Larry Lee Interview

2009 interview with installation artist and curator Larry Lee by Ami ShahLarry Lee website View Larry\u27s work in the AAOH project galler

Role of diagnostic laparoscopy in infertility

Background: Use of diagnostic and therapeutic laparoscopy in infertility has been a focus of attention in recent years and demonstrated to be very effective method in evaluating these cases. The main objective of the study was to detect the diagnostic efficacy of laparoscopy in uterine, pelvic and ovarian pathologies.Methods: This prospective study included 50 infertile women and it was conducted at department of Obstetrics and Gynaecology, Smt. N.H.L. Municipal Medical College, Ellisbridge, Ahmedabad during the period between May 2006 to November 2008. After thorough gynecological examination, necessary investigations were made and written consent form was taken from them before laparoscopy. The patients were kept fasting for 24 hours before the laparoscopy and the procedure was performed under general anaesthesia. All the data was collected on pre-designed proforma and the results were tabulated and raw percentages calculated to describe the results.Results: Among 50 patients, 34 were of primary infertility cases and 16 were of secondary infertility. In primary infertility maximum number of patient belonged to age group of 21-25 years where as secondary infertility were under the age group 26 – 30 years and above 31 years of age. In primary infertility 65% patients had active marriage life duration of 2 – 4 years, while in secondary infertility cases 81% of patients had marriage life age of more than 6 years. Out of 50 patients, 14 (28%) had absolutely normal laparoscopic findings. Among the various pathologies observed, ovarian pathology contributed the most (36%), followed by tubal (26%), pelvic (22%) and uterine (10%) pathologies.Conclusions: Laparoscopy is safe and cost effective method and should be considered as prime diagnostic tool for evaluating the etiology of infertility in women and for effective treatment decisions

A study of maternal and perinatal outcome in patients of postpartum hemorrhage in a tertiary care hospital, Gujarat

Background: Postpartum hemorrhage (PPH) is significant factor for maternal mortality. Prevalence of PPH is 6.0% worldwide and highest prevalence was noted in Africa which is almost 10.1%. In India, maternal hemorrhage is the very common factor for maternal mortality. The objective of the study was to understand incidence of PPH and various risk factors for it, to study maternal morbidity and mortality associated with PPH and to study the effective mode of management in PPH.Methods: This prospective study was done among 50 cases of postpartum haemorrhage out of 13,628 deliveries at civil hospital, Asarwa, Ahmedabad during November 2008 to October 2010 and analysis was done regarding patients’ socio demographic characteristics, various risk factors, causes and maternal and perinatal outcome.Results: Incidence of PPH was 0.36%. Almost >85% cases were belonged to 20-34 years age group. Highest cases (38%) seen in primigravida and 72% cases have normal vaginal delivery. Anemia noted in highest cases (22%) and 68% cases have most common etiology was atonicity. Birth weight <2.5 kg found in 36% cases. Most common maternal outcome was fever (16%) and 72% cases delivered healthy and alive birth.Conclusions: The patients were mostly primiparous. The commonest associated medical condition was anemia. The commonest underlying cause of PPH was atonicity of the uterus. Commonest maternal outcome was fever. Out of total births, 72.0% were alive and healthy babies followed by 18.0% babies were still birth

Long-term neurocognitive function of pediatric patients with severe combined immune deficiency (SCID): pre- and post-hematopoietic stem cell transplant (HSCT).

BACKGROUND:Hematopoietic stem cell transplantation (HSCT) is the only cure for patients with severe combined immunodeficiency (SCID). The purpose of this study was to evaluate long-term neurodevelopment of patients with SCID following myeloablative chemotherapy and HSCT. MATERIALS AND METHODS:Sixteen pediatric patients diagnosed with SCID were tested using the Bayley Scales of Infant Development and the validated Vineland Adaptive Behavior Scales (VABS) pre- and 1-year post-HSCT. Three years post-HSCT, there were 11 patients available for testing and four patients available 5 years post-HSCT. Patients greater than 3 years of age were administered the Wechsler Preschool and Primary Scale of Intelligence. Both raw scores and scaled scores were analyzed. RESULTS:There was a significant decrease 1 year post-HSCT in the Bayley Mental Developmental Index (MDI) [92.5 (pre) vs. 70.81 (1 year post), p &lt; 0.0001] and the VABS [99.73 (pre) vs. 79.87 (1 year post), p = &lt;0.0001]. There was a significant decrease over time in the MDI [95.00 (pre) vs. 72.64 (1 year post) vs. 71.82 (3 years post), p &lt; 0.0001], but no significant change between 1 and 3 years post-HSCT. There was no change in the Bayley Psychomotor Development Scale (PDI) [82.4 (pre) vs. 84.8 (1 year post), p = 0.68]. The PDI scores decreased over time [86.29 (pre) vs. 86 (1 year post) vs. 74.14 (3 years post), p = 0.045]. Although there was a decrease in scaled scores, there was not a loss of skills. Analysis of raw scores showed that there was an increase in the raw test scores, which indicated that these children acquired developmental skills, but at a slower rate than normal infants and toddlers. Younger children had a more significant decrease in adaptive scores compared with older children. CONCLUSIONS:These findings may reflect the effects of the isolation and prolonged hospitalization that characterizes the immediate post-transplant period. Patients miss out on social interactions and learning opportunities that normally occur at their respective stages of development. These restrictions keep patients from acquiring developmentally appropriate cognitive skills as well as gross and fine motor developmental milestones. Longitudinal follow-up will be important to quantify acquisition of skills

Factors predicting success of trial of labour after caesarean in current scenario

Background: Cesarean deliveries have been on the rise in recent decades, and as a result the question of how to manage subsequent deliveries becomes ever more important. The National Institute for Health and Care Excellence, RCOG, American College of Obstetricians and Gynecologists, and National Institutes of Health are in consensus that planned VBAC is a clinically safe choice for the majority of women with a single previous lower segment caesarean delivery, the authors explain. Aim of the study was to identify potential predictors of successful VBAC and study the risk and benefits involved.Methods: This was a prospective study in GCS Medical College. Seventy five cases were chosen fulfilling the eligibility criteria and were subjected to study.Results: The outcome was measured as successful VBAC. Out of 75 cases included in our study, 43 cases (57.3% of total cases) qualified for TOLAC during labour. Successful TOL (trial of labor) was observed in 48.8 % (21 out of 43) resulting in VBAC (vaginal birth after caesarean) and the rest 51.2% of failed TOL ended in repeat caesarean delivery.Conclusions: In our study, most of the women with successful VBAC were less than 30 years of age (95.2%). In our study, successful VBAC cases (90.5% of cases) presented with cervical dilatation more than equal to 4 cm and most cases (95.2%) of VBAC delivered before 38 weeks of gestation. Out of all VBAC’s, 62% (13 out of 21) had ante natal indication for their previous caesarean delivery; most common indication being breech. In our study, Repeat C.S. in failed TOL was performed for scar dehiscence in 41% cases

Biosynthesis of vitamins and enzymes in fermented foods by lactic acid bacteria and related genera - A promising approach

Lactic acid bacteria (LAB) are widely employed in food fermentation processes for the biosynthesis of certain important products or metabolites. Fermented food provides plenty of vital nutrients and bioactive components that affect a number of functions of human body in a positive way. Fermented milks can be made more functional by incorporating probiotic strains and furthermore, if they are capable of synthesizing essential biomolecules such as vitamins, enzymes, exopolysaccharides, bacteriocins or bioactive peptides serve into the functional and technological properties of the products. Current paper reviews recent advances associated with biosynthesis of vitamins and enzymes by virtue of LAB and related genera. The outcomes of several studies indicate promising applications at commercial level; however adequate selection of strain is vital to increase the concentration and bioavailability of such biomolecules in fermented foods

Early sonographic markers and prediction of pregnancy outcome: a prospective study

 Background: The objective of the study was to examines the pregnancy outcome in patients with early sonography markers and study design was a prospective study.Methods: This prospective study was conducted at Department of Obstetrics and Gynaecology, GCS Medical College, Ahmedabad, Gujarat, India from Feb 2012 to August 2016. Total of 612 Women with early pregnancy were included in the study that fulfilled the inclusion criterias. After first sonography examination patients were assigned to the control group and study group. Patients were followed up for outcome.14 pateients were lost to follow up.Results: The incidence of pregnancy loss was highest with Large yolk sac i.e 78.57%, followed by loss with Bradycardia (38%), Tachycardia (15.78%) and Smaller than normal G Sac to be 14.28%. As compared to control which had pregnancy loss of only 7.7%. Incidence of other complications like IUGR, PIH were also increased in patients with abnormal early sonography markers up to 33%.Conclusions: T Transvaginal sonography should be used adequately to look for early pregnancy markers like Size of Gestational sac, size and shape of yolk sac, fetal heart rate and in cases of threatened abortion presence of subchorionic haematoma and its size because all these markers are good predictors of pragnacy outcome and can prove helpful in patient counseling