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Byline: Snow. Lin, Bryan. Liang Buan, Wilson. Sim, Sneha. Jain, Heidi. Ying Chang, Kuok. Lee, Choon. Chong Aims: The three main types of anastomotic configurations following colorectal resection are Side-to-Side [...]

Introduction: Hypertensive disorders of pregnancy constitute the most widely analysed conditions in pregnancy. Previously, methyldopa was the most commonly used drug, which nowadays has been largely replaced by T. labetalol and T. nifedipine due to the slower onset of action of methyldopa. Chronic hypertension is associated with more maternal and perinatal adverse events, so it is important to determine the optimal antihypertensive therapy. Aim: To compare drug side effects, obstetric complications, and mode of delivery between Group A (T. labetalol administered) and Group B (T. nifedipine administered). Materials and Methods: A prospective interventional study was conducted in the Department of Obstetrics and Gynaecology, Dhiraj Hospital and SBKS Medical Institute and Research Centre, Vadodara, Gujrat, India from December 2022 to May 2023 at Dhiraj Hospital, involving 200 pregnant women with hypertension or Blood Pressure (BP) readings ≥140 mmHg Systolic Blood Pressure (SBP) or ≥90 mmHg Diastolic Blood Pressure (DBP) after 20 weeks gestation. They were randomly divided into two groups: Group A (n=100) with T. labetalol administered and Group B (n=100) with T. nifedipine. The two groups were compared with variables like age, side effects of respective drugs, pregnancy complications, and outcomes, including vaginal or caesarean delivery. The Chi-square and t-test were used to compare variables between the two groups. Results: The mean age in Group A was 25.52±4.10 years, and in Group B, it was 25.95±4.47 years. In Group A (T. labetalol), the majority of cases, i.e., 34 (34%), required a 200 mg dose, followed by 300 mg in 26 (26%) of cases. In Group B (T. nifedipine), the majority of cases, i.e., 48 (48%), required a 30 mg dose, followed by 20 mg in 28 (28%) and 40 mg in 24 (24%) of cases. In Group A (T. labetalol), 2 (1%) cases had Intrauterine Growth Restriction (IUGR), 4 (2%) had oligohydramnios, and 2 (1%) had Intrauterine Demise (IUD). In Group B (T. nifedipine), 6 (3%) cases had IUGR, 6 (3%) had oligohydramnios, and 0 (0%) mmHg had IUD. No significant difference was found between Group A and B (p=0.213). In Group A (T. labetalol), 76 (38%) cases had vaginal delivery, 14 (7%) had emergency caesarean sections, and 10 (5%) had elective caesarean sections. In Group B (T. nifedipine), 70 (35%) cases had vaginal delivery, 18 (9%) had emergency caesarean sections, and 12 (6%) had elective caesarean sections. No significant difference was found between groups A and B (p=0.628). Post-intervention SBP in Group A was 126.06±6.6 mmHg, and in Group B, it was 126.96±8.17 mmHg with no statistically significant difference (p=0.3925). Post-intervention DBP in Group A was 80.6±2.38 mmHg, and in Group B, it was 80.2±1.40 mmHg with no statistically significant difference (p=0.14). Conclusion: Both T. labetalol and T. nifedipine were found to be equally effective. However, with respect to drug side effects and tolerability, T. labetalol was found to be significantly better compared to T. nifedipine. [ABSTRACT FROM AUTHOR]

The molecular pathogenesis of breast cancer (BC), the second most common cancer, varies significantly between sexes, with minimal data in the transgender population. The overall prevalence of BC in transgenders is estimated to be 0.02%. Besides experiencing social disparities, transgenders have to face a lot of discrimination in the healthcare system. Adversities faced, along with the urge to identify with physical attributes to the gender felt by them, forces transgenders to use non-prescribed hormones. Gender affirming hormone therapy (GAHT) is a key feature of transition-related care, rehabbing mental health, and the quality of life of transgenders, but at the expense of their health. Studies have reported that GAHT is associated with severe health conditions such as cancer in transgenders. Estrogens and testosterone are associated with a moderate risk of developing BC. The types of BC diagnosed in transgenders after cross-sex hormone therapy include invasive ductal and neuroendocrine carcinoma, in addition to tubular adenocarcinoma. Although diagnosed at an age earlier compared with ciswomen, BC screening recommendations for transgenders are the same as for ciswomen. This review studies in detail the types of transgenders, their characteristics, different types of breast cancers associated, issues faced while treatment, and their best possible solutions. We also hope to have well-designed research in the future, which will fill the existing gaps in knowledge and provide scientific insight into the transgender population and issues related to their health. There are no international guidelines on screening and management of transgender patients but it appears that breast screening before cosmetic mastectomy, exposure to hormonal therapy for more than 5 years, and as per natal women screening guidelines should be offered to the patient with detailed discussion on the harms and benefits of the same. [ABSTRACT FROM AUTHOR]

A recent study on the glare protection performance of electrochromic (EC) glazing showed that visible transmittance levels lower than 0.6% are necessary to achieve comfortable situations for sun positions, that were close to the central field of view. However, the question that arises is how often such situations occur throughout the year and how the glare protection performance of EC systems is for typical office situations for different climates and orientations. This study aims to quantify the annual performance for such configurations by applying improved simulation methods to conduct annual glare simulations and comparing them to the EN17037 classifications. The enhancement of the simulation method compared to existing methods was necessary to correctly consider the blurring effect in the lens of the eye – neglecting this would lead to an overestimation of glare. We found that for mid and north European climates the extreme situations do not occur such often, so that the ECglazing systems being able to switch to transmittance levels of 1% can mitigate glare throughout the year reasonably well for typical office situations and reaches typically the highest glare protection category according to EN17037 for a viewing direction, that is parallel to the facade. For more sunny climates such as Rome, slightly lower transmittance levels (around 0.5%) would be necessary to achieve a similar glare protection level. The study also revealed that tables E.7 and E.8 of EN17037 with pre-calculated 95-percentile Daylight Glare Probability (DGP) values should be re-calculated.