Physiology and Anatomy

Gastrointestinal duplications are rare congenital anomalies but interesting clinical entities. Most of them showing up in pediatric population they have a varied presentation, with clinical features will vary from asymptomatic abdominal masses to bowel obstruction or perforation. This review traces the embryological origin and describes the anatomical types of duplications. Lack of normal gut motility interferes with movement of intestinal contents In children mostly associated with abdominal surgery or infection. Adhesions are fibrous bands of tissue Cause: postoperative small bowel obstruction after abdominal surgery The majority of obstructions: is single adhesions and can occur any time after 2nd postoperative week

Persistent left superior vena cava is rare but an important congenital vascular anomaly. When superior cardinal vein caudal to innominate vein fails to regresses PLSVC occurs. It is observed in isolation but associated with other cardiovascular abnormalities including atrial septal defect, biscuspid aortic valve, and coarctation of aorta, coronary sinus ostial atresia, and cortriatratium. The PLSVC can render access to right slide of heart challenging via the left subclavian approach, which is utilized using pacemaker and Swiz-Ganz catheters. Incidental notation of dilated coronary sinus on echocardiography raises the suspicion of PLSVC. The diagnosis is confirmed by saline contrast echocardiography.

Interrupted aortic arch a rare abnormality, is the discontinuity of the ascending and descending aorta. There are three types which are classified based on the area of interruptions. They are Type-A, Type-B and Type-C. In the Type-A form, the interruptions occurs distal to the origin of the left subclavian artery. Type-B interrupted left aortic arch is characterized by the interruption that occurs between the left subclavian artery and left common carotid artery. Type-C variants are due to the interruption or discontinuity between the innominate artery and the left common carotid artery.

Leydig cell tumors (LCTs) represent less than 3% of all testis tumors; they concern the interstitial tissue of the testis and occur at any age. They are part of the group of tumors called "sex cords and stroma" with Sertoli cell tumors. Only 7 to 10% of these tumors are malignant and are almost always seen in adults. We report a case found in a 40-year-old adult with a left testis tumor treated with orchiectomy.The diagnosis of malignancy may be difficult to establish and may be beyond histopathological examination, hence the importance of regular long-term follow-up.

Purpose: To find out the prevalence of postpartum depression and its associated risk factors. Design:A descriptive cross sectional prospective survey with sample of 345 postnatal women. Methods: Women were interviewed in hospital after delivery to collect demographic, marital and obstetrical details and participated in a telephonic structured interview 6 weeks after discharge. Additional data were extracted from the records of the women in the hospital.The instruments used were: Background variables Instrument and Edinburgh Postnatal Depression Scale (EPDS). Descriptive statistics, Chi- square test, Fisher’s exact test, odds ratio, and a logistic regression analysis were performed. Findings: 2.9% of the women screened positive for postpartum depression with EDPS. Women’s income, unwanted pregnancy for the husband , marital relationship and adverse life events during past one year were significantly associated with PPD at p < .05 in univariable analyses. The multivariable analysis identified two predictor variables for depression: unwanted pregnancy for the husband (odds ratio= 0.15, 95% CI = 0.02-0.84 , p < .03) and marital relationship (odds ratio= 0.07, 95% CI = 0.01-0.47 , p < .006). Conclusions: Mothers who experience unpleasant marital relationship, adverse life events and an unwanted pregnancy, are at increased risk of getting postpartum depression. Keywords: Postpartum Depression, postnatal women, risk factors.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common erythrocyte enzymopathy in the world. Its frequency and its involvement in the occurrence of anemia in a group of HIV-positive children was studied. A cross-sectional descriptive and analytical study was conducted from 1st to 30th October 2015 at the Pediatric Department of the Cocody Teaching Hospital including all HIV-positive children undergoing antiretroviral treatment. Hemoglobin (g / dl), G6PD activity, antiretroviral regimen, and grade of anemic toxicity were collected. The severity of anemia was assessed according to the grade classification of hemoglobin in AIDS. Of 171 HIV-positive patients 1, 17.5% had G6PD deficiency (30/171). The mean duration of antiretroviral (ARV) was 52.75 months and their regimen contained Zidovudine in 75.43% of cases. More than ¾ (82%) of our patients had anemia. Grades I and II of anemic toxicity were predominant in 37% in both cases. There was a statistical relationship between G6PD deficiency and grade of anemic toxicity (p = 0.0000). This toxicity was more pronounced when exposed to ZIDOVUDINE (p = 0.0000). This study confirms that the prevalence of G6PD deficiency remains high (17.5%) and thus allows us to advocate for the introduction of the G6PD assay in the initial assessment of HIV. 

Aims & Objective: Objective of this study was to investigate the lipid peroxidation and enzymatic antioxidants status in women with preeclampsia and compare with that of women with normal pregnancy and postpartum preeclamptic women. Materials and Methods: The study comprised of 100 cases out of which 25 were normal healthy non pregnant controls, 25 were normal healthy pregnant women in third trimester, 25 were in third trimester with preeclampsia and 25 were postpartum preeclamptic women. Whole blood was used to detect Malondialdehyde (MDA) a product of lipid peroxide, Enzymatic antioxidants like Superoxide dismutase, Glutathione peroxidase, Glutathione reductase and Catalase. Results: There was 0significant increase in lipid peroxidation (MDA) in all the groups as compared to nonpregnant controls (P< 0.001). Elevated levels of malondialdehyde in pre-eclamptic subjects declined significantly (p<0.001) after delivery. A significant decrease (P<0.001) in the levels of enzymatic antioxidants viz. Superoxide dismutase, Glutathione peroxidase, Glutathione reductase and Catalase was observed in all the groups as compared to nonpregnant controls. In the postpartum preeclamptic group Glutathione reductase and Catalase levels were increased whereas the increase in the levels of Glutathione peroxidase and Glutathione reductase was not significant. Conclusion: Our study shows clear insight into disturbances associated with preeclampsia with enhanced lipid peroxidation and decreased antioxidants which are help full in understanding the pathogenesis of preeclampsia.

The urachal cyst result of the persistence of the middle part of the urachus and obliteration of the cephalic and caudal ends. Its diagnosis is often difficult because of the variability of the clinical signs. Ultrasound and computed tomography scan can establish the diagnosis in the majority of the cases. The objective of our work is to develop this disease, rare in adults, focusing on its epidemiology, diagnostic and therapeutic.

The object of this communication is to call attention to the practical importance of knowledge of abnormalities of the midgut. Intestinal malrotation refers to the partial or complete failure of rotation of midgut around the superior mesenteric vessels in the embryonic life. Arrested midgut rotation results due to narrow based mesentry and increases the risk of twisting midgut and subsequent obstruction and necrosis.

Subglottic stenosis (SGS) is a partial or complete narrowing of the airway under the vocal cords and above trachea and it is third leading congenital abnormality of larynx. It is because of incomplete development of lumen of laryngotracheal tube in 3rd month of gestation. But it appears in first few months after birth. Larynx develops from 4th and 6th branchial arches. The incidences related to congenital SGS had a significant increment in the late 1960s. Patient with SGS may or may not have some significant respiratory distress. Subglottic stenosis can be membranous or cartilaginous.