6 research outputs found
Inadvertent laparoelytrotomy in second stage of labour: a case report
No full textLaparoelytrotomy is the accidental delivery via a vaginal incision during caesarean section in second stage of labour. It refers to the inadvertent delivery of the foetus through a transverse incision given over the vagina during a caesarean section (C-section). It is a rather uncommon complication of C-section encountered at advanced dilation which can lead to maternal complications such as traumatic postpartum hemorrhage, injury to bladder, ureters and difficult reconstruction of vagina. Here, we present a case report of inadvertent laparoelytrotomy during C-section
Exploring the efficacy of centchroman as a postpartum contraceptive: an observational study
No full textBackground: Centchroman, a non-hormonal contraceptive, offers a safer alternative for postpartum women, particularly in India, where the responsibility of contraception largely falls on females. Despite its benefits, including minimal side effects and efficacy in pregnancy prevention, its adoption remains low. This study examines Centchroman’s effectiveness as a postpartum contraceptive in eastern India
Methods: This prospective observational study (March 2017–February 2018) recruited postpartum women from SCB Medical College, Odisha, meeting inclusion criteria. Participants took Centchroman following a structured regimen, with follow-ups at 1, 3 and 6 months. The primary objective was to determine contraceptive efficacy. Secondary objectives were to assess compliance, satisfaction and adverse effects. Data were analysed using SPSS using Statistics (Version 23.0).
Results: During the study, 785 eligible participants were counselled and 247 consented to use Centchroman, resulting in an acceptance rate of 31.5%. Most were aged 25–29, Hindu (79.7%) and from rural areas (59.5%). Compliance was high, with 96.2% satisfaction by the third follow-up. Common adverse events included delayed periods and heavy bleeding, which decreased over time. Milk secretion reduction was minimal. The main reasons for discontinuation were living apart from their husband (4.8%) and fear of side effects (4.4%). Centchroman showed high adherence, safety and effectiveness as a postpartum contraceptive.
Conclusions: This study highlights Centchroman as a safe, effective, non-hormonal postpartum contraceptive with high acceptability. Minimal adverse effects make it suitable for lactating mothers
Author's personal copy Specialization of right temporo-parietal junction for mentalizing and its relation to social impairments in autism
No full textOver the last 25 years, "mindblindness" (deficits in representing mental states) has been one of the primary explanations behind the hallmark social-communication difficulties in autism spectrum conditions (ASC). However, highlighting neural systems responsible for mindblindness and their relation to variation in social impairments has remained elusive. In this study we show that one of the neural systems responsible for mindblindness in ASC and its relation to social impairments is the right temporo-parietal junction (RTPJ). Twentynine adult males with ASC and 33 age and IQ-matched Controls were scanned with fMRI while making reflective mentalizing or physical judgments about themselves or another person. Regions of interest within mentalizing circuitry were examined for between-group differences in activation during mentalizing about self and other and correlations with social symptom severity. RTPJ was the only mentalizing region that responded atypically in ASC. In Controls, RTPJ was selectively more responsive to mentalizing than physical judgments. This selectivity for mentalizing was not apparent in ASC and generalized across both self and other. Selectivity of RTPJ for mentalizing was also associated with the degree of reciprocal social impairment in ASC. These results lend support to the idea that RTPJ is one important neural system behind mindblindness in ASC. Understanding the contribution of RTPJ in conjunction with other neural systems responsible for other component processes involved in social cognition will be illuminating in fully explaining the hallmark social-communication difficulties of autism
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Why are autism spectrum conditions more prevalent in males?
No full textAutism Spectrum Conditions (ASC) are much more common in males, a bias that may offer clues to the etiology of this condition. Although the cause of this bias remains a mystery, we argue that it occurs because ASC is an extreme manifestation of the male brain. The extreme male brain (EMB) theory, first proposed in 1997, is an extension of the Empathizing-Systemizing (E-S) theory of typical sex differences that proposes that females on average have a stronger drive to empathize while males on average have a stronger drive to systemize. In this first major update since 2005, we describe some of the evidence relating to the EMB theory of ASC and consider how typical sex differences in brain structure may be relevant to ASC. One possible biological mechanism to account for the male bias is the effect of fetal testosterone (fT). We also consider alternative biological theories, the X and Y chromosome theories, and the reduced autosomal penetrance theory. None of these theories has yet been fully confirmed or refuted, though the weight of evidence in favor of the fT theory is growing from converging sources (longitudinal amniocentesis studies from pregnancy to age 10 years old, current hormone studies, and genetic association studies of SNPs in the sex steroid pathways). Ultimately, as these theories are not mutually exclusive and ASC is multi-factorial, they may help explain the male prevalence of ASC
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Social and non-social autism symptoms and trait domains are genetically dissociable
No full textThe core diagnostic criteria for autism comprise two symptom domains – social and communication difficulties, and unusually repetitive and restricted behaviour, interests and activities. There is some evidence to suggest that these two domains are dissociable, though this hypothesis has not yet been tested using molecular genetics. We test this using a genome-wide association study (N = 51,564) of a non-social trait related to autism, systemising, defined as the drive to analyse and build systems. We demonstrate that systemising is heritable and genetically correlated with autism. In contrast, we do not identify significant genetic correlations between social autistic traits and systemising. Supporting this, polygenic scores for systemising are significantly and positively associated with restricted and repetitive behaviour but not with social difficulties in autistic individuals. These findings strongly suggest that the two core domains of autism are genetically dissociable, and point at how to fractionate the genetics of autism
Imbalanced social-communicative and restricted repetitive behavior subtypes of autism spectrum disorder exhibit different neural circuitry.
No full textSocial-communication (SC) and restricted repetitive behaviors (RRB) are autism diagnostic symptom domains. SC and RRB severity can markedly differ within and between individuals and may be underpinned by different neural circuitry and genetic mechanisms. Modeling SC-RRB balance could help identify how neural circuitry and genetic mechanisms map onto such phenotypic heterogeneity. Here, we developed a phenotypic stratification model that makes highly accurate (97-99%) out-of-sample SC = RRB, SC > RRB, and RRB > SC subtype predictions. Applying this model to resting state fMRI data from the EU-AIMS LEAP dataset (n = 509), we find that while the phenotypic subtypes share many commonalities in terms of intrinsic functional connectivity, they also show replicable differences within some networks compared to a typically-developing group (TD). Specifically, the somatomotor network is hypoconnected with perisylvian circuitry in SC > RRB and visual association circuitry in SC = RRB. The SC = RRB subtype show hyperconnectivity between medial motor and anterior salience circuitry. Genes that are highly expressed within these networks show a differential enrichment pattern with known autism-associated genes, indicating that such circuits are affected by differing autism-associated genomic mechanisms. These results suggest that SC-RRB imbalance subtypes share many commonalities, but also express subtle differences in functional neural circuitry and the genomic underpinnings behind such circuitry
