Twisted ovarian cyst in pregnancy: a case report

Ovarian cysts are frequently encountered during pregnancy due to the use of routine prenatal ultrasound. Most of them are benign but in some cases, complications can occur such as torsion, rupture and malignant change. In pregnancy risk of torsion increases 5-fold. It carries significant risk to a pregnant woman and her intrauterine foetus. Here we are reporting a 30-year-old female G3 P1+1L2 with 15 weeks of gestation who presented to antenatal OPD with complain of dull aching abdominal pain for 1 month and nausea and vomiting for 5 days. On ultrasound bilateral ovarian cysts were found, with one of the cyst with multiple septations. She underwent laparotomy, a right sided twisted ovarian cyst was found for which salpingoophrectomy was done. Left sided cyst was simple where cystectomy was done. Her histopathology report showed a bilateral benign serous cystadenoma. Her pregnancy was followed up. She delivered a healthy male baby at term. Ovarian cyst diagnosed in pregnancy can be followed up with serial ultrasound but if associated with complication such as torsion then urgent surgical intervention has to be done

A case series of caesarean myomectomy

Uterine fibroids are benign, monoclonal tumors of smooth muscle cells of the myometrium. Most fibroids do not increase in size during pregnancy and are not always removed when encountered during cesarean section. Objective was to see the outcome of patients undergoing cesarean myomectomy. The study design was observational study. All patients undergoing cesarean section with uterine fibroid of size more than 5 cm. In carefully selected patients and with use of intraoperative vasopressin, myomectomy may be safely accomplished at the time of caesarean section by experienced surgeons. cesarean myomectomy is safe and successful if patient selection is done carefully and does not add to any additional post-operative morbidity

Intravaginal Administration Of Misoprostol Alone Versus Misoprostol And Isosorbidemononitrate For Cervical Ripening And Labour Induction

ABSTRACTOBJECTIVES: To compare the efficacy and safety of intravaginal administration of misoprostol  alone versus misoprostol and  isosorbide mononitrate for cervical ripening and labour induction.MATERIAL AND METHODS: One hundred women with term gestation,  Bishop  score <4 with various indications for labour induction were randomly divided into two groups. In Group I, 50 µg of misoprostol tablet was placed intravaginally, 4 hourly maximum upto 4 doses. In Group II,50 µg of misoprostol tablet with 40mg of isosorbide mononitrate was placed intravaginally in posterior fornix upto 4 doses.RESULTS: Two groups were similar in their clinical characteristics. The induction to delivery interval  was 20.8±2.9 hours vs 14.2±2.7 hours in two groups respectively. Misoprostol and isosorbide mononitrate was associated with a shorter induction to delivery interval, decreased oxytocin requirement higher rate of  vaginal delivery i.e 62.8% Vs 53.9% . Uterine hyperstimulation was more common with misoprostol. Neonatal outcome was similar in both the groups.CONCLUSION: The present study suggests that both intravaginal misoprostol and combination of isosorbide mononitrate and misoprostol are safe and effective modes of labour induction. Isosorbide mononitrate and misoprostol is more effective than misoprostol alone in terms of  shorter induction to active phase interval and induction to delivery interval.  

Ultrasonographic measurement of placental thickness and its correlation with estimated fetal weight

Background: The human placenta develops with the principal function of providing nutrients and oxygen to the fetus. Objective of present study was to assess the relationship between placental thickness with estimated fetal weight.Methods: The present study was a prospective observational study and includes 152 pregnant women with known last menstrual period, history of regular menstruation, singleton pregnancy and aged between 20 and 35 years. After Institutional Ethics Committee approval all recruited women were observed for baseline demographic and obstetric data including age, parity and past medical events at first antenatal visit. All women provided an informed written consent and underwent ultrasound evaluation of placental thickness at 18 to 40 weeks of gestation.Results: In the present study the mean placental thickness between the ranges of 18-40mm was 31.63±4.79mm and the mean estimated fetal birth weight was 2145.86±121.24grams. The pearson’s correlation coefficient between the two was 0.982. Thus, proving the significant positive correlation between placental thickness and estimated fetal birth weight (p-value <0.001).Conclusions: Estimated fetal weight is a very important component of antenatal care in which ultrasonography plays an important role. Placental thickness measured at the level of umblical cord insertion can be used as an accurate sonographic indicator in the assessment of fetal weight because of its linear correlation. Therefore, it can be used as an additional sonographic tool in assessing fetal weight

Gestational diabetes mellitus, Vitamin D status and fetomaternal outcome

Background: Diabetes is the most common medical complication of pregnancy. Vitamin D deficiency which was initially considered only to influence bone metabolism, is now known to exert a wide spectrum of extra-skeletal effects. Vitamin D deficiency is closely associated with gestational diabetes mellitus, it also leads to adverse maternal and child outcome. Objective of this study was to compare the vitamin D levels in healthy pregnant women and women with gestational diabetes mellitus and to observe the feto-maternal outcome.Methods: This prospective study was carried out on 160 pregnant women between the age group 20-40 years attending the Obstetrics and Gynaecology department of JNMC, AMU, Aligarh from October 2016 to October 2018. Women were divided into group A- normal pregnant women and group B- women with GDM. Estimation of vitamin D was done in both the groups.Results: Mean vitamin D levels were lower in women with GDM as compared to normal pregnant women.Conclusions: Women with vitamin D deficiency have an increased risk of developing GDM and adverse feto maternal outcome as compared to those who had normal level of vitamin

Amniotic fluid index versus maximum vertical pocket measurement in predicting perinatal outcome at 40 weeks or beyond

Background: The aim of this study is to compare the use of amniotic fluid index with maximum vertical pocket for predicting perinatal outcomes.Methods: The present study was a prospective observational study and includes 140 The study include normal antenatal women at gestational age 40 weeks or beyond (by last menstrual period/1st trimester scan) referred from antenatal between 20 to 40 years were enrolled in this study from 2015 to 2017. After Institutional Ethics Committee approval all recruited women was assessed at the 3rd trimester visit for baseline demographic and obstetric data. After taking a detailed history and examination the women were subjected to ultrasonography for Amniotic Fluid index (AFI) and Maximum vertical pocket (MVP). The women were divided into 2 groups based on measurement of AFI and MVP ultrasonologically. The correlation of Amniotic fluid index and Maximum vertical pocket with perinatal outcome were computed for the 2 groups: Group Ia - women having normal AFI and normal MVP; Group Ib - women having decreased AFI and normal MVP.Results: In Group Ia, 31(34.44%) women were induced and in Group Ib 59 (65.56%) women were induced for oligohydramnios. 65 women (72.22%) had normal vaginal delivery versus 25women (27.28%) had undergone LSCS in Group Ia, while in Group Ib, 32 women (64%) versus 18 women (36%) had vaginal delivery and LSCS respectively. Higher rate of LSCS was observed in Group Ib. There was no significant difference in the rate of LSCS for fetal distress between Group Ia and Ib for fetal distress.Conclusions: Amniotic fluid index (AFI) compared with the maximum vertical pocket (MVP) excessively characterizes patients as having oligohydramnios, leading to an increase in obstetric interventions, without any documented improvement in perinatal morbidity and mortality. Thus, authors cannot find any objective reason to favour AFI over MVP

Emotions Regulation and Academic Performance of Elementary School-Aged Students

Abstract Emotions regulations is the capacity that plays a necessary function in our routine lives and essential not only for the attainment of socialization but also necessary in achieving educational tasks.This research proposed to examine the association between the emotions regulations and academic achievement of elementary aged students. The quantitative research method was adopted to determine the results. The sample size of the study confined 209 students (boys &amp; girls) of twelveelementary schools in district Bahawalnagar of Punjab Pakistan. The sample of the study utilized simple random sampling. A self-report questionnaire was used to collect the data from students regarding their emotions regulations. School records and Punjab Board Gazette (Punjab Examination Commission)was included to collect data of the study. Mean, standard deviation, and Pearson correlation techniques were applied to analyze the data. The results of the study exploredthat most of the respondents practice positive strategies while expressing their emotions and have a high level of academic sores. It was also found that the students who could not able to express their emotions in positive ways; consequently, they show poor performance in education. Therefore, policy makers need to focus on attention to develop positive emotions regulations among elementary aged students. Keywords; Emotions, Emotions regulations, academic achievements, elementary educatio

Impact of parents’ authoritative style on personality traits of children: a case study of Elementary class students in Pakistan

The study was carried out to determine the effects of authoritative parenthood on the personality traits of elementary school children including all the five traits namely agreeableness, conscientiousness, extraversion, neuroticism and openness. The study is significant as it gives parents a chance to evaluate their parenting style and comprehend its positive and negative effects on children&rsquo; personality traits. It was an Ex Post Facto study in which data was collected about the cases of elementary class children in Pakistan. A multistage random sample of 30 elementary schools, three hundred cases (children and their parents) and 90 teachers was chosen. Two questionnaires were used in the study; One to evaluate the parenting styles of the parents which was adopted from Robinsons Parenting style questionnaire and second, adopted from the Big Five Inventory questionnaire to assess the personalities of the children. Cronbach&rsquo;s Alpha value of the total parenting style questionnaire was 0.95 and Cronbach&rsquo;s Alpha value of the total personality style tool used in this study was 0.84. Data was collected by the researchers during parent-teacher meetings and meetings with teachers in the selected schools. Percentage of frequencies, mean score, standard deviation, ANOVA statistics and correlation values were calculated using SPSS. Results indicated highly significant and positive relationship between authoritative parenting style and the four personality traits i.e. agreeableness, conscientiousness, extraversion and openness but a significant and negative relationship with neuroticism. Moreover, a highly significant impact of parenting authoritativeness level on children personality traits was explored. Therefore, it is recommended that parents should practice authoritative parenting style to raise strong and healthy individuals and refrain the negativism in the personality of children. &nbsp

Neurotransmitters Regulation and Food Intake: The Role of Dietary Sources in Neurotransmission

Neurotransmitters (NTs) are biologically active chemicals, which mediate the electrochemical transmission between neurons. NTs control numerous organic functions particularly crucial for life, including movement, emotional responses, and the physical ability to feel pleasure and pain. These molecules are synthesized from simple, very common precursors. Many types of NTs have both excitatory and inhibitory effects. Neurotransmitters' imbalance can cause many diseases and disorders, such as Parkinson's disease, depression, insomnia, increased anxiety, memory loss, etc. Natural food sources containing NTs and/or their precursors would be a potential option to help maintain the balance of NTs to prevent brain and psychiatric disorders. The level of NTs could be influenced, therefore, by targeting dietary habits and nutritional regimens. The progressive implementation of nutritional approaches in clinical practice has made it necessary to infer more about some of the nutritional NTs in neuropsychiatry. However, the importance of the intake of nutritional NTs requires further understanding, since there are no prior significant studies about their bioavailability, clinical significance, and effects on nerve cells. Interventional strategies supported by evidence should be encouraged

Metabolic analyses reveal common adaptations in two invasive Haemophilus influenzae strains

Non-typeable Haemophilus influenzae (NTHi) is a major pathogen in upper and lower respiratory tract infections in humans, and is increasingly also associated with invasive disease. We have examined two unrelated NTHi invasive disease isolates, R2866 and C188, in order to identify metabolic and physiological properties that distinguish them from respiratory tract disease isolates such as Hi2019. While the general use of the Hi metabolic network was similar across all three strains, the two invasive isolates secreted increased amounts of succinate which can have anti-inflammatory properties. In addition, they showed a common shift in their carbon source utilization patterns, with strongly enhanced metabolism of nucleoside substrates, glucose and sialic acid. The latter two are major compounds present in blood and CSF. Interestingly, C188 and R2866 also shared a reduced ability to invade or survive intracellularly in 16HBE14 bronchial epithelial cells relative to Hi2019 (4-fold (4 h), 25-fold (24 h) reduction). Altered metabolic properties such as the ones observed here could arise from genomic adaptations that NTHi undergo during infection. Together these data indicate that shifts in substrate preferences in otherwise conserved metabolic pathways may underlie strain niche specificity and thus have the potential to alter the outcomes of host-NTHi interactions