Particulate Matter 2.5 and Obstetric Complications

Particulate matter (PM) is microscopic solid or liquid matter suspended in the atmosphere of Earth. The sources of PM can be natural or anthropogenic. The most common used for classification of PM is the size of PM. PM 2.5 influences general health problems. Inhalation of PM 2.5 also causes obstetric complications such as low birth weight, preterm delivery and stillbirth. Thus, pregnant women should avoid the exposure to PM 2.5 for prevention of these obstetric complications

Zika virus infection in pregnancy

Zika virus is a mosquito-borne virus. It is transmitted to humans by infected Aedes spp. mosquitoes. Non-vector-borne transmission routes of Zika virus include blood transfusion-related transmission, sexual transmission, transplacental transmission, and perinatal transmission. Zika virus infection is asymptomatic in most cases. If symptoms occur, symptoms are generally mild and self-limited. Signs and symptoms, diagnosis and treatment of Zika virus infection in pregnant women are similar to non-pregnant women. Zika virus infection in pregnancy is associated with fetal structural brain abnormalities and microcephaly. The treatments are symptomatic and supportive. Prevention from mosquito bites is the best way to prevent Zika virus infection. Treatment of Zika virus infection in pregnant women is similar to non-pregnant women. However, obstetricians should be aware of congenital Zika virus infection when pregnant women infected with Zika virus especially in the first trimester

ANTIMICROBIAL AND CYTOTOXIC ACTIVITIES OF BIOACTIVE COMPOUNDS PRODUCED BY STREPTOMYCES SP. KB1

Objective: To investigate the antimicrobial and cytotoxic activities of bioactive compounds produced by Streptomyces sp. KB1 isolated from the air sample at Ao-nang, Krabi province, Thailand.Methods: Streptomyces sp. KB1 was identified by 16S rDNA gene sequencing. It was preliminarily investigated the antibacterial activity by cross streak method and then cultivated in the half-formula of Luria Bertani at 30 °C, 200 rpm in shaking incubator for 7 d. Culture broth of each day was prepared as cell-free culture broth and tested the anti-Staphylococcus aureus TISTR 517 activity by agar well diffusion method along with determined the protein concentration by Bradford assay. Bioactive compounds were assessed the antimicrobial activity and cytotoxicity against brine shrimp by broth microdilution method and brine shrimp lethality bioassay, respectively.Results: Bioactive compounds were excreted into liquid culture medium within 2 d of cultivation and showed a broad spectrum of antibacterial activity. Whereas, the highest activity has shown since day 4th of an incubation period which had protein concentration equal 254 ± 3.1 µg/ml. Bioactive compounds showed strong activity against Gram-positive bacteria, moderate activity against Gram-negative bacteria and weak activity against yeasts and Pseudomonas aeruginosa TISTR 1467. The MIC, MBC or MFC, and LC50 value of bioactive compounds were in the range of 0.49-63.50, 0.49-127.00, and 131.58 µg/ml, respectively.Conclusion: This study implied that bioactive compounds produced by Streptomyces sp. KB1 may be the important polypeptide compound that can be used as lead compounds for novel drug discovery. Â

CT Images of a Malignant-Transformed Ovarian Mature Cystic Teratoma with Rupture: a Case Report

A malignant transformation or a tumor rupture is a rare complication of ovarian mature cystic teratoma (MCT). A tumor rupture in a malignant-transformed MCT has never been reported in the literature. We present the CT images of a 39-year-old woman showing a large, predominantly cystic mass in the lower abdomen, with fat-fluid-level ascites. A contrast-enhanced solid component, with regional discontinuity within the cystic lesion, is also demonstrated. The pathologic diagnosis of the ruptured MCT unveils the malignant transformation (squamous cell carcinoma) and mesenteric carcinomatosis

Dengue fever in pregnancy: a case report

<p>Abstract</p> <p>Background</p> <p>Dengue, a mosquito-borne flavivirus infection, is endemic in Southeast Asia. Currently, the incidence has been increasing among adults.</p> <p>Case presentation</p> <p>A 26-year-old Thai woman, G₁P₀ 31 weeks pregnancy, presented with epigastric pain for 1 day. She also had a high-grade fever for 4 days. The physical examination, complete blood counts as well as serology confirmed dengue fever. The patient was under conservative treatment despite severe thrombocytopenia. She was well at the 3^rd day of discharge and 1-week follow-up. The pregnancy continued until term without any complication and she delivered vaginally a healthy female baby.</p> <p>Conclusions</p> <p>More cases of dengue infection in pregnancy can be found due to the increasing incidence during adulthood. It should be suspected when a pregnant woman presents with symptoms and signs like in a non-pregnant. Conservative treatment should be conducted unless there are any complications.</p

Ruptured ovarian cystic teratoma in pregnancy with diffuse peritoneal reaction mimicking advanced ovarian malignancy: a case report

<p>Abstract</p> <p>Introduction</p> <p>This case illustrates the unusual complication of granulomatous peritonitis following rupture of a dermoid cyst in pregnancy resembling disseminated ovarian carcinoma. To the best of the authors' knowledge, this is the first report of this complication during advanced pregnancy in the literature.</p> <p>Case presentation</p> <p>A dermoid cyst ruptured during surgical removal in the second trimester of pregnancy in a 27-year-old primigravida. Postoperatively the patient suffered pulmonary embolism and leakage of sebaceous material through the abdominal wound. She gradually developed significant abdominal distension, gastrointestinal symptoms and lost more than 8 kg of weight in the 12 weeks postoperatively. The baby was delivered at 31 weeks by a technically challenging caesarean section owing to severe dense adhesions obscuring the uterus. Bowel resection was performed for suspected malignant infiltration and adhesion causing obstruction. She had a protracted convalescence with an ileostomy and mucus fistula. Histology confirmed granulation without malignancy. One year following the surgical treatment, she had recovered well and was planning her next pregnancy.</p> <p>Conclusion</p> <p>Although granulomatous peritonitis following rupture of a dermoid cyst is very rare, awareness is the key to diagnosis and appropriate management. Per-operative frozen section may be helpful.</p

Twisted fallopian tube in pregnancy: a case report

BACKGROUND: Isolated twisted fallopian tube is an uncommon event, isolated twisted fallopian tube in pregnancy is also very rare. The diagnosis is often difficult and established during the operation. The right fallopian tube is most common affected. CASE PRESENTATION: We report an uncommon twisted left fallopian tube in pregnancy. A 34-year-old G(3)P(2) 28 weeks pregnant woman presented with acute left lower abdominal pain. The clinical and ultrasonographic findings led to diagnosis of twisted left ovarian cyst. Emergency exploratory laparotomy was performed. A twisted left fallopian tube and paratubal cyst was noted and left salpingectomy was performed. The postoperative course was uneventful and the pregnancy continued until term without complication. CONCLUSIONS: Although isolated twisted fallopian tube during pregnancy is very rare, it should be included in the differential diagnosis of acute abdomen in pregnancy. Early surgical intervention will decrease obstetric morbidity and may allow preservation of the fallopian tube

Diffusion-weighted magnetic resonance imaging to detect synchronous uterine endometrial and endocervical adenocarcinoma

Synchronous endometrial and cervical cancer is a very rare condition. This report describes a case of a 46-year-old woman who presented with a cervical mass that measured 5.6 cm along its longest diameter, whose biopsy analysis revealed an endocervical mucinous adenocarcinoma. She was classified as having an IB2 cervical carcinoma and treated with concurrent chemoradiation plus hysterectomy. Pathological and immunohistochemical analysis of the surgical specimens revealed a synchronous endometrioid grade 2 adenocarcinoma in the endometrium, and a well-differentiated mucinous adenocarcinoma in the cervix. Magnetic resonance imaging (MRI) studies performed prior to treatment were reviewed and apparent diffusion coefficient (ADC) maps were generated. The ADC values demonstrated distinct signal intensity differences between the endometrial and endocervical tumors. In conclusion, diffusion-weighted MRI and ADC maps can help to distinguish the site of origin of synchronous tumors

Rickettsial Infections and Fever, Vientiane, Laos

Rickettsia spp. are an underrecognized cause of undifferentiated febrile illness

Towards reducing variations in infant mortality and morbidity : a population-based approach

Background: Our aims were (1) to improve understanding of regional variation in early-life mortality rates and the UK’s poor performance in international comparisons; and (2) to identify the extent to which late and moderately preterm (LMPT) birth contributes to early childhood mortality and morbidity. Objective: To undertake a programme of linked population-based research studies to work towards reducing variations in infant mortality and morbidity rates. Design: Two interlinked streams: (1) a detailed analysis of national and regional data sets and (2) establishment of cohorts of LMPT babies and term-born control babies. Setting: Cohorts were drawn from the geographically defined areas of Leicestershire and Nottinghamshire, and analyses were carried out at the University of Leicester. Data sources: For stream 1, national data were obtained from four sources: the Office for National Statistics, NHS Numbers for Babies, Centre for Maternal and Child Enquiries and East Midlands and South Yorkshire Congenital Anomalies Register. For stream 2, prospective data were collected for 1130 LMPT babies and 1255 term-born control babies. Main outcome measures: Detailed analysis of stillbirth and early childhood mortality rates with a particular focus on factors leading to biased or unfair comparison; review of clinical, health economic and developmental outcomes over the first 2 years of life for LMPT and term-born babies. Results: The deprivation gap in neonatal mortality has widened over time, despite government efforts to reduce it. Stillbirth rates are twice as high in the most deprived as in the least deprived decile. Approximately 70% of all infant deaths are the result of either preterm birth or a major congenital abnormality, and these are heavily influenced by mothers’ exposure to deprivation. Births at < 24 weeks’ gestation constitute only 1% of all births, but account for 20% of infant mortality. Classification of birth status for these babies varies widely across England. Risk of LMPT birth is greatest in the most deprived groups within society. Compared with term-born peers, LMPT babies are at an increased risk of neonatal morbidity, neonatal unit admission and poorer long-term health and developmental outcomes. Cognitive and socioemotional development problems confer the greatest long-term burden, with the risk being amplified by socioeconomic factors. During the first 24 months of life each child born LMPT generates approximately £3500 of additional health and societal costs. Conclusions: Health professionals should be cautious in reviewing unadjusted early-life mortality rates, particularly when these relate to individual trusts. When more sophisticated analysis is not possible, babies of < 24 weeks’ gestation should be excluded. Neonatal services should review the care they offer to babies born LMPT to ensure that it is appropriate to their needs. The risk of adverse outcome is low in LMPT children. However, the risk appears higher for some types of antenatal problems and when the mother is from a deprived background