COVID-19 pandemic influence on epilepsy course in pediatric patients.

INTRODUCTION: In 2020, Coronavirus Disease 2019 (COVID-19) was declared as a global pandemic. Self-reported stress, anxiety, and insomnia, which are believed to be common triggers for epilepsy, are more likely to occur. We aimed to establish the influence of COVID-19 pandemic itself on changes in the daily life routine related to pandemic on epilepsy course in pediatric patients. The unique form of clinical care which is telemedicine was also taken into consideration. We wanted to evaluate patients' satisfaction with telemedicine and if changing stationary visits into telemedicine influenced epilepsy course in our patients. METHODS: Patients, who attended developmental neurology outpatient clinic in the period March-December 2020 were collected. As patients were minors, legal guardians were asked to fill out the questionnaire. Patients were divided according to the outcome into three groups: those with a worsened, stable, or improved course of epilepsy during the pandemic. Appropriate statistical tests for two-group and multi-group comparisons have been implemented. Post hoc p values were also calculated. RESULTS: Four hundred and two questionnaires were collected. Most of the patients had a stable course of epilepsy during the pandemic; in 13% of participants an improvement has been observed, worsening of the disease was seen in 16% of patients. Age, sex, type of epilepsy, number of seizure incidents before pandemic, and duration of the disease had no statistically significant connection with changes in the course of the disease. Behavioral changes and altered sleep patterns were found to be more common in the worsened group. Fifty-eight percent of patients were satisfied with telemedicine. Poorer satisfaction was connected with less frequent visits, cancellation of scheduled appointments, and lack of help in case of need in an emergency situation. CONCLUSION: Epilepsy course in pediatric patients seems to be stable during COVID-19 pandemic. Sleep disturbances and changes in a child's behavior may be related to increase in seizure frequency. Telemedicine is an effective tool for supervising children with epilepsy. Patients should be informed about possible ways of getting help in urgent cases.

Family delivery from the standpoint of fathers--can stereotypes of participant or non-participant father be fully justified?

OBJECTIVES: Family delivery is an important aspect of modern obstetrics. The aim of this study was to estimate the phenomenon of family delivery from the standpoint of participating and non-participating fathers. STUDY DESIGN: Two types of questionnaires were used in the study. Five hundred and five men were divided into two groups: (A) delivery participants and (B) delivery non-participants. RESULTS: The participants were significantly younger than non-participants. Better educated men dominated in group (A), whereas men with trade education were the majority in group (B). Low birth classes attendance among women in group (B) was noticed. All men in group (B) knew about the possibility of taking part in the delivery. Almost 100% of participants declared their satisfaction with family delivery. For non-participants, wife and media were the main source of knowledge, while for participants it was the medical staff and labor schools. CONCLUSIONS: Family labor is commonly accepted by both partners and is generally connected with positive emotions. This phenomenon is generally approved by couples with higher economical status. Family labor resignation, common among pairs with lower economical status, is caused generally by fear and lack of proper knowledge. Health care providers, through labor schools and outpatients visits, should concentrate on getting to couples, whose attitude towards family labor is negative. Educational programs and popular press articles should be prepared more thoroughly, focusing on the whole population of potential fathers.

The usefulness of laparoscopy and hysteroscopy in the diagnostics and treatment of infertility.

OBJECTIVES: The aim of the study was to analyze the use of endoscopic procedures in the group of infertile patients. MATERIAL AND METHODS: The study material consisted of 636 patients, aged 20-41. They all had endoscopic procedures performed (laparoscopy and/or hysteroscopy) due to infertility, and were qualified for the procedure after a gynecological examination and ultrasound scan. The study group was divided into subgroups of primary and secondary sterility and endoscopic procedures were then analyzed. RESULTS: A total of 724 endoscopic procedures were performed on 636 patients. Eighty eight women had both hysteroscopy and laparoscopy performed, 476 had only laparoscopy, while 72--only hysteroscopy. Women diagnosed due to primary sterility more often had no visible abnormalities in the pelvic region (30%) and patent oviducts than those with secondary sterility. The remaining 70% more often had ovaries typical for polycystic ovarian syndrome and endometriosis. However, periadnexal adhesions and tubal impotency were more common in the group of secondary sterility. As to hysteroscopy, women with primary sterility more often had congenital uterine malformations, while submucosal myomas and intrauterine adhesions were less common in that group. All the surgical procedures performed during laparoscopies were analyzed. Tubal patency assessment and ovarian drilling were significantly more often performed in the subgroup of primary sterility. All intrauterine pathologies were treated during hysteroscopy. CONCLUSIONS: Laparoscopy and hysteroscopy play an important role as both diagnostic and therapeutic tools in the infertility treatment centers.

[Ectopic pregnancy--still a live clinical issue --a case report]. / Ciaza ektopowa jako wciaz aktualny problem kliniczny - opis przypadku.

We report a case of a 23-year old patient with extrauterine (tubal) pregnancy at 14 weeks gestational age. The patient was admitted to the Clinic with growing abdominal pain lasting few hours, with worsening general condition with no previous symptoms. In ultrasound examination a normal size uterus was described. On the right and behind the uterus the structures of an alive fetus, 13 weeks gestational age according to biometry (BPD, FL) and a large amount of blood clots were seen. Laparotomy was performed and 1500 ml of blood with clots were evacuated from the peritoneal cavity. The right fallopian tube, bulged in isthmal region (close to its intramural part) was ruptured about 2 cm from the uterine corn. The 10 cm long fetus and afterbirth were born into the peritoneal cavity. Right salpingectomy was performed with no complications in the postoperative period.

[Heterotopic pregnancy]. / Ciaza heterotopowa.

We report a case of combined intrauterine and extrauterine (tubal) pregnancy in 24-year-old woman. The patient was admitted to the Clinic at 9 weeks gestational age with abdominal pain lasting 2 hours. Pelvic ultrasonography revealed alive 9-week intrauterine pregnancy, free fluid in the peritoneal cavity and left adnexal mass. A left salpingectomy was performed, with removal of ruptured ampulla with ectopic pregnancy, without complications. The intrauterine pregnancy proceeded uneventfully to 39 weeks, was terminated by cesarean section, resulting in birth of a healthy female infant of 3630 grams.

[Use of misoprostol in the termination of missed abortion]. / Zastosowanie misoprostolu w indukcji poronienia u kobiet z ciaza obumarla.

The efficiency of misoprostol in the termination of missed abortion was estimated. The group of 66 patients aged 19 - 37, who received 400 microg of vaginal misoprostol for termination of missed abortion was subjected. The overall success rate for a complete abortion was 30.3%, for incomplete abortion 25.8% and in a group of 27.2% women there was no need for cervix canal dilatating during the excochleation of uterus cavity. 16.7% cases failed. The results obtained in this study led us to the conclusion that 400 microg of vaginal misoprostol can induce the termination of missed abortion or dilatation of the uterus' canal.