Posterior capsule opacification following acrylic and PMMA IOL implantation in pediatric age group

Evaluation of the value of Acrylic IOLs in minimizing the rate of posterior capsule opacification [PCO] in pediatric age group in comparison to PMMA IOLs. This study included 37eyes of 29 patients with congenital, developmental or traumatic cataract, with a mean age 6.54 +/- 1.90 years, and 68.97% of them were males. The mean of the follow up period was 17.72 +/- 4.32 months. Patients with any associated ocular or systemic disease were excluded from the study. The study group was divided into 2 subgroups; the first group was implanted with Acrylic IOL [21 eyes,.] while the second group was implanted with PMMA IOL [18 eyes]. Statistical analysis of the BCVA, rate of development of PCO and the onset of its development were done. In both groups, there was statistically significant improvement of the visual acuity postoperatively; but the BCVA was significantly better in the first group than in the second group. The rate of development of PCO dense enough to affect the visual acuity was significantly lower in the group of patient implanted with Acrylic IOLs [28.57%] compared to the group implanted with PMMA lenses [4 7.62%]. At the same time, the onset of development of PCO was significantly earlier in the PMMA lenses than in the Acrylic IOLs [5.14 +/- 2.91 months and 8.40 +/- 4.40 months respectively,]. Pediatric patients implanted with Acrylic IOLs have less incidence of clinically significant PCO than patients implanted with PMMA IOLS. Also, the posterior capsule remains clearer for a longer- period of time with the Acrylic lenses. However the long terms effects of Acrylic IOLs in children whose life expectancy is much more are yet to he assessed

Urodynamic effects of various alpha blockers used for treatment of benign prostatic obstruction

We aimed to evaluate the effect of alpha-blockers on the urodynamic parameters of bladder outlet obstruction [BOO] and to know when to shift to more aggressive interventional procedures. Ninety patients having benign prostatic obstruction [BPO] were divided into three groups that received Doxazosin [GI], Alfuzosin [GII] and Tamsulosin [GIII]. Scores of symptoms, pressure/flow [P/F] studies and ultrasound estimated bladder weight [UEBW] were evaluated before and one year after therapy. Symptom scores and all parameters of P/F studies showed significant improvement after one year of therapy, in all groups. No significant differences were detected between treatment groups. UEBW was insignificantly decreased after therapy. 4.4% of patients were shifted to trans urethral resection of the prostate [TURP]. Alpha-blockers used for treating BPO are an effective modality of treatment not only through improving symptoms, but also through changing the P/F parameters in favour of relief of BOO. UEBW may be a promising tool for monitoring the effect of therapy

Management of penile fracture

This prospective study was carried out over a period of one year, and included 12 patients presented by penile fracture. Diagnosis was made clinically and there is no need to perform cavernosography in any case. The most common cause of fracture was trauma to the erect penis during intercourse. Mean age of cases was 29.5 +/- 8.96 years, while mean time of presentation was 15.5 +/- 8.04 hours. Sub-coronal circumferential degloving incision was done in all cases. Nine patients had been operated upon, while three patients refused surgery and treated conservatively. Repair consisted of evacuation of hematoma, repair of the tunical defect with absorbable sutures. The mean operative time was 33.9 +/- 28.2 minutes. Preoperative and postoperative antibiotics was used and all operated cases discharged on the second postoperative day. All operated caws were able to achieve full erection with straight penis, except one in whom mild curvature and pain during erection was observed. In conclusion, fracture penis is a true urologic emergency. It should be treated surgically as early as possible to ensure a better outcome

impact of stone composition on the results of extracorporeal shock wave lithotripsy of renal calculi

This retrospective study included 341 patients with renal stones treated on the Dornier MPL9000 lithotriptor utilizing ultrasound localization. The inclusion criteria were solitary renal pelvic stones with a stone burden of 1-2 cm, normal renal functions, absent or minimal dilatation of the pelvicaliceal system and documented stone composition. The patient's demographic data, ESWL parameters, treatment results and any recorded complications were documented. Fragment sizes were measured on the early post ESWL films and by passing the expelled gravels through a metal sieve with 3 mm pore. The X-ray diffraction technique was used for stone analysis. The final success was calculated on the basis of a stone free status at 3 months from the last ESWL treatment. Whewellite and struvite calculi required higher average number of shock waves and treatment sessions, shelved higher rates of residual gravels > 3 mm in diameter and significantly lower stone free rates compared to other stone compositions. Other stones did not show statistically significant difference among each other regarding these parameters

Urodynamic evaluation of surgical and endoscopic treatment of benign prostatic hyperlasia

Eighty eight patients suffering from outlet obstruction due to BPH were included in this study and divided into four groups: I open prostatectomy [TVP], II transurethral resection [TURP], III electrovaporization [TUEVP] and IV electrovaporesection [TUEVR]. All groups were age matched and had insignificant difference in means of prostatic size determined by TRUS. Patients with preoperative indwelling catheters were analyzed separately. Significant improvements were achieved in all groups in postoperative follow up of AUA symptom score in comparison with the baseline data. AUA score was significantly higher in TUEVP than in other groups during the first and third month visit. Detrusor instability was considerably reduced from 44.4%, 45.4%, 3.7% and 41.7% to 12.5%, 15.8%, 26.6% and 13.3% after relief of outflow obstruction in the four groups. However, this reduction was not statistically significant. Also, the degree of reduction in TUEVP was less than in the other groups. Other urodynamic parameters as low compliance, maximum flow rate, opening detrusor, detrusor pressure at maximum flow and volume of residual urine have significantly been improved after treatment without significant difference in the degree of improvement between the four groups

Electrovaporization of bladder ulcer, A new approach for treatment of Bilharzial bladder ulcer

The aim of this work was to study the safety and efficacy of electrovaporization as a new modality of treatment of bilharzial bladder ulcers. Sixty-six patients with bilharzial bladder ulcers have been treated by the use of vaportrode or pencil tip electrocautery electrode at high cutting current to evaporate the ulcer bearing area, till the perivesical tissue was exposed. Indwelling urethral catheters were fixed for one week. Successful vaporization of the ulcer bearing area was recorded in 59 patients. Failure to get satisfactory vaporization was reported in seven patients due to extensive calcification in the ulcer bearing area, for whom even trial of excision was failed. The operative time ranged from 7 to 18 minutes. Some postoperative complications occurred in the form of deep hematuria in four patients, peritonism in five patients and secondary hemorrhage in two patients. Symptomatic relief was recorded in 52 patients immediately after the removal of the catheter. Persistence of symptoms was encountered in five patients and proved to be due to persistence of the ulcer, as proved by cystoscopy in two patients and incomplete healing in three patients. Vaporization of chronic bilharzial bladder ulcer is an effective, easy and safe modality of treatment without considerable complications

Abrams-griffiths nomogram and the linear passive urethral resistance relation-which is more valid?

Clinical studies comparing these two nomograms are-to-our knowledge-very few. We aim at evaluating them to determine if they equally diagnose outflow obstruction. Multichannel urodynamics were done in 127 men with lower urinary storage and voiding symptoms. From December 1997 through April 1999. The data obtained from each study were plotted on both PURR, and Abrams-Griffith nomograms. Placebo treatment was given to patients with equivocal obstruction and they were followed 6 months later. On applying the data on Abrams-Griffith nomograms 71 patients [55.9 percent] were found to be obstructed, 38 patients [29.9 percent] were unobstructed, and 18 patients [14.2 percent] were plotted in the equivocal zone. On applying the data of the same three groups on the PURR nomogram, all the 71 obstructed patients were distributed through grades 3 to 6 [i.e. moderate to severe obstruction]. The 38 unobstructed patients were plotted into grade O. Among the 18 patients with equivocal obstruction 16 patients were distributed into grades 1 and 2 [mild obstruction]. Two patients were found in the initial part of grade 3. With follow up pressure/flow studies, these two patients were clearly categorized into grade 3 and the remaining 16 patients were distributed into grades 1 and 2. Both nomograms are nearly equally diagnostic for outlet obstruction. However, PURR grades the degree of obstruction. Follow up urodynamics is indicated for patients with equivocal obstruction. These patients are candidates for medical treatment

Experimental induction of Klebsiella rhinoscleromatis infection in albino rats. [a histopathologicaland bacteriological study]

Scleroma, the chronic specific granuloma of the nose and upper respiratory tract is endemic in Egypt and many other countries. The exact pathogenesis of the disease as regards the etiologic role of Klebsiella rhinoscleromatis is contradictory. This work investigated the effect of experimental intravenous injection of Klebsiella rhinoscleromatis bacilli in albino rats to demonstrate that the organism can fulfill Koch's postulates. Organisms were isolated from biopsy specimens taken form nasal lesions of ten patients in the granulomatous stage of scleroma. Specimens were subjected to bacteriological and histopathological examinations to confirm the diagnosis. One hundred micro of freshly prepared bacterial inoculum containing 10[8] CFU/ml was injected weekly in the tail vein of each of thirty albino rats and repeated for 5 consecutive weeks. Biopsy specimens were taken form sacrificed animals and subjected to bacteriological and histopathological examinations. Positive histopathological diagnosis of scleroma was reported in the nose of 66.7% of rats, the larynx of 46.7%, the lungs of 26.7% and liver of 20% of rats. Bacteriological techniques were successful in revealing Klebsiella rhinoscleromatis form the nose of 36.7% of rats, the larynx of 30% and the lungs of 20% of rats. Various techniques were carried out to demonstrate the organisms in tissue sections. Two histochemical stains were employed including silver and periodic acid Schiff [PAS] stains. Immunoperoxidase technique using Klebsiella capsular type 3 antiserum was Care applied It gave positive results in 66.7% or the 6 stained liver sections inspite of negative bacteriological cultures. The histiocytic nature of the Mikulicz cells was confirmed using alpha-1 antitrypsin, an immunohistochemical marker of histiocytes, and by studying the ultrastructural features of Mikulicz cells using the transmission electron microscope

efficacy and side effect of some antiparasitic drugs in normal and S. mansoni infected mice

The present work aims to study the schistosomicidal and side effects of two antibilharzial drugs, the Praziquantel and Anthiomaline beside Fasinex which is used in this field for the first time and was effective in the treatment of fascioliasis. For this purpose, eight groups each of 30 mice were selected, then four groups were infected with S. mansoni cercariae. The treatment started at seven weeks postinfestation when the eggs were detected in the faeces for groups [I, II and III]. Praziquantel, [7.5 mg / mouse] and Fasinex [0.02 ml/mouse] were given per os as a single dose while Anthiomaline [6.5 mg / mouse] was given intramuscularly 3 injections / week for three weeks. The sacrifice of 8 mice for each group was carried out at one week post - treatment for worm load and biochemical analysis of SGOT and SGPT and after four weeks for histopathological examination of the liver and counting worms. The results showed that Praziquantel reduced the worm load by 97.65% and 99.73% at one and four weeks post treatment and had no destructive effect on normal liver function or hepatic-tissues. Also, it improved the liver function and the pathological picture of the liver, leaving only fibrosed egg granulomes, in the infected mice. Anthiomalin reduced the worm load by 81.86% and 96.27% after the same periods. It had slight destructive effect on the liver function in both normal and infected mice [elevation of SGOT and SGPT, also produced some swelling, vacuolation and hydropic changes in the hepatocytes of these groups]. Fasinex reduced the worm load by 52% and 60.33%. It had slight destructive effect in the liver function for normal and infected groups, but the drug had no toxic effect on the liver tissues in these groups

Trypanosoma mega [Kinetoplastida] from bufo viridis in Siwah Oasis, Egypt

A large pleomorphic trypanosome [identified as Trypanosoma mega] was described from the toad Bufo viridis collected from Siwah Oasis at the Western Desert of Egypt. The prevalence of the trypanosome was 83.3%. Three trypanosome forms were described [small, intermediate and large stumpy form]. Observations were also made on the lysed [diffused] trypanosomes. This was the first record of T. mega from B. viridis in Egypt, which represents a new host and new geographical location. The measurements of the present trypanosome were given and compared with related forms previously described from Egypt

Prevalence of hepatitis B and hepatitis C viral infections among schistosoma mansomni patients in Egypt

The Prevalence of hepatitis B [HBV] and hepatitis C [HCV] virus infections among Schistosoma mansoni patients was studied, Serum samples from 33 Schistosoma mansoni diseased patients were tested for antigen of HBV and antibody to HCV [anti-HCV] using enzyme-linked immunosorbent assay [ELISA]. Hepatitis B surface antigen was detcted in the serum of 8 patients [24.2%], compared with [5.2%] in the sera of control group of non infected individuals [2 out of 38], while hepatitis C antibodies were detected in the serum of 6 patients [18.2%] compared with [7.8%] in the sera of the control group [3 out of 38 non schistosomal individuals]. These figures illustrate the significant prevalence of hepatitis B and C infections in association with Schistosoma mansoni

Post-partum anxiety and depression among Saudi mothers having pre-term infants

Mothers of premature babies may experience more anxiety and depression than other full term infants mothers. This study examined the level of anxiety and depression among Saudi mothers having premature babies. The study included 120 Saudi mothers from two maternity hospitals at El Riyadh city. Each mother was individually interviewed to assess her anxiety and depression level using Beck Depression inventory and Taylor Anxiety Scale. The findings revealed that Saudi mothers of premature infants had levels of anxiety and depression which ranged from mild to very severe in early post-partum days. Some factors such as age marital status and number of previous deliveries were found to be statistically significant determinants of depression, while parity an x-ray examination during ante natal period were found to be the statistically significant determinants of anxiety level

Oral health status of children with acute leukemia A suggested oral health plain

This study assessed the oral health problems of 60 leukemic children divided into 3 equal groups, and suggested an oral health regimen for each group. The results showed that the control group who have not received oral hygiene instruction throughout a course of therapy over one year, had the highest incidence of oral problems, while the fresh cases who instituted the preventive procedures from the start had fewer oral complications than the second group, which started the preventive regimen after a period of more than one month from the institution of cancer chemotherapy. Although the nursing staff has the initial responsibility for the oral care of the ill child, the provision of adequate oral care which should be organized and planned by the dentist together with the treating hospital team, would do much help to alleviate the problem

Video-coelioscopic anatomy of the cystic artery

Arterial bleeding is a serious problem in laparoscopic cholecystectomy, therefore careful identification of the cystic artery and its anomalies as seen through the video-laparoscope could be of significant help in avoiding one of the greatest problems of biliary surgery, namely iatrogenic injury of the bile ducts. So, we reviewed the anatomy of the cystic artery during 80 laparoscopic cholecystectomies. A normal cystic artery was found in [76.2%] of patients, doubling of the artery in [17.5%] and an artery inferior to the cystic duct in [6.2%]. Dissection of the porta is avoided until the lateral edge of the cystic duct is identified after that identification of the cystic artery is attempted. Cautery and sharp dissection of the tissues in the portal area should be done cautiously to identify any arterial anomalies

value of video-laparoscopy in the management of the impalpable testes

The management of a boy presenting with unilateral or bilateral impalpable testes presents a diagnostic and therapeutic challenge. This work describes the technique of video-laparoscopy in the diagnosis and management of such testes in 20 patients [24 testes]. The testis was absent or atrophic in 5 patients [20.8%]; it was in the inguinal canal in 12 patients [50%]; just canalicular in 5 patients [20.8%] and abdominal in 2 patients [8.3%]. We also found that the laparoscope can be used therapeutically in straightening the course of gonadal vessels and vas deferens in 3 cases and in performing fowler-stephens long loop vas orchidopexy in 2 cases. We recommended the use of video laparoscope as a routine in cases of clinically impalpable testes

In vitro study on the effect of low level fast neutrons on cow hemoglobin

The induced changes in biophysical properties such as: viscosity and turbidity of cow hemoglobin exposed to different low level fast neutron fluences in the range from 10[5] to 10 [8]n/cm [2]are examined. The data indicated that strong correlation relations between the changes in the parameters under investigation and the molecular weight of hemoglobin specimens due to neutron irradiation. Empirical for mulae are deduced to calculate the correspondence neutron fluence from the induced effects of viscosity as well as turbidity

Pinworm prevalence in preschool children attending nurseries

In Egypt, children constitute an important age group population and are considered as one of the most vulnerable groups. They are living their first exposure outside their homes susceptible to many hazards [Awad, et al., 1985]. This study was performed on 300 infants and preschool children of both sexes chosen, from 5 nurseries of different socioeconomic classes in Cairo. The work was done to measure the prevalence rate of pinworm infection by clinical examination, manifestations and parasitological analysis scotch tape method. The prevalence of pinworm infection among the sample was 20.7% and it increased with age as it was higher in children from 2 years up to 5 years [91.9%], while in infants and below 2 years of age it was 8.1%. There was no sex difference among positive and ngative children. Comparison between positive and negative children in the socioeconomic status and frequency of brushing of finger nails showed statistically insignificant differences. Examination of the positive children showed that the most frequent sign was scratching marks in the perianal region [35.5%], followed by vulvitis [24.2%] and the least common sign was septic dermatitis [1.6%]

Study of prolactin hormone level in chronic hepatic diseases with endocrine changes

The aim of this work was to assess prolactin level, basal and after metoclopramide stimulation, in chronic hepatic diseases with endocrinal changes. The work was performed on 15 male patients with chronic hepatic diseases essentially cirrhosis with endocrinal changes and 10 normal controls matched for age and sex. Every patient was subjected to fine clinical examination, liver function tests, abdominal ultrasonography, upper gastrointestinal endoscopy. Liver biopsy was done for 3 cases and estimation of serum prolactin basal and after metoclopramide [dopamine antagonist] stimulation. The results revealed that 5 out of 15 cases had elevated serum prolactin values however the mean basal values of serum prolactin in cirrhotic patients did not vary significantly from that of control groups. There is no significant difference in prolactin response after metoclopramide administration in both cirrhotic and control groups. Basal serum prolactin values and values 1 and 2 hours after metoclopramide administration in cirrhotic patients with gynecomastia did not vary significantly from the corresponding values in cases without gynecomastia. There is no significant difference of serum prolactin values between cirrhotic patients with serum bilirubin less than 1.5 mg% and those with serum bilirubin more than 1.5 mg%. Cirrhotic patients with marked hepatocellular affection showed an exaggerated response at two hours after stimulation, while there was no significant difference of prolactin values before and 1 hour after metoclopramide administration in cirrhotics with elevated serum transaminases and those with normal serum transaminases

Insulin tolerance test and tolbutamide tolerance test in acromegaly

Five healthy normal volunteers and seven nor diabetic aeromegalic patients were studied during the last 10 years augmented I.T.T .and i.v. tolbutamide test were done. Results were compared to the normal controls. All the 7 patients showed abnormal curves and a high in sulin resistance index. The drop of blood sugar after i.v. tolbutamide was less than 20%; of the starting level, indicating resistance to endogenous insulin. Also the ratio between the nadirs in Tolbutamide test and augmcntcr I.T.T. was more than 2.5 : 1, compared to the ratio in normal controls of less than 2 : 1. In absence of facilities for growth hormone radio-immuno assay in most of our hospitals, the importance of these indirect measures for growth hormone activity is stressed