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Objective: Ectopic pregnancy [EP] is an implantation of fertilized ovum outside the intrauterine cavity. Many cases of EP are not associated with a clinical signs at early stages that makes its diagnosis is difficult. The confirmation of EP needs several investigations as ultrasonography and repeated measurements of serum beta-hCG levels every 48 hours that make it very expensive and take a long time so, rupture may be occurred that leads to increased maternal morbidity and mortality rates. Thus, the aim of this study was to investigate the alterations of some hematological and biochemical parameters associated with normal and ectopic pregnancy in addition to evaluate their efficacy in early diagnosis of tubal ectopic pregnancy [TEP] among women living in Jazan area, Kingdom of Saudi Arabia
Subjects and methods: this retrospective study was carried out on 200 women with their ages ranged from 25-37 years old at the Obstetric and Gynecology Department of King Fahd Central Hospital and Sabiya General Hospital during the period between March 2010 and March 2014. The subjects were divided into three groups. Group [1] consists of 69 cases ruptured EP; Group [2] consists of 61 cases non-ruptured by visual examination during surgery and subsequently histopathological examination, where as group [3] consists of 70 women representing the control group having a normal intrauterine pregnancy. Hematological and biochemical measurements were done on all groups
Results: the hematological findings revealed a significant increase in mean platelet volume [MPV], total leukocytic count [WBC] and erythrocyte sedimentation rate [ESR] among TEP patients especially in ruptured cases in comparison with those of normal pregnancy control. A significant decrease in hemoglobin [Hb] and packed cell volume [PCV] in TEP cases either ruptured or non-ruptured and a non-significant changes in total erythrocytic count [RBC]. The biochemical findings revealed a significant increase in serum creatine kinase [ CK] but a significant decrease in serum beta-hCG in both ruptured and non-ruptured TEP
Conclusion: it could be concluded that the WBCs, MPV count and ESR were significantly increased in TEP especially in ruptured cases. The MPV can differentiate between TEP and normal pregnancy but has less clinical significance to differentiate between ruptured and non-ruptured cases. On the other hand, the level of beta-hCG is an important indicator of TEP. Moreover, serum CK cannot be used as a tool for diagnosis of TEP but may differentiate between ruptured and non-ruptured cases
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Sudanese medical volunteers have a long history of working in districts with poor health-care infrastructure. Altababa medical volunteer group [AMVG] was established by Sudanese physicians working in Saudi Arabia who desired to contribute to improving clinical services and training in their country of origin. This paper documents steps in the planning and evaluation of AMVG's first mission to Almanagil hospital in Sudan in 2013. Over a 3-day period the visiting team of 4 physicians performed 25 laparoscopic surgical and obstetric/gynaecological procedures and 36 echocardiogram tests-all with hands-on training-presented 11 lectures and consulted with 137 patients. A total of 247 trainees and patients completed a 22-item evaluation survey. The first mission was highly rated by both trainees [health-care providers] and patients. The results provided a road map for volunteers to accomplish cost-effective goals in small hospitals with modest facilities
Subject(s)
Humans , Male , Female , Surveys and Questionnaires , Medical MissionsABSTRACT
Research training at higher education level for clinical and teaching staff is important and there are methods to introduce research culture in employees at clinical and teaching departmental level. Objectives: To recognize and quantify the research productivity status of teaching and clinical faculty of [DUHS] Dow University of Health Sciences Karachi before and after its establishment in 2003. Design: Non experimental cross sectional study. Period: 1st October 2012 to 1st February 2013.. Setting: Medical college Karachi. Subjects and method: Students of third semester were applied to sort out the ten years record from 1998 to 2008 of all researches conducted by faculty of Dow University of Health Sciences, published in international and national journals by using different online search engines. Research Output was measured in terms of the increase in the number of publications and quality of publications before and after the launch of Dow University. Data was entered in Microsoft office excel version 2007 and analyzed it in statistical package for social sciences [SPSS] version 17; person chi-square was applied to test the statistical significance at 95% confidence interval. Results: Data of total 594 researches was found out between the years1998 to 2008, 175[29.5%] researches were published before the foundation of Dow university of Health sciences Karachi [2003] while 419[70.5] researches were produced after 173[45.6%] research papers were published in indexed journals before, "whereas" 206[54.4%] were published in indexed journal after 2003. Original research articles were 152 [31%] before 2003, which rose to 339 [69%]. Publications of article types such as case reports, case series, and short communication, editorials and review articles also increased to 80 from 23 after establishment of Dow University. Conclusions: From a total of 594 faculty researches o published in indexed and non indexed journals between the years 1998 and 2008; there was a significant increase in production after establishment of Dow university of Health Sciences Hence it is confidently reported that due to establishment of research committees after the founding, there is a promotion and facilitation of research activities among faculty members.
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Introduction: Amelogenesis imperfecta (AI) is a dental anomaly that causes defects in enamel with no evident association of systemic disease. Presentation of Case: This clinical report describes the oral rehabilitation of a 24-year-old woman diagnosed as having hypoplastic type of amelogenesis imperfecta along with palatally positioned maxillary lateral incisors. The aim of the treatment was to eradicate dental sensitivity, to correct of maxillary anterior malocclusion, and to restore esthetics and masticatory function. The treatment included removal of maxillary lateral incisors and placement of metal-ceramic fixed bridge dentures, as well as placement of all ceramic, metal-ceramic and full metal crowns for other affected teeth. Discussion: Interdisciplinary approach of the management of AI is necessary. Depending on the type and severity of the disorder, esthetic and functional concerns, prosthetic management of anterior teeth, like complete crowns, porcelain laminate veneers are the best options. For many years the most predictable and durable esthetic restoration of anterior teeth has been complete crowns. Conclusion: Porcelain bonded to metal fixed bridge partial dentures and full ceramic, porcelain bonded to metal and full metal crowns to correct the malocclusion and aesthetic problem, to eradicate sensitivity and to restore the masticatory function in this case was satisfactory.
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Background: Accurate diagnosis of Methicillin-resistant Staphylococcus aureus (MRSA) is essential for the clinician. In Bangladesh MRSA creates a great problem for the treatment of infection. Objective: The purpose of the present study was to observe the clinical and diagnostic significance of MRSA infection in Bangladesh. Design: Systematic review of published articles in Bangladesh. Data Sources: PubMed (Medline), Embase, Scopus, Web of Science, the Cochrane Library, and the World Health Organization (WHO) Regional Databases (African, eastern Mediterranean, Latin American and Caribbean, western Pacific, and southeast Asian regions) as well as Google Scholar, Banglajol, Asiajol. Review Methods: The search was restricted to full articles published from January 2000 (publication date of the first study identified by the research) to December 2013. Studies were excluded that did not provide appropriate data on the prevalence of MRSA. Only English language was applied. Result: A total number of 125 studies were identified during systematic review which were relevant to the present research question and among these only 14 studies were met the criteria for analysis. The level of evidence and freedom from bias of these studies were generally low. MRSA was diagnosed phenotypic in most of the articles. Majority were isolated from skin wound. The isolation rate of MRSA among all culture isolates ranged from 4.8-78.7%. From all studies diagnosis of MRSA infection was done from hospital setting; however, only two studies had been reported from community settings though the CDC definition was not followed in either study. Conclusion: Significance of methicillin-resistant Staphylococcus aureus infection in Bangladesh is very high leading to a huge clinical as well as laboratory burden in the heath care facilities as well as in the community settings of Bangladesh.
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Tuberculosis [TB] remains one of the major causes of death from a single infectious agent worldwide. The rapid emergence of drug resistant mycobacteria has strengthened the demand for rapid methods for detection of mycobacteria in clinical samples. As prevention of tuberculosis relies on the early detection and cure of the infectious cases, current efforts are focused upon improving the rapidity of identification of Mycobacterium tuberculosis, allowing prompt initiation of appropriate therapy. The rapid enzyme linked immunospot assay [ELISpot] method was developed in the late 1990s based on the numbers of spots made by interferon gamma producing T cells stimulated by culture filtrate protein-10 [CFP-10] or early secretory antigenic target-6 [ESAT-6]. Therefore, a T-cell response to these antigens could in theory serve as a specific marker of M. tuberculosis infection. Is to assess the potential utility of ELISpot assay for monitoring treatment response of pulmonary tuberculosis patients. The study was done on 30 patients diagnosed as pulmonary tuberculosis on clinical, radiological and bacteriological bases. They were collected from Zagazig Chest Hospital and Zagazig University Hospitals from January 2010 to January 2011. A total of 15 healthy volunteers were enrolled in this study as control subjects. The following were performed for all patients before treatment initiation: full history taking, complete clinical examination, chest X-ray, postero-anterior and lateral views, tuberculin skin test [TST] by Mantoux technique, and routine laboratory investigations. Three successive sputum samples for sputum smear Ziehl-Neelsen [Z-N] staining and sputum collection for Mycobacterium culture on Lowenstein-Jensen media [LJ. Media] were done. Collection of 2 ml heparinized blood for enzyme linked immunospot assay [ELISpot] was done. All patients received four antituberculous drugs, isoniazid, rifampicin, pyrazinamide and ethambutol, for the initial 2 months. After 2 months of therapy; another three successive sputum samples for sputum smear Ziehl-Neelsen [Z-N] staining and sputum collection for Mycobacterium culture on Lowenstein-Jensen media were done. Collection of 2 ml heparinized blood for enzyme linked immunospot assay [ELISpot] was done. The results of this study showed that all patients were complaining of cough and expectoration. Tuberculin skin test was positive in 18 patients [60%]. Most patients [46.6%] had moderately advanced disease as regards the radiological extent. It was found that the median INF-y ELISpot response to ESAT-6 was significantly decreased after 2 months of antituberculosis therapy. The number of pre-treatment ESAT-6 ELISpot count in patients with positive tuberculin skin test was significantly higher than those with negative tuberculin skin test [P < 0.01]. As regards bacillary load, a statistical significant difference between patients with AFB+ + + and patients with [AFB +, AFB + +] as regards pre-treatment ELISpot count was recorded. Higher statistical significant difference in patients with AFB +, AFB + + and AFB + + 4- pre and post treatment ESAT-6 ELISpot count was found. It was found that the number of pre-treatment ESAT-6 ELISpot count in patients with cavitary lesion was higher than those without cavitary lesion and the difference was highly significant [P = 0.01]. As regards radiological extent, it was found that the number of pre-treatment ESAT-6 ELISpot count in patients with far advanced disease was higher than patients with minimal or moderately advanced disease. Also, after 2 months of therapy the number of ESAT-6 ELISpot count in patients with far advanced disease showed more decline than patients with minimal or moderately advanced disease. It was found that ELISpot assay sensitivity, specificity, positive predictive value and negative predictive value in relation to L.J. media were 93.3%, 100%, 100% and 88.2%, respectively. ELISpot assay may be used as a useful tool in the diagnosis of pulmonary tuberculosis. The decrease in the M. tuberculosis-specific T cell responses following 2 months of successful antituberculosis therapy may have a clinical value as a supplemental tool for the monitoring treatment response of pulmonary tuberculosis patients
Subject(s)
Humans , Male , Female , Enzyme-Linked Immunosorbent Assay/methods , T-Lymphocytes/immunology , Treatment Outcome , Hospitals, University , Biomarkers, Tumor/bloodABSTRACT
Several genes of Helicobacter pylori, such as vacA, cagA, iceA and babA, have been reported to significantly increase the risk of gastrointestinal diseases. The aim of this study was to study the relationship between H. pylori virulence factors and clinical outcomes and identify the independent markers of peptic ulcer disease in Iraq. DNA was extracted from specimens taken from 154 unselected H. Pylori positive Iraqi patients. Genotyping was performed by the polymerase chain reaction [PCR] using specific primers for cagA, vacA [s, m], iceA and babA2 genes. A total of 56 [82%] peptic ulcer disease [PUD] patients carried cagA+ strains, significantly more than the 56 [65%] non-ulcer disease [NUD] patients [p = 0.017]. The difference in the prevalence ofbabA2 positivity was significant between patients with NUD [33.7%] and PUD [58.8%] [p = 0.002]. In addition, babA2 was associated as an independent factor, with PUD [p = 0.005; odds ratio [OR] = 0.4; confidence interval [CI] = 0.18-0.68] followed by cagA [p = 0.05; OR = 0.4; CI = 0.18-0.85]. Forty-five isolates [29%] were typed as 'triple positive' strains, and their presence was significantly associated with PUD [p = 0.001]. The cagA and babA2 genotypes might be considered as useful markers for PUD patients. However, iceAl and iceA2 seem not to be good markers for the disease. The presence of H. pylori strains with triple-positive status is of high clinical relevance to H. pylori-associated diseases
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Dust storms are strongly and negatively associated with the annual cycle of rainfall and coincide with the west and southwesterly winds in west and south west of Iran. Accuracy assessment of particulate matter products of moderate resolution image spectroradiometer was studied in this research. Moderate resolution image spectroradiometer products consist of aerosol optical thickness, its corresponding image red, green and blue and moderate resolution image spectroradiometer/ terra calibrated radiances 5 minutes L1B swath 1 km, which shows the environmental information at terrestrial, atmospheric and ocean phenomenology. Daily aerosol optical thickness data retrieved from moderate resolution image spectroradiometer from May 2009 to May 2010 were compared with the amount of particulate matter measured at ground in Sanandaj, Iran, using non-linear correlation coefficient. Results showed that the moderate resolution image spectroradiometer image / terra calibrated radiances 5 minutes L1B swath 1 km is able to detect dust storms distribution and their blowing direction over study area clearly. The air quality conditions obtained in with dust storm period were unhealthy and correlation coefficients between moderate resolution image spectroradiometer aerosol optical thickness and particulate matter concentration in this period were higher than without dust storm period. The moderate resolution image spectroradiometer aerosol optical thickness values lower than 0.1 were acquired uncertainty level. Comparison of moderate resolution image spectroradiometer images/ terra calibrated radiances 5 minutes L1B swath 1 km and image red, green and blue showed that moderate resolution image spectroradiometer has limitation in retrieval of aerosol optical thickness from the dust storm with high concentration of particulate matter. This study reveals that the algorithm which is applied to refine the aerosol optical thickness is not able to recognize the amount of particulate matter in low and very high concentrations sensitively. No study has previously been conducted to investigate the accuracy of the moderate resolution image spectroradiometer particulate matter products
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Among 30 blood group systems ABO and Rh blood groups are clinically significant. So they are called major blood groups. Frequencies of ABO blood groups and Rh types show geographic variations. The objective of this study was to estimate frequencies of ABO and Rh blood groups in native Saudi blood donors in Jazan region. A total of 30481 healthy donors, donating blood for various reasons at Blood Bank Department of King Fahd Central Hospital in Jazan from January 2002 to December 2008 were evaluated for the ABO and Rh blood groups. Only Saudi nationals were included in this study. Out of 30481 donors, 18909 [62%] were group O, 8411[27.6%] were group A, 2662 [8.7%] were group B and 499 [1.7%] were group AB. Rh+ were 28988 [95%] and 1493 [5%] were Rh-. The results of this study were compared with results of the Southwest and the Eastern regions of Saudi Arabia. This study confirmed that blood group O was the most common of the ABO blood group system in the Jazan region. AB blood group was quite rare and Rh positive was more common than Rh negative phenotype. Significant differences were observed between the results of this study and the results of the Southwest and the Eastern regions of Saudi Arabia in the distribution of both ABO groups and the Rh phenotypes
Subject(s)
Humans , Rh-Hr Blood-Group System , Blood Donors , Retrospective StudiesABSTRACT
This study aimed to evaluate the effect of antibiotic combination between beta-lactams and aminoglycosids with another group of antibiotics. Fifty isolates of Pseudomonas aeruginosa were identified using different microscopic, cultural characteristics and biochemical tests. Eight isolates [16%] were from burn infections, 20 [40%] from urinary tract infections, 16 [32%] from burn infections and 6 [12%] from otitis media cases. Antimicrobial susceptibility tests and minimal inhibitory concentration MIC were performed. Pseudomonas aeruginosa exhibited [100%] resistance to amoxicillin, amoxicillin/clavulanic acid and cefazolin. While percentages of resistance to carbenicillin, cefotaxime and ceftazidime were [84%], [80%] and [78%] respectively. Resistance percentages to gentamycin, tobramycin, piperacillin, amikacin and ciprofloxacin were [52%], [26%], [24%], [6%] and [4%] respectively. All isolates of Pseudomonas aeruginosa were highly sensitive [100%] to aztreonam, cefepime, imipenem, peofloxacin and ofloxacin. Combinations of ciprofloxacin with gentamycin and ceftazidime gave interesting results against the local bacterial isolates in reducing their MIC values. Gentamycin and ceftazidime gave an obvious decrease in MIC values after combination of these drugs and used against Pseudomonas aeruginosa. The study shows that the combination of beta-lactams and aminoglycosids with ciprofloxacin is highly effective in treatment of Pseudomonas aeruginosa infections
Subject(s)
Humans , Aminoglycosides , Anti-Bacterial Agents , Drug Therapy, Combination , Drug Synergism , Ciprofloxacin , Pseudomonas Infections/drug therapy , Treatment Outcome , Drug Resistance, Bacterial , Microbial Sensitivity TestsABSTRACT
Fat embolism occurs in all patients with long bone fractures and intramedullary reaming of long bone but is usually asymptomatic. A few patients will have pulmonary, cerebral and dermal dysfunction; this triad is called fat embolism syndrome [FES]. We report a case of FES developed after intramedullary nailing of both femurs that was successfully managed in our surgical intensive care unit [SICU]
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To examine the validity of central venous oxygen saturation [ScvO 2] as a numerical substitution of mixed venous oxygen saturation [SvO 2] in adult patients undergoing normothermic on pump beating coronary artery bypass grafting [CABG]. Prospective clinical observational study was done at King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. Thirty four adult patients scheduled for coronary artery surgery were included. Patients were monitored by a pulmonary artery catheter [PAC] as a part of our routine intraoperative monitoring. SvO 2 and ScvO 2 were simultaneously measured 15 minutes [T1] and 30 minutes [T2] after induction of anesthesia, 15 and 30 minutes after initiation of cardiopulmonary bypass [T3 and T4], and 15 and 30 minutes after admission to intensive care unit [T5 and T6]. ScvO 2 showed higher reading than SvO 2 all through our study. Our results showed perfect positive statistically significant correlation between SvO 2 and ScvO 2 at all data points. Individual mean of difference [MOD] between both the readings at study time showed MOD of 1.34 and 1.44 at T1 and T2 simultaneously. This MOD was statistically insignificant, but after on pump beating normothermic bypass was initiated; MOD was 5.2 and 4.4 at T3 and T4 with high statistical significance. In ICU, MOD continues to have high statistical significance, MOD was 6.3 at T5 and at T6 it was 4.6. In on pump beating CABG patients; ScvO 2 and SvO 2 are not interchangeable numerically. ScvO 2 is useful in the meaning of trend; our data suggest that ScvO 2 is equivalent to SvO 2, only in the course of clinical decisions as long as absolute values are not required
Subject(s)
Humans , Male , Female , Oxygen , Prospective Studies , Hemodynamics , HemoglobinsABSTRACT
Malaria is a serious childhood disease causing high morbidity and mortality despite control measures. Immunological control against malaria was initiated early, and immunity acquired by children in endemic areas, which is age and exposure dependant, differs in different endemic settings. The objective of the study was to determine antibodies against Merozoite surface protein-1 [MSP-I] and Merozoite surface protein-2 [MSP-2], and to determine their relation to the age of Sudanese children. The study was descriptive, cross-sectional, conducted in Khartoum Children Emergency Hospital [KCEH]. 150 children with positive blood films for P. falciparum malaria were classified according to age, and a blood sample was taken from each one, and tested for antibodies against MSP-I and MSP-2. Antibodies to MSP-I and MSP-2 were 46% and 42% respectively. Sero-positivity and sero-negativity for both antigens were 26.6% and 42.7% respectively. Seropositivity to either MSP2 or MSPl antigen alone was present in 18.7% and 12% of patients respectively. High seropositivity [52.9%] was found in the age group 12-15 years of age. MSP-1 and MSP-2 antibodies in Sudanese children according to this study were age dependant, and findings were similar to what had been reported in some African countries
Subject(s)
Humans , Child , Cross-Sectional Studies , Age Factors , Protozoan Proteins , Antigens, Protozoan , Antibodies , Plasmodium falciparum , Malaria , Malaria, FalciparumABSTRACT
To evaluate acute morbidity, radiation dermatitis and pneumonitis, of Patients treated with whole breast hypo fractionated radiotherapy [RT] after breast-conserving Surgery [BCS], compared to conventional RT and to confirm the equivalence in terms of late effects between two the fractionation schedules of radiotherapy. Sixty patients with Tl-3a breast cancer who underwent breast conserving surgery [B CS] were included in the study. Half of the patients received whole breast irradiation, consisting of 50 Gy/25f/5w+boost 10Gy/5f/l w to tumor bed [group A]. The other half received 45Gy/15f/5weeks+boost 10Gy/5f/1w to tumor bed [group B]. The two groups were comparable otherwise. Early skin reaction were graded according to the Common Terminology Criteria for adverse events version 3.0 by the investigators and late cosmetic results were evaluated with the SOMA-LENT scoring system. A comparison was done between the incidence of these reactions and different variables as: total radiation dose, number of surgically dissected nodes. etc. The majority of patients [64.1%] had grade 0 /11 radiation reaction and 35.9% had grade Ill/TV reaction. On uni-variate analysis, there was no statistically significant difference between the two radiation arms regarding the incidence of radiation reaction. In conventional group [13%] [Grade 0]. Moreover, 15 [50%][, 5 [17%] and [20%] had Grade I, II and III radiation dermatitis, respectively. With the hypo fractionated RT. Furthermore, 8 [60%], 5 [17%] and 4 [13%] bad Grade I, II and III radiation dermatitis, respectively. Regarding radiation pneumonitis] [6%] of conventional fractionation group had Grade I radiation pneumonitis. 5 [17%] had grade 11. Pneumonitis graded III or more was not observed. No patient treated with the hypo fractionated schedule had symptomatic radiation pneumonitis In SOMALENT scoring system Pain. In 3 [9%] and [6%] of both groups respectively had grade2-3. No grade 4 pain was reported. [6%] of group A and [9%] of group B had grade 2 breast edema. No patient of either group had grade 3-4 breast edema. [17%] and [27%] had group 1-2 and grade 2 fibrosis in group A and B, respectively. Telangiectasia grade 2 and grade 1-2 were reported in [6%] of both groups A and B, respectively. [17%] in group A had grade 2 and grade 3 arm edema, respectively. In-group B only 2 patients had grade 2, one patient had atrophy in group 1 while no cases were seen in conventional group and no skin ulceration was seen in either groups. Preliminary results showed that Radiation dermatitis and pneumonitis in patients treated with the Hypo fractionated schedule is acceptable. Especially, radiation dermatitis by the hypo fractionated. Schedule is milder than that by the conventional schedule and that supports the use of a shorter fractionation schedule of 45Gy/l5f/5w plus boost in patients with breast conserving surgery. The study is still going on to study the late effects on a larger number of patients for final evaluation of this regimen
Subject(s)
Humans , Female , Dose Fractionation, RadiationABSTRACT
Uncuffed endotracheal tubes are still being recommended by most pediatric anesthetists at our institutes. Different algorithms and formulae have been proposed to choose the best-fitting size of the tracheal tube. The most widely accepted is related to the age of the child [inner diameter [ID] in mm= [age in yr/4] +4; the second is a body, length-related formula [ID in mm=2 + height in cm/30]; the third, a multivariate formula [ID in mm=2.44 + age in yr x 0.1 + height in cm x 0.02 + weight in kg x 0.016] [5]; the fourth, the width of the 5[th] fingernail is used for ID prediction of the ETT [ID in mm = maximum width of the 5[th] fingernail]. The primary endpoint of this prospective study was to compare the size of the 'best fit' tracheal tube with the size predicted using each of the above mentioned formulae. With Institutional Ethics Committee approval and parental consent, 27 boys, 23 girls, ASA I-III, 2-10 years, scheduled for different surgical procedures requiring general anesthesia and endotracheal intubation, were enrolled in the study. The size of 'best fit' endotracheal tubes in those children were compared. The internal diameter considered the 'best fit' by the attending pediatric anesthesiologist was compared to age-based, length-based, multivariate-based and 5[th] fingernail width-based formulae. For all test, P<0.05 was considered to be statistically significant. The mean [SD] IDs for the 'best fit', age-based, length-based, multivariate and 5[th] fingernail techniques were 5.31 [0.691], 5.54 [0.622], 5.82 [0.572], 5.71 [0.67] and 5.43 [0.821] mm, respectively. The age-based and 5[th] fingernail width-based predictions of ETT size are more accurate than length-based and multivariate-based formulae in terms of mean value and case matching
Subject(s)
Humans , Male , Female , Child , Prospective Studies , Anesthesia, General , Age Factors , Multivariate AnalysisABSTRACT
It was proved that current anti-allergic drugs comprise piperazine and acrylic acid segments. These compounds were structurally designed as 5-lipoxygenase inhibitors depending on two action mechanisms of the ready drugs used to treat allergy e.g.[Oxatomide], which contains piperzine moiety, its anti-allergic effects possess antagonist activities against chemical mediators such as histamine, serotonine and leukotrienes [which cause allergy]. Also, [Tranilast], which contains acrylic acid segment; its activity depends on inhibition of mediator release. In harmony with these findings new structures having anti-allergic properties are proposed in this manuscript. New products, [5a-u] with expected better biological activities and decreased side effects were synthesized by the addition of an amino acid conjugate of cinnamic acid to a piperazine segment. Their anti-allergic and anti-inflammatory activities were evaluated. Most of them show promising activities
Subject(s)
Peptides/chemistry , Cinnamates/chemical synthesis , Anti-Inflammatory Agents , Anti-Allergic AgentsABSTRACT
This study was conducted to assess the risk of recurrent laryngeal nerve palsy [RLNP] in different types of thyroidectomy with identification of the nerve during operation and its relation to different thyroid diseases. One hundred eighty seven patients were included in this study, 69 men and 118 women, Patients classified into four groups according to the underlying disease benign thyroid disease [n=56], Graves' disease [n=21], thyroid carcinoma [n=73], and recurrent goiter [n=37]. Of recurrent group 7 had recurrent Graves' disease, 10 had thyroid cancer, and 20 had recurrent nodular goiter. Total thyroidectomy was done in 85 patients, near total in 45, subtotal thyroidectomy in 30 and lobectomy in 27 patients. Temporary and permanent RLNP rates were analyzed for patients groups, 7 patients develop RLNP postoperatively [3.74%], recovery of nerve function was documented for 6 patients [85.7%]. recovery from temporary RLNP ranged from 5 days to 2 months [mean 27 days]. Overall incidence of temporary and permanent RLNP was 3.74% and 0.53% respectively. The rates of temporary/permanent RLNP were 0.0%, 0.0% for benign thyroid disease, 4.1%, 0.0% for thyroid cancer, 4.76%, 0.0% for Graves' disease, 5.4%, 2.7% for recurrent goiter. Surgery for thyroid cancer, Graves' disease, and recurrent goiter were associated with significantly higher RLNP rates. Temporary RLN palsy rate was not affected by the type of operation, while permanent vocal cord palsy occurred in total thyroidectomy and this attributed to recurrence more than to the type of operation. Identification of the nerve during operation does not affect the rate of RLNP
Subject(s)
Humans , Male , Female , Recurrent Laryngeal Nerve/injuries , Incidence , Thyroid Gland/pathologyABSTRACT
To look for any possible coexistence of CACNA1A, ATP1A2, and KCNN3 gene mutations in migraine patients who had human platelet HPA-1a/1b polymorphism, which is also known as PlA1/A2 polymorphism. The study was carried out at the Neurology Clinic, Hospital University Sains Malaysia, Kelantan, Malaysia between April 2004 and March 2005. The DNA from 4 patients who had migraine with the HPA1a/1b polymorphism were analyzed by polymerase chain reaction using the allele specific oligonucleotide technique to detect the presence of CACNA1A, ATP1A2, and KCNN3 genotypes. We found that the CACNA1A gene mutation alone was present in only one patient who presented with classical migraine with aura. The gene mutations on ATP1A2 and KCNN3 were seen in none of our 4 cases with migraine. There is no coexistence between the platelet HPA-1a/1b polymorphism and the ATP1A2 and KCNN3 gene mutations, though one classical migraine patient with HPA-1a/1b polymorphism had the CACNA1A gene mutation. Larger studies are warranted to confirm these findings
Subject(s)
Humans , Female , Blood Platelets , Polymorphism, Genetic , Calcium Channels/genetics , Sodium-Potassium-Exchanging ATPase/genetics , Small-Conductance Calcium-Activated Potassium Channels/genetics , Mutation , Genes , Migraine with AuraABSTRACT
Background: Tobacco smoking is a self-inflicted major health hazard worldwide. Cigarette smoking influences proliferative activity in normal oral mucosa. This proliferative activity can be detected by AgNOR count. This study was conducted in an attempt to find any association between smoking [Pack Years] and AgNOR count
Methods: Silver stained cytologic smears of buccal mucosa in 75 smokers and 75 nonsmokers were viewed for AgNOR count and a comparison between pack years of smoking and increased AgNOR number was assessed using SPSS analysis
Results: A positive correlation [r = .604] significant at the 0.01 level was found, between pack years and AgNOR count. This explains significant replicative activity under the influence of cigarette smoking
Conclusion: The effect of cigarette smoking in buccal mucosa is related to dose exposure [Pack Years of smoking] and a positive correlation exists between proliferative activity [AgNOR Count] and smoking [Pack Years]. An association between pack years of smoking and increased AgNOR count explains cigarette smoke`s effect on buccal mucosa
ABSTRACT
This study aimed at evaluating the effect of application of different patterns of positive ventilatory pressure either during or after cardiopulmonary bypass [CPB], on lung functions. 30 patients undergoing coronary artery revascularisation under the management of CPB were randomly allocated into 3 groups. Group I [VCM] 10 patients were subjected to manual vital capacity manoeuvre [VCM] before weaning off the CPB. Group II [CPAP] 10 patients were subjected to continuous positive airway pressure [CPAP] of 10 cm H[2]O during CPB. Group III [PEEP] 10 patients were subjected to positive end expiratory pressure [PEEP] of 7 cmH[2]O after weaning off the CPB. Measurements included the PO[2] PCO[2] together with derived calculated parameters as the alveolar-arterial oxygen difference [P [A-a] DO[2]] and shunt fraction, as welt as the dynamic lung compliance being recorded directly from the anesthetic and ventilatory equipments. All readings were taken on closed chest and on FiO[2] of 0.5. Intraoperative anesthetic and surgical data as well as postoperative extubation time and length of ICU stay were also evaluated. Statistical analysis of ventilatory parameters showed no significant differences for both PO[2] and PCO[2] in between the studied groups. Alveolar-Arterial oxygen difference mean values were comparable in the 3 studied groups. The mean values of intrapulmonary shunt fraction showed a significant difference in relation to the baseline values in Group I [VCM] and Group III [PEEP] at 30 minutes after ICU admission and 4 hours post CPB with estimated P value <0.01 and <0.05 respectively, while in Group II [CPAP] mean values started to be significant after chest closure with a P value <0.05, but there was no significant intergroup differences with a P value >0.01. Dynamic lung compliance mean values showed no intergroup statistical significance. Maintenance of ventilatory parameters was achieved in all the positive pressure ventilatory methods applied, either being applied during or after CPB