Non-surgical treatment of ectopic pregnancy

In the past few decades, ectopic pregnancy has been termed by medical practitioners has a global epidemic. With the questions lingering on everbody minds how this menace can be tamed. In a bid to reduce the mortality and financial burden brought by this evolving growing health concern, the medic has developed non-surgical alteratives to deal with ectopic pregnancy, i.e., treatment using methotrexate. In a bid to explore this topic further, these study goals were to share the experience of treating mothers who have un-ruptured ectopic pregnancies traditionally. Mothers who were found to have an ectopic pregnancy and fit the medical care were encompassed in the program, a total of 37 women. For instance, those with serum beta HCG in the range of 1000 mIU per liter were treatment expectantly whereas those with a level more than a thousand were given an injection of methotrexate. To monitor the response of experiment, beta HCG levels were monitored for each mother. The results of the current study established that 88.0% of women who underwent the study, only 12.0% of them exhibited full rsolution while the remaining lot resolved only after a sole dose of methotrexate. From the results of this study, it is evidently clear that a lot of pregnant mothers would be greatly helped if they are enrolled in such therapy at early days

Serum osteocalcin in subjects with metabolic syndrome and central obesity.

AIMS: The aim of this study was to determine if osteocalcin is related to adiposity and hyperglycaemia in metabolic syndrome irrespective of the presence of diabetes mellitus. MATERIALS AND METHODS: This was a cross sectional study of 90 patients (59 men and 31 women) with metabolic syndrome as defined by the International Diabetes Federation criteria. Based on medical history 50 out of 90 patients had a diabetes. Anthropometric data were collected and blood taken for measurement of osteocalcin, fasting lipids, fasting glucose and insulin resistance (using homeostatic model assessment index, HOMA-IR). RESULTS: Osteocalcin correlated negatively with fasting glucose (r=-0.366, p<0.001) and HOMA-IR (r=-0.305, p<0.05) but not with waist circumference (r=0.079), body mass index (r=0.028), total cholesterol (r=0.061) or triglycerides (r=0.009). Diabetics had higher HOMA-IR (p<0.01) and lower osteocalcin levels (p<0.01) than non-diabetics. Among diabetics, osteocalcin correlated with glucose only (r=-0.341, p=0.015). In non-diabetics, osteocalcin correlated with HOMA-IR (r=-0.359, p=0.023) via insulin (r=-0.402, p=0.010). Patients with impaired fasting glucose levels (5.6-6.9mmol/L) had the same HOMA-IR as diabetics (p=0.076) but not low osteocalcin (p=0.025). CONCLUSIONS: In this cross-sectional study of subjects with metabolic syndrome and central obesity, low osteocalcin was associated with diabetes but not adiposity.

Lambda light chain myeloma with co-migrating paraprotein at beta region on agarose gel electrophoresis: a case report.

Paraproteinemia is one of the diagnostic features of multiple myeloma. A commonly used method is the detection of paraprotein by agarose gel electrophoresis (AGE) followed by by immunofixation electrophoresis (IFE) to confirm monoclonality. Due to their smaller size, immunoglobulin A (IgA) and light chain only paraproteins may appear at the beta or even alpha 2 protein fractions. Here, we discuss a case report of a 47-year-old man who presented with pathological fracture of third thoracic (T3) vertebra. Serum protein electrophoresis (SPE) was initially reported as no paraprotein detected. However, a bone biopsy was reported to show plasma cell proliferation with light chain restriction. A repeat sample for protein electrophoresis together with IFE revealed lambda light chain paraprotein co-migrating at the beta region. The beta band plus paraprotein was quantitated as 4.3 g/L (7.0%), which was within normal limits of the beta protein fraction. Hence, it has to be remembered that if the SPE is negative, it does not necessarily mean that the paraprotein is absent in cases which are highly suspicious.

Blood flow characteristics of the human lactating breast.

BACKGROUND: Despite the increased metabolic activity of the lactating breast, no studies have been carried out to determine mammary blood flow (MBF) parameters or the relationship between MBF and milk production in women. The aim of this study was to measure the MBF in the internal mammary artery (IMA) and lateral thoracic artery (LTA) of lactating women and determine if these were related to milk production. METHODS: Blood flow in the IMA and LTA was measured with color Doppler ultrasound in 55 lactating women. Twenty-four-hour milk production was determined with the test-weigh method. RESULTS: IMA contributed the greater proportion of blood flow to the lactating breast (70%). MBF was highly variable between women but consistent between the left (126 L/24 h; interquartile range, 76-169) and right (110 L/24 h) breasts. No relationship between MBF and milk production was demonstrated. For 3 women, MBF was markedly reduced in 1 breast that was synthesizing almost no milk compared to the other that was producing a normal volume of milk. DISCUSSION: Although no relationship between MBF and milk production was found, the substantial reduction in blood flow in the breasts of lactating women producing almost no milk suggests a threshold below which milk production is compromised. CONCLUSION: Doppler ultrasound did not demonstrate a relationship between MBF and milk production in lactating women. Further investigation is required to fully understand the role of blood flow in milk synthesis.