Hysteroscopic management of complete septate uterus with septate cervix, and longitudinal vaginal septum: a case report.

Mullerian anomalies occur as a result of errors during embryogenesis. The estimated incidence of these anomalies is around 1% in the general population and 3% in women complaining of suboptimal reproductive outcomes and infertility. A 21-year-old female patient was referred to our hospital due to primary infertility for 18 months. After a proper history, physical examination and further diagnostic steps, including ultrasound and magnetic resonance imaging, a diagnosis of complete septate uterus with septate cervix and longitudinal vaginal septum was made. Following hysteroscopic resection of all the septa and two cycles of ovulation induction, the patient was able to conceive. However, she needed cervical cerclage later due to cervical insufficiency. The baby was delivered at term and was healthy. A uterine, cervical and longitudinal vaginal septum is a unique entity of Mullerian anomalies. Resection of all septa through a hysteroscopic approach resulted in a good outcome for our patient.

Antiapoptotic and antioxidant effects of carvedilol and vitamin E protect against diabetic nephropathy and cardiomyopathy in diabetic Wistar albino rats.

Carvedilol is a novel ß-adrenoreceptor blocker, with antioxidant properties inhibiting lipid peroxidation and preventing the depletion of endogenous antioxidants. Moreover, carvedilol was reported to enhance the expression of Bcl-2 gene, which has antioxidant and antiapoptotic effects. There are few researches testing the protective effect of carvedilol on the development of diabetic cardiomyopathy and nephropathy. In this study, we induced diabetes mellitus in male Wistar albino rats. We investigated carvedilol, as well as vitamin E, administrated in healthy and diabetic rats for 6 weeks to compare their effects on biochemical parameters and the expression of Bcl-2 protein in both myocardial and renal tissues by immunohistochemistry. The study showed that the diabetic rats not only had renal dysfunction and more myocardial damage, but also showed lower expression of Bcl-2 protein. Carvedilol and vitamin E treatments were associated with better renal function and less myocardial damage, lower blood glucose, and lipid peroxidation, higher antioxidant capacity, better serum lipids, and higher expression of Bcl-2 protein in diabetic rats. These results indicate that carvedilol and vitamin E treatments partly protect against myocardial and renal damage probably via their antioxidant and antiapoptotic properties in diabetic rats.

The effect of two benzodiazepine receptor agonist hypnotics on sleep-dependent memory consolidation.

INTRODUCTION: Numerous studies have demonstrated that sleep promotes memory consolidation, but there is little research on the effect of hypnotics on sleep-dependent memory consolidation. We compared bedtime administration of zolpidem-ER 12.5 mg (6- to 8-h duration of action), middle-of-the-night administration of zaleplon 10 mg (3- to 4-h duration of action), and placebo to examine the effect of different durations of hypnotic drug exposure on memory consolidation during sleep. METHODS: Twenty-two participants with no sleep complaints underwent 3 conditions in a counterbalanced crossover study: (1) zolpidem-ER 12.5 mg (bedtime dosing), (2) zaleplon 10 mg (middle-of-the-night dosing), and (3) placebo. Memory testing was conducted before and after an 8-h sleep period, using a word pair association task (WPT; declarative memory) and a finger-tapping task (FTT; procedural memory). RESULTS: ANOVA revealed a significant condition effect for the WPT (p = 0.025) and a trend for the FTT (p = 0.067), which was significant when sex was added to the model (p = 0.014). Improvement in memory performance following sleep was lower with bedtime dosing of zolpidem-ER compared to placebo and middle-of-the-night dosing of zaleplon. There were no differences between placebo and zaleplon. CONCLUSIONS: The results suggest that in some circumstances hypnotics may have the potential to reduce the degree of sleep-dependent memory consolidation and that drug-free sleep early in the night may ameliorate this effect.

Corrected QT dispersion improves diagnostic performance of exercise testing in diagnosing coronary artery disease.

To determine the best combination of parameters that would improve the diagnostic performance of exercise testing, coronary angiography plus exercise testing were done on 112 patients with angina pectoris and normal electrocardiogram. The univariate predictors of coronary artery disease included: age > or = 40 years, male sex, hypertension, smoking, development of exertional chest pain, decrease in systolic blood pressure (BP) > or = 10 mmHg or systolic BP 3 min post-exercise > 90% of peak, heart rate drop < 12 beats/min 1 min postexercise, exercise-induced ST-segment depression > or = 1 mm. Multivariate logistic regression analysis showed that using either ST depression > or = 1 mm or peak exercise QTDc > 70 ms significantly improved sensitivity and negative predictive value of the test without a significant decrease in specificity.

Pattern and possible contributing factors to dialysis-associated arrhythmia in young patients.

We studied dialysis-associated arrhythmia in 48 uraemic patients < 35 years on chronic haemodialysis (HD) (> 3 months). Holter findings showed only minor arrhythmia; atrial in 42% of patients and ventricular in 38%. ST-segment depression > 1 mm was observed in 58% of patients; 80% had arrhythmia, and 36% experienced anginal pain. HD caused a significant increase in QTc, QTdc and Ca2+ level, while K+ level was significantly decreased. Patients who experienced arrhythmia during HD had higher left ventricular mass and left ventricular mass index, lower post-dialysis K+ level, higher QTc and QTdc both before and after HD. They were more frequently hypertensive. ST-segment depression was significantly related to ventricular arrhythmia.