Interstitial pulmonary disease in hepatitis C virus patients

Chronic hepatitis C virus infection has been reported in association with several extrahepatic manifestations. Included in this list is interstitial lung involvement. This study aimed to elucidate the association of HCV infection with interstitial pulmonary involvement and to investigate the relationship of severity of hepatic affection and respiratory functional and radiological changes among involvement. Thirty patients with proved hepatitis C virus [HCV] infection from the outpatient clinic of tropical department of Kasr El-Aini hospital were enrolled in this study. High resolution CT [HRCT] chest was performed to all the patients. Pulmonary changes were detected in HRCT of 14 patients [46.6%]. Lung spirometry was done to all of them. FVC%, and FEV1% were abnormal in 6 patients [20%], FEF25-75% were abnormal in 3 patients [10%]. DLCO was measured in 23 patients and was abnormal in 3 patients [13%]. Liver biopsy results according to the fibrosis stage [METAVIR fibrosis grading scale] revealed to be grade I in 11 patients [36.7%], grade II in 9 patients [30%], grade III in 8 patients [26.7%] and grade IV in 2 patients [6.7%]. The study showed significant inverse correlation between viremia level with DLCO% pred as well as significant direct correlation between liver fibrosis stages with AFP, FEV1/FVClevel and HRCT score in the studied patients. In addition to this AFP was directly correlated with the HRCT score. Otherwise, there was no significant correlation between the following variables: HRCT score and pulmonary function tests, Liver fibrosis with FEV1%, FVC%, DLCO% and viremia level, Alphafetoprotein with pulmonary function tests and viremia level in the studied patients and Age with pulmonary function tests, AFP, liver fibrosis, and viremia level and HRCT chest

Induction of labor with prostaglandin E2 in women with previous cesarean section and unfavorable cervix

Induction of labor is common in obstetric practice. According to the most current studies, the rate varies from 9.5 to 33.7 percent of all pregnancies annually. In the absence of a ripe or favorable cervix, a successful vaginal birth is less likely. Therefore, cervical ripening or preparedness for induction should be assessed before a regimen is selected. To objective is to study the pregnancy outcome of induction of labor with prostaglandin E2 [PGE2] in women with one previous lower segment cesarean section. A prospective study was conducted at Maternity and Children Hospital, Buraidah [Qassim], Saudi Arabia. The sample included 153 consecutive women with one previous cesarean section, of whom 75 underwent induction of labor [study group] and 78 were admitted with spontaneous onset of labor [control group]. Vaginal tablets of PGE2 were used for cervical ripening in the study group. Mode of delivery, neonatal outcome, indications for cesarean section, and rate of uterine rupture were compared between the groups. There were no significant differences between the study and control groups in mean [JS.D.] maternal age [30:9 - 4:7 years versus 31:2 - 4:8 years, P% 0:6], gestational age at delivery [39:2 - 1:8 weeks versus 39:3 - 1:6 weeks, P% 0:36], overall rate of cesarean section [24% versus 20.5%, P% 0:8], rates of low 5-min Apgar score [3.1% versus 3.7%, P% 0:67] or cesarean section performed for non-reassuring fetal heart rate [9.3% versus 7.69%, P% 0:1]. There were no cases of uterine rupture, in both groups. The findings suggest that induction of labor in women with one previous cesarean section does not increase the risk of cesarean section rate and does not adversely affect immediate neonatal outcome. We cautiously suggest that when there is no absolute indication for repeated cesarean section, induction of labor may be considered

Improvement of some cases of impotence from the medicolegal point of view

A detailed study on a new treatment of male impotence by using a smooth muscle relaxant drugs which is papaverine by local intracavernous injection. This treatment found to be successful in all cases of psychogenic impotence and almost all cases of organic impotence giving hope to many patients who were until recently beyond any hope of ever achieving an erection again. In light of this study a new evaluation diagnosis and judgment in many cases of impotence will emerge on the medicolegal surface and we must consider these cases with a different perspective