Minimally invasive Fothergill -Manchester operation with connective tissue conservation

Our minimally invasive Fothergill-Manchester technique aims to decrease blood loss and surgical trauma and to preserve function by1. Vaginal conservation. 2. Cardinal (CL) and uterosacral (USL) ligaments plicated, not severed. 3. Direct suture of vagina to cervix without Sturmdorf sutures after cervical amputation. 4. Use of No2 polyester sutures to create new collagen to reinforce the plicated ligaments.

Ayurvedic Management of Congenital Elongation of Cervix- A Single Case Study

Elongation is one among the various congenital abnormalities of cervix, which is often one of the causes of primary infertility. The only available treatment is cervical amputation. The word yoni collectively refers to reproductive organs, however here it can be considered as the cervix. So elongated cervix can be correlated to Prasramsini Yoni Vyapat where there is laxity and descend of the cervix. All Acharyas have mentioned similar mode of treatment in case of Srasta Yoni which include Abhyanga, Sweda, Veshavara Bandha, Uttarabasti etc. A case report of patient presenting with congenital cervical elongation is being discussed here. In this case there was reduction in the elongation of the cervix by Veshavara Bandha and Uttarabasti with Jathyadi Taila. The drugs used in Veshavara Bandha were having Balya, Brimhana and Grahi properties which helped in reducing the length of the cervix significantly and preventing further elongation. Thus Ayurvedic management was found to be effective in elongation of cervix to an extent even though it cannot be cured completely.

Clinical Risk Factors for Uterine Cervical Elongation among Women with Pelvic Organ Prolapse

Background: Cervical elongation is commonly associated with pelvic organ prolapse (POP). It was an identified risk for recurrent prolapse after hysteropexy, requiring additional surgeries. The aim of the study is to investigate the risk factors for uterine cervical elongation among women with POP. Methods: In this single-center retrospective cohort study, women who underwent vaginal total hysterectomy for POP between 2014 and 2016 were collected. The cervical and total uterine lengths were measured by pathologists, while the ratio of cervical length to total uterine length were calculated. The cervical elongation is defined as corpus/cervix ratio ≤ 1.5. Results: A total of 133 patients were enrolled in this study. Among these patients, 43 women had cervical elongation and 90 women had normal length of uterine cervix. We found that age > 65 years old (67.4% vs. 42.2%, p = 0.007), total vaginal length ≥ 9.5 cm (65.1% vs. 45.6%, p = 0.035), uterine weight < 51 gm (72.1% vs. 52.2%, p = 0.03), and Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6) ≥ 12 (30.2% vs. 14.4%, p = 0.032) were associated with the risk of cervical elongation. There were no significant differences on preoperative urodynamic parameters in the two groups. Conclusion: The patient age > 65 years old, the total vaginal length of POP-Q system ≥ 9.5 cm, uterine weight < 51 g, and POPDI-6 ≥ 12 are independent risk factors of cervical elongation in women with POP. For women scheduled for pelvic reconstructive hysteropexy, concomitant cervical amputation should be considered.

Neuroprotective Effects of Higenamine Against the Alzheimer’s Disease Via Amelioration of Cognitive Impairment, Aβ Burden, Apoptosis and Regulation of Akt/GSK3β Signaling Pathway

The present investigation was envisaged to elucidate the neuroprotective effect of Higenamine (HGN) against aluminum chloride (AlCl3) triggered experimental Alzheimer’s disease (AD) rat model. Thirty-six male albino Wister rats were randomized and divided in 6 groups and subjected to experimentation for 6 weeks. Control group, AlCl3 (100 mg/kg orally), HGN (50 mg/kg orally), HGN25, HGN50, HGN75 (HGN 25, 50 and 75 mg/kg respectively and AlCl3 100 mg/kg orally). After completion of 42 days protocol, the animals were subjected to passive avoidance test. The animals were then anesthetized by intramuscularly injecting ketamine hydrochloride (24 mg/kg body weight) and euthanized by cervical amputation. Cortical and hippocampal tissues were carefully removed and were employed for quantification of aluminum and acetylcholinesterase. The tissues were quantified using Western blotting and detection kits for APP, Aβ1-42, β and γ secretases, Bax, Bad, caspases-9, cyto-c, pAkt and pGSK-3β, and oxidative markers. HGN significantly protected AlCl3 induced memory and learning impairments, Al overload, AChE hyperactivity, amyloid β (Aβ) burden and apoptosis in brain tissues via activating Akt/GSK3β pathway. HGN attenuated oxidative damage induced by Al by modulation of oxidative markers. Our findings advocate the neuroprotective effect of HGN in AlCl3 induced AD rat model.

ACCORDING TO NOTES MADE BY PROF. OTT TO MY ARTICLE "TO THE QUESTION ABOUT INDICATIONS TO PARTIAL CERVICAL AMPUTATION IN CANCER OF THE VAGINAL UTERINE"

Prof. Ott, analyzing the reasons that prompted me not to take into account the results obtained by him with vaginal excision of the uterus, says (Journal of Akush. 1892, No. 1, p. 66) that since these results go completely against with the premise that I wish to defend, then I should especially carefully and carefully analyze the cases he cites and the conclusions drawn from them.

TO THE QUESTION OF INDICATIONS FOR PARTIAL CERVICAL AMPUTATION IN CANCER OF THE VAGINAL UTERINE

The issue of radical treatment of uterine cancer has been deservedly attracting special attention of gynecologists for a long time. In fact, this disease, which until recently was considered incurable, accounts for about 3.5% of all diseases of the female genital area; so according to the statistics of Petrov (V. Petrov. On the issue of radical surgical treatment of uterine cancer. Dis. 1888) for the ambulatory of the St. Petersburg Mariinsky hospital and clinic prof. Lebedev, embracing 5,040 gynecological patients, uterine cancer occurs in an amount of 3.5%. According to statistics prof. Ott (D. Ott. Complete vaginal uterine eruption, etc. Doctor. 1889, No. 39-49) 4228 uterine cancer is 3.7% of all gynecological patients. According to Schrder (Schroeder. Guide to diseases of female sex. Organs) for 16,800 patients, this disease occurred in 3.6%.

ABOUT THE ARTICLE OF DOCTOR MIRONOV “TO THE QUESTION OF INDICATIONS FOR PARTIAL CERVICAL AMPUTATION IN CANCER OF THE VAGINAL UTERINE”

In the above-published article of Dr. Mironov, the author wishes, mainly by means of statistical data, to justify the suitability of cutting off the uterine cervix alone, instead of completely removing the entire organ, for the purpose of radically curing patients with uterine cancer. Without going into a critical assessment of all the arguments that the author uses to convince the reader of this, in this note I will focus mainly on only the coverage that the author gives to the published cases and the results obtained.