Ambulatory Hysteroscopy in Abnormal Uterine Bleeding: A Tertiary Care Hospital Perspective

Background: To avoid delays in outpatient facilities for managing benign gynecological conditions like abnormal uterine bleeding (AUB), there is a need to evaluate the usage of unconventional methods like outpatient hysteroscopy. Objectives: To evaluate the usage of outpatient diagnostic hysteroscopy in women with abnormal uterine bleeding. Methods: An observational study was conducted at the Obstetrics and Gynecology Department of Combined Military Hospital, Kharian. The study included 56 women having AUB with or without a history of failed medical treatment. The study participants underwent outpatient diagnostic hysteroscopy. Diagnostic hysteroscopy was done under the local para-cervical block in the Outpatient department. Procedure indications, outcome and biopsy findings were recorded on predesigned proformas. Results: Median age of the study participants was 44 years. The most common indications for diagnostic hysteroscopy were postmenopausal bleeding (34%) and heavy menstrual bleeding (28%). Hysteroscopy outcomes included endometrial biopsy (34%), discharge with no biopsy (25%), further test and evaluations required (21%), and admission due to failed outpatient procedures (20%). Sixty-two percent of the study participants had normal biopsy findings while other biopsy findings included polyps (20%), fibroids (14%) and endometrial hyperplasia (4%). Nine percent had unsuccessful hysteroscopy due to patient refusal to proceed. Conclusion: Outpatient hysteroscopy can be helpful in the early and rapid diagnosis of women with abnormal uterine bleeding.  

Potential of Compost and Plant Growth Promoting Rhizobacteria for Biofortification of Iron and Zinc in Wheat

Agriculture have been responsible for feeding growing population for decads by developing new technologies of crops especially staple crops like maize, wheat, rice etc. But unfortunately the main focus of agriculture have always been on increasing crop production instead of promoting human health. To improve human health, increase in micronutrient contents in crops are required. To mitigate this micronutrient malnutrition, fortification of food is most common approach. Among fortification, biofortification of crops with essential nutrients provides an economical tool to rescue micronutrient deficiency in target populations globally. The use of plant growth promoting microorganisms (PGPR) is promising technique in this respect. It is well recognized that the mobilization of plant nutrient is promoted by the use of microorganisms and it ultimately reduces the need of chemical fertilizers. However, informations on interventions using PGPR or other biological agents is limited. This study included isolation, screening and characterization of Zn-solubilizing and siderophore producing PGPR and optimization of different compost levels for improving Zn and Fe availability in soils. For this purpose, several zinc solubilizing bacteria (ZSB) were isolated from rhizosphere of wheat crop from different areas and quantified on the basis of zinc solubilizing potential and maximum pH reduction in broth culture by bacterial isolates. The isolates were then checked for their potential to produce siderophores. Af ter that, 35 bacterial isolates were selected and screened on the basis of plant growth promotion activities under axenic conditions. From this, 7 bacterial isolates were selected for pot study. These isolates had ability for IAA production both in presence and absence of L-tryptophane and also had ACC-deaminase activity. These isolates were also capable of producing different types of organic acids that reduces the soil pH. Different levels of compost (0, 200, 400, 600, 800, 1000, 1200, 1400, 1600, 1800 and 2000 kg/ha) was mixed with soil and incubated for different time intervals and then selected on the basis of iron and zinc release pattern through optimization study. With increasing application of compost, the iron and zinc release was also increased and became maximum at 800 kg/ha compost. After that there was non-significant effect of compost on zinc and iron release and with further increase, this release start decreasing. Soil dehydrogenase and phosphatae activities was also increased with compost application. The release was maximum after 45 days of incubation. These compost levels and selected isolates from previous study was then evaluated in pot experiment. Data were analyzed following Factorial under CRD. The inoculation of bacterial isolates showed positive effect on physical, physiological and yield parameters over un-inoculated control. Among the isolates H-103 performed better and showed maximum growth. The results of 800 kg/ha application of compost was significant from lower levels (0 and 600kg/ha) and nonsignificant with higher level (1000 kg/ha). Grain zinc and iron concentration was also significantly increased by combined use of compost and bacterial isolates. These results were then confirmed under field trial. Data were analyzed following Factorial under RCBD. The inoculation of bacterial isolates showed positive effect on physical, physiological and yield parameters over un-inoculated control. Among the isolates H-103 performed better and showed maximum growth. Maximum growth was recorded with 800 kg/ha compost application. Seed zinc and iron concentration was increased and phytic acid contents were decreased upon inoculation. Concluding, the combined use of PGPR and compost is an effective, economical, novel approach for improving yield, quality and nutritional status of wheat crop which can help in combating micronutrient deficiencies. ate showed less height as compared to other isolate, but still it shows a positive response when compared with the control.