Large vaginal varicosities in the pregnancy without any known systemic disease: a rare case report

Vaginal varices during pregnancy is a rare condition. Only a few cases have been reported in the literature. Most vaginal varices are asymptomatic, but some are associated with a sense of local mass, or severe discomfort and spontaneous vaginal bleeding. A 26-year-old woman was admitted for spontaneous vaginal bleeding at 38 weeks’ gestation. Upon pelvic inspection, we observed dilated vascular structure on the sub-urethral vaginal wall, and the trans-labial ultrasound imaging revealed a blood flow along the vaginal area, confirming the presence of a vaginal varicosity (Figure 3). We concluded that the mass was large vaginal varicosities as there was no discernible etiolgy. Instead of a normal delivery, we performed a cesarean section to prevent the potential risk of the profuse vaginal bleeding. For long-term management, close observation in postpartum period was recommended. Spontaneous resolution is a potential outcome and this is what our patient experienced

Analyzing Sustainable Practices in Fashion Supply Chain

Fast fashion brands create high quantities of synthetic, petroleum-based garments that result in high levels of textile waste and emissions. To change the dreadful tag of hazardous production, top-notch fast fashion leaders started paying attention towards adopting sustainable practices, including sustainable supply chain management (SSCM).This paper conducts a structured review of the annual reports on the topic of energy efficiency and environmental sustainability practices adopted by fashion brands in the supply chain management context. This study tries to identify the factors and classification influencing energy efficiency and environmental sustainability initiatives that impact supply chain performance, the customer perspective and the different technologies supporting energy efficiency and sustainable practices based on the analysis of the data related to the sustainability of top fashion brands from their past five year annual reports.</p

Safety and effectiveness of intravenous iron sucrose versus standard oral iron therapy in pregnant women with moderate anaemia in India

Background: Aim of the study was to diagnose and treat pregnant females with iron deficiency anaemia, to reduce the complications associated with anaemia in pregnancy and to compare the efficacy, safety and side effects of iron sucrose with ferrous sulphate in the treatment of iron deficiency anaemia in pregnancy. Methods: The subjects for study were enrolled on fulfilling the inclusion and exclusion criteria. After detailed history, examination and investigations of patient the dose of intravenous iron sucrose was calculated by using the following formula: dose of iron: 2.4 x Hb deficit (11-patient’s actual Hb) x body weight in kg + 500. The following investigations were done on day 1: (a) complete blood count (CBC)- Hb, MCV, MCH, MCHC and PCV; (b) urine examination. Patients was randomly allocated into two groups. Group-A: oral group- containing 150 pregnant females. Group-B: intravenous group- containing 150 pregnant females. Results: Majority of women (48%) were from lower middle class and lower class (30%). Only 5.3% were from higher socioeconomic class (p value 0.0001). Maximum women (60%) were primigravida and 40% were multigravida. which indicates that most ladies enter pregnancy with poor iron reserves. Improvement in the mean haemoglobin levels after 4 weeks of treatment was statistically significant in both the groups (p value 0.0001). Similarly rise in the mean PCV levels after 4 weeks of the treatment was significantly associated in both the groups (p value 0.0001). There was slight rise in the mean MCV and MCH after 4 weeks. Peripheral blood film had changed from microcytic hypochromic to normocytic normochromic after 4 weeks of the treatment in both the group (p value 0.004). Presence of side effects with the oral and parenteral treatment were 81.3% and 12% respectively (p value 0.0001). Conclusions: From our study, it can be concluded that intravenous iron sucrose has lesser side effects along with better absorption

Peroxisome proliferator-activated receptors and thiazolidinediones in diabetic nephropathy

Diabetic nephropathy is global problem with several drugs into trial without much success the current article highlights the role of thiazolidinedione’s in diabetic nephropathy by scrutinizing and reconnoitring the cellular and intracellular mechanism and shielding action and the role of peroxisome proliferator-activated gamma receptors (PPARγ) receptors. Not only anti-diabetic action but renal protective effect with evidence based study has been highlighted. PPAR γ-is versatile target having numerous benefits and mainly preventing fibrosis in diabetic experimental model and some clinical case report yet, the benefits are not up to mark, since renal failure itself causes volume expansion and the thiazolidinedione’s (TZDs) also preserve salt and water and lead to congestive heart failure which constraints its clinical application. Dual activators and balaglitazone selective PPAR modulator are having upcoming potential for treatment of diabetic nephropathy. Further detail investigation on such drug is needed to explore. However adverse effect like heart failure, osteoporosis and volume expansion effect over-rides the beneficial effect thus limiting its clinical use of currently available TZDs

A "Parenting Licence" Granted by One’s Existing Children? Critical Analysis of the Judgment in Ex Parte JCR 2022 5 SA 202 (GP)

In Ex parte JCR 2022 5 SA 202 (GP) the Pretoria High Court per Neukircher J seeks to introduce new requirements for all surrogacy agreements in South African law. The court considered the psychological impact of surrogacy on the children of both the surrogate parents and the commissioning parents and the need to put in place procedures ‘for preparing them for this process [of not bringing the surrogate baby home]’ or ‘for a new addition to their family’, respectively. The court ordered the mandatory psychological assessment of the existing children of the surrogate parents and commissioning parents. A report emanating from such an assessment would ostensibly assist the court in determining the best interests of the existing children of the parties to the agreement. We argue that the psychological evaluation of the existing children of the parties to a surrogate motherhood agreement fundamentally upsets the balance between the interests of the parties involved in the surrogacy process. In fact, it shifts the balance of power almost entirely into the hands of the existing children, such that they may be said to decide whether their parents allowed to have any more children. We argue that the court’s interpretation that such assessments would be in the best interests of existing children, is based on a fundamental misunderstanding of the court’s duty in this regard. The new assessment requirement is more likely to undermine these children’s interests, to violate the commissioning parents’ constitutional rights to dignity and equality, and their rights to reproductive autonomy, privacy, and access to reproductive healthcare

Prêt-à-Porter Procreation: Contemplating the Ban on Preimplantation Sex Selection

Preimplantation genetic testing makes it possible to genetically test in vitro embryos for the presence of genetic disease. It also identifies the sex of the embryo. Preimplantation sex selection is prohibited in a number of jurisdictions, including South Africa. Sex selection may be considered to be included in the ambit of the right to reproductive autonomy under the Constitution of the Republic of South Africa, 1996. An analysis of international human rights law supports such a view, and a comparison with foreign law suggests that South Africa should be wary of adopting blanket prohibitions without considering their context. The analysis demonstrates that a prohibition of preimplantation sex selection may have no place in South African law

Prêt-à-Porter Procreation : contemplating the ban on preimplantation sex selection

Preimplantation genetic testing makes it possible to genetically test in vitro embryos for the presence of genetic disease. It also identifies the sex of the embryo. Preimplantation sex selection is prohibited in a number of jurisdictions, including South Africa. Sex selection may be considered to be included in the ambit of the right to reproductive autonomy under the Constitution of the Republic of South Africa, 1996. An analysis of international human rights law supports such a view, and a comparison with foreign law suggests that South Africa should be wary of adopting blanket prohibitions without considering their context. The analysis demonstrates that a prohibition of preimplantation sex selection may have no place in South African law

Ayurvedic Products and Services for Health Tourism Niche in India and the Contamination of Ayurvedic Content

In past few years India has originated as one of the most important hubs for health tourism. There are several pull factors like excellent health facilities, low cost, easy accessibility, picturesque locations for excellent holiday etc. Globalized and modernized practices derived from Ayurveda traditions gave impetus to health tourism. Ayurvedic science is a monumental contribution of India to the world. Its main objective is preventive health care along with disease cure. The main attraction for tourists is rejuvenation promised by Yoga and Ayurvedic massage. Kerala is hub of health tourism just because of Panchkarma therapy. Despite it, ideal geographic location, salubrious climate and Samhita based approach are the other key factors. Other potential and developing fields in Ayurveda for Health Tourism are Swasthvritta (lifestyle modification), Pathya-apathya (dietary habits/Nutrigenomics), Garbha Sanskara (having a healthy and desired progeny), infertility management, Rasayana (rejuvenation), Vajikarana (aphrodisiac) etc. Ayurvedic medicines are herbal or herbo-mineral. Lack of identification, availability, proper collection and processing of herbs are the major hurdles that lead to contamination and affect the potency of preparation. Mineral compounds must be processed strictly following the guidelines mentioned in Ayurvedic texts. Otherwise, heavy metal contaminants left in the preparation might cause metal toxicity in consumers. Strict adherence to “Drug Standardization Protocols” is the need of hour by drug manufacturing units to remove the taboo of metallic toxicity and placebo for Ayurvedic preparations globally