A Novel Method to Decrease Shoulder Tip Pain during Cesarean Section

Objective:To investigate the efficacy of the placement of two towels around uterus before delivery of fetes upon the incidence of intraoperative shoulder tip pain (STP) during cesarean section.Methods:Two hundred and sixty parturient were scheduled to undergo elective cesarean section under spinal anesthesia were randomized to do packing around the uterus before uterine incision or placebo (control group). The primary outcome was the incidence of intraoperative shoulder pain. Secondary outcomes were operative time, amount of intraoperative blood loss, incidence of hypotension, and the Need of post-opertive morphine.Results:Shoulder tip pain was recorded only in 7 cases (5.4%) in towel placement group compared to 25 cases (19.2%) in placebo group (P value, 0.001). The need of post-operative morphine was statistically significant lower in Towel placement group (33.8%) compared to (47.7%) in control group (P value, 0.023).Conclusion:Packing around the uterus just before uterine incision decreases the incidence and severity of intraoperative shoulder pain in patients undergoing cesarean section

Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility

Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm's potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause.

Study of obesity associated proopiomelanocortin gene polymorphism: relation to metabolic profile and eating habits in a sample of obese Egyptian children and adolescents

Background: Melanocortinergic system represents a known system involved in the central regulation of body weight with the central proopiomelanocortin [POMC] neurons forming a potent anorexigenic network. Polymorphisms in the POMC gene locus are associated with obesity phenotypes

Aim: To assess the contribution of the POMC gene 9-bp insertional polymorphism in the susceptibility to obesity and its relation to body mass index [BMI] and adiposity-related co-morbidities in obese children and adolescents; as well as binge eating behavior

Patients and methods: Fifty obese children and adolescents with simple obesity were screened for Binge Eating Disorder [BED] by The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5], they were compared to 50 age, sex and pubertal stage-matched non obese controls. Anthropometric measurements, blood pressure, abdominal ultrasound for fatty liver, measurement of fasting lipid profile, fasting insulin, fasting blood glucose and assessment of POMC gene 9-bp insertional polymorphism were done

Results: Obese patients had significantly higher anthropometric measurements, blood pressure percentiles, fasting glucose, fasting insulin, homeostasis model assessment for insulin resistance [HOMA-IR] and fasting lipid profiles, and higher frequency of occurrence of non alcoholic fatty liver disease and BED. Allelic frequencies of POMC gene 9 bp insertional polymorphism were comparable in patients and controls [p= 0.956]. Fasting insulin levels were significantly higher in the heterozygous cases having the polymorphism than in wild homozygous cases; whereas no difference was observed among the controls

Conclusion: This polymorphism was associated with higher fasting insulin levels in the obese patients only. These findings support the hypothesis that the melanocortin pathway may modulate glucose metabolism in obese subjects indicating a possible gene-environment interaction. POMC variant may be involved in the natural history of polygenic obesity, contributing to the link between type 2 diabetes and obesity

Apolipoprotein E gene polymorphism in Egyptian acute coronary syndrome patients

Background: Apolipoprotein E [apo E] gene polymorphism was found to be associated with coronary artery disease in several studies. In this investigation, we aimed to study the association between apo E gene polymorphism and acute coronary syndrome in Egyptian population

Subjects and methods: The study included 200 patients with acute coronary syndrome [myocardial infarction and unstable angina], and 100 healthy controls. Anthropometric, clinical and lipid profile parameters were evaluated. Apo E genotyping was carried out using sequence-specific-primer [SSP]-PCR methodology

Results: E3/4 genotype frequency was higher in the patients than in the controls [P < 0.05], while E2/3 genotype frequency was elevated in the controls than in the patients [P < 0.05]. In addition, the frequency of E4 isoform was higher in the patients compared to the controls [P < 0.001]. Patients with E3/4 and E4/4 genotypes had significantly higher total cholesterol and low density lipoprotein cholesterol, and lower triglyceride levels than those with E3/3 genotype. No significant differences in apo E genotype distribution were found between myocardial infarction and unstable angina patients

Conclusion: Apo E gene polymorphism had a role in acute coronary syndrome, possibly through affecting plasma lipid parameters

Optimisation of the MAGAT gel dosimeter compositions

Background: an effective polymer gel dosimeter can be fabricated by varying the composition of its chemical components

Materials and Methods: the MAGAT gel dosimeter formulations that used different compositions of Methacrylic acid [MAA] and gelatin were extensively investigated in the present study according to the R2-dose response and R2-dose sensitivity. The irradiation of MAGAT gel was performed by 6-MV photon beam at a dose range 1 to 10 Gy and was imaged by 1.5T Magnetic Resonance Imaging [MRI]. The dose response of MAGAT gel dosimeter was obtained from spin-spin relaxation rate [R2] of MRI signal

Results: the MAGAT gel dosimeter composed of 5% gelatin and 6% MAA gave the highest sensitivity [1.1180 s[-1]Gy[-1]]

Conclusion: understanding the effects of the compositional changes will help to clarify the mechanisms involved in the dose response of the MAGAT gel dosimeter

Morphometry and body mass index to assess health condition in captive population of Greek tortoise, Tesudo greaca

Body mass and morphometric data from a sample of captive Greek tortoise, Testudo greaca were collected to assess body condition based on linear association. Mass- length linear relationship differed between the sexes where mass-straight carapace length was strongly associated in males while mass- curved carapace length was strongly associated in females compared with other morphometric measures. Females were heavier, deeper and longer than males. Mass-length linear relationship was used to calculate the condition index log [M/m], where [M] is the observed mass and [m] is the predicted mass. The loss in body condition was recorded in 47% of females and 50% of males. The percentage of body condition loss ranged between 1.5 to 13% and 2.7 to 15.9% in females and males, respectively. The mass-length technique is a useful means of evaluating health and growth in tortoises

Some studies on E-Coli mastitis in cattle and buffaloes

The aim of this study is to identify the role E.coli in bovine, its virulence factors and antimicrobial sensitivity. Three hundred and sixty locating cows and buffaloes were examined clinically and by CMT, 210 were suffering from clinical mastitis with percentage of 62.7% and 39[20.4%] E.coli isolates were detected in clinical cases of mastitis, 90 cases were suffering from subclinical mastitis and 6[6.8%] E.coli isolates were detected from these samples. The percentage of E.coli in cows was 31[21.1%] while in buffaloes 8[18.3%] isolates. Serotyping of E.coli revealed that O55[30%], O111[15%], O124[15%], O119[10%], O114[10%], O26[5%], O157[10%] and O44[5%]. That's showing that O55, O111 and O124 were the most serotypes causing mastitis. PCR identification of TraT gene revealed 5 cases were positive and give positive reaction at 307 bp. and for eaeA gene revealed 6 cases and give positive reaction at 384 bp. the antimicrobial sensitivity indicated that the most effective antibiotics were lincospectine [56.6%], danofloxacin[56.6%], enrofloxacin[40%] and ceftifure [40%], while the lowest effective antibiotics were oxytetracycline and ampicillin

Prevalence in some pathogens in a population of zoo animals

Zoos unintentionally provide pathogens with a high diversity of species of different origins. Zoo practices of mixing reservoir species with other susceptible species can provide opportunities for pathogens to spread beyond normal hosts. This paper describes some pathogens of bacterial, parasitological and viral origin that were identified in some bovines [five species], caprines [two species], cervids [two species], primates [two species] and felines [two species] groups. Bacterial examination of fecal samples revealed the detection of E.coli, Salmonella spp., Pasteurella spp., Klebseilla spp., Campylobacter spp. Streptococci spp., and Staphylococci spp., with 52% overall prevalence of infection. Parasitological investigation using floatation and sedimentation technique of fecal samples indicated the occurrence of Isopora spp., Trichuris spp., Ascarids spp., Toxocara spp., Trichostrongyloid spp., and Nematodirus spp. with 19% prevalence of infection of the examined samples. Sarcoptic mange was only identified in olive baboon, Papio anubis through examination of skin scrapings. Antibodies against bovine viral diarrhea [BVD] and bovine herpes virus-1 [BHV-1] in antelopes and feline corona virus [FCoV] in felines were detected using specific Enzyme-linked immune assay [ELISA test]. The seroprevalence of BVD and BHV-1 in the examined antelopes was 5.3% and 6.7%, respectively. Antibodies against FCoV were detected in both lions and cheetahs where cheetahs had higher seroprevalence rate [100%] than lions [50%]. There is a need for zoo veterinarians to review and update the current preventive and management policies to identify sources of infection and control diseases of exotic species in future

Classical abdominoplasty with flank liposuction versus extended abdominoplasty

AbdominopIasly is one of the most commonly performed aesthetic surgery procedures. We have chosen comparison between two groups, group 1-25 patients who underwent classical abdominoplasty with flank liposuction which will stop the incision at the anterior/superior iliac spine.and groupII-25 patients who underwent extended abdominoplasty with lateral extension of the lower abdominal incision in the flanks as regards to patient satisfaction, scar length, lateral upper thigh sensation, dog ears, and skin redundancy.Fifty patients underwent cihdominoplasty between July 2009 and July 2012 The mean age of the studied groups of patients in this work was 35.36 in group I and 36.20 in group II and we had female to male incidence of 9:1.With inclusion criteria presented with abdominal deformities [Matarasso type HI]. In both groups there were no skin redundancy and dog ears, no step-off borders, the scar was narrow, the edges were coapted, there was no inflammation, the overall cosmetic result was excellent and the scar was optimum.Hypothesia in upper lateral thigh was [20%] group 7, [40%] group II and total [30%]. Unilateral loss of sensation in upper lateral thigh in group II was [4%] in group II,but there was no significant difference between the two groups as regards to hypothesia bilateral and unilateral, age groups and hypothesia, age groups and loss of sensation, and sex and hypothesisa and loss of sensation bilateral and unilateral. Patients usually seek abdominoplasty for abdominal wall laxity, excess skin, striae, or diastasis of the rectus muscles. Liposuction is a very affective treatment for recontouring localized fat and decreases the length of abdominoplasty scar and decreases complications such as hypothesia and loss of sensation in upper lateral thigh

Acute hemiplegia as a rare presentation of infantile Guillain-Barre syndrome

Guillain-Barre syndrome [GBS] usually presents in a symmetrical ascending fashion of weakness. We present a 6-month-old male infant who presented to our emergency room with acute left-sided limb weakness and head lag 3 days after a febrile upper respiratory tract infection. A diagnosis of GBS was established by confirming high cerebrospinal fluid protein, motor nerve reduced amplitude, and prolonged conductions, and MRI T2 high signal intensity affecting the ventral roots of the spinal cord. He showed remarkable clinical and neurophysiological improvement after intravenous immunoglobulin and intensive physiotherapy. The occurrence of infantile acute hemiplegia as a presentation of GBS is rare. This report highlights the importance of considering GBS in the differential diagnosis so that early effective treatment may be started

Knowledge and attitude of healthcare professionals toward medication pregnancy category systems in Saudi hospitals

To assess the knowledge and attitudes of healthcare professionals [HCPs] toward systems used in describing the safety of medications use during pregnancy. A cross-sectional self-administered survey was conducted in 4 tertiary hospitals in Riyadh, Saudi Arabia between March and May 2012. The targeted HCPs were physicians and pharmacists. The survey was validated and contained 4 main sections. Descriptive statistics were used to report responses to the survey's questions. A total of 393 HCPs responded to the survey, with a response rate of 97%. Half of the respondents were physicians. Of the participants, 60% were males. Most respondents [66%] stated that they have prescribed/dispensed a drug that may cause teratogenicity. Moreover, 87% of the respondents [48% pharmacists and 39% physicians] were aware of the Food and Drug Administration [FDA] pregnancy category, and most [72%] found it helpful. Only 11% of the participants strongly agree to use the European Medicine Agency [EMA] system for pregnancy category system as their main reference. In general, HCPs in Saudi Arabian hospitals have good knowledge of and attitudes toward pregnancy category systems, with more familiarity with the FDA system. The FDA system is preferred over the EMA system

Serum procalcitonin in Egyptian patients with acute meningitis and a negative direct cerebrospinal fluid examination

To reduce the morbidity and mortality related to bacterial meningitis, it is important to discriminate bacterial meningitis from aseptic meningitis during the acute phase of the disease, when the clinical symptoms are often similar. To test the reliability of serum procalcitonin [PCT] to discriminate bacterial meningitis from aseptic meningitis in patients who have a negative direct cerebrospinal fluid [CSF] examination, and to evaluate the role of serum PCT to assess treatment efficacy compared with the total leukocyte count [TLC], erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP]. Forty patients with suspected acute meningitis and negative gram stains were included, and ten healthy persons were included as controls. According to the clinical examination and the CSF cytochemical analysis and cultures, the patients were divided into bacterial and aseptic groups. The measurements of serum PCT, ESR, CRP and TLC were performed. Patients in the bacterial group had a higher value of serum PCT at admission and at 3 days post-treatment than those in the aseptic group, with a highly significant difference between them. Serum PCT and, to a lesser extent, TLC had prognostic value in patients with acute meningitis, and PCT is more useful because it can be frequently measured for the diagnosis and follow-up of bacterial meningitis.

Can gold nanoparticles affect the histological structure of the pulmonary alveoli in adult albino rats?

Gold nanoparticles [GNPs] are currently used in several consumer products as well as in laboratory-based research either as a diagnostic imaging agent or as a therapeutic agent in gene delivery and photothermal cancer therapy. They are synthesized by chemical methods in which toxic reducing agents are involved. There is a growing need to develop environmentally benign NP synthesis processes that are free from toxic chemicals. The study aimed to ascertain the possible histological alterations that might occur in the pulmonary alveoli of adult albino rats after intraperitoneal administration of 10 nm GNPs prepared by two different methods [chemically prepared and green synthesized]. Fifty adult male albino rats [140-160 g] were assigned to three groups. Group I was the control group. The rats in this group were further divided into three equal subgroups Ia, Ib, and Ic that received daily intraperitoneal injection of PBS, trisodium citrate, and cumin-gum Arabic solutions, respectively. Rats in group II received a daily intraperitoneal injection of 100 micro l of chemically prepared GNPs using trisodium citrate. Rats in group III received a daily intraperitoneal injection of 100 micro l of green-synthesized GNPs using cumin and gum Arabic. After 7 days, the animals were euthanized and specimens from the lungs were taken and processed for histological and immunohistochemical studies. H and E-stained sections of group II rats depicted multifocal thickening of the interalveolar septa and collapsed alveoli. Immunohistochemical analysis revealed high vimentin expression. Ultrastructurally, type II pneumocytes showed degenerative changes. Relatively thick interalveolar septa with many active interstitial cells were also seen. GNPs were detected in pneumocytes and alveolar macrophages. In contrast, the lung sections of group III rats showed considerable preservation of normal alveolar architecture with nearly normal vimentin immunoreactivity. GNPs were detected in the pneumocytes and interalveolar septa as well. Green-synthesized GNPs using cumin-gum Arabic are safer for the pulmonary alveoli compared with chemically prepared GNPs using trisodium citrate. Long-term studies are required to verify the toxicity of GNPs on various cell types

Histological study of adult male rat seminiferous tubules following triclosan administation and the possible protective role of pomegranate juice

Triclosan [TCS] is an antimicrobial agent, widely incorporated in a variety of personal care products, household items, medical devices, and clinical settings. Recently, concern has been raised over TCS's potential for endocrine and reproductive disruption. The study aimed to elucidate the impact of TCS on the histological structure of the seminiferous tubules [STs] in adult male albino rats, as well as the possible protective role of pomegranate juice [PJ] coadministration. A total of 32 adult male albino rats [140-160 g] were randomly categorized into four equal groups. Group I [the control group]: rats in this group received PBS [1 ml/kg/day] orally. Group II: rats in this group received PJ orally at a dose of 10 ml/kg/day. Group III: rats in this group received TCS orally at a dose of 20 mg/kg/day. Group IV: rats in this group received TCS at the same dose as group III in conjunction with PJ daily. The experiment continued for 60 days. At the end of the experiment, blood samples were collected from the retro-orbital venous plexus of all rats for estimation of serum testosterone level. The animals were then euthanized. The testes of all rats were harvested for both light and transmission electron microscopic examination of the STs. The germinal epithelial height and the number of germ cells/high-power field [HPF] were estimated morphometrically in H and E-stained sections and statistically analyzed. The study revealed that PJ administration was safe as it did not alter serum testosterone levels as compared with the control group. Histologically, the STs of these animals exhibited normal appearance similar to that of the control group. TCS administration was associated with significantly lowered serum testosterone levels as compared with the control group. Histologically, the STs were lined with relatively few spermatogenic cells with deeply stained nuclei. Cytoplasmic vacuolation of the lining cells and exfoliation of germ cells in the tubular lumina were seen as well. Ultrastructurally, vacuolar degenerative changes involving all types of spermatogenic cells as well as Sertoli cells were revealed. Moreover, the germinal epithelial height and the number of germ cells/HPF were significantly reduced compared with the control group. Coadministration of PJ with TCS resulted in a significant increase in serum testosterone level as compared with the TCS group. Histologically, most of the STs retained normal appearance and epithelial stratification. Only some tubules revealed vacuolation of germ cells in the basal compartment with deeply stained nuclei. Mild ultrastructural alterations of germ cells were evidenced as well. These results were confirmed histomorphometrically by the significant increase in the germinal epithelial height and number of germ cells/HPF as compared with the TCS group. The study clearly indicates that TCS has the potential to adversely impact the testicular structure and function, and that PJ is able to ameliorate such adverse effects

Light and electron microscopic study of thyroid follicular cells in adult albino rats following green tea administration

Green tea [GT] is one of the most popular beverages with high daily consumption worldwide. It has a rich content of polyphenols, among which catechins predominate. Its extracts are widely used as ingredients in dietary supplements, beverages, and functional foods, which may lead to a higher consumption of GT polyphenols by the general population. Recently, a relationship between GT administration and disruption of thyroid homeostasis was suggested. The goal of the study was to clarify the impact of GT administration on the histological structure of thyroid follicular cells of adult albino rats. Thirty adult male albino rats [140-160 g] were categorized into three equal groups: group I served as the control group; groups II and III received 1.25 and 5.0 g% GT extract orally at a dose of 10 ml/kg body weight, respectively, every day for 30 days. At the end of the experiment, blood samples were collected from all animals for estimation of serum triiodothyronine [T[3]], thyroxine [T[4]], and thyroid stimulating hormone. Rats were then euthanized and the thyroid glands were harvested for histological examination of thyroid follicular cells by light and transmission electron microscopy. The follicular epithelial height and colloid area of thyroid follicles were morphometrically evaluated and statistically analyzed. GT in small concentrations [in group II] did not induce any significant change in hormonal, histological, and histomorphometric assessments as compared with the control group. However, some follicular cells exhibited mildly dilated rough endoplasmic reticulum and multiple lysosomes. In contrast, GT administration in group III induced hypothyroidism as evidenced by significant reduction in serum T[3] and T[4] levels along with substantial increase in thyroid stimulating hormone level compared with controls. Histologically, many follicles displayed signs of hyperactivity as evidenced by focal hypertrophy and hyperplasia of the follicular cells along with colloid depletion. Ultrastructurally, dilated rough endoplasmic reticulum and disrupted mitochondria were encountered. Some severely degenerated follicular cells were revealed as well. Histomorphometrically, there was a significant increase in the mean follicular epithelial height, whereas the colloid area was significantly lowered as compared with the respective controls. The study clearly indicates that GT in large concentrations has the potential to disrupt thyroid follicular cell structure and function

Value of positron emission tomography/ computed tomography with [18] f-fluoro-2-deoxyglucose [[18]F-FDG PET/CT] in patients with ovarian cancer

This article discusses the current role of [18]F-fluoro-deoxy-glucose [FDG] PET, CT and integrated PET/CT in the management of ovarian cancer patients. 87 PET/CT scans of 64 women with clinically suspected or pathologically proven ovarian cancer were analyzed. The findings of contrast enhanced CT [CE-CT] were interpreted by one experienced radiologist unaware of P ET/CT findings. Two experienced nuclear medicine physicians who were unaware of CE-CT findings examined PET images, evaluating localization and characterization and compared them to co-registered PET/CT images. Diagnostic accuracy was determined on a patient level and a region level. PET has significantly higher Sensitivity, specificity PPV NPV, and overall accuracy [94.7%, 86.7%, 93.1%, 89.7%, and 91.9% respectively] compared to [89.5%, 30%, 70.8%, 60% and 68.9%] for CT on patient level. The diagnostic performance of PET was also better at most anatomical sites when results were analyzed on region level. [18]F FDG PET in addition to conventional imaging modalities should represent an important step in the diagnostic flow chart of ovarian cancer patients. Particularly in patients having a high risk for the presence of extra-abdominal metastatic deposits

Posterior vitreous detachment and retinal detachment after implantation of the visian phakic implantable collamer lens

To evaluate the vitreoretinal complications in myopes after Visian implantable collamer lenses [ICL] implantation. This is a retrospective, observational, non-comparative clinical study that evaluated 617 consecutive myopes who underwent ICL implantation at the Department of Refractive Surgery, Yemen Magrabi Hospital, Sana'a, Yemen between July 2006 and May 2010. Follow up ranged from 6 months to 40 months. Preoperative and postoperative patient evaluation included manifest and cycloplegic refractions, uncorrected [UCVA] and best spectacle-corrected visual acuity [BSCVA], slit-lamp biomicroscopy, intraocular pressure and dilated retinal examination. Investigations included corneal topography, central corneal thickness, anterior chamber depth and white to white diameter. Retinal diseases and complications were recorded and analyzed preoperatively and postoperatively. Preoperatively, 61 [9.9%] eyes had posterior segment pathology requiring prophylactic laser photocoagulation. One eye developed spontaneous rhegmatogenous retinal detachment [RRD], one eye developed traumatic retinal detachment and two eyes required laser treatment postoperatively. The overall retinal detachment rate post-ICL was 0.32%. Posterior segment complications are rare after ICL implantation but dilated vitreoretinal assessment is important before and after the procedure. Patients with suspicious retinal lesions need a comprehensive vitreoretinal evaluation by a retinal specialist. If a patient develops floaters or blurry vision he/she requires further assessment by a vitreoretinal specialist

Entropy-guided end-tidal desflurane concentration during living donor liver transplantation

The three phases of living donor liver transplantation [LDLT] represent different liver conditions. The aim is to study the required end-tidal desflurane concentration [ET-Des] guided with entropy monitoring for the depth of anesthesia. After the Ethics and Research Committee approval, 40 patients were included in this prospective study. Anesthesia was maintained with Desflurane-O2-air. State entropy [SE] and Response entropy [RE] were kept between 40 and 60. Age and Model for End-stage Liver Disease [MELD] score were 45 +/- 10 years and 15.43 +/- 3.92, respectively. ET-Des were significantly lower in the anhepatic phase [2.8 +/- 0.4%] than in the pre-anhepatic and neohepatic phases [3.3 +/- 0.3%, 3.47 +/- 0.3%, respectively, P<0.001]. The SE and RE for pre-anhepatic, anhepatic, and neohepatic phases were [45.6 +/- 3.7, 47.4 +/- 3.2], [44.7 +/- 2.1, 46.4 +/- 2.04], and [46.1 +/- 3.3, 47.9 +/- 3.3], respectively, with no significant changes between the phases, P > 0.05. Total operative time was 651 +/- 88 minutes, and for each phase it was 276 +/- 11, 195 +/- 55, and 191 +/- 24 minutes, respectively. Significant changes were found in hemoglobin g/dl and hematocrit% between the three phases [10.28 +/- 1.5, 30.48 +/- 4.3], [9.45 +/- 1.34, 28.36 +/- 4.1], and [8.88 +/- 1.1, 26.63 +/- 3.5], P<0.05. The heart rate and mean blood pressures were stable despite the cardiac index demonstrated a significant reduction during the anhepatic phase [2.99 +/- 0.22] when compared to the pre-anhepatic and neohepatic phases [3.60 +/- 0.29] and [4.72 +/- 0.32], respectively, [P<0.05]. There was a significant correlation between CI and ET-Des% [r=0.604, P<0.05]. Inhalational anesthetic requirements differed from one phase to another during LDLT, with requirements being the least during the anhepatic phase. Monitoring of the anesthesia depth was required, to avoid excess administration, which could compromise the hemodynamics before the critical time of reperfusion

External cephalic version for breech presentation at term: predictors of success, and impact on the rate of caesarean section

The incidence of caesarean section for breech presentation has increased markedty in the last 20 years. A prospective, interventional cohort study was carried out of the success rate of external cephalic version [ECV] and its predictors of as well as its impact on the rate of caesarean section for vaginal breech delivery. All 128 women admitted during the study period to the obstetrics department of a tertiary care military hospital in Taif Saudi Arabia with breech presentation at term, regardless of age and parity, who accepted ECV were recruited ECV was successful in 53.9% of the women. Most of the women with successful ECV delivered normally [84.1%] and only 14.5% of them delivered by caesarean section. Conversely, normal vaginal delivery was reported among 8.5% of those who had spontaneous version with failed ECV and approximately two-thirds of them delivered by caesarean section [62.7%]. Successful ECV reduced the breech and caesarean section rate

Chemical and biological evaluation of biscuits rich fiber from different sources

This study was carried out to investigate the effect of replacing wheat flour [72%extraction] by some fiber sources at different levels on charactertics of wheat flour and produced biscuit quality. The produced biscuit samples were also evaluated for its biological effects. The used fiber sources is wheat bran .orange peel powder and carrot powder and the replacement levels were 15,20,25and 30%.The obtained results indicated that orange peel powder showed the highest fiber content [12.00%] and wheat flour showed the lowest content [0.30%].Carrot powder showed the highest ash content [8.17%] compared to wheat flour [0.68%] .The results indicated that addition of these fiber sources to wheat flour [72%extraction] lead to sharply increase in fiber and ash contents of the resulted biscuit samples. Concerning the Theological properties, the added fiber sources lead to increase the water absorption and dough stability. The elasticity and proportional number values were also increased while extensibility and energy were decreased. With respect to organoleptic evaluation, the obtained results indicated that biscuit samples produced using wheat bran at level of 15% were not significantly different from control sample for all the evaluated characteristics. The biscuit samples produced using wheat bran at level of 20% was not significantly different from control for color, taste, odor and overall acceptability. On the other had the biscuit samples produced using orange peel powder or carrot powder were found to be significantly different from control for all the evaluated characteristics and at all replacement levels. The biological evaluation of the biscuits produced from wheat flour [72%extraction] with and without replacement by 20% of each of fiber sources under study revealed less in total serum lipid in rats fed on biscuits containing orange peel powder 20% compared with other treatments

Concerning total cholesterol and triglycerides, some trends were obtained with rats fed on 20% orange peel and the rats that fed on biscuits containing wheat flour were worst. Also, results showed that the rats fed on biscuits containing 20% orange peel showed best results in HDL, LDL, Albumin, SCOT and SGPTcompared to other treatments. From the obtained results it could be revealed that using of wheat bran, orange peel powder and carrot powder as rich fiber sources with wheat flour [72%extraction] for production of biscuit at replacement level up to 20% could be recommended from the stand point of economical and better health