Rupture of ectopic pregnancy in rudimentary horn of uterus at 20 weeks of gestation

Ectopic pregnancy is a well-known complication in early pregnancy .the commonest site is ampullary region of fallopian tube but sometime presentations at rare sites like rudimentary uterine horn can also happen. These rare presentations are difficult to diagnose and needs high index of suspicion on behalf of obstetrician. A 28 years old Saudi female patient with previous cesarean delivery in her second pregnancy at 20 weeks presented to the emergency department of medicine with severe abdominal pain, nausea, vomiting, dizziness and breathlessness. She was investigated on lines of pulmonary embolism but it was all inconclusive. Obstetrics & gynaecology department was consulted regarding the status of her pregnancy. On examination she was hypotensive and distended abdomen. Clinical and sonographic examination was going with internal bleeding in pelvis. Uterus was seen as separated from the fetus which was floating in free fluid in pouch of Douglas and measurements were going with 20 weeks of gestation. Initial suspicion was scarred ruptured ectopic pregnancy. The patient was immediately shifted to theatre and laparotomy performed with removal of blood and blood clots in abdomen and pelvis, an accessory horn on right side of uterus with a rent on posterior aspect noted and horn was excised. Patient recovered well and received 8 units of packed RBCs, FFP.

Outcome of pregnancy in Saudi women with sickle cell disease attending the Tertiary Care University Hospital in eastern province of Saudi Arabia

Sickle cell disease (SCD) is a chronic genetic hematological disorder with multiorgan involvement and is associated with complications during the pregnancy. This is a well-known disorder in Saudi Arabia, but no study has reported its outcomes in pregnant Saudi females of the Eastern region. This study was carried out to compare the fetomaternal outcome in patients with SCD with those without SCD. This was a retrospective cohort study done in the Eastern Province of Saudi Arabia in a tertiary care, teaching hospital, by retrieving the data through the code ICD-9 for SCD, the control group was also selected with comparable characteristics. A total of 302 SCD pregnant patients were included for comparison with 600 pregnant women without SCD as control, during the period of Jan 1, 2008 to December 31, 2018. After the data retrieval, percentages of complications were calculated between the study and control groups. Fischer‘s exact test and t-test were used for statistical analysis by using SPSS version 22. The results showed higher complication rates in pregnancies of patients with SCD. Hypertensive disorders (13.3%), abruptio placenta (1.6%), intrauterine growth restriction (19.2%), thromboembolism (6.6%) and stroke (2.6%) were all higher in SCD as compared to the control group .The complications of SCD itself including anemia (89.4%), acute chest syndrome (13.2%) and sickle cell crisis (39.2%) were also increased during the pregnancy. Both still birth (3.3%) and neonatal intensive care unit admission (1.6%) were also higher in SCD. SCD during the pregnancy is a high-risk situation and can lead to many fetomaternal complications; however, preconceptional counselling, early booking, a careful monitoring during pregnancy and multidisciplinary management approach can prevent potential adverse outcome in this regard.La maladie drépanocytaire (MD) est une anomalie hématologique génétique chronique impliquant plusieurs organes et qui est associée à des complications au cours de la grossesse. Il s'agit d'un trouble bien connu en Arabie Saoudite, mais aucune étude n'a rapporté ses résultats chez les femmes saoudiennes enceintes de l'est du pays. Cette étude a été réalisée dans le but de comparer les résultats foeto maternels chez les patientes atteintes de MD avec ceux ne souffrant pas de MD. Il s'agissait d'une étude de cohorte rétrospective réalisée dans un hôpital universitaire de soins tertiaires de la province orientale de l'Arabie saoudite. Les données ont été extraites du code ICD-9 pour MD. Le groupe témoin a également été sélectionné avec des caractéristiques comparables. Au total, 302 patientes atteintes de MD et enceintes ont été incluses pour la comparaison avec 600 femmes enceintes mais non atteintes servant comme témoin, entre le 1er janvier 2008 et le 31 décembre 2018. Après la récupération des données, les pourcentages de complications ont été calculés entre les groupes d'étude et de témoin. Le test exact et le test t de Fischer ont été utilisés pour l‘analyse statistique à l‘aide de la version 22 de SPSS. Les résultats ont montré des taux de complication plus élevés lors de la grossesse chez les patientes atteintes de MD. Les troubles hypertensifs (13.3%), une rupture du placenta (1.6%), une restriction de croissance intra-utérine (19.2%), une thrombo-embolie (6.6%) et un accident vasculaire cérébral (2.6%) étaient tous plus élevés chez patientes atteintes par rapport au groupe témoin. Les complications de MD ellemême y compris l‘anémie (89.4 %), le syndrome thoracique aigu (13.2%) et la crise de drépanocytose (39.2%) ont également augmenté au cours de la grossesse. Les taux d‘admission dans une unité de soins intensifs néonatals (1.6%) et de mortinatalité (3.3%) étaient également plus élevés chez les patients atteints de MD. La MD pendant la grossesse est une situation à haut risque et peut entraîner de nombreuses complications foeto-maternelles; Cependant, les conseils d‘avant-conception, les réservations précoces, une surveillance attentive pendant la grossesse et une approche de gestion multidisciplinaire, peuvent empêcher des résultats défavorables potentiels à cet égard.Keywords: Fetomaternal outcome, Maternal Complications, Vaso-occlusive crisis, Venous thromboembolismAfr J Reprod Health 2019; 23[3]: 42-48)

Impact of External Monitoring Mechanism on Deal Amounts in Corporate Mergers and Acquisitions: Evidence from Pakistan

The studies regarding the deal amount paid in mergers and acquisitions (M&As) become especially important, as reduction of profits in such deals might be due to large amounts paid in acquisitions. The methodology of this study is novel as it takes into account the external governance mechanism by considering both the institutional ownership and external block-holders along with bidder and targeted firm characteristics on deal prices involved in M&As in case of Pakistan during period of 2005-12. The results of study show the existence of external monitoring in form of institutional ownership in both sectors. The study proves that the aim of acquisitions is to achieve a big size instead of value maximization and the managers who exaggerated their confidence attempt to overemphasize their capability to handle the target company, which leads to high amounts paid to acquire target. The nonfinancial sector proves the absence of agency conflicts, however agency hypothesis is not proved significant in financial sector case. The financial sector result shows that cash financed deals are associated with lower price that depends on presence of asymmetric information about acquiring firm, as management (i.e. managers of firm) possess more information as compared to other stakeholders

Application of chitosan padded rice and wheat husk for the removal of reactive dye from aqueous solution

Industrial waste especially textile effluents contain many harmful ingredients, which cause environmental problems. In the present study, the removal of reactive red 195 dye was carried out using chitosan padded wheat husk (CWH) and rice husk (CRH) adsorbents. Chitosan was prepared in the laboratory from chitin which was obtained from crab shells by adopting reported method. The removal of dye was carried out by batch adsorption method under the optimized conditions of amount of adsorbent, stay time, temperature and dye concentration. Spectrophotometric technique was adopted for the measurement of concentration of dye before and after adsorption. Adsorption data was fitted in Freundlich and Dubinin-Radushkevich adsorption isotherm equations. The values of the corresponding constants were evaluated from the slope and intercept of their respective plots. Thermodynamic parameters such as free energy (ΔGo), enthalpy (ΔHo), and entropy (ΔSo) of the system were also calculated by using distribution coefficient KD. From the percent removal data, it was concluded that chitosan-rice husk (CRH) and chitosan- wheat husk (CWH) systems showed about 83 and 79% removal tendency respectively. Chitosan itself act as a good adsorbent and its derivative with rice and wheat husk (mainly cellulose) show high removal tendency and may be used as low cost biosorbents for the removal of pollutants from the industrial effluent.Keywords: Adsorption, reactive red 195 dye, chitosan, rice husk, wheat hus

COMPARATIVE PRODUCTIVE PERFORMANCE AND EGG CHARACTERISTICS OF PULLETS AND SPENT LAYERS

Production performance and egg quality characteristics of pullets and spent layers were compared in this study. Forty birds, each from the flocks of pullets (24 weeks old) and spent layers (76 weeks old) were selected as experimental birds. The birds from each age group were divided into five replicates, each comprising of eight birds. All the experimental birds were fed a commercial layer ration @ 110g/bird/day for 12 weeks. The data on egg production, feed consumption, egg weight and egg quality characteristics viz. shell thickness, shell weight, breaking strength, albumen diameter, albumen weight and yolk weight were recorded. The data thus collected were utilized for calculation of FCR, Haugh unit and yolk index values. The results revealed that pullets produced more eggs and utilized their feed more efficiently than spent layers. However, egg weight in spent layers was higher than in their counterparts. Pullets also produced eggs with thicker shell and higher Haugh unit values when compared to the spent layers. Feed consumption and yolk index values remained unaffected due to the age. Pullets also had better egg quality characteristics than those of spent layers

The nexus between Basel capital requirements, risktaking and profitability: what about emerging economies?

The study examines the nexus between Basel capital requirements, banking sector risk-taking, and profitability in Asian emerging markets by using dynamic panel GMM methodology. The findings of the study suggest that regulatory capital positively affects risk-taking which validates the “regulatory hypothesis.” The findings also reveal that regulatory capital positively while risk negatively affects the profitability in the banking sector. The current study finds the bidirectional causality between the regulatory capital and risk-taking, implying that banks with higher capital ratios are expected to increase in risk-taking and vice versa. The findings also suggest that managerial ownership positively affects while foreign ownership negatively impacts risk-taking consistent with the agency theory of corporate governance. The study proposes that ownership structure has a significant influence on bank risk and profitability, however, the combined impact of regulatory capital through its interaction with the ownership structure is not proved to be significan

Warm-e-Lauztain (Tonsillitis): Diagnosis and Management with reference to Unani System of Medicine

Warm-e-Lauztain (Tonsillitis) being very common clinical condition affecting mostly the school going children is the one of the important reason to visit a doctor frequently. Diagnostic features and findings on clinical examination are described very clearly in classical texts of Unani medicine, e.g.  if the tonsillitis is caused due to abnormality of khilt-e-dam (humour sanguine), it is expressed by severe pain in the throat, fever, redness of eyes and face, sweetish taste in mouth etc.; if it is due to khilt-e-safra (humour bile), then it is characterized by severe pain in the throat, difficulty in the swelling, high grade fever, dryness, paleness of face; if there is imbalance in khilt-e-balgham (humour phlegm), there will be soft whitish swollen tonsils associated with paresis and softness of the tongue; tonsillitis due to the abnormality in khilt-e-sauda (humour black bile) exhibit hard swelling of tonsils encroached into the tongue and surrounding tissues. On examination, if there is much congestion and redness on the tonsils or it is black in colure and hard in consistency then surgical procedure should be avoided. Always first emphasis should be given for medical treatment, if it fails then opt surgical management. When the acute inflammation (warm-e-haar) has been subsided and the base of swelling is soft and thin, than it is suitable time for tonsillectomy. Surgical procedure is also described by Abu Al-Qasim Al-Zahrawi and others in detail. Therefore it may be concluded that scholars of Unani medicine were much aware about the signs & symptoms of chronic tonsillitis; they were able to diagnose the disease clinically and were expert enough to assess the condition, whether requiring medical management or surgical intervention. Surgeons of that time knew clear-cut indications and contraindications for surgical intervention along with the procedure of tonsillectomy Keywords: Warm-e-lauztain, Tonsillitis, Unani classical, Treatment, surger