ABSTRACT
Introduction Neonatal mortality is a major challenge in low-middle-income countries. The current study was conducted to assess the association between preterm cesarean delivery and fetal outcomes. Methods A prospective study was conducted at the Combined Military Hospital in Peshawar, Pakistan, from October 1, 2020, to March 31, 2021. All women reporting to the hospital with a cephalic presentation and singleton pregnancies between the 27th and 34th weeks of gestation were included in the study. Pregnancies with an abnormal presentation, those diagnosed with a congenital abnormality, and those with indications for growth restriction or preterm delivery were excluded from the study. We also excluded infants delivered via vacuum or forceps. The outcomes of interest in this study included neonatal death prior to discharge, neonatal respiratory distress, sepsis, intraventricular hemorrhage (IVH), seizure, subdural hemorrhage (SDH), or appearance, pulse, grimace, activity, and respiration (APGAR) test score of less than 7 at five minutes. Maternal features including diabetes, hypertension and gestational age of delivery, parity, previous cesarean sections (CS), and last pregnancy outcomes were documented in a predefined pro forma. Results Our sample size consisted of 288 women, who were classified into two groups. Group A comprised 144 women who gave birth vaginally and group B consisted of 144 women who underwent CS. It was observed that women who underwent cesareans had a higher likelihood of a history of hypertension and related pathologies. It was also observed that these women had a greater likelihood of being of higher age compared to women who underwent vaginal deliveries. Neonates of women who had CS were at a greater risk of presenting with respiratory distress than those who had spontaneous vaginal deliveries. Conclusion Based on our findings, respiratory distress was significantly more common in babies of women who delivered via CS. However, there was no difference in neonatal outcomes in terms of IVH, seizures, SDH, and APGAR score of <7.
ABSTRACT
Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer and is on the rise. Most BCCs are benign; however, a very small percentage are locally advanced and metastatic. The pathway that normally regulates cell growth and proliferation is directed by the hedgehog pathway (HP). In BCC, it becomes over-stimulated due to genetic abnormalities. Treatments for BCC include local treatment by cryotherapy (liquid nitrogen), topical immunosuppression, surgery, or radiotherapy. Systemic treatment may be required in locally advanced lesions, metastatic BCC, or individuals who are inoperable. The systemic treatments of BCC act to inhibit the HP and are called hedgehog pathway inhibitors. The first one being vismodegib and the second sonidegib. Although these treatments have shown promising results, they have prominent side effects in almost all patients, with few patients having to discontinue the treatment. About 50% of patients did not respond to treatment from the beginning, some had partial responses, others had recurrence after discontinuing the drugs, and few had worsening of the disease. In this paper, we will explore the most common side effects, resistance, and different methods to overcome resistance to ensure the highest rate of cure for BCC.
ABSTRACT
Introduction Adult-onset type 2 diabetes mellitus (T2DM) is defined as a chronic hyperglycemic state, characterized by insulin resistance and declining islet B-cell function, eventually leading to islet B-cell function failure. The present study evaluated the association of T2DM with the type of blood group. Methodology A case-control study was conducted from April 2020 to September 2021 in Karachi, Pakistan. An electronic questionnaire was used to determine if there is an association between ABO blood groups and type 2 diabetes mellitus. Our study involved two groups with an equal number of participants. The patient group contained participants who had been diagnosed with type 2 diabetes mellitus, whereas the control group contained participants who had never been diagnosed with type 2 diabetes mellitus. Information was collected through a self-administered electronic questionnaire which was circulated through social media. Results The mean ± SD age was reported to be 25.98 ± 12 years. The study found a significant association between blood group B and type 2 diabetes mellitus (p=0.006), whereas a negative association was seen between the blood group O and type 2 diabetes mellitus (p=0.001). It should be noted, however, no significant association was found between the blood groups A and AB and type 2 diabetes mellitus (p>0.05). Conclusion The results of this study indicate that there is an association between type 2 diabetes mellitus and the ABO blood group system; a significant association was found between blood group B and risk of type 2 diabetes mellitus (T2DM). Nevertheless, we recommend regular screening for T2DM in individuals with a high-risk profile. Those at risk can adopt measures that are beneficial for them in the long run such as dietary control and physical exercise. Further studies using explorative techniques with a diversified population are recommended.
