Vitamin B12 status among pregnant women and Its association with obesity and gestational diabetes

Background: pregnant women in resource-poor areas are at risk of multiple micronutrient deficiencies, and diets that are low in animal products place women at increased risk of vitamin B12 deficiency. Aim of the Work: to investigate the vitamin B12 status of pregnant women in Egypt and its relationship with obesity and gestational diabetes mellitus (GDM). Patients and Methods: this clinical observational prospective study has been conducted at Bab Al-Shaaria University Hospital Obstetrics and Gynecological Department from April 2018 to January 2019. To assess vitamin B12 status among pregnant woman and its association with obesity and gestational diabetes. 80 pregnant women attended to out-patient clinic were included in the study. The evaluation included data collection through: history taking, examination, anthropometric measurement, maternal blood vitamin B12 level estimation at second and third trimester and blood glucose level. Results: vitamin B12 deficiency in pregnancy is common particularly in obese women and those with GDM. Conclusion: vitamin B12 deficiency is silent and common in general population. Causes of vitamin B12 deficiencies are multifactorial and associated with many health problems. Also, obesity is common and its prevalence is increasing in the world. Therefore, both health problems have gained importance in family medicine practice in the last decades

Pathogenetics. an introductory review

Pathogenetics refers to studying the different aspects of initiation/development/progression and pathogenesis of genetic defects. It comprises the study of mutagens or factors capable of affecting the structural integrity of the genetic material leading to mutational changes that, in the majority of cases, result in harmful effects due to the resulting disturbances of functions of mutated components of the genome. The study of mutagens depicts different types of mutagenic factors, their nature, their classification according to their effects on the genetic material and their different modes of action. The study of mutation involves different types of mutations classified according to various parameters, e.g. magnitude, severity, target of mutational event as well as its nature, which can be classified, in turn, according to whether it is spontaneous or induced, static or dynamic, somatic or germinal mutation etc. Finally, pathogenetics comprises studying and delineating the different and innumerable pathophysiological alterations and pathogenetic mechanisms that are directly and indirectly involved in, and leading to, the development of genetic disorders, coupled with a parallel study of various anti-mutation mechanisms that play critical roles in minimizing the drastic effects of mutational events on the genetic material and in effective protection against the development of these diseases

Formal genetic maps

Formal genetic maps are databases, represented as text or graphic figures, that can be collected/organized/formulated and constructed for nearly any, and every, structural or functional region of the genetic material. Though these maps are basically descriptive, their analysis can provide relevant crucial data that can be applied for different purposes in many fields. The more comprehensive these maps are the more significant information that can be provided through their analysis. Formal genetic maps comprise four main categories: physical maps detailing the structural characteristics of different regions/sequences of both the nuclear and the mitochondrial genomes, functional maps describing the varied functional potentials of the different components of the gen-ome/transcriptome/proteome, experimental induced maps that are intentionally designed and constructed for specific purposes and constructed maps that are deduced and extracted from other formal maps to serve particular targets that cannot be achieved solely by the constituent maps. Formal genetic maps have a wide spectrum of applications in all fields of human genetics including basic genetics as well as medical genetics. The beneficial impact of the different types of formal genetic maps imposed their application in nearly all fields of medical genetics including basic/clinical/diagnostic/therapeutic/prophylactic and applied genetics and made these maps indispensable tools in research studies relevant to these fields

Cancer: Some genetic considerations

Malignant transformation of normal cells to cancer cells represents an enigmatic phenomenon because of the many ambiguous controversies embodied within most of its aspects. Within a clinical context, cancer, with very few exceptions, is a dreadful disease that ends lethally. Within a biological context, however, cancer is a peculiar biosystem that has its own rules that regulate the actions/interactions/structure and behavior of its components. Unfortunately, the majority of these rules are, still, unknown. The current disappointing situation as regards research trials aiming at constructing effective treatments for cancer might be attributed, in part, to incomplete recognition of the significant differences between these two contexts of malignant transformation. Although the peculiar characteristics of cancer as a self-dependent biosystem are well studied and well defined, the basic dilemma of malignant transformation continues to exist: we know, largely, how things happen but we do not know, to any extent, why they happen. Though the logic that motivates researches aiming at formulating genetic therapies for cancer is quite reasonable, as cancer is primarily a genetic alteration, lack of essential basic knowledge regarding the different aspects of this alteration adjourn successful radical cure of cancer. Till comprehensive disclosure of the underlying mechanisms regulating growth/progression/metastasis and survival of malignant cells is attained, treatments of cancer based on different strategic concepts, viz. proteomic therapies rather than genetic therapies, might, hopefully, be the best approaches available in the fight against cancer in the current as well as in the coming era

Sand-Fly Phlebotomus Papatasi [Phlebotominae]: a general review with special reference to Zoonotic Cutaneous Leishmaniasis in Egypt

Leishmania are digenetic protozoa which inhabit two hosts, the sandfly where they grow as promastigotes in the gut, and the mammalian macrophage where they grow as amastigotes Sandfly [or sand fly] is a colloquial name for any species or genus of flying, biting, blood- sucking Dipteran encountered in sandy areas. In the United States, sandfly may refer to certain horse flies that are also known as "greenheads" [family Tabanidae], or to members of the family Ceratopogonidae, also known in Florida and elsewhere as a sand gnat, sandflea, no-see-um [no-see-em, noseeum], granny nipper, chitra, punkie, or punky. Outside the United States, sandfly may refer to members of the subfamily Phlebotominae within the Psychodidae. Biting midges [Ceratopogonidae] are sometimes called sand flies or no-see-ums [no-see-em, noseeum]. New Zealand sandflies are in the Austrosimulium genus, a type of black fly. Of 500 known phlebotomine species, only some 30 of them have been positively identified as vectors of the disease. Cutaneous leishmaniasis [ZCL] is a protozoan disease well documented not only in Egypt, but in nearly all the East Mediterranean Countries. It is prevalent in the Egyptian Sinai Peninsula with at least three identified foci

Biological evolution: Some genetic considerations

The concept of biological evolution has long been accepted as a palatable theory aiming at explaining how life began and how creatures diverged so widely along the life span of the earth. Meticulous analysis and criticism of the different postulations of this concept, however, reveals that evolution is an illogic concept based on theoretical hypotheses that can never be tested. Creation, on the other hand, represents the other side of the coin, and up till now debates confronting creation versus evolution are still occupying much interest of atheist as well as of believer biologists. The motive for accepting the concept of evolution by most biologists, stems solely from their atheism and their saying that creation can neither be experimented nor validated, the same criticism directed against their assumptions regarding the basic aspects of evolution. This article, through analysis, criticism and reevaluation of some relevant genetic considerations that have long been traditionally considered as observations in support of the concept of evolution, viz. genetic memory and evolutionary variations, genomic adaptations to stress and evolution, comparative genomics and natural versus targeted selection, tries to elucidate and reveal some insensible assumptions embodied within the core ideas of evolution that stand in direct controversy with many well-known facts regarding the structure, function and behavior of living matter. Natural selection might be observed in nature but not in life. The concept of biological evolution is an illogic and insensible hypothesis since it stands in direct contradiction with our current knowledge regarding the behavior as well as the structural and functional characteristics of the human genome and human proteome. Additionally, almost all basic postulations of this concept can neither be tested nor imitated for experimentation, which is a prerequisite for acceptance and validation of any scientific hypotheses

Pancreatic pseudocyst or a cystic tumor of the pancreas? / 癌症

Pancreatic pseudocysts are the most common cystic lesions of the pancreas and may complicate acute pancreatitis, chronic pancreatitis, or pancreatic trauma. While the majority of acute pseudocysts resolve spontaneously, few may require drainage. On the other hand, pancreatic cystic tumors, which usually require extirpation, may disguise as pseudocysts. Hence, the distinction between the two entities is crucial for a successful outcome. We conducted this study to highlight the fundamental differences between pancreatic pseudocysts and cystic tumors so that relevant management plans can be devised. We reviewed the data of patients with pancreatic cystic lesions that underwent intervention between June 2007 and December 2010 in our hospital. We identified 9 patients (5 males and 4 females) with a median age of 40 years (range, 30-70 years). Five patients had pseudocysts, 2 had cystic tumors, and 2 had diseases of undetermined pathology. Pancreatic pseudocysts were treated by pseudocystogastrostomy in 2 cases and percutaneous drainage in 3 cases. One case recurred after percutaneous drainage and required pseudocystogastrostomy. The true pancreatic cysts were serous cystadenoma, which was treated by distal pancreatectomy, and mucinous cystadenocarcinoma, which was initially treated by drainage, like a pseudocyst, and then by distal pancreatectomy when its true nature was revealed. We conclude that every effort should be exerted to distinguish between pancreatic pseudocysts and cystic tumors of the pancreas to avoid the serious misjudgement of draining rather than extirpating a pancreatic cystic tumor. Additionally, percutaneous drainage of a pancreatic pseudocyst is a useful adjunct that may substitute for surgical drainage.

Life quality after video-assisted thoracoscopic thoracic sympathetic chain clipping for patients with isolated primary palmar hyperhidrosis

Video-assisted thoracic sympathectomy [VATs] is the most frequently used procedure in the treatment of primary hyperhidrosis. The objective of the present study was to assess the life quality of patients before and after VATs clipping using a specific questionnaire. Between February 2009 and September 2012, 45 patients with primary palmar hyperhidrosis admitted to King Abdulaziz University Hospital were administered a disease-specific questionnaire preoperatively and 6 months after VATs clipping of the third and fourth sympathetic chain thoracic segment [T3, 4] under general anesthesia. The mean age of the patients was 27.8 years [range 19-35]. Thirty [66.67%] patients were female, with a mean age of 27 years [range 19-35]. Fifteen [33.33%] patients were male, with a mean age of 29.3 years [range 25-34]. Six [13.33%] patients were obese and consisted of one [2.22%] male and five [11.11%] female patients. All patients were discharged on the second day, except for one who had pneumothorax [fifth day]. There was another patient with pneumothorax [2.22%], two patients with VATs port infection [4.44%], and 17 patients with compensatory hyperhidrosis [37.78%]. All domains of the specific questionnaire reported a statistically significant improvement in each domain separately [P<0.001] and in the total test score [P<0.001]. Preoperatively, 15 [33.33%] patients were in very poor [VP] health and 30 [66.67%] were in poor [P] health. Postoperatively, the condition of 17 [37.8%] patients improved considerably [of whom 12 were VP and five were P] and that of 28 [62.2%] improved but to a less extent [three were VP and 25 were P]. VATs is a straightforward, effectual, safe, and sound method for relieving the symptoms of primary palmar hyperhidrosis and improving the quality of life

Transabdominal preperitoneal laparoscopic inguinal hernia repair

To determine the outcome of transabdominal preperitoneal [TAPP] inguinal hernia repair. Descriptive study. At Surgical C Unit, Khyber Teaching Hospital Peshawar, from April 2010 to June 2011. A total of 88 patients, aged between 16-60 year were included in the study and subjected to transabdominal preperitoneal inguinal hernia repair. The outcome measures such as operative time, length of hospital stay and postoperative complications were analyzed. The mean age of patients was 38.64 +/- 9.04 year. The mean operative time was 60.13 +/- 14.76 minutes. The mean hospital stay was 1.45 +/- 0.72 days. The postoperative complications were urinary retention [n=1 - 1.1%], wound hematoma [n=1 - 1.1%], surgical site infection [n=2 - 2.2%] and recurrence of hernia [n=1 - 1.1%]. Transabdominal preperitoneal inguinal hernia repair is associated with minimal complications but requires a long learning curve

One-year audit of breast clinic at abbasi shaheed hospital, Karachi

The British Association of Surgical Oncology [BASO] has set standards for services provision and provides an audit program for the breast clinics. This study is an audit based on retrospective data to examine and report the one-year performance of Breast clinic at Abbasi Shaheed Hospital, Karachi. Between October 2009 and September 2010,615 new and 1158 follow up in a total of 1773 patients visited Breast clinic for their breast symptoms. A specially designed Performa for breast diseases was filled on the first visit of all patients, which included each patient's detailed history, physical examination, investigations and diagnosis. Each Performa was reviewed for audit. The total number of patients visited Breast clinic at Abbasi Shaheed hospital was 1773 including 615 new and 1158 were follow-up cases.Majority of them were between 16 to 50 years of age group. There were 348 [56.58%] patients with breast lump out of which 300 [48.78%] turned out to be benign on further investigation and 48 [07.80%] were malignant. Breast pain was the presenting complaint in 144 [23.41%] patients while 33 [05.36%] patients presented with nipple discharge, 54 [08.78%] with breast abscess, 15 [02.43%] had atrophy breast, 06 [0.97%] had hy-pertrophied breast, 09 [01.46%] were with asymmetry of breast and 06 [0.97%] with eczema of nipples. The audit showed that 03 out of 07 performances based standard, according to British Association of Surgical oncology [BASO] were not met satisfactorily. It is concluded that multidisciplinary breast clinic in public hospital provides better services to the symptomatic breast patients on their first visit

Endovenous laser therapy for great saphenous vein reflux and its preliminary results

This study was conducted to describe the feasibility and short-term outcome of patients with varicose great saphenous vein [GSV] using Endovenous laser therapy [EVLA]. Between June 2010 and April 2011 EVLT is performed to 25 patients treated for varicose veins with saphenous reflux who were admitted in King Abdul Aziz university hospital consisting of 6 women and 19 men with an age ranging from 21 to 54 years [median 36 years]. In total, 31 great saphenous veins were treated by Endovenous laser therapy. Tumescent anesthesia was given before the ablation procedure. All patients were advised to return for the first follow-up after 3 weeks and to be visited earlier in the clinic if complications ensued. Patients were followed up with Doppler ultrasonography and clinic assessment at the first to third week and the first to third month after operation. All patients attended for post procedural duplex examination and clinical follow-ups. Twenty three patients [29 limbs] returned for 3-weeks follow-up. The GSV was occluded in 27 [93.1%] limbs at 3 weeks, at 3 months, 17 [19 limbs] patients continued the DUS follow-up. The recurrence of varicose GSV was not seen in 18 [94.7%] limbs. EVLA appears to be a very effective and safe option in the treatment of varicose GSV. It can be performed under local anesthesia, after EVLA treatment, patients can immediately return to their daily life activities with the improved aesthetic outcome, especially among women

Stem cells .. basics and applications

Stem cells are cells that divide to form one daughter cell that goes on to differentiate, and one daughter cell that retains its stem-cell properties. All stem cells regardless of their source have three general properties: they are unspecialized, they are capable of dividing and renewing themselves for long periods, and under certain physiologic or experimental conditions, they can be induced to become cells with special functions, i.e. they can give rise to specialized cell types. Importance of stem cells Sources of stem cells Prospects of stem cells Spectrum of stem cell research Stem Cells in Early Development Biological Characteristics Of Stem Cells Using Stem Cells for Human Therapy Practical Aspects of Embryonic Stem Cell Research Adult Stem Cells The Potential Uses Of Human Stem Cells The Production Of Human Embryonic Stem Cells By Somatic Cell Nuclear Transfer L Chromatin Decondensation and Nuclear Reprogramming by Nucleoplasmin