The umbilical cord lacks vasavasorum and is prone for hypoxic injuries. Gestational diabetes mellitus (GDM) causes structural changes with in umbilical cord blood vessels. Knowledge of which would be helpful for the gynecologist and obstetricians to assess the prognosis and prevent the complications. The present study was concentrated from December 2016 to December 2019 on 50 normal and 56 GDM umbilical cords. GDM group included 23 GDM mothers managed by diet (GDM-Diet) and 33 GDM mothers managed by drugs (GDM-Drug). Placentas along with the attached umbilical cords were collected and stored in 10% formaline. Tissue processing, slide preparation and stainings were done using standard protocols.A significant reduction was observed in the number of Hoboken nodules of umbilical arteries of GDM-Diet. Reduction of myofibroblasts with an increase in the empty spaces was observed in the Wharton’s jelly of both GDM cases. Similarly, smooth muscle disintegration and migration of smooth muscles to intima was significantly higher in GDM umbilical arteries and veins than normal umbilical vessels. The total wall thickness and tunica media was significantly thicker in the umbilical arteries of GDM-Drug group only. The umbilical venous lumen was found significantly wider in GDM groups compared to normal. The elastin fibers were significantly found reduced in the tunics of umbilical arteries and veins in GDM. However, a significant difference in these parameters was not observed between the GDM-Diet and GDM-Drug groups except for total wall and tunica media thickness of umbilical arteries.

The umbilical cord lacks vasavasorum and is prone for hypoxic injuries. Gestational diabetes mellitus (GDM) causes structural changes with in umbilical cord blood vessels. Knowledge of which would be helpful for the gynecologist and obstetricians to assess the prognosis and prevent the complications. The present study was concentrated from December 2016 to December 2019 on 50 normal and 56 GDM umbilical cords. GDM group included 23 GDM mothers managed by diet (GDM-Diet) and 33 GDM mothers managed by drugs (GDM-Drug). Placentas along with the attached umbilical cords were collected and stored in 10% formaline. Tissue processing, slide preparation and stainings were done using standard protocols.A significant reduction was observed in the number of Hoboken nodules of umbilical arteries of GDM-Diet. Reduction of myofibroblasts with an increase in the empty spaces was observed in the Wharton’s jelly of both GDM cases. Similarly, smooth muscle disintegration and migration of smooth muscles to intima was significantly higher in GDM umbilical arteries and veins than normal umbilical vessels. The total wall thickness and tunica media was significantly thicker in the umbilical arteries of GDM-Drug group only. The umbilical venous lumen was found significantly wider in GDM groups compared to normal. The elastin fibers were significantly found reduced in the tunics of umbilical arteries and veins in GDM. However, a significant difference in these parameters was not observed between the GDM-Diet and GDM-Drug groups except for total wall and tunica media thickness of umbilical arteries.

The umbilical cord lacks vasavasorum and is prone for hypoxic injuries. Gestational diabetes mellitus (GDM) causes structural changes with in umbilical cord blood vessels. Knowledge of which would be helpful for the gynecologist and obstetricians to assess the prognosis and prevent the complications. The present study was concentrated from December 2016 to December 2019 on 50 normal and 56 GDM umbilical cords. GDM group included 23 GDM mothers managed by diet (GDM-Diet) and 33 GDM mothers managed by drugs (GDM-Drug). Placentas along with the attached umbilical cords were collected and stored in 10% formaline. Tissue processing, slide preparation and stainings were done using standard protocols.A significant reduction was observed in the number of Hoboken nodules of umbilical arteries of GDM-Diet. Reduction of myofibroblasts with an increase in the empty spaces was observed in the Wharton’s jelly of both GDM cases. Similarly, smooth muscle disintegration and migration of smooth muscles to intima was significantly higher in GDM umbilical arteries and veins than normal umbilical vessels. The total wall thickness and tunica media was significantly thicker in the umbilical arteries of GDM-Drug group only. The umbilical venous lumen was found significantly wider in GDM groups compared to normal. The elastin fibers were significantly found reduced in the tunics of umbilical arteries and veins in GDM. However, a significant difference in these parameters was not observed between the GDM-Diet and GDM-Drug groups except for total wall and tunica media thickness of umbilical arteries.

The umbilical cord lacks vasavasorum and is prone for hypoxic injuries. Gestational diabetes mellitus (GDM) causes structural changes with in umbilical cord blood vessels. Knowledge of which would be helpful for the gynecologist and obstetricians to assess the prognosis and prevent the complications. The present study was concentrated from December 2016 to December 2019 on 50 normal and 56 GDM umbilical cords. GDM group included 23 GDM mothers managed by diet (GDM-Diet) and 33 GDM mothers managed by drugs (GDM-Drug). Placentas along with the attached umbilical cords were collected and stored in 10% formaline. Tissue processing, slide preparation and stainings were done using standard protocols.A significant reduction was observed in the number of Hoboken nodules of umbilical arteries of GDM-Diet. Reduction of myofibroblasts with an increase in the empty spaces was observed in the Wharton’s jelly of both GDM cases. Similarly, smooth muscle disintegration and migration of smooth muscles to intima was significantly higher in GDM umbilical arteries and veins than normal umbilical vessels. The total wall thickness and tunica media was significantly thicker in the umbilical arteries of GDM-Drug group only. The umbilical venous lumen was found significantly wider in GDM groups compared to normal. The elastin fibers were significantly found reduced in the tunics of umbilical arteries and veins in GDM. However, a significant difference in these parameters was not observed between the GDM-Diet and GDM-Drug groups except for total wall and tunica media thickness of umbilical arteries.

The umbilical cord lacks vasavasorum and is prone for hypoxic injuries. Gestational diabetes mellitus (GDM) causes structural changes with in umbilical cord blood vessels. Knowledge of which would be helpful for the gynecologist and obstetricians to assess the prognosis and prevent the complications. The present study was concentrated from December 2016 to December 2019 on 50 normal and 56 GDM umbilical cords. GDM group included 23 GDM mothers managed by diet (GDM-Diet) and 33 GDM mothers managed by drugs (GDM-Drug). Placentas along with the attached umbilical cords were collected and stored in 10% formaline. Tissue processing, slide preparation and stainings were done using standard protocols.A significant reduction was observed in the number of Hoboken nodules of umbilical arteries of GDM-Diet. Reduction of myofibroblasts with an increase in the empty spaces was observed in the Wharton’s jelly of both GDM cases. Similarly, smooth muscle disintegration and migration of smooth muscles to intima was significantly higher in GDM umbilical arteries and veins than normal umbilical vessels. The total wall thickness and tunica media was significantly thicker in the umbilical arteries of GDM-Drug group only. The umbilical venous lumen was found significantly wider in GDM groups compared to normal. The elastin fibers were significantly found reduced in the tunics of umbilical arteries and veins in GDM. However, a significant difference in these parameters was not observed between the GDM-Diet and GDM-Drug groups except for total wall and tunica media thickness of umbilical arteries.

Methods: The study included 60 patients graded American Society of Anesthesiologists I and II and scheduled for thoracolumbar spine surgery involving >3 vertebral levels. The patients were divided into two groups: group KD (ketodex) and group F (fentanyl). The primary objective was to compare the postoperative analgesic requirements among the groups. The secondary objectives included a comparison of the intraoperative anesthetic requirements, postoperative pain scores, hemodynamic parameters, side effects of the study drugs, and the duration of post-anesthesia care unit stay of both the groups. Results: Ketodex use prolonged the mean time to first rescue analgesia (22.00±2.30 hours vs. 11.69±3.02 hours, p <0.001) and reduced the requirement of rescue analgesics in the first 24 hours postoperatively compared to fentanyl use (70.00±8.16 μg vs. 113.31±36.65 μg, p =0.03). The intraoperative requirement of desflurane was comparable between the groups (p >0.05). The postoperative pain scores were significantly lower in the group KD than in group F at most timepoints (p <0.05). Patients in group KD had a shorter post-anesthesia care unit stay than group F did (p <0.001). Conclusions Low-dose ketodex could be a safe substitute for fentanyl infusion when employed as an anesthetic adjuvant for patients undergoing thoracolumbar spine surgeries involving >3 vertebral levels to achieve prolonged analgesia without any opioidrelated side effects.

Background: In order to assess the effectiveness of various analgesio-sedative combinations for pain relief and sedation in pediatric dental patients, a thorough evaluation of clinical studies and patient outcomes is necessary. Methods: A total of 128 healthy, uncooperative pediatric dental patients were randomly allocated to receive one of the four combinations of drugs via the intranasal (IN) route: Group I received midazolam-ketamine (MK), Group II received dexmedetomidine-ketamine (DK), Group III received midazolam-fentanyl (MF), and Group IV received dexmedetomidine-fentanyl (DF) in a parallel-arm study design. The efficacy and safety of the combinations were evaluated using different parameters. Results: The onset of sedation was significantly faster in the DF group than in the DK, MF, and MK groups (P < 0.001). The depth of sedation was significantly higher in the DK and DF groups than in the MK and MF groups (P < 0.01). DK and DF produced significant intra- and postoperative analgesia when compared with combinations of MK and MF. No significant adverse events were observed for any of the combinations. Conclusions The DK and DF groups showed potential as analgesio-sedatives in view of their anxiolytic and analgesic effects.

This was a prospective, randomized, and double-blind study.

This was a prospective, randomized, and double-blind study.

Hodgkin’s lymphoma most commonly presents as painless lymphadenopathy and systemic B symptoms like fever, night sweats, and weight loss. But rarely, it can present with unusual paraneoplastic manifestations. In the present case, we report a 30-year-old woman who presented with sub-acute onset pan-cerebellar symptoms. The serum neuronal antibody panel was negative. She underwent F-18 FDG PET/CT to evaluate the neoplastic etiology as the underlying cause, which demonstrated both the primary etiology and the paraneoplastic changes in the brain.