Pregnancy Outcome in Patients with Solitary Kidney

Background

Solitary kidney may be congenital or as a result of nephrectomy. There is a lot of literature available on quality of life in these patients, but there is limited data on pregnancy outcome.

Objectives

To study pregnancy outcome in patients with solitary kidney either congenital or due to nephrectomy.

Materials and Methods

Study Design This is a retrospective observational study conducted at tertiary health center in Ahmedabad, from 2011 to 2014. Sample Size There were 164 patients of solitary kidney, out of which two patients had congenital solitary kidney and the remaining had solitary kidney due to nephrectomy. Among 164 patients, 96 (58.53 %) patients had completed family, 37 (22.56 %) patients did not try for pregnancy, 15 (9.14 %) patients have conceived, 12 (7.3 %) were lost to follow up and 4 (2.43 %) patients were infertile. Method Patients in reproductive age group (20–40 years), with solitary kidney either congenital or due to nephrectomy, were included. Maternal and fetal outcome was studied, and patients were followed up till 2 years postpartum. Exclusion Criteria Patients with solitary kidney due to post-renal transplant were excluded.

Results

There were 15 (9.14 %) patients who had conceived, out of which 11 (73.33) patients delivered and 4 (26.67 %) patients had spontaneous abortion. Two patients developed gestational hypertension and one had preeclampsia. On follow-up, all babies were normal and none of them had delayed developmental milestones.

Conclusion

Preconceptional counseling should be done in these patients regarding risk of developing preeclampsia during pregnancy and preterm delivery. These patients can have good pregnancy outcome with close monitoring during antenatal period.

     

Temperamental traits associated with conversion disorder

The aim of this study was to analyze the temperamental traits associated with conversion disorder in children. Thirty children with conversion disorder attending a child guidance clinic were compared with an age and sex matched control group of normal children for life stresses and temperament dimensions. The temperament measurement schedule (TMS) and the life event scale for Indian children (LESIC) were used for evaluating the temperament dimensions and life stresses respectively. Children with conversion disorder experienced significantly more stressful life events compared to the children in the control group. The stress factors included scholastic difficulties, examination failures, punishment by teacher, conflict with peers, parental disharmony and family problems and sibling rivalry. The characteristic temperamental traits associated with conversion disorder were low emotionality and low threshold of responsiveness.     

Coronary vasospasm: A narrative review

Coronary artery vasospasm (CAVS) plays an important role in acute chest pain syndrome caused by transient and partial or complete occlusion of the coronary arteries. Pathophysiology of the disease remains incompletely understood, with autonomic and endothelial dysfunction thought to play an important role. Due to the dynamic nature of the disease, its exact prevalence is not entirely clear but is found to be more prevalent in East Asian and female population. Cigarette smoking remains a prominent risk factor, although CAVS does not follow traditional coronary artery disease risk factors. Many triggers continue to be identified, with recent findings identifying chemotherapeutics, allergens, and inflammatory mediators as playing some role in the exacerbation of CAVS. Provocative testing with direct visualization is currently the gold-standard for diagnosis, but non-invasive tests, including the use of biomarkers, are being increasingly studied to aid in the diagnosis. Treatment of the CAVS is an area of active research. Apart from risk factor modification, calcium channel blockers are currently the first line treatment, with nitrates playing an important adjunct role. High-risk patients with life-threatening complications should be considered for implantable cardioverter defibrillator (ICD), although timing criteria for escalated therapy require further investigation. The role of pharmaceuticals targeting oxidative stress remains incompletely understood.     

Analytic methods for colorectal cancer

Colorectal cancer (CRC) is a major cause of morbidity and mortality from cancers in the United States. The field of molecular epidemiology is in the forefront in the discovery of genes associated with the development and progression of complex diseases such as CRC, including hereditary CRC, and polyposis syndromes such as familial adenomatous polyposis and hereditary nonpolyposis colon cancer. Recent advances in laboratory methods (ie, high-throughput genotyping and high-density single nucleotide polymorphism chips, etc.) allow the molecular epidemiologist to elucidate biological determinates of disease. However, with these advancements in the lab, advances in modeling and testing of such data are needed as well. Herein, we review the current analytical methods that have been applied to molecular epidemiologic studies for CRC and hereditary nonpolyposis colon cancer within the past 2 years, comment on the application of these methods, and examine new and promising tools that will likely influence the discovery of gene-gene and gene-environment interactions and development of pathway-based analytical approaches for CRC risk and progression.     

Fermentation and antimicrobial activities of extracts from different species of fungus belonging to Genus, Trichoderma

The present paper discusses the effects of the crude extracts of Trichoderma spp. on a number of fungal and bacterial organisms. These include Paecilomyces variotii, Penicillium notatum, Nematospora corylii, Mucor miehei, Bacillus brevis, Bacillus subtilis, Enterobacter dissolvens and Sarcina lutea. The culture broth extracts of different isolates of Trichoderma harzianum, T. longibrachiatum and T. koningii cultured in different media were investigated individually for in-vitro antifungal and antibacterial activities by agar diffusion technique. The culture broth extracts of T. harzianum produced definite antifungal and antibacterial activities against most of the test organisms. The results indicate that the extracts were fungicidal and antibacterial at a concentration of 100 microg per 6mm paper disks. Trichoderma harzianum showed the highest activity while T. koningii showed the least activity against most of the test organisms especially the yeast Nematospora coryli. The results of this study indicate that the Trichoderma species especially T. harzianum is a possible source of useful antimicrobial agents against pathogenic microorganisms which include gram-negative, gram-positive, fungi and yeasts.