Low level laser therapy versus benzydamin in prevention and treatment of oral mucositis induced by anticancer treatments (clinical and biochemical study) / Terapia a laser de baixa intensidade versus benzidamina na prevenção e tratamento da mucosite oral induzida por terapia oncológica

Objective: In this study, patients undergoing neck and head radiotherapy (RT) with or with no chemotherapy were contrasted to the low-level laser therapy (LLLT) efficacy against benzydamine hydrochloride in treating and preventing oral mucositis (OM) (CHT). Material and Methods: This study included 90 individuals with neck and head cancer who were undergoing radiotherapy (RT) individually or in mixture with chemotherapy (CHT), varying in age from 18 to 80 years. Three equal groups were randomly formulated: Group, I patients were using oral care only, Group II patients were using benzydamine hydrochloride mouth rinse, and Group III patients were medicated by using low-level laser therapy. The National Institute of Cancer-Common Toxicity Criteria (NIC-CTC) and the World Health Organization (WHO) were used to rate the severity of OM, and the pain was validated utilizing a visual analog scale (VAS). The salivary level of tumor necrotic factor-α (TNF- α) was assayed. Results: As per WHO and NIC, the grade of oral mucositis at the end of cancer treatment was less in the LLLT group than in the other two groups. The alteration in TNF- α level was not significant. The laser group is more liable to have less salivary levels of the pro-inflammatory cytokines TNF- α . Conclusion: The incidence of oral mucositis severity has seemed to be reduced due to the prophylactic use of benzydamine hydrochloride and laser therapy protocols. However, laser therapy was more efficient in controlling the shape and progression of OM (AU)

Objetivo: Neste estudo, pacientes submetidos à radioterapia (RT) da cabeça e pescoço com ou sem quimioterapia foram avaliados quanto à eficácia da terapia com laser de baixa potência (LLLT) versus o cloridrato de benzidamina no tratamento e prevenção da mucosite oral (MO) (CHT). Material e Métodos: Este estudo incluiu 90 indivíduos com câncer de cabeça e pescoço submetidos à radioterapia (RT) individualmente ou em combinação com quimioterapia (QT), com idade variando de 18 a 80 anos. Três grupos iguais foram aleatoriamente formulados: os pacientes do Grupo I usaram apenas higiene bucal, os pacientes do Grupo II usaram bochechos com cloridrato de benzidamina e os pacientes do Grupo III foram medicados com terapia a laser de baixa intensidade. Foram utilizados os critérios do National Institute of Cancer-Common Toxicity Criteria (NIC-CTC) e da Organização Mundial da Saúde (OMS) para classificar a gravidade da OM, e a dor foi validada utilizando uma escala visual analógica (VAS). O nível salivar de fator necrótico tumoral-α (TNF-α) foi ensaiado. Resultados: De acordo com a OMS e NIC, o grau de mucosite oral ao final do tratamento do câncer foi menor no grupo LLLT do que nos outros dois grupos. A alteração no nível de TNF-α não foi significativa. O grupo com tratamento a laser apresentou menores níveis de citocinas pró-inflamatórias TNF-α na saliva. Conclusão: A gravidade da mucosite oral parece ser reduzida devido ao uso profilático de cloridrato de benzidamina e protocolos de laserterapia. No entanto, a laserterapia foi mais eficiente em controlar a forma e a progressão da MO. (AU)

Free thyroxine in early pregnancy and risk of developing gestational diabetes

Background: Pregnancy has a considerable physiological impact on the thyroid gland and its metabolic unction and to meet the increased demands during pregnancy. Thyroid disease is known to impact pregnancy outcomes, and gestational diabetes is the most common obstetric metabolic disease. Both of these conditions can cause short- and long-term harm to the mother and child, and an increasing number of scholars have therefore begun to investigate whether there is a correlation between thyroid disease and GDM

Objective: evaluation of the relations between different thyroid hormone levels in early pregnancy and the incidence of gestational diabetes mellitus [GDM]

Study design: This prospective observational cross-sectional study was conducted during the January 2018 to June 2018. The study comprised one hundred, euthyroid women with singleton pregnancy who provided early pregnancy serum samples for analyses of thyroid function. GDM was diagnosed using a 2 hours, 75-g oral glucose tolerance test, and the mothers were grouped and compared according to the results

Results: The incidence of GDM in pregnant women tended to increase with age [P< .0001]. The level of free T4 [FT4] in early pregnancy in GDM women was lower than that in non GDM women [P< .0001] also found that high maternal weight was associated with a higher GDM rate in the first trimester [P< .0001]

Conclusion: Low thyroxine levels in early pregnancy could be a risk factor for GDM development

Management of postoperative Complications after posterior lumber spinal fixation

Background: For increasing safety and reducing complications that may occur with Trans-Pedicular Scre Placement, different ways have been reported including application of C-arm X-ray view, application of axial computed tomography scan [CTS], frameless stereotactically guided screw placement and different guidance devices. However, the application of all these devices and techniques are not so easy and even in many operating rooms such kinds of instruments are not available. A posterior approach to anterior and middle column reconstruction is often preferred in the lumbar spine for two reasons, the first is that the morbidity associated with an anterior approach is significant and delays recovery, the second is that pedicle screws and rods or plates can be placed before dural retraction and dissection of the intervertebral disk

Aim of the Work: The aim of this work was to evaluate the postoperative Complications. In posterior lumber transpedicular fixation and their management

Patients and Methods: Retrospective and prospective study for evaluating the history, clinical state, laboratory investigations, radiological findings and way of management in 25 cases of postoperative Complications after posterior lumber spinal fixation

Results: 25 patients operated upon for posterior lumbar fixation were included in the present work, In the current work we divided complications of posterior lumbar fixation into intraoperative complications and postoperative complications, Among the 25 patients of our work we had 5 cases of intraoperative complications [20 %] and 20 cases of postoperative complications [80%], Dural tear was the most common intraoperative complications [8%], instrument failure was the most common postoperative complications 12 cases [48%]

Conclusion: According to medical history smoking was statistically significant risk factor for intraoperative complications; significant epidural bleeding and dural tear. Hypertension was statistically significant risk factor for intraoperative complications; inappropriate screw insertion and fracture pedicle. Also, smoking was Statistically significant risk factor for development of postoperative complications; infection, C.S.F leak, infection, nerve root injury and pseudoarthrosis

Somatic embryo-like structures of strawberry regenerated in vitro on media supplemented with 2,4-D and BAP.

Somatic embryo-like structures (SELS) were produced in vitro from leaf disk and petiole explants of two cultivars of strawberry (Fragaria × ananassa Duch) on Murashige and Skoog medium with different concentrations and combinations of 2,4‑dichlorophenoxyacetic acid (2,4-D), 6-benzylaminopurine (BAP) and sucrose to check the embryonic nature of these structures histologically. A large number of SELS could be regenerated in both cultivars on media with 2 - 4 mg L-1 2,4-D in combination with 0.5 - 1 mg L-1 BAP and 50 g L-1 sucrose. Histological examination of SELS revealed the absence of a root pole. Therefore these structures cannot be strictly classified as somatic embryos. The SELS formed under the tested culture conditions represent malformed shoot-like and leaf-like structures. The importance of these results for the propagation of strawberries via somatic embryogenesis is discussed.

Helicobacter pylori Infection and its response to treatment in diabetic Patients versus non diabetics

Background: H. pylori has been recognized as a public health problem worldwide affecting approximately 50% of the world population and more prevalent in developing than the developed countries. It is a common infection in diabetic patients

Aim of the work: The study designed to study the prevalence of H. pylori infection in diabetic patients in comparison with non diabetic patients and the response to treatment ofH. pylori in both groups

Methods: WO patients were enrolled in the study. They were classified into 2 groups: Group [I] 50 patients complaining of dyspepsia with DM, and group [2] 50 non-diabetic patients complaining of dyspepsia. Serum H.pylori IgG antibodies and stools H.pylori antigen were determined for all patients by Gen Way H. pylori IgG ELISA and OneSite H pylori rapid test respectively

Results: H. Pylori stools Ag was positive in 58% of diabetics and 40% of non diabetics with no significant difference [P value 0.085]. Serum H.pylori Ig G were significantly positive in diabetes [52%] compared to non diabetic patients [32%]; P value 0.05. HE Ale was significantly higher in diabetics positive H.pylori cases compared to diabetics negative for H.pylori. Change in the HBAlc blood level before and after H.pylori treatment was highly significant in diabetic cases [P value <0.001]

H.pylori was more resistant to treatment in diabetic patients compared to non diabetics

Conclusion: No significant difference between both diabetics and non diabetics regarding prevalence of H pylori infection. Type 2 diabetic patients showed a significantly lower eradication rate than non diabetic patients. Successful eradication of H pylori infection significant I improve HBAlc

Pseudomonas aeruginosa clonal dissemination in adult intensive care unit in Benha university hospital

To investigate the sources and spread of Pseudomonas in the Adult Intensive Care Unit [ICU], Benha University Hospital, 60 Pseudomonas aeruginosa strains were isolated from patients, staff and environmental samples and were typed using the randomly amplified polymorphic DNA [RAPD] and the enterobacterial repetitive intergenic consensus [ERIC] polymerase chain reaction [PCR] methods. Testing for extended spectrum beta lactamses and metallo-beta-lactamase [MBL] production was also performed. 50% of patient samples were positive for Pseudomonas aeruginosa. 33% of the environmental samples were positive for Pseudomonas aeruginosa Highest frequencies of Pseudomonas isolation were from Ambu bags [100%], stethoscope [100%], suction apparatus tubing [100%], water tap/sink [80%] and floor [75%]. 13% of staff hand samples were positive for Pseudomonas aeruginosa. MBL production was highest in patient strains [92%], less in environmental strains [19%] and was not detected in staff hand samples. The difference in MBL distribution between patient and environmental/stuff samples was statistically significant [P < 0.00 I]. All the Pseudomonas aeruginosa isolates were typable by both RAPD and ERIC-PCR methods. Seven RPAD patterns [RAPDI-RAPDVII] and eight ERIC patterns were obtained ERIC typing method gave higher discriminatory index [0.7955] than RAPD [0.7706], still the combination of both gave the highest discriminatory index [0.7977]. Water-tap and suction apparatus played a central role in the spread of Pseudomonas aeruginosa in the ICU. Both water-tap and suction apparatus were epidemiologically linked and both had been epidemiologically linked to patients. Water-top was molecularly linked to staff hands and artificial ventilation fluid reservoir. Suction apparatus was linked to medical trays and stethoscope. Epidemiological linkage has been also proved between patients and artificial ventilation tubing. The patient MBL-producing strains were epidemiologically linked to water tap and suction apparatus tubing

Impact of an exercise program on postoperative complications and hospital stay following lung resection

To develop and implement an exercise program for patients undergoing lung resection and to assess the impact of this exercise program on postoperative pulmonary complications and hospital stay following lung resection. 59 patients underlying lung resection were included in the study. Patients were randamly assigned to two groups 35 as controls and 24 as intervention group. All patients had preoperative assessment [including history taking physical examination, general laboratory tests, arterial blood gases, pulmonary function tests, 12-lead surface ECG and color Doppler echocardiography as well as postoperative pulmonary function tests [3 months postoperative] and hospital stay. Postoperative pulmonary complications were noted according to a precise definition. The intervention group was subjected to pre- and postoperative exercise program. The risk of PPC's associated with selected factors was evaluated. The operations performed included 13 RUL, 9RML, 13RLL, 15LUL and 9 LLL. Fifty-nine patients were studied [35 patients as control and 24 patients as intervention]. There were no differences between the 2 groups regarding age, sex, BMI, pulmonary functions tests ABG, and general laboratory results also had preoperative cardiovascular evaluation criteria that did not differ between the 2 groups. PPCs occurred in 12 patients of controls [34.3%] compared to 2 patients in intervention group [8.3%]; a difference that was highly statistically significant [p<0.001]. The hospital slay was significantly shorter in the intervention group compared to controls [p<0.001] There was no significant difference between patients with and without postoperative complications regarding results of pulmonary function tests. Exercise program developed and evaluated in this study could decrease the frequency of PPCs and shorten hospital stay. Preoperative pulmonary function tests did not contribute to the identification of high-risk patients

Reactions of patients and psychiatric hospital staff about physical restraint

The use of physical restraint in a variety of health care settings, has received increased attention in recent years. Restraint when used properly, can be a lift saving and an injury sparing measure. However, it has a potential for abuse if used improperly. The responsibility of ordering restraint is that of the physician, and his opinion and experience toward restraint is one of the significant factors affecting the frequency with which this intervention is used. Nurses are often on the front line, interacting with patients who may be violent or who display disruptive behavior, and they may choose to use restraint as an intervention. Front the patients' perspective, restraint can be understood as a form of assault, humiliation and detention. The controversy over how helpful physical restraint is to the patients continues to be an issue in psychiatric settings. This highlights the need and importance of systematic and comprehensive research of patients and staff experience about restraint. The main results yielded by the study proved that, concerning the patients' feelings during restraint, humiliation and worthlessness are the most common feelings experienced by 38.75% of the patients, followed by rage and resentment [25.00%], sadness and despair as well as injustice were experienced equally by the patients [18.75%], feeling guilty was mentioned by 11.25% of the studied subjects; and 3.75% said that they calmed down

Intra-articular fractures of the calcaneus: results of the open reduction and internal fixation with angle fixed calcaneus plate

Between January 2001 and May 2004, 25 patients with 36 intra-articular fractures of the calcaneus were treated using a standard protocol of open reduction and angle fixed calcaneus plate fixation. All patients with displaced intraarticular fractures were treated surgically. Only those with undisplaced fractures, extra articular fractures, and fractures more than four weeks old and the severely comminuted fractures were treated conservatively. The mean period of follow-up was 26 months [range; 18 to 34], their clinical and radiological results were analyzed. Clinical results were satisfactory [excellent, and good] in 22 patients [88%], and radiological results were excellent in 14 fractures [38.4%], good in 20 fractures [55.6%], superficial infection and wound healing problems was in 3 patients [8.3%]. Analysis of the clinical and radiological results showed that open reduction and internal fixation of displaced intraarticular fractures Sanders type-II, and type-III os. calcis with angle fixed calcaneus plate is suitable and reliable type of fixation

MRI diagnostic value in pregnant patients with acute abdominal and pelvic pain

The use of ultrasonography during pregnancy provides a tremendous amount of valuable information about fetal and maternal well-being. However, in some cases the image quality may be poor. Excellent soft-tissue contrast resolution and multiplanar imaging capability, in combination with lack of ionizing radiation, make magnetic resonance imaging a promising modality for use in pregnant women. The purpose of this study was to show the usefulness of magnetic resonance imaging in the evalluation of pregnant women with acute abdominal or pelvic pain. in Alyamamah Maternity Hospital and Hammadi General Hospital. prospective observational study. 25 pregnant patients were referred for magnetic resonance imaging examination because of acute abdominal or pelvic pain with insufficient ultrasonographic findings between September 2003 and August 2005. Multiplanar multisequence magnetic resonance imaging of the abdomen and pelvis were obtained in each patient. The magnetic resonance imaging interpretations were compared with follow-up medical, surgical and obstetric final diagnosis to determine the correctness of the interpretation. Correlation of magnetic resonance imaging interpretations with final diagnosis showed correct identification of disease entities in all but one patient with acute appendicitis, falsely diagnosed by magnetic resonance imaging as normal findings. Magnetic resonance imaging showed an accuracy rate of 96% in diagnosing acute abdominal and/or pelvic pain in pregnant women with unclear ultrasound diagnosis. The Specificity and positive predictive value were 100% but sensitivity was 94.7% and negative predictive value was 85.7 Abdominal and pelvic diseases in pregnant patients can be well evaluated by magnetic resonance imaging, when it is an available modality. It can provide important information that may influence a patient's treatment options, which range from operating emergently to delaying treatment until after delivery. Magnetic resonance imaging should be reserved for cases in which results of ultrasonography are inconclusive and patient care depends on further imaging.

Clinical, sonographic and doppler flow effects of levonorgestrel releasing intrauterine system in menorrhagic women

Menorrhgia is one of the commonest gynecological problems, yet medical treatment has been disappointing. Levonorgestrel released from an intrauterine system suppresses endometrial growth and causes marked reduction of menstrual loss menorrhagic women. To study the mechanism by which Levonorgestrel releasing intrauterine system, [Mirena, Schering], can control menorrthagia by evaluating its effect on blood flow in the uterine and subendometrial region, and endometrial thickness using color Doppler. Setting: in Alyamamah Maternity Hospital and Hammadi specialized Hospital. Design: prospective observational study. Patients and thirty two patients were included in this study complaining of menorrhagia. Levonorgesttrel releasing intrauterine system, [Mirena, Schering], was inserted. Menstrual blood loss was measured using the pictorial blood loss assessment chart, pulsatility index of uterine artery, subendometrial blood flow and endometrial thickness were measured before and six months after insertion. Levonorgestrel releasing intrauterine system reduced menstrual blood loss. There was no significant difference in pulsatility index of uterine artery before and after insertion, but, there was highly significant reduction in the blood flow in the subendomentrial region. Also, there was highly significant reduction in the endometrial thickness. Through its local effect on endometrium, Levonorgestrel releasing intrauterine device a good option for treatment of menorrhagia so, it is advisable before resorting to any invasive surgical maneuver

Repair of hallux valgus with a distal-soft-tissue procedure and proximal metatarsal osteotomy

The aim of this study was to evaluate of the results of the treatment of the Hallux Valgus deformity by first metatarsal osteotomy and distal soft tissue release. Twenty-four patients [14 female patients, and 10 males] with 34 symptomatic Hallux Valgus feet were studied [21 feet for females and 13 feet for males] who ranged in age from 22 to 56 years [mean: 39 years]. Average follow-up was 33 months [30 months to 45 months]. The patients in the present study were managed by release of the distal soft tissues, including the lateral capsule of the first MLP joint, and the lateral collateral ligament and release of the tendon of the adductor hallucis from the proximal phalanx, excision of the medial eminence, plication of the medial capsule, and the tendon transfer of the abductor hallucis more distally to the proximal phalanx, and a proximal wedge osteotomy of the first metatarsus. After correction crossing two Kirschner wires were applied fixing the osteotomy site. Clinical and radiological results were evaluated, comparing the preoperative and postoperative findings. The preoperative hallux valgus angle averaged 36 +/- 4.6 degree, and the postoperative angle averaged 15.2 +/- 3.6 degree. The preoperative intermetarsal angle averaged 22.4 +/- 4.3 degree, and the postoperative angle averaged 9.7 +/- 3.5 degree. No significant shortening of the first metatarsus relative to the second metatarsus postoperatively. Bone union was completed within three months in all cases. No significant difference was found between preoperative and postoperative range of motion of the first MTP joint. Lateral displacement of the sesamoids was not improved postoperatively. The complications included sensory disturbance in the medial portion of the great toe and the foot in two feet. Avascular necrosis of the metatarsal head was not encountered. Eighty-six percent of the patients were satisfied with the result of the procedure. Our clinical and radiological results concluded that the distal soft tissue release; including abductor hallucis tendon transfer to the proximal phalanx, the proximal, close wedge osteotomy of the first metatarsal and fixation of the osteotomy with Kirschner wires could be sufficient to obtain a satisfactoiy outcome for the correction of the hallux valgus deformity

Patellar pain after total knee arthroplasty comparison of the results of total knee arthroplasty with and without resurfacing of the patella

This study included 43 patients with 56 knees in whom the patella was not severely deformed and whom had primary total knee arthroplasty [TKA] for osteoarthritis of the knee, the operation was done by the same team of surgeons using; one type of prothesis [PFC]. The study and follow-up of the patients was done through years 2000-2004, at Barah a Hospital UAR. The patients were randomly allocated either to have the patella retained [36 knees] or resurfaced with a cemented, all polyethelyne component regardless of the state of the patellar articular cartilage [20 knees]. Apart from removal of osteophytes, patelloplasty was done on the retained patellae. The aim of the study was to compare the clinical results with total knee arthroplasty with patellar resurfacing and those after total knee arthroplasty with retension of the patella. The patients were followed for 3 years [mean, 38 months], and the postoperative status of the patients was evaluated with use of the clinical scoring system of the knee society, a patient satisfaction questionnaire, specific questions regarding patello-femoral symptoms and function, and radiograph findings. Preoperatively, the mean Knee Society Score, on a scale ranging from 0 to 100 points, was a mean of 47.6 [range, 45.0 to 49.7 points]; postoperatively, this score improved to a mean of 81.6 points [range, 56.6-93.9 points]. With the number available for the study we could detect a significant difference between the knees that had patellar resurfacing with the mean of 91.6 points [range, 89.5 to 93.9 points]; and those without with the mean of 70.7 points [range, 56.1 to 65.7 points]. Eight [22.2%] of the 36 knees with retained patella had anterior knee pain compared with 1 knee [5%] of the 20 knees with resurfaced patella; this was a significant difference [P<0.05]. The findings suggest that, in order to diminish pain on the patellofemoral joint, replacement of the patella during total arthroplasty is preferable

Ankle fractures in diabetic complications of open reduction and internal fixation

Diabetes Mellitus is considered an indicator of poor prognosis of acute ankle fractures, to determine the relative risk of complications in treating ankle fractures in patients with diabetes, we compared the results of the management of displaced bimalleolar and trimalleolar fractures in 24 patients with those of a matched group of 22 non-diabetic patients. Patients were individually matched by age, gender and fracture type. Diabetic patients had complications at higher rates [14 patients; 58.3%] than non-diabetic patients [2 patients; 9.0%] [P= 0.001]. An increase risk of complications in diabetic patients with the duration of the diabetes mellitus more than 5 years [10 patients; 71.4%] [P = 0.001] and the increase risk of complications in diabetic patients was related to trimaleolar fracture type [10 patients; 76.1%] [P = 0.001]

U vular double opposing z- plasty: a new method of cleft palate repair

In this prospective study, a new technique in the repair of cleft palate utilizing the uvular tissue to lengthen the palate was done. This technique was done not only to achieve the anatomical repair of the palate, but also to determine the improvement of speech outcome as measured objectively by a speech pathologist. In the uvular transposition procedure, the palate was lengthened with tissue from the uvular by a double-opposing Z-plasty, an intravelar veloplasty was performed and most of the uvular mass, about 2/3, was transposed to the nasal surface of the soft palate. The study was carried out at the Pediatric Surgery Unit, Faculty of Medicine, Al-Azhar University from January 1999 to December 2002 to evaluate the speech outcome by using the uvular double opposing Z-plasty in the repair of cleft palate. Forty children, aging from 1-2 years old, with a complete cleft palate were treated by this procedure. Then, the children were enrolled for follow up programming and blindly evaluated every six months. Perceptual nasal emission was found to be normal in 38 of the 40 children. Nasometry was performed in all 40 children. Only one child of these patients required pharyngeal flap for velopharyngeal dysfunction. Also, one child was improved by training at the Phonetic Unit by a specialist, where no more surgery was done

Some immunological studies in allergic rhinitis in children

Allergic rhinitis [AR] is a common disease in children. Eosinophils play an important role in the pathogenesis of allergic rhinitis by releasing toxic granule proteins which are directly involved in the late phase of allergic inflammation. For underst and ing the role of eosinophils in the pathogenesis of allergic rhinitis, the serum level of eosinophil cationic protein [ECP] was measured in children with AR. Blood eosinophilia and serum total IgE level were also evaluated in these patients. The study involved 50 children with AR and 22 normal children as control group. AR was diagnosed by history, skin tests and RAST. Blood sample was taken from each subject, absolute eosinophil count was done and serum used for measuring total IgE and ECP levels by monoclonal antibody based fluorometric assay. Allergen specific IgE antibody was measured by quantitative radioallergosorbent test [RAST] Serum ECP levels in the patient groups were significantly higher than those in the control group [P < 0.01]. All the patient groups studied showed significant high levels of serum total IgE [P<0.001] and total eosinophil count [P<0.01] compared with control group. The increased. level of ECP in patients with AR reflects eosinophil activation and this indicates the role of eosinophil degradation in the pathogenesis of allergic rhinitis. This result may help in developing pharmacological agents that can inhibit migration and /or degradation of eosinophils and hence control of the disease

Manegment of spontaneous intracerebellar haematomas

The term spontaneous intracerebellar hematomas means bleeding into cerebellar parenchyma without trauma. Cerebellar hemorrhage represents 10% of all spontaneous cerebral hemorrhage. Twenty patients with spontaneous intracerebellar hemorrhage were the material of this study to evaluate the outcome of both surgical and medical treatment modalities. Patient were divided into two groups according to the general condition of the patients and [the Hunt and Hess scale] and GCS for the level of consciousness, the first group contains five patients were treated conservatively, and the other fifteen patients were operated upon through a sub occipital craniectomy; and ventricular drainage. After resuscitation all cases were examined clinically after taking the history briefly, complete radiological investigations [CT brain scan MRI and MRA]. Evaluation of pathological causes, risk factors, clinical presentations, radiological findings, different management decisions and discussing factors affecting its outcome. Spontaneous intra cerebellar hemorrhage is a common neurosurgical emergency occurring with no much differences in both sexes; Uncontrolled systemic arterial hypertension, diabetes mellitus, and smoking were the commonest risk factors. Altered consciousnesses, acute sever headache, cerebellar manifestations, brainstem, manifestations, and hemiplegia was the commonest clinical findings. Intraventricular hemorrhage extension, hydrocephalic changes and obliteration of the quadrigeminal cistern were poor prognostic signs. The early the detection and management the best the outcome is. In case of large and rapid progressive increase in size of the IC hematoma needs rapid emergent surgical evacuation, and CSF drainage [in case of hydrocephalic changes]. should be on emergency bases too. The factors influencing the neurosurgical outcome in cases of spontaneous intra cerebellar hemorrhage are: The age of the patient and his general condition on admission.The early suspect and detection to save time avoiding deterioration of consciousness and neurological status. The state of consciousness at time of presentation and preoperatively that the patients with GCS 8 had a worse outcome. *The radiological findings the larger sized hematoma, the hydrocephalic changes. and obliteration of the quadrigeminal cistern the worse the prognosis, and are indicators for rapid surgical evacuating of the hematoma, and /or ventricular drainage. The more stable clinical course the best the results is. Rapid deterioration of the conscious level show bad diagnosis

clinical utility of serum lipids in early pregnancy and risk of pre-eclampsia

This study was carried out on 393 women to evaluate the clinical utility of the measurements of serum lipids in the first and late second trimester of pregnancy and the risk of development of preeclampsia in a prospectively followed group of healthy pregnant women aged 36 years and older. Criteria for eligibility were diastolic blood pressure at recruitment below 85 mmHg, no history of cardiovascular disease or diabetes, a viable singleton pregnancy not beyond 11 weeks and maternal age 36 years or older at 20 weeks of gestation. Serum total cholesterol and high density lipoprotein cholesterol were measured by an automated enzymatic method. Uterine artery flow velocity waveforms were recorded using continuous Doppler ultrasound. Pregnancy outcome was also assessed. In conclusion, the data suggested a relation between serum lipids in early pregnancy and the development of preeclampsia

Different gynecological and endometrial pathologies in post menopausal breast cancer patients treated with tamoxifen

In the present study, the histopathological conditions diagnosed in endometrium, myometrium and ovaries of 28 postmenopausal breast cancer patients treated with tamoxifen [study group] were assessed and their findings were compared with those obtained from 14 similar patients without tamoxifen treatment [control group I] and 28 age-matched healthy postmenopausal controls [control group II]. The results obtained suggested that there might be an association between the postmenopausal tamoxifen exposure and the development of different coexisting or specific single gynecological pathologies originating from the endometrium