Role of Procalcitonin in the diagnosis of Neonatal Sepsis

Objectives: Early diagnosis of neonatal sepsis and appropriate treatment decreases the mortality and morbidity of these infants. The aim of this study was to assess the role of procalcitonin [PCT] as a marker in the early diagnosis of neonatal sepsis

Study design: 35 neonates with early onset sepsis [admitted to the Neonatal Intensive Care Units at El-Minia Children University Hospital [from August 2012 to August 2013] were included in the study. Another 35 healthy neonates with no clinical and biological data of infection were taken as control, they were subjected to thorough history taking, routine laboratory investigations and serum Procalcitonin and C-reactive protein [CRP] were determined by ELISA

Results: Mean levels of procalcitonin and CRP in neonates with sepsis were significantly higher than the control. There was a significant moderate positive correlation between procalcitonin and C-reactive protein and insignificant correlation between procalcitonin and total leukocytic count among the neonates with sepsis. Also procalcitonin had high sensitivity, specificity, high positive predictive value and high negative predictive value. PCT showed higher sensitivity in comparison to that of CRP

Conclusion: Procalcitonin is a sensitive, independent and useful biomarker than CRP in early diagnosis of neonatal sepsis

Evaluation of the phenolic content and antioxidant potential of althaea rosea cultivated in Egypt

The aim of this study was to evaluate the total phenolic content [TPC] and antioxidant potential of Althaea rosea Cav., family Malvaceae, as well as to isolate and identify the flavonoid content of the methanolic extract of the aerial parts. In addition, a comparison between the TPC and antioxidant capacity of the methanolic extract of both aerial parts and flowers was carried out to discover new active constituents that can be utilized in drug industry. The extraction of the flavonoid compounds was carried out by percolation of the dried aerial parts of the plant under investigation with 70% methanol until exhaustion. The combined extract was then concentrated and defatted with petroleum ether [60-80[degree sign] C]. After separation of the lipoidal matter, the remaining extract was purified from mucilage and subjected to several column chromatographic techniques for isolation of the flavonoids. The identification of flavonoid compounds was carried out using physical, chemical, and spectral methods such as ultraviolet, [1]H NMR, and [13]C NMR. The antioxidant potential of the methanolic extracts of both aerial parts and flowers was determined using the stable 2, 2-diphenyl-1-picrylhydrazyl free radical scavenging activity method. Furthermore, their TPC was also determined using the Folin-Ciocalteu method. Five flavonoid compounds were isolated from the aerial parts of A. rosea Cav., which were identified as quercetin 3-O-beta-d-glucuronopyranoside-8-C-beta-d-glucopyranoside, kaempherol-3-O-beta-d-rutinoside, kaempherol-4´-O-beta-d-glucoside, kaempherol-3-O-beta-d-glucoside, and kaempherol. The antioxidant activity was measured in terms of their IC[50]. The IC[50] values of the methanolic extracts of the aerial parts and flowers were 11 and 1 mg/ml, respectively, whereas the TPCs were 48 and 73 micro g/ml, respectively. The methanolic extracts of both aerial parts and flowers of A. rosea Cav. are rich in phenolic compounds and have a prominent antioxidant activity. The antioxidant activity of both extracts may be attributed to their phenolic content

Serum level of ghrelin in umbilical cord in small and appropriate for gestational age newborn infants and its relationship to anthropometric measures

Ghrelin natural growth hormone secratogogue originating from the stomach, is characterized by non endocrine activities such as orexigenic effects and modulation of the endocrine and metabolic response to variation in energy balance. However it nor not known whether it plays a role in energy homeostasis during fetal life or not. The study aims to determine cord blood ghrelin level in small for gestational age [SGA] infants compared with appropriate for gestational age [AGA] infants and its relationship to anthropometric measurements at delivery. Fifty newborn infants, 30 SGA, their gestational age ranged from 36 to 39 weeks and their weight ranged from 1 to 2.2 Kg and 20 AGA infants, their gestational age ranged from 38 to 41 weeks and their weight ranged from 3 to 3.6 Kg were included in the study and were subjected to complete clinical examination, anthropometric measurements and ghrelin assay. The study showed that the cord blood ghrelin level in SGA infants [mean :t SD.; 8.18 :t 1.00 pg/ml] was Significantly greater than that in AGA infants [4.37 :t 0.50 pg/ml]. [p-value 0.0001]. Cord ghrelin level was correlated negatively with gestational age, weight, length and body mass index in SGA group[r=-0.55;p =0.002, r=-0.63,p =0.0001,r=-0.61, p=0.07 and r=0.56, p=0.001] and in AGA group [r=-0.48 ;p =0.05, r=-0.59,p =0.6, r=-0.37, p=0.7 and r=--0.47, p=0.7]. The study showed that the most important factor affecting ghrelin level in both SGA and AGA neonates was their weight, while the least factor is their mid arm circumference. Cord ghrelin concentration increased in small for gestational age infants due to state of prolonged under nutrition. The source of ghrelin remain unknown, it may be either from the placenta or fetal tissues origin

Health needs and problems related to food hygiene practices among primary school children

Food hygiene is the action taken to ensure that food is handled, stored, prepared and served in such a way to prevent the contamination of food, poor food hygiene may cause food poisoning outbreaks and eventually loss of lives. This study aimed to assess health needs and problems related to food hygiene practices and assess knowledge and practices of primary school children. study was done on 503 pupils at 6th grade. primary schools in El Mehalla Elkoubra.10 governmental, 2 private and 2 Azhar schools, including east sector schools and west sector schools. Tool: three tools were used to collect the data, self administered questionnaire sheet, Physical assessment sheet, Observation check list. Data were analyzed using SPSS soft ware The result of the study revealed that more than half of of study sample were females, Pupils had poor knowledge score were less than one third ,those had average knowledge score were about two fifths ,less than one third had good knowledge score. Sources of knowledge were teachers for two thirds and parents for less than two thirds, Parent's education Affected pupil's knowledge significantly. Pupils had poor practices score were less than one fifth, those had average practices score were slightly less than two thirds and more than one tenth had good practices score, knowledge affected pupil's and practices significantly. Bathroom were unclean in more than one half of schools in addition to inadequate time for hand washing in more than four fifths of schools. Score level of school environment affected significantly score level of pupil's practices. health education for children about healthy food hygiene practices with attention to school environment and involving parents and teachers to act as .a model for healthy habits

Influence of Feeding Pattern on Head circumference as a Marker for Nutritional Status during the First Year in Healthy Infants and Malnourished Infants

Frequent and accurate assessment of growth is of primary importance in the care of children. Growth curves or charts are a standard part of any checkup, and they show health care providers how children are growing compared with other children of the same age and gender. Observation and recording of a growth parameter over a period of time permit early detection of any deviation from normal growth pattern. Weight is early affected by malnutrition. Length, on the other hand, is affected by malnutrition and also head circumference is affected if this is for at least 6 months. Human breast milk is the unique and superior form of infant nutrition against which all substitute feeding methods must be measured with regards to growth, health, development, and other effects. Our aim of this work is to evaluate height, weight and head circumference in healthy infants and infants with malnutrition, in the first year with different types of feeding. In our study, we evaluated the measurements of one hundred and forty infant; 20 normal nevvborns, 60 babies at 6 months and 60 at 12 months of age also we recalled the pattern of their feeding. History about the type of feeding, breast, formula and mixed feeding were taken, complete clinical examination including anthropometric measurements were performed including weight, height and head circumference . Cases of malnutrition were diagnosed according to water low classification. Our results found that a statistically significant difference between head circumference and length between breast, mixed fed infants compared to formula fed infants, being higher in infants exclusively breast fed and mixed fed infants and this nutritional superiority continued - to a slightly less significant degree throughout the end of year. In our study we found that malnutrition not only affects weight and height but also affects head circumference. Our study showed this strong linkage between malnutrition and failure to establish breast feeding as we found that all malnourished cases included in our study were formula fed exclusively. Encourage of breast feeding is a protective against malnutrition

Extend internet usage as a source of reproductive health information and appliance of these information among adolescent girls in Arar, Saudi Arabia

The Internet is the world's largest network of information, communication and services. It is one of a range of health information sources available to adolescents. It is recognized that young people have difficulties accessing traditional health services; in theory, the internet offers them confidential and convenient access to an unprecedented level of information about a diverse range of subjects including reproductive health information. The study aims to a] explore the prevalence of Saudi adolescent girls' experiences of using the internet to meet their reproductive health information needs, b] identify the relationship between socio-demographic characteristics and internet usage and c] identify the appliance extend of reproductive health information among Saudi adolescent girls' A descriptive design and convenient sample were used in this study. A total of 416 adolescent girls in the third level were selected from all female secondary schools in Arar. Data was collected in four months from the beginning of January 2010 to June 2010. A structured interviewing questionnaire was used in collecting data. It included the following parts; 1] socio-demographic data, 2] sources of reproductive health information, 3] adolescents perception of the available health information usefulness on the internet, 4] the most common health information topics accessed by adolescents' girls through internet and 5] Health assessment sheet, to assess the students health practices 72% of girls aged 16-l8years and 28% of them aged 19-21 years, living with both parents 62%, live with father only 18.8% and with mother only 9.2% respectively. 44.4% of the total number of the sample her mother education is a primary school education while 39.2% of her father had a secondary school education. The total sample has all household appliances and 79% of them considered the internet as a main source of the reproductive health information. Regarding adolescents Perception about health information on the Internet; the majority of them reported that it was available, useful accurate relevant, easy to read, trust worthy and visually appealing respectively. Sexually transmitted diseases was found to be the most common reproductive health information topic accessed by the adolescent [35%] followed by pregnancy [32%], drug abuse [12%], fitness and exercises [8%], dieting and nutrition [7%] and sexual abuse [6%] respectively. As well as the rates of harmful health practices and health problems and lack of awareness were significant higher among adolescent's girls with less internet usage

Platelet associated CD154 in immune thrombocytopenic purpura in children

CD40-ligand [CD 154] is expressed on activated CD4+T lymphocytes and is essential for the T cell-dependent activation of B lymphocytes. CD154 is also expressed at the activated platelet surface. The study aim to investigate the role of CD154 in ITP pediatric patients and correlate their levels with the course and progression of the disease. This study included 25 patients with acute ITP [13 females and 12 males] with age ranged between 2-6 years [group 1] and 25 patients with chronic ITP [14 females and II males] with an age ranging between 8-12 years [group II], also 25 apparently healthy children [10 females and 15 males] with an age ranging between 3-12 years as control [group III]. Studied groups were subjected to the following investigations; complete blood count, bone marrow examination and flowcytometric analysis of CD154 B lymphocyte counts. We found that there was a highly significant increase in CD 154 in patients with acute ITP compared with chronic ITP and control group [p=0.001 and 0.9001 respectively]. Also there was a negative correlation between CDI54 and platelet count in acute and chronic groups [r=-0.6, p=0.004 and r=-0.5, p=0.005 respectively]. There was a positive correlation between CD 154 and lymphocytic count in acute and chronic groups [r=0.422, p=0.007 and r=0.77, p=0.001 respectively]. In conclusion, the increased number of CD 154 might be one of the mechanisms that cause immune regulation dysfunction in ITP. Furthermore, the count is related to the severity of the disease as it was highly increased in acute phase than chronic and therefore CD154 expression is increased in ITP and is able to drive the activation of auto reactive B lymphocytes in this disease

Consequence of perineal trauma during labor on women's sexuality

To evaluate the consequence of perineal trauma during labor on women's sexuality. Descriptive study design. Gynecological out patient clinic at Benha University hospital, from December 2005 to December 2006. Simple random sample composed of 410 women was selected randomly every third women from those attending the gynecological out patient clinic at Benha University hospital a period of one year. a structured interview questionnaire sheet from was used to collect the data related to women's sexuality. Most of the women had sexual morbidity during 3 months after labor, such as dyspareunia compared to few during pre-pregnancy state. Difficulty in reaching orgasm constituted 30% among the sample post-perineal trauma, compared to 10% of women pre pregnancy State. Most of the sample had reported worsened sexual satisfaction and less ability to achieve orgasm compared with these parameters before giving birth. Sexual problems were very common among women with perineal trauma. A program about sexual health for all female during childbearing period is recommended for early detection and treatment of sexual problems

Effect of instructional intervention about self-care on female adolescents' reproductive health

To investigate the influence of an instructional intervention about self-care on promotion of female adolescents' reproductive health female hostel at Zagazig University. Pre-post intervention design. All female adolescent students aged 17 to 19 years, and residing in the university hostel for at least 6 months. Pre-post self-administered questionnaire to evaluate female adolescent students' knowledge and misconceptions, and a checklist to assess the practice of breast self-examination and genital hygiene on models. A self-instruction booklet was used for the intervention. statistically significant improvements were revealed in adolescents' knowledge and attitude post intervention in relation to self-care, reproductive biology, nutrition, hazard of FGM, premarital counseling and examination, consanguinity, and sexually-transmitted diseases. A statistically significant positive effect of the intervention was noticed regarding adolescents' reported self-care practice of regular exercise, rest and sleep, as well as observed breast self-examination and genital hygiene on models. Most of the participants have identified their menstrual problems after the intervention, and utilized health services for management. programs for adolescents friendly family and community are needed to empower all those who are in a position to deal with them such as parents, teachers, and health team members. Training and guiding adolescents about self-care in reproductive health is recommended

Nicotine impact on testis, epididymis and semen pattern in adult male rats

Male reproductive function depends on integrity of seminiferous epithelium as well as integrity of accessory sex organs. Nicotine is the major component of tobacco that is responsible for deleterious effect of cigarette smoking. This study is designed to investigate influence of nicotine administration for variable durations on the structure and function of adult male rat genital system. A total number of 60 adult male three months aged albino rats were used. They were divided into four groups [15 animals each]. First group: the animals were served as control Second group: was treated by nicotine subcutaneously in a dose of 6 mg /kg/day for two weeks. Third group: was treated by nicotine in the same dose for four weeks. Fourth group was treated by nicotine in the same dose for nine weeks. Serum testosterone level of rats was .determined. The sperms were examined for estimation of percent of sperm alive, motility, abnormality, and protoplasmic droplets. The animals were sacrificed. Histological section of testis and epididymis were taken. Serum testosterone level of treated animals is reduced but it did not reach a significant level except after four weeks of treatment. The percentage of both the sperm alive, motility were significantly reduced even after two weeks of treatment with nicotine. Sperm abnormalities and percent of unripe [with protoplasmic droplets] showed significant progressive increase starting after two weeks. The testis shows thickening of the tunica propria and irregular basal lamina. Degeneration of germ cells especially with prolonged duration of exposure was observed. Nicotine consumption, especially with prolonged duration, has deleterious effect on male fertility potential

Serum levels of adiponectin and resistin in obese children: relationship with insulin resistance

Adiponectin and resist in are fat cell-derived hormones, which are thought to be respectively protective and disadvantageous with regard to the development of cardiovascular disease and diabetes mellitus type 2. The aim is to study the relationship between insulin resistance and serum adiponectin and resistin in obese children. A total of 60 obese and 30 nonobese children were enrolled and serum levels of adiponectin and resistin were measured by enzyme immunoassay. Compared with controls, higher insulin resistance by homeostasis model [HOMA-lR] and lower whole body insulin sensitivity index [WBISI] were found in obese children [all p=0.000]. The acliponectin levels in obese children and controls were 3.41 +/- 1.93 and 5.21 +/- 3.1 micro g/L with a significant difference [p=0. 001], while the difference of resistin levels was not significant [p=0.963]. Significant correlations between insulin resistance parameters [HOMA-lR and WBISI] and age, sexual development, body mass index, serum triglyceride, HDL-cholesterol, LDL-cholesterol, alanine aminotransferase, uric acid, or adiponectin levels [all p<0.05] were noted. On the other hand there was no significant correlation between insulin resistance parameters and serum levels of resistin[p>0.05]. In conclusion, These results suggest that adiponectin may play a protective role in obese children through decreasing insulin resistance

Plasma-free carnitine levels in preterm infants with respiratory distress syndrome

Antenatal carnitine administration has been shown to induce fetal lung maturity by increasing pulmonary surfactant in animal and human studies. In this study, the aim was to investigate the status of carnitine in maternal and neonatal plasma of preterm infants with respiratory distress syndrome [RDS] in the first hours of life. We also aimed to characterize the carnitine status in these neonates with respect to sex, gestational age, birth weight, mode of delivery, and antenatal corticosteroid administration. Maternal plasma-free carnitine levels were determined before delivery and neonatal plasma-free carnitine levels were determined within 2 h of birth in preterm infants

effect of mobile phone on the electrical activity of the brain in school children

Increasing use of mobile phones [MPs] by the growing vulnerable children in Egypt arouses the question about their effect on the electrical activity of the brain. To detect the early effects of MP use on the electrical activity of the brain in children. Study population: School-aged children of both sexes attending El-Sahel Teaching Hospital for mild illness. Thirty-three MP users and 40 non-users were given appointments after recovery to be recruited in the study. A questionnaire including psychiatric symptoms was filled followed by eliciting electroencephalography [EEG] after 5 minutes of MP use. The frequency of the psychiatric symptoms and EEG changes were significantly higher in the MP users than in non-users [p<0.05 and 0.01 respectively]. There is an increase in estimated risk [Odds ratio] of developing psychiatric symptoms and EEG changes in the MP users [3.9 and 5.8 respectively]. There was a significant increase in the frequency of the generalized paroxysmal waves in EEG among the MP users than non-users [33.3% Vs. 12.5% respectively] [p<0.01]. The effect of MP use on presence of psychiatric symptoms and on EEG in this study alarms the restriction of MP use by children

Prophylaxis of postoperative nausea and vomiting with ondansetron, metoclopramide, or placebo in total intravenous anesthesia patients undergoing laparoscopic cholecystectomy

To compare total intravenous anesthesia [TIVA] with ondansetron, and metoclopramide in preventing postoperative nausea and vomiting [PONV] in laparoscopic cholecystectomy patients. A prospective randomized double-blinded study was performed at King Abdulaziz University Hospital, Jeddah, Saudi Arabia in 2007. Seventy-five patients scheduled for laparoscopic cholecystectomy under TIVA were randomized to receive either: metoclopramide 10 mg [n=25], 4 mg ondansetron [n=25], or placebo [n=25] at the end of surgery. Postoperative nausea and vomiting episodes, analgesic supply, rescue medication, adverse events, and patient satisfaction were collected over 24 hours. Nineteen patients developed PONV. The frequencies of PONV were equal for the 2 groups [28%], and lower among the ondansetron group [20%] [p>0.05]. Female gender, lengthy surgery, and longer hospital stay were associated with more frequent PONV regardless of the study group [p<0.05]. Patient's satisfaction was more frequent among the ondansetron group [p>0.05]. Morphine consumption was associated with more PONV, but it was statistically significant only in the placebo group. There was no difference between the 3 groups with regard to the VAS pain score, cardiovascular parameters, or oxygen saturation. It is unlikely that a single technique or drug will ever be effective in treating emesis under all surgical circumstances. Therefore, a multimodal regimen incorporating avoidance of emesis triggering factors, and administration of antiemetic medications is recommended

Scanning electron microscopic study on the effects of oral formaldehyde adminstration on the gastrointestinal track of the adult albino rat

The formaldehyde is the simplest aldehyde. It is an important chemical used widely by industry to manufacture building materials and household products. Everybody can be exposed to small amounts of formaldehyde in air and in some foods. Various dosages of formalin oral administration were used in experimental animals to study its toxicity on the mucosa of different parts of the gastrointestinal tract. A total number of 15 adult male albino rats, two to three months age average and weight between 200 to 250 mg average, at the start of the experiment, were used in the present work. The rats were divided into two groups, control group of 5 animals and experimental one of 10 animals. The experimental group animals received a formaldehyde solution through a gastric tube in a dose of 165 mg/kg/ body weight once daily for consecutive 30 days. The fundic region of the stomach and segments from the jejunum and ileum were extracted, fixed in 5% glutraldehyde and prepared for scanning electron microscopic [examination. The present work revealed indicative changes on the level of scanning electron microscopic findings that observed in the mucosa of the stomach, jejunum and ileum. These findings range from severe damage and ulcer formation in the stomach to mild and moderate toxic effects in the jejunum and ileum including edema, congestion partial destructions in the form of fenestrations and cracks or even complete and partial fragmentations of their villi

Role of thrombopoietin and plasma erythropoietin in neonatal sepsis

The objectives is to evaluate the role of thrombopoietin [Tpo] and esythropoietin [Epo], as reliable indicators of neonatal sepsis and the value of rhuEpo in improving the outcome of septic neonates. A prospective study was conducted on 120 sick neonates with sepsis. Sixty two [51.7%] were fullterms and 58 [48.3%] were preterms with a mean gestational age of 32.8. +/- 2.9 weeks. The mean birth weight was 2.7 +/- 0.98 Kg and the mean age of sampling was 5.5 +/- 1.9 days. Sixty neonates received treatment with rhuEpo in addition to the classic therapy of sepsis for 10-14 days. Another group of 60 septic neonates received the classic therapy of sepsis only for 10-14 days. Thirty healthy neonates, age and sex matched with the study groups, were served as a control group. Serum Tpo and Epo levels were measured by ELISA [enzyme-linked immunosorbent assay]. Significant higher differences of serum Tpo and Epo levels were found between septicemic neonates and control group [P<0.001]. The higher the septic score, the higher the serum levels. Septicemic neonates with DIC had significantly higher serum Tpo levels than septicemic neonates without DIC [216.42 +/- 66.5 pg/ml, 172.69 +/- 62.4 pg/ml P=0.042]. Also, septicemic neonates with pallor had significantly higher serum Epo levels than those without pallor [24.1 +/- 7.4 IU/ml, 20.3 +/- 5.2 IU/ml, P=0.022]. On admission, the serum Tpo levels ranged between 39-344 pg/ml with a mean +/- SD of 173.76 +/- 62.67 pg/ml and was statistically significant when compared with control group [32-114 pg/ml, 69.63 +/- 21.4 pg/ml, P=0.001]. After improvement, the serum Tpo levels ranged between 29-133 pg/ml with a mean of 74.5 +/- 25.3 pg/ml and insignificant difference when compared with control group [P=0.37]. Serum Epo levels at the onset [21.14 +/- 6.28 IU/ml] and after improvement [8.81 +/- 3.71 IU/ml] were significantly higher [0.001 and 0.009 respectively] when compared to controls [6.73 +/- 2.9 IU/ml]. Septicemic neonates who received treatment with rhuEpo in addition to the classic therapy showed significantly lower mortality rate [18 patients died, 30%] than those who received the classic therapy only [34 patients died. 56.7%], P=0.003. Serum Tpo and Epo levels are increased in neonates with sepsis, the higher the septic score, the higher the serum levels of both markers. Increase in serum Epo levels during neonatal septicemia is a multifactorial process rather than affecting the haemostatic mechanisms only. The use of rhuEpo in management of septicemic cases could improve the outcome of septicemic patients and decrease the mortality rate

Postnatal development of the cat's epididymis [light microscopic study] [with 20 figures]

This study was carried out to follow up the postnatal development of the epididymis in cats. A total number of twenty cats was used at the ages of one week, one, three and six months as well as adult cats. Some specimens were prepared for routine histological examination and stained with haematoxylin and eosin while others were prepared for making semithin sections. The results showed that the epithelial cells of all regions of the epididymis were undifferentiated at the age of one week. At the age of one month differentiation occurred by the appearance of "halo" cells and 2 types of dark cells. While at the three month of age basal cells appeared. At the age of 6 month, expansion of the epididymal tubules occurred with the appearance of narrow cells, apical cells and clear cells and also the principal cells became differentiated. No sperms were observed at this age. In adult cat, sperms appeared in the epididymal lumen with more development of principal cells and disappearance of narrow cells from corpus and caudal regions. The results also revealed differences in the epithelial height of the epididymal tubules, diameter of the lumen, length of stereocilia and peritubular smooth muscle cells of the three regions of the epididymis

Experimental study on the effects of melatonin administration on the ovary and the oviduct in the adult mice [with 2 tables and 22 figures]

The aim of the present work is to demonstrate the effect of the melatonin administration for different periods of time on the ovarian follicles and the oviductal epithelium in the adult mice. Also the reversibility of melatonim effect is studied in a trial for assessment of its effect on the fertility in females. In this work, a high dose [8.0 mg/kg] and a low dose [4.0 mg/kg] of melatonin were used. Melatonin was injected to the animals subcutaneously once daily in the late afternoon. A total number of 40 young adult female mice were used. At the beginning of the experiments, they were two months old. Animals were divided into eight groups. Groups I and II composed of three and four months old control animals. Group III received the low dose of melatonin for one month and group IV received the same dose for two months. Group V received the high dose of melatonin for one month and group VI received the same dose for two months. At the end of the experiments, animals received the treatment for one month became three months old and those received the treatment for two months became four months old. Group VII composed of seven months old control animals. Group VIII composed of recovered animals [animals allowed to survive three months without treatment after receiving the high dose for two months]. At the end of the experiment, the recovered animals became seven months old. Animals were sacrificed, their ovaries and the oviducts were removed and processed for histological examination after staining with Haematoxylin and Eosin. Some specimens of the ampulla of the oviduct were processed for ultrastructural study with transmission electron microscope. The numerical density and the diameter of the primary follicles, growing follicles and corpora lutea in the ovaries of all groups of animals were measured and statistically analyzed. The results of the present work demonstrated apparent increase in the size of the ovary in the melatonin treated animals. The numerical density and the diameter of the growing follicles and corpora lutea in all melatonin treated groups showed significant increase in comparison with their corresponding control. The primary follicles showed significant reduction in their numerical density in melatonin treated animals as compared with the control. In the recovered animals, the size and the structure of the ovary appeared nearly similar to the control. Also the numerical density and the diameter of the primary follicles, growing follicles and corpora lutea showed non significant change in comparison with their corresponding control. The oviductal epithelium of the ampulla in the high dose melatonin treated animals showed predominance of the secretory cells. The ultrastructual study of these cells revealed that the apical surface had many microvilli and their cytoplasm contained a lot of secretory granules. This study revealed that nighttime melatonin administration had a stimulatory effect on the ovarian follicular growth. This effect was independent to the dose or the duration of its administration. The oviductal epithelium showed predominance of secretory cells. Its effect on the ovary was reversible. This may provide in the future new insights and directions for the study of its role in the physiology and pharmacology of fertility and contraception in animals and humans

Diagnostic value of arterial oxygen tension, alveolo-arterial oxygen gradient and right-to-left shunt fraction in pulmonary embolism

Pulmonary embolism is a common clinical disorder that is associated with high morbidity and mortality if untreated. The diagnosis of pulmonary embolism is difficult because the clinical presentation is non-specific all of the objective tests have limitations. The aim of this study was to evaluate the utility of the arterial partial pressure of oxygen, alveolo-arterial oxygen gradient and right to left shunt fraction as screening tests in the diagnosis of acute pulmonary embolism and to set an equation including the three variables with a more better clinical probability. Eighty patients presented with clinical suspicion of pulmonary embolism were studied including 57 patients as a test group with objectively confirmed diagnosis and a control group of 23 patients with the diagnosis of pulmonary embolism excluded on confirmatory workup. Arterial oxygen tension and alveolo-arterial oxygen gradient proved to have significant sensitivity and positive predictive value. The right to left shunt fraction has excellent sensitivity, positive predictive value and diagnostic likelihood ratio. However, the probability equation of A-alpha X SH/PaO2 has the best of over all diagnostic values. In conclusion, the probability equation suggested in the present study is a simple and accurate clinical screening test in cases with suspected PE. Compared to the other study parameters it has excellent diagnostic values including sensitivity, specificity, positive predictive value, negative predictive value and diagnostic likelihood ratio. The value of PEQ defines the degree of severity of PE

Effect of growth hormone in the management of short bowel syndrome in neonates

Management of short bowel syndrome is a challenge in the postoperative period due to defect in the absorptive surface area which leads to diarrhea with loss of a large amount of fluids and nutrients that necessitates specific enteral and parenteral nutrition. These manifestations improve when the process of intestinal adaptation starts. There is a controversy about the role of growth hormone in accelerating the process of intestinal adaptation. In this study, 24 patients with short bowel syndrome were divided into two groups. The first group consists of 14 patients received growth hormone and a second group consists of 10 patients that didn't receive growth hormone. In both groups, enteral and parenteral nutrition, loperamide to delay intestinal motility and ranitidine in the first week to decrease gastric hypersecretion were given. The beginning of intestinal adaptation beside histological examination of the intestine was compared in both groups. Growth hormone appeared to have a positive effect on accelerating the intestinal adaptation in short bowel syndrome clinically. The histological examination which was done 3-6 months postoperatively revealed increase of the length of the villi with thickened mucosa in both groups without significant difference because, most probably, the histological study was done after the intestinal adaptation has started in both groups