Fetal head circumference as a Predictor of successful spontaneous vaginal delivery

Background: intrapartum head circumference is an integral part of sonographic models and important for the purpose of fetal weight estimation as well as in cases which abnormal fetal head growth is suspected, it is considered the interface between maternal pelvis and fetus

Aim: this study aims to assess the accuracy of fetal head circumference compared to expected fetal weight as a predictor of spontaneous vaginal delivery

Methods: a prospective observational study was conducted on 996 women in active stage of labor admitted to Labor ward of Ain Shams University Maternity Hospital and Labor ward in Manshiet El Bakry general hospital

Results large head circumference [odds ratio, 2.8; 95% CI, 1.37-5.73; p-value; .005 was independent predictors for cesarean delivery, and no significant difference on mode of delivery between different expected fetal weight

Conclusion: a large head circumference is more strongly associated with unplanned caesarian section than high expected fetal weight

Role of fexible ureterorenoscopy in the management of lateralizing essential haematuria

Objective: To evaluate the role of flexible ureterorenoscopy in diagnosis and treatment of lateralizing essential haematuria. Patients and Methods: Twenty-three patients suffering from unilateral haematuria were included in the study and underwent flexible ureterorenoscopy. Their age ranged from 17 to 68 years (mean age: 36 years). Unilateral gross haematuria was demonstrated cystoscopically. The patients were subjected to a careful history taking; full laboratory and radiological investigations. However; we failed to localize the cause of haematuria in the patients included in the study. This necessitated flexible ureterorenoscopy on the affected ureterorenal unit. Results: The collecting system was inspected in 21/23 patients. Discrete lesions were identified in 11 patients (haemangioma on a renal papilla in six; small vascular lesions in three; a small calculus in one and a small papillary growth in one). Non-specific abnormalities (erythema of the infundibulumor abnormal configuration in the renal papilla) were found in six patients. No lesion was detected in 4 patients. Patients with non-specific abnormalities were biopsied and coagulated. The remaining 11 patients with discrete lesions underwent laser fragmentation of the calculus; nephroureterectomy for the papillary transitional cell carcinoma (TCC) and 9 patients underwent fulguration with or without biopsies. The haematuria resolved in all patients with discrete lesions. Patients with non-specific abnormalities had a poor outcome in our series; since all had recurrent or persistent bleeding. Follow-up ranged from 6-18 months (mean 9 months). Conclusion: Flexible ureterorenoscopy can be of value in the diagnosis and treatment of lateralizing haematuria. Patients with discrete lesions respond well to endoscopic treatment (electrocoagulation)

Corporoplasty with saphenous vein graft in the surgical management of peyronie's Disease

Objectives The aim of this study is to evaluate the use of the saphenous vein in grafting the tunica albuginea defect after excision/incision of Peyronie's plaque in cases of disabling penile deformity. Patients and Methods A total of 12 patients with significant penile curvature due to Peyronie's disease interfering with their sexual activity were subjected to plaque excision/ incision and corporoplasty by saphenous vein patch grafting of the tunica albuginea. Results Penile straightening was achieved in 9 patients. One patient had a minimal residual curvature with induration at the graft site which; however; did not interfere with his sexual activity. Two patients complained of less rigid erections and are currently responding to oral measures and ICI. Penile numbness occurred in four patients with dorsal plaques; and it was self limiting within six months. We encountered no complaint of penile shortening or impotence. Conclusion The saphenous vein presents a reasonable alternative grafting material for the repair of tunica albuginea defects in patients with Peyronie's disease after plaque excision/incision. It is particularly useful in large plaque remnants and yields a satisfactory and appreciable outcome

Can external carotid endarterectomy and stumpectomy prevent neurological detertoration in patients with internal carotid occlusion

Eighteen patients with symptomatic carotid artery occlusion were divided into two groups: A and B each containing nine patients. There were thirteen males and five females, with an age range from 51 to 69 years. The presenting symptoms' were TIA with or without previous CVA in 13 patients, amarousis fugax in 3 and stroke in 2 patients. All patients were subjected to thourough history taking and clinical examination, laboratory study, duplex study and brain CT scan. MRI performed for 12 patients. Group A patients underwent surgical treatment, while group B patients were treated medically. The type of surgery was proximal pouch angioplasty stumpectomy in 3 patients, external carotid endarterectomy in 2 patients' and both in 4 patients. Medical treatment included oral anticagulation with warfarin to achieve a prothrombin concentration around 30%. The patients were followed for at least 12 months after surgery or oral anti-coagulation, and up to 5 pears. In group A [the surgically treated group,] no mortalities' were reported, I mild stroke occurred and 2 patients experienced TIAs. In group B [the medically treated group] 1 patient died following a major stroke, another patient had a recurrent stroke and 2 patients' had TIAs. Analysis of the clinical data showed that surgical treatment decreased the risks' of recurrent strokes and TIAs more than medical treatment, The results of the study strongly recommend that symptomatic patients' with total internal carotid occlusion should be treated surgically

Proposed solution for correcting discrepancy of maxillary acrylic denture bases

Two groups of dentures were constructed on 20 identical upper casts. The modified dentures were constructed by attaching four molars, two on each side of the buccal flange of the waxed up dentures, at the tuberosity and the first molar areas. After denture processing, the created spaces between the denture bases and their casts of the conventional and modified groups, were measured and statistically analyzed

Effect of occlusion pattern on masticatory efficiency

To study the effect of occlusion pattern on masticatory efficiency, 10 edentulous subjects were selected. Upper and lower complete dentures were constructed with protrusive balancing ramps to establish protrusive balance. Masticatory efficiency was tested by chewing hard and soft type of foods. The time needed to masticate both types of food was recorded. The balancing ramps were ground and masticatory efficiency was tested again. The recorded time values were calculated and statistically analyzed

Effect of increasing weight of lower complete denture on physiologic rest position of the mandible

To study the effect of increasing weight of the lower denture on the physiologic rest position of the m and ible, 30 complete denture wearers complaining of instability of their lower dentures were selected. The physiologic rest position was recorded and the weight of the lower denture was increased 50% for one week and the rest position was recorded. After one week, the weight was increased 100% of its original weight and the physiologic rest position was recorded. The collected data were tabulated and statistically analyzed

Suporte nutricional em pacientes hospitalizados: experiencia de um ano. / Nutritional support in hospitalized patients: experience of 1 year

A equipe de nutricao clinica da Escola Paulista de Medicina (EPM) atende aos pedidos de interconsulta das diversas enfermarias do Hospital Sao Paulo que estao sob a responsabilidade de diferentes disciplinas da EPM. De outubro de 1982 a outubro de 1983, a equipe avaliou o estado nutricional e indicou a conduta de suporte nutricional em 89 doentes. Quando a alimentacao enteral foi a indicada, a dieta formulada foi adaptada a cada caso,segundo as necessidades energeticas e, quando necessario, com restricoes de nutrientes, tais como proteina, sodio e agua. A prevalencia de desnutricao proteico-calorica foi de 68%. A nutricao enteral foi indicada em 80 pacientes, sendo instalada em 57 dos quais 24 receberam-na, durante a hospitalizacao, por tempo medio de 32 dias e 4 receberam-na no hospital e, depois da alta, em seus domicilios, por tempo medio de 46 dias.Esses pacientes mostraram melhora do estado nutricional e nao apresentaram complicacoes decorrentes da terapeutica nutricional aplicada