Orofacial findings associated with obstructive sleep apnea in a group of Saudi Children

To evaluate orofacial and occlusion findings associated with obstructive sleep apnea [OSA] in a group of Saudi children. The sample consisted of 30 OSA patients, and 30 age and gender matched, healthy control. The following facial and occlusal features were evaluated: frontal view, facial profile, mandibular angle, tongue size, dental midline to facial midline, upper to lower dental midline, overjet, overbite, anterior open bite, cross bite, scissors bite, palatal vault, maxillary and mandibular arch crowding and spacing, molar and canine relationship. Participants age ranged from 3 to 8 years. Study group had steeper mandibular angle, deeper palatal vault, and less spaced upper and lower arches. There was no statistically significant difference between the two examined groups regarding facial morphology, facial profile, midline, anterior openbite, tongue size, posterior crossbite, overjet or molar relationship. OSA children have a relatively different orofacial morphology compared with control children. OSA subjects had deeper palatal vault, steeper mandibular plane angle and less spaced upper and lower arches compared to control

Retinopathy of prematurity: a study of prevalence and risk factors

Retinopathy of prematurity [ROP] is a serious complication of prematurity treatment and can lead to blindness unless recognized and treated early. The objective was to estimate the prevalence of ROP in preterm infants in the Neonatal Intensive Care Unit [NICU], to identify the risk factors which predispose to ROP, and to assess the outcome of these cases. A ROP prospective screening survey was performed enrolling all prematures admitted to the NICU from January 2009 to December 2010, with a gestational age of 32 weeks or less at birth and a birth weight of 1500 g or less. Infants whose gestational age was >32 weeks or birth weight was >1500 g were included if they were exposed to oxygen therapy for more than 7 days. A total of 172 infants [84 males and 88 females] had retinal evaluation by indirect ophthalmoscopy from the fourth postnatal week and followed up periodically. Perinatal risk factors for ROP were assessed using univariate and multivariate analysis. Infants who progressed to stage 3 ROP were given laser therapy. Out of the studied 172 infants, 33 infants [19.2%] developed ROP in one or both eyes; 18 [54.5%] cases stage 1, 9 [27.3%] cases stage 2, and 6 [18.2%] cases stage 3. None of the studied neonates presented ROP at stages 4 or 5. The six cases diagnosed as ROP stage 3 underwent laser ablative therapy. Univariate analysis showed that there was a significant relationship between the occurrence of ROP and gestational age [P = 0.000], sepsis [P = 0.004], oxygen therapy [P = 0.018], and frequency of blood transfusions [P = 0.030]. However, an insignificant relationship was found between the occurrence of ROP and sex, mode of delivery, birth weight, respiratory distress syndrome, patent ductus arteriosus, intraventricular hemorrhage, hypotension, phototherapy, duration of oxygen therapy, mechanical ventilation, and CPAP [all P > 0.05]. Gestational age, sepsis, oxygen therapy, and frequency of blood transfusions remained significant variables after logistic regression analysis. The prevalence of ROP in this study was 19.2%; low gestational age, sepsis, oxygen therapy, and frequent blood transfusions were significant risk factors for ROP. Laser was effective in treatment and decreasing the progression of ROP. As this is a unit-based study, a comprehensive countrywide survey on ROP in Egypt is recommended to determine any regional differences in disease prevalence

Cervical ripening and induction of labour with foley's catheter compared to oxytocin

The purpose of this study was to evaluate the effectiveness, efficiency, benefit, safety and maternal and fetal complications by using the Foley's urinary catheter size 20 versus oxytocin for preinduction ripening of the uterine cervix and induction of labour. Prospective randomized clinical trial. Labour and delivery ward Medani Maternity Teaching Hospital. In the period from Jul. 2004 to Feb. 2005 Seventy patients requiring induction of labour at term with a Bishop score of

Response of arbuscular mycorrhizal mungbean plants to ambient air pollution

The experiments were conducted in open top chamber system installed at the University of the Punjab, Quaid-e-Azam Campus, Lahore, Pakistan. The mungbean [Vigna radiata [L.] Wilczek var.M28] seeds were sown in earthen pots and were kept in filtered air, unfiltered air and ambient air. The ozone concentration was monitored daily during l000hrs till 1600 h. The data for light intensity and relative humidity was also regularly collected. The sets of plants growing in FA chambers [without ozone and dust particles] responded well as regards growth and yields are concerned. Unfiltered air reduced the number of nodules, their biomass and nitroginase activity in mungbean plants. The present study documents that the species of mycorrhizal fungi sensitive to tropospheric ozone failed to reproduce in ambient air and unfiltered air chambers [without dust particles]. Out of a total of 24 species, eighteen species belonged to the genus Glomus, two each to Sclerocystis, to Acaulospora and one each to Gigaspora and Scutellospora. The total number of species was variable during the growth phase. The total number of species reduced in soil of UFA chambers with the passage of time. Species richness reduced to almost half in UFA plants as compared to FA plants. Species of the Genus Glomus were highly abundant species at various harvests in all air treatments. Amongst most abundantly recovered Glomus species were G.fasciculatum, G. mosseae, G. aggregatum, G. caledonicum, G. deserticola, G. geosporum, and G. monosporum. The pattern of abundance kept on varying at various harvests for different air and mycorrhizal treatments. In the case of plants of UFA treatment, only two species of Glomus were abundant namely G.fasciculatum and G. geosporum. Species of'Acaulospora and Gigaspora in particular and Scutellospora and Sclerocystis in general were sensitive to polluted air

Chemical composition of urinary stones in Rahim Yar Khan and adjacent districts of Sindh and Baluchistan

To find out the constituents of the urinary stones, so that preventive measures would be taken against recurrence. A total No. of 200 consecutive patients with upper urinary tract calculi, that were operated in the urology and general surgical wards of Sh. Zayed Hospital Rahim Yar Khan were included in the study. In addition to Rahim Yar Khan the patients also came from adjacent districts of Sindh and Baluchistan. Qualitative Chemical analysis was carried out using Merchognost [Germany] urinary calculi analysis kit. All the tests were performed according to the instruction of manufacturers of the kit. Stone samples were collected from 200 patients, out of these 138 [69%] were male and 62 [31%] of patients were female with male to female ratio 2.2:1 age range was between 9-72 years. Results of stone analysis indicate that calcium oxalate is the most common ingredient found in 100% of the stone samples. In 83% of patients it was found mixed with other varieties of stones while in 17% samples it was seen in pure form. Uric acid was the second most common ingredient seen in 73% of patients mixe d with calcium oxalate and magnesium ammonium phosphate but it was not found as pure form. Magnesium Ammonium phosphate found in 13% of stones samples in mixed form only, not as isolated stone

Prevalence of lead toxicity among secondary school students in Sohag city and its impact on cognitive functions

Lead is an extremely toxic metal. Lead intoxication in children has been associated with cognitive impairments. This study was designed to determine the prevalence rate of lead toxicity among secondary school children in Sohag City [Upper Egypt], sources of lead toxicity and the impact of lead toxicity on cognitive function of studied student. The studied students [600] were recruited from three schools, 200 students from Elaskaria school [main stream school] and 400 students from two technical schools [200 from industry and 200 from Elzekhrofia]. A control group was selected from the same sample of studied school, who proved to have normal urinary lead level [<50 micro g/L]. All studied students were subjected to body measurements, clinical evaluation, soft neurological signs, social level, psychometric tests [WAIS, CASI and WMS]. Urine sample were collected for assessment of lead level. The study revealed that the prevalence rate of lead toxicity was 50.5% and the highest rate among studied schools was reported in Elzekhrofia school [62%]. Sources of lead toxicity in this community were old houses [77.9%], presence of repair shops [60.8%], and garbage combustion 60.3%, and smoking [62.1%]. Soft neurological signs were significant abnormal among student with toxic urinary lead level [> 80 micro g/L] in comparison to student with normal lead level [<50 micro g/L] except in one test [standing on one foot]. Student with toxic urinary lead level [> 80 micro g/L] had inverse proportion with social level. There were statistically significant lower scores among students with pre clinical toxicity [>50-80 micro g/L] and toxic level than students with normal urinary lead [<50 micro g/L] in total, verbal and performance Wechsler adult intelligence scale [WAIS], in all Wechsler memory scale [WMS] subitems and in all cognitive abilities screening instrument [CASI] subitems

Blood lead levels during pregnancy and pregnancy outcome in Karachi women

To evaluate association of blood lead levels with pregnancy outcome in the obstetrics and gynaecology unit. Blood lead levels were measured in 73 pregnant women at the time of delivery and assessed its association with pregnancy outcome. Mean maternal lead level was 9.91+4.44 mg/dL [range 2.28 - 36.35 mg/dL]. Mothers of boys had significantly higher [p=0.013, one-tailed t test] blood lead levels [11.05+5.19] when compared to mothers of girls [8.74+3.18 mg/dL. Maternal lead levels at the time o delivery showed no association with gestational age, birth weight, recumbent length, or head circumference

Coronary artery disease risk profiles at a specialized tertiary care centre in Pakistan

The aim of our study was to evaluate the prevalence of the different risk factors [diabetes, hypertension, hypercholesterolemia, family history, smoking and obesity] in patients with CAD in our patient population. BACKGROUND: The patients with first episode of acute coronary syndrome [ACD] are assessed. The total of 110 consecutive patients admitted to general ward of the National Institute of Cardiovascular Diseases [NICVD] in the month of April were interviewed. Information regarding their co-morbid status and drug usage was obtained as well as details of their admission and treatment plans. The data obtained was analyzed by statistical software [SPSS] ver 10.0.5] Our sample showed a mean age of 55.39 years with a predominance of male patients [65.5%]. Although there was no significant difference in the mean age of presentation of males versus females, Hypertension was the single most common factor being present in 59.1% of subjects. Female patients were obese, hypertensive, and by perch olesterolemic as compared to their male counterparts; while majority of males were smokers, diabetic and positive family history. It was also seen that females were found to have an average four of the seven risk factor assessed; while males average two. Twenty of the twenty two patients who developed complications [left ventricular failure, bundle branch blocks and arrhythmias] were shown to have two or more risk factors. Although ST elevation MI was the most common diagnosis [as compared to non ST elevation MI or unstable angina]. The type and number of risk factors did not seem to influence this outcome. Coronary artery disease has once again been shown to be more prevalent in males than females. Smoking is the most common risk factor amongst the male population. Female patients with CAD are presenting at a much earlier age and majority are obese, hypertensive, have hypercholesterolemia and a history of angina as compared to males; and have on average more risk factors than their male counterparts

comparison of brachial versus femoral approach for coronary angiography in coronary artery disease [CAD] patients with peripheral vascular disease [PVD]

Diagnostic left heart catheterization [LHC] and coronary angiography via Brachial Seldinger technique was compared to Femoral Seldinger technique with a view to determine its feasibility, efficacy and safety. 22 patients in the brachial group [Br] and 20 matched patients in femoral group [Fe] were retrospectively reviewed. The sources of information included hospital records of the patients [medical and nursing] and catheter laboratory data. The two groups were compared with respect to patient tolerance of the procedure, complications, time for radiation exposure, hemostasis, ambulation and procedure. The mean age of patients was 65.8 +/- 11.4 yrs. The reasons for performing LHC via brachial approach included known Peripheral Vascular Disease [PVD] in 72.7 percent, difficult access due to previously unrecognized aorto-iliac disease in 22.7 percent and tight coractation of aorta in 4.6 percent. Mean procedure time for Br group was 31.6 + 33.0 min and for Fe group was 12.6 + 5.2 [p = 0.004]. Mean ambulation time for Br pts was 2 hrs and that for Fe patients was 4.3 hrs + 0.9 hrs [p < 0.001]. The mean time to discharge for Br patients was 6.0 +/- 0.2 hrs and for Fe patients 7.6 +/- 0.9 hrs [p <0.001]. Br group was complicated by one significant hematoma [4.8 percent] and one arterial spasm [4.8 percent]. No complications occurred in Fe group. There was no significant difference between Fe and Br patients as far as tolerability was concerned. Hemoastasis time was significantly lower in patients who underwent Br angiography compared to Fe group [p-value = 0.003]. Conclusion we conclude that brachial approach for LHC is a very safe and equally effective alternative to femoral approach and even more so in patients with PVD. Br approach was similar to Fe in terms of tolerance, complication profile and technical feasibility but required longer laboratory time. Its advantages include lesser time for hemostasis, ambulation and discharge

Role of glycoprotein receptor IIB/IIIA antagonists in acute coronary syndromes, comparative study between Eptifibatide and Tirofiban

The aim of this study was to determine the difference between eptifibatide and tirofiban as glycoprotein IIb/IIIa receptor antagonists in acute coronary syndromes, as regards the efficacy in reducing morbidity and mortality and also as regards safety. A total of 60 patients was enrolled between November 2000 and October 2001. All eligible patients were those who had ischemic chest pain, either ECG changes indicative of ischemia or high serum concentration of CK- MB troponin I or both. They were randomly assigned to receive either eptifibatide or tirofiban, in addition to standard therapy. Drugs were infused for 48 hours. The endpoint was a composite of death, myocardial infarction and refractory ischemia within seven days after randomization. There were no significant differences between both groups [eptifibatide and tirofiban] as regards the frequency of the composite end point [at 48 hours, 26% in the eptifibatide group vs. 20% in tirofiban group and at 7 days, 20% versus 24%]. Similarly, the frequency of bleeding events was not significantly different between both groups [14% in the eptifibatide group versus 6% in the tirofiban group]. The study concluded that there were no significant differences between eptifibatide and tirofiban in acute coronary syndromes, as regards efficacy and safety