Successful pregnancy after recurrent hysteroscopic polypectomy

This case demonstrates that hysteroscopic polypectomy can enhance fertility. A 35-year-old woman was being evaluated for assisted conception. She was referred from an in vitro fertilisation clinic for polypectomy, which she had undergone on two occasions. She conceived spontaneously, had an uneventful antenatal period, and delivered a healthy baby at 39 weeks' gestation.     

The clinical and biochemical effects of vitamin C supplementation in short-stay hospitalized geriatric patients

A double-blind placebo trial has been undertaken on 199 elderly patients admitted to an "acute" geriatric assessment ward. Clinical and biochemical assessment was made on admission (0) and at 2, 4, 8, 16 and 24 weeks (after admission). Ninety-four patients were supplemented with vitamin C (200 mg per day) and 105 had placebo tablets. Biochemical assessment included estimations of plasma and leucocyte (buffy layer) vitamin C, plasma folate, vitamin B12, cortisol and total white cell count. Plasma and leucocyte vitamin C levels remained low for several weeks in a substantial proportion of the non-supplemented patients, whereas low levels were virtually eliminated in the supplemented group. The results from this study suggest that the leucocyte vitamin C levels may give some indication of prognosis in this category of patients (ie. "acute" geriatric admissions) as evidenced by: i) the significantly higher mortality rate during the trial period of patients who started with low initial leucocyte vitamin C levels compared with those starting with higher levels, despite similar mean initial "severity of illness scores" between the two groups. ii) the marked trend, amongst placebo subjects, for those commencing the study with higher leucocyte vitamin C levels to fare better, in terms of progression to "well", than those starting with low levels. Amongst subjects starting with low leucocyte vitamin C levels, there was a trend for "vitamin C" subjects to have fared better by 8 weeks than "placebo" subjects. This again occurred despite similar mean initial "severity scores" between the two groups. Amongst subjects diagnosed with respiratory infections there was some tendency for supplemented patients to fare better than unsupplemented patients. Low leucocyte vitamin C levels, on admission, appear to be predictive of poor subsequent prognosis in elderly hospitalised patients. Results from this trial suggest that supplementation with a moderate dose of vitamin C may improve this prognosis and larger trials with greater numbers appear to be merited to confirm or deny this hypothesis.     

Catastrophic familial rhabdomyolysis: compartment syndrome with muscle fiber regeneration

Two reports of patients with rhabdomyolysis are described. Patient 1 was a 4-year-old-girl who had a 48-hour history of pyrexia and a 24-hour history of vomiting, drowsiness, polydipsia oliguria, and back pain. She could not walk easily because of tenderness in the calves. She was treated with furosemide and dopamine. On day 9, she was mobilized with the aid of physiotherapy. After 2 years, she tired easily but could walk normally. Patient 2 was a 3-year-old girl who had a 24-hour history of general malaise, peripheral aches and pain, and increasing drowsiness. She had severe swelling in the calves. Full-leg four compartment fasciotomies were performed on both calves. After patient 2 healed, she was observed to have muscle regeneration, which is very rare.     

Effect of soybean fortification on Ghanaian fermented maize dough aroma

The effect of soy fortification on the development of aroma compounds, dough acidity and growth of the predominant microorganisms were investigated in Ghanaian maize dough fermented spontaneously over a period of 72 h. The fortified maize dough was prepared from a milled mixture of soaked maize grains and pre-soaked, blanched and dehulled soybeans added at 20% replacement level. Extracts of volatiles from the soy-fortified and unfortified dough samples were obtained by Likens–Nickerson simultaneous distillation and extraction method analysed by gas chromatography-mass spectrometry and gas chromatography-olfactometry (gas chromatography-sniffing). Major aroma compound groups identified in the fermented dough samples were carbonyls, alcohols, esters and volatile organic acids. Twenty-nine carbonyls were found in soy-fortified maize dough compared with 21 in the unfortified dough. Although the same alcohols were found in both dough samples, the total concentration of alcohols was slightly different, being less for the soy-fortified sample. Total concentration of esters in soy-fortified dough decreased after 72 h while levels in the unfortified dough increased. Increases in the production of lactic and acetic acids occurred in soy-fortified samples, but the maximum concentrations of acetic acid achieved did not differ significantly between the two types of dough. Twenty-three compounds were perceived to be contributing to the typical aroma of soy-fortified maize dough by the method of gas chromatography-sniffing. These included 12 carbonyls, six alcohols, two esters, two acids and one furan.     

Future desire for children among women living with HIV in Atlanta,Georgia

Little is known regarding family planning desires among women living with HIV in the United States. This study aimed to identify factors influencing desire for children in the future among HIV-infected women in Atlanta, Georgia. HIV-infected women ages 18–45 completed an ACASI (audio computer-assisted self-interview) questionnaire. Chi-square, t-tests, and multivariate logistic regression evaluated factors associated with desire for future children. Of 181 participants, 62 (34.3%) expressed desire for children in the future, with increased desire among younger women (age <26) and those with seronegative partners. Concerns for horizontal and vertical HIV transmission were deterrents to future childbearing. Condom use and overall knowledge of transmission risk was low. Over a third of women desiring a child never discussed their desire with a physician. Misinformation regarding HIV transmission risks persists and is a notable concern influencing desire for children. Providers should reassess family planning desires regularly through integrated HIV care.