Effects of cabergoline on pregnancy and embryo-fetal development: retrospective study on 103 pregnancies and a review of the literature

The aim of the study is to assess the rate of any potential adverse effects on women who became pregnant under cabergoline (CAB) treatment and to evaluate any effects on the embryo-fetal development and on children who were born from mothers exposed to CAB in early weeks of gestation. Observational, retrospective and multicenter study on 103 pregnancies in 90 women with hyperprolactinemia. All patients were under CAB at conception. Serum prolactin at baseline was between 30 and 1921 ng/ml. Duration of therapy before pregnancy ranged from 1 to 120 months and doses ranged from 0.125 to 5 mg/week. Fetal exposure ranged from 3 to 25 weeks, 96.9% of patients received CAB during the first trimester of pregnancy and the rest until the second one. No significant complications during pregnancy were found. Seven women (7.2%) had spontaneous abortions. Preterm deliveries were recorded in eight (8.8%), only one with low weight for gestational age. Neonatal abnormalities were observed in 3 (3.6%): 1 major (Down syndrome) and 2 minor malformations (umbilical and inguinal hernia). We were able to asses the children’s development in 61. Two had epilepsy and two had Pervasive Developmental Disorder (PDD). No significantly higher frequency of complications was found in pregnancies and/or offspring exposed to CAB than in the normal population. We registered 2 abnormalities in the development of the children: epilepsy and PDD. Larger series of patients are needed to assess the safety of this drug during pregnancy.     

Diabetes foot ulceration in a Nigerian hospital: in‐hospital mortality in relation to the presenting demographic,clinical and laboratory features

This prospective study assessed in‐hospital mortality from diabetic foot ulcer in relation to the demographic, clinical and laboratory features at presentation. Forty‐two patients admitted with diabetic foot ulcer were followed up from admission till discharge from hospital. Those who survived or died were compared for any differences in demographic, clinical and laboratory parameters at presentation. The mean age and duration of diabetes for the 42 patients were 56.1 ± 1.9 years and 8.3 ± 1.1 years, respectively. The in‐hospital mortality rate amongst the 42 subjects was 40.5%. Ulcer grade 4, leucocytosis and anaemia were more prevalent in those who demised in comparison with survivors.     

Emotional distress is associated with poor self care in type 2 diabetes mellitus

Background: The aim of the present study was to evaluate possible clinical and psychosocial variables that influence diabetes self‐care management in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 150 individuals with T2DM who had had diabetes for at least 6 months were recruited to this cross‐sectional study. Levels of self‐care and psychosocial status were determined using the Self‐Care Inventory (SCI) and Problem Areas in Diabetes (PAID) scale. The PAID scores were calculated using a five‐point Likert scale with options ranging from 0 (not a problem) to 4 (serious problem). Data were evaluated using non‐parametric and parametric tests as appropriate. Results: The mean age of the study participants was 69.97 ± 8.68 years. Cronbach’s α for SCI and PAID scores was 0.85 and 0.98, respectively. People with poor glycemic control had significantly higher mean (±SD) total PAID scores than individuals with good glycemic control (29.5 ± 30.9 vs 16.7 ± 26.9, respectively; P = 0.012). There was a significant relationship between PAID scores and glycemic control (r = 0.2; P = 0.012). Conclusions: The present study demonstrates that psychosocial factors directly influence glycemic control and diabetes self‐care habits. In addition, diabetes‐specific distress in study population was unrelated to the duration of diabetes, the age of the patients and anthropometric indices.     

Case Report: Saw-Scaled Viper Bites in Sri Lanka: Is It a Different Subspecies? Clinical Evidence from an Authenticated Case Series

The saw-scaled viper (SSV) (Echis carinatus) is considered to be a highly venomous snake in Sri Lanka despite any published clinical justification. Being a rarity, the clinical profile of SSV bites is not well established in Sri Lanka. We report a series of 48 (n-48) SSV bites from the Northern Province of Sri Lanka. The majority (65%) of victims had evidence of local envenoming at the site of the bite; however, 29% showed spontaneous bleeding and 71% had coagulopathy. There were no deaths in the series. The envenoming was mild in contrast to the mortality and significant morbidity associated with SSV bites in West Africa and some parts of India. These observations need to be further explored with laboratory studies to identify the venom components, study of morphological characteristics, and genetic profiling of the Sri Lankan SSV to see if it is different from the subspecies found elsewhere.     

A Review of Clinical Pattern and Outcome of Vesicovaginal Fistula

ObjectivesThe aim of this study was to determine the incidence, sociodemographic parameters, and outcome of surgical repairs of obstetric fistula in our center.MethodsCase files of patients managed for genital tract fistula over a 10-year period (January 1, 1997 to December 31, 2006) were retrieved and analyzed.ResultsFifty-five patients with of genital tract fistula were managed in the period under review, constituting 1.17% of total gynecological admissions. Obstetric fistula accounted for 51 (93%) of genital fistula, and 92.7% of cases were caused by prolonged obstructed labor. The most common form of fistula was the midvaginal type, and 89% of affected women were married with primiparous women mostly affected (43.6%). Menstrual function was lost in 51% of the patients, while obstetric palsy complicated 18.2% of the cases. Half of the women (51%) were abandoned by their spouses, and surgical repair was successful in only 32% of the cases.ConclusionObstetric fistula continues to show the deficiency in women’s general health status occasioned by poor childbirth attendance in developing countries. Affected women suffer double jeopardy as a result of dearth of appropriate experts in fistula repair.     

Safety and efficacy of misoprostol for induction of labour in a semi-urban hospital setting.

Most studies on the use of misoprostol for induction of labour have been carried out in well-endowed hospitals in developed countries with state-of-the-art monitoring equipment. There is need for more studies to be conducted in facilities with limited resources, if more patients are to benefit from the low cost and effectiveness of the drug. Following Ethical Committee approval, 152 women had labour induced in our maternity unit using intravaginal misoprostol. The patients were monitored clinically using the WHO model partograph with digital palpation of uterine contractions and intermittent auscultation of fetal heart with a pinard stethoscope. One hundred and thirty-five (88.8%) of the women had a vaginal delivery, while nine (5.9%) had a caesarean section for various obstetric indications. Eight cases of uterine hyperstimulation were noted but none of uterine rupture. We conclude that misoprostol can be used safely for induction of labour in less endowed hospital settings such as in developing countries, using basic clinical tools for monitoring.     

Evaluation of the corrosion inhibition effect of the combined admixture of rosemary and cinnamon cassia oil on mild steel in weak acid electrolyte

The corrosion resistance of mild steel (MS) in 0.5 M H₂SO₄ and HCl solution with specific concentrations of the intermixture of rosemary and cinanamon cassia essential oil extracts (RCC) was studied by potentiodynamic polarization method, open circuit potential analysis (OCP) and optical macroscopy. Information obtained showed RCC effectively inhibited MS corrosion from the lowest to the highest concentrations in both acids with lowest inhibition result of 95.30% and 94.19%, and highest inhibition efficiency of 99.21% and 97.69%. RCC exhibited dominant cathodic inhibition effect in H₂SO₄ due to suppression of the reduction reactions while in HCl RCC displayed mixed inhibition properties due to surface coverage effect in the presence of Cl^? anions. OCP showed RCC increased the thermodynamic tendency of MS to corrosion in H₂SO₄ solution despite effective inhibition performance with significant electronegative shift in corrosion potential. In HCl significant electropositive potential displacement was observed relative to the potential of the control MS due to adsorbed protonated RCC molecules unto the steel. Adsorption of RCC molecules on MS aligned with Langmuir, Frumkin and Freundlich isotherm models through chemisorption mechanism in both acids with average correlation coefficient value above 0.9. Optical images of MS in both acids without RCC showed severe surface degradation with the degree of degradation being higher from H₂SO₄ solution. Optical images from RCC inhibited steel depict effective surface protection.     

Improving quality of family life among Christian parents of children with low vision in Nsukka catholic diocese using rational emotive family health therapy

Background:Most Christian parents living with children with low vision have reported to be experiencing psychological disturbances that are affecting the family health. As a result, the quality of family life is being impaired. The experience of parents catering for children with low vision is mainly influenced by psychosocial factors that could determine the quality of family life of such parents. This present study is to investigate the efficacy of rational emotive family health therapy in reducing poor quality of family life among Christian parents of children with low vision in Nsukka Catholic Dioceses.Method:This is a randomized pretest and posttest control trial. Participants were 88 parents of children living with low vision in Nsukka Catholic Dioceses, Nigeria. The power of the sample size was determined using Gpower statistical software. The participants in rational emotive family health therapy programme-group were exposed to a 12-session treatment programme whereas their counterparts in waitlisted control group did not receive anything. A family quality of life scale was utilized in assessing the participants. Data analyses were performed using repeated measures ANOVA.Results:It was found that rational emotive family health therapy had a significant positive effect on increasing quality of family life among the study participants compared to those in the waitlisted control group.Conclusion:This study contributed and validated the efficacy of rational emotive family health therapy in improving quality of family life among parents of children with low vision.