Drinking water: a major source of lead exposure in Karachi, Pakistan

Excess lead in drinking water is a neglected source of lead toxicity in Pakistan. A cross-sectional survey in 2007/08 was made of water samples from drinking water sources in Karachi, a large industrial city. This study aimed to compare lead levels between untreated ground water and treated surface [tap] water in 18 different districts. Of 216 ground and surface water samples collected, 86% had lead levels higher than the World Health Organization maximum acceptable concentration of 10 ppb. Mean lead concentration in ground water [146 [SD 119] ppb] was significantly higher than in surface water [77.1 [SD 54] ppb]. None of the 18 districts had a mean lead level of ground or surface water below the WHO cut-off and ground water sources in 9 districts had a severe level of contamination [> 150 ppb]. Urgent action is needed to eliminate sources of contamination

effect of 23-valent pneumococcal polysaccharide vaccine on pharyngeal colonization in healthy children under 5 years of age

Streptococcal pneumonia is one of the most common pathogens that cause otolaryngological diseases [otitis media, sinusitis, tonsillitis] and other invasive diseases such as pneumonia, so that decreasing the pharyngeal carriage of pneumococci will eventually decrease the occurrence of these common diseases and hence decrease the morbidity and mortality associated with these diseases. Are to evaluate the pharyngeal carrier rate of pneumococci in healthy children and to demonstrate the effect of 23-valent pneumococcal polysaccharide vaccine on pneumococcal pharyngeal carriage. This prospective study was carried on 100 healthy children under 5 years of age. They were divided into two groups, the control group consisting of 65 children, throat swabs were taken for them, and the vaccinated group consisting of 35 children which received 23-valent pneumococcal polysaccharide vaccine and throat swabs were taken 1 and 6 months after vaccination. The pharyngeal carriage of pneumococci in the control group was 60% while in the vaccinated group was 8.6%. 23-valent pneumococcal polysaccharide vaccine is significantly effective in decreasing the pharyngeal carriage of pneumococci

Ondasetron versus dexamethazone for treating patients with intractable hyperemesis gravidarum: a randomized study

To evaluate the antiemetic effectiveness of ondasetron and dexamethasone in patients with intactable hyperemesis gravidarum. OB. and Gyn. Department, Sohag University hospital. A prospective randomized study. Sixteen patients with hyperemesis gravidarum resistant to the conventional therapy. There were randomly allocated into two groups; the 1st [8 patients] treated with ondasetron 4 mg/day I.V. as a single injection while the 2nd group was treated with dexamethazone 24 mg/day I.V. on three divided doses. The frequency of vomiting was evaluated for every patient daily every morning. At the end of the study period, the antiemetic efficacy, the duration of hospital stay and the side effects of both drugs were compared. 38% of patients receiving ondasetron [group I] showed stoppage of vomiting after a single injection. After the 2nd injection, all patients were cured of vomiting. The average duration of hospital stay was 3.8 +/- 0.8 days. In group II, only one patient [12.5%] showed improvement of vomiting after the 1st day of treatment. After the 3rd day of treatment, only 12.5% of patients were cured while 50% of patients were resistant to dexamethazone. The average hospital stay was 6.2 +/- 1.3 days. The difference between the two groups regarding the antiemetic efficacy and the duration of hospital stay was statistically significant [P < 0.05]. No side effects for both drugs have been reported. Ondasetron is a highly effective drug for treating women with intactable hyperemesis gravidarum. It is more effective than dexamethazone, associated with less frequent injection, less hospital stay and produces no significant side effects. Ondasetron should be only used as a last resort as an alternative to termination of pregnancy

Outcome of pregnancy in patients with liver cirrhosis

To evaluate the maternal and foetal outcomes in patients with liver cirrhosis and to determine the impact of pregnancy on the hepatic disease process. A prospective observational study. Setting: Sohag University hospital. Fifty one pregnant women with liver cirrhosis. They were followed throughout pregnancy to detect signs of hepatic decompensation and to detect any obstetric complication. Foetal growth curve was done bimonthly or monthly. 18% of patients developed hepatic decompensation during pregnancy; of whom 88% have occurred during the last 4 weeks of pregnancy. Only 2% of this decompensation has occurred before 32 weeks of gestation. 60% of patients developed obstetric complications. Preterm labour, HELLP syndrome, pre-eclpmsia and non-traumatic postpartum haemorrhage increase in patients with liver cirrhosis. The vast majority of these complications have occurred in patients delivered beyond 36 weeks of pregnancy. 30% of fetuses showed IUGR and 15% died intrauterine mainly in patients who developed hepatic decompensation. The maternal mortality was 8% and all were the result of hepatic coma occurring during labour. The risk of hepatic decompensation increases during the last 4 weeks of pregnancy. Preterm labour, HELLP, PET and PPH increases in decompensated patients. Hepatic coma during labour is the leading cause of maternal death. Termination of pregnancy at 36 weeks of pregnancy can decrease the maternal morbidity and mortality

Pregnancy spacing after primary cesarean section: its impact on uterine scar strength and mode of delivery

To evaluate the strength of uterine scar in pregnancy following primary cesarean section [CS] and its effect on the mode of delivery, and subsequently to define the safe interval of pregnancy spacing after primary CS. Ninety cases were recruited from the outpatient clinic of Sohag University Hospital [SUH] during the period from Feb. 2005 to Jan. 2006. All had singleton pregnancy in the third trimester and previous one uncomplicated CS for a relative indication done in the emergency sector of SUH with no other risk factors in the current pregnancy. The patients were allocated into 3 groups, G I [13 patients] who got pregnant within 6 months after CS, GII [27 patients] who got pregnant 6 months to one year after CS, and G III [50 patients] who got pregnant after more than one year of CS. During every antenatal visit, in addition to the routine evaluation, ultrasonographic measurement of the lower uterine segment [LUS] was done and a thickness < 3 mm was considered to be abnormal according to Tanik et al [1996]. Elective CS was done for those with thin LUS [<3mm] or for those who developed other complications of pregnancy. Otherwise, patients were allocated for the trial of vaginal delivery. The patients characteristics showed that most of the patients were primiparous, noneducated and from rural areas with a mean age of 28 +/- 3.7. The LUS thickness at 36 weeks was found to have a thickness of <3mm in 9 cases [69%] of GI, 7 cases [26%] of GII and 5 cases [10%] of GIII. A LUS of >/= 3mm was detected in 4 cases [30%] of GI, 20 cases [74%] of GII and 45 cases [90%] of GIII; the differences were statistically significant. With regard to the mode of delivery, 92% of patients in GI were delivered by CS [elective+emergency] compared to 20% in GIII where 80% of patients were delivered vaginally, and the difference was statistically significant. This study can conclude that the interval of 6 months or more after CS can be considered safe for pregnancy to be allowed and the safety increases with more than one year interval. An interval of less than 6 months does not seem to be safe; the LUS is frequently too thin to stand for trial of vaginal birth. Sonographic measurement of the thickness of the LUS is considered a reliable method for determining the strength of the scar and the mode of delivery

ratio of middle cerebral to umbilical artery blood velocity versus biophysical profile in post-term pregnancies for the prediction of perinatal outcome

To compare the ratio of middle cerebral artery to umbilical artery blood velocity waveform's systolic/diastolic [MCA/UA] S/D ratio and biophysical profile as regard their ability to predict adverse outcome in post-term pregnancies. A prospective observational study was done in Antenatal clinic and Emergency Department of Obstetrics and Gynecology of Sohag University hospital. Sixty pregnant women were recruited in the study fulfilling the selection criteria of being 42 weeks or more calculated from the first day of the reliable last menstrual period, having a singleton fetus in the vertex presentation. All accepted to participate in the study after explaining its nature. All cases underwent antepartum testing every other day for biophysical profile and Dopplcr ultrasound examination of the fetal middle cerebral artery and umbilical artery. Adverse post-term related outcome was defined as perinatal death, occurrence of mcconium aspiration syndrome, cesarean delivery for fetal distress, admission to the neonatal intensive care unit and low Apgar at 1 and 5 minute. The predictive values of a middle cerebral artery to umbilical artery ratio

Zooplankton biomass in the most Northern tip of the Gulf of Aqaba, a case study

This work aims at studying zooplankton biomass in the oligotrophic water of the most northern tip of the Gulf of Aqaba, Red Sea. Zooplankton were sampled twice at two different days during September 2003 from three sites at 25 and 50m depths. Stations were selected near areas with high human activities at the northern coast of Aqaba. Slight differences between 25m and 50m water depth were found at the different selected sites. A notable increase was observed in surface zooplankton biomass inside the yachting club pool compared to the other locations which attributed to human activities at this station. However, the results indicated that the distribution of zooplankton biomass at the most northern tip of the Jordanian sector of the Gulf of Aqaba was fairly homogeneous. Fractions of the zooplankton biomass of the studied areas were distributed ascendingly with an increase in the fraction size of the following order 100-200, 200-500, 500-1000 and >1000 microm. It is concluded that, anthropogenic activities at the northern tip of the Gulf of Aqaba, which results in higher nutrient levels, may subsequently increase the biomass of zooplankton in the sea water

Changes in gassing powder and carbohydrate substances during wheat flour dough formation and fermentation

Changes in gassing power and carbohydrate constituents during formation and fermentation of dough as affected by wheat flour variety, yeast type and level and fermentation time were evaluated. The acidity of wheat flour dough varied according to wheat variety, yeast type and level and fermentation time. The higher acidity values were noticed in the presence of Soltani starter compared with dry and compressed yeast. The addition of dry yeast at 0.5% level gave the highest gas production followed by dough mixed with compressed yeast and Soltani starter. Also, wheat flour of Sakha 69 [strong type] gave the highest gas production compared to Sakha 8 and Giza 157. Changes in total carbohydrates, reducing and non-reducing sugars were noticed during the fermentation time. The higher changes were found for Sakha 69 wheat flour dough followed by Sakha 8 and Giza 157 wheat flour dough variety

Prevalence of acne amony secondary school students

This is a cross-sectional, case-control study of the secondary school students in Tikrit in 1994. A random sample of 630 students were studied. The results have revealed a prevalence rate of 14% with female to male ratio of 2:1. Most of the students with acne were in the 15-18 years age group. More than one half of the cases were from the middle class families. Fat rich and spicy diet preference among cases were 35% and 29% respectively. Students with emotional stress formed 33% of the cases while 67% of cases reported positive family history. Most of the cases have greasy skin while 51% of the female cases suffered, in addition, of menstrual irregularity. The lesion in 62% of cases were located on the face, the rest of them were located on the face in addition to other body localities

Evaluation of lumbar laser diskectomy

Laser discectomy is one of the less invasive methods in the treatment of lumbar disc problems. This work was done on 130 patients with prolapsed lumbar disc in order to evaluate and find out the efficacy of laser technique in the treatment of prolapse lumbar disc. These patients were divided according to their age into different groups. It was found out that percutaneous laser discectomy was effective in treating young patients with disc size 4 mm or less and in absence of spinal canal stenosis. The absence of complications, the minimal trauma, the immediate effect, the brief duration of the procedure, the least hospital stay and the limited sick leave would justify this procedure

Early experience in the transpedicular screw plate fixation of the dorsolumbar area with VSP system

There is a multitude of techniques and materials which have been utilized to achieve spinal stability and to correct deformity of the dorso-lumbar area. The transpedicular screw plate fixation has become an important method for internal fixation of the dorso-lumbar area. This technique was applied on 35 patients presented to them with different clinical pictures as a result of trauma. They were divided into grades according to Frankel Grid Classification. There were 18 patients with postoperative good improvement and 17 patients without neurological recovery. The preoperative radiological planning and the intraoperative radiological assistance are mandatory to achieve proper trajectory of the screw through the pedicle and to avoid nerve root injury

Relationship between some trace elements and urinary stone formation

Some trace element concentrations [manganese, iron, cupper, nickel, zinc, cadmium and lithium] were determined in the urinary stones, serum and 24 hour urine of 20 urinary stone patients using an atomic absorption spectrophotometric method. Thirty two calculi were examined; group I [12] were pure calcium oxalate, group II [9] were mixed calcium oxalate/uric acid and group III were pure uric acid. An attempt was made to compare the levels of these trace elements in calculi with the levels in normal hair as standard. The data obtained from serum and urine for 20 stone patiens were compared with those of 10 healthy individuals. Urinary manganese, nickel, zinc and lithium excretion and serum manganese, nickel and cadmium concentrations were statistically significantly lower for stone patients compared to those of healthy individuals. In groups I and II zinc content in stone was lower than that of hair. On the other hand, no difference in the concentrations of other trace elements could be found for stone patients and healthy control

Four years experience with potency sparing, continence preserving radical cystectomy for carcinoma of the bilharzial bladder

Between May 1985 and May 1989, 27 patients underwent potency sparing radical cystectomy with dissection of the neurovascular bundles as described by Walsh. The bladder was reconstructed using the ileocecal segment, and the Teniae coli were interrupted with multiple transverse incisions in order to obtain a high compliance reservoir overall. 60% of these patients were potent postoperatively. Day and night continence was achieved in 81% of the cases. Eleven patients, constituting 40% are still alive and free of tumor, after a follow-up period between 27 and 63 months. The results of the report were presented and discussed

Testosterone dependent regulation of growth and DNA synthesis in rat prostate

The prostate of the adult rat is dependent on a continuous supply of androgen to maintain its normal growth and function. In the present study it was found that the weight of the prostate was significantly reduced to 38.2% of the control weight at 7 days after castration, and reached 22.9% of the control weight after 4 weeks of castration. As early as one week after castration, the strong activity of alkaline phosphatases, normally observed, showed an apparent irregular decrease. With more advanced period, the enzyme activity continues to decrease to be apparently weak, two weeks of castration. It was found that the total prostatic DNA was reduced to 34% of the control after two weeks in castrated rats and reached 22.5% of the control after 4 weeks of castration. With commencement of testosterone treatment, the prostatic weight started to be restored, reaching 83.7% of the normal weight after two weeks of treatment. Furthermore, DNA content started to increase with testosterone treatment, reaching 93% of the control after one week and exceeded the control after two weeks. These results suggested that DNA is mostly regulated by testosterone, and hence playing an important role in the regulation of prostatic cellular proliferation