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.  

Ferrocenyl Amides, Promising Materials for Certain Potential Applications

Some ferrocenyl amides were synthesized by the solution phase condensation reaction of 4-ferrocenyl benzoyl chloride and 4-ferrocenyl aniline with organic amine and acid chloride derivatives respectively. A series of semi aromatic amine derivatives with variable alkyl chain at one end was prepared in a three step process which was condensed with 4-ferrocenyl benzoyl chloride resulting in the formation of ferrocene derivatives with two amide bonds. Another series with a single amide bond was prepared by the condensation of 4-ferrocenyl aniline with n-alkyl acid chloride derivatives of different chain length. The third series of ferrocenyl amides was synthesized by the reaction of 4-alkoxy benzoyl chloride and 4-ferrocenyl aniline to get seven compounds with variable alkoxy chain. The fourth and final series was prepared by using 4-(4- alkoxy phenyl) benzoyl chloride derivative to condense with 4-ferrocenyl aniline and five products bearing different alkoxy end groups were obtained. All the synthesized compounds were characterized by their physical properties, elemental analysis, FTIR and 1 H/ 13 CNMR spectroscopic techniques for the structure elucidation. The crystals of some organic intermediates were also developed and studied for the single crystal XRD structural factors. A strong intermolecular H-bonding was confirmed for the secondary amide groups present within all the molecules of the intermediates and final products by spectroscopic and XRD techniques. These secondary types of forces are pre-requisite for a compound to interact with the bio molecules such as DNA by developing some intermolecular forces between the two. Therefore, the synthesized nitroaromatic compounds and their amine derivatives along with ferrocenyl amides were studied for the DNA-binding properties by using UV visible spectroscopic and cyclic voltammetric techniques. The DNA-interactional behaviour of organic intermediates was also supported by the docking studies leading to the conformation of bonding modes that are accessible. Ferrocenyl amides and nitroaromatic compounds were investigated for their electrochemical properties and the redox mechanism involved for the both was suggested using cyclic voltammetric methods. The melting point behavior of the synthesized materials was also depictive of their mesomorphic nature, so the selected compounds were studied for the metallomesogenic properties using DSC and POM techniques. The phase transition temperatures and the heat changes associated with different transitions were evaluated for the thermodynamic behavior of the materials and texture of the iiiAbstract mesophases were studied by POM at different temperatures. The thermotropic liquid crystalline nature of the synthesized compounds was found to have some relationship with the structure of molecules which was further evaluated by the theoretical calculations of the rigid and flexible part lengths of molecules by using PM6 method. The effect of alkyl and alkoxy chain lengths on the electrochemical, DNA-binding and liquid crystalline properties were studied in detail and found to influence the properties in following order; liquid crystalline > electrochemical > DNA-binding properties. In fact, it has no effect on DNA-binding strength as alkyl chain is not being actively involved in the binding process.