Ethnicity in polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is the commonest gynecological endocrinopathy. Little is known about the exact etiopathogenesis and cardiometabolic mortality and morbidity in women with PCOS. PCOS is beyond the cosmetic concerns of an adolescent and fertility concerns of an adult and can cause serious unhealthy consequences in perimenopausal and postmenopausal age. This area needs to be assessed and addressed since the majority of these patients are lost to follow-up after completion of their families. Good evidence suggests that there are significant racial and ethnic differences in prevalence, insulin resistance, metabolic syndrome, hyperandrogenemia and the related cardiometabolic risk in women with PCOS.

Hepatoprotective activity of Balsamodendron mukul extract against Paracetamol-induced liver toxicity in rats: In vivo pharmacological and toxicological evaluation.

Overuse of the antipyretic agent Paracetamol (PCM) is linked to hepatotoxicity, which limits its clinical use. The goal of this investigation was to find out how well Balsamodendron mukul (B. mukul) extract protects the liver from acute PCM poisoning. B. mukul extract was procured from a standard crude drug supplier in the local market. The PCM-induced hepatotoxicity was screened in experimental animals. Animals that were treated only with excessive PCM (2g/kg) had changes in their serum biomarkers (i.e., serum glutamate oxaloacetate transaminase, serum glutamate pyruvate transaminase, alkaline phosphatase, and serum total bilirubin), oxidative stress, Tumor Necrosis Factor-α (TNF-α), and Interleukin-1 proteins. B. mukul extracts of 245µg and 332µg revealed 50% of hydroxyl radical scavenging and lipid peroxidation inhibiting, respectively, which was found to be more significant when compared to ascorbic acid treatment. The outcomes confirmed that B. mukul extract has strong antioxidant activity, which leads to the inhibition of reactive oxygen species (ROS). Treatment with B. mukul extract at doses of 300 and 600mg/kg produced a dose-dependent reduction in the PCM-induced rise of the biochemical parameters. Silymarin at 100mg/kg body weight significantly prevented such rise in the study. Finally, the findings confirmed that the B. mukul extract has more potent than silymarin and revealed higher antioxidant and hepatoprotective activity, which could consider a novel approach for the reduction of PCM-induced liver toxicity.

Massive Subcutaneous Emphysema and Pneumothorax in a Case of Attacked by a Domesticated Bull - An Autopsy Based Diagnosis.

Subcutaneous emphysema is a condition when air or gas gets trapped within the subcutaneous layer. It is characterised by crackling feeling on palpation of the skin known as subcutaneous crepitation which is described as touching rice krispies. A 70 years male from hilly region of Nepal with agricultural background suffered multiple injuries sustained due to an attack by domesticated bull in his house. Upon the incident the injured male was taken to hospital, where he was declared "Brought Dead" by the Emergency Department of Dhulikhel Hospital, Kathmandu University Hospital. His body was brought for autopsy in Department of Forensic Medicine and Toxicology of Kathmandu University School of Medical Sciences. On complete autopsy, massive subcutaneous emphysema and pneumothorax was demonstrated. The details of finding are discussed in detail as follows.

Risk factors and outcome analysis of patients with intraoperative rupture (IOR) of ruptured cerebral aneurysm during microsurgical clipping.

PURPOSE: To analyse baseline characteristics of patients with intraoperative rupture (IOR) or non-IOR who underwent microsurgical clipping for ruptured intracranial aneurysms. Additionally, to asses functional outcome in terms of Glasgow Outcome Scale (GOS) at 6 and 12 months. METHODS: A retrospective analysis of 471 patients who underwent microsurgical clipping for ruptured intracranial aneurysms from 2007 to 2018 in Nepal Mediciti Hospital, Nepal. Patients who underwent surgery for unruptured aneurysm were excluded from the study. The association of the base line characteristic in IOR and non-IOR were analysed. Variables analysed were the Hunt and Hess Scale (HHS) dichotomized as (1-3) and (4-5), Modified Fisher Scale dichotomized as (0-2) and (3-4), type of rupture, use of brain retractor, timing of IOR during surgery, aneurysmal factors (size of the neck, location, lobulation) and time of surgery. Outcome, GOS dichotomized into favourable (4-5) and unfavourable (1-3), assessed at 6 months and 12 months. RESULTS: Out of 471 patients treated for ruptured intracranial aneurysm, IOR occurred in 57 (12.10%) with mean age 49.47 (SD ±12.9), occurred more in smoker than non-smoker (45.6% vs. 18.6%; p=.000) and regular alcohol consumers (36.8% vs. 17.9%; p=.004). Favourable outcome with GOS (4-5) at 6 months was observed among patients with lower HHS (1-3), p=.025 and lower MFS (0-2), p=.04. However, outcome at 12 months was better associated with MFS (p=.013) and aneurysm size (p=.038), with more favourable outcome associated with aneurysm less than 10 mm. CONCLUSIONS: Alcohol consumption and smoking are associated risk factors that may contribute to IOR. HHS and MFS are strong predictors of outcome for IOR patients at 6 months. However, at 12 months, MFS is more predictive of outcome. Aneurysms greater than 10 mm had a strong association with outcome at 12 months than 6 months.

Development, validation, and application of an RP-HPLC method for concurrent quantification of Minoxidil and Finasteride in a topical solution for hair regrowth.

A topical solution comprising of Minoxidil (MXL) and Finasteride (FNS) for alopecia is formulated in the present work, which essentially contains a lipid-Lauroglycol FCC as a penetration enhancer. The objective of the proposed work was to develop a rapid, simple, and robust reverse phase high performance liquid chromatographic (RP-HPLC) method to determine MXL and FNS in the said formulation. Herein, the chromatographic conditions were optimized based on the theoretical principles of separation and physicochemical properties such as pKa and log P of both the Active Pharmaceutical Ingredients (APIs). The separation was accomplished on an Inertsil® ODS-3 C18 column (150mm×4.6mm; 5µm of particle size) at 25°C by using a mobile phase composed of 70:30 v/v ratio of Methanol and Milli-Q water along with 0.5% Triethylamine at pH 6.4 adjusted with Ortho Phosphoric Acid. Drug peaks showed a good resolution at 210nm. The retention times for MXL and FNS were found to be 2.40min and 6.39min, respectively. The developed method was found to be linear (R2≥0.998) in a concentration range of 5-100µg/mL for both the drugs. The method was validated according to the ICH guidelines Q2 (R1). The ability of the method to differentiate between the types formulations was demonstrated by the in vitro diffusion data performed using a highly sophisticated Strat-M® membrane. The cumulative amount of drug released (MXL and FNS) at the end of 24hours was maximum for the topical formulation containing lipids prepared using isopropyl alcohol and propylene glycol as the base.

COVID-19 pandemic and its positive impacts on environment: an updated review.

In December, 2019 in Wuhan city of China, a novel coronavirus (SARS-CoV-2) has garnered global attention due to its rapid transmission. World Health Organization (WHO) termed the infection as Coronavirus Disease 2019 (COVID-19) after phylogenic studies with SARS-CoV. The virus causes severe respiratory infections with dry cough, high fever, body ache and fatigue. The virus is primarily transmitted among people through respiratory droplets from COVID-19 infected person. WHO declared this COVID-19 outbreak a pandemic and since February, 2020 affected countries have locked down their cities, industries and restricted the movement of their citizens to minimize the spread of the virus. In spite of the negative aspects of coronavirus on the globe, the coronavirus crises brought a positive impact on the natural environment. Countries where the movement of citizens was seized to stop the spread of coronavirus infection have experienced a noticeable decline in pollution and greenhouse gases emission. Recent research also indicated that this COVID-19-induced lockdown has reduced the environmental pollution drastically worldwide. In this review, we have discussed some important positive impacts of coronavirus on environmental quality by compiling the recently published data from research articles, NASA (National Aeronautics and Space Administration) and ESA (European Space Agency).

Changes in cellular structure of heat-treated Salmonella in low-moisture environments.

AIMS: Salmonella cells desiccated in an environment with low-water activity (aw ) show longer survival times and enhanced resistance to heat. However, little is known about the cellular ultrastructure of Salmonella in low-aw environment in relation to the survival and persistence during desiccation. MATERIALS AND RESULTS: In this study, Salmonella Enteritidis strain PT30 was dehydrated by exposure to air or by mixing with wheat flour (aw 0·30 at room temperature) for 7 days followed by heat treatment at 80°C for 10, 20, 60 min respectively. Transmission electron microscopy (TEM) was employed to examine and compare the ultrastructure of heat-treated S. Enteritidis cells after desiccation with the cells suspended in trypticase soy broth (TSB). Cells suspended in TSB broth showed disrupted ribosomes, congregated proteins and denatured DNA. However, no significant alterations were observed in the ultrastructure of the desiccated cells after heat treatment. The number of desiccated S. Enteritidis cells decreased by <1·5 log CFU per gram after 80°C treatment for 60 min, however, cells suspended in TSB declined more than 5 log10 CFU per mL at 80°C within 5 min. CONCLUSIONS: A drastic difference in the number of survivors and cellular ultrastructure was observed between vegetative and air or food-dried S. Enteritidis cells after subjecting to heat treatment at 80°C. No significant ultrastructure changes were observed in desiccated cells after heat treatment except for roughening and corrugating surfaces. SIGNIFICANCE AND IMPACT OF THE STUDY: This study provides a direct comparison to illustrate how desiccation influences the cell ultrastructure before/after heat treatment, which will aid in better understanding of the fundamental mechanism underlying the increased thermal resistance of Salmonella cells in low-aw environment.

Sexual Dimorphism of Greater Sciatic Notch among Nepalese Population by Three Dimensional CT Images of Pelvis.

Background Sex identification from the skeletal remains, is the first and the foremost step encountered by forensic experts. Hip bone being comparatively robust is resistant to damage and scores even in improperly preserved skeletons. It is also widely agreed that the greater sciatic notch (GSN) holds the greatest degree of sexual dimorphism. Objective To study the role of greater Sciatic Notch parameters in sex determination among Nepalese population by means of reconstructed Multi Slice Three-Dimensional Computed Tomography (MDCT) images. Method The CT images of individuals who underwent pelvic CT in the Department of Radiology, Dhulikhel Hospital were included in the study. Measurements of width, depth, angles and indices of greater sciatic notch were measured and calculated. Data were entered and analyzed using SPSS (Statistical Package for Social Sciences) version 25.0. Result There was a significant difference between means of all greater sciatic notch parameters (p > 0.001) between sex showing sexual dimorphism except depth (p=0.65). By using limiting point, 78.18% male and 83.64% female were correctly classified by using total width. Total angle, Posterior segment and Total width had sensitivity and specificity exceeding 80% and overall accuracy of 87% to 92% in all parameters except depth by receiver-operator characteristic curve analysis. Conclusion Application of 3D-CT virtual images in the present study helped us to easily quantify greater sciatic notch parameters. The important greater sciatic notch predictors for sex determination in Nepalese population were determined which would help forensic experts in ascertaining the sex of an unknown individual.

Clinical, humanistic, and economic burden of osteoarthritis among noninstitutionalized adults in the United States.

OBJECTIVE: To estimate the burden of osteoarthritis (OA) among noninstitutionalized adults (≥18 years of age) in the US. DESIGN: Weighted nationally representative data from the 2015 Medical Expenditure Panel Survey were used to estimate OA prevalence in noninstitutionalized adults and compare adults with OA to those without OA for clinical (pain interference with activities [PIA], functional limitations), humanistic (health-related quality-of-life [HRQoL]) and economic outcomes (healthcare costs, wage loss). Productivity/wage loss was estimated among employed working-age adults (18-64 years). Multivariable regression analyses examined the associations between OA and outcomes. RESULTS: In 2015, 10.5% (25.6 million) of noninstitutionalized US adults reported having any OA. Regression analyses indicated that adults with OA were significantly more likely than those without OA to report moderate (adjusted odds ratios [AOR] 1.99; 95% confidence interval [CI] 1.65-2.40] or severe PIA (AOR 2.59; 95% CI 2.21-3.04), any functional limitation (AOR 2.51; 95% CI 2.21-2.85), and poorer HRQoL on the SF-12 version 2 Physical Component Summary score (adjusted beta [standard error] -3.88 [0.357]; P < 0.001). Adjusted incremental annual total healthcare costs and lost wages among adults with OA relative to those without OA were $1778 and $189 per person, respectively, resulting in estimated national excess costs of $45 billion and $1.7 billion, respectively. CONCLUSIONS: OA affects approximately 10% of noninstitutionalized adults in the US, resulting in substantial clinical, humanistic, and economic burdens.

Human articular cartilage mechanosensitivity is related to histological degeneration - a functional MRI study.

OBJECTIVE: To investigate changes in response to sequential pressure-controlled loading and unloading in human articular cartilage of variable histological degeneration using serial T1ρ mapping. METHOD: We obtained 42 cartilage samples of variable degeneration from the medial femoral condyles of 42 patients undergoing total knee replacement. Samples were placed in a standardized artificial knee joint within an MRI-compatible whole knee-joint compressive loading device and imaged before (δ0), during (δld1, δld2, δld3, δld4, δld5) and after (δrl1, δrl2, δrl3, δrl4, δrl5) pressure-controlled loading to 0.663 ± 0.021 kN (94% body weight) using serial T1ρ mapping (spin-lock multigradient echo sequence; 3.0T MRI system [Achieva, Philips]). Reference assessment included histology (Mankin scoring) and conventional biomechanics (Tangent stiffness). We dichotomized sample into intact (n = 21) and degenerative (n = 21) based on histology and analyzed data using Mann Whitney, Kruskal Wallis, one-way ANOVA tests and Spearman's correlation, respectively. RESULTS: At δ0, we found no significant differences between intact and degenerative samples, while the response-to-loading patterns were distinctly different. In intact samples, T1ρ increases were consistent and non-significant, while in degenerative samples, T1ρ increases were significantly higher (P = 0.004, δ0 vs δld1, δ0 vs δld3), yet undulating and variable. With unloading, T1ρ increases subsided, yet were persistently elevated beyond δ0. CONCLUSION: Cartilage mechanosensitivity is related to histological degeneration and assessable by serial T1ρ mapping. Unloaded, T1ρ characteristics are not significantly different in intact vs degenerative cartilage, while load bearing is organized in intact cartilage and disorganized in degenerative cartilage.

Functional Data Analysis of Weather Variables Linked to Fusarium Head Blight Epidemics in the United States.

In past efforts, input weather variables for Fusarium head blight (FHB) prediction models in the United States were identified after following some version of the window-pane algorithm, which discretizes a continuous weather time series into fixed-length windows before searching for summary variables associated with FHB risk. Functional data analysis, on the other hand, reconstructs the assumed continuous process (represented by a series of recorded weather data) by using smoothing functions, and is an alternative way of working with time series data with respect to FHB risk. Our objective was to functionally model weather-based time series data linked to 865 observations of FHB (covering 16 states and 31 years in total), classified as epidemics (FHB disease index ≥ 10%) and nonepidemics (FHB disease index < 10%). Altogether, 94 different time series variables were modeled by penalized cubic B-splines for the smoothing function, from 120 days pre-anthesis to 20 days post-anthesis. Functional mean curves, standard deviations, and first derivatives were plotted for FHB epidemics relative to nonepidemics. Function-on-scalar regressions assessed the temporal trends of the magnitude and significance of the mean difference between functionally represented weather time series associated with FHB epidemics and nonepidemics. The mean functional weather-variable curve for epidemics started to deviate, in general, from that for nonepidemics as early as 40 days pre-anthesis for several weather variables. The greatest deviations were often near anthesis, the period of maximum susceptibility of wheat to FHB-causing fungi. The most consistent separations between the mean functional curves were seen with the daily averages of moisture-related variables (such as average relative humidity) and with variables summarizing the daily variation in temperature (as opposed to the daily mean). Functional data analysis was useful for extending our knowledge of relationships between weather variables and FHB epidemics.

Women's rights in Asia and elsewhere - a fact or an illusion?

More than one-third of the world's population resides in Asia. China and India have the largest population densities and the focus of this article is on these two countries. In the seventeenth century, women were globally treated as inferior and subordinate to men. Women had to listen to their fathers, husbands, and sons, and they could not inherit business or wealth. Starting in the eighteenth century and continuing in the nineteenth century, women's rights became central to political debates in Europe which demanded human rights, leading to the Women's Rights Movement. The Feminist movement began in the twentieth century, which focused on the reproductive rights of women. In the twentieth century, various Declarations have been signed by the United Nations to offer both gender equity and equality to women in the world, but unfortunately many of them have not been put into practice in Asia. In the twenty-first century, the feminist movement is focusing more on women having the power to decide the course of their lives. We still have to overcome challenges of unequal economic opportunity, political empowerment, gender violence, and human trafficking to achieve gender equality in Asia.

Synthetic sodalite doped with silver nanoparticles: Characterization and mercury (II) removal from aqueous solutions.

In this work, a novel silver nanoparticles-doped synthetic sodalitic composite was synthesized and characterized using advanced characterization methods, namely TEM-EDS, XRD, SEM, XRF, BET, zeta potential, and particle size analysis. The synthesized nanocomposite was used for the removal of Hg2+ from 10 ppm aqueous solutions of initial pH equal to 2. The results showed that the sodalitic nanocomposites removed up to 98.65% of Hg2+, which is ∼16% and 70% higher than the removal achieved by sodalite and parent coal fly ash, respectively. The findings revealed that the Hg2+ removal mechanism is a multifaceted mechanism that predominantly involves adsorption, precipitation and Hg-Ag amalgamation. The study of the anions effect (Cl-, NO3-, C2H3O2-, and SO42-) indicated that the Hg2+ uptake is comparatively higher when Cl- anions co-exist with Hg2+ in the solution.

Elevated obstructive sleep apnoea risk score is associated with poor healing of diabetic foot ulcers: a prospective cohort study.

AIMS: To assess the prevalence of risk factors for obstructive sleep apnoea in people with diabetic foot ulcers and to determine whether this risk predicts diabetic foot ulcer healing. METHODS: We studied 94 consecutive people (69% men) with diabetic foot ulcers (Type 2 diabetes, n=66, Type 1 diabetes, n=28) attending a university hospital foot unit. All participants were screened for obstructive sleep apnoea using the STOP-BANG questionnaire, with a score ≥4 identifying high risk of obstructive sleep apnoea. The primary outcome was poor diabetic foot ulcer healing, defined as diabetic foot ulcer recurrence (diabetic foot ulcers which healed and re-ulcerated in same anatomical position) and/or diabetic foot ulcer persistence (no evidence of healing on clinical examination). All participants were evaluated at 12 months. RESULTS: Of the 94 participants, 60 (64%) had a STOP-BANG score ≥4. Over 12 months, 27 participants with a score ≥4 had poor diabetic foot ulcer healing as compared to seven with a score <4 (45% vs 20.5%; P=0.025). A STOP-BANG score ≥4 significantly increased the relative risk of poor healing more than twofold, independently of other risk factors in multivariable analyses. CONCLUSIONS: There is a high prevalence of features and risk of obstructive sleep apnoea in people with diabetic foot ulcers. A STOP-BANG score ≥4 predicts poor diabetic foot ulcer healing. Obstructive sleep apnoea may be a potential, modifiable risk factor/treatment target to improve diabetic foot ulcer outcomes.

Minimally invasive and targeted therapeutic cell delivery to the skin using microneedle devices.

BACKGROUND: Translation of cell therapies to the clinic is accompanied by numerous challenges, including controlled and targeted delivery of the cells to their site of action, without compromising cell viability and functionality. OBJECTIVES: To explore the use of hollow microneedle devices (to date only used for the delivery of drugs and vaccines into the skin and for the extraction of biological fluids) to deliver cells into skin in a minimally invasive, user-friendly and targeted fashion. METHODS: Melanocyte, keratinocyte and mixed epidermal cell suspensions were passed through various types of microneedles and subsequently delivered into the skin. RESULTS: Cell viability and functionality are maintained after injection through hollow microneedles with a bore size ≥ 75 µm. Healthy cells are delivered into the skin at clinically relevant depths. CONCLUSIONS: Hollow microneedles provide an innovative and minimally invasive method for delivering functional cells into the skin. Microneedle cell delivery represents a potential new treatment option for cell therapy approaches including skin repigmentation, wound repair, scar and burn remodelling, immune therapies and cancer vaccines.

Perceptions of Midwestern Crop Advisors and Growers on Foliar Fungicide Adoption and Use in Maize.

Foliar fungicide use in hybrid maize in the United States was rare before 2000. The decade from 2000 to 2010 saw foliar fungicides increasingly applied to maize in the absence of appreciable disease pressure, a practice seemingly at odds with integrated pest management philosophy. Yet, it is commonly believed that growers do not employ management strategies unless there are perceived benefits. Maize (corn) growers (CGs) and certified crop advisors (CCAs) across four Midwestern states (Iowa, Illinois, Ohio, and Wisconsin) were surveyed to better understand their practices, values and perceptions concerning the use of foliar fungicides during 2005 to 2009. The survey results demonstrated the rapid rise in maize foliar fungicide applications from 2000 through 2008, with 84% of CGs who sprayed having used a foliar fungicide in maize production for the very first time during 2005 to 2009. During 2005 to 2009, 73% of CCAs had recommended using a foliar fungicide, but only 35% of CGs sprayed. Perceived yield gains, conditional on having sprayed, were above the break-even point on average. However, negative yield responses were also observed by almost half of CCAs and a quarter of CGs. Hybrid disease resistance was a more important factor to economically successful maize production than foliar fungicides. Diseases as a yield-limiting factor were more important to CGs than CCAs. As a group, CGs were not as embracing of foliar fungicide as were CCAs, and remained more conservative about the perceived benefits to yield.

The futile case of the aging ovary: is it mission impossible? A focused review.

Despite immense and impressive progress in the field of reproductive medicine, little has been achieved in terms of replenishing aged ovaries and improving their reproductive outcome. Age causes irreversible damage to human eggs in terms of quantity as well as quality. Nature probably designed women to reproduce best in their twenties and thirties. However, due to social, personal, career, educational and financial pressures, women delay pregnancies until their late thirties, by which time the chance of becoming pregnant is compromised by low fecundity rates and an increased risk of miscarriage. Age, unfortunately, is the most detrimental prognostic factor for success of fertility treatment. We have seen an increasing population of older women seeking fertility treatment. The existing evidence does not offer any clear-cut guidelines for the clinical handling of older women seeking fertility treatment. Various strategies have been tried to improve the fertility outcome of such women, but none has met with significant success. This review focuses on what can and what cannot be done in terms of improving fertility rates in older women.

Differentiating recurrent tumours from post-treatment changes in head and neck cancers: does diffusion-weighted MRI solve the eternal dilemma?

AIM: To evaluate the utility of diffusion-weighted imaging (DWI) in differentiating post-treatment changes from tumour recurrence in head and neck cancers and to establish a threshold apparent diffusion coefficient (ADC) value to differentiate the two conditions. MATERIALS AND METHODS: This was a prospective study of 80 treated head and neck cancer patients. The patient cohort consisted of a wide spectrum of head and neck sites, including the oral cavity, oropharynx, larynx, hypopharynx, paranasal sinuses, orbits, salivary glands, and infra-temporal fossa. Qualitative analysis of the diffusion images and quantitative analysis of the corresponding ADC maps was performed and the data were correlated with histopathological findings and clinical examinations. RESULTS: The mean ADC value of recurrent tumours in the present cohort was 0. 932±0.19×10-3 mm2/s and the mean ADC value of lesions representing post-treatment changes was 1.394±0.32×10-3 mm2/s. A threshold ADC value of 1.2×10-3mm2/s used to differentiate post-treatment changes from recurrent head and neck cancers showed the highest combined sensitivity of 90.13%, specificity of 82.5%, accuracy of 86.4%, positive predictive value of 84.4%, negative predictive value of 88.9%, and mean kappa measurement of agreement of 72.8. CONCLUSION: Combined qualitative and quantitative analysis of DWI is a useful non-invasive technique to differentiate recurrent head and neck malignancies from post-treatment changes using a threshold ADC value.

Polycystic ovary syndrome and metabolic syndrome: the worrisome twosome?

By virtue of insulin resistance being the common etiology for polycystic ovary syndrome (PCOS) and metabolic syndrome, the cardiometabolic risks of these two syndromes are shared. The usual concerns of a PCOS patient are cosmetic or reproductive. However, there are more serious concerns past the reproductive age. Early treatment of insulin resistance, hypertension and hyperlipidemia reduces the long-term risk. This review highlights the unhealthy association of metabolic syndrome with PCOS and emphasizes the importance of early diagnosis, patient education and long-term follow-up beyond the reproductive age into menopause to prevent the long-term serious co-morbidities.