Azathioprine for prevention of postoperative recurrence in crohn's disease

Crohn's disease is a chronic inflammatory bowel disease that can involve any portion of the gastrointestinal tract. Up to 74% of patients require surgery. However, although respective surgery improves the clinical situation, relapses is frequent in most cases. The aim of this clinical trial was to evaluate the profile of patient who received AZA after surgical treatment in order to prevent postoperative recurrence. This was a retrospective study including 17 patients with severe Crohn's disease attending our gastrointestinal unit from September 1998 to June 2004. Patients were eligible if they have severe Crohn's disease, undergoing curative surgical treatment and received azathioprine for the first time after surgery to prevent postoperative recurrence. The study population comprised 17 patients with Crohn's disease [10 men and 7 women; mean age, 27 years]. The Crohn's disease was ileo-colic in 10 cases with perineal manifestations for 2 patients and ileal in 7 cases. The indications for surgery were stenosis in 10 cases, fistula in 5 cases, perforation in 1 case and corticosteroid-resistance in 1 case. The median folio wing-up period was 40 months [9-80 months]. During this period, only 1 patient reported severe adverse event and discontinued treatment due to acute pancreatitis. 1 patient was lost to follow-up and 3 patients had moderate clinical relapse. Maintained remission was obtained for 12 patients. None of our patients had surgical relapse. The result of this study shows the effect of Azathioprine in preventing both clinical and surgical relapses in patients with Crohn's disease who have undergone surgery

Comparative study between the toxic effects of rofecoxib and harpagophytum procumbens extract on adult albino rats

The highly selective cyclo- oxygenase II [COX-II] inhibitors could alleviate pain and inflammation and have fewer side effects than conventional non-steroidal anti-inflammatory drugs [NSAIDs]. Herpagophytum Procumbens has been shown to reduce inflammation and pain associated with various types of arthritis. The aim of this work was to perform a comparison between the toxic effects of Rofecoxib and Harpagophytum Procumbens [herpago] on adult male albino rats. This study included 170 adult male albino rats divided into 5 groups. Group I, II and III were used as control groups [-ve control group, Gum acacia group and distilled water group]: each consisted of 30 rats remained for 6 weeks. Group IV [rofecoxib group]: consisted of 40 rats, each rat was gavaged with 1.8 mg rofecoxib/rat [double human therapeutic dose] once daily for 6 weeks. Group V [herpago group]: consisted of 40 rats, each rat was gavaged with 86.4 mg herpago/rat [double human therapeutic dose] once daily for 6 weeks. At the end of six weeks: ten rats from rofecoxib [IV] and herpago [V] groups and fifteen rats from each control group [I, II and III] were used for blood pressure measuring. Another ten rats from groups IV and V and fifteen rats from I, II and Ill were used for biochemical and histopathological studies. The remaining rats of both groups IV and V were left for another 6 weeks without drug administration for follow up. At the end of this period the follow up rats were examined as above. Groups I, II and III showed no abnormal findings without statistically significant difference between them [P>0.05]. In rofecoxib group an increase in systolic and diastolic blood pressures [SBP, DBP] were detected with a significant difference when compared with -ve control group [P<0.001], while herpago group showed a decrease in SBP and DBP with a statistically significant difference when compared with the -ve control group [P<0.001]. After 6 weeks of follow up, the SBP and DBP of rofecoxib and herpago groups showed no significant difference when compared with the -ve control group [P>0.05]. After 6 weeks of treatment there were an increase in serum Na+ and K+ levels with a decrease in serum pH and HCO3- with a statistically significant difference in rofecoxib group when compared with the -ve control group [P<0.001]. Herpago group showed no abnormal findings in the above mentioned biochemical, parameters. Six weeks after the discontinuation of rofecoxib administration the Na+ level returned to its control level and gave no significant difference when compared with the -ye control group [P>0.05]. Serum K+, HCO3- and pH levels improved but didn't reach to the control level and gave significant difference when compared with the -ve control group [P<0.05]. Macroscopically, no abnormal findings in the heart gastro- intestinal tract [GIT] were detected in all tested groups. With rofecoxib group, microscopical examination of the cardiac sections showed ischemic changes with atrophy of cardiac muscles. Herpago group showed no histopathological abnormalities on microscopical examination. After 6 weeks of follow up histopathological examination of the heart in rofecoxib group showed disappearance of the ischaemic changes. The cardiac muscles regain its normal thickness and length. Histopathological examination of the stomach and small intestine of rofecoxib group showed different degrees of affection varies from edema of lamina propria and vascular congestion to loss of superficial epithelium [erosion] and peptic ulcer. Herpago group showed no histopathological abnormalities in the GIl. After 6 weeks of follow up in rofecoxib group partial healing of erosions and ulcers occur and the mucosa regained its normal thickness. It could be concluded that rofecoxib is more toxic than herpago and its toxic effects were partially reversible after its discontinuation

Human leukocytes antigens in insulin dependent diabetes mellitus [IDDM] type I

This study consists of 72 diabetic patients of type I and 52 diabetic patients of type II besides 35 normal control of matched age and sex. There are some alleles more frequent in IDDM group than in control. In patients, they are DQA1 *0301/2,*0102, *0101- DQBl*0201,*0302,*0602-3,*0301- DRB1*0101,*0301,*04,1101,. While in normal control,they are DQAI*0101,*0102,*103,*0201,*0501 DQBI*0301,*0602-3,*0201,*0601 ORB1*1101,*1501/2/3. Three times high positive percent were observed regarding rubella IgM of IDDM as compared to NIDDM while it was zero percent with respect to control

Evaluation of risk factors associated with recurrent cesarean section morbidity: a suggested score

This prospective study included 1000 women undergoing cesarean section [CS] under general anesthesia. They were divided into two groups. Group 1 [control group] included 500 patients, who underwent CS for the first time. Group 2 [study group] included 500 patients who had one or more previous CS. Simple scoring system was developed to record the possible risk factors related to CS morbidity. There were six significant preoperative risk factors [high parity, preterm delivery, placenta praevia, antepartum hemorrhage, medical disorders and bad general condition]. There were five highly significant risk factors related to intra-operative morbidity [high parity, placenta praevia, intra-peritoneal adhesions, low experienced surgeon and preterm gestational age] and five risk factors related to previous CS operation [previous three or more CS, previous CS at rural hospital or private clinic, previous upper segment CS, previous complicated CS and tender previous scar]. Eleven factors related to postoperative morbidity were more significant in the repeated CS group. The incidence of overall morbidities was significantly more in the repeated CS group. Total postoperative morbidity was highly significant starting from previous 4 or more CS. Risk factors related to intra-operative morbidity were used to develop a mortality scoring system. Based on a summation of logistic coefficient corresponding to individual risk factors, a scoring system was suggested, which can help in the prediction of CS morbidity. Further prospective evaluation of this scoring system would be helpful to confirm the usefulness and practicality of this system

Transvaginal ultrasonography, sonohysterography hysterosalpingography and operative hysteroscopy in predicting endometrial hyperplasia

A prospective study was performed at Al-Azhar University Hospital, Cairo, Egypt, and Hadi Hospital, a private hospital in Kuwait. A total of 255 patients [160 Egyptian and 95 Kuwaiti] with abnormal uterine bleeding were enrolled [165 premenopausal, 90 postmenopausal]. All participants were evaluated with transvaginal sonography [TVS], transvaginal sonohysterography [TV-SH] and operative hysteroscopy [HSC]. Hysterosalpingography [HSG] was performed only for 40 Egyptian and 10 Kuwaiti patients. Endometrial curettage and/or histopathology of hysterectomy specimen were considered the gold standard diagnostic procedures. TV-SH is an advanced enhancement of conventional TVS. It is an easy, safe, rapid and tolerable procedure. It has an excellent diagnostic accuracy in EH, but it cannot substitute tissue diagnosis

Transvaginal sonohysterography [TV-SH], versus hysterosalpingography [HSG] and laparoscopy for the assessment of tubal patency

A prospective study was performed at Al-Azhar University Hospital, Cairo, Egypt, and Hadi Hospital, a private hospital in Kuwait. A total of 200 infertile patients [150 Egyptians and 50 Kuwaiti]. All women underwent HSG, TV-SH and diagnostic laparoscopy. Patients were classified into two groups: Group 1, 100 patients had primary infertility and group 2, 100 patients had secondary infertility. From the results obtained, it was concluded that TV-SH is a simple procedure, it does not involve radiation exposure, it could be added to the usual conventional procedures to assess tubal patency as a new, easy and safe method and can be performed as an outpatient procedure in the routine infertility clinic

Epidemiological and sociocultural study of burn patients in Alexandria, Egypt

All burn cases admitted to the burns unit of Alexandria Main University Hospital over a period of one year were investigated. Burns were found to occur in younger age groups. There was an almost equal distribution of cases by sex, but when stratified by age, more females were found in most age groups. Most burns were domestic, with cooking being the most prevalent activity. Flame was the most common agent. Death occurred in about one-third of cases; when using logistic regression analysis, the outcome of the burn injury was significantly associated with age, sex, total surface area burnt and degree and depth of the burn

Kinetics of the reaction of 2,4 dinitrophenyl-4-substituted phenyl sulfones with morpholine in methanol

The present article reports the kinetic data of the reaction of 2, 4-dinitrophenyl-4'-substituted phenyl sulfones [1-6] with morpholine and study the effect of substituents in the aryl sulfonyl moiety at different temperatures in methanol

Urodynamic Studies after natural menopause

Urodynamic evaluation of lower urinary tract function was performed for 20 postmenopausal women of different age groups [group I, range 45 - 58 y., mean 51 +/- 4.2, group II, range 60-70 y. mean 65 +/- 3.4, n = 10 for each group]. Cystometric study showed an increase in time and volume of first sensation to void, indicating hyposensitivity of the bladder, in the older age group. Also, the detrusor pressure at the maximum cystometric capacity was significantly higher in older postmenopausal women reflecting a decrease in the elastic properties of the bladder wall. Static profilometry showed a significant decrease in maximum urethral pressure, maximum closure pressure and functional urethral length with advance of age. Uroflowmetry, that assess the functional coordination of the detrusor and the urethra showed a significant decrease in the average flow rate in older postmenopausal women. These urodynamic data may suggest an age-related deterioration in the intrinsic properties and/ or the extrinsic innervation of the female urinary tract, besides the expected effects of estrogen deficiency, after natural menopause

Synthesis of 1-alkyl-2-methoxybenzylpyrrolidinol esters of analgesic activity

A series of 1-alkyl-2[4-methoxybenzyl]-3-pyrrolidinol estera [2 al-L] was synthesized and evaluated for their analgesic activity. Two of these derivatives [2f, 2L] showed noticeable activity

Relative safety of contraceptives

The aim of the study was to identify the factors that affect the relative safety of different types of contraceptives for Egyptian women. This study was carried out on married women in their reproductive age [16-49 years], seeking family planning services and attending the Outpatients Family Planning Clinics of Al-Azhar University Hospitals. An interview with 407 married women seeking family planning services was used for data collection. The results of the study revealed that the majority of the studied samples were illiterates and housewives. The mean duration for pill usage was 18.5 +/- 12.8 months and for local method usage was 6.9 +/- 6.7 months. Obesity, lower limbs edema, hypertension and anemia were detected more often among pill users. Regarding gynecological examination, it was found that excessive vaginal discharge, cervical erosion and bulky uterus were detected in high percentage among pill users. Concerning the microscopic findings of vaginal discharge, it was found that 21.6+ACU- of local method users had leucorrhoea, whereas 8.7+ACU- had moniliasis and 3.1+ACU- of IUDs users had mixed vaginal infection. Medical examination was recommended for every women before the use and choice of the suitable contraceptive method and periodic medical examination was also suggested for the prevention of complications

Synthesis and analgesic properties of some 1-anilidocyclohexanecarboxamides

A series of 1-Anilidocyclohexanecarboxamides 2 a-1 were prepared and screened for their analgesic activity using the mouse hot-plate test

Evaluation of medical treatment in secretory otitis media

The present study was conducted on eighty patients proved clinically and audiologically to have secretory otitis media. They were divided into four groups each comprised of twenty patients: Group I: patients were given antihistamines. Group II: patients were given mucolytics. Group III: patients were given corticosteroids. Group IV: control group, they were left without treatment. Medical treatment were tried for one month. Follow up were done every two weeks during treatment and after three months for the improved cases. From the results of this study we can conclude that, corticosteroid is the main therapy in the management of secretory otitis media