This study examined fibrinogen concentration and thrombin time (TT) levels in 195 pregnant women in Nigeria compared to 150 non-pregnant women. Fibrinogen concentration and TT were significantly higher in pregnant women compared to non-pregnant women. Fibrinogen concentration and TT levels increased with each trimester of pregnancy and were highest in the third trimester. The increases in coagulation factors during pregnancy are likely due to hormonal changes and inflammation of pregnancy to prepare the body for potential blood loss during childbirth. Baseline measurements of these coagulation factors during antenatal visits could help detect any abnormalities.
Cord blood TGF-α concentrations were measured in 160 pregnancies, including 110 appropriate for gestational age (AGA) and 50 intrauterine growth restricted (IUGR) cases. No significant differences were found in TGF-α levels between the IUGR and AGA groups. TGF-α levels were higher in vaginal deliveries compared to cesarean sections. The results suggest that cord blood TGF-α levels at term are not affected by IUGR and are increased by the stress of vaginal delivery.
The herbal formulation Hyponidd was found to be as effective as metformin in managing anovulatory PCOS women with insulin resistance by lowering insulin resistance and hyperandrogenemia without side effects. A comparison study found that both Hyponidd and metformin significantly reduced fasting insulin levels, insulin resistance indicators, and hyperandrogenemia markers. However, Hyponidd resulted in fewer side effects like nausea and diarrhea than metformin.
A 33-year-old man presented with gynecomastia and galactorrhea as initial symptoms of hyperthyroidism. Laboratory tests confirmed Graves' disease with high free thyroxine, suppressed TSH, and elevated anti-TSH receptor antibodies. Though rare, galactorrhea can occur in males with hyperthyroidism due to changes in estrogen and testosterone levels caused by thyroid hormones. The gynecomastia and galactorrhea resolved after successful treatment of the hyperthyroidism with methimazole, demonstrating the causal relationship between the thyroid condition and extra-thyroidal manifestations.
Methods: The current case-control study was conducted at Ain Shams University Maternity Hospital. The study included two groups of women: group A, including pregnant women with a history of unexplained recurrent miscarriage; and group B, including control pregnant women with no prior miscarriage. Women included in either group were at their first trimester of pregnancy (6-13 weeks of gestation). For all included women, 3-hour oral glucose test was performed. Serum insulin levels were measured at the same times. Markers of insulin resistance, including HOMA-IR, HOMA-B, AUCG and AUCI were calculated.
This study investigated whether the protein Lnk is involved in insulin resistance (IR) in polycystic ovary syndrome (PCOS). The researchers found that:
1) Lnk expression was higher in ovarian tissues from PCOS patients with IR compared to tissues from normal controls and PCOS patients without IR, mainly in follicular cells.
2) Lnk bound to and inhibited the insulin receptor and its downstream signaling molecules IRS1, Akt, ERK1/2 in response to insulin stimulation.
3) Overexpression of Lnk in ovarian cells inhibited insulin signaling and increased IRS1 phosphorylation, indicating Lnk plays a role in the development of IR in PCOS by inhibiting insulin signaling in the ovaries.
PATTERN OF DRUG PRESCRIBING DURING PREGNANCY IN NEPALESE WOMENPriyanka Shrestha
This study assessed the pattern of drug prescribing for 94 pregnant women in Nepal. The majority of women were aged 15-25 years. Most drugs prescribed were categorized by the FDA as category B, meaning they have been shown to have no evidence of risk in humans. The most commonly prescribed drugs were nutritional supplements like iron and folic acid, followed by antibiotics and antacids. Some category X drugs like oxytocin and dydrogesterone were prescribed, indicating potential teratogenic risk. Overall, the study provides insight into prescribing practices for pregnant women in Nepal.
Screening for and treatment of asymptomatic bacteriuria in high-risk pregnant women reduces the risk of preterm birth. However, routine screening of all pregnant women in the first trimester with urine culture is not currently recommended due to the low prevalence of asymptomatic bacteriuria in the general pregnant population and the costs of universal screening.
This study investigated transforming growth factor beta 1 (TGF-β1) concentrations in umbilical cord blood from pregnancies complicated by intrauterine growth restriction (IUGR) compared to appropriate-for-gestational-age (AGA) controls. The study found no significant differences in TGF-β1 concentrations between the IUGR and AGA groups. Higher TGF-β1 concentrations were associated with vaginal delivery and lower infant growth percentiles in the IUGR group. The results suggest TGF-β1 may be related to fetal growth but not directly involved in pathophysiological processes leading to IUGR.
Cord blood TGF-α concentrations were measured in 160 pregnancies, including 110 appropriate for gestational age (AGA) and 50 intrauterine growth restricted (IUGR) cases. No significant differences were found in TGF-α levels between the IUGR and AGA groups. TGF-α levels were higher in vaginal deliveries compared to cesarean sections. The results suggest that cord blood TGF-α levels at term are not affected by IUGR and are increased by the stress of vaginal delivery.
The herbal formulation Hyponidd was found to be as effective as metformin in managing anovulatory PCOS women with insulin resistance by lowering insulin resistance and hyperandrogenemia without side effects. A comparison study found that both Hyponidd and metformin significantly reduced fasting insulin levels, insulin resistance indicators, and hyperandrogenemia markers. However, Hyponidd resulted in fewer side effects like nausea and diarrhea than metformin.
A 33-year-old man presented with gynecomastia and galactorrhea as initial symptoms of hyperthyroidism. Laboratory tests confirmed Graves' disease with high free thyroxine, suppressed TSH, and elevated anti-TSH receptor antibodies. Though rare, galactorrhea can occur in males with hyperthyroidism due to changes in estrogen and testosterone levels caused by thyroid hormones. The gynecomastia and galactorrhea resolved after successful treatment of the hyperthyroidism with methimazole, demonstrating the causal relationship between the thyroid condition and extra-thyroidal manifestations.
Methods: The current case-control study was conducted at Ain Shams University Maternity Hospital. The study included two groups of women: group A, including pregnant women with a history of unexplained recurrent miscarriage; and group B, including control pregnant women with no prior miscarriage. Women included in either group were at their first trimester of pregnancy (6-13 weeks of gestation). For all included women, 3-hour oral glucose test was performed. Serum insulin levels were measured at the same times. Markers of insulin resistance, including HOMA-IR, HOMA-B, AUCG and AUCI were calculated.
This study investigated whether the protein Lnk is involved in insulin resistance (IR) in polycystic ovary syndrome (PCOS). The researchers found that:
1) Lnk expression was higher in ovarian tissues from PCOS patients with IR compared to tissues from normal controls and PCOS patients without IR, mainly in follicular cells.
2) Lnk bound to and inhibited the insulin receptor and its downstream signaling molecules IRS1, Akt, ERK1/2 in response to insulin stimulation.
3) Overexpression of Lnk in ovarian cells inhibited insulin signaling and increased IRS1 phosphorylation, indicating Lnk plays a role in the development of IR in PCOS by inhibiting insulin signaling in the ovaries.
PATTERN OF DRUG PRESCRIBING DURING PREGNANCY IN NEPALESE WOMENPriyanka Shrestha
This study assessed the pattern of drug prescribing for 94 pregnant women in Nepal. The majority of women were aged 15-25 years. Most drugs prescribed were categorized by the FDA as category B, meaning they have been shown to have no evidence of risk in humans. The most commonly prescribed drugs were nutritional supplements like iron and folic acid, followed by antibiotics and antacids. Some category X drugs like oxytocin and dydrogesterone were prescribed, indicating potential teratogenic risk. Overall, the study provides insight into prescribing practices for pregnant women in Nepal.
Screening for and treatment of asymptomatic bacteriuria in high-risk pregnant women reduces the risk of preterm birth. However, routine screening of all pregnant women in the first trimester with urine culture is not currently recommended due to the low prevalence of asymptomatic bacteriuria in the general pregnant population and the costs of universal screening.
This study investigated transforming growth factor beta 1 (TGF-β1) concentrations in umbilical cord blood from pregnancies complicated by intrauterine growth restriction (IUGR) compared to appropriate-for-gestational-age (AGA) controls. The study found no significant differences in TGF-β1 concentrations between the IUGR and AGA groups. Higher TGF-β1 concentrations were associated with vaginal delivery and lower infant growth percentiles in the IUGR group. The results suggest TGF-β1 may be related to fetal growth but not directly involved in pathophysiological processes leading to IUGR.
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is an open access international journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Preterm labor is a multifactorial problem that current treatment options address only symptomatically rather than causally. Preventative treatment with progesterone can lower preterm birth rates in high-risk groups by over 30%. Tocolysis using beta-adrenergic agonists like terbutaline and fenoterol can be used to prevent premature labor by relaxing the uterus. However, these drugs often cause side effects from activating the sympathetic nervous system.
Do Women With Polycystic Morphology Without Any Other Features of PCOS Benefi...Alex Swanton
Women with ovaries of polycystic morphology (PCO), without any other features of polycystic ovary syndrome(PCOS), respond similarly to women with PCOS when stimulated with exogenous gonadotrophins, and both groups share various endocrinological disturbances underlying their pathology.
Role of Dydrogesterone in repeated pregnancy lossNiranjan Chavan
Dydrogesterone has been shown to effectively treat recurrent pregnancy loss by modulating the immune system. It shifts the balance from a pro-inflammatory Th1 response towards an anti-inflammatory Th2 response by [1] inhibiting the production of Th1 cytokines IFN-γ and TNF-α and [2] inducing production of the Th2 cytokines IL-4 and IL-6. This results in improved pregnancy outcomes by supporting embryonic development. Clinical studies demonstrate dydrogesterone significantly reduces miscarriage rates in women with recurrent pregnancy loss.
The profile of infants born to mothers with subclinical hypothyroidism in a t...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Cell Deveolpment and Biology- A Study of Liver Regeneration CapacityNatasha A. Mahadeo
This document summarizes a research article that studied how pregnancy can restore the regenerative capacity of the aged liver. The study found that activating the Akt/mTORC1 pathway in older mice through chemical induction stimulated liver cell hypertrophy and improved regeneration, mimicking the effects of pregnancy. Inhibiting this pathway increased only cell proliferation. This suggests activating the Akt/mTORC1 pathway could be a therapeutic strategy for resolving age-related liver cell deterioration. The abstract and introduction provide background on cellular aging and loss of liver regenerative function in the elderly, as well as evidence that heterochronic parabiosis and pregnancy can increase cell proliferation in other aged tissues.
The document discusses insulin-like growth factor I (IGF-I) and insulin-like growth factor binding protein 3 (IGFBP-3), their roles in growth and metabolism, and emerging clinical applications of measuring their levels in serum. It covers background biochemistry, modern assay methods and reference ranges, and applications in conditions like cancer, heart disease, and growth hormone disorders like acromegaly and growth hormone deficiency.
The Women's Health Initiative (WHI) was a 15-year study from 1991-2010 that examined the effects of postmenopausal hormone therapy (HT) and lifestyle interventions on health outcomes in postmenopausal women. The WHI hormone therapy trials found that estrogen plus progestin therapy increased risks of heart disease, stroke, blood clots and breast cancer. Estrogen-alone therapy increased risks of stroke and blood clots but did not change heart disease risk. Subsequent research has found that risks may depend on factors like age at start of therapy, duration of use, and type of progestin used. Current recommendations are to use the lowest effective dose of HT for the shortest time to treat menop
This document summarizes a study that investigated levels of the cytokine IL-17A in Type 1 diabetes mellitus (T1DM) patients compared to healthy controls. Sixty T1DM patients and sixty healthy controls matched for age and sex were included. The mean age of patients was 16.32 years and most patients were between 10-19 years old. IL-17A levels were significantly higher in the sera of diabetic patients (1312.06 pg/ml) than in healthy controls (332.28 pg/ml). The study concludes that IL-17A may play an important role in the susceptibility or protection against the development of T1DM.
Journal Club - Assisted Reproductive Technology Outcomes in Female-to-Male Tr...Vharshini Manoharan
1) The study compared IVF outcomes between female-to-male transgender patients and cisgender patients matched for age, BMI, and AMH.
2) It found that transgender patients had a higher number of oocytes retrieved compared to cisgender patients, though they required a higher gonadotropin dose.
3) Among transgender patients who underwent embryo transfer, all achieved pregnancy and most had live births, providing support for fertility preservation and family building options for these patients.
1. Phytosterols are plant compounds similar in structure to cholesterol that have shown promise in treating various cancers. Studies in animal models and cell cultures have found that phytosterol supplementation reduced tumor growth and progression of breast, prostate, colon and other cancers.
2. Mechanisms by which phytosterols may treat cancer include inducing apoptosis of cancer cells, reducing oxidative stress, decreasing inflammatory cytokines and angiogenesis to cancer cells. Doses of 300mg per day have shown benefits, though most Americans consume only 80mg daily.
3. Further research is still needed to better understand long term effects and interactions with drugs, but initial animal and cell studies provide evidence that phytosterols may be a potential dietary intervention
This study investigated umbilical cord blood concentrations of the protein survivin in pregnancies complicated by intrauterine growth restriction (IUGR) or large-for-gestational age (LGA) babies due to gestational diabetes, and compared them to appropriate-for-gestational age (AGA) controls. The study found no statistically significant differences in survivin concentrations between the three groups. Additionally, survivin levels were independent of factors like birthweight, gestational age, gender, mode of delivery, and parity. The study concludes that cord blood survivin levels do not reflect disturbances in fetal-placental apoptosis seen in IUGR and LGA pregnancies.
A 15-year-old female presented to the emergency department with vaginal bleeding and weakness. She was found to have a hemoglobin of 2.4g/dL and pelvic examination revealed spontaneous discharge of blood, clots and grapelike spongy material. Surgical pathology confirmed a complete hydatidiform mole (molar pregnancy). She received blood transfusions and was taken urgently to the operating room for dilation and curettage. Molar pregnancies can present with vaginal bleeding and excessive beta-human chorionic gonadotropin levels, as seen in this case.
This document analyzes histomorphologic changes in placentas from pregnancies complicated by hypertension. Placentas from 50 normal pregnancies and 50 pregnancies with hypertension were examined. Microscopic analysis found significantly increased villous abnormalities in placentas from pregnancies with hypertension, including higher rates of syncytial knots, decreased vasculo-syncytial membranes, more fibrinoid necrosis, thicker basement membranes, and more villous stromal fibrosis. These findings suggest reduced blood flow in the placenta among pregnancies with hypertension, which can impact fetal and maternal health.
Experience of Metformin Use in Gestational Diabetes: Contribution to the DebateApollo Hospitals
This article discusses the experience of using metformin to treat gestational diabetes at a hospital in the UK. It summarizes the results of a retrospective study of 54 women treated with metformin between 2006-2009. The study found metformin was well tolerated with few adverse maternal or fetal outcomes. Only 7.4% discontinued metformin and 22% required supplemental insulin. Preeclampsia occurred in 3.7% of cases. Fetal outcomes like macrosomia and neonatal complications were also low. The article contributes to the debate around using metformin as an alternative to insulin for treating gestational diabetes.
1. The document provides information on the emergency contraceptive ulipristal acetate (UPA), including its mechanism of action, pharmacokinetics, clinical evaluations in randomized studies, contraindications, precautions, adverse reactions and drug interactions.
2. Key points include that UPA prevents pregnancy by inhibiting or delaying ovulation and altering the endometrium; clinical trials found it to be over 99% effective in preventing pregnancy when taken as directed within 120 hours of intercourse.
3. Common adverse reactions included headache, nausea and menstrual irregularities. UPA should not be used by women with current or history of certain cancers, liver disease or high risk of arterial or venous thrombotic diseases.
This document discusses the rational use of medications during pregnancy and breastfeeding. It provides examples from clinical practice and aims to better recognize and recommend avoiding medications that pose risks to the fetus, whether they are prescription or over-the-counter. Several online evidence sources that can be used to classify medication risk during pregnancy and breastfeeding are also presented. A case study example involves advising a pregnant patient on treatment options for urinary symptoms.
This study compared ovarian response, oocyte and embryo quality, and pregnancy rates between PCOS and non-PCOS patients undergoing IVF. The main findings were:
1. PCOS patients had more follicles on the day of retrieval but fewer mature oocytes and top-quality embryos compared to non-PCOS patients.
2. The recovery rates of oocytes and mature oocytes per follicle were lower in the PCOS group.
3. Pregnancy rates were comparable between the two groups despite differences in ovarian response and embryo quality.
Updates on management of Adolescent PCOS An evidence based approachAboubakr Elnashar
This document discusses guidelines for the management of adolescent polycystic ovary syndrome (PCOS) from an evidence-based perspective. It covers the diagnosis, evaluation, and treatment of adolescent PCOS according to guidelines from various medical societies. For diagnosis, the guidelines emphasize avoiding a premature diagnosis and monitoring for physiological changes versus PCOS. Evaluation involves screening for comorbidities like obesity, depression, sleep disorders, diabetes and cardiovascular risk. Treatment options include lifestyle changes, hormonal contraceptives, metformin, and sometimes a combination depending on the individual's age, symptoms and risks.
Hyperemesis Gravidarum is a condition of severe nausea and vomiting during pregnancy that can lead to weight loss and nutritional deficiencies. It is associated with multiple pregnancies, certain fetal conditions, and other issues. Treatment involves managing triggers, dietary changes, medications like antihistamines, dopamine receptor antagonists, and serotonin antagonists. Intravenous fluids and supplementation of vitamins and minerals is also important to prevent complications like Wernicke's encephalopathy. Enteral nutrition through nasojejunal feeding or nasogastric tubes may be preferable to parenteral nutrition via central lines due to lower risks of infections and thromboembolism.
Obstetric outcomes associated with second trimester unexplained abnormal mate...Apollo Hospitals
1) To compare the adverse obstetrical outcomes in the patient population with normal blood MoMs.
2) To determine the probability of occurrence of an adverse obstetric event in relation with abnormal maternal blood
analytes.
Subclinical hypothyroidism in patients with recurrent early miscarriageMohamed Ashour
This study assessed the prevalence of subclinical hypothyroidism in Egyptian women with recurrent early miscarriage. The study included 150 women with recurrent early miscarriage and 150 control women with at least one successful pregnancy. Thyroid function tests found subclinical hypothyroidism in 8.0% of women with miscarriage and 4.7% of controls, which was not a statistically significant difference. Logistic regression also found no significant association between subclinical hypothyroidism and recurrent early pregnancy loss after adjusting for potential confounding factors. The study concluded that subclinical hypothyroidism does not appear to be a significant risk factor for recurrent early miscarriage in this population.
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is an open access international journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Preterm labor is a multifactorial problem that current treatment options address only symptomatically rather than causally. Preventative treatment with progesterone can lower preterm birth rates in high-risk groups by over 30%. Tocolysis using beta-adrenergic agonists like terbutaline and fenoterol can be used to prevent premature labor by relaxing the uterus. However, these drugs often cause side effects from activating the sympathetic nervous system.
Do Women With Polycystic Morphology Without Any Other Features of PCOS Benefi...Alex Swanton
Women with ovaries of polycystic morphology (PCO), without any other features of polycystic ovary syndrome(PCOS), respond similarly to women with PCOS when stimulated with exogenous gonadotrophins, and both groups share various endocrinological disturbances underlying their pathology.
Role of Dydrogesterone in repeated pregnancy lossNiranjan Chavan
Dydrogesterone has been shown to effectively treat recurrent pregnancy loss by modulating the immune system. It shifts the balance from a pro-inflammatory Th1 response towards an anti-inflammatory Th2 response by [1] inhibiting the production of Th1 cytokines IFN-γ and TNF-α and [2] inducing production of the Th2 cytokines IL-4 and IL-6. This results in improved pregnancy outcomes by supporting embryonic development. Clinical studies demonstrate dydrogesterone significantly reduces miscarriage rates in women with recurrent pregnancy loss.
The profile of infants born to mothers with subclinical hypothyroidism in a t...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Cell Deveolpment and Biology- A Study of Liver Regeneration CapacityNatasha A. Mahadeo
This document summarizes a research article that studied how pregnancy can restore the regenerative capacity of the aged liver. The study found that activating the Akt/mTORC1 pathway in older mice through chemical induction stimulated liver cell hypertrophy and improved regeneration, mimicking the effects of pregnancy. Inhibiting this pathway increased only cell proliferation. This suggests activating the Akt/mTORC1 pathway could be a therapeutic strategy for resolving age-related liver cell deterioration. The abstract and introduction provide background on cellular aging and loss of liver regenerative function in the elderly, as well as evidence that heterochronic parabiosis and pregnancy can increase cell proliferation in other aged tissues.
The document discusses insulin-like growth factor I (IGF-I) and insulin-like growth factor binding protein 3 (IGFBP-3), their roles in growth and metabolism, and emerging clinical applications of measuring their levels in serum. It covers background biochemistry, modern assay methods and reference ranges, and applications in conditions like cancer, heart disease, and growth hormone disorders like acromegaly and growth hormone deficiency.
The Women's Health Initiative (WHI) was a 15-year study from 1991-2010 that examined the effects of postmenopausal hormone therapy (HT) and lifestyle interventions on health outcomes in postmenopausal women. The WHI hormone therapy trials found that estrogen plus progestin therapy increased risks of heart disease, stroke, blood clots and breast cancer. Estrogen-alone therapy increased risks of stroke and blood clots but did not change heart disease risk. Subsequent research has found that risks may depend on factors like age at start of therapy, duration of use, and type of progestin used. Current recommendations are to use the lowest effective dose of HT for the shortest time to treat menop
This document summarizes a study that investigated levels of the cytokine IL-17A in Type 1 diabetes mellitus (T1DM) patients compared to healthy controls. Sixty T1DM patients and sixty healthy controls matched for age and sex were included. The mean age of patients was 16.32 years and most patients were between 10-19 years old. IL-17A levels were significantly higher in the sera of diabetic patients (1312.06 pg/ml) than in healthy controls (332.28 pg/ml). The study concludes that IL-17A may play an important role in the susceptibility or protection against the development of T1DM.
Journal Club - Assisted Reproductive Technology Outcomes in Female-to-Male Tr...Vharshini Manoharan
1) The study compared IVF outcomes between female-to-male transgender patients and cisgender patients matched for age, BMI, and AMH.
2) It found that transgender patients had a higher number of oocytes retrieved compared to cisgender patients, though they required a higher gonadotropin dose.
3) Among transgender patients who underwent embryo transfer, all achieved pregnancy and most had live births, providing support for fertility preservation and family building options for these patients.
1. Phytosterols are plant compounds similar in structure to cholesterol that have shown promise in treating various cancers. Studies in animal models and cell cultures have found that phytosterol supplementation reduced tumor growth and progression of breast, prostate, colon and other cancers.
2. Mechanisms by which phytosterols may treat cancer include inducing apoptosis of cancer cells, reducing oxidative stress, decreasing inflammatory cytokines and angiogenesis to cancer cells. Doses of 300mg per day have shown benefits, though most Americans consume only 80mg daily.
3. Further research is still needed to better understand long term effects and interactions with drugs, but initial animal and cell studies provide evidence that phytosterols may be a potential dietary intervention
This study investigated umbilical cord blood concentrations of the protein survivin in pregnancies complicated by intrauterine growth restriction (IUGR) or large-for-gestational age (LGA) babies due to gestational diabetes, and compared them to appropriate-for-gestational age (AGA) controls. The study found no statistically significant differences in survivin concentrations between the three groups. Additionally, survivin levels were independent of factors like birthweight, gestational age, gender, mode of delivery, and parity. The study concludes that cord blood survivin levels do not reflect disturbances in fetal-placental apoptosis seen in IUGR and LGA pregnancies.
A 15-year-old female presented to the emergency department with vaginal bleeding and weakness. She was found to have a hemoglobin of 2.4g/dL and pelvic examination revealed spontaneous discharge of blood, clots and grapelike spongy material. Surgical pathology confirmed a complete hydatidiform mole (molar pregnancy). She received blood transfusions and was taken urgently to the operating room for dilation and curettage. Molar pregnancies can present with vaginal bleeding and excessive beta-human chorionic gonadotropin levels, as seen in this case.
This document analyzes histomorphologic changes in placentas from pregnancies complicated by hypertension. Placentas from 50 normal pregnancies and 50 pregnancies with hypertension were examined. Microscopic analysis found significantly increased villous abnormalities in placentas from pregnancies with hypertension, including higher rates of syncytial knots, decreased vasculo-syncytial membranes, more fibrinoid necrosis, thicker basement membranes, and more villous stromal fibrosis. These findings suggest reduced blood flow in the placenta among pregnancies with hypertension, which can impact fetal and maternal health.
Experience of Metformin Use in Gestational Diabetes: Contribution to the DebateApollo Hospitals
This article discusses the experience of using metformin to treat gestational diabetes at a hospital in the UK. It summarizes the results of a retrospective study of 54 women treated with metformin between 2006-2009. The study found metformin was well tolerated with few adverse maternal or fetal outcomes. Only 7.4% discontinued metformin and 22% required supplemental insulin. Preeclampsia occurred in 3.7% of cases. Fetal outcomes like macrosomia and neonatal complications were also low. The article contributes to the debate around using metformin as an alternative to insulin for treating gestational diabetes.
1. The document provides information on the emergency contraceptive ulipristal acetate (UPA), including its mechanism of action, pharmacokinetics, clinical evaluations in randomized studies, contraindications, precautions, adverse reactions and drug interactions.
2. Key points include that UPA prevents pregnancy by inhibiting or delaying ovulation and altering the endometrium; clinical trials found it to be over 99% effective in preventing pregnancy when taken as directed within 120 hours of intercourse.
3. Common adverse reactions included headache, nausea and menstrual irregularities. UPA should not be used by women with current or history of certain cancers, liver disease or high risk of arterial or venous thrombotic diseases.
This document discusses the rational use of medications during pregnancy and breastfeeding. It provides examples from clinical practice and aims to better recognize and recommend avoiding medications that pose risks to the fetus, whether they are prescription or over-the-counter. Several online evidence sources that can be used to classify medication risk during pregnancy and breastfeeding are also presented. A case study example involves advising a pregnant patient on treatment options for urinary symptoms.
This study compared ovarian response, oocyte and embryo quality, and pregnancy rates between PCOS and non-PCOS patients undergoing IVF. The main findings were:
1. PCOS patients had more follicles on the day of retrieval but fewer mature oocytes and top-quality embryos compared to non-PCOS patients.
2. The recovery rates of oocytes and mature oocytes per follicle were lower in the PCOS group.
3. Pregnancy rates were comparable between the two groups despite differences in ovarian response and embryo quality.
Updates on management of Adolescent PCOS An evidence based approachAboubakr Elnashar
This document discusses guidelines for the management of adolescent polycystic ovary syndrome (PCOS) from an evidence-based perspective. It covers the diagnosis, evaluation, and treatment of adolescent PCOS according to guidelines from various medical societies. For diagnosis, the guidelines emphasize avoiding a premature diagnosis and monitoring for physiological changes versus PCOS. Evaluation involves screening for comorbidities like obesity, depression, sleep disorders, diabetes and cardiovascular risk. Treatment options include lifestyle changes, hormonal contraceptives, metformin, and sometimes a combination depending on the individual's age, symptoms and risks.
Hyperemesis Gravidarum is a condition of severe nausea and vomiting during pregnancy that can lead to weight loss and nutritional deficiencies. It is associated with multiple pregnancies, certain fetal conditions, and other issues. Treatment involves managing triggers, dietary changes, medications like antihistamines, dopamine receptor antagonists, and serotonin antagonists. Intravenous fluids and supplementation of vitamins and minerals is also important to prevent complications like Wernicke's encephalopathy. Enteral nutrition through nasojejunal feeding or nasogastric tubes may be preferable to parenteral nutrition via central lines due to lower risks of infections and thromboembolism.
Obstetric outcomes associated with second trimester unexplained abnormal mate...Apollo Hospitals
1) To compare the adverse obstetrical outcomes in the patient population with normal blood MoMs.
2) To determine the probability of occurrence of an adverse obstetric event in relation with abnormal maternal blood
analytes.
Subclinical hypothyroidism in patients with recurrent early miscarriageMohamed Ashour
This study assessed the prevalence of subclinical hypothyroidism in Egyptian women with recurrent early miscarriage. The study included 150 women with recurrent early miscarriage and 150 control women with at least one successful pregnancy. Thyroid function tests found subclinical hypothyroidism in 8.0% of women with miscarriage and 4.7% of controls, which was not a statistically significant difference. Logistic regression also found no significant association between subclinical hypothyroidism and recurrent early pregnancy loss after adjusting for potential confounding factors. The study concluded that subclinical hypothyroidism does not appear to be a significant risk factor for recurrent early miscarriage in this population.
Letrozole combined with Misoprostol for management of delayed miscarriages Dr. Aisha M Elbareg
This document describes a study that compared the effectiveness of letrozole combined with misoprostol versus misoprostol alone for medical termination of first trimester delayed miscarriages. 126 women with miscarriages under 12 weeks gestation were randomly assigned to receive either letrozole followed by misoprostol (n=64) or misoprostol alone (n=62). The complete miscarriage rate was significantly higher in the letrozole/misoprostol group compared to the misoprostol alone group. The time from treatment to miscarriage was also shorter for the letrozole/misoprostol group. Fewer women in the letrozole/misopro
“A Study on Coagulation Profile in Pregnancy Induced Hypertension Cases”iosrjce
IOSR Journal of Biotechnology and Biochemistry (IOSR-JBB) covers studies of the chemical processes in living organisms, structure and function of cellular components such as proteins, carbohydrates, lipids, nucleic acids and other biomolecules, chemical properties of important biological molecules, like proteins, in particular the chemistry of enzyme-catalyzed reactions, genetic code (DNA, RNA), protein synthesis, cell membrane transport, and signal transduction. IOSR-JBB is privileged to focus on a wide range of biotechnology as well as high quality articles on genetic engineering, cell and tissue culture technologies, genetics, microbiology, molecular biology, biochemistry, embryology, cell biology, chemical engineering, bioprocess engineering, information technology, biorobotics.
Anti-Mullerian hormone (AMH) is a glycoprotein, a member of the transforming growth factor-B super family. This hormone is a sensitive marker of ovarian reserve. The present study aims to measure the Anti-Mullerian hormone in thalassemic females receiving the regular blood transfusion as well as patients of chronic idiopathic thrombocgtopenic purpura and age and sex matched controls. Serum Anti-Mullerian hormone was measured by ELISA and Ferritin were measured by RIA. Clinical evaluation was done for all patients including anthropometric measurements, pubertal staging and history taking. Results of the study were analyzed by appropriate statistical methods. Obtained results revealed that the values of Body Mass Index as well as Anti-Mullerian were significantly higher in controls than thalassemics and chronic idiopathic thrombocytopenic purpura and there was a negative correlation between serum Ferritin and Anti-Mullerian hormone. Moreover, Anti-Mullerian hormone was significantly higher in patients receiving Desferal than in those receiving Deferriprone. Reduced Anti-Mullerian hormone in thalassemics as well as chronic ITP patients are considered an important indicator declines in ovarian function which entail modification in the therapeutic plans for thalassemic and chronic ITP patients.
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
— This study was conducted to find out if AFI ≤ 5 cms has any clinical significance in identifying the subsequent fetal distress & associated maternal & perinatal outcomes, in pregnancies beyond 37 weeks. Methodology: This is a prospective case control study done from July 2010 to July 2012 (24 months) at Dr Vasantrao Pawar Medical College, Hospital and Research Center. Adgaon, Nashik. It study the pregnancy outcome comparison of 58 Anenatal Cases(ANCs)as Study Group with diangosis of oligohydramnios (AFI ≤ 5 cms) by ultrasound after 37 completed weeks of gestation w e r e compared with 58 ANCs (Control Group) with no oligohydramnios (AFI > 5 cms). These two groups were matched for other variables like age, parity, gestational age and any pregnancy complication. Results: There was significant difference between two groups. Hypertension and Preeclampsia were found significantly more in ANCs with oligohydramnios. FHR deceleration was also significantly higher in women with oligohydramnios. Women require LSCS were also significantly more in women with oligohydramnios. Newborn borned by women with oligohydramnios had significantly more chances to admit in NICU than in newborn born by women without oligohydramnios. Conclusion: It can be concluded from this study that women with oligohydramnios poor pregancy outcomes. Determination of AFI can be used as an adjunct to other fetal surveillance methods. Determination of AFI can be used as valuable screening test for predicting fetal distress in labour, requiring caesarean section.
Dynamics of Combined Oral Contraceptive: A Study of Some Haematological Param...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
This research article examines alterations in reproductive hormones during pregnancy and the risk of preeclampsia. The study followed 79 preeclamptic women and 80 healthy pregnant controls longitudinally from the third trimester through 6 weeks postpartum. Blood samples were taken at each visit and analyzed for beta-hCG, oestriol, progesterone and prolactin levels. Results showed beta-hCG and oestriol levels were significantly altered in the preeclamptic group compared to controls in the first and third trimesters respectively, indicating these hormones may help identify risk of preeclampsia earlier in pregnancy. The study aims to determine the gestational age at which hormonal changes occur that are associated with developing preecl
A COMPARATIVE ANALYSIS OF HEMATOLOGICAL INDICES IN PREGNANT WOMEN AND NON PR...FidelityP
Red blood cell (RBC) indices are individual components of a routine blood test called the complete blood count (CBC). The CBC is used to measure the quantity and physical characteristics of different types of cells found in your blood. Blood consists of RBCs, white blood cells (WBCs), and platelets that are suspended in your plasma. Platelets are cells that enable clot formation. RBCs contain hemoglobin, which carries oxygen throughout your body to all of your tissues and organs. An RBC is pale red and gets its color from hemoglobin. It’s shaped like a doughnut, but it has a thinner area in the middle instead of a hole. Your RBCs are normally all the same color, size, and shape. However, certain conditions can cause variations that impair their ability to function properly. The RBC indices measure the size, shape, and physical characteristics of the RBCs. Your doctor can use RBC indices to help diagnose the cause of anemia. Anemia is a common blood disorder in which you have too few, misshapen, or poorly functional RBCs123
This study aimed to compare the endometrial secretory cytokine profiles between women with recurrent implantation failure (RIF) and fertile controls. Endometrial fluid was collected from 16 RIF patients and 20 controls using an embryo transfer catheter. Levels of 23 cytokines were measured using luminex technology. Only beta-nerve growth factor (bNGF) showed a significant difference between RIF and controls by univariate analysis. Multivariate analysis using partial least squares modeling showed clear separation of the two groups, with 8 cytokines including leukemia inhibitory factor (LIF) being lower in RIF patients. This suggests alterations in endometrial secretions may influence implantation success.
1) The study examined the effect of probiotics in preventing necrotizing enterocolitis (NEC) in preterm neonates compared to a control group.
2) 115 preterm infants weighing 750-1500g or less than 32 weeks gestation received probiotics or did not (control). The probiotic group had significantly lower incidence of NEC and fewer cases of elevated C-reactive protein.
3) However, there were no significant differences between the groups in duration of oxygen therapy, total parenteral nutrition, time to full feeding, or length of hospital stay. The study results suggest probiotics have a protective effect against NEC in preterm infants.
This study examined maternal and fetal outcomes in term premature rupture of membranes (PROM) using medical records from a hospital in Ethiopia between 2011-2013. The study found that 22.2% of women experienced unfavorable maternal outcomes like puerperal sepsis. 33.5% of neonates experienced unfavorable outcomes like stillbirth. Factors associated with unfavorable outcomes included residing in a rural area, duration of PROM over 12 hours, latency over 24 hours, and birth weight under 2500g. The study aims to identify factors that can help reduce complications from term PROM and improve outcomes.
11.relationship between the levels of serum thyroid hormones and the risk of ...Alexander Decker
This study examined the relationship between serum thyroid hormone levels and the risk of breast cancer. The study analyzed thyroid hormone and antibody levels in 100 breast cancer patients and 75 control individuals without breast or thyroid disease. The mean values for thyroid hormones (T3, T4) and anti-thyroid peroxidase antibodies were significantly higher in breast cancer patients compared to controls. The results indicate an increased prevalence of autoimmune and non-autoimmune thyroid diseases in breast cancer patients, suggesting that abnormal thyroid gland characteristics may influence breast cancer progression.
This guideline provides recommendations for the management of gestational trophoblastic disease (GTD) and gestational trophoblastic neoplasia (GTN). It covers definitions, presentation, diagnosis, evacuation methods, and follow up of molar pregnancies. The definitive diagnosis of GTD requires histological examination. Suction curettage is recommended for evacuating complete molar pregnancies, while medical evacuation may be used for partial molar pregnancies if fetal parts prevent suction curettage. Follow up beta hCG testing and treatment is important to monitor for GTN.
Accuracy of Combined Maternal Serum Interleukin-8 and Salivary Estriol in Pre...Samir elsayed
This study aimed to assess the accuracy of combined maternal serum interleukin-8 and salivary estriol levels in predicting preterm labor in Egyptian pregnant females. The study found that maternal serum interleukin-8 alone had the highest accuracy at a cut-off of 965 pg/ml, with an overall accuracy of 79%, sensitivity of 92.5%, and specificity of 42.5%. Combined interleukin-8 and estriol had an overall accuracy of 68% and salivary estriol alone had an accuracy of 58%. The study concluded that maternal serum interleukin-8 is a more accurate, effective, and relatively non-invasive strategy for predicting preterm labor compared to salivary estriol alone.
Safety of neuraminidase inhibitors in pregnant and breastfeeding women tanaka...Ruth Vargas Gonzales
1) A new strain of influenza A virus (H1N1) emerged and spread rapidly globally, increasing concern as it disproportionately affected young people. Pregnant women are also at high risk.
2) The antiviral drugs oseltamivir and zanamivir are effective against the new H1N1 strain. Limited data suggests oseltamivir is unlikely to cause major birth defects, while even less is known about zanamivir's safety during pregnancy.
3) Both drugs are considered compatible with breastfeeding as levels transferred to breastmilk would be low. Continued breastfeeding is recommended even if the mother is being treated.
This study examined the relationship between maternal consumption of polyphenol-rich foods late in pregnancy and fetal ductus arteriosus flow dynamics. Doppler ultrasound was used to compare ductal velocities and right-to-left ventricular dimensions in 102 fetuses exposed to high maternal polyphenol intake versus 41 unexposed fetuses. Exposed fetuses had higher ductal velocities and right-to-left ventricular ratios, suggesting maternal polyphenol-rich food intake may influence fetal ductal dynamics by inhibiting prostaglandin synthesis, similarly to non-steroidal anti-inflammatory drugs. As polyphenol-rich foods are commonly consumed during pregnancy, their effects on the fetal ductus warrant further consideration.
Similar to Fibrinogen concentration and thrombin levels in pregnant women in nnewi, anambra state, south, eastern nigeria. (20)
Abnormalities of hormones and inflammatory cytokines in women affected with p...Alexander Decker
Women with polycystic ovary syndrome (PCOS) have elevated levels of hormones like luteinizing hormone and testosterone, as well as higher levels of insulin and insulin resistance compared to healthy women. They also have increased levels of inflammatory markers like C-reactive protein, interleukin-6, and leptin. This study found these abnormalities in the hormones and inflammatory cytokines of women with PCOS ages 23-40, indicating that hormone imbalances associated with insulin resistance and elevated inflammatory markers may worsen infertility in women with PCOS.
A usability evaluation framework for b2 c e commerce websitesAlexander Decker
This document presents a framework for evaluating the usability of B2C e-commerce websites. It involves user testing methods like usability testing and interviews to identify usability problems in areas like navigation, design, purchasing processes, and customer service. The framework specifies goals for the evaluation, determines which website aspects to evaluate, and identifies target users. It then describes collecting data through user testing and analyzing the results to identify usability problems and suggest improvements.
A universal model for managing the marketing executives in nigerian banksAlexander Decker
This document discusses a study that aimed to synthesize motivation theories into a universal model for managing marketing executives in Nigerian banks. The study was guided by Maslow and McGregor's theories. A sample of 303 marketing executives was used. The results showed that managers will be most effective at motivating marketing executives if they consider individual needs and create challenging but attainable goals. The emerged model suggests managers should provide job satisfaction by tailoring assignments to abilities and monitoring performance with feedback. This addresses confusion faced by Nigerian bank managers in determining effective motivation strategies.
A unique common fixed point theorems in generalized dAlexander Decker
This document presents definitions and properties related to generalized D*-metric spaces and establishes some common fixed point theorems for contractive type mappings in these spaces. It begins by introducing D*-metric spaces and generalized D*-metric spaces, defines concepts like convergence and Cauchy sequences. It presents lemmas showing the uniqueness of limits in these spaces and the equivalence of different definitions of convergence. The goal of the paper is then stated as obtaining a unique common fixed point theorem for generalized D*-metric spaces.
A trends of salmonella and antibiotic resistanceAlexander Decker
This document provides a review of trends in Salmonella and antibiotic resistance. It begins with an introduction to Salmonella as a facultative anaerobe that causes nontyphoidal salmonellosis. The emergence of antimicrobial-resistant Salmonella is then discussed. The document proceeds to cover the historical perspective and classification of Salmonella, definitions of antimicrobials and antibiotic resistance, and mechanisms of antibiotic resistance in Salmonella including modification or destruction of antimicrobial agents, efflux pumps, modification of antibiotic targets, and decreased membrane permeability. Specific resistance mechanisms are discussed for several classes of antimicrobials.
A transformational generative approach towards understanding al-istifhamAlexander Decker
This document discusses a transformational-generative approach to understanding Al-Istifham, which refers to interrogative sentences in Arabic. It begins with an introduction to the origin and development of Arabic grammar. The paper then explains the theoretical framework of transformational-generative grammar that is used. Basic linguistic concepts and terms related to Arabic grammar are defined. The document analyzes how interrogative sentences in Arabic can be derived and transformed via tools from transformational-generative grammar, categorizing Al-Istifham into linguistic and literary questions.
A time series analysis of the determinants of savings in namibiaAlexander Decker
This document summarizes a study on the determinants of savings in Namibia from 1991 to 2012. It reviews previous literature on savings determinants in developing countries. The study uses time series analysis including unit root tests, cointegration, and error correction models to analyze the relationship between savings and variables like income, inflation, population growth, deposit rates, and financial deepening in Namibia. The results found inflation and income have a positive impact on savings, while population growth negatively impacts savings. Deposit rates and financial deepening were found to have no significant impact. The study reinforces previous work and emphasizes the importance of improving income levels to achieve higher savings rates in Namibia.
A therapy for physical and mental fitness of school childrenAlexander Decker
This document summarizes a study on the importance of exercise in maintaining physical and mental fitness for school children. It discusses how physical and mental fitness are developed through participation in regular physical exercises and cannot be achieved solely through classroom learning. The document outlines different types and components of fitness and argues that developing fitness should be a key objective of education systems. It recommends that schools ensure pupils engage in graded physical activities and exercises to support their overall development.
A theory of efficiency for managing the marketing executives in nigerian banksAlexander Decker
This document summarizes a study examining efficiency in managing marketing executives in Nigerian banks. The study was examined through the lenses of Kaizen theory (continuous improvement) and efficiency theory. A survey of 303 marketing executives from Nigerian banks found that management plays a key role in identifying and implementing efficiency improvements. The document recommends adopting a "3H grand strategy" to improve the heads, hearts, and hands of management and marketing executives by enhancing their knowledge, attitudes, and tools.
This document discusses evaluating the link budget for effective 900MHz GSM communication. It describes the basic parameters needed for a high-level link budget calculation, including transmitter power, antenna gains, path loss, and propagation models. Common propagation models for 900MHz that are described include Okumura model for urban areas and Hata model for urban, suburban, and open areas. Rain attenuation is also incorporated using the updated ITU model to improve communication during rainfall.
A synthetic review of contraceptive supplies in punjabAlexander Decker
This document discusses contraceptive use in Punjab, Pakistan. It begins by providing background on the benefits of family planning and contraceptive use for maternal and child health. It then analyzes contraceptive commodity data from Punjab, finding that use is still low despite efforts to improve access. The document concludes by emphasizing the need for strategies to bridge gaps and meet the unmet need for effective and affordable contraceptive methods and supplies in Punjab in order to improve health outcomes.
A synthesis of taylor’s and fayol’s management approaches for managing market...Alexander Decker
1) The document discusses synthesizing Taylor's scientific management approach and Fayol's process management approach to identify an effective way to manage marketing executives in Nigerian banks.
2) It reviews Taylor's emphasis on efficiency and breaking tasks into small parts, and Fayol's focus on developing general management principles.
3) The study administered a survey to 303 marketing executives in Nigerian banks to test if combining elements of Taylor and Fayol's approaches would help manage their performance through clear roles, accountability, and motivation. Statistical analysis supported combining the two approaches.
A survey paper on sequence pattern mining with incrementalAlexander Decker
This document summarizes four algorithms for sequential pattern mining: GSP, ISM, FreeSpan, and PrefixSpan. GSP is an Apriori-based algorithm that incorporates time constraints. ISM extends SPADE to incrementally update patterns after database changes. FreeSpan uses frequent items to recursively project databases and grow subsequences. PrefixSpan also uses projection but claims to not require candidate generation. It recursively projects databases based on short prefix patterns. The document concludes by stating the goal was to find an efficient scheme for extracting sequential patterns from transactional datasets.
A survey on live virtual machine migrations and its techniquesAlexander Decker
This document summarizes several techniques for live virtual machine migration in cloud computing. It discusses works that have proposed affinity-aware migration models to improve resource utilization, energy efficient migration approaches using storage migration and live VM migration, and a dynamic consolidation technique using migration control to avoid unnecessary migrations. The document also summarizes works that have designed methods to minimize migration downtime and network traffic, proposed a resource reservation framework for efficient migration of multiple VMs, and addressed real-time issues in live migration. Finally, it provides a table summarizing the techniques, tools used, and potential future work or gaps identified for each discussed work.
A survey on data mining and analysis in hadoop and mongo dbAlexander Decker
This document discusses data mining of big data using Hadoop and MongoDB. It provides an overview of Hadoop and MongoDB and their uses in big data analysis. Specifically, it proposes using Hadoop for distributed processing and MongoDB for data storage and input. The document reviews several related works that discuss big data analysis using these tools, as well as their capabilities for scalable data storage and mining. It aims to improve computational time and fault tolerance for big data analysis by mining data stored in Hadoop using MongoDB and MapReduce.
1. The document discusses several challenges for integrating media with cloud computing including media content convergence, scalability and expandability, finding appropriate applications, and reliability.
2. Media content convergence challenges include dealing with the heterogeneity of media types, services, networks, devices, and quality of service requirements as well as integrating technologies used by media providers and consumers.
3. Scalability and expandability challenges involve adapting to the increasing volume of media content and being able to support new media formats and outlets over time.
This document surveys trust architectures that leverage provenance in wireless sensor networks. It begins with background on provenance, which refers to the documented history or derivation of data. Provenance can be used to assess trust by providing metadata about how data was processed. The document then discusses challenges for using provenance to establish trust in wireless sensor networks, which have constraints on energy and computation. Finally, it provides background on trust, which is the subjective probability that a node will behave dependably. Trust architectures need to be lightweight to account for the constraints of wireless sensor networks.
This document discusses private equity investments in Kenya. It provides background on private equity and discusses trends in various regions. The objectives of the study discussed are to establish the extent of private equity adoption in Kenya, identify common forms of private equity utilized, and determine typical exit strategies. Private equity can involve venture capital, leveraged buyouts, or mezzanine financing. Exits allow recycling of capital into new opportunities. The document provides context on private equity globally and in developing markets like Africa to frame the goals of the study.
This document discusses a study that analyzes the financial health of the Indian logistics industry from 2005-2012 using Altman's Z-score model. The study finds that the average Z-score for selected logistics firms was in the healthy to very healthy range during the study period. The average Z-score increased from 2006 to 2010 when the Indian economy was hit by the global recession, indicating the overall performance of the Indian logistics industry was good. The document reviews previous literature on measuring financial performance and distress using ratios and Z-scores, and outlines the objectives and methodology used in the current study.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Fibrinogen concentration and thrombin levels in pregnant women in nnewi, anambra state, south, eastern nigeria.
1. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol.3, No.7, 2013
144
Fibrinogen Concentration and Thrombin Levels in Pregnant
Women in Nnewi, Anambra State, South, Eastern Nigeria.
AMILO G.I1
., ANOKWUTE M.U2
., IFEANYICHUKWU M.O3
., CHUKWUANUKWU R.C3
, ONYENEKWE
C.C4
., IFEDIATA F.C2
. EZEAH S.C2
.
1
Haematology Department, College of Health Sciences, Nnamdi Azikiwe University, P.M.B 5001, Nnewi,
Anambra State, Nigeria.
2
Haematology Department, Nnamdi Azikiwe University Teaching Hospital P.M.B 5025, Nnewi, Anambra
State, Nigeria.
3
Immunology Department, College of Health Sciences, Nnamdi Azikiwe University, P.M.B 5001, Nnewi,
Anambra State, Nigeria.
4
Medical Laboratory Science Department, College of Health Sciences, Nnamdi Azikiwe University P.M.B
5001, Nnewi, Anambra State, Nigeria
Corresponding author, E-mail: ifymilo@yahoo.com
ABSTRAST
This study was aimed at looking at the influence of pregnancy on fibrinogen concentration and thrombin time
(TT) levels. A total of 195 pregnant women between 18 and 35 years were recruited, 59 were in their first
trimester (group A), 61 second trimester (group B) and 75 the third trimester (group C). A total of 150 apparently
healthy non pregnant women were used as normal control (group D). Blood samples which was collected from
each of the participants after obtaining informed consent was tested for the fibrinogen concentration using Clauss
method and thrombin time using two stage method. The study was approved by Nnamdi Azikiwe University
Teaching Hospital Ethical Committee Nnewi. ANOVA and students t-test were used for statistical analysis. The
results showed that fibrinogen concentration (mg/dL) were significantly higher (p<0.05) in group A, B and C as
compared with the control group. TT (s) were significantly higher (p<0.05) in group A, B and C compared with
the control group. This study therefore suggests that the increase in these coagulation factors observed are due to
increased thrombin generation, inflammatory state of pregnancy and fibrinogen being an acute-phase protein. It
is important to obtain a baseline of these parameters for all pregnant women during antenatal visits, in order to
detect any abnormality early.
Key words: Fibrinogen concentration, thrombin time and pregnancy.
INTRODUCTION
Pregnancy is the carrying of one or more offspring known as foetus or embryo inside the womb of a female. In
pregnancy, physiological changes affect coagulation and fibrinolytic system. These physiological changes are
seen in blood volumes, blood pressure, gastrointestinal system, metabolism, renal physiology, the endocrine
system, haematological parameters, liver enzymes (Jamjute et al., 2009). Many clotting factors increase and
anticoagulation factors decrease causing augmented coagulation and decrease fibrinolysis (Dahlman et al., 1999;
Thorton and Dauglas, 2010). Haemostasis abnormalities have been associated with various complications of
pregnancy (Awodu and Enosolease, 2003). These changes result in a state of hypercoagulability and are likely
due to hormonal changes and increase the risk of thromboembolism (Salter et al., 2007). These changes in
haemostatic system are considered to be in preparation for the maintenance of the placental function which
occurs during pregnancy. These substances stimulate clot formation to stop maternal blood loss. As placental
blood flow is up to 700ml/min considerable haemorrhage can occur if clotting fails (Dahlman et al., 1999).
Increase in the blood level of these coagulation factors is maximal in the 3rd trimester of pregnancy Fibrinogen
is a soluble plasma glycoprotein protein produced in the liver by hepatocytes. It is a large molecule, made up of
two identical halves, each half composed of three protein chains (α alpha, β beta, and γ gamma). Thrombin
cleaves fibrinogen with the release of fibrinopeptides A and B, producing fibrin monomer which then
polymerizes and is stabilized by the action of factor XIII, Fibrin is then cross linked by factor XIII to form a clot.
In its natural form, fibrinogen can form bridges between platelets, by binding to their GpIIb/IIIa surface
membrane proteins. Thrombin is the essential enzyme product of the blood coagulation enzymatic cascade.
Thrombin is a "trypsin-like" serine protease protein that in humans is encoded by the F2 gene (Degen and Davie,
1987). Prothrombin (coagulation factor II) is proteolytically cleaved to form thrombin in the first step of the
coagulation cascade, which ultimately results in the stemming of blood loss. Thrombin in turn acts as a serine
protease that converts soluble fibrinogen into insoluble strands of fibrin, as well as catalyzing many other
coagulation-related reactions. In the blood coagulation pathway, thrombin acts to convert factor XI to XIa, VIII
to VIIIa, V to Va, and fibrinogen to fibrin. In a country like Nigeria, high maternal mortality and fetal wastage is
2. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol.3, No.7, 2013
145
associated with high incidence of antepartum and postpartum haemorrhage, high parity, home deliveries not
supervised by trained personnel, inadequate and inaccessible health facilities and late presentation of cases to
health facilities. The aim of this study was to determine to what extent pregnancy affects fibrinogen
concentration and thrombin time when compared with a control group of non pregnant women.
SUBJECTS AND METHODS
Subjects: One hundred and ninety five (195) pregnant women aged 18-35 years attending antenatal clinic in
Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi between September and November 2011 were
screened. The questionnaires were completed and their informed consent was obtained. The information
obtained using the questionnaires include age, parity, past history of pregnancy related problem(s), duration of
pregnancy, history of any miscarriage. Out of 195 pregnant women recruited, 59 were in the first trimester
(group A), 61 second trimester (group B) and 75 third trimesters (group C). One hundred and fifty (150) non
pregnant women (group D) were also screened and they served as controls.
One thousand eight hundred milliliter (1.8mls) of venous blood was collected from each of the subjects, and was
added into Trisodium Citrate container containing 0.2mls of Trisodium Citrate (1:9 dilution) mixed immediately
by reverse uniform inversion for fibrinogen concentration and thrombin time. The sample was spun with a bench
centrifuge at 3000rpm for 10mins. Then the clear plasma was collected into a clean dry plastic container. The
test was performed using Rayto Semi Auto coagulation analyser RT-2204C model manufactured by Rayto Life
and Analytical sciences Co., Ltd.
Exclusion Criteria: Pregnant and control subjects with bleeding disorders, underlying coagulation disorders,
pregnancy related problem, patients on anticoagulants therapy and patients that refused to give consent were
excluded.
Study Sites: This study was carried out at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi
with the approval of the Nnamdi Azikiwe University Teaching Hospital Ethical Committee. The samples were
collected in the Antenatal Clinic while analysis was carried out in the Hospital Laboratory.
Determination of Thrombin Time (TT): This was done using the Two Stage Method. It measures the time it
takes plasma to clot, when thrombin acts upon fibrinogen converting it to insoluble fibrin in the common
pathway. The TT reagent was reconstituted with 1ml of distilled water and mixed by inversion and allowed to
stand at room temperature. 100µL of sample was added to the test cuvette, and then 50µL of the reconstituted TT
reagent was added. The clotting time was recorded in seconds. One normal control plasma sample was setup for
each batch of tests.
Determination of Fibrinogen concentration: This was done using the Clauss Method. In the presence of high
concentration of thrombin, diluted plasma gives a required time of clot formation which is inversely proportional
to the fibrinogen concentration. The sample is diluted with 450µL of imidazole buffer to 50µL of sample to give
a 1:10 dilution. 200µL of prediluted sample is added to the test cuvette, the sample was incubated for 5mins at
37 O
C. Then 100µL of bovine thrombin is added. The time of clot was recorded in seconds and the concentration
in mg/dL.
RESULTS: Table 1 showed comparisons of mean±SD TT (s) and fibrinogen concentration (mg/dL) in pregnant
women in first trimester (group A), second trimester (group B) and third trimester (group C), and control non
pregnant women (group D). The mean±SD fibrinogen concentration 505.97±178.22 for the pregnant women in
the group C respectively compared with that of 404.26±143.92 for group A, 422.33±126.75 for group B and
283.87±98.90 for group D, (in each case) showed higher significant different (P<0.05). Also the fibrinogen
concentration 404.26±143.92 for pregnant women in group A showed a higher mean difference compared with
the mean value 283.87±98.70 in group D (P<0.05). Moreover, the mean value fibrinogen concentration
422.33±126.75 for group B compared with 283.87±98.70 in group D was significantly higher (P<0.05).
However, the comparison in fibrinogen concentration mean value between the pregnant women in the group A
and B showed no significant value (P>0.05).
The mean±SD TT in pregnant women in the group A 16.79±0.82, B 15.59±1.46, C 16.47±1.32 and control
group D 14.87±1.08, compared amongst the group showed significant different in value (F 52.988; P<0.05). The
within group comparison showed that TT 16.79±0.82 for pregnant women in group A compared with that of
group B 15.59±1.46 and group D 14.87±1.08 in each case, showed higher significant difference (P<0.05). Also
the TT 15.59±1.46 for pregnant women in group B compared with 16.47±1.32 for pregnant women in the group
C showed significantly lower difference (P<0.05). Moreover, the mean±SD of TT 15.59±1.46 for pregnant
women in the group B showed higher significant difference compared with the mean value 14.84±1.08 in group
D (P<0.05). Furthermore, there was higher significant difference in the mean±SD of TT 16.47±1.32 for pregnant
women in the group C compared with that of 14.87±1.07 in group D (P<0.05). However, the mean values in TT,
compared between the pregnant women in group A and C showed similar mean value (P>0.05).
3. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol.3, No.7, 2013
146
DISCUSSION
Pregnancy is a complex physiological process with many physiological changes as seen in increased coagulation
factors and decreased anticoagulation factors. During pregnancy there are significant changes in coagulation in
the direction of coagulability, thus decreasing bleeding complications in connection with delivery (Olorunshola
et al., 2011). Thrombin time obtained in pregnant subject was significantly higher than that obtained in the
control subjects. This was also observed in the works of (Ekaterine and Ilija, 2005), the slightly elevated TT was
as a result of increased thrombin generation in pregnancy which also accounts for the hypercoagulability state in
pregnancy, and also as a result a gross elevation of fibrinogen concentration (Dacie and Lewis, 2002). In our
study, there is a significant elevated value of fibrinogen concentration in pregnancy when compared with the non
pregnant control subject. Duperray et al (1997) reported a significant increase in fibrinogen concentration which
was mainly due to the inflammatory state of pregnancy and also fibrinogen being an acute-phase protein. Works
of (Duperray et al. 1997, Romero et al. 2007) saw a significant elevated fibrinogen in pregnancy; this elevation
may be as a result of its involvement in both cell–cell interaction and the interaction of cell and extracellular
matrix like collagen. This highly elevated fibrinogen concentration was markedly seen in the third trimester.
CONCLUSION
During pregnancy, the activation of coagulation is counterbalanced by haemostatic balance thus decreasing
bleeding complication in connection with delivery. Physiological changes in pregnancy affect the coagulation
and fibrinolytic system, which responses in preparation for protecting against excessive haemorrhage or blood
coagulation at parturition. The results of this research work conclude that there is a significantly higher
difference in TT and fibrinogen in pregnancy when compared with non pregnant control women.
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Dacie, J., V., Lewis, S., M., (2002), Practical Haematology, Ninth Edition. Churchill Livigstone. PP 344–353.
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4. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
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TABLE 1: Mean±SD of TT(s) and fibrinogen concentration (mg/dL), compared among pregnant women
in first (group A), second (group B), third trimester (group C) and control non pregnant women (group D).
Group TT (s) Fibrinogen (mg/dL)
A (n=59) 16.79± 0.82 404.26± 143.92
B (n=61) 15.59± 1.46 422.33± 126.75
C (n=75) 16.47± 1.32 505.97± 178.22
D (n=150) 14.87± 1.08 283.87± 98.90
F (P) Value 52.988(0.000) 51.720(0.000)
A vs B 0.000 0.878
A vs C 0.414 0.000
A vs D 0.000 0.000
B vs C 0.000 0.002
B vs D 0.000 0.000
C vs D 0.000 0.000
Key:
F (P) Value= Mean±SD of TT and fibrinogen concentration, compared among pregnant women in first, second,
third trimester and control non pregnant women (using ANOVA).
A vs B= Mean±SD of TT and fibrinogen concentration, compared between pregnant women in first and second
trimester (using student t test).
A vs C= Mean±SD of TT and fibrinogen, compared between pregnant women in first and third trimester (using
student t test).
A vs D= Mean±SD of TT and fibrinogen concentration, compared between pregnant women in first trimester
and control non pregnant women (using student t test).
B vs C= Mean±SD of TT and fibrinogen concentration, compared between pregnant women in second and third
trimester (using student t test).
B vs D= Mean±SD of TT and fibrinogen concentration, compared between pregnant women in second trimester
and control non pregnant women (using student t test).
C vs D= Mean±SD of TT and fibrinogen concentration, compared between pregnant women in third trimester
and control non pregnant women (using student t test).
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