both), perhaps was the most promising technique among all. CONCLUSION: The study emphasized the fact that the noninvasive, continuous BP measurement technique needs to evolve further to make it reliable, accurate, and user-friendly. Lastly, a possible direction toward a more reliable and comfortable noninvasive continuous BP measurement technique has been discussed.

A Universal Noninvasive Continuous Blood Pressure Measurement System for Remote Healthcare Monitoring.

BACKGROUND: The effectiveness of any remote healthcare monitoring system depends on how much accurate, patient-friendly, versatile, and cost-effective measurement it is delivering. There has always been a huge demand for such a long-term noninvasive remote blood pressure (BP) measurement system, which could be used worldwide in the remote healthcare industry. Thus, noninvasive continuous BP measurement and remote monitoring have become an emerging area in the remote healthcare industry. INTRODUCTION: Photoplethysmography-based (PPG) BP measurement is a continuous, unobtrusive, patient-friendly, and cost-effective solution. However, BP measurements through PPG sensors are not much reliable and accurate due to some major limitations like pressure disturbance, motion artifacts, and variations in human skin tone. MATERIALS AND METHODS: A novel reflective PPG sensor has been developed to eliminate the abovementioned pressure disturbance and motion artifacts during the BP measurement. Considering the variations of the human skin tone across demography, a novel algorithm has been developed to make the BP measurement accurate and reliable. The training dataset captured 186 subjects' data and the trial dataset captured another new 102 subjects' data. RESULTS AND DISCUSSION: The overall accuracy achieved by using the proposed method is nearly 98%. Thus, demonstrating the efficacy of the proposed method. CONCLUSIONS: The developed BP monitoring system is quite accurate, reliable, cost-effective, handy, and user friendly. It is also expected that this system would be quite useful to monitor the BP of infants, elderly people, patients having wounds, burn injury, or in the intensive care unit environment.

Performance Analysis of IEEE 802.15.6 CSMA/CA Protocol for WBAN Medical Scenario through DTMC Model.

The newly drafted IEEE 802.15.6 standard for Wireless Body Area Networks (WBAN) has been concentrating on a numerous medical and non-medical applications. Such short range wireless communication standard offers ultra-low power consumption with variable data rates from few Kbps to Mbps in, on or around the proximity of the human body. In this paper, the performance analysis of carrier sense multiple access with collision avoidance (CSMA/CA) scheme based on IEEE 802.15.6 standard in terms of throughput, reliability, clear channel assessment (CCA) failure probability, packet drop probability, and end-to-end delay has been presented. We have developed a discrete-time Markov chain (DTMC) to significantly evaluate the performances of IEEE 802.15.6 CSMA/CA under non-ideal channel condition having saturated traffic condition including node wait time and service time. We also visualize that, as soon as the payload length increases the CCA failure probability increases, which results in lower node's reliability. Also, we have calculated the end-to-end delay in order to prioritize the node wait time cause by backoff and retransmission. The user priority (UP) wise DTMC analysis has been performed to show the importance of the standard especially for medical scenario.

Telemedicine Supported Chronic Wound Tissue Prediction Using Classification Approaches.

Telemedicine helps to deliver health services electronically to patients with the advancement of communication systems and health informatics. Chronic wound (CW) detection and its healing rate assessment at remote distance is very much difficult due to unavailability of expert doctors. This problem generally affects older ageing people. So there is a need of better assessment facility to the remote people in telemedicine framework. Here we have proposed a CW tissue prediction and diagnosis under telemedicine framework to classify the tissue types using linear discriminant analysis (LDA). The proposed telemedicine based wound tissue prediction (TWTP) model is able to identify wound tissue and correctly predict the wound status with a good degree of accuracy. The overall performance of the proposed wound tissue prediction methodology has been measured based on ground truth images. The proposed methodology will assist the clinicians to take better decision towards diagnosis of CW in terms of quantitative information of three types of tissue composition at low-resource set-up.

A review on telemedicine-based WBAN framework for patient monitoring.

OBJECTIVE: In this article, we describe the important aspects like major characteristics, research issues, and challenges with body area sensor networks in telemedicine systems for patient monitoring in different scenarios. Present and emerging developments in communications integrated with the developments in microelectronics and embedded system technologies will have a dramatic impact on future patient monitoring and health information delivery systems. The important challenges are bandwidth limitations, power consumption, and skin or tissue protection. MATERIALS AND METHODS: This article presents a detailed survey on wireless body area networks (WBANs). RESULTS AND CONCLUSIONS: We have designed the framework for integrating body area networks on telemedicine systems. Recent trends, overall WBAN-telemedicine framework, and future research scope have also been addressed in this article.

Papillary cystadenocarcinoma of the mammary gland with metastases to the gastrointestinal tract in a Himalayan brown bear (Ursus arctos).

A 17-yr-old, multiparous female brown bear (Ursus arctos) bred in captivity at the Himalayan Nature Park, Kufri, Shimla, Himachal Pradesh, India, died after a short progressive illness of 2 wk duration. Clinically, the bear had dyspnea and was pyretic, inappetent, and lethargic. Within the right pectoral mammary gland was an 11-cm diameter, round, firm, subcutaneous mass. At postmortem examination, the mammary gland revealed a well-differentiated, multinodular infiltrative mass with multiple nonuniform cystic spaces. These cystic spaces were filled with watery, opaque white to yellow contents. Additionally, multifocal, nodular, ovoid intraluminal masses that extended transmurally from the mucosal surface to the serosa were detected in the duodenum and jejunum. Histopathologic examination revealed papillary cystadenocarcinoma of the mammary gland with metastases to the intestine, which has not been documented previously in Himalayan brown bears.

Cough Audio Analysis for COVID-19 Diagnosis.

Humanity has suffered catastrophically due to the COVID-19 pandemic. One of the most reliable diagnoses of COVID-19 is RT-PCR (reverse-transcription polymer chain reaction) testing. This method, however, has its limitations. It is time consuming and requires scalability. This research work carries out a preliminary prognosis of COVID-19, which is scalable and less time consuming. The research carried out a competitive analysis of four machine-learning models namely, Multilayer Perceptron, Convolutional Neural Networks, Recurrent Neural Networks with Long Short-Term Memory, and VGG-19 with Support Vector Machines. Out of these models, Multilayer Perceptron outperformed with higher specificity of 94.5% and accuracy of 96.8%. The results show that Multilayer Perceptron was able to distinguish between positive and negative COVID-19 coughs by a robust feature embedding technique.

Implant abutment using hand drivers versus torque wrench.

The most frequent instrument used to begin tightening screws is a manually regulated screwdriver. Regarding manually regulated screwdrivers, predicted margins of error vary between fifteen percent to forty eight percent. Mechanical Torque restricting devices can consistently produce the requisite torques. As a result, devices like wrenches are needed to achieve the desirable values of torque. Hence, the present study was designed to evaluate the torque difference between handheld drivers and torque wrench and thereby its effect on the internal threads of implant surface.120 blocks was prepared from an autopolymerizing type of acrylic material each with a dimension of 1 inch. The centre of each block was affixed with analogue of dental impalnts with dimensions of 3.5 mm width and 13 mm length. With 60 specimens each, these models were split into two categories: hand torque specimens category and torque wrench specimens category. A stereomicroscope was used to look at the implant analog's internal threading architecture at a magnification of 100. At the bottom and top, four threads were spaced apart by a certain amount. Biowizard software was used for the assessment, and the results were recorded. Threads on the internal surface of dental implants were produced once more following torquing the implant's impression, and the stereomicroscope was used to quantify the separation between the 4 threads. Statistics were used to correlate the readings. All study participants' hand torque as well as torque wrench measurements were documented and statistical analysis was performed on them. When there was statistical analysis of the measurements then it was observed that mean values of torque in specimens included category of manual torque application was found out to be 33.6 ± 6.510 Ncm. On the other hand the mean values of torque in specimens included in category of torque application by torque wrench were found out to be 33.57 ± 3.472 Ncm. The outcome showed operator heterogeneity for both categories and operator variance when using a manual driver to generate torque. One independent - sample t test was used to contrast the mean data between the two categories, and P< 0.05 was chosen to determine whether the intergroup difference was meaningful. Because the torque values obtained with hand tightening were uneven, it may be concluded that different levels of hand torquing skill caused the torque to fluctuate. The torque wrench device displayed the desired torque data in the range that the manufacturer had advised. However, utilising manual drivers and a mechanical torque instrument did not cause any modifications to thread on the internal surface, and it rarely underwent significant deformation during the preliminary tightening torque readings. Thus, given that manually hand regulated drivers create a range of torques, it may be inferred that the employment of mechanical torque restricting instruments should be required.

Effect of curcumin, betadine and chlorhexidine in gingival wound healing.

The effect of chlorhexidine (CHX) digluconate, Betadine (BET), curcumin (CUR) on gingival wound healing is of interest to dental practitioners. Hence, we studied the average fibroblast viability % for each of the concentrations of CUR, BET and CHX over various time durations. It was found that mean percentage of viability of fibroblasts is high in CUR and low in CHX at all time periods while the mean percentage of viability of fibroblasts in BET 1% was greater than CHX but lower than CUR at all time periods. Thus, curcumin at a concentration of 0.003% demonstrates the least cytotoxicity for fibroblasts. Hence, it is the most effective bacterial suppression, and the best wound healing.

Silver nano particles prevent platelet adhesion on immobilized fibrinogen.

Vascular thrombotic disorders have emerged as a serious threat to our society. Platelet adhesion to fibrinogen, collagen and other platelet activators exposed over the atherosclerotic plaques can trigger platelet signaling events, activate platelets and lead to thrombotic events. Since anticoagulant and thrombolytic treatment strategies are usually associated with serious bleeding complications, preventing platelets adhesion may help to maintain platelets in an inactive state. In this study we tried to find out the effect of Silver nanoparticles, through their interaction with various platelet surface integrins on platelet adhesion on immobilized fibrinogen. Platelets, isolated from anti-coagulated human whole blood sample from healthy donors, were suspended in physiological buffer and each sample was divided into four tubes. In three of them 0.05, 0.5, and 5 µM concentrations of Silver nanoparticles were added, fourth tube served as control. Platelet adhesion on immobilized fibrinogen matrices and integrin mediated cell signaling events were studied in all the four samples. In the present study we show that nanosilver prevent platelet adhesion without conferring any lytic effect on them and effectively prevents integrin-mediated platelet responses in a concentration-dependent manner.

Impact of radiotherapy and shielding on the efficacy of the self-etch adhesive technique.

Context: The exposure to gamma radiation affects the enamel and dentin in teeth restored with composite restoration, but a little has been done to protect from the detrimental effect. Aims: The aim of this in vitro study was to evaluate the effect of gamma radiation, with or without shielding (0.5 mm thickness of lead), in Class V cavities prepared on teeth exposed before and after restoration using the self-etch adhesive technique. Methods: A total of 75 intact teeth were selected. The samples were divided into five groups: Group I (15 teeth) not exposed to gamma radiation. Group II and III exposed to gamma radiation as per the standardized radiation protocol (2 Gy/day for 5 days/week = 10 Gy/week for 6 weeks = 60 Gy). Group III shielded, using a "0.5 mm thickness of lead" molded into a "C" shaped tube. Standardized Class V cavities were prepared on the buccal surface of all teeth and were restored by composite. Groups IV (not shielded) and V (shielded) were then exposed to standardized radiation protocol. All the samples were evaluated for the assessment of microleakage under stereomicroscope. Statistical Analysis Used: Statistics were tabulated using the Kruskal-Wallis ANOVA test. Results: Samples showed a significant difference in dye penetration scores. Conclusions: The samples restored before being exposed to gamma radiations performed better. Shielding with 0.5 mm of lead has shown increased efficacy of self-etch adhesive system irrespective of the stage of exposure.

Ceramic Inlays: A Case Report.

Aesthetic dentistry continues to evolve via advances in bonding agents, restorative materials, and conservative preparation methods. Alternatives to dental amalgam and gold include ceramic dental restorative materials. The lifespan of ceramic inlay repairs is still up for debate. When it comes to durability, colour matching, and anatomical shape stability, ceramic inlay restorations top the list of options. More predictable long-term performance may be achieved by strategically placing ceramic inlays in teeth that are not subjected to significant occlusal stress. Preparation design for ceramic inlay materials is necessary to avoid flexure. This case report discusses the ceramic inlay practice for functional and aesthetic restoration in a patient.

Effect of Different Preparation Techniques on Root Canal Geometry: An In Vitro Study.

Aim and objective: To compare and evaluate canal preparation using hand stainless steel files, hand ProTaper files, and rotary ProTaper files for change in root canal geometry in terms of surface area and volume changes assessed by computed tomography. Materials and methods: The present study was conducted in Nair Hospital and Dental College, Department of Pediatric and Preventive Dentistry in collaboration with insight CBCT, imaging technologies. A total of 36 extracted human primary mandibular second molars were collected from the Department of Pediatric and Preventive Dentistry. All the teeth were scanned using cone-beam CT (i-CAT CT Scanner Next Generation, Imaging Sciences International) preoperatively and postoperatively to assess the mean absolute change in surface area and mean change in the volume of all the canals at different levels with the use of hand stainless steel files, hand ProTaper and rotary ProTaper files. Results: ProTaper instruments, both hand ProTaper and rotary ProTaper caused significant changes in the surface area in the coronal thirds and middle thirds of the canal when compared to hand stainless steel files. No difference was found in surface area and volume changes between hand ProTaper and rotary ProTaper instrumentation. Conclusion: Use of ProTaper instruments for preparation of deciduous teeth can render benefit of an improved canal preparation to facilitate better obturation and successful root canal therapy. How to cite this article: Bheda P, Kakade A, Takate V, et al. Effect of Different Preparation Techniques on Root Canal Geometry: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(S-1):S71-S79.

Accuracy of MRI without intracavernosal prostaglandin E1 injection in staging, preoperative evaluation, and operative planning of penile cancer.

PURPOSE: To evaluate the performance of non-erectile MRI in staging and preoperative evaluation of penile carcinomas, compared to postoperative histopathology. METHODS: In this retrospective study, MRI scans of patients who had undergone surgery for penile carcinoma (n = 54) between January 2012 and April 2018 were read by two radiologists; and disagreement was solved in the presence of a third experienced radiologist. Data necessary for preoperative evaluation and staging were collected and compared with final postoperative histology and the type of surgery performed. All MRI had been performed without intracavernosal injection of prostaglandin E1 and with IV Gadolinium, as per local protocol. RESULTS: 54 patients were included in the study (mean age 57.52 ± 12.78). The number of patients with T1, T2, and T3 staging in histopathology were 32, 14, and 8. Moderate interobserver agreement was found for staging, disease-free penile length, and all subsites except urethra, which had weak agreement. Strong agreement of consensus MRI with final histopathological staging was found (49/54, weighted κ = 0.85), with high sensitivity and specificity. Sensitivity and specificity for involvement of corpus spongiosum, corpora cavernosa, and urethra were 95.5% and 93.8%, 87.5% and 97.8%, and 90.9% and 86.1%, respectively. Sensitivity (89.6%) and specificity (100%) of MRI for predicting adequate disease-free penile length were high. CONCLUSION: There were acceptable interobserver agreement and good diagnostic performance of MRI for staging and preoperative assessment without intracavernosal injection, especially for higher stages and higher degrees of invasion which require more extensive surgery.

A novel gene expression test method of minimizing breast cancer risk in reduced cost and time by improving SVM-RFE gene selection method combined with LASSO.

Breast cancer is the leading diseases of death in women. It induces by a genetic mutation in breast cancer cells. Genetic testing has become popular to detect the mutation in genes but test cost is relatively expensive for several patients in developing countries like India. Genetic test takes between 2 and 4 weeks to decide the cancer. The time duration suffers the prognosis of genes because some patients have high rate of cancerous cell growth. In the research work, a cost and time efficient method is proposed to predict the gene expression level on the basis of clinical outcomes of the patient by using machine learning techniques. An improved SVM-RFE_MI gene selection technique is proposed to find the most significant genes related to breast cancer afterward explained variance statistical analysis is applied to extract the genes contain high variance. Least Absolute Shrinkage Selector Operator (LASSO) and Ridge regression techniques are used to predict the gene expression level. The proposed method predicts the expression of significant genes with reduced Root Mean Square Error and acceptable adjusted R-square value. As per the study, analysis of these selected genes is beneficial to diagnose the breast cancer at prior stage in reduced cost and time.

Neuroendoscopy - Is it safe?

BACKGROUND: The effect of heat in endoscopic instruments used for laparoscopy and hysteroscopy has been well-studied. Reports of thermal injury from nasal endoscopes have also been reported. However, there are no experimental studies, which have objectively documented and provided recommendations for safe use of endoscopes in neurosurgery. OBJECTIVES: To study the heat generated at the tip of the endoscope and the subsequent thermal damage caused to a cotton drape placed in proximity, by varying the intensity of light delivered through different optical cables, ambient (operating room) temperatures and working distances. MATERIALS AND METHODS: The study was carried out in the operation theater using a 300 watt xenon light source connected to the endoscope with 3.5 mm and 4.8 mm optical cables. A digital thermometer was used to record the heat generated at the tip of the endoscope. RESULTS: The heat generated at the tip of the endoscope reached its peak in the first 6 min and attained a plateau at 15 min after turning on a light source of 60% intensity. Thermal injury to the cotton drape took a longer time with a 3.8 mm cable compared with 4.8 mm cable. The heat generated at the tip of the endoscope, and thereby the thermal injury caused was found to be lower when the ambient temperature was close to 20°C. CONCLUSIONS: Complications related to thermal injuries caused by heat generated at the tip of an endoscope can be reduced by using a smaller diameter cable, light intensity of 60%, increasing the working distance (as permissible), reducing the time spent for dissection while keeping the endoscope very close to the target and lowering the ambient temperature to 20°C.

Clinical and Radiologic Evaluation of Regenerative Potential of NHA Paste and DBM in the Treatment of Periodontal Intra-bony Defects -A Randomized Control Trial.

INTRODUCTION: Previous studies have shown that Hydroxyapatite (HA) has shown good results in the treatment of intra-osseous periodontal defects. A newer variety of HA has been designed over a period of research which has nano-sized particles and is availed in a paste consistency called Nanocrystalline Hydroxyapatite paste (NHA paste). This variation in size and surface area of NHA paste can provide better results when used in intra-bony defects. AIM: The purpose of this study was to compare the clinical and radiographic outcomes obtained with usage of NHA paste to those obtained with Demineralized Bone Matrix (DBM) in the treatment of periodontal intra-bony defects. MATERIAL AND METHODS: A clinical trial was carried out for a period of 12 months. A total of 26 intra-bony defects in 10 patients were divided into experimental and control sites. The experimental sites were debrided and grafted with NHA paste. The control sites were debrided and grafted with DBM-Xenograft. Probing Depth, Clinical Attachment Level (DCAL) and Gingival Margin (GM) position were recorded at baseline 3, 6, 9 and 12 months. Standardized radiographs were also documented at these recalls. The results were averaged (mean± standard deviation) for each parameter and Student t-test was used to determine intra-group statistical difference and One way analyses of variance (ANOVA) to test the difference between groups using Excel and SPSS (SPSS Inc, Chicago) software packages. RESULTS: On completion of 12 months, the mean percentage of PD reduction achieved in the experimental and control sites was 67.45% and 69.03% respectively (p<0.05). The mean percentage of gain achieved in CAL was 63.58% and 61.42% in the experimental and control sites respectively (p<0.05). Gingival recession was seen to be non-significant in the experimental and control sites. The mean percentage of bone fill in the control group obtained was 48.16% where as the percentage of bone fill obtained in the experimental group was 48.64% (p<0.05). CONCLUSION: Overall, both therapies led to significant improvements of the investigated parameters. The NHA paste was as effective in terms of improving clinical and radiographic parameters as DBM-Xenograft, which is an already established bone graft. There is a need for further long term controlled studies evaluating the adjunctive benefits of usage of NHA paste in the treatment of periodontal intra-bony defects.

A rare case report of bilateral internal carotid artery hypoplasia in postpartum female: Clinical spectrum and role of various modalities in diagnosis.

Congenital hypoplasia of bilateral internal carotid arteries (ICAs) is an extremely rare anomaly with less than 25 reported cases in literature till date. We present a case of a 30-year-old primigravida, who developed seizures and subsequently loss of consciousness just few minutes after the delivery of a healthy male child. To the best of our knowledge, this is the first case with bilateral ICA hypoplasia presenting in postpartum female who developed infarct in bilateral frontal region and subarachnoid hemorrhage (SAH). On a postpartum three-dimensional (3D) computed tomography (CT) angiography, bilateral ICA hypoplasia was confirmed and the manifestations of infarcts were probably the consequence of altered hemodynamics of pregnancy. In conclusion, a patient in her late pregnancy and postpartum period, having nonspecific cerebral symptoms or having suffered a cerebrovascular accident, should not only be evaluated for pregnancy or puerperium-related complications but also whenever possible a baseline screening with Doppler study of neck vessels and a noncontrast magnetic resonance imaging (MRI) angiography of neck and cerebral vessels should be performed to rule out congenital anomalies.

Evaluation of serum prolactin level in patients of subclinical and overt hypothyroidism.

BACKGROUND: Prolactin secretion is controlled by prolactin inhibitor factor that is secreted from hypothalamus; factors like vasoactive inhibitory peptide (VIP) and thyroid releasing hormone (TRH) lead to increase in prolactin secretion. Hyperprolactinemia is a common condition that can result from a number of causes including hypothyroidism. Objective of the study was to determine correlation between serum levels of prolactin and thyroid hormones in euthyroid, subclinical and overt hypothyroid cases. MATERIALS AND METHODS: Consecutive patients presenting for various thyroid related problems were segregated into two groups subclinical and overt hypothyroidism according to their diagnosis based on history and clinical examination, laboratory reports, inclusion and exclusion criteria. Newly diagnosed 75 patients in each group were finally enrolled. Similar number of age and sex matched controls were selected. All subjects filled a predesigned questionnaire for the evaluation of hypothyroid symptoms. Thyroid profile for T3, T4 (total and free), TSH and prolactin were determined in all the subjects and analyzed. RESULTS: Prolactin elevation was found in 16 patients (21.33 %) with overt hypothyroidism, and in six patients (8%) with subclinical hypothyroidism. The control group and subclinical hypothyroid patients exhibited no significant difference in terms of total and free T3, total and free T4. For TSH and prolactin on the other hand, a statistically significant elevation was found in patients with overt hypothyroidism when compared with subclinical hypothyroidism; and in patients with subclinical hypothyroidism when compared to the controls. A significant statistical difference was observed between the two groups of hypothyroid patients for all hypothyroid symptoms except alopecia and hirsuitism. CONCLUSION: The incidence of hyperprolactinemia in hypothyroidism was found to be higher when compared with normal controls. Serum prolactin assessment should be performed on all patients with hypothyroidism (overt and subclinical) before performing further tests.