Acute pulmonary edema as a complication of urinary infection in pregnant women: a case report

Introduction: Urinary infection (UI) is the third most common pathology during pregnancy, affecting 10-12% of pregnant women in the first trimester. Thus, the prenatal care is important to reduce indicators of maternal-fetal mortality, promoting quality of life during pregnancy and postpartum. Objective: The aim of this study is to report the case of a pregnant woman with pyelonephritis, who evolved with acute pulmonary edema. Case report: The present study was elaborated according to the rules of CARE case report. This study was analyzed and approved by the Research Ethics Committee (CEP) according to a substantiated opinion number 4,375,418 and obtaining the patient's consent. The present study therefore highlights pyelonephritis as the most severe form of UI in pregnant women, associated with septic shock, with evolution to respiratory failure, resulting from acute pulmonary edema, and may be related to worse maternal-fetal prognoses. This clinical study contributes to the literature, emphasizing that, currently, all forms of UI during pregnancy should be considered as great potential for complications, and should be treated even in its asymptomatic form. Conclusion: It is evident the need for early intervention to minimize maternal-fetal losses, unnecessary interventions and to reduce costs in relation to additional treatments. The importance of rapid diagnosis and early treatment is emphasized in order to minimize or extinguish the damage. As well as promoting actions to encourage pregnant women to perform prenatal care.

Rapid Propagation System in Vitro of Medicinal Plant Cynanchum Atratum Bunge

As a traditional Chinese medicinal material, Cynanchum atratum Bunge has been widely used in traditional Chinese medicine for its treatment of abscesses, acute urinary infection and hectic fever.Thus, wild resources of it have been endangered by overharvesting. Plant tissue culture technology is an important measure to protect wild resources of medicinal plants, including C. atratum. Therefore, a fast and efficient propagation system of C. atratum through axillary bud proliferation pathwayhas been established. Through axillary bud proliferation, the medium [MS+sucrose 30 g/L+Agar 7 g/L+NAA 0.2 mg/l+IBA 1.5mg/l+KT 0.5 mg/l] can effectively proliferate adventitious buds, and the induction rate was 100 %, proliferation coefficient could reach 8.56. MS medium was used to induce adventitious bud rooting, with rooting rate of 98% and no callus. The highest survival rate was 90% when the ratio of grass mud pond and orchard red soil was 1:1. To our knowledge this is the first report of rapid propagation system in C. atratum, it achieve rapid reproduction of C. atratum.

Prevalence of Genitourinary Infections with Sodium Glucose Co-transporter-2 (sglt2) inhibitors in patients with type 2 diabetes

Objectives: The present study was conducted to observe the prevalence of urine and genital infections by the SGLT-2 inhibitors patients with type 2 diabetes Methods: This multi centre cross sectional study was conducted on type 2 diabetic patients using two different SGLT-2 inhibitors dapagliflozin and empagliflozin either as monotherapy or combination therapy over a period of 03 months from 02-02-2020 to 02-05-2020. The risk of urinary and genital tract infection was assessed on the basis of structured questionnaire performa and medical records. Results: Out of 615, 296(48%) patients were using dapagliflozin and 319(52%) were using empagliflozin. Male to female ratio in both group were i.e dapagliflozin: 65 %( 192) and 35 %( 104) empagliflozin 72 %( 230) and 28 %( 89%) respectively. The risk of urinary infection in dapagliflozin group was 4.3% while it was 6.5% in and empagliflozin. On the other hand the risk of genital tract infection was 3% in dapagliflozin and 4.3% empagliflozin respectively. The prevalence of genital infection was more in female 6(67%) by dapagliflozin and 10(71%) by empagliflozin versus male 3(33%) by dapagliflozin and 4(29%) by empagliflozin respectively. Similarly the prevalence of urinary infection was more in female 8(62%) by dapagliflozin and 14(67%) by empagliflozin versus male 5(38%) by dapagliflozin and 7(33%) by empagliflozin respectively. A significant co relation was found between prevalence of genitourinary infection with female sex and uncontrolled diabetes with p.value 0.001 and 0.003 respectively. Conclusion: SGLT-2 inhibitors are not associated with increased of risk of genitourinary infection in diabetic patients. Keywords: SGLT-2 Inhibitors, Dapagliflozin, Empagliflozin, Genitourinary infection

Eleusine Indica for Food and Medicine

Eleusine indica, a perennial herb that belongs to the Poaceae family, is locally known as “rumput sambau”. The species can be found in the tropical regions and it is the only species of Eleusine in Malaysia. In India, some parts of the plant such as the roots and the seeds are used as food and can be eaten raw or cooked. The young seedling is also used as a side dish with rice, while the seeds are sometimes used as a famine food. Although this grass is not considered as food in Malaysia, the local people utilise it to treat various ailments such as hastening the placenta delivery after childbirth, pain relieve for vaginal bleeding, asthma, fever, urinary infection, haemorrhoids, and tonic for flu related symptoms. Due to wide spectrum of traditional usage, a complete review of E. indica which focusing on food and medicinal perspectives is necessary to organize and evaluate its potential for further studies and commercial exploitation. The information on the species was collected from scientific journals, books, and reports searched through available databases such as Google Scholar, PubMed, Directory of Open Access Journals, Science Direct, Bioline International, and Reaxys. Contextually, the present review reveals that apart from the roots, the plant is relatively safe to ingest. It represents a rich source of nutrients and contains therapeutic phytochemicals such as flavonoids, steroids, essential oils, cardiac glycosides, coumarins, fatty acids, anthraquinones, anthrones, triterpenes, tannins, and alkaloids. Thus, E. indica can be considered as a natural reservoir for both food and medicine.

Pattern of Lower Urinary Tract Symptoms (LUTS) and satisfaction among patients having diagnostic cystoscopy

Aims: To study the pattern of LUTS during diagnostic cystoscopy and to evaluate patient’s satisfaction using rigid cystoscopy with intra-urethral lignocaine gel. Methods: Hospital based cross-sectional observational study done in all patients attending Department of Obstetrics and Gynecology with LUTS. Diagnostic cystoscopy was performed after using intra-urethral lignocaine gel. Patients profile and indications for cystoscopy were recorded; and VAS (Visual Analogue Scale) was used to assess procedure related pain. Data stored in MS Excel and descriptive analysis performed using SPSS 21. Result: Forty-three patients were included in the study. The mean age of presentation was 45.77 years. Majority of the patients were pre-menstrual and with symptoms less than 5 year duration. Twenty-seven (62.8%) patients had urgency as indication for cystoscopy followed by cystitis and recurrent urinary infection each (16.3%). Only 2 patients had mixed urinary incontinence. Thirty- one (72.1%) had mild discomfort, seven (18.7%) moderate and 5(9.2%)severe in visual analogue scale. Conclusions: Urgency was found to be a frequent indication for diagnostic cystoscopy and use of rigid cystoscope using inra-urethral gel showed only mild discomfort to majority of patients.