Bone morphogenetic protein-2 (BMP-2) has unique bone regeneration property. The powerful osteoinductive nature makes it considered as second line of therapy in nonunion bone defect. A large number of carriers and delivery systems made up of different materials have been investigated for controlled and sustained release of BMP-2. The delivery systems are in the form of hydrogel, microsphere, nanoparticles, and fibers. The carriers used for the delivery are made up of metals, ceramics, polymers, and composites. Implantation of these protein-loaded carrier leads to cell adhesion, degradation which eventually releases the drug/protein at site specific. But, problems like ectopic growth, lesser protein delivery, inactivation of the protein are reported in the available carrier systems. Therefore, it is need of an hour to modify the available carrier systems as well as explore other biomaterials with desired properties. In this review, all the reported carrier systems made of metals, ceramics, polymers, composites are evaluated in terms of their processing conditions, loading capacity and release pattern of BMP-2. Along with these biomaterials, the attempts of protein modification by adding some functional group to BMP-2 or extracting functional peptides from the protein to achieve the desired effect, is also evaluated. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 904-925, 2017.

CONTEXT/BACKGROUNDAdolescence, meaning "To grow up," is a transitional stage of physical, sexual and mental human development occurring between puberty and legal adulthood. The Government of India in National Youth Policy defines adolescents as individuals between 13 to 19 yrs. of age. AIMSTo study the magnitude of different adolescent gynecological problems in patients attending OPD of GRMC, Gwalior, MP. SETTINGS AND DESIGNProspective study in patients attending gynecological OPD of GRMC, Gwalior, MP. SAMPLE SIZE: 75 METHODS AND MATERIALSSeventy five adolescent girls in the age group of 13-19 yrs. attending gynecological OPD of GRMC, Gwalior, from November 2013 to October 2014 were included in the study. Detailed history, general examinations and investigations were done to evaluate their health. STATISTICAL ANALYSISWas done using Microsoft Excel. RESULTSIncidence of gynecological problem in our study was 3.33%. Different gynecological problems were menstrual disorders (60%), leucorrhoea (10.66%), infections (8%), ovarian cyst (5.33%), sexual assault (2.66%), teenage pregnancy (10.66%) and infertility (2.66%). Majority of girls with menstrual disorders suffered from puberty menorrhagia (55.55%). Dysfunctional uterine bleeding was diagnosed in 96% of girls suffering from puberty menorrhagia. Pelvic Inflammatory Disease was exclusively seen in married adolescent girls. Vaginal atresia and imperforate hymen were causes of primary amenorrhoea. PCOD was commonest cause of secondary amenorrhoea amongst adolescents. CONCLUSIONMenstrual abnormalities are the most common problems of adolescent girls. Setting up adolescent clinics is desirable.

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Numerous preclinical studies have been carried out using mesenchymal stem cells (MSCs) therapy for ischemic stroke. The purpose of the present meta-analysis is to review the quality of preclinical studies. In all, 4,361 articles were identified, out of which 64 studies were included (excluding in vitro studies). The results were obtained across species, route, and time of administration, immunogenicity, and doses. The median quality score 4.90/10, confidence interval 95%, and large effect size were observed, which strongly supports the translation potential of MSC therapy for ischemic stroke.

OBJECTIVE:To evaluate the efficacy of blastocyst transfer in comparison with cleavage stage transfer.STUDY DESIGN:A randomized, prospective study was conducted in Infertility clinic, Department of Obstetrics and Gynecology, Mahatma Gandhi Hospital, Jaipur on 300 patients aged 25-40 years undergoing in-vitro fertilization (IVF)/intra-cytoplasmic sperm injection (ICSI) cycle from May 2010-April 2011. When three or more Grade-I embryos were observed on day 2 of culture, patients were divided randomly into two study groups, cleavage stage transfer and blastocyst transfer group having 150 patients each. Primary outcomes evaluated were, Clinical pregnancy rate and Implantation rate. The results were analyzed using proportions, standard deviation and Chi-square test.RESULTS:Both the groups were similar for age, indication and number of embryos transferred. Clinical pregnancies after blastocyst transfer were significantly higher 66 (44.0%) compared to cleavage stage embryo transfer 44 (29.33%) (P < 0.01). Implantation rate for blastocyst transfer group was also significantly higher (P < 0.001).CONCLUSION:Blastocyst transfer having higher implantation rate and clinical pregnancy rate lead to reduction in multiple pregnancies.

<b><i>Introduction:</i></b> Twin reversed arterial perfusion (TRAP) sequence is a phenomenon seen in 1–3% of monochorionic twin pregnancies, where the acardiac fetus is found to have multiple anomalies. The normal pump twin maintains its own perfusion in addition to that of its acardiac co-twin. As a result, if the acardiac twin increases in size, the burden on the pump twin is increased, leading to cardiac failure, hydrops fetalis, polyhydramnios, premature delivery, and perinatal death. The outcome of pregnancy is largely dependent on the growth of the acardiac twin. In view of high perinatal loss, surgical techniques to interrupt the blood flow to the acardiac twin have been evaluated. <b><i>Methods:</i></b> We evaluated interstitial laser therapy, which is the main mode of therapy in our unit, of TRAP pregnancies referred over a 5-year period. Interstitial laser was offered if the blood flow in the acardiac twin was found to be persistent at 2 consecutive examinations or if there were cardiac or hydropic changes in the pump twin at the first examination. <b><i>Results:</i></b> A total of 18 cases of TRAP were referred during this period and all were counselled regarding fetal therapy if the situation were to deteriorate; 5 couples (27.7%) opted for termination of pregnancy; of the remaining 13, 7 (53.8%) agreed to perform intervention following confirmation of a normal karyotype. Six (85.7%) and 1 (14.3%) lasers were performed in the second and third trimesters, respectively; all 7 had a normal outcome of the pump twin. There were 6/13 (46.2%) in the expectant group who continued the pregnancy with no intervention, with 2 term live births (33.3%). <b><i>Conclusions:</i></b> Our study confirms that there is a high risk of spontaneous loss in untreated pregnancies with TRAP, primarily due to polyhydramnios and fetal hydrops. In the pregnancies that underwent interstitial laser, there was a more favourable outcome. Interstitial laser is minimally invasive, safe, and feasible in experienced hands.

In this study, caudal LMM were much more likely than either dorsal or transitional types to have orthopedic complications. These data may prove useful to clinicians in predicting outcome and in counseling patients and their parents.

Background: Abnormal uterine bleeding is defined as any deviation from the normal menstrual cycle this include change in regularity, frequency of menses, duration or amount of bleeding during or in between periods. Objective of present study was to evaluate abnormal uterine bleeding with transvaginal sonography and hysteroscopy in perimenopausal women.Methods: This study is conducted on women presenting to the gynecological OPD with complain of abnormal uterine bleeding in perimenopausal age group. A total of 50 patients were subjected to transvaginal sonography and Diagnostic hysteroscopy.Results: On TVS, out of total 50 patients, 50% patient showed normal endometrial finding. 24% Patient showed Endometrial hyperplasia, 14% Endometrial Polyp, 8% Submucosal fibroid, 4% Adenomyosis. On TVS, out of total 50 patient, 50% patient showed normal endometrial finding. 24% Patient showed endometrial hyperplasia, 14% endometrial Polyp, 8% submucosal fibroid, 4% adenomyosis. Out of total 50 patients, 28 (56%) showed normal endometrial finding.20% cases showed endometrial Hyperplasia, 16% showed endometrial Polyp, 8% showed submucosal fibroid. Sensitivity, specificity, PPV, NPV of endometrial hyperplasia – 81.81%, 92.3%, 75%, 94.73% respectively.Conclusions: Transvaginal sonography has a moderate diagnostic accuracy in detecting endometrial hyperplasia and other intrauterine pathology. TVS is safe, acceptable and easily available & is noninvasive. It should be used as 1st line diagnostic tool in patients with AUB in perimenopausal women. Hysteroscopy has important tool in the diagnosis of various endometrial and intrauterine lesions TVS and hysteroscopy should be employed hand in hand in evaluation of AUB.