Impacts of obesity on the health of women of childbearing age: A call for action

Background: Obesity is a leading preventable cause of death worldwide with higher prevalence among women of childbearing age than men. It is a clinical condition characterized by accumulation of excess body fat with resultant high health challenges and reduced life expectancy. It is an emerging problem in Nigeria especially among women of childbearing age due to its negative effects on their reproductive life; hence it needs to be addressed to reduce the incidence of infertility, as well as maternal and neonatal morbidity and mortality.Aim: To identify the impacts of obesity on the health of women of childbearing age for improved knowledge on its prevention and management.Methods: Data from textbooks, original and online journals and published articles were reviewed, their findings discussed and recommendations made. Findings: Obesity was found to be an emerging disease due to increasing westernization of societies and change in lifestyle. It showed a higher prevalence among women than men; worse still among women of childbearing age and was found to be associated with various reproductive health problems such as difficulty in conceiving, reduced fertility, less successful assisted reproduction and poor health during pregnancy, labour and postnatal period. It also has negative foetal and neonatal consequences in babies of obese women such as neural tube defects, cleft palate, cleft lip, congenital heart disease, increased admission to neonatal intensive care units, omphalocele, macrosomia, shoulder dystocia and stillbirth.Conclusion: Obesity is preventable, and for obese women, management measures are available to control the condition for improved fertility and maternal and neonatal outcomes.Keywords: Obesity, infertility, neural tube defects, shoulder dystocia, still birth, reproductive healt

Gastroparesis and functional dyspepsia: excerpts from the AGA/ANMS meeting

Despite the relatively high prevelance of gastroparesis and functional dyspepsia, the aetiology and pathophysiology of these disorders remain incompletely understood. Similarly, the diagnostic and treatment options for these two disorders are relatively limited despite recent advances in our understanding of both disorders.This manuscript reviews the advances in the understanding of the epidemiology, pathophysiology, diagnosis, and treatment of gastroparesis and functional dyspepsia as discussed at a recent conference sponsored by the American Gastroenterological Association (AGA) and the American Neurogastroenterology and Motility Society (ANMS). Particular focus is placed on discussing unmet needs and areas for future research.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78690/1/j.1365-2982.2009.01434.x.pd

Congenital Diaphragmatic Hernia

Congenital Diaphragmatic hernia (CDH) occurs in approximately 1 in every 2,500 births and the cause is yet unknown. In CDH the diaphragm fails to form correctly, allowing herniation of the abdominal contents into the thoracic cavity and results in pulmonary hypolplasia. This book describes the embryology, genetics, antenatal diagnosis, management, associated congenital anomalies and long-term outcomes of children with CDH. It is a valuable up-to-date reference for pediatricians, neonatologists and allied health professionals who care for children with CDH

Endoscopic Ultrasound in Pancreatic Cancer

Endoscopic ultrasound (EUS) has been developed over the course of the last 50 years. This technique has been shown to improve diagnosis, provide more accurate local information with regards to staging and enhance prediction of surgical resectability. Further to this, minimally-invasive local techniques have been developed, and continue to be developed, to provide both active and palliative management within the treatment schema for pancreatic cancer (PC)

Artificial intelligence applications in disease diagnosis and treatment: recent progress and outlook

The use of computers and other technologies to replicate human-like intelligent behaviour and critical thinking is known as artificial intelligence (AI).The development of AI-assisted applications and big data research has accelerated as a result of the rapid advancements in computing power, sensor technology, and platform accessibility that have accompanied advances in artificial intelligence. AI models and algorithms for planning and diagnosing endodontic procedures. The search engine evaluated information on artificial intelligence (AI) and its function in the field of endodontics, and it also incorporated databases like Google Scholar, PubMed, and Science Direct with the search criterion of original research articles published in English. Online appointment scheduling, online check-in at medical facilities, digitization of medical records, reminder calls for follow-up appointments and immunisation dates for children and pregnant women, as well as drug dosage algorithms and adverse effect warnings when prescribing multidrug combinations, are just a few of the tasks that already use artificial intelligence. Data from the review supported the conclusion that AI can play a significant role in endodontics, including the identification of apical lesions, classification and numbering of teeth, detection of dental caries, periodontitis, and periapical disease, diagnosis of various dental problems, aiding dentists in making referrals, and helping them develop more precise treatment plans for dental disorders. Although artificial intelligence (AI) has the potential to drastically alter how medicine is practised in ways that were previously unthinkable, many of its practical applications are still in their infancy and need additional research and development. Over the past ten years, artificial intelligence in ophthalmology has grown significantly and will continue to do so as imaging techniques and data processing algorithms improve

Pre- and Postnatal Surgery, Most Common Conditions, Diagnosis and Treatment

The authors make a general but relevant description of the most common surgical problems occurring both in the human being that develops in the uterus and in the one that has already been born

The enteric nervous system and interstitial cells of cajal of the horse

Gastrointestinal diseases, including obstructive and motility disorders such as grass sickness, are very common in the horse. Motility disorders may represent a dysfunction of the neural, muscular or pacemaker components (interstitial cells of Cajal, ICC) of bowel control. ICC are the c-Kit-immunoreactive cells responsible for the generation of pacemaker activity in gastrointestinal smooth muscle. Impairment of this ICC-mediated pacemaker action has been implicated in several motility disorders in humans and laboratory mammals. Equine dysautonomia (grass sickness) is a common, frequently fatal disease of horses characterised by dysfunction of the gastrointestinal tract. Neurons of the enteric nervous system (ENS) are primarily and most severely targeted by the putative neurotoxin causing the disease. The aims of this study were:• to characterise the morphology and neurochemical expression of the equine ENS using tissue culture and immunohistochemistry.• to study the distribution of the ICC in the intestine in normal and grass sicknessaffected horses.• to perform a detailed in vitro investigation of the electrical properties and control of smooth muscle in both the healthy and diseased intestine.• to test the hypothesis that impaired ICC-mediated control is responsible for intestinal dysfunction.Fresh ileal samples were harvested from adult horses free from gastrointestinal disease euthanased on humane grounds. Small mammal (guinea pig and rat) systems were used for comparison and development of techniques. The tissues were microdissected to prepare wholemounts for immunohistochemistry and for either explant or dissociated culture systems of the ENS. Immunoreactivity was assessed using a standard indirect immunofluorescence technique. In the horse, explant culture systems were established using wholemounts of either the submucous plexus or the muscularis externa (including the myenteric plexus). Dissociated cell cultures could only be obtained from the submucous plexus. This was in contrast to small mammal models where enteric neurons were grown in both the myenteric and submucous systems. Culture systems were maintained for up to 5 days in the horse and 8 days in the guinea pig. Immunoreactivity for a neuronal marker {Pan-N) and for glial cell markers (GFAP and SI00) indicated the presence of both neurons and enteric glia in the tissue culture preparations. Further refinements to the techniques will be required before this in vitro model can be used for quantitative analysis.To examine the ICC in the horse, samples were taken at multiple anatomicallydefined sites from stomach to small colon. After tissue fixation in 10% phosphatebuffered formalin, 10 pm cryostat sections were processed using standard immunohistochemical techniques and the avidin-biotin-peroxidase method. The primary antiserum used was an affinity-purified polyclonal antibody raised against the c-Kit protein. Specific immunoreactivity for c-Kit was detected in all sites and three types of immunoreactive cell were identified. These were spindle-shaped cells in the region of the myenteric plexus with occasional cellular processes extending into the longitudinal muscle, stellate- or bipolar-shaped cells in the circular muscle layer and round cells in the submucosa. The round cells were shown to be mast cells with the use of toluidine blue staining whereas the other c-Kit-immunoreactive cells did not exhibit metachromasia and were therefore classified as ICC. In the duodenum, jejunum and ileum, ICC were found predominantly in the region of the myenteric plexus and to a lesser extent in the circular muscle. In contrast, in the large intestine (large colon, caecum, small colon) most cells were seen throughout the circular muscle and very few ICC were seen in the myenteric plexus area. A semi¬ quantitative grading system was used to examine any differences in ICC in grass sickness-affected ileum and pelvic flexure sections compared to normal animals. In horses with grass sickness, ICC were significantly decreased in both the myenteric plexus and circular muscle regions of both ileum and pelvic flexure compared to normal animals. It is possible therefore that the decline in ICC may be in some way responsible for the development of intestinal dysmotility in grass sickness.Normal and diseased equine tissue from clinical cases and abattoir samples from pigs were collected and examined using in vitro microelectrode electrophysiological recordings from smooth muscle cells. Slow wave activity and spike potentials were recorded in normal equine and porcine ileal preparations. The slow wave activity was preserved in the presence of tetrodotoxin. A waxing and waning pattern of the slow wave activity was noted. Nifedipine abolished the spiking contractile activity of the smooth muscle but did not abolish the slow waves. The majority of ileal preparations from grass sickness-affected horses exhibited prominent slow wave activity with reduced slow wave frequency and increased duration suggesting that, although the neural elements are destroyed, the ICC-mediated pacemaker function remains intact.This work will increase understanding of gastrointestinal dysmotility and information on the role of ICC will also offer benefits in potential developments in pharmacological therapy

New Techniques in Gastrointestinal Endoscopy

As result of progress, endoscopy has became more complex, using more sophisticated devices and has claimed a special form. In this moment, the gastroenterologist performing endoscopy has to be an expert in macroscopic view of the lesions in the gut, with good skills for using standard endoscopes, with good experience in ultrasound (for performing endoscopic ultrasound), with pathology experience for confocal examination. It is compulsory to get experience and to have patience and attention for the follow-up of thousands of images transmitted during capsule endoscopy or to have knowledge in physics necessary for autofluorescence imaging endoscopy. Therefore, the idea of an endoscopist has changed. Examinations mentioned need a special formation, a superior level of instruction, accessible to those who have already gained enough experience in basic diagnostic endoscopy. This is the reason for what these new issues of endoscopy are presented in this book of New techniques in Gastrointestinal Endoscopy

Artificial Intelligence in Oral Health

This Special Issue is intended to lay the foundation of AI applications focusing on oral health, including general dentistry, periodontology, implantology, oral surgery, oral radiology, orthodontics, and prosthodontics, among others