Hyperhomocysteinemia in Recurrent pregnancy loss

Background: Hyperhomocysteinemia is associated with many pregnancy related complications. Its association with recurrent pregnancy loss has been investigated recently. Not only it is associated with recurrent pregnancy loss but also associated with complications like Preeclampsia, intrauterine growth retardation and low birth weight. The objective of this study to assess the prevalence of Hyperhomocysteinemia in patients with unexplained recurrent pregnancy loss and to evaluate the association of hyperhomocysteinemia with pregnancy complications in patients of recurrent pregnancy loss.Methods: 50 Patients of unexplained recurrent pregnancy loss were selected as cases and 50 patients with atleast one successful pregnancy were taken as controls. Their blood sample was assayed for Fasting Homocysteine levels. They were followed up throughout pregnancy for any complications and neonatal outcome was recorded.Results: 19 patients out of the 50 cases had Hyperhomocysteinemia. Hyperhomocysteinemia was thrice more common in Primary aborters when compared to secondary aborters. Out of 19 patients with hyperhomocysteinemia in patients with recurrent pregnancy loss, 14 patients also developed Hypertensive disorder of pregnancy during their antenatal period. Among patients with Hyperhomocysteinemia in study group, 47% had low birthweight babies when compared to 25% among control group.Conclusions: Hyperhomocysteinemia is associated with recurrent pregnancy loss and patients of Recurrent pregnancy loss who have Hyperhomocysteinemia have a higher risk of developing pregnancy complications like Preeclampsia, low birth weight and Intrauterine growth retardation

Intraoperative findings in primary caesarean section for non-reassuring fetal status and its correlation with cardiotocography

Background: Cardiotocography plays an important role in diagnosing nonreassuring fetal status during labour, which is a leading cause for caesarean section among primigravida. These abnormal cardiotocographic traces may or may not translate into intraoperative findings of meconium stained liquor or low APGAR at birth. Hence a study is warranted to understand their correlation, thereby demonstrating the utility of cardiotocography in diagnosing nonreassuring fetal status. The objective of the study was to assess the correlation of intraoperative findings and neonatal outcome in primigravida undergoing emergency caesarean section for nonreassuring fetal status with cardiotocography.Methods: A retrospective analysis of 104 case records of primigravida undergoing emergency caesarean section for fetal distress at Department of Obstetrics and Gynecology, Apollo Institute of Medical Sciences and Research, Hyderabad, was done. Their CTG traces were correlated with their intraoperative findings such as meconium stained liquor; nuchal cord and APGAR score at birth.Results: Out of these 104 primigravida who underwent emergency caesarean section for nonreassuring fetal status, 63.4% had CTG with decelerations-Non reactive, 28% had a CTG trace with persistent decreased variability while 7.6% had a reactive CTG with meconium stained liquor. Among patients with CTG trace showing decelerations 54.5% had meconium stained liquor, 28.7% had cord around the neck and 43.9% had low APGAR scores at birth. Among the group of patients with decreased variability 63.4% had meconium stained liquor, 30% had cord around the neck and 30% had low APGAR scores at birth. There were 8 patients who had reactive CTG with meconium stained liquor, among them only 3 had low APGAR scores.Conclusions: Cardiotocography positively correlates with meconium stained liquor and APGAR scores at birth, but not with the presence of nuchal cord. Hence, judicious interpretation of CTG and introduction of another noninvasive, cost effective and acceptable test to detect non reassuring fetal status is warranted to prevent unnecessary caesarean sections

Metanephric adenoma of kidney: a rare and distinct entity

Metanephric adenoma (MA) is an unusual renal neoplasm with benign behaviour most of the times. Clinically MA mimics malignant renal neoplasms due to nonspecific signs and symptoms such as polycythaemia, haematuria and abdominal pain. MA usually presents as a mass lesion on radiographic studies and can be found incidentally. The treatment of choice is surgical excision. Though MA is usually a benign tumour, increase in the knowledge of MA pathology may lead to less invasive treatments in the future. Less than 200 cases of metanephric adenoma are reported till date in the literature

Comparative Evaluation of Smear Layer Removal Using Four Different Irrigation Techniques: An in-vitro Study

INTRODUCTION: Irrigation is the vital part of root canal debridement. Usually post biomechanical preparation, the canal walls are covered by smear layer. It is important to remove this layer before obturation for better bond between the filling and walls. Conventional needle irrigation doesn’t give us adequate cleaning, therefore, new irrigation techniques are being tried to facilitate better smear layer removal. AIM: The aim was to evaluate and compare the smear layer removal by PATS,  EndoActivator device, Passive ultrasonic irrigation and side vent needle irrigation from canal walls. MATERIALS AND METHODS:  60 extracted mandibular premolars were instrumented up to 35/.04 with Heroshaper files. Samples were divided into 4 groups randomly before final irrigation as follows: Group I (n=15): Irrigation with side vent needles (Nexus ltd.,India), Group II (n=15): Irrigation with EndoActivator (Advanced Endodontics, Santa Barbara, CA ) Group III (n=15): Irrigation with PATS ( InnovationsEndo,India), Group IV (n=15): Irrigation with ultrasonic tips (Mani inc.). Teeth were split and one-half of each tooth was chosen for SEM examination.  The images were taken at apical third and scoring was done according to criteria by Torabinejad et al in 2003. Data obtained were analyzed using Kruskal-Wallis analysis of variance followed by Mann–Whitney U-test for individual comparison. RESULTS: All irrigating systems remove smear layer but PUI has better cleaning ability as compared to other groups. CONCLUSION: Passive ultrasonic irrigation shows better smear layer removal as compared to other technique

To Study The Efficacy Of Reciprocating Single File System And Multifile Rotary Systems In Elimination Of Root Canal Bacteria And Endotoxins

AIM: To study the efficacy of reciprocating single file system and multifile rotary systems in elimination of root canal bacteria and endotoxins. MATERIAL AND METHOD: Forty permanent single rooted mandibular premolars with straight canals inoculated with Escherichia Coli suspension for 21 days were selected for the study. Teeth were randomly divided into four groups (n=10) according to instrumentation system: Grp. A–Reciproc (VDW); Grp. B–WaveOne (Dentsply Maillefer); Grp. C–MTwo (VDW); and Grp. D–K3( Sybron Endo); Bacterial and endotoxin samples were collected with a sterile paper point before instrumentation  and after instrumentation. Culture methods estimated the colony-forming units (CFU) and the Limulus Amebocyte Lysate test was used for quantification of endotoxins. Results so obtained were calculated and statistically analysed.  RESULT: Results at S1 concluded that bacteria and endotoxins were found in all of the investigated root canals. After instrumentation all systems were associated with the significant reduction of the bacterial load and endotoxins respectively: Grp. A– Reciproc (88.25% and 89.10%); Grp. B– WaveOne (83.53% and 80.59%); Grp. C– MTwo(79.41% and 75.84%) and Grp. D– K3 (67% and 74.4%). Statistically no difference was found amongst the instrumentation systems regarding bacteria and endotoxin elimination (P <0.05).  CONCLUSION: The reciprocating single file, Reciproc and WaveOne were as effective as the multifile rotary systems for the eradication of bacteria and endotoxins from root canals

Uptake and Predictors of Anal Cancer Screening in Men Who Have Sex With Men

Objectives. We investigated attitudes about and acceptance of anal Papanicolaou (Pap) screening among men who have sex with men (MSM)

Non-uniform recovery of left ventricular transmural mechanics in ST-segment elevation myocardial infarction

<p>Abstract</p> <p>Background</p> <p>After a transient ischemic episode, the subendocardial region is more severely injured than outer subepicardial layers and may regain a proportionately greater degree of mechanical function in the longitudinal direction. We sought to explore left ventricular (LV) transmural mechanics in patients with ST-segment elevation myocardial infarction (STEMI) for determining the mechanism underlying recovery of global LV function after primary percutaneous coronary intervention (PCI).</p> <p>Methods</p> <p>A total of 42 patients (62 ± 11 years old, 71% male) with a first STEMI underwent serial assessments of LV longitudinal, circumferential and radial strains (LS, CS and RS) by selective tracking of subendocardial and subepicardial regions within 48 hours and a median of 5 months after PCI. LV mechanical parameters were compared with sixteen age and gender matched normal controls.</p> <p>Results</p> <p>In comparison with controls, endocardial and epicardial LS were markedly attenuated at 48 hours following PCI (P < 0.001). An improvement in LV ejection fraction (EF > 5%) following PCI was seen in 24 (57%) patients and was associated with improvement in endocardial and epicardial LS (P < 0.001 and P = 0.003, respectively) and endocardial CS (P = 0.01). Radial strain and wall motion score index, however, remained persistently abnormal. The change in endocardial LS (OR 1.2, 95% CI 1.03 to 1.42, P = 0.01) and the change in epicardial LS (OR 1.2, 95% 1.03 to 1.46, P = 0.02) were significantly associated with the improvement in LVEF, independent of the location of STEMI and the presence of underlying multivessel disease.</p> <p>Conclusions</p> <p>In patients with STEMI treated by PCI, the recovery of LV subendocardial shortening strain seen in the longitudinal direction underlies the improvement in LV global function despite persistent abnormalities in radial mechanics and wall motion score index.</p

Immunity and vaccine development efforts against Trypanosoma cruzi

Artículo de revisión especializadoTrypanosoma cruzi (T. cruzi) is the causative agent for Chagas disease (CD). There is a critical lack of methods for prevention of infection or treatment of acute infection and chronic disease. Studies in experimental models have suggested that the protective immunity against T. cruzi infection requires the elicitation of Th1 cytokines, lytic antibodies and the concerted activities of macrophages, T helper cells, and cytotoxic T lymphocytes (CTLs). In this review, we summarize the research efforts in vaccine development to date and the challenges faced in achieving an efficient prophylactic or therapeutic vaccine against human CD.UTM

Testing the Efficacy of a Multi-Component DNA-Prime/DNA-Boost Vaccine against Trypanosoma cruzi Infection in Dogs

Immunization of dogs with DNA-prime/DNA-boost vaccine (TcVac1) enhanced the Trypanosoma cruzi-specific type 1 antibody and CD8+ T cell responses that resulted in an early control of acute parasitemia and a moderate decline in pathological symptoms during chronic phase. Further improvement of vaccine-induced immunity would be required to achieve clinical and epidemiological benefits and prevent transmission of parasites from vaccinated/infected dogs to triatomines