Term pregnancy with gastroschisis presenting as prolapsed bowel loops

Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 63-64 DOI: http://dx.doi.org/10.3126/njog.v8i1.8870

Disability in Indian patients with haemophilia

Chronic shortage of clotting factor concentrates, exorbitant treatment costs and the poor economic status of patients makes disability an inevitable consequence of haemophilia in India. The prevalence and risk factors for disability were studied in 148 patients with severe haemophilia A registered at five haemophilia clinics in the country. Disability was measured using a scoring method that used a compilation of functional ability, mobility and range-of-motion scores for each patient. Patients ranged in age from 5 to 55 years. Only nine of 148 patients were free of disability. The proportion of disability free patients in the 5-12, 13-24 and 25+ age groups were 14.3%, 4.4% and 0% respectively. The risk factors significantly associated with disability were patients age, socio-economic status, number of persons in the family, family history of haemophilia, frequency of physiotherapy exercises, home use of coagulation factor concentrate and type of blood product(s) used, that is clotting factor concentrate or cryoprecipitate. The study highlights the need to provide coagulation factor concentrates in sufficient amounts to prevent disability, the beneficial role of physiotherapy exercises and the advantage of older patients as peer educators for younger patients. The most important utility of the data is to demonstrate the widespread prevalence of disability amongst patients, its social costs in terms of incomplete education and unemployment, which justifies the need to include haemophilia as one of the conditions under the Disability Act of India.

Hemispheric specialization for English and ASL: left invariance-right variability

Functional magnetic resonance imaging (fMRI) was used to compare the cerebral organization during sentence processing in English and in American sign language (ASL). Classical language areas within the left hemisphere were recruited by both English in native speakers and ASL in native signers. This suggests a bias of the left hemisphere to process natural languages independently of the modality through which language is perceived. Furthermore, in contrast to English, ASL strongly recruited right hemisphere structures. This was true irrespective of whether the native signers were deaf or hearing. Thus, the specific processing requirements of the language also in part determine the organization of the language systems of the brain.

Cerebral organization for language in deaf and hearing subjects: biological constraints and effects of experience

Cerebral organization during sentence processing in English and in American Sign Language (ASL) was characterized by employing functional magnetic resonance imaging (fMRI) at 4 T. Effects of deafness, age of language acquisition, and bilingualism were assessed by comparing results from (i) normally hearing, monolingual, native speakers of English, (ii) congenitally, genetically deaf, native signers of ASL who learned English late and through the visual modality, and (iii) normally hearing bilinguals who were native signers of ASL and speakers of English. All groups, hearing and deaf, processing their native language, English or ASL, displayed strong and repeated activation within classical language areas of the left hemisphere. Deaf subjects reading English did not display activation in these regions. These results suggest that the early acquisition of a natural language is important in the expression of the strong bias for these areas to mediate language, independently of the form of the language. In addition, native signers, hearing and deaf, displayed extensive activation of homologous areas within the right hemisphere, indicating that the specific processing requirements of the language also in part determine the organization of the language systems of the brain.

Long-term in vivo cochlear transgene expression mediated by recombinant adeno-associated virus

Adeno-associated virus (AAV) integrated transgene expression within guinea pig cochlea has been previously documented. This article extends these studies by characterizing the AAV-mediated gene transfer for duration of transgene expression within the cochlea and its effect upon cochlear cytoarchitecture over a period of 6 months. All animals infused with AAV expressed the transgene product, bacterial beta-galactosidase (beta-gal) enzyme, in the spiral limbus, spiral ligament, spiral ganglion cells and the organ of Corti at 2-24 weeks after infusion. However, the level of beta-gal expression, as determined from intensity of immunoreactivity, was relatively lower at 24 weeks as compared with 2 weeks. The cellular and tissue architecture within the AAV-beta-gal perfused cochleae, harvested 2-8 weeks after AAV infusion, was generally intact, ie free from inflammation and cellular degeneration. However, cellular degeneration and degradation was apparent in the cochleae of some but not all animals harvested at 12 and 24 weeks after AAV infusion.

The history of Meniere's disease

Prosper Meniere is widely credited with the first description of endolymphatic hydrops. Meniere's discovery was made possible through a combination of technical and scientific advances, a supportive scientific environment, and a keen intellect able to put the pieces of a puzzle together. Meniere's novel concept, however, that vertiginous disorders were caused by a pathologic process in the semicircular canals was not accepted overnight, but realized only after another 70 years of scientific debate. This article traces the story of endolymphatic hydrops from its anatomical beginnings to its current place in otolaryngology and the individuals who brought us to this point today.

Sentence Reading: A Functional MRI Study at 4 Tesla

In this study, changes in blood oxygenation and volume were monitored while monolingual right-handed subjects read English sentences. Our results confirm the role of the left peri-sylvian cortex in language processing. Interestingly, individual subject analyses reveal a pattern of activation characterized by several small, limited patches rather than a few large, anatomically well-circumscribed centers. Between-subject analyses confirm a lateralized pattern of activation and reveal active classical language areas including Broca's area, Wernicke's area, and the angular gyms. In addition they point to areas only more recently considered as language-relevant including the anterior portion of the superior temporal sulcus. This area has not been reliably observed in imaging studies of isolated word processing. This raises the hypothesis that activation in this area is dependent on processes specific to sentence reading.

Physician-only and physician assistant statutes: a case of perceived but unfounded conflict

In the 1970s, after the US Supreme Court declared in Roe v Wade that a woman has a fundamental right to terminate a pregnancy, most states enacted laws decriminalizing abortion. Generally, these statutes legalized abortion when performed by a physician. (Only six states--AZ, KS, NH, OR, VT, WV--do not require explicitly that abortions be performed by physicians.) At around the same time, but for different reasons, most states adopted regulatory measures establishing and defining the profession of physician assistant (PA). These laws broadly define the scope of practice of PAs as the practice of medicine by trained and licensed professionals under the supervision of physicians. Inconsistencies between physician-only abortion laws and PA statutes have generated confusion in the medical community as to whether PAs, working under the supervision of physicians, can legally perform abortions. Using three case studies, this article examines the statutory dynamic against the backdrop of the severe and intensifying shortage of trained abortion providers in the United States. The authors conclude that the perceived conflict between physician-only and PA statutes should not preclude PAs from providing this vital service.