Neurodevelopmental disorders, which emerge early in development, include a range of neurological phenotypes and exhibit marked differences in prevalence between sexes. A male predominance is particularly pronounced in autism spectrum disorder (ASD). Although the precise cause of ASD is still unknown, certain genetic variations and environmental influences have been implicated as risk factors. Preclinical ASD models have been instrumental in shedding light on the mechanisms behind the sexual dimorphism observed in this disorder. In this review, we explore the potential processes contributing to sex bias by examining both intrinsic differences in neuronal mechanisms and the influence of external factors. We organize these mechanisms into six categories: 1) sexually dimorphic phenotypes in mice with mutations in ASD-associated genes related to synaptic dysfunction; 2) sex-specific microglial activity, which may disrupt neural circuit development by excessively pruning synapses during critical periods; 3) sex steroid hormones, such as testosterone and allopregnanolone, that differentially influence brain structure and function; 4) escape from X chromosome inactivation of the O-linked-N-acetylglucosamine transferase gene in the placenta; 5) sexually dimorphic activation of the integrated stress response pathway following maternal immune activation; and 6) immunological responses that are differentially regulated by sex. Understanding these mechanisms is essential for deciphering the underlying causes of ASD and may offer insights into other disorders with notable sex disparities.

Ectopic pregnancy (EP) refers to blastocyst implantation outside the uterine endometrium. EP is major cause of maternal morbidity and mortality. Treatment options include surgery, medical therapy with methotrexate, or expectant management. Methotrexate is the primary regimen used in cases of early, unruptured ectopic pregnancies. Most side effects of methotrexate are minor, including nausea, vomiting, abdominal discomfort, and photosensitive skin reaction. Serious side effects, including bone marrow suppression, and pulmonary fibrosis, are invariably observed when methotrexate is administered in high doses with frequent dosing intervals, in chemotherapeutic protocols for malignancy. These side effects are uncommon with the doses used to treat ectopic pregnancies. Since cases of methotrexate-induced pancreatitis are rare, we report a case of pancreatitis in a patient with EP treated with methotrexate and expect to consider pancreatitis as a side effect of methotrexate in a patient with upper abdominal pain undergoing methotrexate chemotherapy.

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• Methotrexate
  
  Reactions Weekly.2023; 1972(1): 212.     CrossRef

Hemorrhoids are varicose veins of the rectum that are located in or near the anal canal and are covered by mucosa. They can occur at any age, are generally symptomless, and affect both sexes equally. Hemorrhoids are a common complaint among younger women and are more likely to occur during pregnancy and the menstrual cycle. In this article, we discuss the many approaches in the treatment of hemorrhoids. Laxatives, stool softeners, and fiber supplements are all considered safe for use by pregnant women. Moderate use of laxatives is also acceptable. Since there is a lack of sufficient evidence to support the safety and efficiency of topical medicines or oral phlebotomies during pregnancy, these treatments must to be utilized with an increased degree of extreme caution. In the case that considerable bleeding occurs, anal packing may be a straight forward and helpful operation to implement. A hemorhoidectomy is the treatment option for hemorrhoids that have become strangulated, badly thrombosed, or have bleeding that cannot be controlled.

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• Efficacy and Safety of Oral Euphorbia prostrata Tablet and Topical Cream in the Management of Hemorrhoids During Pregnancy: Results From a Prospective Multicenter Study
  Ashwin Porwal, Paresh Gandhi, Nameeta Mokashi-Bhalerao, Nilesh Borkar, Kunal Khobragade
  Cureus.2024;[Epub]     CrossRef

Ectopic pregnancy is an implantation of the fertilized ovum outside the uterine cavity. Most of ectopic pregnancies are located within the fallopian tube. We describe a rare case of 34-year-old woman complaining of lower abdominal pain and positive urinary pregnancy test. Pelvic ultrasound exam suggested tubal pregnancy with hemoperitoneum. However, pelviscopy revealed the bleeding point was subserosal myoma located just next to the right ovary. Uterus and both fallopian tubes were grossly free. Laparoscopic myomectomy with ectopic mass excision was performed and we observed the serial decrease of β-hCG level. Patient was well recovered and postoperative finding was not remarkable. Hereby, we report a rare case of ectopic pregnancy on uterine myoma with subserosal type with a brief review of literatures.

The coexistence of intrauterine and extrauterine gestation is a somewhat rare obstetric phenomenon thought to occur in 1 of 30,000 spontaneous pregnancy. Recently, Assisted reproductive technology such as IVF and ET are increasingly common in the management of infertility. There is a higher maternal morbidity and fetal loss due to delayed or missed diagnosis, so a combined pregnancy is guite difficult to diagnosis clinically. We experienced a case of intrauterine pregnancy coexisting with right tubal pregnancy as combined pregnancy in 24 year old iparous woman, so we reported this case with a brief review of the literature.

This 31 years old female patient visited our hospital on July 2000, with complaint of painful ulceration on vulvar with withish coated membrane and oral mucosa ulceration at 28 weeks of pragnancy.

Behҫet's disease is an inflammatory disorder of unknown cause, characterized by recurrent oral aphthous ulcers, genital ulcers, uveitis, and skin lesion.

We are present a case of Behҫet's disease in pregnancy with a brief review of literature.

Primary transitional cell carcinoma(TCC) of the bladder is a rare during child-bearing age and only 10 such cases have been reported in the literature^1-6). The patients presented with gross hematuria which was initially mistaken as vaginal bleeding. Initial diagnosis was made with sonography. Diagnosis was easily confirmed by cystoscopy with biopsy. Transurethral resection of the bladder tumor was performed as usual manner and postoperative course was uneventful. We experienced transitional cell carcinoma of bladder in a 26 year-old in the 21 week of pregnancy.