Protective effects of onion oil and selenium against cisplatin-induced nephrotoxicity and oxidative stress in rats

Nephrotoxicity is an inherent of certain anticancer drugs. This study aimed to assess the protective effect of onion oil and selenium against cisplatin-induced nephrotoxicity in male rats. Cisplatin [5 mg/kg, i.p.] caused significant increases in serum sodium, blood urea nitrogen, serum creatinine, total sodium and potassium excreted in urine, urine volume and lipid peroxides measured as the malondialdehyde content of kidney, with significant decreases in serum total protein, creatinine clearance, reduced glutathione content of kidney and kidney superoxide dismutase activity as compared to the control group. On the other hand, administration of onion oil [100 mg/kg, p.o.] or selenium [1 mg/kg, p.o.] for 14 days with a single cisplatin dose on the 10[th] day ameliorated the cisplatin-induced nephrotoxicity as indicated by the restoration of kidney function and oxidative stress biomarkers. Onion oil and selenium showed protective effects against cisplatin-induced nephrotoxicity

Knowledge of and risky behaviours towards hepatitis B virus infection among Egyptian school children

Background and study aims: Success in the prevention of hepatitis B virus [HBV] depends to a large extent on the adolescents' HBV knowledge and their risky behaviours. This study aims to assess the knowledge of and the risky behaviours towards HBV among school students and to determine the significant predictors affecting their knowledge

Patients and methods: A cross-sectional study was approved in four Egyptian governorates [Dakahleya, Gharbeya, Cairo, and Beni-Suef] on 574 students aged 11-17 years. A questionnaire was filled through a face-to-face interview to collect data about the socio-demographic character, HBV knowledge, and risky behaviours among children who were chosen for this study

Results: While 75% of students had poor levels of HBV knowledge, 1.7% had good levels of knowledge. As regards gender, more than 60% of students shared scissors and went to dental clinic with no significant difference. While boys reported a significant history of hospitalisation [50.2%] and wound stitches [36%], girls reported a lesser degree of the same [40.2% and 22.6, respectively], p < 0.01. During logistic regression analysis, the most important predictors of poor HBV knowledge were age <15 years and living in Cairo governorate, with adjusted odds ratio [AOR] 1.5 and 5.0, respectively

Conclusion: The majority of students chosen for the study had low levels of knowledge and high risky behaviours towards viral hepatitis. In order to minimise the risky behaviours among adolescents, health education programmes should be conducted concerning the mode of transmission and prevention of viral hepatitis

Influence of sociodemographic factors and environmental conditions on husbands' behavior toward maternal healthcare

Improving maternal health depends on husband's behavior which is affected by certain sociodemographic factors and environmental conditions. The study aimed to assess the husband's behavior toward maternal healthcare and emergency first aid measures for pregnancy and obstetric risks that might put life of women at risk of maternal death. The study also determined the socio-demographic factors and environmental conditions that influenced husband's behavior and attitude toward antenatal care providers and providers of assisted delivery. One thousand husbands of women in childbearing period were randomly selected through a community-based study that was conducted in 23 rural villages of four chosen districts of Benisuef and Al Fayoum governorates of Egypt. The study is a cross-sectional investigation conducted over a period of 8 months starting from July 2010 until February 2011. Data were collected from interviews of husbands on their sociodemographic characteristics, environmental conditions, and their knowledge, attitudes, intention, and practices toward maternal healthcare and services provided as well as toward providers of maternal healthcare. The study revealed that husbands who were younger than 20 years at the time of marriage, had a lower middle environmental score, and an upper middle income were nearly two or more times as likely of being unaware of the risk symptoms during pregnancy [odds ratio [OR] = 2.73, 1.37, and 1.59, respectively], during delivery [OR = 1.93, 1.31, and 1.76, respectively], and during the postnatal period [OR = 2.42, 1.36, and 1.77, respectively] compared with those older than 20 at the time of marriage, who had an upper middle environmental score, and a lower middle income. It is recommended to target husbands as an influential factor among high-risk wives by educating them on maternal health risks and by increasing their accessibility to maternal and obstetric health services, with special emphasis on younger men and those living under poor environmental conditions irrespective of their economic status

Ultrastructural study of the mucosal layer of the adult albino rat ureter

The ureter is a dynamic organ rather than a simple conduit through which urine flows. The aim of the study was to explore the electron microscopic structure of the mucosa of the rat ureter in a trial for understanding the adaptive functional interactions between the urothelium and the different components found in the lamina propria. The mucosa of the ureter of 10 adult healthy male albino rats was studied under a transmission electron microscope. The rat ureter mucosa was formed of urothelium and lamina propria. The uroepithelium consisted of basal, intermediate, and apical umbrella cells. The cytoplasm of the basal cells contained few rounded vesicles with homogeneous content, bundles of microfilaments, and ribonucleoprotein particles. Besides basal cells, a few bundle cells were observed; these cells contained small dense bodies retained within large vacuoles. Desmosomal junctions interconnected the neighboring intermediate cells of the urothelium, and many rounded vesicles, mitochondria, and Golgi saccules appeared in their cytoplasm. The apical plasma membrane of the umbrella cells showed plaques and intervening hinge regions. Some rounded and many fusiform vesicles appeared within their cytoplasm. The lamina propria contained many capillaries in concavities formed by the basal layer of the urothelium; their lining endothelial cells were unusually thick. Many telocytes appeared in close contact and encircled the blood capillaries and groups of nerve fibers in the lamina propria. The telocytes were interconnected with each other and with other connective tissue cells by their telopodes. The lamina propria also revealed immune cells such as eosinophils and mast cells. Morphological analysis of the ureter mucosa is providing clues how epithelial cells sense different stimuli and transduce-in these stimuli into the underlying nervous, vascular, and active cellular elements in the lamina propria

Comparative study between the effects of yohimbine and sildenafil on erectile dysfunction in stressed male rats

The incidence of erectile dysfunction increases as a result of stressful conditions such as industrialized lifestyles. Both physical and psychological stress may interfere with the reproductive capacity of several species. In this work stress was induced by immersion of rats in cold water [15 minutes/day] for 14 consecutive days. The effects of yohimbine [0.2mg/Kg, i.p.] and sildenafil [20mg/Kg, i.p] on erectile dysfunction of stressed rats were assessed in comparison with control group. Furthermore the levels of testosterone, LH and FSH in blood were evaluated. Results revealed that, immersion of rats in cold water significantly increased mount, intromission, ejaculation latencies and intercopulatory interval indicating a decrease in sexual arousal and motivation, and also decreased ejaculation frequency indicating a decrease in copulatory performance and potency. In addition immersion of rats in cold water for prolonged period could decrease the copulatory activity as evidenced by mating test and decreased testosterone, LH and FSH levels. Results revealed that treatment with yohimbine or sildenafil significantly increased the sexual arousal and potency and corrected the effects induced by stress on the mating behavior of male rats. On the contrary they did not significantly alter testosterone, follicle stimulating hormone [FSH] and luteinizing hormone [LH] levels

Laparoscopic pyeloplasty: contemporary results of a prospective study from a high-volume laparoscopy center

For the treatment of UPJO with success rates of up to 95%. Current reports of laparoscopic pyeloplasty showed success rates >95%. We aim at defining a new gold standard by evaluating the results of laparoscopic pyeloplasty in a high volume laparoscopy center. The research done between October 2009 and March 2011, 26 patients having primary UPJO were operated using conventional laparoscopy in the department of Urology, Klinikum Dortmund hospital, Germany. Preoperative evaluation included clinical assessment, abdominal ultrasound, MAG3 diuretic renography and retrograde pyelography. Postoperative follow-up included assessment of pain, analgesic requirements, laboratory parameters, abdominal ultrasound and reflux retrograde pyelography. Long term follow-up included improvement of symptoms; and pelvi-calyceal decompression by ultrasound, retrograde pyelography and MAG3 diuretic renography. Results were as follow the age range of the 26 patients was 13-74 years [mean 42.2, SD 17.6], 13 males and 13 females. The cause of obstruction was intrinsic stenosis in 11[42.4%], crossing lower pole vessel[s] in 14[53.8%] and external adhesions in one patient [3.8%]. All cases had a unilateral lesion; with the 26 patients equally divided as regards the side of obstruction. Pain was the presenting symptom in 20 patients [76.9%]. Operative time ranged 135-300 min. [mean 211.5, SD 41.9]. Intraoperative blood loss was generally negligible and no intraoperative complication occurred. There was no conversion to open surgery in any case. The total hospital stay ranged 5-11 days [mean 7.8, SD 1.5]. Follow-up ranged 3-18 months. In 24 patients, there was a definite resolution of pain and other symptoms postoperatively. Postoperative evaluation showed a statistically significant improvement of the degree of hydronephrosis by both ultrasonography and retrograde pyelography [p = 0.0001]. In 2 patients with mild postoperative radiological improvement, despite the clinical resolution of symptoms, MAG3 scan showed a mild obstructive drainage pattern. Criteria of success, defined as relieve of symptoms and obstruction together with a half-time clearance of 10 min. or less, shown a short-term success rate of 96%. In conclusion laparoscopic pyeloplasty is a safe and effective treatment option; and it could be a reasonable replacement for open surgery as a new gold standard for treatment of UPJO

Expression of p-selectin [CD62p] on platelets as activated marker in preeclampsia

Pre-eclampsia is a medical condition in which hypertension arises in pregnancy [pregnancy-induced hypertension] in association with significant amounts of protein in the urine. Pre-eclampsia may develop from 20 weeks gestation [it is considered early onset before 32 weeks, which is associated with increased morbidity]. Platelets play an important role in the pathophysiologic mechanisms of preeclampsia. The aim of this work was to study the platelet activation state by flow cytometer analysis of platelet expression of CD62p in patients with preeclampsia. This study was conducted on ten cases of mild preeclampsia [group I], their ages range was 22- 36 years and ten cases of severe preeclampsia [group II] their ages range was 20-35 years .Also ten normotensive pregnant women were included as a control group [group III] . The percentage of platelets expression of the CD61, CD62p and MFI were analyzed by the flow- cytometr . The mean percentage of CD62p expression on platelets and MFI were 67. 3% and 6.5 respectively in mild preeclampsia compared with 3.7% and 1.5 in normotensive pregnant as control [p < 0.01 and p < 0.015 respectively]. Also the mean percentage of CD62p expression on platelets and MFI were 73.3% and 2.1 respectively in severe preeclampsia, they showed significant increase when compared with normotensive pregnant as control [p < 0.01 and p < 0.015 respectively]. There were a positive significant correlation between% of expression of CD 62p on platelets and SBP, DBP, protein in urine, and% CD61. While a negative significant correlation between% of expression of CD 62p on platelets and age, platelet count and CD62P MFI was found. High levels of platelet glycoprotein CD62p expressions in patients with mild and severe preeclampsia, could be a compensatory mechanism for the preeclampsia induced thrombocytopenia

Amelioration of carbendazim-induced testicular dysfunction by vitamin E and pumpkin seed oil in rats

Carbendazim, a carbamate fungicide, is one of the most widespread environmental contaminant of major concern to human and animal reproductive health. The present study was undertaken to investigate the ameliorating effect of vitamin E and Pumpkin seed oil on carbendazim-induced testicular toxicity in male rats. Safety profile of vitamin E and pumpkin seed oil was firstly examined on normal rats and found to be safe on all the examined parameters. Adult Sprague dawley male rats were used in this study. Carbendazim [100 mg/ kg] was administered alone or combined with either vitamin E [200 mg/ kg] or pumpkin seed oil [40 mg/ kg] for 48 successive days. Carbendazim exposure significantly reduced the weights of testes, prostates and seminal vesicles. Also, serum testosterone, sperm count, motility and viability were diminished. The incidence of sperm abnormalities and testicular cholesterol content, were markedly elevated. In addition, carbendazim caused oxidative stress as observed by elevation of malondialdehyde [MDA] and lactate dehydrogense [LDH]. The antioxidant system including superoxide dismutase [-SOD], glutathione peroxidase [GSHPX] and glutathione [GSH] were also reduced. Carbendazim also produced marked histopathological changes including degeneration of most seminiferous tubules with absence of spermatogenic series in tubular lumen in the testis. Co-administration of either vitamin E or pumpkin seed oil with carbendazim significantly ameliorated most of these deleterious effects where weights of testes, prostates and seminal vesicles were regained. They also elevated serum testosterone level, sperm count, sperm motility and sperm viability. Furthermore, administration of vitamin E and pumpkin seed oil with carbendazim reduced the incidence of sperm abnormalities and nearly normalized the testicular cholesterol content, They also reduced the oxidative stress caused by carbendazim which was associated with normal histopathological features of the testis

Potential antihypertensive and antioxidative effects of Nigella sativa seeds or biomass and Syzygium aromaticum extracts on L-NAME- induced hypertensive rats

Plant tissue culture techniques had captured the attention of researchers in a wide range of scientific areas. The aim of the present investigation is to assess the potential antihypertensive and antioxidative effects of Nigella sativa seeds or biomass and Syzigium aromaticum buds extracts on L-NAME - induced hypertension in rats. In the present study, rats were randomly allocated into 5 groups, all groups except the normal control one were administered N[omega] -nitro-L-arginine methyl ester [L.NAME][50 mg/kg/day p.o] for two weeks. The treatment started after the first week of L-NAME administration; Nigella sativa seeds and biomass extracts were used in a dose of 400 mg/kg and Syzygium aromaticum extract was used in a dose of 100 mg/kg. Blood pressure [systolic, mean and diastolic] and oxidative stress biomarkers: serum LDH activity and nitric oxide level were measured. A significant increase in systolic, mean and diastolic blood pressure was observed by administration of L-NAME, in addition to a significant increase in serum LDH activity and a significant decrease in serum nitric oxide level. Nigella sativa seeds or biomass and Syzigium aromaticum buds extracts normalized the increment in systolic, mean and diastolic blood pressure [p<0.05]. Furthermore, all the test agents reversed the elevated serum LDH level and increased serum nitric oxide level up to three fold. It could be concluded that Nigella sativa seeds and Syzigium aromaticum might have antihypertensive effect which may be mediated through antioxidant action and that the biomass of Nigella sativa may possess an active constituent possessing antihypertensive activity similar to that of the original plant

Serum levels of matrix metalloproteinase-2 [MMP-2] in children and adolescents with type I diabetes mellitus

Type I diabetes mellitus [T1DM] is an autoimmune disorder of unknown etiology. It has been suggested that matrix metalloproteinases [MMPs] play important roles in the development and complications of autoimmune disorders. Results published on the use of MMPs as markers in relation to diabetic complications are somewhat conflicting. The aim of this study was to estimate serum levels of MMP-2 in children and adolescents with T1DM, compared with levels in age-matched controls, and to correlate the levels of MMP-2 with duration of the disease, and with parameters of both glycemic control and renal function. We measured serum levels of MMP-2 in 60 patients with T1DM, aged 2-18 years, with or without microangiopathic complications and in 20 sex-and age-matched controls using enzyme immunoassay. Serum levels of MMP-2 were significantly higher in the studied patients than in the controls [p=0.000]. Serum levels of MMP-2 in diabetic patients with microangiopathic complications were significantly higher than serum levels of MMP-2 in diabetic patients without microangiopathic complications [p=0.002]. Positive significant correlation between serum level of MMP-2 and disease duration [r=0.715; p=0.000] was noted. On the other hand, no significant correlation was found between serum level of MMP-2 and any of the following parameters: Fasting blood glucose, glycated hemoglobin, blood urea, and serum creatinine [all p>0.05]. In conclusion, Serum MMP-2 levels are elevated in T1DM. Because higher MMP-2 levels were associated with the presence of diabetic complications, we raise the possibility that upregulation of MMP-2 levels might play a role in the pathogenesis of diabetic complications. Measurement of serum MMP-2 is a potentially useful marker in studies of diabetic patients at risk of progression to diabetic complications

Plasma concentration of osteopontin [OPN] in children with systemic lupus erythematosus: relationship with disease activity

Osteopontin [OPN] is an important bone matrix mediator found to have key roles in inflammation and immunity. OPN is a cytokine which can play a number of roles in promoting activation of T lymphocyte, regulating balance between T-helper 1 and T-helper 2, participating in cell-induced immunologic response and stimulating B lymphocyte to express multi-clone antibodies. Overexpression of OPN has been associated with the development of the autoimmune/lymphoproliferative syndrome. The aim of our present study was to analyze the possible correlation between the plasma concentration of OPN and disease activity in children with Systemic Lupus Erythematosus [SLE]. We also investigated the correlation between plasma IL-18 and OPN concentrations to further confirm the association of OPN with disease activity. We measured the plasma concentration of OPN, and the plasma proinflammatory IL-18 concentration in 40 SLE patients with or without renal disease [RSLE group and SLE group, respectively] and in 30 sex-and age-matched controls using enzyme immunoassay. Plasma OPN concentrations were significantly higher in RSLE and SLE patients than in the controls [p=0.000 and p=0.002]. Increase in OPN concentration correlated positively and significantly with SLE disease activity index in all SLE patients [r=0.34; p=0.04]. In RSLE patients, plasma OPN concentration showed a significant positive correlation with proinflammatory cytokine IL-18 concentration [r=0.48; p=0.004]. In conclusion, The above results suggest that the production of OPN is associated with the inflammatory process and SLE development, and may serve as a potential disease marker of SLE

Serum levels of ghrelin, tumor necrosis factor-A [TNF- A], and lnterleukin-6 [IL-6] in infants and children with congenital heart disease

Ghrelin increases food intake, body weight, and growth hormone secretion. The cause of growth retardation in congenital heart disease [CHD] is multifactorial. The aim of this study was to estimate serum levels of ghrelin, tumor necrosis factor-a [TNF-alpha], and interleukin-6 [IL-6] ih infants and children with CHD, compared with levels in age-matched controls, and to correlate the levels ofghrelin with TNF- alpha, and IL-6. We measured serum ghrelin, TNF- alpha and IL 6 levels using ELISA in 60 patients with CHD [40 acyanotic and 20 cyanotic] and in 20 control subjects. Our results showed that patients with CHD, whether compiled in one group or classified into acyanotic and cyanotic, had significantly higher serum ghrelin TNF- alpha, and IL-6 than controls [p = 0.000]. Serum levels of ghrelin and TNF- alpha in the acyanotic patients were significantly higher than in the cyanotic patients [p = 0.000]. On the other hand, there was no significant difference in serum levels of IL-6 between the acyanotic and the cyanotic patients [p = 0.126]. In acyanotic and cyanotic patients with CHD, there was a positive correlation between ghrelin and TNF- alpha [r = 0.424; p = 0.006 and r = 0.577; p = 0.008, resp.]. Ghrelin levels were not correlated with IL-6 in the acyanotic and cyanotic patients with CHD [r = -0.211; p = 0.216 and r = -0.341; p = 0.08, resp.]. Serum ghrelin, TNF- alpha, and IL-6 levels are elevated in patients with CHD whether acyanotic or cyanotic. Increased ghrelin levels represent malnutrition and growth retardation in these patients. The relation of ghrelin with TNF- alpha may be explained by the possible effect of chronic congestive heart failure and chronic shunt hypoxemia

Effect of antioxidant vitamin on oxidative stress induced by high dietary iron in rats

This study was aimed to investigate the effect of dietary antioxidant vitamins such as vitamin C and vitamin E. alone and in combination on the oxidative stress induced by high dietary iron concentration in male albino rats

Expired breath hydrogen peroxide as a marker of acute airway inflammation in children with asthma

Airway inflammation is an important factor in the development and progression of asthma. Activation of inflammatory cells induces a respiratory burst resulting in the production of reactive oxygen species, such as hydrogen peroxide [H[2]O[2]]. The aim of this study was to measure the levels of H[2]O[2] in expired breath condensate in asthmatic children, compared with levels in age-matched controls and to outline its relation to asthmatic triggers, asthma severity, treatment modalities, pulmonary function tests, and total and differential white cell count. Forty asthmatic and 20 healthy children were studied. Their ages ranged from 6-18 years. Expired H[2]O[2] was measured using a colorimetric assay. In asthmatic children, there was a significant elevation of the mean H[2]O[2], level compared to values in controls [p=0.003]. Asthmatic triggers [e.g.: bad housing1 passive smoking, upper respiratory tract infection] showed non significant relation to the mean value of H[2]O[2] level in expired air of asthmatic children. Bad housing showed significant relation to number of acute asthmatic attacks [p=0.03]. There was no significant difference between moderate and severe asthma regarding H[2]O[2] levels [p=0.424] Similarly, there was no significant difference between asthmatic patients whether they received inhaled steroids or not regarding H[2]O[2] levels [p=0.875]. Basal spirometric pulmonary function tests, showed no significant correlation to the level of H[2]O[2]. Correlations of H[2]O[2] level in expired air of asthmatic children with total leukocytic counts [r=0.024; p=0.899], eosinophilic counts [r=0.092; p=0.630] and neutrophilic counts [r=0.021; p=0.910] were all non significant. We conclude that expired H[2]O[2] is significantly elevated in asthmatic patients. Measurement of expired H[2]O[2], may be useful to assess airway inflammation and oxidative stress in asthmatic patients

ACE gene polymorphism: a predictor of instent restenosis

Restenosis is the maladaptive response of the coronary artery to Restenosis occurs in 20-50% of patients [Pts] after balloon angioplasty and in 10-30% of patients receiving a stent. Neointimal proliferation is one distinct processes involved and the rennin-angiotensin system has been implicated in its pathogenesis. The level of plasma has been implicated in its pathogenesis. The level of plasma ACE is party under genetic control and the plasma and cellular levels pf ACE are associated with the insertion/deletion [I/D] polymorphism in the ACE gene where DD genotype bearers have higher levels of ACE than either ID or II genotype bearers. Aim: To assess the possible role of ACE gene polymorphism in the pathogenesis of instent restenosis [ISR]. We studies 136 patients having elective or emergency successful angioplasty and of a previously untreated native single coronary artery, including 117 males and 19 females, with a mean age of 52.5 +/- 9.8 years. Besides clinical evaluation, all pts were subjected to routine laboratory measurements, followed by DNA extraction for a peripheral venous sample using the QUIAmp Blood Kit. ACE gene was amplified by PCR-technique [30cycles], then were electrophoresed in agars gel and visualized directly with ethidium bromide staining under an ultraviolet light source to determine the ACE I/D genotypes. Clinical follow-up was performed on monthly basis up to six months for the occurrence of major adverse cardiac events. Angiographic follow-up was done in 93 patients at a mean of 6.17 +/- 2.3 months after PCI using edge detection and segment analysis by the Xcelera catch Philips Intruris QCA program to detect the minimal lumen diameter, reference vessel diameter and segment length before and after PCI and after 6 months follow up in the same views at baseline, to detect acute gain, late lumen loss and binary restenosis rate. ISR was expressed as >/= 50% diameter loss. Out of 136 pts, 93 were available for angiographic follow- up. Those were divided into two groups: 41 pts with angiographic evidence of restenosis [ISR], and 52pts without angiographic evidence of restenosis [NO-ISR]. The homozygous DD genotype was significantly more frequent in the ISR group compared to the NO-ISR group [51.2% vs 11.5%, p=0.005]. The heterozygous ID genotype was significantly more frequent in the NO-ISR group compared to the ISR group [76.9% vs 39%, p=0.005]. The homozygous II genotype was equal in both group [11.5% in ISR vs 9.8% in No ISR, p=0.79]. Compared to the heterozygous ID and the homozygous II, genotypes the homozygous DD genotype, of the ACE gene was more significantly associated with in-stent restenosis. This knowledge may help in the selection of subgroups of patients who will benefit form alternative therapeutic strategies such as CABG surgery or intensive preventive treatment or drug-eluting stent

Attitude toward malocclusion and desire for orthodontic treatment among 9-17 year old Saudis

The objective of the study was to determine the attitude to malocclusion and the desire for orthodontic treatment among 9-17 years old Saudis. A cross-sectional epidemiologically study was carried out in a sample of 1459 pre-adolescent and Saudi subjects aged 9 to 17 years old. To measure the attitude toward malocclusion and the desire for orthodontic treatment, a questionnaire based on an orthodontic attitude survey was used. The findings revealed that 31 percent of the subjects were dissatisfied with thief diental appearance. Children below the age of 10 years were the most dissatisfied. The results indicated a positive attitude towards various aspects of orthodontic treatment such as braces' appearance and tolerance. However, 17 percent of the subjects fell that orthodontic braces were ugly and only 20 percent thought treatment could be quite painful. While a high percentage of the subjects [92 percent] agreed that proper occlusion is important, only 69.4 percent of them agreed on the importance of correcting malocclusion. Almost 52 percent of the subjects indicated a demand for orthodontic treatment. In analysis across age groups, no discernible pattern or statistically significant difference was detected. The majority of the subjects were concerned regarding their malocclusion and showed a desire for orthodontic treatment mainly for aesthetic improvement

Extracorporeal shock wave lithotripsy versus lasertripsy for the treatment of upper ureteric calculi

Objectives: To compare the efficacy, cost effectiveness and safety of both extracorporeal shock-wave lithotripsy [ESWL] and Holmium: YAG laser lithotripsy for the management of upper ureteric stones

Patients and Methods: One hundred and eight patients of various age groups and of both sexes who had primary or recurrent unilateral or bilateral upper ureteric stones underwent 108 primary procedures and 19 ancillary procedures [total: 127] including in-situ ESWL [60 patients] using the Dornier MPL 9000 machine and ureterorenoscopy [URS] combined with Holmium: YAG laser lithotripsy [46 patients]

Results: The overall stone-free rate was 93.75% for the patients subjected to URS ir] combination with laser lithotripsy and 91. 7% for the patients subjected to ESWL. For stones < 1 cm, the success rate was 100% in the laser and 95.65% in the ESWL group. For stones > 1 cm, the success rate was 90% in the laser and 78.6% in the ESWL group. For impacted stones, the success rate was 92.85% in the laser and 72.7% in the ESWL group. The efficiency quotient [EQ] for the laser and ESWL groups was 0.86 and 0.73, respectively. The complication rate was 12.53% in the laser and 11. 7% in the ESWL group. The average cost [in Egyptian pounds] was 1618.1 pounds E for Holmium: YAG laser treatment and 1069.1 pounds E for ESWL treatment

Conclusion: Apart from the treatment of impacted stones and stones larger than 1 cm, ESWL is the first choice as treatment modality for upper ureteric stones. However ESWL and URS combined with holmium: YAG laser lithotripsy may be complementary to each other in treating upper ureteric stones

Pattern of primary nocturnal enuresis in primary school children [first grade] in Assiut city

Objectives: To assess the prevalence of nocturnal enuresis in primary school children, first grade [6-7 years old] in Assiut. City and study its pattern and risk factors

Patients and Methods: A random cross-sectional study including 1519 children was conducted in 10 primary schools in Assiut City throughout a period of six months. A self-administered questionnaire was completed voluntarily by the parents. Children reporting two or more incidents of nocturnal enuresis per month during the preceding year were considered positive repliers and were subjected to further evaluation. The control group consisting of 100 age-matched non-enuretic children presenting for other urologic or non-urologic problems mandating a plain abdominal X-ray, was subjected to the same evaluation. In these children the possible detection of spina bifida was the point of concern

Results: The response rate to the questionnaire was 79%. The prevalence of enuresis was 20.2%. Out of the enuretic children, 87.6% complained of nocturnal enuresis only; 72.1 % of them were primary enuretics. Monosymptomatic enuresis was observed in 46.3% of the cases. Marked enuresis [every night] affected 52% of the total number of enuretic children. Statistically significant risk factors were deep sleep and a high educational level of the parents. Primary nocturnal enuresis was insignificantly associated with a positive family history, family size or birth rank. In primary nocturnal enuretics the results of the urogenital and neurological examinations were normal in 91.5% and 80.6%, respectively, and only 4% received a specific treatment. A large amount of post-void residual urine was observed in 7.4%. Spina bifida occulta was observed in 10.8% of primary nocturnal enuretics and in 11 % of the control group

Conclusions: This is the first large population based study of the prevalence of agerelated enuresis in Assiut, but it does not differ much from those reported in other parts of the world. Enuretic children and their parents are mildly concerned about enuresis. Investigations for mono-symptomatic primary nocturnal enuresis are not of significant diagnostic value or cost effectiveness