Efficacy and speed of conversion of recent onset atrial fibrillation using oral propafenone versus parenteral amiodarone: A randomized controlled comparative study

Background: Atrial fibrillation is the most commonly encountered arrhythmia. Several antiarrhythmic agents are effective in restoring and maintaining sinus rhythm. Aim of the work: To compare the efficacy and rapidity of conversion of recent onset atrial fibrillation using oral propafenone versus intravenous infusion of amiodarone. Methods: The study included 200 patients with recent onset atrial fibrillation. Patients were equally divided into 2 groups; group A where intravenous infusion amiodarone was given and group B where oral propafenone was administrated. The effectiveness and the time needed for conversion of atrial fibrillation to sinus rhythm were compared in both groups. Results: The success of conversion of atrial fibrillation to sinus rhythm was 83% in group A and 85% in group B, p-value ¼ 0.699. The time elapsed from drug administration till conversion of atrial fibrillation was 9.07 ± 5.04 hours in group A versus 3.9 ± 1.54 hours in group B, p-value ¼ 0.001. In both groups, patients who showed failed conversion had a significantly larger left atrial diameter and a significantly higher high sensitivity C-reactive protein (hsCRP) level. Conclusion: Oral propafenone was faster than parenteral amiodarone in the conversion of recent onset atrial fibrillation to sinus rhythm. Patients with failed conversion had a bigger left atrial diameter and a higher hsCRP when compared to patients with successful conversion

Role of liver and cardiac enzymes as markers of parasite load and recovery after treatment in experimental murine toxocariasis

Background: Toxocara is mainly a parasite of animals. The disease is caused mainly due to accidental ingestion of Toxocara canis embryonated eggs and to a lesser extent T.cati eggs. Till now, there is no marker of severity of infection or treatment in toxocariasis

Aim of the study: The current work aimed at studying the role of liver enzyme aspartate transaminase [AST] and cardiac enzyme creatine kinase-MB isoenzyme [CK-MB] as markers of severity infection and treatment of toxocariasis in correspondence to serum immunoglobulin with study of histological cardiac effects of toxocariasis

Materials and Methods: Laboratory mice were divided into groups infected with different doses of Toxocara eggs. Sera were collected from each group before and after treatment for measurement of AST and CK-MB, as well as ELISA for anti-Toxocara immunoglobulin IgG. T test, ANOVA test and Pearson correlation tests were used to assess the results

Results: CK-MB was elevated significantly with infection and reduced significantly after treatment. The serum level of CK-MB also correlated significantly and positively with parasite load

Conclusion: CK-MB can be used together with anti-Toxocara IgG in diagnosis and CK-MB can be a good markers of treatment and parasite load in toxocariasis

Effect of 8 weeks selective training program with instructions focus of internal and external attention on statical balance of multiple sclerosis patients

Background and Objective: Multiple sclerosis [MS] is the most common progressive neurologic disorder among young adults. This disease leads to lesions regarded to as demylinating plaques which are scattered in the white matter of CNS hence create various neurological problems. This study was done to evaluate the effect of 8 weeks selective training program with instructions focus of internal and external attention on statical balance of MS patients$Methods: In this quasi-experimental study, 23 MS patients were non-randomly divided into, two interventional and one control groups. Training program for two interventional were carried out in 8 weeks, three sessions per week, and each session lasted about one hour. Pre and post test to evaluate the fall risk of subjects using Biodex system was performed in three groups

Results: Statical balance was significantly improved in the two interventional compared to control group [P<0.05]

Conclusion: The training program with instructions focus of internal and external attention significantly improves statical balance of MS patients

Polymerase chain reaction techniques: applications in parasitic diseases

dNTPs: Nucleotides; ESTs: Expressed sequence tags; HAT-RAPD-PCR: High annealing temperature random amplified polymorphic DNA PCR; HSP: Heat shock protein; ITS: Internal transcribed spacer; mRNA: Messenger RNA; MSP: Merozoite suiface proteins; MT-PCR: Multiplex tandam PCR; PCR: Polymerase chain reaction; qPCR: Quantitative basic PCR; qRtime-PCR: Quantitative real-time PCR; qRT-PCR: Quantitative reverse transcriptase PCR; QT-NASBA: Quantitative nucleic acid sequence-based amplification; RAPD: Random amplified polymorphic DNA; RFLP: Restriction fragment length polymorphism; RNA: Ribonucleic acid; Rtime-PCR: Real time PCR; RT-PCR: Reverse transcriptase PCR; SNP: Single nucleotide polymorphism;TLRs: Toll-like receptors

Micro-implant: a new time saving device for hair transplantation [A Case report]

Hair transplantation is the main therapeutic method for androgenic alopecia. Improvement of the hair transplant techniques with more acceptable appearance of the transplanted hair has made this method more popular. Nowadays, for more acceptable appearance of transplanted hair, every follicle is transplanted separately or in small groups which is a time consuming procedure and exposes the follicles to environmental stressors. The new device that we introduce here can be time saving and decreases the exposure time to stressors. This device was named Micro-implant and we used it for hair transplantation in a 45 years old man with androgenic alopecia. After informed consent and adequate explanations, necessary laboratory tests were performed which their results were normal. Three 10×2 cm grafts were resected from occipital area. The grafts were placed into sterile physiologic buffer rapidly and then divided by a scalpel into small pieces, each containing 1-4 follicles. These graft units were transplanted into the frontal bald area by means of the Micro-implant. Use of this device will reduce transplantation time notably and maintain the viability of the transplanted follicles which ensure success of transplantation

Determination of the attenuation coefficient for megavoltage photons in the water phantom

Attenuation coefficient [micro] plays an important role in calculations of treatment planning systems, as well as determination of dose distributions in external beam therapy, dosimetry, protection, phantom materials and industry. So, its exact measurement or calculation is very important. The aim of this study was to evaluate the micro in different points in the water phantom analytically as a formula, in addition to derive and parameterize it with dosimetry measurements data results. To find the attenuation coefficients at each point along the central axis of the beam in the phantom for every size of the fields, the first mathematical approach was performed for derivation of micro s from percentage depth dose [PDD] formula. Then by dosimetry for different fields in different depths of water phantom, one can parameterize the obtained formula for micro in any field and depth. By comparing the mathematical and dosimetry results, the parameters of the micro-expression were derived in terms of the dimension of square field in different depths. From this formula one can find the micro for any field in different depths for two energies of the Varian 2100CD linear accelerator, 6, 18MV with the statistical coefficient of determination of R2>0.98. The measurement of the micro in each field size and depth has some technical problems, but one can easily measure the micro for every point of central axis of the beams in any field size

Histopathological, histochemical and immunohistochemical studies of experimental heterophyiasis in dogs and the protecting role of praziquantel

Parasitic diseases are associated with oxidative stress leading to DNA damage and apoptosis. Study of apoptosis pathway in heterophyiasis can help in treatment and prevention of pathological changes in tissues. Evaluation of the role of caspase 3 pathway in apoptosis, DNA changes and the role of praziquantel in heterophyiasis. Study design included experimental infection of dogs with encysted metacercariae of H. heterophyes followed by treatment with praziquantel. Tissue samples from the small intestine and the heart, before and after treatment, were stained for histopatholgical, histochemical and immunohistochemical studies. DNA damage was detected in infected tissues by histochemical stains, while apoptotic changes were detected in histopathological and immunohistochemical stained tissues. These changes were reversible with treatment by praziquantel. DNA and tissue damage due to heterophyiasis can be corrected by praziquantel treatment

[Effects of physical, mental and mixed practices on the static and dynamic balance of aged people]

Physiological changes related to aging and muscular problems can increase the risk of injury in elderly. Falling down, accounts for a major risk in the mortality of this age group. Thus, we examined the effect of practice type [physical, mental and mixed practices] on the static and dynamic balance of the old people in Shahrekord. 60 old men and women in the range of 60 to 70 years were randomly divided into three experimental [physical, mental, and mixed practices] groups. Their static and dynamic balances were assessed in advance by using Stroke Stand [standing with one leg] and Star Excursion Balance tests, respectively. Based on the researchers' protocol, 8 practice sessions were performed for all participants, afterwards. The same balance tests were repeated for the post test. Obtained data was analyzed by either one was ANOVA or two way ANOVA test with Repeated Measures and Bonferroni Post Hoc tests at the level of P<0.05. Balance tests showed a statistically significant difference between the experimental groups in the post test [P<0.05]. The mixed practice group had a better performance than the two other groups [P<0.05]. The performance of the physical practice group was also better than the mental practice group, too [P<0.05]. Combined application of the physical and mixed exercises make a better performance for increasing the muscle strength of lower extremities and improving the static and dynamic balance in old people

Effects of spinosad, zingiber officinale and allium sativum on chrysomyia albiceps larvae: biological, histological and ultrastructural studies

Chrysomyia albiceps fly is associated with animal and human myiasis and is a potential mechanical transmitter of pathogens. It is prevalent in tropical and subtropical countries, including Egypt. To examine the effects of natural products as spinosad and water extracts of ginger roots of Zingiber officinale and garlic fruits of Allium sativum on Chrysomyia albiceps larvae aiming to establish safe control methods. C. albiceps flies were reared in the laboratory at 28 +/- 2°C. Adults were offered sugar solution and pieces of minced meat in Petri dishes for feeding and as media for oviposition. Larvae were fed minced meat to which was added one of three compounds: spinosad, water extract of either Z. officinale or A. sativum. Larvae and pupae were monitored for development to the adult stage. Biological, histological and scanning electron microscopic studies were conducted to investigate the effects of these compounds as control measures against C. albiceps larvae. All tested materials affected biological aspects of larvae. In histological sections, spinosad proved more potent causing decrease in cuticle thickness and integument degenerative changes. Using scanning electron microscopy, Z. officinale and A. sativum extracts appeared to cause changes in the cuticle and moderate degenerative changes in the integument. Spinosad, Z. officinale and A. sativum affected survival of C. albiceps larvae and could be used effectively in control of larvae and prevention of myiasis

Outcome after total mesorectal excision in the management of rectal experience of 150 patients

To assess oncological outcomes including local recurrence and cancer-specific survival as well as functional outcomes including urinary and sexual functions in 150 cases of rectal cancer underwent total mesorectal excision [TME]. Patients with mid or low rectal cancer underwent TME with preservation of autonomic pelvic plexus. Oncological and functional outcomes were prospectively recorded and analyzed. A total of 150 patients of middle and lower rectal cancer underwent either APR or LAR with total mesorectal excision and pelvic nerve preservation between 1997 and 2007 were collected. Anastmotic leak was the commonest complication [16.6%]. Isolated local pelvic recurrence was 10.6%.The 5-year overall survival and cancer-specific survival rale were 45% and 52% respectively. All patients could void urine spontaneously and no patient became incontinent or went on chronic retention requiring catheterization. Postoperative urodynamics revealed normal mean maximal urinary flow rate and voided volume in 90% of patients. Erection was possible in 93%; penetration ability was possible in 69 patients [80%]. Doppler US was normal on both sides in 80%. Advances in rectal cancer surgical techniques allows improving overall survival and quality of life through local control and preservation of sphincter, sexual and urinary function

Study of thyroid function in children with attention deficit hyperactivity disorder and aggressive behavior

Attention deficit hyperactivity disorder [ADHD] is a well recognized psychiatric disorder of childhood. Its cause is unknown, but there is evidence of familial predisposition. Symptoms suggestive of the disorder have been reported in patients with generalized resistance to thyroid hormones [GRTH], a disease caused by a mutation in the thyroid receptor beta gene and characterized by reduced responsiveness of peripheral and pituitary tissues to thyroid hormone actions. This study was conducted to assess the frequency of thyroid hormone abnormalities in children with ADHD and/or aggressive behavior and to relate these abnormalities to the type of behavioral disorder. Thirty cases with behavioral disorders [ADHD and/or aggression] diagnosed by DSM-IV classification were studied in comparison to 10 age-and sex-matched healthy controls. Clinical examination and psychiatric evaluation including IQ and psychosocial assessment were done to all patients. Measurement of serum free triiodothyronine [fT3], free tetraiodothyronine [fT4] and thyrotropin [TSH] was done to cases and controls. There was a significantly lower IQ [p <0.05] among patients [84.2 +/- 16.4%] when compared to controls [100.9 +/- 5.4%]. Significantly higher mean fT3 and TSH levels [p <0.05] were detected among cases [5.96 +/- 2.9 pg/ml and 6.53 +/- 3.2 ulU/ml respectively] when compared to controls [2.96 +/- 0.82 pg/ml and 2.28 +/- 1.28 ulU/ml respectively] while a non significant difference [p >0.05] in the fT4 level was detected. Twelve out of our 30 studied cases [40%] had thyroid hormone resistance among whom 7 [23.3%] had high fT3 and high TSH levels while 5 [16.7%] had high fT3 and normal TSH. Among the ADHD group, 3/16 [18.8%] had high fT3 and high TSH levels and 1/16 [6.3%] had high fT3 and normal TSH levels. Among those with aggression, 2/8 [25%] had high fT3 and high TSH and a similar percentage had high fT3 and normal TSH. Among those with both ADHD and aggression, 2/6 [33.3%] had high fT3 and high TSH and a similar percentage had high fT3 and normal TSH. In the 3 groups of behavioral disorders, none of the cases had high fT4 levels above the age-matched controls.A significant number of patients meeting the diagnostic criteria for ADHD have associated RTH. Therefore, measurement of TSH and fT3 should be incorporated in the work up of children in families having ADHD and/or aggression. In children with ADHD and concomitant RTH, particularly those who exhibit hyperactivity, liothyronine [L-T3] in supraphysiological doses could be beneficial in reducing hyperactivity and impulsivity and thus decreasing the need for psychostimulants. Further studies are warranted regarding the role of RTH in the pathophysiology of ADHD

Bone mineral density in ankylosing spondylitis

We investigated the frequency and distribution of osteopenia osteoporosis according to the clinical severity In ankylosing spondylitis [AS]. Through clinical examination, laboratory investigations and plain radiography were done to all patients. Twenty three patients with AS were recruited to this study and divided according to the disease severity into 2 groups; mild and advanced. Twelve men with a mean age of 36.6 +/- 7.5 years with mild disease of mean duration 8.7 years represented the first group. The second subgroup of patients consisted of 11 men with a mean age of 42.5 +/- 10.1 years with severe disease and a mean duration of 11.7 years. Bone mineral density [BMD] was measured in patients with mild and advanced AS with dual energy X-ray absorptiometry [DEXA]- Definition of clinical severity was based on the Schober's test. Twenty two age-matched male subjects had BMD measurements as a control group. Osteopenia was commonly detected [48% in mild AS and 39% severe AS] and, in mild disease, more frequently observed at the lumbar spine than the femoral neck. In severe AS, however, the frequency of osteopenia at the femoral neck was as high as at the lumbar spine. Both bone mineral density and t-scores in severe disease were lower than In mild disease at the femoral neck, but not in the lumbar spine. The progression of osteopenia/osteoporosis may be reflected more reliably at the proximal femur than at the lumbar spine

LMA-proseal versus endotracheal intubation for elective laparosgopic cholecystectomy

The aim of this study was to evaluate the effectiveness of laryngeal mask airway -ProSeal as compared to endotracheal intubation during laparoscopic cholecystectomy as regards pulmonary ventilation and respiratory events at emergence. Forty patients aged 18 years or above, ASA 1 or 2 subjected to laparoscoeic cholecystectomy under general anesthesia were included. Patients with a history of hiatus hernia, gastroesophagcal reflux or diabetes mellitus were excluded Patients were randomized into two groups: Group 1 [LMA-PS] [Laryngeal mask airway ProSeal]: LMA-PS size 3 for female and size 4 for male patient were used. The cuff was inflated with air in 2-3ml increments until effective airway was obtained. Group 2[ETT][Endotracheal tube]: Cuffed ETT size 7mm for female and 8mm for male patient were used and inflated the cuff until no leak was audible. After preoxygenation with 100% oxygen for 3 minutes, anesthesia was induced with 20mg lidocaine, 2-2.5mg.kg[-1] propofol, 1-2micro g. Kg[1] fentanyl and vecuronium 0.05mg .kg[-1]. Positive pressure ventilation [PPV] was not used until after insertion of LMA-PS or ETT. Anesthesia was maintained with 50%nitrous oxide in oxygen, sevoflurare 1 -3%. We started with 6L.min[-1] fresh gasflow to be reduced to 3L.min[1] closed circuit. Incremental doses of vecuronium and fentanyl was given as required. Minute volume and Fio2 were adjusted to maintain SpO2 > 94% and PETCO2 < 45mmHg. If effective airway could not be maintained for 90 seconds or SpO2 /= 45mmHg at any time of the procedure, the LMA-PS will be shifted to ETT. Insufflation time, total anesthetic time, regurgitation [clear or bile stained fluid] and respiratory events at extubation cough, laryngeal spasm, the need for PPV, tracheal intubation] were recorded and compared in both groups. Our study showed that the incidence of respiratory events at extubation were significantly less in group 1 [LMA-PS] as compared to group 2. There was insignificant difference as regard ventilation parameters in both groups and was within normal physiological range. The use of Laryngeal mask airway ProSeal is associated with less incidence of respiratory events at recovery compared to endotra-cheal intubation and both were effective as regard pulmonary ventilation during laparoscopic cholecystectomy

phytochemical and biological investigations of halocnemunt strobilaceum [Pall.]

The lipid content of Halocnemurn strobilaceum grown in Egypt was studied. The unsaponifiable fraction was identified by GLC. A series of hydrocarbons ranging from C[17]-C[31] in addition to campasterol, stigmasterol, beta-sitosterol and the triterpenoid cc-amyrin were identified. The GLC analysis of the fatty alcohol fraction revealed the presence of 7 fatty alcohols, also the analysis of the fatty acid fraction revealed the presence of 10 fatty acids in which palmitic acid was the main acid [39.26%]. The flavonoidal constituents isolated from the chloroform and the ethyl acetate fractions of the aqueous alcoholic extract of Halocnemurn strobilaceum were identified as Chrysoeriol, Luteolin 7-O-galactoside, Quercetin 7-O-rhamnoside, Luteolin, and a coumarinic compound, Scopoletin was also identified. Their identity was proved by m.p., TLC, PC, UV, 'H-NMR and MS analysis. GLC analysis of the volatile oil of the plant revealed the identification of 23 compounds which accounted for 63% of the oil. The oil is characterized by a high content of hydrocarbons [55.9%], while the oxygenated hydrocarbons were represented by [33.8%] of the identified components. Also, the sesquiterpene hydrocarbons and oxygenated sesquiterpene compounds were found to be 2.6% and 8.2% respectively. The radical scavenging effects of the extracts and isolated compounds on DPPH free radical were studied. The ethyl acetate extract had a strong antioxidant activity, also the isolated flavonoidal compounds showed high antioxidant activity as compared to Trolox [standard antioxidant compound]. The different extracts and isolated compounds of the plant exhibited no cytotoxic activity against Ehrlich-ascitis carcinoma cell line at the tested concentrations, except the volatile oil which showed moderate activity

phytochemical investigation of asteropterus leyseroides [Desf] and their biological activity

The flavonoidal constituents isolated from the chloroform and ethyl acetate fractions of aqueous alcoholic extract of Asteropterus leyseroides [Desf] were identified as quercetin, Jaceidin, jacein and a phenolic acid, caffeic acid using PC, TLC, uv,[1-]H-NMR and MS analysis. Also, the lipid content was studied. GLC analysis of the unsaponifiable fraction revealed the presence of a series of hydrocarbons ranging from C[I2]-C[29] in addition to cholesterol, stigmasterol and alpha-amyrin, as well as fatty alcohol fraction ranging from C[24]-C[39] were identified. The fatty acid fraction revealed the presence of 10 fatty acids in which linoliec acid [35.99%] represented the major constituent. The crude protein of the plant was found to be [12.71%]. The analysis of the amino acids using the amino acid analyzer revealed the presence of 15 amino acids. The mucilage hydrolysate of the aerial parts of Asteropterus leyseroides was found to contain glucouronic acid, xylose, rhamnose and glucose using PC. The radical scavenging effects of the tested extracts and isolated compounds on 1, 1 Diphenyl-2-picrylhydrazyl [DPPH] free radical were observed. The ethyl acetate fraction and the isolated flavonoidal compounds showed high antioxidant activity. The different extracts and isolated compounds of the plant exhibited no cytotoxic activity against Ehrlich-ascitis carcinoma cell line at the tested concentrations

[Ultrastructural study of combined therapy effect of losartan and octreotide on inhibition of glomerular epithelial changes inuninephrectomized diabetic rats]

In diabetes mellitus the increase of Agll [Angiotensin II], IGF-1 [insulin like growth factor-1] and growth hormone induce kidney lesions especially changes in content and thickness of GBM and widening and fusion of podocyte pedicles. In this research for the first time the combination of Losartan [ATI receptor blocker] and Octreotide [Somatostatin analogue] were used in order to prevent glomerular epithelial lesions.In this experimental study 15 male rats [2 months age] were uninephrectomised from left flank and divided in 5 groups [3 per group]. 7 days later diabetes was induced in 2[th], 3[th], 4[th] and 5[th] group by Alloxan [120mg/kg] subcutaneously. 5 days after diabetes induction, the third group received Losartan [5mg/kg/day] orally, 4[th] group Octretide [10 ug/day] subcutaneously and 5[th] group both two drugs with the mentioned doses for 8 weeks. The 2[th] group was served as diabetic non treatment group. Kidneys of all groups were fixed by perfusion technique. After second fixation of 1 mm[3] cortex parts in Osmium Tetroxide, they were processed in TAAB812 resin for embedding. Thin sections [600 nm thickness] were prepared and investigated by transmission electron microscope qualitatively.Losartan inhibited fusion and thickening of podocyte pedicles but in some cases couldn't maintain the 3 layer form of GBM. Octreotide had little effect on inhibition of fusion and thickening of podocyte pedicles and no effect in 3 layer form maintaining of GBM. Combined therapy inhibited fusion and thickening of podocyte pedicles and maintained 3 layer form of GBM but in some cases the lamina rara near endothelium was not seen.Octreotide have little effect on prevention of glomerular epithelium lesions. However Losartan could prevent glomerular epithelium lesions well, but combined drug therapy showed better results comparing Losartan

Thoracic paravertebral block versus intrapleural analgesia following cancer breast surgery

The aim of this study was to evaluate the effeciveness of postoperative analgesia of thoracic paravertebral nerve block in comparison to intrapleural analgesia after cancer breast surgery. The study was carried out on thirty patients subjected to cancer breast surgery. General anesthesia was fixed for all patients as follow: peroxygenation by 100% oxygen for at least 3 minutes. Intravenous 2mg/kg propofol and 80ug/kg vecurounium. Intubation was done under complete muscle relaxation and anesthesia was maintained by a mixture of NO2/02[FiO2=40%] and isoflurane 1-1.5%. Top up dose of vecuronium was one fifth of the initial dose. At the end of surgery and before reversal of muscle relaxation and extubation patients were randomly assigned to one of two groups: GroupI patients received Thoracic paravertebral block[TPVB] at T4. GroupII patients received intrapleural analgesia[IPA]. A mixture of local anesthetic [0.3ml/kg ropivacaine0.5%] and 2mg morphine were injected before extubation of the patients to both groups. The duration of analgesia, verbal rating pain score[VRS] values, sedation score, vital sings and adverse effects were recorded. our study showed that TPVB was more effective in postoperative control of pain compared to IPA, has lower VRS scores, less analgesic requirements and longer duration of analgesia. Both techniques showed hemodynamic stability and significant decrease in PH but was within normal physiological range. TPVB has the upper hand in comparison to IPA in pain management, has lower VRS score, less additional analgesic requirements and longer duration of analgesia

Towards a unified theory of alkaline scale formation from seawater

Alkaline scale formation inside the condenser tubes is one of the main operation problems encountered in seawater desalination plants. The scales are composed of CaCO3 and/or Mg[OH]2 and impair heat transfer and reduce flow velocities. Scale formation is inherent to the special composition of seawater, which contains HCO3, Ca[2+] and Mg[2+] ions. The two theories accounting for scale formation are reviewed in short. The one, Langelier's, suggests the primary precipitation of CaCO3 at intermediate temperatures followed, at higher temperatures, by the separation of Mg[OH]2. Dooly and Glater's theory, on the other hand, is based on the separation of Mg[OH]2 at all temperatures. Hitherto, no satisfactory explanation has been presented to explain the reasons behind the variation in scale composition. Like other chemical reactions, scaling can be studied either thermodynamically or kinetically. In the present paper both approaches are attempted. The free energy changes accompanying scale formation reactions at 25 and 100°C are computed and their implications discussed. It is concluded that thermodynamics alone is not adequate to explain scaling. The kinetic aspects of the reactions are then considered. The OH and CO3[2-] ions necessary for the precipitation of Mg[OH]2 and CaCO3 are considered to form as: HCO3[-] = OH[-] + CO2[i] and 2 HCO3[-] = CO3[2-] + H2O + CO2 [ii] with reaction [i] being rate determining. The two reactions are assumed to have different, temperature-dependent activation energies. Because it involves bond cleavage, reaction [i] is regarded to have, at low temperatures, a high activation energy. This decreases, however, appreciably as the temperature increases. On the other hand, reaction [ii] is an acid-base neutralization reaction. It is likely to have low- activation energy with smaller dependence on temperature. A schematic presentation of the variation of the activation energy of the two reactions as function of temperature will exhibit two straight lines of different slopes, crossing at an intermediate temperature. As a result of curve crossing, the energy-restricted reaction at low temperatures becomes kinetically favoured at higher temperature. This concept adequately explains the change in scale composition from one of CaCO3-rich to that of Mg[OH]2 -rich as the temperature is raised

Can stapler haemorrhoidectomy replace conventional open haemorrhoidectomy at present in Egypt

Postoperative pain associated with conventional open haemorrhoidectomy remains problematic. Stapler haemorrhoidectomy as a new technique with its advantages over conventional open haemorrhoidectomy in terms of operating time, postoperative pain and hospital stay, can replace it

randomized controlled study of the immunosuppressive versus of whole blood transfusion versus packed red blood cells transfusion in patients undergoing elective colorectal surgery

In a randomized study, the effect of whole blood transfusion versus packed RBCs transfusion on CD4+:CD8+ ratio, the levels of soluble interleukin 2 receptor [sIL-2R] and interleukin IL-6 as well as on the development of the postoperative wound infection and intra-abdominal abscess, was assessed in 45 patients undergoing elective colorectal surgery. The patients were subdivided into three groups: Group A included 13 patients who were randomly selected received whole blood transfusion when blood transfusion was indicated, group B included 13 patients who were randomly selected received packed RBCs when blood transfusion was indicated and group C included 19 patients who did not receive any blood transfusion. The samples were obtained prior operation and 3, 7 and 30 days postoperatively. The study demonstrated that transfusion with whole blood in elective colorectal surgery was followed by a significant depression in immunocompetence and this depression is attenuated by the use of packed RBCs transfusion