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Abstract Introduction: Laparoscopic myomectomy is a commonly performed operation with fast recovery and excellent results. However, haemorrhagic nature of the operation mandates us to use variety of vasoconstrictive and uterotonic agents. Amongst which, one of them is vasopressin. It is a synthetic antidiuretic hormone analogue which has been in common use as a vasoconstrictive agent in various surgical procedures including laparoscopic myomectomy. Methods: A meta-analysis of randomised controlled trials published from 2013 to 2023 (10 years) comparing the use of vasopressin against other drug or placebo or different doses of vasopressin was performed. The outcome measures were intraoperative blood loss, need for blood transfusion, difference in the haemoglobin (Hb) and haematocrit (Hct). Results: We identified 176 articles through the study search, amongst which 12 articles were included for the meta-analysis. There was a significant heterogeneity in the studies with moderate risk of bias in eight studies and low risk of bias in four studies. Compared to placebo, vasopressin showed significantly lower odds need of blood transfusion (odds ratio [OR] 0.28, 95% confidence interval [CI]: 0.13-0.61, P = 0.002) and significantly lower pre-post fall in Hb (OR −3.12, 95% CI: −4.63-−1.60, P < 0.0001). However, there was no statistically significant difference in intraoperative blood loss (OR −0.56 (95% CI: −2.04-0.92, P = 0.46) and pre-post fall in Hct (OR −0.94, 95% CI: −1.96-0.07, P > 0.05). Compared to other drug (epinephrine, misoprostol and octreotide acetate), vasopressin showed no significant superiority in controlling blood loss (P > 0.05). Even the two doses of vasopressin (dilute vs. concentrated) showed no statistically significant difference between surgical blood loss and need for blood transfusion (P > 0.05). Conclusion: Vasopressin is an efficacious drug to be used for controlling blood loss, decreasing blood transfusion requirement and maintaining Hb and Hct during laparoscopic myomectomy.

Advances in DNA sequencing technology have facilitated the determination of hundreds of complete genome sequences both for bacteria and their bacteriophages. Some of these bacteria have well-developed and facile genetic systems for constructing mutants to determine gene function, and recombineering is a particularly effective tool. However, generally applicable methods for constructing defined mutants of bacteriophages are poorly developed, in part because of the inability to use selectable markers such as drug resistance genes during viral lytic growth. Here we describe a method for simple and effective directed mutagenesis of bacteriophage genomes using Bacteriophage Recombineering of Electroporated DNA (BRED), in which a highly efficient recombineering system is utilized directly on electroporated phage DNA; no selection is required and mutants can be readily detected by PCR. We describe the use of BRED to construct unmarked gene deletions, in-frame internal deletions, base substitutions, precise gene replacements, and the addition of gene tags.

CA125 levels show a variation in premenopausal women during the menstrual cycle. Moreover, various modifiable and non-modifiable factors affect its value which needs to be taken into account while interpreting the results. The study was done with an objective (1) to determine differences in CA125 levels during the mid-cycle and menstrual phase of menstruation and (2) to determine the factors (demographic and clinical) that may affect CA125 values. An observational study was conducted from December 2017 to May 2019. Women of reproductive age group of 15-45 years with regular menstrual cycles were included in the study. The CA125 levels were compared among mid-cycle values and values during menstruation. A mean of the values was taken, and factors affecting it were determined by regression analysis. < 0.05 was considered statistically significant. The mean age of the patients was 28.71 ± 6.14 years. The median day of sample collection during menses was day 2 and during mid-cycle was day 14. Compared to mid-cycle CA125 values, values during menses were significantly higher (24.74 ± 17.43 vs. 12.39 ± 7.3, < 0.0001) with a mean difference of 12.35 ± 15.04. Multivariate regression analysis showed that days of menses (beta coefficient 3.49, = 0.0001) and regular caffeine consumption (beta coefficient 7.074, = 0.007) were significant independent positive risk factors of CA125 levels. In conclusion, CA125 levels are significantly higher during menstruation as compared to mid-cycle values in premenopausal women. The significant factors leading to higher CA125 levels are days of menses and caffeine consumption.

Tuberculosis is the leading cause of death due to a single infectious agent, and over one-third of the global population is infected with Mycobacterium tuberculosis, the etiologic agent of human tuberculosis. In recent years, the likelihood of biofilm-based infections contributing toward bacterial persistence and increased drug tolerance, has gained some recognition. M. tuberculosis and its non-pathogenic fast-growing relative, M. smegmatis, have been found to form biofilms that harbor bacteria that are more resistant to anti-tuberculosis agents than free-living cells. Biofilm formation involves the development of several distinct morphological structures, with associated physiological features. Bacteria growing within biofilms exist as heterogeneous populations, dependent on the distinct micro-environments within the complex community structure. Consequently, gene expression profiles differ between sub-populations of cells, and also during distinct stages of biofilm development. Gene expression in biofilms also differs greatly from the gene expression profiles of planktonically growing cells of the same species. M. smegmatis biofilms can serve as a model for other mycobacterial biofilms. Transcriptome analyses of M. smegmatis biofilms have led to the identification of several genes that were induced in a biofilm-specific pattern. Iron plays an essential role in mycobacterial growth, metabolism and infection. Taken together with its significance in biofilm development, the detailed profiling of the expression of iron acquisition genes in mature biofilms would provide insight into the physiological state of the bacterial cells within these structures. Using stable fluorescent reporter constructs, we have provided a detailed profile for the expression of the intramembrane-associated siderophore, mycobactin. Our results suggest that mycobactin biosynthesis is differentially induced in biofilms and in liquid cultures. In mature biofilms, a significant proportion of cells induce mycobactin biosynthesis in spite of the availability of iron-rich conditions. Our analyses also attempt to sort out subsets of cells within the biofilm that differentially induce mycobactin biosynthesis. In a related study undertaken to understand the relationship between biofilm formation and surface translocation in M. smegmatis, we have isolated a transposon mutant that is defective in sliding motility, but proficient in biofilm formation. This mutant suggests that biofilm formation in M. smegmatis does not depend on sliding motility.