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The exotic disease like dengue which is more prevalent in metropolitan city like Delhi and surrounding areas, has now invaded our small state Manipur. This disease is causing health alert in valley areas particularly in Imphal East and West. Before going to details of the disease it is pertinent to know thoroughly the vector of the disease. Main objective of the study is to explore the diversity of Aedes species and morphometrics of the insect and their biological cycle and measures for prevention of this disease. The larvae, pupa and adults of the mosquito were collected from dengue affected homesteads and studied the morphological features in accordance with relevant keys. Dengue cases in different districts of Manipur had experienced a sudden surge from 2022-2023. The species collected from infected areas is Aedes aegypti but other species of Aedes is Ae. albopictus, more prevalent in hilly areas in the state. In metropolitan city like Delhi, the peak months of the year range from October to November but sporadic reports till January, 2024 in Manipur, primarily in the valley districts. Urgently, there is a need for a comprehensive study of the vectors, life cycle and understand any impacts of global climate change on the vectors to safeguard lives and the economy in the state. [ABSTRACT FROM AUTHOR]

Background: Progestin-primed ovarian stimulation (PPOS) protocol is a new ovarian stimulation regimen based on a freeze-all strategy that uses progestin as an alternative to a GnRH antagonist for suppressing a premature LH surge during the follicular phase. Objectives: To compare clinical outcome between progestin-primed ovarian stimulation (PPOS) protocol using medroxyprogesterone acetate and gonadotropin-releasing hormone (GnRH) antagonist protocol using cetrorelix acetate in polycystic ovarian syndrome (PCOS) patients in IVF cycles. Materials and methods: A prospective randomised controlled trial was conducted at Fortis Ridge IVF, Delhi for a period of six months from January 2021 to June 2021. In total, 60 females with PCOS, who underwent IVF cycle were included, with randomised a !location of 30 females in each of the following two groups: - 1) Gn RH antagonist protocol using 0. 25 mg cetrorelix acetate subcutaneously 2) Progestin primed ovarian stimulation protocol using medroxyprogesterone acetate, oral, 10 mg twice daily. All IVF cycles were followed by frozen embryo transfers. Primary outcome measured was clinical pregnancy rate. Secondary outcomes measured were the incidence of premature LH surge, duration of gonadotropins stimulation, total dose of gonadotropins, cost per cycle for premature LH surge prevention, numberofoocytes retrieved, number of meta phase II oocytes, fertilisation rates, and number of viable embryos for transfer and risk of OHSS (ovarian hyperstimulation syndrome). Results: The study groups were comparable with respect to demographic variables such as age, years of marriage and duration of infertility. The hormonal levels at various days of IVF cycles were similar except for the endometrial thickness which was significantly higher in GnRH antagonist group then PPOS group (8.42 ± 0.91vs7.57±1.06 respectively, p=0.019). Incidence of premature LH surge was same in both groups, which was statistically not significant ( p=0.012). The rate of clinical pregnancy was similar in both groups (55.6% vs 44.4% respectively, p=0.505) and equal incidence of OHSS (5.6% in each group, p=1.00) was observed. Cost analysis for prevention of premature LH surge was performed which revealed significantly low cost in PPOS group (p <0.001). Conclusion: Considering similar profile of hormonal levels, oocytes retrieved and fertilized, clinical pregnancy rates and incidence of OHSS, PPOS protocol had enough merit to be considered in terms of cost effectiveness and better patient compliance. [ABSTRACT FROM AUTHOR]

Background: Successful outcome with frozen-thawed human embryo transfer has made embryo cryopreservation a routine procedure in assisted reproductive technology (ART). Evidence did not support the use of one cycle regimen in preference to another in frozen-thawed embryo transfer (FET) preparation of infertile women with regular ovulatory cycles. Objective: To analyse whether down-regulation with a gonadotropin-releasing hormone agonist (GnRHa) has any effect on clinical outcomes of FET cycles using oestrogen (E2) and progesterone (P4) sequentially for the artificial preparation of the endometrium. Materials and methods: A retrospective analysis was done on 100 women (50 in each group) who underwent FET cycle from December 2018 to August 2019 at Ridge IVF centre, Gouri Hospital and Fortis hospital, Shalimar Bagh, Delhi. Inclusion criteria were women who have undergone all consecutive cycles with the same protocol (either with or without GnRH agonist). Donor oocyte and cross-over cycles were excluded. In GnRH-downregulated cycles (group A-53 cycles) Leuprolide acetate (Leuprodex depot 3.75 mg) was given intramuscularly on day 2 of the menses and the patients were called after 3 weeks of injection and the endometrium was prepared artificially using combination of oestrogen (E2) and progesterone (P4). In GnRH non-downregulated group (group B-55 cycles), artificial preparation began on days 1-3 of the cycle. Cryopreserved embryos (day 3 or day 5) were transferred (4 days and 6 days) after initiation of progesterone therapy respectively and clinical outcomes were compared. Results: Both the groups were similar in terms of baseline characteristics like age, BMI, duration, type and cause of infertility, number of embryos cryopreserved, thawed and, transferred and endometrial thickness on the day of beginning progesterone therapy. There was difference of 7% in the rate of implantation (67% versus 60.0%), 13.6% in the clinical pregnancy rate (59.6% versus 46%), and 13.7% in ongoing pregnancy rate (57.7% versus 44%) in group A versus group B respectively, although the difference was not statistically significant (p value >0.05). The cycle cancellation rate was also higher in group B 9% as compared to 1.9% in group A but it was not statistically significant (p-0.11). Conclusion: Although, hormone therapy FET with GnRHa down regulation group reported better clinical outcomes, the difference was not statistically significant when compared with hormone therapy FET without GnRHa. [ABSTRACT FROM AUTHOR]

Stigmatized psychosocial perception poses a serious challenge and source of discrimination which impedes epilepsy patients from attaining a satisfactory quality of life. The present study was aimed to obtain information on knowledge, attitudes and practices (KAP) of epilepsy patients in Delhi and compare with the published data from India. We included 120 people with epilepsy (PWE) attending the Neurology outpatient services of the Institute of Human Behavior and Allied Sciences (IHBAS), Delhi. Demographic details and responses to a questionnaire assessing the knowledge, attitude and practices were recorded. Although majority of the patients belonged to low socioeconomic strata, the literacy rate was reasonably high (70%). A large majority (94%) of PWE had heard about epilepsy and 91% knew that epilepsy can be treated with modern drugs. Positive attitude was observed with respect to allowing a child with epilepsy to study (80%), not objecting children to play with a child with epilepsy (95%), marriage (89%) and having children (92%). Negative attitude was refl ected in the belief that epilepsy is due to supernatural powers (16%) and sins committed by patient or ancestors (21%). Analysis of Indian data revealed regional differences in KAP which could be attributed to local factors, such as literacy, awareness about epilepsy, and practice of different systems of medicine. Some of the differences can also be attributed to category of study population whether it included patients or non epilepsy individuals, since the former are likely to have less negative attitudes than the public. There is a need to create awareness about epilepsy on a nation-wide basis to dispel the misconceptions and stigma through effective and robust programs with the aim to lessen the disease burden. [ABSTRACT FROM AUTHOR]