Central airway obstruction caused by adenoid cystic carcinoma in pregnancy: a case report and review of the literature.

Malignancy complicates one in a thousand pregnancies. The most frequently diagnosed of these are breast, cervical, melanoma, ovarian, and haematological neoplasms. Tumours of respiratory origin are very uncommon during pregnancy. We present a case of tracheal adenoid cystic carcinoma (ACC), a rare type of primary airway tumour, diagnosed in a pregnant woman. To our knowledge, this is the third reported case of tracheal ACC complicating pregnancy. We discuss potential barriers to timely diagnosis of malignancies during pregnancy and consider optimal management strategies, taking into account the potential harm to the mother and foetus in a field with a limited evidence base.

Eating soup with nails of pig: thematic synthesis of the qualitative literature on cultural practices and beliefs influencing perinatal nutrition in low and middle income countries.

BACKGROUND: The perinatal period, i.e. pregnancy, childbirth and early infancy, is a significant transition period where the biological and the social strongly intersect. In low and middle-income countries the disease burden arising from the perinatal period, is still substantial. The perinatal period is also a crucial window of opportunity for reducing undernutrition and its long term adverse effects. METHODS: We explored qualitative research conducted in low resource settings around the perinatal continuum over the past two decades, with a particular focus on the 'cultural' realm, to identify common themes influencing maternal and infant nutrition. We systematically searched electronic databases from 1990 to 2014, including MEDLINE, EMBASE, PsycINFO, Scopus and Cumulative Index to Nursing and Allied Health Literature, using relevant search terms including traditional beliefs, practices, pregnancy, childbirth, developing countries etc. Adapted Consolidated Criteria for Reporting Qualitative Health Research and Critical Appraisal Skills Programme criteria were used to determine quality of studies. We synthesised the literature thematically, enabled by NVivo 10 software. RESULTS: Most studies showed cultural support for breastfeeding, although most traditional societies delayed breastfeeding due to colostrum being considered 'dirty'. A range of restrictive practices through pregnancy and the post- partum period were revealed in Asia, Latin America and Africa. There was a strong cultural understanding of the healing power of everyday foods. A wide range of good foods and bad foods continued to have currency through the perinatal continuum, with little consensus between groups of what was beneficial versus harmful. Cross-cutting themes that emerged were 1) the role of the woman/mother/wife as strong and good; 2) poverty restricting women's nutrition choices; 3) change being constant, but the direction of change unpredictable. CONCLUSIONS: A rich and diverse repertoire of cultural practices and beliefs influenced perinatal nutrition. Results from this synthesis should influence public health policymakers and practitioners, to tailor contextually specific, culturally responsive perinatal nutrition interventions to optimise health and wellbeing of mother-infant dyads. Ideally these interventions should build on culturally sanctioned life affirming behaviours such as breastfeeding, promoting post-partum rest and recovery, while modifying the potentially harmful aspects of other cultural practices in the perinatal period.

How natural is the supernatural? Synthesis of the qualitative literature from low and middle income countries on cultural practices and traditional beliefs influencing the perinatal period.

OBJECTIVE: to review qualitative research studies conducted in low resource settings around the perinatal continuum over the past two decades, with particular focus on the cultural realm; to identify common themes in the research-base, in order to provide policy direction for culturally appropriate perinatal interventions. DESIGN: systematic literature search of electronic databases from 1990 to 2014, including Medline, Embase, CINAHL and PsycINFO, using relevant search terms such as traditional beliefs, practices, pregnancy, childbirth; established criteria used to determine quality of studies; and thematic synthesis of the literature enabled by NVivo 10 software. SETTING: low and middle income countries using the World Bank classification. FINDINGS: religious and spiritual beliefs strongly influenced behaviour over the perinatal period. Beliefs in supernatural influences, particularly malevolent forces were widespread, such that pregnancy was concealed in many parts of Africa and Asia. In most low resource settings, pregnancy and childbirth were seen as normal phenomena. Rituals played an important part for women and their infants, reinforced by inter-generational support. Cross-cutting themes that emerged were: (1) the role of women as mothers, demonstrating their'goodness' by bearing pain and suffering; (2) the idea of the 'natural' incorporating the supernatural; and (3) negotiating change across generations. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: a diverse repertoire of cultural practices influences perinatal well-being across low resource settings. Health practitioners and policy-makers need to acknowledge the primacy of women's reproductive roles, the cultural constructions of motherhood; that supernatural forces are believed to exert powerful influences on the health of mother and infant; that inter-generational tensions result in resisting or embracing change. Public health planners and practitioners need to take culture seriously, not ignore the contribution of culture in shaping women's behaviours and choices throughout the perinatal continuum and deliver contextually specific, culturally responsive care to optimise perinatal health and well-being.

The effect of Vitamin E on learning and memory deficits in intrahippocampal kainate-induced temporal lobe epilepsy in rats.

OBJECTIVE: Since temporal lobe epilepsy (TLE) is associated with learning and memory impairment, we investigated the beneficial effect of Vitamin E on the impaired learning and memory in the intrahippocampal kainate model of TLE in rats. MATERIALS AND METHODS: Rats were divided into sham, Vitamin E-treated sham, kainate, and Vitamin E-treated kainate. Intrahippocampal kainate was used for induction of epilepsy. Vitamin E was injected intraperitoneal (i.p.) at a dose of 200 mg/kg/day started 1 week before surgery until 1 h presurgery. Initial and step-through latencies in the passive avoidance test and alternation behavior percentage in Y-maze were finally determined in addition to measurement of some oxidative stress markers. RESULTS: Kainate injection caused a higher severity and rate of seizures and deteriorated learning and memory performance in passive avoidance paradigm and spontaneous alternation as an index of spatial recognition memory in Y-maze task. Intrahippocampal kainate also led to the elevation of malondialdehyde (MDA) and nitrite and reduced activity of superoxide dismutase (SOD). Vitamin E pretreatment significantly attenuated severity and incidence rate of seizures, significantly improved retrieval and recall in passive avoidance, did not ameliorate spatial memory deficit in Y-maze, and lowered MDA and enhanced SOD activity. CONCLUSION: Vitamin E improves passive avoidance learning and memory and part of its beneficial effect is due to its potential to mitigate hippocampal oxidative stress.