Emergency peripartum hysterectomy: review of 48 cases

To determine the incidence, indications, complications and associated risk factors with emergency peripartum hysterectomy at El-Sahel Teaching Hospital, Cairo, Egypt. This is a retrospective study of 48 cases of emergency peripartum hysterectomy done from January 2000 to December 2009. 48 Patients of emergency peripartum hysterectomy were identified among 35,576 deliveries and the incidence rate was [0.13%]. Uterine atony 23 [47.9%], uterine rupture 15 [31.3] and placenta previa with accreta 10 [20.8%] were the most common indications of hysterectomy. Of the atony group, 18 bilateral uterine arteries [78%] and 13 bilateral internal iliac arteries ligation [57%] were performed as conservative surgery before proceeding to hysterectomies. In placenta previa with accreta group, the prior cesarean deliveries were higher compared to both atony and uterine rupture groups and that variable was statistically significant. 16 patients [33.2%] were complicated by disseminated intravascular coagulopathy [11/23 patients in atony group [47.8%], 4/15 patients in uterine rupture group [26.7] and one/10 [10%] in placenta previa with accrete group]. Uterine atony group received the highest volume of transfusion [packed red cells and fresh frozen plasma]. Differences in both gestational age [p<0.01], previous cesarean section [p<0.05] and fetal weight [p<0.05] between the three groups were significant. Placenta previa with accreta group had the highest rate of previous cesarean sections [2 +/- 1.4] suggesting a higher incidence of this complication with repeated cesarean sections. Uterine atony is still the main indication of peripartum hysterectomy. Careful prenatal care is needed for women who are at risk of postpartum hemorrhage. Cesarean deliveries of patient with suspected placenta accreta, specifically those performed due to placenta previa in women with a previous uterine scar, should involve specially trained obstetricians. In addition, detailed informed consent about the possibility of emergency peripartum hysterectomy and associated morbidity should be obtained

Improvement of the cycling performance of LiMn[2]O[4] as cathode material for lithium batteries by Cr, Al, Co and Ni substitution

The main advantages of LiMn[2]O[4] spinel system are low cost, high cathode potential versus lithium and lack of toxic metals such as cobalt or nickel present in LiCoO[2] and LiNiO[2] cathode materials whereas the main drawback of the system is the fading capacity during cycling as compared to LiCoO[2] and LiNiO[2]. To improve the structural and electrochemical properties of LiMn[2]O[4], as cathode material for lithium secondary batteries, Co, Cr, AI and Ni ions were substituted for manganese ions. LiMn[2]O[4], and LiM[gamma]Mn[2-gamma]O[4] [M = Al, Co, Cr and Ni; gamma = 1/6] samples were prepared by solid state reactions. The X-ray powder diffraction patterns of the substituted samples are almost identical to the parent sample. A well defined highly pure spinel was characterized for all samples without observation of extra phases for substituted samples. The electrochemical performance of the prepared samples was evaluated through cyclic voltammetry and galvanostatic charge/discharge operations. The first discharge capacities of the substituted spinels are lower than that of LiMn[2]O[4], but better cycling performance and capacity retention was observed for the substituted spinels compared to the parent LiMn[2]O[4],. The improvement in the cycling performance of LiM[gamma]Mn[2-gamma]O[4][M = Co, Cr, Ni and Al; gamma = 1/6] compared to that of parent LiMn[2]O[4] is attributed to the stabilization of the spinel structure by the substituted metal cations

Spectroscopic studies of the UV photodissociation of nitrosyl chloride

Vibrationally excited Nitrosyl Chloride and Nitric Oxide NO [X2pi, v"

Evaluation of mycobacterium bovis cell extract antigens for in-vitro diagnosis of bovine tuberculosis in experimentally infected guinea pigs

M. bovis cell extract antigens as filter-sterilized lysozyme and sarkosyl extracts have been evaluated and successfully used in vitro for diagnosis of bovine tuberculosis. They were compared with the bovine PPD by measuring the cell mediated immunity using the lymphocyte blastogenesis assay [LBA] as detected by tetrazolism [MTT] reduction and skin sensitivity test, as well as measuring the serum antibody levels using ELISA in experimentally infected guinea pigs with M. bovis and M. tuberculosis. The lymphocytic proliferative response in the infected guinea pig groups 2 weeks post infection was higher than that obtained 4 weeks post infection. The use of lysozyme and sarkosyl extract antigens was found to be advantageousover the bovine PPD in lymphocytic blastogenesis assay due to their abilities to confirm specificity and to discriminate between animals infected with M. bovis and those infected with M. tuberculosis. The obtained results of the skin sensitivity test revealed that, the bovine PPD, sarkosyl and lysozyme extract antigens were able to differentiate the guinea pigs, infected with typical mycobacteria from those infected with atypical. ELISA results confirmed the superiority of sarkosyl extract over bovine PPD and lysozyme extract in distinguishing between guinea pigsinfected with typical and atypical mycobacteria at serum dilution of 1/80 [4, 6 and 9 weeks post infection]. Both sarkosyl extract and lysozyme extract antigens would be advantageous over bovine PPD in differentiating M. tuberculosis infected guinea pigs from M. bovis infected group at serum dilution 1/160 while bovine PPD, was not able to differentiate between those two groups. The results of ELISA in this work suggested, that M. bovis cell extract antigens [lysozyme and sarkosyl extracts] were useful antigens to minimize non-specific reactions in diagnosis of bovine tuberculosis. It was clear from the preliminary results of naturally infected cattle with M. bovis that, using the lysozyme and sarkosyl extract antigens could be of value in diagnosis of bovine tuberculosis

Clinical and laboratory evaluation of a rapid screening test for the detection of urinary tract infections in children

Recently, dipsticks using nitrite and leukocyte esterase [LE] have become available as markers of urinary tract infection [UTI]. Dipsticks have been extensively tested in adults, but little is known on their use as a routine screening test for the diagnosis of UTI in children to begin presumptive treatment while waiting for the results of the urine culture. To evaluate the reliability of rapid dipstick test as a screening test for the diagnosis of UTI and to determine whether it correlates with the clinical criteria suggestive of UTI in children. A number of 342 schoolchildren were randomly selected from public and private, mixed primary schools located in El Doki and El Mohandesin in Giza governorate. A urine sample was collected from each child, by midstream clean-catch technique in sterile containers. Results of urine dipstick tests for LE and/or nitrite, and microscopic examination of urine [white blood cells] were compared to urine culture results. Dipstick with both nitrite and LE positive had a specificity of 100%, a sensitivity of 93%, 99%, and 98% of positive and negative predictive values respectively. Dipstick of either nitrite or LE positive had a higher sensitivity 99% but a lower specificity 77%. Microscopic examination of urine showed the lowest sensitivity 89%. Results of dipstick [nitrite and LE] and colony count were the highest between all the tests in correlating with clinical criteria suggestive of UTI [Z value: 12.23 and 12.25 respectively; p<0.001]. LE and nitrite dipstick urinalysis offers the best combination of test performance characteristics

Studies on the dissolution of phosphate ore in mineral acids

The dissolution of Abou-Tartor phosphate ore in sulphuric acid, phosphoric-sulphuric acid mixture and hydrochloric acid was studied. The effects of time, temperature, acid/ore ratio and shaking were investigated. The results indicated that the dissolution of the ore in sulphuric acid was rather difficult; but the dissolution in H3PO4- H2SO4 mixture [76.1: 54.5 g] gave good result from 100 g of the ore at an acid/ore ratio of 1.4 after 30 min, at 70 degree and a shaking rate of 100-200 rhm. The optimum condition of the dissolution in HCl/ore ratio of 27: 1 was 80 min, at 25 degree and a rate of shaking of 120 rhm. The obtained results showed that the dissolution of Abou- Tartor phosphate ore in HCl is more preferable than other mineral. acids

Occupational exposure to toluene inhalant among young car-paint-workers

Forty young car-paint-workers from Mahalla El Kobra, Gharbia Governorate were selected from those who recently joined work [less than one week] at car workshops and were subjected to the following: a] complete personal, family, and medical history taking, b] Complete medical examination, c] Psychological assessment battery of 24 items, d] Complete blood picture, liver function tests, blood urea, serum calcium, potassium, magnesium, and acid phosphatase, and hippuric acid level in urine. Results showed disturbed general behavior. Of the studied cases 89.7% suffered from irritability, 68.9% from talk slow, 34.5% from depressed mood, 65.5% had illusionary misinterpretations, 72.4% had visual hallucinations, 24.2% had distorted body form perception, and 55.2% showed impaired recent memory. Serum magnesium and Hippuric acid level in urine showed significant increase after three-month period of exposure. Attention is drawn to the necessity for educational programs in this area

study of Hb levels and iron stores of women using Cu T380 a IUD and low dose contraceptive pills in Alexandria

The study sample consisted of women attending the family planning clinic of El-Shatby Hospital, aged 18-35 years, with Hb levels 9-12 gm/dl, who did not use any hormonal contraception or IUD for the previous 6 months and menstruating regularly for the previous 3 months. They were divided into 3 groups each of 100 females : The first group used Cu 380A IUD, the second used low dose contraceptive pills, the third was a control group of those who used barrier and natural methods. They were interviewed their Hb and iron stores were determined at admission and reassessed at sixth and seventh months. The 3 groups had almost similar means of Hb on admission, while mean serum ferritin [SF] and mean serum iron were significantly higher among IUD users than OCP users and controls on admission. At follow up I and II, IUD users had the lowest significant mean Hb, mean SF, and mean S. iron, while OCP users had the highest means and there was no change in the control group. Among IUD users there was a gradual significant decrease of means of Hb, SF, S iron throughout the study, among OCP users, there was a gradual significant increase of the 3 means, while among the control group there was no significant change. Mean days of menstrual blood flow; at follow up I and II there was significant increase among IUD users significant decrease among OCP users, and no change among controls. It was recommended that anaemic and potentially anaemic women using IUD should be encouraged to use OCP and the cause of the anaemia should be investigated

epidemiologic study of bone tumorous in Alexandria

The records of 368 patients with bone tumours and tumour-like conditions presented to El Hadra University Orthopaedic Hospital over a three-year period were studied. Benign tumours constituted 30.2% and malignant tumours were 25.8% of cases. Tumours with variable behaviour comprised 9.5% of the studied cases. Metastatic tumours and tumour-like lesions comprised 12.2% and 22.3% of cases, respectively. The male to female ratio was 1:1. The highest age incidence was in the second and third decades of life. All bones were affected except for the carpal bones. The highest incidence was in the femur [36%] followed by the humerus and tibia [16% for each]. Nearly all types of the common bone tumours and tumour-like lesions were encountered. Osteochondroma was the commonest benign tumour while osteosarcoma was the commonest primary malignant bone tumour. Of the tumour-like lesions, simple bone cyst was the commonest. Benign tumours presented more commonly with swelling, while pain and swelling were more common with malignant tumours. Metastatic and tumour-like lesions presented more frequently with pathologic fractures

Rehabilitation in coronary artery disease: assessment and outcome

This study included 69 male patients with corollary artery disease [CAD] of whom 47 were in stable angina pectoris and 22 had myocardial infarction. Thirty matched normal subjects were considered as controls. All the patients were subjected to complete clinical examination and maximal exercise performance was determined using maximum symptom limited progressive exercise test according to Burce et al., [6]. The parameters of VO2 max., HR max., treadmill duration, systolic B.P max., double product of maximal HR and functional aerobic impairment were assessed. The patients were trained on treadmill 3 times per week for 3 months at 70% of predetermined maximal heart rate. The patients were encouraged to do their daily activities and aerobic maintenance activities during the follow up period. The results of this study lead to the conclusion that the 3 months' physical training program prescribed on the basis of symptom limited graded exercise test and maintenance activities led to significant maintained improvement of maximal exercise performance inpatients with CAD. So the use of physical training call be considered as a valuable component in management of these patients

Evaluation of the use of hydrotherapy in management of chronic polyarthritis

This study included forty chronic polyarthritic patients [24 osteoarthritis, 11 rheumatoid arthritis and ankylosing spondylitis]. 24 were females and 16 males. The patients were classified into 2 groups; the first group treated by hydrotherapy and the second group performed gymnastic exercises and was considered as a control group. All the patients were subjected to full clinical evaluation including the degree of pain and active geometric range of joint motion and functional assessment of the activities of daily living. The assessment was done before and after 2 months treatment and one month later as follow up. The results showed that hydrotherapy is superior to gymnastic exercises. It is very valuable in relieving pain improving active mobility and performance in activities of daily living. In absence of contraindications, hydrotherapy can be recommended as a constant addition to comprehensive program of management of chronic polyarthritis. Gymnastic exercises being also valuable, should be recommended as home exercises

Thermal and spectroscopic characterization of Pd [II] and Pt [IV] thiobarbiturate complexes

Pd [II] and Pt [IV] thiobarbiturate complexes [Ligaud: 2-thiobarbituric acid; Abbreviation, HTBA] were synthesized as solid phases. Chemical and thermogravimetric analyses, together with IR and electronic absorption spectra of the ligand and the two complexes were carried out. IR vibrational bands support M-S and M-N bondings in the Pd [II] and Pt [IV] ions are tetra-and hexa-coordinated, as deduced from their electronic absorption bands characteristic of square planar and octahedral configurations, respectively. Results of thermogravimetric analysis were in agreement with the general molecular formulae: Pd [TBA]2 and Pt [TBA]4 [HTBA]2 proposed by chemical analysis. The TG and DTG curves of both the Pd [II] complex and the Pt [IV] complex showed three thermal dissociation steps ending with a final step at>790 and >772 omicron, respectively. The thermal stability of the studied compounds was found to have the order: Pt [TBA]4 [HTBA]2> HTBA>pd [TBA]2

Feeding patterns and growth of infants in Jeddah

Infants aged 9-10 months brought for measles vaccination were Investigated to assess their pattern of feeding and their growth. They totalled 347 and they were chosen from 8 health centres in Jeddah. The present mode of feeding was predominantly bottle fed [42.4%]. The modal age for those who stopped breast was 1 month, while 52.7%, were still exclusively breast fed or in fccabination. Maternal causes were responsible for 55% and infant causes for 35%. The modal age for introduction of semisolid food was the fourth month [31.4%]. The modal age of supplementation with artificial milk among those who were supplemented was since birth [15.9%]. Infants below Harvard's third percentile cons-tituted 16.4% of the total sample and they were found with all types of feeding except with exclusive breast or exclusive bottle Infants. All patterns of feeding will lead to growth faultering males and females and among Saudi and non-Saudi infants when seen at the age of 9 months

Anemia in pregnancy in Jeddah Saudi Arabia: an epidimiologic study

From 7 centers in Jeddah, 272 pregnant were chosen. They were interviewed, examined and some laboratory investigations were performed. Anemic women among Saudi pregnant women were 25.6% while they were 18.3% among non-Saudi women. South centers and illiteracy had an adverse effect on Hb level. In addition, higher gravidity, higher parity, greater number of living children and shorter spacing between last delivery and this pregnancy all shared in increasing percentage of anemia among pregnant women. Second and third trimester had the highest level of anemic women

comparative study of reproductive profile in Abbis 2 and Abbis 8 villages

Fertility levels have been studied among a statistical sample 1:4 consisting of 169 and 185 non pregnant users aged 15-45 years in Abbis 2 and 8 villages respectively. Fertility indicators were higher in Abbis 8 than Abbis 2 village. Fertility levels increase insignificantly with increase of age and probably with higher education and higher social class. More contraceptive users were found in Abbis 2 than Abbis 8 villages. Contraceptive use is significantly more common with increasing age and probably with higher education, higher social class, more living children and with a living outcome of last pregnancy