A Review of Obstetrical Outcomes and Complications in Pregnant Women after Bariatric Surgery

Bariatric surgery (BS) is a novel treatment for weight reduction with longer lasting health benefits. This review aimed to summarise the available evidence regarding the fetomaternal outcomes and the most common challenges and complications in pregnancies following BS. Google Scholar (Google LLC, Mountain View, California, USA) and PubMed<sup>®</sup> (National Library of Medicine, Bethesda, Maryland, USA) databases were searched for articles published until December 2018. A total of 64 articles were included in this review and results showed that BS mitigates the risk of gestational diabetes mellitus, hypertensive disorders in pregnancy and fetal macrosomia. However, it can also have detrimental effects on fetomaternal health. There is paucity of data regarding small for gestational age intrauterine growth restriction, premature rupture of membranes and longterm effects on the children born to women who underwent BS.Keywords: Bariatric Surgery; Nutritional Deficiencies; Obesity; Pregnancy; Surgical Injuries

Identifying new targets in leukemogenesis using computational approaches

AbstractThere is a need to identify novel targets in Acute Lymphoblastic Leukemia (ALL), a hematopoietic cancer affecting children, to improve our understanding of disease biology and that can be used for developing new therapeutics. Hence, the aim of our study was to find new genes as targets using in silico studies; for this we retrieved the top 10% overexpressed genes from Oncomine public domain microarray expression database; 530 overexpressed genes were short-listed from Oncomine database. Then, using prioritization tools such as ENDEAVOUR, DIR and TOPPGene online tools, we found fifty-four genes common to the three prioritization tools which formed our candidate leukemogenic genes for this study. As per the protocol we selected thirty training genes from PubMed. The prioritized and training genes were then used to construct STRING functional association network, which was further analyzed using cytoHubba hub analysis tool to investigate new genes which could form drug targets in leukemia. Analysis of the STRING protein network built from these prioritized and training genes led to identification of two hub genes, SMAD2 and CDK9, which were not implicated in leukemogenesis earlier. Filtering out from several hundred genes in the network we also found MEN1, HDAC1 and LCK genes, which re-emphasized the important role of these genes in leukemogenesis. This is the first report on these five additional signature genes in leukemogenesis. We propose these as new targets for developing novel therapeutics and also as biomarkers in leukemogenesis, which could be important for prognosis and diagnosis

Anterior abdominal wall ectopic testes: A report of two cases

Undescended testis (UDT) is a common anomaly of the male reproductive system  affecting about 2% to 4% of male infants more commonly preterms. If the testis remains in the line of normal descent, it is classified as an UDT. If it is not in the line of  normal descent, it is termed an ectopic testis. Common sites of ectopic testes are  perineal, transverse ectopia, pubopenile and femoral. To the best of our knowledge only two cases of anterior abdominal wall ectopic testis have been reported in the literature.  We present here two cases of anterior abdominal wall testis,  one of which was  associated with indirect inguinal hernia.Keywords: anomalies of the testis, ectopic testis, empty scrotu

Multifocal necrotizing fasciitis following Hirshsprung’s disease surgery away from the surgical wound site

Necrotizing fasciitis (NF) is a life-threatening infection with rapidly progressive necrosis. Escherichia coli is rarely reported as causative agent of type 2 NF. NF typically arises in a single area usually secondary to penetrating injury. NF was only reported as a postoperative complication of Hirshsprung’s disease in one report, where the causative agent was Pseudomonas aeruginosa. We here present a case of synchronous multifocal NF in a 7-month Hirshsprung’s disease patient after abdominal Soave procedure. The patient presented with constipation and had a colosotomy undergone at the splenic flexure through a left transverse supraumbilical incision during neonatal period. At the age of 7 months and after preoperative preparation, abdominal Soave procedure was performed through a Pfannestiel incision. Few days following operation he had fever, tachycardia, and pain. Local examination showed red edematous areas at both flanks away from the wounds. Shortly afterwards skin became dark, tense, and started to slough. At this stage the clinical diagnosis of NF was raised and surgical debridement was done. Blood and tissue cultures were positive for E. coli. Five days later the patient had another debridement due to necrotic wound edges. Vacuum assisted closure therapy with Aquacel Ag dressings was fitted and changed every 48 h. Eighteen days later split thickness skin-graft was carried out. The patient was discharged home; 10 days later he is doing fine on follow-up.Keywords: complication of swave procedure, Hirshsprung’s disease, necrotizing fasciiti

Inferring the Phylogeny of Bovidae Using Mitochondrial DNA Sequences: Resolving Power of Individual Genes Relative to Complete Genomes

Molecular techniques that assess biodiversity through the analysis of a small segment of mitochondrial genome have been getting wide attention for inferring the mammalian diversity. Due to their highly conserved nature, specific mitochondrial genes offer a promising tool for phylogenetic analysis. However, there is no established criteria for selecting the typical mitochondrial DNA (mtDNA) segments to achieve a greater resolving power. We therefore chose the family Bovidae as a model and compared the tree-topologies resulting from the commonly used and phylogenetically-informative genes including 16S rRNA, 12S rRNA, COI, Cyt b and D-loop with respect to complete mitochondrial genome. The tree topologies from the whole mitochondrial genome of 12 species were not identical albeit similar with those resulting from the five individual genes mentioned above. High bootstrap values were observed for mtDNA compared with that of any single gene. The average pair-wise sequence divergence using different genetic modes was found to be: D-loop (0.229) > Cyt b (0.159) > COI or complete mtDNA (0.143) > 12S rRNA (0.094) > 16S rRNA (0.091). The tree resulting from complete mtDNA clearly separated the 12 taxa of Bovidae into 3 major clusters, one cluster each for subfamily Cervinae and Bovinae and the third cluster comprised the distinctive clades of Caprinae and Antilopinae. However, jumping clades of Antilopinae were observed while using the individual genes. This study showed that Bison bison and Bos Taurus have very close phylogenetic relationship compared to Bubalus bubalis (Bovinae), irrespective of the method used. Our findings suggest that complete mtDNA genome provides most reliable understanding of complex phylogenetic relationships while the reliability of individual gene trees should be verified with high bootstrap support

Modes of Action of Different Classes of Herbicides

The mode of action of herbicides is important for understanding the management, classification, organization, and hierarchy of the herbicides. It also provides an insight into herbicide resistance, which continues to be a problem in sustainable agricultural management. The overuse of herbicides, just like other pesticides such as insecticides, has led to increased development of resistance among weeds, causing injury and destruction of useful plants in agriculture, land management, and other related industries. This chapter focuses on the main theme while providing in-depth analysis of the different modes of action of various classes of herbicides. The modes of action of herbicides are as variable as their chemical compositions as they focus on controlling susceptible plants through various biochemical means. Depending upon the specific mode of action at work, it may involve a plant enzyme or a biological system that the herbicide may interrupt, thus injuring or disrupting the regular plant growth and development and causing eventual plant death. Having an in-depth knowledge of the mode of action of herbicides is important in choosing a specific herbicide for a specific crop, understanding the injury symptoms, and devising an appropriate crop-management strategy

Baseline and On-Treatment High-Density Lipoprotein Cholesterol and the Risk of Cancer in Randomized Controlled Trials of Lipid-Altering Therapy

ObjectivesWe sought to examine the relationship between high-density lipoprotein cholesterol (HDL-C) levels and the risk of the development of cancer in large randomized controlled trials (RCTs) of lipid-altering interventions.BackgroundEpidemiologic data demonstrate an inverse relationship between serum total cholesterol levels and incident cancer. We recently reported that lower levels of low-density lipoprotein cholesterol are associated with a significantly higher risk of incident cancer in a meta-analysis of large RCTs of statin therapy. However, little is known about the relationship between HDL-C levels and cancer risk.MethodsA systematic MEDLINE search identified lipid intervention RCTs with ≥1,000 person-years of follow-up, providing baseline HDL-C levels and rates of incident cancer. Using random-effects meta-regressions, we evaluated the relationship between baseline HDL-C and incident cancer in each RCT arm.ResultsA total of 24 eligible RCTs were identified (28 pharmacologic intervention arms and 23 control arms), with 625,477 person-years of follow-up and 8,185 incident cancers. There was a significant inverse association between baseline HDL-C levels and the rate of incident cancer (p = 0.018). The inverse association persisted after adjusting for baseline low-density lipoprotein cholesterol, age, body mass index (BMI), diabetes, sex, and smoking status, such that for every 10-mg/dl increment in HDL-C, there was a 36% (95% confidence interval: 24% to 47%) relatively lower rate of the development of cancer (p < 0.001).ConclusionsThere is a significant inverse association between HDL-C and the risk of incident cancer that is independent of LDL-C, age, BMI, diabetes, sex, and smoking