"I can't make it safe, so I don't do it": Exploring obstetricians' views on barriers and enablers to promoting vaginal birth after caesarean section in Bangladesh.

The rise in the number of facility-based births in Bangladesh has been accompanied by a caesarean section (CS) epidemic. The current CS rate is 45% and while many are performed when medically unnecessary, there is still maternal mortality due to lack of access to CS. A significant contributor to the rising CS rates in Bangladesh is repeat CS.

Steam distillation process for flavor enhancement of milk coffee: Effects of condensation temperature on volatile compounds and flavor characteristics.

To enhance the flavor characteristics of milk coffee, steam distillation was applied to roasted ground coffee to obtain extracts that were then added to the hot water extract of the residue. The effects of different condensation temperatures for steam distillation on the volatile compounds of condensates and the flavor characteristics of the milk coffees prepared with each condensate were investigated. The volatile compounds were analyzed by gas chromatography/mass spectrometry, and principal component analysis (PCA) was performed on the mean peak areas of the volatiles that showed significant differences between the samples.

Splenic Infarction in Acute Cytomegalovirus and Epstein-Barr Virus Concomitant Infection.

In immunocompetent individuals, cytomegalovirus (CMV) infection can range from asymptomatic to infectious mononucleosis syndrome and can cause hemolysis. However, in immunocompromised individuals, the presentation may be complicated with various life-threatening complications. CMV-associated thrombosis is commonly reported in patients who are immunocompromised, especially in transplant recipients and in HIV-positive patients.

Sporadic Hemiplegic Migraine.

An uncommon presentation of a migraine headache is hemiplegic migraine, which can clinically imitate other conditions including transient ischemic attacks and stroke with unilateral muscle weakness or hemiplegia. We present a 46-year-old female patient who was admitted with symptoms of a unilateral occipital headache, dysphagia and left-sided motor weakness. Diffusion magnetic resonance imaging (MRI) and brain tomography results were normal.

Atraumatic Vertebral Dissection in a Patient With Altered Mental Status.

The most common manifestations of vertebral artery dissection in approximately 80% of patients are headaches or neck pain. We discuss a case of a 34-year-old patient who presented to the emergency department with altered mental status and nonspecific symptoms. A CT angiogram with intravenous contrast revealed a dissection of the left vertebral artery, and the patient was found to have thromboembolism in the right occipital lobe with ischemia on MRI.