Optimizing Care for High-Risk Multiple Pregnancy with POCUS – A Case of Quadruplet Pregnancy Early Diagnosis

Managing multiple pregnancies is challenging and requires careful evaluation. Point of care ultrasound (POCUS) has emerged as a potentially crucial tool in assessing suspected first-trimester pregnancies. However, its role in evaluating multiple pregnancies remains uncertain. We present the case of a 36-year-old Ghanaian female who presented with acute vaginal bleeding after undergoing in vitro fertilization. A bedside transabdominal POCUS identified four intrauterine gestations with fetal poles and cardiac activity, suggesting a quadruplet viable pregnancy. A subsequent transvaginal ultrasound confirmed the findings. The patient was discharged with a follow-up appointment with an Obstetrician-Gynecologist. This case highlights the significance of POCUS in early pregnancy diagnosis, facilitating accurate identification and appropriate referral for further management. It also demonstrates the utility of POCUS in determining gestational age and viability. To our knowledge, no published case reports specifically address the diagnosis of a quadruplet pregnancy, emphasizing the role of POCUS in optimizing care for high-risk multiple pregnancies

Microspectrophotometric evidence for cone monochromacy in sharks

Sharks are apex predators, and their evolutionary success is in part due to an impressive array of sensory systems, including vision. The eyes of sharks are well developed and function over a wide range of light levels. However, whilst close relatives of the sharks—the rays and chimaeras—are known to have the potential for colour vision, an evolutionary trait thought to provide distinct survival advantages, evidence for colour vision in sharks remains equivocal. Using single-receptor microspectrophotometry, we measured the absorbance spectra of visual pigments located in the retinal photoreceptors of 17 species of shark. We show that, while the spectral tuning of the rod (wavelength of maximum absorbance, λmax 484–518 nm)and cone (λmax 532–561 nm) visual pigments varies between species, each shark has only a single longwavelength-sensitive cone type. This suggests that sharks may be cone monochromats and, therefore, potentially colour blind. Whilst cone monochromacy on land is rare, it may be a common strategy in the marine environment: many aquatic mammals (whales, dolphins and seals) also possess only a single, green-sensitive cone type. It appears that both sharks and marine mammals may have arrived at the same visual design by convergent evolution. The spectral tuning of the rod and cone pigments of sharks is also discussed in relation to their visual ecology