relation between serum homocystiene level and recurrent abortion in Egyptian women

Background: Early pregnancy loss is defined as the termination of pregnancy before 20 weeks' gestation or with a fetal weight of <500 g. Of those that are recognized, 15-20% result in spontaneous abortions [SABs] or ectopic pregnancies. Approximately 5% of couples trying to conceive have two consecutive miscarriages, and approximately 1% of couples have three or more consecutive early pregnancy loss. Increased levels of homocysteine may be due to inadequate dietary intake of folate and vitamin B12 and inherited defects within the methionine-hmocysteine pathway such as MTHFR c677T gene polymorphism. Hyperhomocysteinemia is associated with the syndromes of repeated miscarriage

Objective: The aim of the current study is to estimate the serum levels of Homocystine and vitamin B12 and their relation to prevalence of recurrent spontaneous abortion in pregnancies with history of recurrent miscarriage

Subjects and Methods: In this study 80 pregnant women classified into two groups: GroupI:60 consecutive pregnant women who had suffered from two or more miscarriages, and Group II: 20 pregnant women with no history of abortion .The following estimations were done [for each woman in the study]: serum homocysteine and vitaminB12 were estimated using ELISA technique

Results: Results showed a significant increase in serum level of homocysteine in the first group compared to control group[p<0.0001] and a low serum level of vitamin B12 which was significantly decreased in the study group [group 1] compared to control group[p<0.0001]. Moreover, Our results showed a negative correlation between homocysteine and vitamin B12

Conclusion: The elevated serum homocysteine levels during pregnancy were significantly associated with recurrent pregnancy losses. Moreover, reduced serum vitamin B12 level was considered a risk for recurrent miscarriage. Homocysteine is most sensitive and specific parameters in the recurrent pregnancy losses

Level of chemerin and anti-mullerian hormone in Egyptian obese women with polycystic ovarian syndrome

Background: Chemerin is a newly discovered adipokine that regulates adipocyte development, metabolic function as well as immune function. Anti-Mullerian hormone [AMH] is a dimeric glycoprotein that belongs to the transforming growth factor-beta family

Aim of the study: was to evaluate the serum levels of Chemerin and AMH in one trial to show their possible involvement in the pathogenesis of PCOS and their association with obesity

Subjects and methods: This study was performed on eighty subjects divided into 4 groups: Group I: 20 non-obese control [BMI< 30], Group II: 20 non-obese patient with polycystic ovarian syndrome [BMI< 30], Group III: 20 obese Control [BMI >/= 30] and Group IV: 20 obese patient with PCOS [BMI >/= 30]. Serum levels of Chemerin and AMH were estimated by ELISA

Results: Results showed a significant increase in serum levels of Chemerin and AMH in [non-obese and obese] PCOS groups when compared to their controls. Results showed also a significant increase in the serum level of Chemerin in obese PCOS group when compared to non-obese PCOS group. While a significant decrease in serum level of AMH in obese PCOS group when compared to non-obese PCOS group. There were a significant positive correlation between Chemerin and AMH in PCOS groups

Conclusion: Chemerin together with AMH may be used as a biomarker for early detection of PCO and Clinical parameters as Infertility and Hyper and rogenism in women with PCOS

Effect of fortification of biscuits with flaxseed on omega 3 and calcium content of the products

Background: air Quality Health Index [AQHI] is a scale, which was designed in Canada to help people to understand how the air quality affects their health. It measures the relationship between the air quality and health on a scale from 1 to l0+

Aim: the aim of this study was to assess traffic AQHI on one street in Alexandria, Egypt at different seasonal conditions

Methods: this was a time-series study that was conducted during the period andom January 1 to December 31, 2016 at Ibrahim Sherif Street. It was accomplished by three-hour air sampling of respirable particulates [PMlO], nitrogen dioxide [NO2], sulfur dioxide [SO2] and ground-level ozone [O3], during the morning rush hours. A total of 156 samples for each pollutant covered all seasonal variations and activities. After laboratory analysis, the added health risks [%AR] and AQHI were calculated using the Hong Kong equation

Results: the uppermost median value of %AR was during April r72.9 [23.4]] and the minimum was during January r32.2 [10.0]]. The traffic AQHIs in the study setting were of the serious category 10+ in almost all sampling days. The maximum %AR was during spring r70.0 [19.7]], and the minimum was during winter [40.6 [1 9.0]]

Conclusion: from the results of the present study, we can conclude that; the highest %AR was during April, and the minimum was during January. The traffic AQHIs in the study setting were of the serious category 10+ in almost all sampling days. The most dominating pollutant affecting the %AR and AQHI was the PM10

Lactoferrinsupplementation for prevention of sepsis in preterm neonate

Background: Sepsis related morbidity and mortality is a concern in neonatal intensive care units [NICUs]specially in preterm and Low birth weight [LBW] infants who are more vulnerable due to immaturity of immune defenses and protective barriers. Lactoferrin is an iron binding glycoprotein presents in mammalian milk and involved in innate immunity. Recent data suggest that bovine lactoferrin[BLF] might prevent late onset sepsis in preterm and LBW neonates

Objective; To evaluate the effectiveness of oral bovine lacoferrin in prevention of neonatal sepsis in Egyptian preterm neonates

Patients of Methods: A randomized clinical trial, double blind, placebo-controlled study was conducted on 135 preterm neonates [born before 37 weeks of gestation] admitted to the NICUs of Ain Shams University and Manshiet El Bakry Hospitals from February 20l3 to January 2015. Infants were randomly sub-divided into two groups: Group 1 consisted of 45 infant received oral lactoferrm supplementation [100 mg/day] within a day of starting feeds for 4 weeks. Group 2 consisted of 90 infants matching group 1 neonates, received placebo in the form distilled water in the same schedule. History and physical examination were carried out laying stress on signs of sepsis, severity [classified according to Tollnerscore], laboratory investigations were done: CBC with blood film [classified according to hematological scoring system], CRP, Blood culture upon admission and on suspicion of sepsis, other cultures and arterial blood gases when clinically indicated. Radiological investigation were done when clinically indicated, Data were analyzed using the Statistical Package for Social Sdences SPSS

Results: Lactoferrin group [45 preterm neonates] with mean gestational age [33.11 +/- 1.81 weeks]. 32 males [71%] and 13 females [29%]. Placebo group [90 preterm neonates] with mean gestational age [33.28 +/- 1.89 weeks], 45 males [50%] and 45 females [50%]. Lactoferrin group showed a significantly lower incidence of late onset sepsis according to Tollner score and Rodwell score and blood cultures [6.7%] compared to placebo group [17.8%]. E coli and Soureuswere the most common organisms found in septic neonates in the current study [28.6% for each]

Conclusion: BLF supplementation would be a suitable preventive tool for late onset neonatal sepsis in preterm neonates

Patterns of drug resistance in case of smear positive pulmonary tuberculosis in Giza and Cairo governorate

Pulmonary tuberculosis is a major cause of morbidity and mortality World Wide, resulting in the greatest number of deaths due to any other single infectious agent. Drug resistance threatens global tuberculosis control efforts. Multi drug resistance means drug resistance to at least rifampicin and isoniazid. One hundred and nineteen sputum and culture positive patients underwent drug susceptibility to the first line drugs [Isoniazid, Rifampicin, Streptomycin and Ethambutol]. 79/119 patients in addition underwent drug susceptibility to Pyrizinamide, Ofloxacin, Amikacin and Levofloxacin. The susceptibility test shows that 35/119 patients [29.4%] were sensitive to all the tested drugs. 84/119 of the included patients [70.6%] showed drug resistance to at least one of the first line drugs by different patterns. 29/119 patients were diagnosed as MDR cases with a percent of 31% [resistant to both INH and Rifampcin]. This study shows increase incidence of resistance to first line drugs as well as increase incidence of MDR

Phytochemical and biological study of petrea volubilis L. [verbenaceae]

Petrea volubilis L. was studied for its secondary metabolites and biological activities. The phytochemical screening of dried aerial parts revealed the presence of different constituents such as unsaturated sterols, triter pens, and flavonoids. The biological activities of the total extract and different fractions were evaluated in a series of bioassays [antioxidant, antiinflammatory, analgesic, antipyretic and antibacterial], the majority of them showed significant activities in the applied test systems. Extensive purification of the ethyl acetate extract led to isolation of apigenin [1], quercetin [2], 4, 6-dimethylscutellarien [3], hypogallic acid [3,4-dihydroxybenzoic acid] [4], trans-caffeic acid [5] vanillic acid [6] and acteoside [7]. The structure elucidation of 1-7, was carried out by [1]H-NMR, UV and MS analyses

Prognostic significance of P27 [Kip 1] and MUC1 in papillary transitional cell carcinoma of the urinary bladder

To examine p27 [Kip 1] and MUC1 expression in specimens of papillary transitional cell carcinoma [PTCC] of the urinary bladder and to correlate their expression with the tumor grades,stages and outcome. Paraffin sections from previously diagnosed PTCC bladder were graded, staged and the patients were followed up for 5 years. Ten non-neoplastic urological lesions diagnosed as polypoid cystitis were taken as control. Three sections of 4 um thickness were obtained from every case. One was hematoxylin and eosin [H and E] stained for diagnosis, reviewing and confirmation. The other two sections were immunohistochemically stained for both p27and MUC1. The data of immunohistochemical results were correlated with the following conventional prognostic variables: tumor grade, stage, distant metastasis and 5 year survival. The results showed a highly significant and an insignificant relationship between p27 expression and tumor grade and stage [P<0.01 and P>0.05], respectively. Correlating p27 expression with distant metastasis and overall survival showed a significant relationship with distant metastasis [P<0.05] and a highly significant one with overall survival [P<0.01]. The results showed also a significant relationship between MUC1 expression and both tumor grade [P<0.01] and overall survival [P<0.05]. p27 and MUC1 immunohistochemistry augment the classic histochemistry for the prognosis of PTCC of the bladder as well as improving the prediction of the patient outcome and survival

Epidemiological studies on the role of fish in transmitting some zoonotic diseases to man

This study was performed for determination of the role played by fish in transmitting some bacterial and parasitic zoonoses to man. A total of 300 fish of Tilapia spp. were collected [50 from a farm in El-Fayoum Governorate, 100 from a farm in Beni-Suef Governorate and 150 from Beni-Suef markets]. In addition, 73 humans [60 fish sellers and 13 farm workers] were examined. Staph. aureus, Aeromonas hydrophila, Proteus spp., Shigella spp. Pseudomonas aeruginosa and Pseudomonas fluorescence were isolated from the examined fish at percentages of 4.3, 9.7, 3.0, 1.7, 2.0 and 2.0, respectively. Among the isolated bacteria, Staph. aureus, Proteus spp. and Shigella spp. were found restricted to fish skin and gills, while Aeromonas hydrophila and Pseudomonas spp. were isolated from all the examined fish bodyparts [skin, gills, muscles and internal organs] with varying percentages. Out of the examined fish, 26.7% were harboring parasitic cysts including metacercariae of CHnostomum complanatum, Heterophyes heterophyes, Centrocestus armatus and Haplorchis pumilio. Examination of hand swabs obtained from humans demonstrated that 12.3% revealed a positive result for Staph. aureus. Among farm worker stool samples examined, 7.7% tested positively for Staph. aureus and 15.4% were Aeromonas hydrophila-positivQ. None of the parasites recovered from fish was detectable in humans. It was concluded that fish sold in the examined localities may occasionally represent a serious threat to public health as a result of its content of zoonotic fish pathogens

Role of Helicobacter pylori [H.pylori] infection and cyclooxygenase-2 [COX-2] expression in chronic gastritis and gastric carcinoma: an immunohistochemical study

Malignant tumors of the stomach are common, but the incidence of stomach cancer varies from country to another, probably as a result of genetic, epigenetic and environmental factors. Stomach cancer often occurs in older people whose stomachs produce only small quantities of acid. Although infection with Helicobacter pylori has been proven beyond doubt in the aetiopathogenesis of various gastric disorders, not much is known about the role of H.pylori infection in onset and progression of chronic gastritis as well as gastric cancer. Although recent studies have indicated that the clinicopathological parameters in patients with gastric carcinoma, the prognosis of advanced cancer still remains unsatisfactory. This study aimed at investigating the expression of H pylori antibody and cyclooxygenase-2 [COX-2] in cases with chronic gastritis and gastric carcinomas and to correlate this expression with various clinicopathological parameters. Paraffin sections from previously diagnosed chronic gastritis [CG] and gastric carcinomas [GC] were classified, graded and staged according to the updated for CG and the World Health Organization [WHO], for GC. Two sections were immunohistochemically stained for antibodies against H.pylori and COX-2. One section was stained with Feulgen stain for assessment of ploidy and proliferative activity using the Image analyzer system CAS 200. Infection with H.pylori and cox-2 overex-pression are common in patients with chronic gastritis and gastric carcinoma. Both anti-H pylori and cox-2 proteins are implicated in gastric carcinogenesis and their over expression may be a good predicator for worse prognosis and poor patient's outcome

Role of P27 [Kip 1] and MUC1 in papillary transitional cell carcinoma of the urinary bladder

To examine P27 and MUC1 protein expression in specimens of papillary transitional cell carcinoma-urinary bladder and to compare both of them with the tumor outcome. Paraffin-sections from previously diagnosed papillary transitional cell carcinoma-urinary bladder were graded, staged and followed up for 5 years. Ten non neoplastic urologicl lesions diagnosed as polypoid cystitis were taken as a control. Three sections of 4 micron thickness were obtained for every case. One is H and E stained for diagnosis reviewing and confirmation. The other 2 sections are immunohistochemically stained for both P27 and MUC1. The data of immunohistochemical results were correlated with the following conventional prognostic variables: tumor grade, stage, distant metastasis and 5-year survival of papillary transitional cell carcinoma [PTCC]-urinary bladder. The results showed a highly significant and an insignificant relationships between P27 expression and tumor grade and stage respectively [p<0.01 and >0.05]. Correlating P27 expression with distant metastasis and overall survival showed a significant relationship with distant metastasis [p<0.05] and a highly significant one with overall survival [p<0.01].The results showed also a significant relationships between MUC1 expression and both tumor grade and 5-year overall survival [p<0.05 for both]. In conclusion, P27 and MUC1 immunohistochemistry may augment the classic histochemistry for prognosis of PTCC as well as prediction of the patient outcome. Specific oncogene markers are more significant than oncogene phenotype markers in clinical diagnosis and screening of PTCC

Impact of specific enteral regimen on improvements of nutritional status and gastrointestinal problems among traumatized intensive care patients

Metabolic alteration following severe trauma cause the body to lose its ability to adopt to starvation. Evidence of that early nutritional support is beneficial. The primary goal of nutritional support for trauma patients is to meet increased energy and protein demands and provide adequate defenses against injury. Hence the effect of using specific balanced enteral nutritional formula on improvement of nutritional status and counteraction of gastrointestinal problem among traumatized patients. The study sample consists of 60 adult male and female patients. They were randomly assigned into either study or control group. Each 30 subject was matched according to age and sex. Subjects of the study group received specific enteral formula in addition to the routine hospital care, while subjects of the control group ones received only routine enteral nutritional feeding in the unit. Two tools were developed by the researcher, the first tool includes demographic information, nutritional assessment data including anthropometric measurements and possible blood tests important in evaluating the nutritional status of the patients. The second tool consists of 4items which reflect gastrointestinal problems as diarrhea, vomiting, constipations, and distention. The study reveal that subjects who received specific enteral, nutritional formula had less GIT problems and there were no statistical significant differences between the two studied groups for almost all study variables except in total protein and calcium. These results generate attention and motivation for further investigation about this topic

Recurrent myocardial infarction: new concepts in predisposing factors

At one end of the clinical spectrum of coronary artery disease [CAD] are subjects who have had repeated acute ischemic events [unstable angina, acute myocardial infarction or sudden death], and at the other end are those with longstanding stable angina who have never been unstable. The variability of serum level of thrombomodulin [TM] in various phases of ischemic heart disease [IHD] raised the question of variable pathphysiological role as vasoprotective, thromboresistant, and anti-inflammatory factor. To answer the question of TM variable levels in IHD, we studied 100 patients [90 males and 10 females, mean age 57 +/- 11.3 range 38 to 69 years,] with IHD including 5 groups [20 pts for each], Recurrent MI [RMI], Old stable MI [OSMI], Stable Angina [SAP], Acute MI [AMI], and a control group [normal coronary angiography]. Following clinical examination TM level was determined using ELIZA technique. Genetic studies using single strand conformation polymorphism [SSCP] method was done to determine mutation in TM gene G-33 A. Compared to control group, patients with IHD had significantly lower TM level [5.7 +/- 3.6 VS 3.06 +/- 2.8; p=0.002]. Serum TM in patients with SAP was significantly lower compared to control subjects [5.7 +/- 3.6 VS 3.92 +/- 2.8; p=0.004]. Compared to pts with OSMI., Pts with RMI had significantly higher levels of TM [4.52 +/- 4.3 VS 5.85 +/- 3.8; p=0.031]. Compared to pts with SAP, Pts with OSMI had significantly higher level of TM [3.06 +/- 2.8 VS 4.52 +/- 4.3; p=0.003]. In ischemic pts, there is a constant tendency of increased TM level from SAP to OSMI to RMI [3.06 +/- 2.8, 4.52 +/- 4.3 and 5.85 +/- 3.8, respectively]. There was no significant difference between pts with RMI and the control group [5.85 +/- 3.8 VS 5.7 +/- 3.6; p=0.93]. Compared to control group, pts with AMI had significantly lower level of TM [2.8 +/- 2.1 VS 5.7 +/- 3.6; p=0.0001] and significantly lower level of TM compared to pts with IHD not in the acute stage [p=0.026]. Regarding TM gene mutation, this study revealed that patients with a mutant TM gene have a significantly less TM level compared to patients with the mild type TM gene [2.85 +/- 2.1 vs 4.7 +/- 3.6, p=0.04] with the consequences of decreased surface expression of TM and decreased level of soluble TM in plasma. Our data point to the duality of the role of thrombomodulin in IHD as a thromboresistant and anti-inflammatory molecule. Reduced serum levels of TM could predispose to IHD and acute MI. Higher TM levels in normal population reflect activation of thrombin through protein C pathway activation [antithrombotic mechanism] whereas the lower levels of thrombomodulin in stable angina and acute MI might reflect a deficient anti thrombotic mechanism and may speak of the underestimated anti inflammatory role of thrombomodulin knocked down by inflammatory mediators released in the ischemic process. Recurrence of MI might explain the high levels of TM which serves as endothelial anti-inflammatory maker which is signaled by the continued inflammatory state caused by recurrent MI. The reduced TM expression on the coronary endothelium could facilitate thrombus formation at the site of plaque injury, highlighting the cardioprotective role played by TM at the coronary vasculature

Retractile testis: management of 50 boys

Retractile testes are testes that can be brought down into their normal positions in the scrotum but then immediately retract upward and out of the scrotum. This study was undertaken to evaluate the management of 50 boys with retractile testes and its effect on future fertility. Fifty boys were diagnosed and confirmed as retractile testes in our outpatient clinic. Hormonal treatment in the form of Human chorionic Gonadotrophin [HCG] was started for all boys. Orchiopexy was indicated for nonresponder and re-ascending testes. Testicular biopsy was taken after taking consent from parents of the boys. Follow up of the boys continued for at least 6 months after the treatment. Response to HCG treatment occurred in 38 boys [76%] [responder]. Orchiopexy was performed for 14 boys [12 boys were non-responder and 2 re-ascending]. Testicular biopsies revealed abnormal histology in 5 boys [35.7%]. The retractile testes are not a benign entity or a normal variant of descended testes. The patients with retractile testes should be carefully examined, managed and followed up

Investigation of toxoplasmosis in pregnant women and slaughtered animals

A total of 21 women with complicated pregnancy [abortion, premature labor and genital disorders] together with 51 with normal pregnancy from Beni-Suef Governorate hospitals were investigated for detection of anti-toxoplasma antibodies level by ELISA [IgM and IgG]. Tissues [diaphragm, masseter and thigh muscles] from slaughtered animals [60 cattle, 97 sheep and 26 camels] were collected from Beni-Suef abattoir for detection of Toxoplasma cyst [bradyzoites] using bioassay in mice. The results showed that all controls [normal pregnancy] were 1gM negative, however 19 [37.25%] were IgG positive. As to the women with complicated pregnancy 3/21 or 14.28% were IgM positive and 15/21 or 71.42% were IgG positive. The epidemiological survey revealed that the risk factors associated with Toxoplasma infection in humans were contact with cat, eating raw or undercooked meat and other uncertain factors. Concerning meat, Toxoplasma cysts [bradyzoites] were detected only in sheep meat at a rate 15.46% but failed detection in bovine and camel meat. However, as T. gondii was principally detectable in sheep meat, the consumption of such meat harbors a potential infection risk for humans

Comparative study for induction of painless labor between bupivacaine 0.25%, bupivacaine-fentanyl and clonidine-fentanyl

Labor analgesia is better provided by the epidural administration of local anesthetics with adjuvants e.g Opioids and alpha agonist to reduce local anesthetic requirements and side effects [e.g] systemic toxicity and motor blockade. 60 pregnant women subjected to: Action; Group I; Group II; Group III-Onset of analgesia; 20 Min; 17 Min; 26. Min-Duration of analgesia; 57 Min; 72 Min -; 57 Min-Motor Weakness; Sever; Moderate; Mild-Hemodynamic changes; Mild; Mild; Mild. From the previous study we concluded that the addition of adjuvants to local anesthetics in epidural labor analgesia is better than local anesthetics alone as regard complication and obstetric intervention

Assessment of the correlation between open lumbar discectomy and stability of the lumbar Spine

We assessed the stability of lumbar spine in cases subjected to open lumbar discectomy. Operative interference was mainly at the level of L4-5 in 76 cases [84.4 percent]. All cases had subjected to clinical and radiological examination pre- and post-operative for a period of follow-up at least one year to detect post-operative sequel and instability. The results of this study proved that instability of lumbar spine post-operative was detected in 36 cases [40 percent]. It was found that there was a significant relation between sex and lumbar instability [more in males 52.1 percent] and a significant relationship between occupation and lumbar stability where instability was higher in manual workers [50 percent]. Also, there was a significant relation between the period of follow-up and instability. We concluded from this study that here is a significant relation between lumbar discectomy and instability, more in males and manual workers and with the length of the period of follow-up

Endoscopic transurethral resection of bilharzial ulcers of the urinary bladder: Single-center experience with 1000 patients

Objective: To report on the results of endoscopic transurethral resection of chonic bilharzial ulcers of the urinary bladder at the Assiut University Hospital, Assiut, Egypt

Patients and Methods: Between June 1995 and April 2001, 1000 patients [87.3% males and 12.7% females] with chronic bilharzial ulcers [78% de novo and 22% recurrent ulcers after previous open partial cystectomy] were treated by endoscopic transurethral electroresection [TUR] at our department. Single ulcers were diagnosed in 612 [61.2%], double ulcers in 261 [26.1%] and multiple ulcers in 127 [12.7%] patients. Ulcers of a moderate diameter [1-2 cm] were present in 505 [50.5%] patients. Electroresection was done until healthy fibers of the detrusor muscle or even the prevesical fat was reached

Results: The mean duration of the resection was 19.8 minutes. Extraperitoneal bladder perforation was recorded in 11 patients [1.1%]. In all these patients conservation was successful. Intraperitoneal bladder perforation was recorded in 16 patients [1.6%]. In six out of these patients conservation was successful, while peritoneal drainage was necessary in the remaining cases. Conservative management was successful in 5 cases [0.5%] of secondary haemorrhage. Hospitalization was one day in 920 patients [92%]. After six months 862 patients [86.2%] were available for follow up. 745 [86.4%] were symptom-free and 794 [92.1%] reported complete healing of the resected ulcer at follow-up cystoscopy

Conclusion: Endoscopic transurethral electroresection is a satisfactory modality for the treatment of bilharzial ulcers of the urinary bladder

Endoscopic transurethral resection of bilharzial ulcers in the urinary bladder. Single-center experience with 1000 patients

Objective To report on the results of endoscopic transurethral resection of chonic bilharzial ulcers of the urinary bladder at the Assiut University Hospital; Assiut; Egypt. Patients and Methods Between June 1995 and April 2001; 1000 patients (87.3males and 12.7females) with chronic bilharzial ulcers (78de novo and 22recurrent ulcers after previous open partial cystectomy) were treated by endoscopic transurethral electroresection (TUR) at our department. Single ulcers were diagnosed in 612 (61.2); double ulcers in 261 (26.1) and multiple ulcers in 127 (12.7) patients. Ulcers of a moderate diameter (1-2 cm) were present in 505 (50.5) patients. Electroresection was done until healthy fibers of the detrusor muscle or even the prevesical fat was reached. Results The mean duration of the resection was 19.8 minutes. Extraperitoneal bladder perforation was recorded in 11 patients (1.1). In all these patients conservation was successful. Intraperitoneal bladder perforation was recorded in 16 patients (1.6). In six out of these patients conservation was successful; while peritoneal drainage was necessary in the remaining cases. Conservative management was successful in 5 cases (0.5) of secondary haemorrhage. Hospitalization was one day in 920 patients (92). After six months 862 patients (86.2) were available for follow up. 745 (86.4) were symptom-free and 794 (92.1) reported complete healing of the resected ulcer at follow-up cystoscopy. Conclusion Endoscopic transurethral electroresection is a satisfactory modality for the treatment of bilharzial ulcers of the urinary bladder

Decreased vascular density and increased nitric oxide synthase activity in the retina of mouse with photoreceptor degeneration [rd+mouse]

This work has been carried out to correlate the vascular development and nitric oxide synthase [NOS] activity in retina with the degenerative changes in photoreceptors. Flat mounted normal and dystrophic retinae have been treated with biotinylated Griffonia simplicifolia isolectin B 4 and then processed for imunofluorescence labelling using fluoresceine - conjugated streptavidin. Vessel length per unit area was determined using computer assisted morphometry. Some of the falt mounted retinas were treated with Avidin - biotin complex, then treated with peroxidase substrate and processed for sectioning to study the retinal vessels in different layers of retina. To study the activity of nitric oxide synthase in the normal and dystrophic retina we have used NADPH - diaphorase histo - chemistry. Our experiments showed a reduction in vascular density and an increase in NOS activity within the dystrophic retina. Our observations are suggesting that a relative hyperoxia resulting from degeneration of photoreceptors inhibits formation of new blood vessels and induces degeneration of the established ones. The increased NOS activity in dystrophic retina could be a compensatory mechanism to increase retinal blood flow and / or a precipitating factor for the retinal dystrophic changes

effect of the most common intravenous anaesthetic on some functions of human neutrophils

Anaesthetics may compromise host defence mechanisms by adversely affecting the specific or non specific components of the normal immune response. Adverse effects of general anaesthetic agents on neutrophil functions in vitro are important as theoretically they could imply compromised function in vivo. The inhibitory effects of some anaesthetic, including intravenous [I.V.] anaesthetics, on neutrophil functions have been well documented, the use of these anaesthetics may result not only in peri -operative immunosuppression, but if used to sedate critically ill patients in the intensive care unit [ICU], may potentially further compromise an already depressed host defense mechanism. We study the effects of the most commonly used intravenous anaesthetic agents [thiopentone, ketamine, propofol and midazolam] on some functions of human neutrophils [PMNLS] [Phagocytosis, phagocytic index [P.I.], phagocytic percentage P% and respiratory burst activity] in vitro at clinical plasma concentration and 100 times. Sample of 3mL peripheral venous blood was drawn from forty healthy volunteers free from diseases not taking medication, incubated with the corresponding I.V. anaesthetic agents, using different concentrations of I.V. anaesthetic agents. The results showed that at 100 times the clinical plasma concentration, thiopentone, ketamine produced highly significant depression of neutrophil phagocytosis and non significant depression of neutrophil phagocytosis was seen with propofol and midazolam. At clinical concentration thiopentone ketamine propofol and midazolam had minimal effects on neutrophil phagocytosis. As regard to respiratory burst activity of neutrophil, there were no significant depression at both concentrations for all durgs used