The rising home birth trend in America

In recent years home birth rates are increased in the whole world, mainly in the United States (US). Between 2004-2012, non-hospital births increasing rate is 89% in the US. Home birth increased especially among the married, non-Hispanic, over 35 years of age, multipar and singleton pregnancies. However the high rate of cesarean birth did not increase in recent years in the US, now it has been stable at 32%. It is reported that the stability of the cesarean rate is related to rising rate of home birth. In this mini review, the rising rate of home birth and its consequences in the US were discussed

Does reactive hypoglycemia during the 100 g oral glucose tolerance test adversely affect perinatal outcomes?

Objectives: To determine whether pregnant women who have reactive hypoglycemia during the 100 g oral glucose toler­ance test (OGTT) are at an increased risk of poor pregnancy outcomes. Material and methods: We retrospectively analyzed perinatal data from 413 women who underwent a 3 h OGTT at 24–28 weeks of gestation and gave birth in our clinics between January 2012 and December 2014. Results: According to OGTT results, the majority of the subjects were normoglycemic (n = 316, 76.5%), while 49 (11.9%) were diagnosed with gestational diabetes, and 33 (8.0%) had single high glucose values. Reactive hypoglycemia was de­tected in only 15 patients (3.6%). The mean age of the women in the reactive hypoglycemia group was significantly lower than that of the women in the gestational diabetes and single high glucose value groups (26.4 ± 4.4 years, 31.4 ± 5.4 years, and 31.8 ± 4.3 years, respectively; p < 0.05). The newborns of the women in the reactive hypoglycemia group had higher rates of APGAR scores < 7, increased admission to the neonatal intensive care unit (NICU), and lower birth weights compared with the other groups (p < 0.001, p < 0.001, and p = 0.009, respectively). Conclusion: Reactive hypoglycemia during the 3 h 100 g OGTT is significantly associated with low APGAR scores, low birth weights, and prenatal admission to the NICU. Therefore, pregnant women who develop hypoglycemia during the 100 g OGTT performed at 24–28 weeks of gestation should receive attentive follow-up care to decrease the possibility of adverse perinatal outcomes

What is the optimal length of stay in hospital for ST elevation myocardial infarction treated with primary percutaneous coronary intervention?

Backgound: The aim of this study was to evaluate the safety and practicality of very early (within 48 h) discharge with long-term follow-up results, and to define an optimal length of stay in hospital for patients with ST elevation myocardial infarction (STEMI) according to their demographic characteristics and risk assessment. Methods: A total of 267 patients with STEMI successfully treated with primary coronary intervention were retrospectively analyzed. Patients was divided into four groups according to length of hospitalization: 24 hours, 48 hours, 72 hours, and more than 72 hours. The groups were compared in terms of the patients’ demographic and clinical characteristics, short- and long-term follow-up results, mortality, revascularization and major adverse cardiac events (MACE). Results: More than two thirds of the patients were discharged within 48 hours (68.9%). No difference was observed between groups in terms of one month and one year MACE and one year restenosis. However, one month restenosis was slightly higher in the fourth group. At the end of the first year, there had been only four deaths, and these were in the third and fourth groups. There were no deaths among patients discharged within 48 hours. Killip class, left ventricular ejection fraction, multi-vessel disease and diabetes were the major determinants of length of stay in hospital. Conclusions: Very early discharge is safe and feasible and does not increase the mortality rate. Uncomplicated STEMI patients with single vessel disease could be discharged after 24 hours. Patients with multi-vessel disease classified in the low risk group could be discharged after 48 hours. (Cardiol J 2011; 18, 4: 378–384

Assessment of fetal adrenal gland enlargement in term and preterm labor cases

Background: The objective of this study was to compare the Fetal Zone Depth (FZD) of fetal adrenal gland in term and preterm labor cases.  Methods: Twenty nine preterm pregnant women at 29-36 weeks of gestation with single pregnancy admitted with the clinical diagnosis of preterm labor and the comparison group of 33 pregnant women at 37-40 weeks with term pregnancy were included in this study. FZD and Total Gland Depth (TGD) of fetal adrenal gland of the entire fetuses in sagittal plane were ultrasonographically measured and FZD/TGD ratios were calculated. Demographic and clinical features, laboratory findings and fetal adrenal gland FZD/TGD ratios were compared between the two groups.Results: No difference was found between the two groups in respect of age, number of pregnancies and delivery method (P >0.05); yet preterm birth history and duration of hospital stay were higher in preterm group (P <0.05). Fetal adrenal gland FZD/TGD ratio was statistically significantly higher in preterm group compared to the term group (55.4% ± 4.9 vs. 47.7% ± 5.6; P <0.001).Conclusion: The growth in FZ as a fetal adaptation mechanism in increased fetal stress in preterm labor cases was at a significant level. Once supported by more comprehensive studies, we think that this result would be beneficial in the prediction of preterm labor in clinical practice.

Fournier's Gangrene after Open Hemorrhoidectomy without a Predisposing Factor: Report of a Case and Review of the Literature

Fournier's gangrene (FG) is a fatal synergistic infectious disease with necrotizing fasciitis of the perineum and abdominal wall along with the scrotum and penis in men and vulva in women. An unpredictable case of FG two weeks after open hemorrhoidectomy in a previously healthy 55-year-old male is described. Full-thickness patchy skin necrosis of the perianal, perineal and scrotal region associated with rectal perforation was detected on admission. Prompt radical debridement together with aggressive fluid resuscitation and broad-spectrum antibiotic administration was initiated. Because of rectal involvement, diverting sigmoid colostomy was fashioned. The patient survived after two additional local debridements. Nevertheless, loss of sphincter function due to massive muscle destruction led to permanent colostomy. Our case together with others reported in the literature illustrates that, although rare, FG after open hemorrhoidectomy represents a life-threatening complication to otherwise healthy patients. The development of fever and urinary retention should draw the attention of the surgeon, even if the presentation is delayed. The current literature only briefly mentions the potential risk of FG after such a common surgical procedure. However, devastating complications occur more often than anticipated. This disastrous complication without predisposing factor is discussed along with a literature review

Obstructive sleep apnea syndrome is associated with maternal complications in pregnant women

Objectives: This study was performed to evaluate the relationship between obstructive sleep apnea syndrome and pregnancy complications.Material and methods: A total of 500 women (18–45 years) who had delivered (vaginal delivery or caesarean section) between January 2017 and March 2017 in our clinic were included in the study. Patients at high risk for obstructive sleep apnea syndrome were identified using the Stop Bang questionnaire. Based on the results of the questionnaire, pregnancy complications were compared between high-risk pregnant women (Group 1) and low-risk pregnant women (Group 2).Results: Age, body mass index, smoking rate, and the rate of systemic disease (e.g., diabetes and/or hypertension) were higher in Group 1 than in Group 2 (p &lt; 0.05). Rates of preeclampsia, gestational diabetes, preterm labor, premature rupture of the membranes, and cesarean section were significantly higher in Group 1 than in Group 2 (p &lt; 0.05).Conclusions: Obstructive sleep apnea syndrome is associated with a higher rate of maternal complications among pregnant women. Affected patients should be carefully monitored

In vitro studies on different extracts of fenugreek (Trigonella spruneriana BOISS.): Phytochemical profile, antioxidant activity, and enzyme inhibition potential

© 2020 Wiley Periodicals LLC. The side effects of synthetic antioxidants make it necessary to find a natural alternative. Therefore, the current study investigates the potential of T. spruneriana as a new alternative in terms of natural bioactive components. In this context, antioxidant activity, enzyme inhibition, and phenolic compounds of different extracts including ethanol, methanol, ethyl acetate, and aqueous were identified. The results show that the ethyl acetate (113.59 ± 2.73 mg GAE/g) has the highest phenolic content, but ethanol extract has the highest scavenging activity for DPPH and TAC. The ethanol extract showed stronger inhibition on cholinesterase and α-amylase compared to other extracts. Besides, 12 bioactive compounds were characterized in T. spruneriana extracts by HPLC-DAD. Our findings support that T. spruneriana could be considered as a new source of active phytochemicals, as well as provide remarkable data on biological activities of some main enzymes playing role in the healing of hyperpigmentation, Alzheimer, and diabetes. Practical applications: This study reports the total content, types and amounts of bioactive compounds and potential beneficial bioactivities of the different extracts of T. spruneriana. Trigonella is abundant in nature and spread over a wide geographical area, and is used in making cheese, pastries, spices, and sausages in different countries, as well as for antidiabetic purposes. Trigonella leaves are a good source of bioactive compounds that contain compounds like quercetin, catechin, cinnamic acid, and coumaric acid, along with it have also a high content of soluble fibers and is suggested for body weight control. Apart from being the first study conducted to point out the potential of T. spruneriana as being a natural food additive, this study also demonstrated its medicinal importance by revealing the anti-hyperpigmentation, antidiabetic, neuroprotective, and antioxidant properties of T. spruneriana.info:eu-repo/semantics/publishedVersio

Cornual molar ectopic pregnancy

The aim of this study is to present a rarely seen cornual molar ectopic pregnancy case regarding with literature. 36 years old patient with the third pregnancy was referred to our clinic with the prediagnosis of viable ectopic pregnancy. The patient had two vaginal delivery history and she had vaginal bleeding as spotting onwards fifteen days. Ultrasonographicassessment demonstrated ectopic pregnancy with positive fetal cardiac activity and 8mm crown-rump length (6W5D) at right cornual region. The patient was performed cornotomy with laparotomy. Postoperative pathological evaluation was reported as a partial molar pregnancy. β-human chorionic gonadotropin (β-hCG) values declined dramatically and so additional treatment was not applied. Molar ectopic pregnancy findings are usually seen as conventional pregnancies and β-hCG values and histopathological evaluation is important for correct diagnosis and follow up

Foliar-applied glyphosate substantially reduced uptake and transport of iron and manganese in sunflower (helianthus annuus L.) plants

Evidence clearly shows that cationic micronutrients in spray solutions reduce the herbicidal effectiveness of glyphosate for weed control due to the formation of metal-glyphosate complexes. The formation of these glyphosate-metal complexes in plant tissue may also impair micronutrient nutrition of nontarget plants when exposed to glyphosate drift or glyphosate residues in soil. In the present study, the effects of simulated glyphosate drift on plant growth and uptake, translocation, and accumulation (tissue concentration) of iron (Fe), manganese (Mn), zinc (Zn), and copper (Cu) were investigated in sunflower ( Helianthus annuusL.) plants grown in nutrient solution under controlled environmental conditions. Glyphosate was sprayed on plant shoots at different rates between 1.25 and 6.0% of the recommended dosage (i.e., 0.39 and 1.89 mM glyphosate isopropylamine salt). Glyphosate applications significantly decreased root and shoot dry matter production and chlorophyll concentrations of young leaves and shoot tips. The basal parts of the youngest leaves and shoot tips were severely chlorotic. These effects became apparent within 48 h after the glyphosate spray. Glyphosate also caused substantial decreases in leaf concentration of Fe and Mn while the concentration of Zn and Cu was less affected. In short-term uptake experiments with radiolabeled Fe (59Fe), Mn (54Mn), and Zn (65Zn), root uptake of 59Fe and 54Mn was significantly reduced in 12 and 24 h after application of 6% of the recommended dosage of glyphosate, respectively. Glyphosate resulted in almost complete inhibition of root-to-shoot translocation of 59Fe within 12 h and 54Mn within 24 h after application. These results suggest that glyphosate residues or drift may result in severe impairments in Fe and Mn nutrition of nontarget plants, possibly due to the formation of poorly soluble glyphosate-metal complexes in plant tissues and/or rhizosphere interactions

Effect of Amygdalin on the treatment and recurrence of endometriosis in an experimental rat study

Background: Endometriosis is an aggressive disorder and associated with infertility, pelvic pain and intra-abdominal adhesions in women of reproductive age. Women with endometriosis has the potential risk of recurrence ranging from 21.5% in two years to 50% in five years after recovery period. Therefore, there is a certain requirement for new drugs as an alternative therapy to the current ones.Aim: The aim of the present study is to compare the effects of amygdalin and leuprolide acetate on endometriosis development and recurrence in rats.Study Design: Animal experimentMethods: A total of 30 adult female rats were enrolled. Induction of endometriosis was performed by implanting endometriotic focci on the peritoneal side of the abdominal wall. Before amygdalin or leuprolide acetate treatment one of the implant was removed for histopathological analysis, and rats were randomly divided into three groups. Saline (Group 1), amygdalin (Group 2), and leuprolide acetate (Group 3) were administered for three weeks. After treatment, one of the remaining three implants was excised for histopathological evaluation, and all treatments were terminated. Estradiol was given after the estradiol induction for the recurrence of endometriosis. Rest of the implanted tissues were removed, then all rats were euthanised. The implant volumes, histopathological injury and fibrosis levels were observed.Results: The endometriotic foci volumes in Group 2 and Group 3 were significantly lower than in Group 1 (p = 0.001, p = 0.002, respectively). The histopathological injury scores and fibrosis levels were not significantly different among the groups (p > 0.05).Conclusion: The present study showed that amygdalin has an evident effect in the treatment of endometriosis.</p