Dose down regulation of tumor necrosis factor - prevent preterm labor?

Labor at term is thought to result from physiologic activation of anatomic, biochemical, and endocrine pathways. Whereas preterm labor result from pathologic activation of such events. The purpose of this study was to determine whether physiologic and pathologic activation could be described by the analysis of a cytokine-receptor signaling system. Tumor necrosis factor alpha [TNF-alpha.] and its soluble receptors [TNF-R1 and TNF-R2] were used as probes because of their role in the regulation of several processes activated during parturition.The in vivo concentrations of TNF-alpha and its soluble receptors were assayed in amniotic fluid obtained from 150 women, classified into 5 groups [each includcd 30]: Group-A consisted of women at term with intact memberanes not in labor, group B women with intact memberanes and in labor, group I women with preterm labor and intact. memberanes who delivered at term with no evidence of infection, group 2 women with preterm labor who delivered prematurely in the absence of chorio-amnionitis, and group 3 consisted of women with preterm labor and proven microbial invasion of the amniotic cavity who delivered preterm neonates women in spontaneous term labor [group-B] had significantly higher median concentrations of TNF-alpha a lower TNF-R1 and TNF-R2 than those at term not in labor [group-A]. Meanwhile, women with preterm labor leading to preterm delivery [group 2] had significantly higher concentrations of TNF-alpha. TNF-R1 and TNF-R2 than those with premature labor leading to term delivery [group 1]. On other hand, microbial invasion of the amniotic cavity [group 3] was associated with dramatic increases in the concentration of TNF-alpha and its soluble receptors than in those with preterm labor who delivered at term and those who delivered preterm but were not infected. It is concluded that levels of TNF-alpha and its soluble receptors, in the amniotic fluid, are different in term and preterm parturition, and that preterm parturition and/or microbial invasion of the amniotic cavity are pathologic conditions associated with increased TNF-alpha receptors which attenuate the deleterious effects of TNf-alpha found in. pathologic labor. It is concluded that the administration of TNF-alpha receptors to mothers at risk of pathologic preterm labor may be beneficial

Efficacy of alpha sympathomimitic ephderine Hcl in the treatment of classic nocturnal enuresis in girls

Voiding problems and in particular nocturnal enuresis can usually be evaluated and managed without resorting to cornilex procedures or invasive tests. A good history with attention to toilet habits can help distinguish patient who may have significant organic pathologic conditions which require further investigations. The cause of classic nocturnal enuresis is unknown, spontaneous resolution rate without any therapy makes it difficult to evaluate any one treatment. Completely different approaches have nearly equivalent success rates in nocturnal enuretics. The concept that enuresis results from failure to gain a high alpha sympathetic tone stimulated us to test the efficacy of giving Ephedilne HCI[an alpha sympathomimitic drug] to treat primary nocturnal enuresis in girls. The study included 154 girls, of ages 6 to 18 years, suffering primary nocturnal enuresis, not responding to conventional therapies. After having a consent to share in the study, all patients were subjected to history-taking, physical examination, routine investigations and urodynamic studies, before and 2 mo after giving Ephedrine UCI tablets, half a tablet for those under 10 years and one tablet for girls over 10 years, twice daily, after lunch an half an hour before bed time. The cure rate accounted for 92%, relapses occurred in 3% and 4.5% of girls, after 3 and 6 mo, respectively, with complete cure after consuming the drug for 1-2 mo more. Side effects were transient and tolerable. Cytometrogram and leak oint pressures displayed non-significant change, after 2 mo treatment, while, out of urethral pressure profilmetry, MUP, MUCP and total closing area displayed significant differences. It is concluded that treatment of primary nocturnal enuresis, in girls, using Ephedrine HCI is both effective and safe

Bed utilization pattern in the neonatology unit of zagazig University Hospitals in the year 1999

The objective of this study was to assess case mix and its effects on the average length of hospital stay, average bed turnover and their outcome over the year 1999. Among 1169 admitted cases, there were significant relationship between the cause of admission and sex, mean age at admission, birth order, place of admission and outcome. On other h and, the outcome of the admitted cases was not affected by the mode of delivery and sex but affected by the weight of infant at admission. Hyperbilirubinemia was the most common cause of admission [29.43%] with the best outcome [89.83% improved] and the lowest average length of stay [4.7 days], while preterms constituted a third cause of admission [20.19%] with the worst outcome [62.71% dead] and the highest average length of stay [12.5 days]. The average length of stay for beds and incubators were 5.6 and 10.7 days respectively, and the bed occupancy rate for beds and incubators were 94.84% and 90.48% respectively. The average bed turnover for beds and incubators were 61.33 and 30.92 turn/year respectively. It is concluded that preventive aspects are important in order to decrease the neonatal morbidity and mortality

Use of oral misoprostol "prostaglandine1 analogue" in the prevention of post-partum haemorrhage

To investigate the use of the oral misoprostol" prostaglandin E1 analogue" in the prevention of post partum haemorrhage. One hundred women undergoing vaginal delivery divided into two graups: [1] Study group: were given 600 ug misoprostol orally at the end of the second stage of labour. [2] Control group: Were given a combination of 5 units oxytocin and 0.5 mg ergometrine intra musculary at the end of the second stage of labour. Post partum haemorrhage occurred in 6% of the women, the need for therapeutic oxytocics in 6%, retained placenta in 2% and the median length of third stage was 5 minutes. Vomiting and diarrhoea in the first hour after delivery occurred in 8% and 4% repectively and shivering in 48% all were self limited. So misoprostol may be effective in the prevention of post partum haemorrhage and has few toleratd side effect