randomized controlled trial comparing the use of prolene suture and nylon tape in modified Shirodkar operation: a clinical-microbiological study

A short cervix during pregnancy offers less resistance to ascending infection, which is related to the occurrence of preterm birth, preterm premature rupture of the membranes, and mid-trimester abortion. All these events significantly increase the incidence of perinatal mortality and morbidity. Cervical cerclage is a procedure used to increase the functional length of the cervix during pregnancy, by placement of a tape at the level of the internal os to support the cervical musculature. Much controversy is present about the value of cervical cerclage in improving perinatal outcome. The use of a braided synthetic material, that will significantly change the bacterial milieu in the upper vagina and cervix, might in itself play a role in promoting infection, and might contribute to this controversy. On the other hand, the use of a monofilament suture material as Prolene, might obviate the changes in the bacterial milieu of the high vagina after the procedure, and might help improve the perinatal outcome. To identify the microbiological changes of the cervico-vaginal flora in women undergoing modified Shirodkar operation using two different suture materials, and to compare the pregnancy outcomes as an indicator of operation effectiveness. A randomised controlled trail was conducted at Ain Shams University Maternity Hospital [ASUMH] from September 2000 through February 2002. Bacteriological indicators of infection [Number and type of colony forming units]; fetal salvage ratio; prematurity ratio. 44 Cases with clinical and/or dynamic ultrasonographic criteria of cervcial incompetence underwent cervical cerclage operation using either Prolene suture or Nylon-tape according to the modified Schirodkar technique. 4 cases dropped out. The rest [40 cases] were followed up till they ended their pregnancy spontaneously. Bacteriological swabs were obtained pre- and 4 weeks post operatively and aerobic and anaerobic cultures were performed and analysed. No difference was observed between the two groups in any of the major confounding variables. The Prolene group had statistically significantly less post-operative bacterial colonizaton compared to the Nylon-tape group. The Prolene group showed better fetal-salvage and prematurity ratois; the results reaching statistical significance. Elective cervical cerclage by modified Shirodkar technique at 12 to 18 weeks' gestation using Prolene suture improves the fetal salvage as well as the prematurity ratio in patients at risk of fetal wastage due to cervical incompetence. Prolene suture was statistically significantly superior to Nylon tape as regards the microbiological and perinatal outcome measures. Intervention on the basis of dynamic ultrasono graphic parameters was related to a better fetal survival outcome

Contribution of interleukin 12 [IL-12] to immunologic responses in bronchial asthma and other lung diseases

Interleukin 12 [IL-12] is an important cytokine produced by monocytes and macrophages. It up regulates Th1 cytokines production especially IFNgamma and inhibits the expression of Th2 cytokines, so, its main function is the regulation of the bias of the immune system towards Th1 or Th2 response through a balance with IL-4 early in the immune response. This work was done to evaluate the serum and bronchoalveolar lavage [BAL] IL-12 in asthmatic patients compared with tuberculous patients and patients with primary lung cancer, to assess the impact of IL-12 on Th1-Th2 cytokines profile which determine the type of the response in these different diseases and to propose its potential clinical usefulness. The study included 4 groups: group I consisted of 20 asthmatic patients, group II: 10 patients who had pulmonary TB, group III: 10 patients with bronchogenic carcinoma, and group IV: 20 normal individuals. For all groups IL-12 was estimated in serum and [BAL] fluid using ELISA technique. Considering the results, IL-12 was significantly decreased in asthmatic patients and it increased with hyposensitiz ation, highly significantly increased in active pulmonary TB and significantly increased in localized bronchogenic carcinoma. It was concluded that IL-12 plays a central role on Th1-Th2 cytokines balance, being decreased in allergic conditions, i.e., producing immunological Th2, shift which is corrected to Th1 pathway by hyposensitization, hence, it may be of diagnostic and therapeutic values in bronchial asthma

Biochemcial studies on Alitame, a dipeptide non-nutritive sweetner on healthy and diabetic rats compared to aspartame

In this study, different biochemical parameters were investigated in 90 albino adult rats, Sprague-Dawely strain, divided into two groups [healthy and diabetic]. They were supplied with alitame and aspartame at 10, 50 and 100 mg/kg body weight/day for five weeks. No significant changes were reported in both groups in serum glucose, hemoglobin, total protein, albumin, globulin, A/G ratio and lipid pattern of healthy rats treated with alitame or aspartame at levels of 10 and 50 m/gkg body weight/day. However, a significant elevation was reported in serum glucose, total protein, globulin and A/G ratio at 100 mg/kg body weight/day for both sweeteners in healthy rats. Glucose was significantly decreased in diabetic rats fed alitame when compared with their corresponding control groups. Regarding liver enzymes, both sweeteners significantly elevated aspartate transaminase [AST] levels in healthy and diabetic groups. Alanine transaminase [ALT] and alkaline phosphatase [ALP] levels also increased in aspartame fed diabetic group. There were no statistical differences between the effect of alitame or aspartame on the biochemical aspects of healthy and diabetic rats except for liver enzymes level

Retrobulbar anesthesia with or without adrenaline in extracapsular cataract extraction

This study aimed to examined the influence of adrenaline in retrobulbar anesthesia on examined the influence of adrenaline in retrobulbar anesthesia on the preoperative IOP and on position of the lens-iris diaphragm during extracapsular cataract extraction [ECCE]. The effect of adrenaline on akinesia, analgesia and the frequency of complications was also studied. 74 patients with cataract underwent a planned ECCE. They were randomly divided into 2 groups: Group I receiving retrobulbar anesthesia with adrenaline and group II without adrenaline. The results revealed that group I had the lowest mean IOP after the retrobulbar injection [P <0.05]. They required shorter time of digital bulbar massage to reduce tension before surgery [P <0.01], they also appeared to have a deeper anterior chamber during the 1st part of surgery. The duration of postoperative analgesia was significantly prolonged in patients receiving adrenaline. The use of adrenaline as an adjunct to the retrobulbar anesthetic solution is beneficial in ECCE

Epidemiology of tuberculosis in a rural area [El-Hawaslia village, El-Minya governorate]

A cross sectional study was conducted to measure the prevalence of tuberculosis. Questionnaires were filled, tuberculin test [2 TU] was conducted, X-ray chest was done and sputum samples were obtained in a systematic r and om sample. Tuberculin positivity increased with age to reach its maximum at the age group of 31 - 50 years, then declined gradually after that. The overall percentage of infection estimated by tuberculin test within the sample was 39.9%. Lung shadows possibly related to tuberculosis were 7%. Pulmonary shadows unlikely were related to tuberculosis in 14%. Acid fast bacilli were found by smear in 1.4% and by culture in 2.3% within the sample. Many factors were contributed to the persistence of the disease in this rural area. Vaccination by BCG must be obligatory and improving the nutritional status of the individuals was highly recommended

Sensitivity, specificity, accuracy percentage and error percentage of prostatic specific antigen [PSA] in diagnosis of cancer prostate

Prostatic specific antigen [PSA] was estimated in 20 normal males [control group] and 22 patients with cancer prostate [cases]. Detection of antigen by immunoassay method and diagnosis was confirmed by histopathology. Sensitivity, specificity, accuracy percentage and error percentage of PSA in the diagnosis of cancer prostate in patients with metastasis were 95.2%, 100%, 95.5% and 4.5%, respectively, and in patients without metastasis were 85.7%, 100%, 86.4% and 13.6%, respectively. PSA detection was recommended for early detection and screening of any suspected prostatic swelling

Epidemiological study of azoospermia in relation to histopathological profiles

The relationship between socioeconomic status of the individual and infertility is not clear. This study was conducted to identify the relationship between histopathological types and hormonal profiles, and the importance of this relation. A case-control study was done on 96 cases of azoospermic men and well matched 96 controls. Cases were divided according to age, occupation, residence, duration of marriage and smoking into separate groups. Serum testosterone [TT], prolactin [PL], follicular stimulating hormone [FSH], luteinizing hormone [LH], T3 and T4 were measured. Serum FSH, LH, TT, PL, T3 and T4 levels in relation to histopathological types were studied. They were classified histologically into normal [28.1%], maturation arrest [MA] [39.6%], Sertoli-cell only syndrome [SCOS] [28.1%] and tubular atrophy [TA] [4.2%] groups. The normal histological group showed normal levels of FSH, LH, TT, T3 and T4. In MA, there was significant increase in FSH [p <0.0001], LH [p <0.0001] and significant decrease in TT [p <0.0001] levels. In SCOS there was a significant increase in FSH [p <0.0001], LH [p <0.0001] and significant decrease in TT [p <0.0001], T3 [p <0.02] and T4 [p <0.005]. Also, in TA there was a significant increase in FSH [p <0.0001], LH [p <0.0001] and significant decrease in TT [p <0.0001], T3 [p <0.01] and T4 [p <0.05]. It was concluded that the hormonal factor is important to determine the relationship between azoospermia and infertility, and to help in the evaluation of this disease. The data collected supported the hypothesis that heavy smoking decreases serum testosterone level