Serum Procalcitonin Guide in a Case of Proteus mirabilis Prosthetic Joint Infection

@#Infection is a dreaded complication in patients who have underwent arthroplasty and often very challenging to treat. It accounts for lesser than 1% of arthroplasty cases and although low in occurrence, requires appropriate investigations and management to successfully treat the condition. This case demonstrates a case of a rare microorganism with unusual antibiotic susceptibility causing a prosthetic joint infection and the use of serum procalcitonin level as guide in management of the patient.

Exogenous application of bio-stimulant and growth retardant improved the productivity of cotton cultivars under different planting arrangement / A aplicação exógena de bioestimulante e regulador de crescimento na melhoria da produtividade de cultivares de algodão sob diferentes configurações de plantio

Optimum planting arrangement is an important attribute for efficient utilization of available resources and to obtain high yield of cotton. Application of plant growth promoter and retardant on cotton in improved planting density are the innovative techniques in the establishment of more productive cotton crop. Therefore, we planned a field study to assess the role of bio-stimulant and growth retardant in the resource utilization efficiency of cotton cultivars planted under variable row spacing at Agronomic Research Area Bahauddin Zakariya University and Usmania Agricultural Farm Shujabad during Kharif 2012. Experimental treatments consisted of cotton genotypes viz. CIM-573 and CIM-598, cultivated under conventional (75 cm), medium (50 cm) and ultra-narrow row spacing (25 cm) with foliar spray of bio-stimulant (moringa leaf extract) and growth retardant (mepiquate chloride), either sole or in combination, keeping distilled water as a control. Exogenously applied MLE alone and MLE + MC significantly enhanced the number of squares, flowers and green bolls per plant leading to higher cotton seed and lint yield of CIM 598 cultivar cultivated under conventional row spacing. While application of MC alone and MLE + MC produced maximum micronaire value, fiber strength and fiber uniformity ratio of CIM 573 cultivar cultivated under conventional row spacing. The results suggested that application of MLE is a possible approach to enhance the cotton productivity and the use of MC to enhance the fiber quality attributes under conventional row spacing.

A configuração ideal de plantio é um atributo importante para a utilização eficiente dos recursos disponíveis e para obter alto rendimento de algodão. A aplicação de promotores de crescimento de plantas e reguladores de crescimento no algodão em uma densidade de plantio adequada são técnicas inovadoras na obtenção de safras de algodão mais produtivas. Portanto, foi planejado um estudo de campo para avaliar o papel de um bioestimulante e um regulador de crescimento na eficiência da utilização de recursos de cultivares de algodão plantadas com espaçamento variável entre linhas na Área de Pesquisa Agronômica Universidade Bahauddin Zakariya e Usmania Agricultural Farm Shujabad durante Kharif 2012. Os tratamentos experimentais consistiram em genótipos de algodão viz. CIM-573 e CIM-598, cultivadas sob espaçamento convencional (75 cm), médio (50 cm) e ultraestreito (25 cm) e pulverização foliar de bioestimulante (extrato de folha de moringa) e regulador de crescimento (cloreto de mepiquato)), sozinho ou combinado, mantendo a água destilada como controle. O MLE aplicado exogenamente sozinho e o MLE + MC aumentaram significativamente o número de quadrados, flores e cápsulas verdes por planta, levando a um maior rendimento de sementes e fibra de algodão da cultivar CIM 598 cultivada sob espaçamento convencional entre fileiras. Enquanto a aplicação de MC sozinho e MLE + MC produziu valor máximo de micronaire, resistência da fibra e razão de uniformidade da fibra da cultivar CIM 573 cultivada sob espaçamento convencional entre linhas. Os resultados sugeriram que a aplicação do MLE é uma abordagem possível para aumentar a produtividade do algodão e o uso de MC para aprimorar os atributos de qualidade da fibra no espaçamento convencional entre linhas.

Exogenous application of bio-stimulant and growth retardant improved the productivity of cotton cultivars under different planting arrangement

Abstract Optimum planting arrangement is an important attribute for efficient utilization of available resources and to obtain high yield of cotton. Application of plant growth promoter and retardant on cotton in improved planting density are the innovative techniques in the establishment of more productive cotton crop. Therefore, we planned a field study to assess the role of bio-stimulant and growth retardant in the resource utilization efficiency of cotton cultivars planted under variable row spacing at Agronomic Research Area Bahauddin Zakariya University and Usmania Agricultural Farm Shujabad during Kharif 2012. Experimental treatments consisted of cotton genotypes viz. CIM-573 and CIM-598, cultivated under conventional (75 cm), medium (50 cm) and ultra-narrow row spacing (25 cm) with foliar spray of bio-stimulant (moringa leaf extract) and growth retardant (mepiquate chloride), either sole or in combination, keeping distilled water as a control. Exogenously applied MLE alone and MLE + MC significantly enhanced the number of squares, flowers and green bolls per plant leading to higher cotton seed and lint yield of CIM 598 cultivar cultivated under conventional row spacing. While application of MC alone and MLE + MC produced maximum micronaire value, fiber strength and fiber uniformity ratio of CIM 573 cultivar cultivated under conventional row spacing. The results suggested that application of MLE is a possible approach to enhance the cotton productivity and the use of MC to enhance the fiber quality attributes under conventional row spacing.

Resumo A configuração ideal de plantio é um atributo importante para a utilização eficiente dos recursos disponíveis e para obter alto rendimento de algodão. A aplicação de promotores de crescimento de plantas e reguladores de crescimento no algodão em uma densidade de plantio adequada são técnicas inovadoras na obtenção de safras de algodão mais produtivas. Portanto, foi planejado um estudo de campo para avaliar o papel de um bioestimulante e um regulador de crescimento na eficiência da utilização de recursos de cultivares de algodão plantadas com espaçamento variável entre linhas na Área de Pesquisa Agronômica Universidade Bahauddin Zakariya e Usmania Agricultural Farm Shujabad durante Kharif 2012. Os tratamentos experimentais consistiram em genótipos de algodão viz. CIM-573 e CIM-598, cultivadas sob espaçamento convencional (75 cm), médio (50 cm) e ultraestreito (25 cm) e pulverização foliar de bioestimulante (extrato de folha de moringa) e regulador de crescimento (cloreto de mepiquato)), sozinho ou combinado, mantendo a água destilada como controle. O MLE aplicado exogenamente sozinho e o MLE + MC aumentaram significativamente o número de quadrados, flores e cápsulas verdes por planta, levando a um maior rendimento de sementes e fibra de algodão da cultivar CIM 598 cultivada sob espaçamento convencional entre fileiras. Enquanto a aplicação de MC sozinho e MLE + MC produziu valor máximo de micronaire, resistência da fibra e razão de uniformidade da fibra da cultivar CIM 573 cultivada sob espaçamento convencional entre linhas. Os resultados sugeriram que a aplicação do MLE é uma abordagem possível para aumentar a produtividade do algodão e o uso de MC para aprimorar os atributos de qualidade da fibra no espaçamento convencional entre linhas.

Exogenous application of bio-stimulant and growth retardant improved the productivity of cotton cultivars under different planting arrangement / A aplicação exógena de bioestimulante e regulador de crescimento na melhoria da produtividade de cultivares de algodão sob diferentes configurações de plantio

Optimum planting arrangement is an important attribute for efficient utilization of available resources and to obtain high yield of cotton. Application of plant growth promoter and retardant on cotton in improved planting density are the innovative techniques in the establishment of more productive cotton crop. Therefore, we planned a field study to assess the role of bio-stimulant and growth retardant in the resource utilization efficiency of cotton cultivars planted under variable row spacing at Agronomic Research Area Bahauddin Zakariya University and Usmania Agricultural Farm Shujabad during Kharif 2012. Experimental treatments consisted of cotton genotypes viz. CIM-573 and CIM-598, cultivated under conventional (75 cm), medium (50 cm) and ultra-narrow row spacing (25 cm) with foliar spray of bio-stimulant (moringa leaf extract) and growth retardant (mepiquate chloride), either sole or in combination, keeping distilled water as a control. Exogenously applied MLE alone and MLE + MC significantly enhanced the number of squares, flowers and green bolls per plant leading to higher cotton seed and lint yield of CIM 598 cultivar cultivated under conventional row spacing. While application of MC alone and MLE + MC produced maximum micronaire value, fiber strength and fiber uniformity ratio of CIM 573 cultivar cultivated under conventional row spacing. The results suggested that application of MLE is a possible approach to enhance the cotton productivity and the use of MC to enhance the fiber quality attributes under conventional row spacing.

A configuração ideal de plantio é um atributo importante para a utilização eficiente dos recursos disponíveis e para obter alto rendimento de algodão. A aplicação de promotores de crescimento de plantas e reguladores de crescimento no algodão em uma densidade de plantio adequada são técnicas inovadoras na obtenção de safras de algodão mais produtivas. Portanto, foi planejado um estudo de campo para avaliar o papel de um bioestimulante e um regulador de crescimento na eficiência da utilização de recursos de cultivares de algodão plantadas com espaçamento variável entre linhas na Área de Pesquisa Agronômica Universidade Bahauddin Zakariya e Usmania Agricultural Farm Shujabad durante Kharif 2012. Os tratamentos experimentais consistiram em genótipos de algodão viz. CIM-573 e CIM-598, cultivadas sob espaçamento convencional (75 cm), médio (50 cm) e ultraestreito (25 cm) e pulverização foliar de bioestimulante (extrato de folha de moringa) e regulador de crescimento (cloreto de mepiquato)), sozinho ou combinado, mantendo a água destilada como controle. O MLE aplicado exogenamente sozinho e o MLE + MC aumentaram significativamente o número de quadrados, flores e cápsulas verdes por planta, levando a um maior rendimento de sementes e fibra de algodão da cultivar CIM 598 cultivada sob espaçamento convencional entre fileiras. Enquanto a aplicação de MC sozinho e MLE + MC produziu valor máximo de micronaire, resistência da fibra e razão de uniformidade da fibra da cultivar CIM 573 cultivada sob espaçamento convencional entre linhas. Os resultados sugeriram que a aplicação do MLE é uma abordagem possível para aumentar a produtividade do algodão e o uso de MC para aprimorar os atributos de qualidade da fibra no espaçamento convencional entre linhas.

Resource use efficiency of cotton in improved vs conventional planting geometry with exogenous application of bio-stimulant and synthetic growth retardant / Eficiência do uso de recursos do algodão na geometria de plantio melhorada vs convencional com aplicação exógena de bioestimulante e retardante de crescimento sintético

Abstract Plant growth regulators and improved planting density are the innovative techniques in the establishment of more productive cotton crop. A field study was planned to assess the role of growth regulators in the resource utilization efficiency of cotton cultivars under different row spacing at Agronomic Research Area, Bahauddin Zakariya University Multan and Usmania Agricultural Farm, Shujaabad during Kharif 2012. The study was comprised of cotton cultivars viz. CIM-573 and CIM-598, cultivated under conventional (75 cm), medium (50 cm) and improved ultra-narrow row spacing (25 cm) and foliar spray of growth regulators viz. moringa leaf extract (MLE) and mepiquat chloride (MC), either alone or in combination, distilled water as a control. The application of MLE alone and in combination (MLE + MC) showed the promoting effect on crop growth rate, net assimilation rate, leaf area index, leaf area duration, sympodial branches and number of bolls leading to higher seed cotton yield of both cotton cultivars grown under conventional row spacing. While application of MC averts the plant growth without considerably improving the productivity. MLE being rich source of growth promoting hormone and nutrients showed its potential to a far greater extent under conventional row spacing in efficient utilization of available resources compared to MC and distilled water.

Resumo Reguladores de crescimento de plantas e melhor densidade de plantio são técnicas inovadoras no estabelecimento de culturas mais produtivas de algodão. Um estudo de campo foi planejado com o objetivo de avaliar o papel dos reguladores de crescimento na eficiência de uso de recursos de cultivares de algodão sob diferentes espaçamentos na Área de Pesquisa Agronômica, da Universidade Multil de Bahauddin Zakariya, e na Fazenda Agrícola da Usmania, Shujabad, durante o Kharif 2012. O estudo foi composto de cultivares de algodão CIM-573 e CIM-598, cultivados em espaçamento de linhas convencional (75 cm), médio (50 cm) e superestreito (25 cm) e de pulverização foliar de reguladores de crescimento, a saber, extrato de folhas de moringa (MLE) e cloreto de mepiquat (MC), isoladamente ou em combinação, e água destilada como controle. A aplicação de MLE isoladamente e em combinação (MLE + MC) mostrou efeito promotor na taxa de crescimento da cultura, taxa de assimilação líquida, índice de área foliar, duração de área foliar, ramos simpodiais e número de cápsulas levando à maior produção de algodão nas cultivares com espaçamento de linha convencional. Em contrapartida, a aplicação de MC evitou o crescimento da planta sem melhorar consideravelmente a produtividade. O MLE, por ser uma rica fonte de hormônio promotor de crescimento e nutrientes, mostrou seu potencial em uma extensão muito maior sob o espaçamento convencional entre as linhas no uso eficiente dos recursos disponíveis em comparação com o MC e a água destilada.

Resource use efficiency of cotton in improved vs conventional planting geometry with exogenous application of bio-stimulant and synthetic growth retardant

Abstract Plant growth regulators and improved planting density are the innovative techniques in the establishment of more productive cotton crop. A field study was planned to assess the role of growth regulators in the resource utilization efficiency of cotton cultivars under different row spacing at Agronomic Research Area, Bahauddin Zakariya University Multan and Usmania Agricultural Farm, Shujaabad during Kharif 2012. The study was comprised of cotton cultivars viz. CIM-573 and CIM-598, cultivated under conventional (75 cm), medium (50 cm) and improved ultra-narrow row spacing (25 cm) and foliar spray of growth regulators viz. moringa leaf extract (MLE) and mepiquat chloride (MC), either alone or in combination, distilled water as a control. The application of MLE alone and in combination (MLE + MC) showed the promoting effect on crop growth rate, net assimilation rate, leaf area index, leaf area duration, sympodial branches and number of bolls leading to higher seed cotton yield of both cotton cultivars grown under conventional row spacing. While application of MC averts the plant growth without considerably improving the productivity. MLE being rich source of growth promoting hormone and nutrients showed its potential to a far greater extent under conventional row spacing in efficient utilization of available resources compared to MC and distilled water.

Resumo Reguladores de crescimento de plantas e melhor densidade de plantio são técnicas inovadoras no estabelecimento de culturas mais produtivas de algodão. Um estudo de campo foi planejado com o objetivo de avaliar o papel dos reguladores de crescimento na eficiência de uso de recursos de cultivares de algodão sob diferentes espaçamentos na Área de Pesquisa Agronômica, da Universidade Multil de Bahauddin Zakariya, e na Fazenda Agrícola da Usmania, Shujabad, durante o Kharif 2012. O estudo foi composto de cultivares de algodão CIM-573 e CIM-598, cultivados em espaçamento de linhas convencional (75 cm), médio (50 cm) e superestreito (25 cm) e de pulverização foliar de reguladores de crescimento, a saber, extrato de folhas de moringa (MLE) e cloreto de mepiquat (MC), isoladamente ou em combinação, e água destilada como controle. A aplicação de MLE isoladamente e em combinação (MLE + MC) mostrou efeito promotor na taxa de crescimento da cultura, taxa de assimilação líquida, índice de área foliar, duração de área foliar, ramos simpodiais e número de cápsulas levando à maior produção de algodão nas cultivares com espaçamento de linha convencional. Em contrapartida, a aplicação de MC evitou o crescimento da planta sem melhorar consideravelmente a produtividade. O MLE, por ser uma rica fonte de hormônio promotor de crescimento e nutrientes, mostrou seu potencial em uma extensão muito maior sob o espaçamento convencional entre as linhas no uso eficiente dos recursos disponíveis em comparação com o MC e a água destilada.

Expression of neuronal and non-neuronal markers in the vomeronasal organs of one-humped camel (Camelus dromedarius) and Egyptian water buffalo (Bubalus bubalis) / Expresión de marcadores neuronales y no neuronales en los órganos vomeronasales del camello jorobado y el búfalo egipcio de agua

Fourteen vomeronasal organs (VNOs) of adult males one-humped camels (Camelus dromedarius) and Egyptian water buffaloes (Bubalus bubalis) (n=7/each) were examined immunohistochemically with neuronal markers; synaptophysin (SYP) and glial fibrillary acidic protein (GFAP) to clarify the distribution of the vomeronasal (VN) receptor cells and nerve fibers, in addition to elucidate the existence of non-neuronal elements via S-100 and endothelial nitric oxide synthase (eNOS). In both animals, the VNO was lined medially with VN sensory (olfactory) epithelium and non-sensory (respiratory) epithelium laterally. Immunohistochemically, both animals showed SYP immunolabeling only in the receptor cells of VN sensory epithelium while GFAP labeled the ensheathing cells of the nerve fibers of VNOs. Both S-100 and eNOS labeled non-neuronal elements of the VNO; the supporting cells of sensory epithelium and the VN glands. In view of these observations, we postulate that the VNOs of both animals contain various cells populations that express several neuronal and non-neuronal markers. As well as, SYP and GFAP are suggested as markers for receptor cells and ensheathing cells of nerves of the VNOs respectively. However, no clear differences can be detected in the expressions of neuronal and non-neuronal markers in VNOs of camel and buffalo since they are ruminant species.

En este estudio fueron examinados 14 órganos vomeronasales (OVN) de machos adultos de camellos de una joroba (Camelus dromedarius) y búfalos egipcios de agua (Bubalus bubalis) (n = 7 / cada uno) por inmunohistoquímica con marcadores neuronales, sinaptofisina (SIP) y proteína ácida fibrilar glial (PAFG), para identificar la distribución vomeronasal (VN) del receptor de células y fibras nerviosas, además de dilucidar la existencia de elementos no neuronales a través de S-100 y óxido nítrico sintasa endotelial (ONSe). En ambos animales, el OVN se encuentra alineado en sentido medial con el epitelio sensorial (olfato) y lateralmente con el epitelio no sensorial (respiratorio). En el estudio inmunohistoquímico, ambos animales mostraron marcadores inmunológicos solamente en las células receptoras del epitelio sensorial VN, mientras que la proteína ácida fibrilar glial marcaba las fibras nerviosas de OVN. Tanto el S-100 como la óxido nítrico sintasa endotelial, marcaron elementos no neuronales del OVN, las células de revestimiento del epitelio sensorial y las glándulas VN. En relación a estas observaciones, se postula que los OVN de ambos animales contienen células que expresan varios marcadores neuronales y no neuronales. SIP y la PAFG se sugieren como marcadores para células receptoras y las células gliales de nervios del OVN, respectivamente. Sin embargo, debido a que son especies de rumiantes, no existen diferencias claras que se puedan detectar en las expresiones de los marcadores neuronales y no neuronales en el OVN de camello y búfalo.

Adhesion, Autoaggregation and Hydrophobicity of Six Lactobacillus Strains.

Aims: The aim of this study was to assess probiotic attributes such as adhesion, auto aggregation, hydrophobicity and antibacterial activity of Lactobacillus strains from dairy products. Methodology: In this study, the autoaggregation, coaggregation, hydrophobicity and adhering abilities and antimicrobial activities of six Lactobacillus strains belonging to different species were assessed. Hydrophobicity was determined by bacterial adherence to hydrocarbons, xylene, n-hexadecane and chloroform. Results: The percentage of hydrophobicity of the strains range from 29.5% to 77.4% as measured by the described test. The autoaggregation among Lactobacillus strains range from 15.8% to 63.1%, while coaggregation range from 18.6% to 55.1%. Adhesion of the tested strains to buccal epithelial cells range from 8.0% to 50%. The tested Lactobacillus strains demonstrated variable inhibitory activity against pathogenic bacteria. Conclusion: Our findings indicated that one Lactobacillus strain expressed broad antibacterial activities against a group of bacterial pathogens and along 2 other strains exhibited ability to adhere to epithelial cells as shown by aggregation, coaggregation and hydrophobicity, indicating that such isolates can be good candidates for probiotic use.

impact and effect of liver insufficiency of HCV infection on patients with chronic obstructive pulmonary diseases

Hepatitis C virus [HCV] infection is associated with a wide series of extra- hepatic manifestations. Pulmonary involvement is one of the extrahepatic manifestations of chronic hepatitis C virus [HCV] infection. The objective of this study was to determine the impact of HCV; infection and the degree of liver dysfunction in patients with chronic obstructive pulmonary disease [COPD]. This study was conducted on COPD patients. They were selected from outpatient chest clinic in the Menoufia University Hospital. They were classified into 2 groups the first group COPD patients [n = 40] without hepatitis C and the second group COPD patients with chronic hepatitis C. Second group [COPD with HCV] classified into 3 subgroups according Child-Pugh classification to determine the degree of liver insufficiency. Group IIA: patients Child-Pugh [A], group IIB: patients Child-Pugh [B] and group IIC: patients Child-Pugh [C]. The following pulmonary function parameters were recorded: Forced Expiratory Volume in the first second [FEV1], Forced Expiratory Volume percent [FEV1/FVC%], Forced Expiratory Flow 25-75% [FEF 25-75%] and Maximal Voluntary Ventilation [MVV]. The study included 80 patients with COPD, 40 patients without chronic HCV infection [group I], and 40 patients with chronic HBV infection [group II].COPD patients with HCV infection have increased deterioration in pulmonary function [FEV1, FEV1/FVC, FEF 25-75% and MVV] than COPD patients without HCV infection. Also there were significant decreases in pulmonary function tests [FEV1, FEV1/FVC, FEF 25-75% and MVV] in group II subgroups IIA, IIB and IIC according to the degree of decompensation. Patients with COPD with HCV infection, have increased deterioration in pulmonary function than patients with COPD without HCV infection and the deterioration increases with hepatitis decompensation

IS6110 Restriction Fragment Length Polymorphism Typing of Drug-resistant Mycobacterium tuberculosis Strains from Northeast South Africa.

Tuberculosis (TB) remains a deadly infectious disease affecting millions of people worldwide; 95% of TB cases, with 98% of death occur in developing countries. The situation in South Africa merits special attention. A total of 21,913 sputum specimens of suspected TB patients from three provinces of South Africa routinely submitted to the TB laboratory of Dr. George Mukhari (DGM) Hospital were assayed for Mycobacterium tuberculosis (MTB) growth and antibiotic susceptibility. The genetic diversity of 338 resistant strains were also studied. DNA isolated from the strains were restricted with Pvu II, transferred on to a nylon membrane and hybridized with a PCR-amplified horseradish peroxidase 245 bp IS6110 probe. Of the 338 resistant strains, 2.09% had less than 5 bands of IS6110, and 98% had 5 or more bands. Unique restriction fragment length polymorphism (RFLP) patterns were observed in 84.3% of the strains, showing their epidemiological independence, and 15.7% were grouped into 22 clusters. Thirty-two strains (61.5%) from the 52 that clustered were from Mpumalanga, 16/52 (30.8%) from Gauteng, and 4/52 (9.6%) from Limpopo province. Clustering was not associated with age. However, strains from male patients in Mpumalanga were more likely to be clustered than strains from male patients in Limpopo and/or Gauteng province. The minimum estimate for the proportion of resistant TB that was due to transmission is 9.06% (52-22=30/331). Our results indicate that transmission of drug-resistant strains may contribute substantially to the emergence of drug-resistant tuberculosis in South Africa.

Non-thermal continuous and modulated electromagnetic radiation fields effects on sleep EEG of rats

In the present study, the alteration in the sleep EEG in rats due to chronic exposure to low-level non-thermal electromagnetic radiation was investigated. Two types of radiation fields were used; 900 MHz unmodulated wave and 900 MHz modulated at 8 and 16 Hz waves. Animals has exposed to radiation fields for 1 month [1 h/day]. EEG power spectral analyses of exposed and control animals during slow wave sleep [SWS] and rapid eye movement sleep [REM sleep] revealed that the REM sleep is more susceptible to modulated radiofrequency radiation fields [RFR] than the SWS. The latency of REM sleep increased due to radiation exposure indicating a change in the ultradian rhythm of normal sleep cycles. The cumulative and irreversible effect of radiation exposure was proposed and the interaction of the extremely low frequency radiation with the similar EEG frequencies was suggested

Fiberoptic bronchoscopic guidance in percutaneous dilational tracheotomy

Blind percutaneous dilational tracheotomy [PDT] holds a lot of peri-operative complications. A lot of assisting tools have long been used to facilitate guidance during PDT, e.g., laryngeal mask airway [LMA], ultrasound [US] imaging of the neck, light wand for trails-illumination of the soft tissues of the neck, and flexible fiberoptic bronchoscopy. The aim of this work was to compare between blind and fiberoptic bronchoscopic guided PDT as regards ease of the technique and complications of the procedure. A randomized prospective comparative trial. Critical care department, main Alexandria university hospital. Thirty adult patients, requiring elective PDT, and need to maintain a secure airway. They were randomly assigned to 2 groups; blind PDT group I and fiberoptic bronchoscopic guided PDT group II. Both groups used Griggs' forceps technique for PDT. Post-operative complications were recorded. End point was 48-h after the procedure. Number of trials was 1.27 +/- 0.46 and 1.00 +/- 0.00 for groups I and II, respectively. Success rate was 100% in both groups. Procedural duration [in minutes] was 2.93 +/- 1.10 in group I versus 3.93 +/- 1.10 in group II. Bleeding was found in 3 patients and 1 patient for groups I and II. Subcutaneous emphysema occurred in one patient in each group, while tube misplacement was recorded in 2 patients in group I and none in group II. Aspiration pneumonia was found in 2 patients in group I and none in group II. Use of flexible bronchoscopy has succeeded in decreasing the number of trials of needle insertion and decreasing the incidence of overall complications, while blind technique was better in shortening procedural time and avoidance of hypercapnia

Knowledge and attitude of primary care doctors towards management of postmenopausal symptoms

According to the current recommendations, women with post-menopausal symptoms should be managed. Knowledge and perception of primary care physicians towards management of postmenopausal symptoms are deficient. The aim of the present study was to explore knowledge and attitude of primary care doctors towards management of postmenopausal symptoms. This study is a cross-sectional survey that was conducted from October to December 2010 in the five health regions in Kuwait. Two centers were selected randomly from each health region. All physicians who were currently working in the selected centers were asked to participate in the study. Out of 209 physicians, 142 agreed to participate and completed a self-administered questionnaire. The study revealed that 82.4% of physicians had moderate knowledge about treatment options for postmenopausal symptoms, 88.0% discussed postmenopausal symptoms with their patients, and 45.1% of them either described or referred their patients for hormonal replacement therapy [HRT]. The correct answers regarding 10 statements related to the Women Health Initiative finding were ranging from 2.8% to 78.9% which indicated low level of knowledge. Regarding the effectiveness of hormonal replacement therapy in post menopausal women, the majority of the physicians agreed correctly that HRT is effective in prevention of osteoporosis [87.3%], treatment of vasomotor symptoms [83.7%], and treatment of vulvo-vaginal symptoms [82.4%]. There was a variation among physicians opinion about the effectiveness of certain treatment options for managing hot flushes in postmenopausal women. The results suggest that there is a lack of primary care physicians knowledge and confidence in recognizing signs and symptoms of menopause and in identifying and prescribing appropriate management

First dose response of treatment of three formulations of interferon alpha in patients using limited sampling strategy

The study was conducted to observe the comparative response of three commercially formulations of interferon alpha 2b in three groups of patients with chronic hepatitis C. The objective was to see best response after first dose of interferon Alfa 2b. This was a quasi - experimental study in which patients of both sexes between ages 20 -49 were randomly allocated to receive three different formulations of interferon alpha 2b in three groups, I, II, and III, after giving them first dose of three million units of interferon alpha 2b subcutaneously. Sixty patients were selected in three groups according to the formulation injected. Blood samples were collected at 00, 08, 20 hours according to limiting sampling strategy. All samples were analyzed by ELISA. The response of serum drug level was different between three groups. Statistically significance differences were observed between group I and II, and group I and III, based on ANOVAs and t-test. Comparison between three groups was significant. Almost all subjects [98%] reported typical mild interferon side effects [flu - like symptoms, headache]. Different formulations have variable response of serum drug level

Unusual anatomic location of a primary intracranial yolk sac tumor

A nongerminomatous germ cell tumor occurring in the brain parenchyma is extremely rare. A 2-year-old boy presented with symptoms of abnormal movements in the hand and mouth. MRI scanning revealed a lesion occupying the left temporoparietal region. Craniotomy was performed and the tumor was removed by en bloc resection. Histological examination revealed that the tumor was arranged in a reticular pattern, and Schiller-Duval bodies were evident at the center of the tumor. Immunohistochemical study showed that the tumor cells were positive for alpha-fetoprotein and vimentin, but negative for glial fibril-lary acidic protein. The histological diagnosis was pure yolk sac tumor

Unusual association between adrenal leiomyoma and autoimmune disease

Adrenal leiomyoma is a rare solid tumor of unknown etiology. Here, we present a case of a 38-year-old woman, a known case of Hashimoto's thyroiditis, presented with right adrenal mass incidentally discovered by computed tomography imaging. The mass was non-functioning according to laboratory results, but because the mass increased in size in a follow up visit, she underwent right adrenalectomy. The histological findings confirmed the diagnosis of adrenal leiomyoma, which was supported by a panel of immunohistochemical stains. Surprisingly, there was a dense lymphocytic infiltrate in the background of the tumor, forming germinal centers. Although most of the reported adrenal leiomyoma cases are associated with immune deficiency, none of the previous cases was associated with an autoimmune disease. We report a case of an unusual adrenal leiomyoma with a dense lymphocytic infiltrate

Yemeni experience with phacoemulsification

To evaluate the first experience of phacoemulsification in Yemen from 2000-2007 regarding the visual results, and complications. Two hundred and fifty-eight eyes of 182 adult patients with significant cataract were included during the last 96 months. All eyes underwent phacoemulsification with implantation of intraocular lenses. The results were recorded and statistically analyzed. The male:female ratio was 1:1, with an average age of 52 years. Phacoemulsification was carried out by scleral approach in 14 eyes, and by clear corneal approach in 244 eyes. A visual acuity of >/= 6/18 was achieved in 85.3%, and the most common serious complication was intraoperative posterior capsule rupture, which was reported in approximately 10.1%. The results of phacoemulsification are very impressive, and the most common intraoperative complication was ruptured posterior capsule

Evaluation of some pulmonary physiological and mechanical parameters as weaning criteeria

Simple protocols can help selecting patients capable of sustaining spontaneous breathing. To evaluate the utility of some pulmonary physiological and mechanical parameters as weaning predictors.Twenty four patients were included, the following data were assessed: spontaneous respiratory frequency [/], spontaneous tidal volume [VT], peak inspiratory pressure [PIP],plateau airway pressure [P plat], maximum inspiratory pressure [PImax], rapid shallow breathing index [RSBI], dynamic compliance [Cdyn], static compliance [Cst], alveolar-arterial oxygen gradient [[A-a] O[2] and]], minute ventilation [VE], shunt fraction and arterial to inspired oxygen ratio [PaO[2]/FIO2].Eighteen patients were successfully weaned [GI] and six failed the T-piece trial [Gil]. Significant differences were found between both groups as regards RSBI, Cst, Cdyn, shunt fraction, p[A-a] O[2] Pplat and PaO2/FIO[2][p<0.05]. By testing cut off values for RSBI [49.78], PaO[2]/FIO[2][155].p [A-a] O[2] A [84] and shunt fraction [25%], they gave a diagnostic accuracy of 91.6%, 91.7%, 100% and 95.8% respectively. PImax, PIP and VE were not discriminating parameters.Simple bedside criteria can help triggering efficient weaning protocols which can be adopted in our intensive care units. The previous cut off values can also be helpful in taking weaning decisions