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Congenital isolated factor X deficiency is a very rare autosomal recessive disorder. The incidence of factor X deficiency is 1 in 10,00,000 in the general population. Pregnancy with factor X deficiency may present with recurrent antepartum and peripartum haemorrhage including recurrent episiotomy site haematoma. Complete absence of Factor X is lethal. Here we report a case of severe factor X deficiency who was referred to our institute at 38 week of gestation. She had history of recurrent episiotomy site haematoma in previous pregnancy and multiple episodes of antepartum haemorrhage in present pregnancy. She was managed successfully with a planned haemostatic strategy at our institute. No specific guidelines for managing such cases are available till date. In our opinion, patients with severe Factor X deficiency can have a normal pregnancy outcome with dedicated multidisciplinary approach and a planned delivery at a tertiary care center. [ABSTRACT FROM AUTHOR]

Background: Perinatal deaths due to hypoxia are preventable with continuous monitoring. Cardiotocography (CTG) is standard for intrapartum foetal assessment, aiming to detect signs of distress and intervene promptly to mitigate risk. Objective: To determine the accuracy of advanced intrapartum monitoring system in comparison with electronic CTG in tracking of non-reassuring foetal symptoms by pattern analysis of the FHR. Materials and methods: A single-centre, observation study was conducted at a tertiary care hospital from January 2020 to December 2021. CTG and an advanced portable intrapartum monitoring system (KEYAR) were applied simultaneously to all participants. Twenty-minute-long recording traces were obtained from both devices. Mode of delivery was noted for all patients along with Apgar score at 1 minute and 5 minutes. Results: The final study cohort was constituted by 94 participants. Most participants (57.4%) were primigravida. The mean (95% CI) sensitivity, specificity, positive predictive value and negative predictive value of KEYAR tracing were 33% (9.6, 70), 97.7% (92.09, 99.37), 50% (15, 85) and 95.5% (89.12, 98.26), respectively. The overall, diagnostic accuracy of KEYAR was 93.6% (86.77, 97.04). Conclusions: Advanced portable intrapartum monitoring device (KEYAR) is a new application with the benefits of easy user operability and portability. [ABSTRACT FROM AUTHOR]

Urinary tract infections (UTI) is a broad term encompassing the urothelium's inflammatory reaction to bacterial invasion, characterized by the presence of bacteria and pus cells. It can manifest anywhere along the urinary tract and can have insidious onset which can be asymptomatic bacteriuria or may present with acute onset of symptoms like in case of cystitis or pyelonephritis. This review aims to determine the causation of UTI during pregnancy and elucidates the methods for diagnosing UTI in pregnant women. We concisely outline the array of treatment alternatives accessible to pregnant patients with UTI aiming to enhance care and outcomes for expectant mothers afflicted with UTI. [ABSTRACT FROM AUTHOR]

Introduction: Supporting vaginal vault or apex is a central component of primary therapy and to prevent recurrence of prolapse. This study aims to review the surgical outcomes and feasibility of the anterior approach following both sacrospinous fixation (SSF) and sacrospinous hysteropexy (SSHP) in a single center over a specific period. And also to review its impact on quality of life. Materials and Methods: This was a retrospective study that included all women who underwent unilateral SSF or SSHP through anterior approach for pelvic organ prolapse (POP) from May 2021 to May 2023 after institutional ethical approval for the study. The anterior approach was undertaken in 47 patients which were included in final review. A retrospective case note review to assess urinary symptoms was undertaken at baseline and 3 months by urinary distress inventory 6 score. The main outcome measure was recurrence of prolapse, predominant compartment for prolapse, presenting complaints, concomitant surgeries performed, and associated urinary complaints. Results: The mean age was 56.17 ± 11.95 years and the average body mass index was 26.12 ± 3.11 kg/m2. Except for 4 cases of SSHP, remaining women were postmenopausal at the time of surgery. Ten women presented with urinary complaints as their chief complaint. On examination, POP Quantification evaluation, 35 cases have Ba as leading point, 10 have Ap as their leading point and in two cases C was the leading point. Conclusion: Anterior unilateral sacrospinous ligament fixation is a safe, effective strategy to treat POP and other concomitant surgery can also be well combined with it. [ABSTRACT FROM AUTHOR]

Microstructural variations have a strong influence on the load transfer capacity of the high-performance polymeric fibers, which is also reflected in their ballistic property changes. The focus of the present study is to investigate thermally induced microstructural changes and their reflection on the mechanical properties and theoretical ballistic limit of poly (p -phenylene terephthalamide) fibers by a correlation. From the quantitative analysis of XRD, thermally induced changes in unit cell a-dimension show profound sensitivity in affecting the tenacity and modulus of the fibers. Based on the physicochemical changes in FTIR and FESEM analysis, significant surface deterioration and changes in the chemical network are observed. However, dimensional variations of the crystal structure along a-direction show a stronger influence than the chemical and morphological changes, reflecting sigmoidal responses with tenacity, modulus and theoretical V 50 by correlations. As an effect of unit cell dimensional variation, changes in crystallinity are resulted and lead to the loss in theoretical ballistic limit of the fibers by following first-order kinetics. Lastly, angular separation and (200) orientation angle are determined to build a global correlation with modulus and theoretical ballistic limit for quickly decoding macro-changes in terms of micro-properties. The given correlations can help to identify crystallographic transformations upon other induction techniques and view their effect on mechanical and ballistic parameters. In addition, the given approach can be extended for different ballistic materials under any environmental conditions. Graphical Abstract [ABSTRACT FROM AUTHOR]