Vaginal birth after cesarean delivery among women who attended Al Sadder teaching hospital, Misan, Iraq, 2016

A trial of labor has become the advisable choice for delivery in women with one previous low transverse segment and no recurring indication for elective repeated CS. However, a controversy exists regarding the safety and efficacy. This study was aimed to assessed Vaginal Birth after Cesarean Delivery among Women. A prospective study was conducted in Missan province at Al-Sadder Teaching Hospital during the period of January 2016 to January 2017. One hundred women with a single previous lower segment, incision attended the maternity unit with labor pain were selected. All data were collected through direct interview. Main characteristics of the study group were described using figures and tables comparing VBAC and CS groups. The data entered and analyzed using by SPSS software version 20. Statistically significant differences were defined as p < 0.05. The results of this study revealed that the mean age was 28 years (± 2.2 SD); 89% were housewives, 73% have had 2-5 previous conceptions, and 80% reported less than two years between the previous CS and the current delivery. This study showed that 55% of the total study group delivered vaginally. The higher incidence of VBAC was among women aged 15-24 and 25-34 year. Significantly the majority of housewives were more likely to deliver vaginally compared with. The highest incidence of successful VBAC was among women when the interval between the previous CS and the current delivery is <2 years. We concluded the study revealed that VBAC is an acceptable choice for delivery, especially if women have been selected with proper criteria with appropriate timing and close supervision.

Endotelium in Turner syndrome with capillaroscopy

OBJECTIVE: The aim of this study was to assess the endothelium function in patients with Turner syndrome using videocapillaroscopy and to compare the results with healthy control. METHODS: Subjects and controls were studied in a temperature-controlled room, 20 days after no nailfold manipulations. The capillaries were visualized by a microscope connected to a television and a computer. The test of post-occlusive reactive hyperemia was performed using a sphygmomanometer attached to the fourth left finger, 20mmHg above maximum arterial pressure during 1 minute, and the following patterns were studied: area of transverse segment, maximal post-ischemia area and time to reach maximal post-ischemia area. RESULTS: The value of measure of transverse segment projected area , the maximal postischemia area of hand nailfold capillary loops using computerized videophotometry and the time to reach maximal post ischemia area were studied in 40 patients with Turner syndrome and 26 healthy women controls of comparable age (20±7.5 versus 18±8.1 years old; p=0.57). There were differences between transverse segment area (706.8±139.1 versus 548.8±117.2; p=0.001). Maximal post-ischemia area (891.3±226.1 versus 643.5±134.3; p=0.001) and the time to reach it (10.8±4.3 versus 5.5±2.5; p=0.001) were different between patients and controls. CONCLUSIONS: Changes of capillary response to ischemia could be observed in patients with Turner syndrome using videocapillaroscopy when they were compared to a healthy control group.

Microvascular reactivity in type 1 diabetics

OBJECTIVE: To evaluate whether differences are present in microvascular response to the schemia induced by dynamic videocapillaroscopy (VCD), through analysis of the measured capillar transverse segment area (CTSA) in patients with type 1 diabetes mellitus (T1DM). METHODS: The vascular reactivity of the CTSA was studied by VCD, using a reactive hyperemia test in 61 volunteers, being 31 healthy controls without diabetes family history (Group 1) and 30 patients with T1DM without complications (Group 2). The images were captured every two seconds, during reperfusion after one minute induced ischaemia, and they were analyzed by the program Studio Version 8 and Motic Image Plus. The pre-ischemia capillary transverse segment (basal area, BA), the maximum strain post-ischemia (maximum area, MA), and time to achieve it (MAt) were measured during reperfusion, and the increased area percentage (Ap) was estimated. RESULTS: The mean differences between groups were evaluated by the t-test. The median comparisons between the groups were studied by the Mann-Whitney test. There was no difference in BA between the groups. The Ap was significantly lower among the diabetic patients, and there was a significant increase in the Mat among the patients of Group 2 when compared to Group 1. CONCLUSIONS: These data suggest that type 1 diabetes provokes earlier endothelial dysfunction, before the onset of clinically detectable degenerative complications. The outcomes from these alterations need further studies.

Dynamics and geometry of the Rauzy–Veech induction for quadratic differentials

Interval exchange maps are related to geodesic flows on translation surfaces; they correspond to the first return maps of the vertical flow on a transverse segment. The Rauzy–Veech induction on the space of interval exchange maps provides a powerful tool to analyze the Teichmüller geodesic flow on the moduli space of Abelian differentials. Several major results have been proved using this renormalization. Danthony and Nogueira introduced in 1988 a natural generalization of interval exchange transformations, namely linear involutions. These maps are related to general measured foliations on surfaces (whether orientable or not). In this paper we are interested by such maps related to geodesic flow on (orientable) flat surfaces with ℤ/2ℤ linear holonomy. We relate geometry and dynamics of such maps to the combinatorics of generalized permutations. We study an analogue of the Rauzy–Veech induction and give an efficient combinatorial characterization of its attractors. We establish a natural bijection between the extended Rauzy classes of generalized permutations and connected components of the strata of meromorphic quadratic differentials with at most simple poles, which allows us, in particular, to classify the connected components of all exceptional strata.

Influence of Core Suture Geometry on Tendon Deformation and Gap Formation in Porcine Flexor Tendons

The effects of core suture geometry on the mechanics of failure in flexor tendon surgery are investigated. Forty porcine flexor tendons were repaired using a Kessler; a Kessler-Pennington; a double Kessler; a continuous Kessler; and a cruciate repair. At maximum breaking strength, the cruciate repair gapped more then the double Kessler (12.8 mm vs 9.1 mm), but the double Kessler was less strong (37N vs 45 N). Transverse narrowing was 22% and 24% for the Kessler and the Kessler-Pennington, 11% for the double Kessler, and 0% for the continuous Kessler and the cruciate repair. Kessler-type sutures failed by suture breakage and the cruciate repair by pull-out. Under load, the transverse part of the Kessler sutures narrows, allowing longitudinal parts to lengthen, leading to gapping. The double Kessler shortened transverse segment decreases gapping. Eliminating a transverse component (the cruciate repair) decreased gapping, but the cruciate failed at higher loads by suture pull-out.

Regional characteristics of the membrane response of an identified crayfish nonspiking interneuron to intracellularly injected current

1. We investigated the membrane response of the local directionally selective (LDS) interneuron, a nonspiking cell identified in the terminal abdominal ganglion of crayfish, to intracellularly injected current in different regions within the cell by single-electrode, discrete current-clamp experiments. The site of electrode impalement into the cell was visualized in situ together with the cell structure under a dissecting microscope. 2. The LDS interneuron has dendritic branches on both hemiganglia connected by a thick segment crossing the midline. Irrespective of the site of electrode impalement, the interneuron showed outward rectification upon depolarization from the resting potential level. When hyperpolarizing current was injected, a linear relationship was observed between the voltage response of the interneuron and the amount of injected current. Upon large hyperpolarization, however, the interneuron showed inward rectification. 3. The input resistance of the interneuron measured within the linear range of the membrane response was significantly lower in the transverse segment than in lateral dendrites (0.001 < P < 0.01). The time constant of the transient voltage response to step current injection was also significantly shorter in the transverse segment than in the lateral dendrites (0.001 < P < 0.01). 4. Although the regional difference in the input resistance could be accounted for, at least partly, by different geometric conditions of each dendritic branch into which current was injected, the regional difference in the time constant of the membrane response cannot be accounted for by structural differences because the time constant is independent of the membrane area. It is thus suggested that the passive properties of the interneuron membrane that are related to its response time constant show regional variability within the cell.

I.—Evidences of a Mandible of a New Labyrinthodont from the Upper Karroo Beds of Cape Colony (Ptychosphenodon Browni)

I am indebted to Mr. Alfred Brown, of Aliwal North, for the opportunity of describing a small fragment of a lower jaw of a Labyrinthodont which shows some unusual characters in the dentition and in the composition of the mandible (Pl. XIX, Fig. 1). Hitherto the evidence of the structure of the mandible has been imperfectly recorded in these South African reptiles.Mr. Brown's specimen is a small transverse segment, probably from the left ramus, at some little distance behind the symphysis. This position may be indicated by an angular ridge upon the inner side, which is becoming more elevated as it extends forward. There is no suggestion of the original length of the mandible, which may have been eighteen inches. The fragment is little more than an inch and a half long. In section the jaw is subquadrate, somewhat depressed, being two inches wide and an inch and a half deep. The external surface of the bones shows no trace of sculpture. From its slightly water-worn condition the specimen (Fig. 1) was probably obtained from the reconstructed bed at the railway station at Aliwal North, which yields Theriodonts and other fossils.The external bone is apparently vertical, traversed on the lower third by a deep longitudinal groove, in which there is a faintly marked suture. The dentary bone above the groove is slightly convex up to the alveolar margin, and shows what may be a sinuous impression above the groove. The bone below the groove, which may be infra-dentary, is well rounded on to the base.