Study of Thrombophilia in Recurrent Pregnancy Loss

Objectives

Recently, it has been found that women who have thrombophilia have increased risk of fetal loss. This study was designed to corroborate the association of elevated factor VIII level, protein C and protein S deficiencies, and the presence of LAC in women with recurrent pregnancy loss.

Materials and Methods

53 patients with history of two or more pregnancy losses and 47 healthy age-matched subjects with no history of pregnancy loss and who have delivered at least one term infant without any complication were enrolled into the study.

Results

Thrombophilic defect was present in 64.15 % of patients of study group. Protein S deficiency (50.94 %) was the most common thrombophilic defect observed. Spontaneous abortion (SA), preterm birth (PTB), and intrauterine growth retardation (IUGR) were the most important pregnancy complications observed. The strongest associations of pregnancy complications were observed with protein S deficiency (87.5 %) and with elevated factor VIII (66.66 %) level.

Conclusion

This study observed strong association of thrombophilia with unexplained recurrent pregnancy loss.     

Effect of vaginally administered (Ala(8,13,18))-magainin II amide on the morphology of implantation stage endometrium in the rhesus monkey (Macaca mulatta).

Intravaginal administration of an anti-microbial agent, (Ala^8,13,18)-magainin II amide, during blastocyst implantation inhibits pregnancy establishment in a dose-related manner in the rhesus monkey (Macaca mulatta). In the present study, mated female rhesus monkeys were vaginally inserted with tampons containing vehicle (Group 1; N = 5) and test agent (magainin, 0.5 mg/animal; Group 2; N = 6) on cycle day 20. Endometrial tissue samples were collected on Cycle Day 24 from all monkeys and processed for morphometric and ultrastructural analysis. Concentrations of estradiol-17β, progesterone, and chorionic gonadotrophin in peripheral circulation were determined, which revealed that two monkeys in Group 1 were pregnant while no animals were pregnant in Group 2. Endometrial morphology, however, revealed histologic evidence of pregnancy in three out of the six magainin-treated animals. It appears that intra-vaginal administration of magainin II amide had a marginal effect on the implantation stage endometrium and the initiation of the implantation process in the rhesus monkey.     

Intraocular gnathostomiasis: report of a case and review of literature

Intraocular gnathostomiasis is a rare parasitic infection caused by the third-stage larvae of spiruroid nematode Gnanthostoma spp. seen mostly in tropical and subtropical regions. It is a food-borne zoonosis caused by ingestion of raw or undercooked freshwater fish, amphibians, reptiles, birds, and mammals, all of which are known to harbor advanced third-stage larvae of Gnanthostoma spp. To date, 74 cases of intraocular gnathostomiasis have been reported from 12 different countries. Only four countries have reported more than 10 cases each, and India shares the rare distinction of being one of them, with 14 cases. Surprisingly, not a single case of cutaneous gnanthostomiasis has ever been reported from India. We present one such case of intraocular gnathostomiasis in a 41-year-old male who presented with an actively motile worm attached to the iris, and we review the pertinent literature of all such cases reported from India.     

Measures of divergence of oriented patterns for the detection of architectural distortion in prior mammograms

Purpose We propose a method for the detection of architectural distortion in prior mammograms of interval-cancer cases based on the expected orientation of breast tissue patterns in mammograms. Methods The expected orientation of the breast tissue at each pixel was derived by using automatically detected landmarks including the breast boundary, the nipple, and the pectoral muscle (in mediolateral-oblique views). We hypothesize that the presence of architectural distortion changes the normal expected orientation of breast tissue patterns in a mammographic image. The angular deviation of the oriented structures in a given mammogram as compared to the expected orientation was analyzed to detect potential sites of architectural distortion using a measure of divergence of oriented patterns. Each potential site of architectural distortion was then characterized using measures of spicularity and angular dispersion specifically designed to represent spiculating patterns. The novel features for the characterization of spiculating patterns include an index of divergence of spicules computed from the intensity image and Gabor magnitude response using the Gabor angle response; radially weighted difference and angle-weighted difference (AWD) measures of the intensity, Gabor magnitude, and Gabor angle response; and AWD in the entropy of spicules computed from the intensity, Gabor magnitude, and Gabor angle response. Results Using the newly proposed features with a database of 106 prior mammograms of 56 interval-cancer cases and 52 mammograms of 13 normal cases, through feature selection and pattern classification with an artificial neural network, an area under the receiver operating characteristic curve of 0.75 was obtained. Free-response receiver operating characteristic analysis indicated a sensitivity of 0.80 at 5.3 false positives (FPs) per patient. Combining the features proposed in the present paper with others described in our previous works led to significant improvement with a sensitivity of 0.80 at 3.7 FPs per patient. Conclusion The proposed methods can detect architectural distortion in prior mammograms taken 15 months (on the average) before clinical diagnosis of breast cancer, but the FP rate needs to be reduced.     

Total magnitude of diffusion tensor imaging as an effective tool for the differentiation of glioma

Objectives

The study aims to evaluate the difference in diffusion properties between high grade glioma and low grade glioma by measuring the total magnitude of diffusion tensor (L), and its isotropic (p) and anisotropic (q) components.

Methods

The diffusion tensor parameters p, q, L and FA from the tumor area, adjacent area to the tumor and corresponding contra lateral normal area of 30 high grade glioma and 49 low grade glioma were calculated. Chi square analysis was done to find the changes in age and sex. One Way ANOVA was performed to compare the mean and ROC curve analysis to confirm the discriminative sensitivity.

Results

Major variation in the mean values of p, L and FA was observed in different brain areas considered. Variation in the p and L values between low grade and high grade glioma were statistically significant (p < 0.001) and their ROC curve analysis yielded 93.9% and 91.8% sensitivity and 53.3% specificity respectively.

Conclusion

Measurement of the isotropic component p and the total value of diffusion tensor L can be effectively correlated with different grades of glioma and can be used to study the diffusion properties of tumor affected brain.     

Endocrine disorders in schizophrenia: Relationship to antipsychotic therapy

Schizophrenia and its treatment are associated with several endocrinopathies, some well studied but others not. Among the most extensively investigated endocrine functions has been the hyperprolactinemia associated with the dopamine receptor antagonism exerted by antipsychotic agents. More recently, diabetes and insulin regulation has been the focus of intensified investigation due the potentially serious metabolic effects. Some evidence points to higher frequency of diabetes in schizophrenia prior to treatment, whereas an expanding body of evidence suggests an increase in diabetes following treatment with some but not all second-generation antipsychotics. This article reviews the recent developments in the treatment-emergent endocrine abnormalities in schizophrenia and points to relevant clinical implications for the treatment of schizophrenia.