Hematological and histopathological changes of rat’s hearts experimentally infected with protoscoleces

@#Hydatidosis; is a zoonotic disease caused by Echinococcus granulosus and characterized by infiltration of inflammatory cells. This study was investigated the hematological and histopathological changes in the hearts of rats injected with protoscoleces. Rats were injected with protoscoleces collected from either liver of sheep, goats, and cows (from the abattoir of Al-Muthanna province, south of Iraq) or isolated from infected humans from Al-Hussein Teaching Hospital. Sheep protoscoleces showed a significant increase of lymphocytes that refer to the induction of a high response of the immune system in rats. The numbers of WBC, RBCs, and platelets were generally increased in rats injected with protoscoleces isolated from sheep and goats. These changes could refer to the activation of defense mechanisms against the hydatid injected materials. However, the levels of MCV, MCH, MCHC, MPV and PDW were less than normal values. Heart sections of rats injected with protoscoleces isolated from humans showed clear histological changes. While TSP, TGP and TCP exhibited variant histopathological changes such as infiltration of inflammatory cells, pink glass appearance and congestion of arteries. Thus, these alterations can be considered as additional evidence of how the immune response reacts against the injected materials in the heart.

Early hemodynamic profile after aortic valve replacement - a comparison between three mechanical valves

Abstract Introduction: There are scarce data comparing different mechanical valves in the aortic position. The objective of this study was to compare the early hemodynamic changes after aortic valve replacement between ATS, Bicarbon, and On-X mechanical valves. Methods: We included 99 patients who underwent aortic valve replacement with mechanical valves between 2017 and 2019. Three types of mechanical valves were used, On-X valve (n=45), ATS AP360 (n=32), and Bicarbon (n=22). The mean prosthetic valve gradient was measured postoperatively and after six months. Results: Preoperative data were comparable between groups, and there were no differences in preoperative echocardiographic data. Pre-discharge echocardiography showed no difference between groups in the ejection fraction (P=0.748), end-systolic (P=0.764) and end-diastolic (P=0.723) diameters, left ventricular mass index (P=0.348), aortic prosthetic mean pressure gradient (P=0.454), and indexed aortic prosthetic orifice area (P=0.576). There was no difference in the postoperative aortic prosthetic mean pressure gradient between groups when stratified by valve size. The changes in the aortic prosthetic mean pressure gradient of the intraoperative period, at pre-discharge, and at six months were comparable between the three prostheses (P=0.08). Multivariable regression analysis revealed that female gender (beta coefficient -0.242, P=0.027), body surface area (beta coefficient 0.334, P<0.001), and aortic prosthetic size (beta coefficient -0.547, P<0.001), but not the prosthesis type, were independent predictors of postoperative aortic prosthetic mean pressure gradient. Conclusion: The three bileaflet mechanical aortic prostheses (On-X, Bicarbon, and ATS) provide satisfactory early hemodynamics, which are comparable between the three valve types and among different valve sizes.

Pericardial effusion in prosthetic and native valve infective endocarditis

Background Pericardial effusion (PE) is widely believed to signify more advanced infective endocarditis (IE) and a generally worse outcome. Purpose To determine the prevalence and clinical significance of PE in a series of patients with confirmed native and prosthetic valve infections. Methods Data were collected from 338 consecutive patients with definite or possible IE who visited a single referral center; these patients were examined for the presence of PE as detected by transthoracic echocardiography. Clinical characteristics, the incidence of complications, and outcomes were compared between patients with IE with and without PE. IE patients with PE were then divided into two subgroups: those with and those without cardiac prostheses. Results Eighty-eight patients out of the total 338 (26%) were found to have PE. Compared with patients who did not have PE, patients who did were significantly younger (32.9 ± 13.4 vs 29.0 ± 9.2, p = 0.003), had more left-sided vegetation (55.6% vs 77.3%, p < 0.001), more root abscesses (9.2% vs 25.0%, p < 0.001), needed surgery more frequently (68.0% vs 84.1%, p = 0.001), and had a higher mortality rate (22.0% vs 32.9%, p = 0.03). PE was not found to be a predictor of mortality. No significant difference was found between IE patients with PE with (n = 13) and without (n = 75) prostheses with regard to causative organisms, clinical characteristics, or clinical outcomes. Conclusion Regardless of whether the IE was in native or prosthetic valves, compared with patients without PE, patients with PE had more severe infections and a worse prognosis, but PE was not an independent predictor of mortality.

Predictors of success of shock wave lithotripsy for ureteral stones based on computed tomography scan parameters

Background: For shock wave lithotripsy has proven to be an effective, safe and truly minimally invasive option for the treatment of nephrolithiasis. Various technical factors as well as patient selection can impact the success of the procedure. Objective: The aim of this study was to identify the parameters on NCCT that may predict the success of shock wave lithotripsy (SWL) in ureteral stones. Patients and Methods: 102 patients who underwent SWL for ureteral stones at sayed Galal University Hospital from January 2015 to August 2018 diagnosed by non-contrasted computed tomography were studied. The failure was defined as remnant stones ﻞ4 mm. We assessed age, sex, body mass index, stone size, location, skin-to-stone distance (SSD), presence of JJ and the presence of secondary signs (hydronephrosis, renal enlargement, perinephric fat stranding, and tissue rim sign). Results: 102 patients with success rate 61.8%, stone size, stone density were significantly associated with outcome of SWL. While SSD, JJ and secondary signs (hydronephrosis, perinephric fat stranding and tissue rim sign) were insignificant. On multivariate analysis, stone size and stone density were the independent factors affecting the outcome of SWL. Conclusions: The study demonstrated that stone size and density are significant and independent predictors of outcome in patients with upper ureteral stones. However SSD and signs of impaction still have to be evaluated

2 Handfuls of Medication in 2 Hours Just to Let Him Talk.

Repeated dose of adrenaline in anaphylaxis is limited evidence in clinical setting. Hence, the usage is depending on physician best interest and knowledge. We reported a case of repeated doses of adrenalin was given through nebulizer and intravenous in anaphylaxis. We believed the unusual circumstances of this case was likely to be repeated on some readers' clinical practice and this mode of treatment is an adjunct to consider in such cases especially in Emergency Department (ED).

Comparing attitudes of medical practitioners and allied medical professionals towards mental illness and patients with mental health disorders in Jordan

The study is aimed to compare the attitudes of medical practitioners and allied medical professionals, other than mental health workers, towards mental illness, mental health services and their patients in Jordan and to recommend a strategy to reduce the stigma, which represents an additional burden on patients with mental health problems and their families. We collected views of 300 medical practitioners and 300 allied medical professionals, from different hospitals in the Jordanian Royal Medical Services concerning stigma. One hundred seventy six medical practitioners compared to one hundred fifty one allied medical professionals considered mental illnesses to be a medical problem like diabetes or hypertension with a statistically significant difference [p<0.001]. A fair number of allied medical professionals believed that mental illness is a type of madness [n=69] or a possession by a demon [n=60], and that mentally ill patients are dangerous and impulsive [n=140] compared to 29, 23, and 99 medical practitioners respectively with statistically significant differences [p<0.0005, 0.00002, 0.002] in that order. One hundred forty five medical practitioners compared to 115 allied medical professionals thought that the public does not trust the treatment provided by psychiatrists and other mental health workers with a statistically significant difference [p<0.0007]. Allied medical professionals believed the media helped to reduce stigma of mental illness in contrast to the medical professionals which thought that it did not. The majority felt the need for an increase in public awareness of mental illness and wish to participate in mental health campaigns to support mental health development in Jordan. Health care professionals at all levels are still carrying negative attitude towards mental health services and their patients in Jordan

No relation between advanced parental age and the risk of autism among Jordanian children

To examine the relationship between advancing parental age, at the time of conception of offspring, and their risk of autism in Jordan. A multicenter descriptive correlational study, conducted in the period between the 1[st] of August 2010 and the 1[st] of January 2011. We included all registered cases of Autism in eleven specialized centers dealing with autistic children, recognized by The National Council for Family Affairs, The Ministry of Education, and The Ministry of Social Affairs, from Irbid in the north to Aqaba in the south. In the present study, we investigated the association of autism with parental age in 229 autism cases from Jordan. Patients were fulfilling the Diagnostic and Statistical Manual of Mental Disorders and the International Statistical Classification of Diseases and Related Health Problems 10[th] Revision criteria for the diagnosis of autism. The Statistical Package for the Social Sciences version 10 programs were used to analyze the data; Non-Parametric tests; chi[2] test, and frequencies were applied to analyze the relation between parental age at the time of conception and the risk of autism. Statistically significant results were those with a P-value < 0.05. There was no significant increase in the risk of autism with advancing parental age. Moreover, Autism was more frequent in the offspring of parents aged [25-35] years at the time of conception. In the majority of cases 127/229 [55.46%], paternal age at the time of conception ranked in the age group of [25-35] years old, chi[2] = 181.463, df = 3, which was found to be of highly statistical significance with a P-value of < 0.0001. Maternal age at the time of conception also ranked in the age group of [25-35] years, 134/229 [58.51%], chi[2] = 71.642, df = 2, it was highly statistically significant with a P-value of < 0.0001. No relation between advanced parental age and the occurrence of Autism. Moreover, Autism was more frequent in parents who were aged less than 35 years old at the time of conception

Endosonography as a predictive tool for first esophagogastric variceal bleeding

The development of portosystemic collaterals is the central pathophysiological event that leads to variceal bleeding in patients with liver cirrhosis. Endosonography [EUS] is useful to evaluate the fine details of the vascular structures at the gastroesophageal junction. EUS may give a promising chance for predicting upper gastrointestinal bleeding in cirrhotic patients. To evaluate the value of extraluminal gastroesophageal vascular collaterals as predictors of first variceal bleeding. A total of 50 cirrhotic patients with no history of previous upper GI bleeding were recruited into this cohort study. After thorough history taking and clinical examination, they were subjected to upper endoscopy and EUS for assessing the number and size of peri- and para-mural collaterals and perforating vessels. All participants were followed up for 24 months for upper gastrointestinal bleeding. Eighteen out of 50 patients [36%] had at least one attack of upper GI bleeding during the follow up period. All patients had one or more type of extraluminal venous collaterals. Gastric varices [P = 0.02], perigastric collaterals [P = 0.03] and perforators [P = 0.02] were independent risk factors for first variceal bleeding. The presence of 3 or more paraesophageat collaterals and the presence of perforators were significantly higher in bleeders compared to non-bleeders [P = 0.034]. Perigastric and paragastric collateral size were significantly larger in bleeders than non bleeders [P = 0.019 and 0.038 respectively]. Perigastric and paragastric collaterals size more than or equal to 2 mm and 6.20 mm respectively were associated with significantly increased risk of first variceal bleeding. Peri-esophageal and para-esophageal collaterals although present in large diameters in all bleeders than non bleeders, did not reach a statistical significant level EUS may be a promising tool for predicting first variceal bleeding in cirrhotic patients thus justifying primary prevention by band ligation or sclerotherapy

Oxidized low-density lipoprotein and carotid intima-media thickness in systemic lupus erythematosus patients: involvement of metabolic syndrome in insulin resistance and atherosclerosis

Traditional risk factors failed to fully account for the premature and accelerated development of atherosclerosis in systemic lupus erythematosus [SLE] patients. The low density lipoprotein [LDL] modification into oxidized LDL [ox-LDL] is a central event in atherogenesis that leads to a cycle of inflammation, endothelial dysfunction and atherosclerotic plaque formation. It is proposed that ox-LDL contributes to the development of autoimmune-mediated atherosclerosis. The metabolic syndrome is closely associated with subsequent development of type 2 diabetes mellitus and cardiovascular disease and is found to be highly prevalent in SLE patients. The aim of the present study was to investigate whether anti-oxLDL antibody [ox-LDL Ab] levels are altered in SLE patients and whether these alterations are related to insulin resistance, atherosclerosis, and components of the metabolic syndrome. Correlation with clinical and laboratory manifestations as well as SLE Disease Activity Index [SLEDAI] and Systemic Lupus International Collaborating Clinics [SLICC]/American College of Rheumatology Damage Index [SLICC/ACR DI] were studied. Thirty SLE women with a mean age of 27.63 +/- 6.11 years, fulfilling the updated ACR revised criteria for the classification of SLE, were recruited from the rheumatology and rehabilitation and internal medicine departments and out patient clinics of Cairo University Hospitals. Consecutive eligible patients, aged >18 years and had disease duration >1 year, were enrolled. Exclusion criteria included overlap syndrome, serum creatinine > 1.4 mg/dl, proteinuria > 0.15 g/24 hour, pregnancy, cancer, cirrhosis, history of myocardial infarction, angina, stroke or receiving insulin. Ten age and sex matched healthy volunteers served as controls with a mean age of 27.8 +/- 4.61 years. Full history taking, clinical examination and investigations were performed for all the patients. Disease activity and damage were assessed by SLEDAI and SLICC/ACR DI respectively. The Adult Treatment Panel [ATP III] criteria were used to define the presence of metabolic syndrome in SLE patients. Levels of insulin, glucose, creatinine, lipid profile as well as, ox-LDL Ab were measured in patients and control. Insulin sensitivity was estimated using the homeostatic model assessment index [HOMA-B] for beta cell function and [HOMA-IR] for peripheral tissue insulin resistance. Intima-media thickness [IMT] of the carotid artery was measured in both patients and control by ultrasonography. Patients with SLE had significantly higher mean values of HOMA-IR, HOMA-B, ox-LDL Ab and intima-media thickness [IMT]. The mean IMT in the SLE patients was 0.74 +/- 0.38 mm vs 0.25 +/- 0.09 mm in the control. Moreover, the circulating serum ox-LDL level in SLE patients was significantly higher compared to control subjects [37.18 +/- 10.85 EU/ml vs. 14.18 +/- 2.42 EU/ml, respectively]. On classifying SLE patients according to the presence or absence of metabolic syndrome, the mean ox-LDL Ab level was significantly higher in patients with metabolic syndrome [n = 11] compared to those without metabolic syndrome [n = 19]. While, no statistically, significant difference was observed between both groups either in SLE disease activity index [SLEDAI], damage index [SLICC/DI], HOMA-IR, HOMA-B or IMT. Correlation of the metabolic features and IMT of the SLE patients with the studied parameters revealed a significant positive correlation between the ox-LDL and the waist-hip ratio, HOMA-IR, SLEDAI, SLICC/DI indices as well as IMT. Beta cell function significantly negatively correlated with the dose of administered steroids. Furthermore,' IMT significantly positively correlated with the SLEDAI and SLICC/DI respectively. It could be concluded that serum ox-LDL is altered in SLE patients especially with metabolic syndrome and is correlated with insulin resistance and atherosclerosis as well as SLE activity and damage indices. Additionally, IMT is increased in SLE patients. Both serum ox-LDL level and IMT measurement are recommended in SLE patients and could be used as useful markers for predicting future cardiovascular events especially in the absence of symptoms of CVD

In vitro infection of primary hepatocytes by HCV genotype 4a and inhibition of virus replication by cyclosporine

In this study we used the newly immortalized primary hepatocyte cell line called HuSE7/DN24 [HuS] to establish an in vitro infection and replication system for HCV genotype 4 [HCV-4a]. HuS cells were infected with sera obtained from Egyptian patients with chronic hepatitis C genotype 4a. HCV-4a could infect HuS cells in a dose dependent manner. HuS cells were permissive for HCV-4a infection and replication by 8 - 20 folds higher than that noticed in Huh 7.5 cells under the same infection conditions. Comparing the infectivity and replication of the HCV-4a from different Egyptian sera with that of HCV-1b from Japanese serum showed that HCV-4a is replicating in HuS cells 5 - 7 times better than HCV-1b under similar infection conditions. The HCV-4a replication in HuS cells was detectable after 3 days of culture, peaked after 5 days and then declined at day 7 of culture. The HCV-4a infection and replication in HuS cells could be completely inhibited by Cyclosporine [CsA] in a concentration of 3 micro g/ml of the culture medium. NIM811 which is a nonimmunosuppressive derivative of CsA could further inhibit HCV-4a infection and replication in HuS cells when added in a concentration of 0.5 micro g/ml of the culture medium. Meanwhile, IFN? in a dose of 50U/ml in culture medium could inhibit HCV-4a replication in HuS cells by more than 90%. This study may be the first ex-vivo study examining the infectivity and replication of HCV-4a in primary hepatocytes. Also, it is the first study examining the effect of cyclosporine and NIM811 on HCV-4a infection and replication in primary hepatocytes in vitro

Interleukin-1 receptor antagonist among chronic renal failure pediatric patients with and without hemodialysis

During hemodialysis [HD], human blood leucocytes in circulation are exposed to several extraneous challenges, thus stimulated to secrete many inflammatory cytokines and its inhibitors as inter-leukin-1 and interieukin-1 receptor antagonist [IL-Ira]. The aim of this study was to investigate difference in the level of IL-IRa synthesis by peripheral blood mononuclear cells [PBMC] between CRF patients under conservative treatment and CRF patients under hemodialysis, and if this cytokine-specific inhibitory protein of PBMC can be used as a marker of dialysis related morbidity. The study included 44 subjects divided into 3 groups: [A] control group, [B] Chronic renal failure[CRF] under conservative treatment, [C] CRF under HD. Peripheral blood mononuclear cells [PBMC] were separated by ficoll-Hypaque. Spontaneous and Phytohemagglutinin [PHA] stimulated total IL-1Ra synthesis [cell-associated and secreted] by cultured PBMC was measured using EL-ISA method. The results of the study revealed that there were significant spontaneous total IL-IRa synthesis by PBMC in dialysis patients [group C] 2812 +/- 836 and in patients with conservative treatment [group B] 1791.2 +/- 252 compared to control group [group A] 940 +/- 227.8 [P value <0.001]. There were significant spontaneous total IL-IRa synthesis by PBMC in dialysis patients [group C] 2812 +/- 836 compared to patients with conservative treatment [group B] 1791.2 +/- 252 [P value <0.001]. There were significant PHA stimulated total IL-IRa synthesis by PBMC in dialysis patients [group C] 34041 +/- 8906 and in patients with conservative treatment [group B] 8565 +/- 1244 compared to control group [group A] 2980 +/- 608 [P value <0.001]. There were significant PHA stimulated total IL-IRa synthesis by PBMC in dialysis patients [group C] 34041 +/- 8906 compared to patients with conservative treatment [group B] 8565 +/- 1244 [P value <0.001]. There was positive correlation between PHA stimulated total synthesis of ILIRa and spontaneous total synthesis of ILIRa by PBMC in the 3 groups [P value <0.001]. There was significant correlation between IL-IRa [spontaneous and stimulated] with blood pressure, urea and creatinine level [P value <0.001]. This study concluded that PBMC of CRF patients synthesize significant level of IL-IRa compared to PBMC of healthy subjects. Also, PBMC of CRF patients on HD synthesize significant level of IL-IRa compared to PBMC of CRF under conservative treatment. Lastly, IL-IRa synthesis by PBMC of CRF patients was correlated with blood urea, serum creatinine and blood pressure level

Assessment of factors that contribute of lung cancer

A descriptive study to assess of factors that contributes of lung cancer. The study was carried out in Specialized Surgery teaching hospital, Ibin Al- Beetar hospital and Ibin Al- Nafees hospital for the period From January 2004 to October 2004 .The study aimed to assess the factors that contribute to lung cancer and to identify the relationship between the variables of the study with lung cancer. A purposive [non-probability] sample of [70] patients with lung cancer was selected for the study. An assessment form was employed for the purpose of the study. Test- retest reliability was employed through computation of Pearson correlation coefficient. Content validity of the assessment was determined through a panel of experts. Data were collected through the interview technique. Data were analyzed through descriptive statistical approach [frequency and percentage] and inferential statistical approach [chi -square]. The study showed that the majority of the study sample were [60-69] years old and most of them were male [65.7%] .The level of education was primary graduate [32.9%] and most of them were working in governmental officer. The result of the study showed that smoking is the majors' factors that contribute to lung cancer. The study recommended stopping smoking, established special center to lung cancer in Iraq, regular chest exam to workers in the industry and need specialist nurse in cancer in Iraq

Assessment of life-style for adults with diabetes mellitus "type II"

A descriptive study to was designed to assess the lifestyle for adults with diabetes mellitus [typeII].The study was carried out at the National Diabetes Center, College of Medicine, Al-Mustansiriya University and Specialized Center for Endocrinology and Diabetes in AL-Kindy Teaching Hospital for the period of July 2002to August 2003. The study also aimed to find out the relationship between the life style pattern with demographic characteristic. A purposive [non-probability] sample of [205] patients with criteria of the sample [age 40 years and above and duration of diabetes one years and above] was selected for the study. An assessment form was constructed for the purpose of the study. Test-retest reliability was employed through computation of Pearson correlation coefficient. Content validity of the assessment form was determined through a panel of experts.Data were collected through the interview technique.Data were analyzed through descriptive statistical approach [frequency and percentage] and inferential statistical approach [chi-square and correlation coefficient]. The study indicated that the mean of age was [56.28] year. The majority of them were males who lived in urban area with a nuclear family. Their level of education was able to read and write and most of them were married and having children. The results of the study confirmed that diabetes had an effect on the adults' lifestyle. The study recommended that the number of diabetic centers should be increased in Iraq. Patients with new diagnosis need a special education program in the specialized centre, identification of a nurse specialist and distribution manual of diabetes to every patient

Comparative study between variceal ligation by detachable snare versus banding in bleeding esophageal varices

Varcial bleeding is a very serious complication with a reported mortality rate of 20-50%. Patients who have had a vatriceal hemorrhage are usually treated by endoscopic injection sclerotherapy or band ligation to eradicate the varices. Endoloop ligation is a new technique invented to achieve hemostatis and variceal eradiation. This work included fifty patients with acute esophageal ariceal bleeding, 25 patients were managed by band ligation and the other 25 patients were managed by endoloop ligation. The number of patients who rebelled during the follow-up was smaller in the endoloop group [12%] compared to the band group [28%], yet, this difference did not reach statistical significance. Also, no statistically significant difference was found between the two groups regarding the number of patients who showed complete varicea eradication, the number of active sessions needed to reach variceal eradiation or the incidence of variceal recurrence by the end of follow-up period of six months. It was found that the total cost of endoloop sessions' needed for variceal obliteration was 1163.9 l.e for erach patient, while it was 12.9.9 l.e for band ligaion. Also, the endoloop showed technical advanced over band application including better field of vision, more tight application, good results on junctional varices, and no strain exerted by the device on the endoscope. We can conclude that endoloop ligation is a new promising technique for managing bleeding esophageal varices

prevalence of exercise induced asthma among Iraqi soccer premier club players

Bronchoconstriction can be provoked by exercise and individuals are vary greatly in their response. Some people, in the absence of pharmacological protection, become symptomatic almost every time they exercise. The change in PEFR was recorded before and after exercise to 35 soccer players [13 seniors and 25 youth players]. There was no significant relationship in resting PEFR between senior and youth players. There were only two players found to have a reduction in PEFR equal or more than 15%. The give a prevalence rate of EIA of approximately 5.7%

Normalization of ventricular late potentials by captopril in survivors of myocardial infraction with reduced left ventricular ejection fraction

This study included 32 MI [myocardial infarction] survivors aged 37-67 years [52 +/- 1.5] [mean +/- SEM] with EF <45% [echocardiographic, biplane area length method] whose signal-averaged electrocardiogram [SAEKG] [standard criteria, time domain analysis] was abnormal 33 +/- 3.3 D after MI. Eighteen patients received captopril [35 mg tid for eight weeks] [active group] while 13 received no ACEI [control]. No patients had bundle branch block, syncope, antiarrhythmic drugs or underwent revascularization procedure. Active and control groups were comparable regarding age, gender, thrombolytic therapy, prevalence of hypertension, time after MI, percentage of anterior MR, FF and prevalence of angina. SAEKG was repeated after eight weeks for both groups. Data of 1st and 2nd recordings showed favorable alteration of all parameters. Out of 13 patients without captopril, only one normalized his SAEKG, whereas 17 of 19 patients on captopril normalized at the same period. Shortening of QRS correlated to EF rise

study on effects of sulphur dioxide exposure on the pulmonary function of the Northern oil refinery workers at Baiji

Sulphur dioxide is widely encountered because of its numerous industrial uses. It is the most prominent gas contributing to atmospheres pollution. Many studies have indicated a great impairments of lung function after chronic exposure to pollution. Pulmonary function is usually estimated by PEFR using Standard Wright Peak Expiration Meter. A 145 male subjects working at the Northern Oil Refinery in Baiji were subjected to a pulmonary function test during of Summer 1994. The study shows that the number of affected subjects were more than those non-affected. [81.37%] was the percentage of the affected subjects. The study shows a significant relationship between height and weight and the performance of the PEFR. Also, there was relationship between the period of employment of the subject in the refinery and the values of the PEFR test. The study shows a significant relationship between subjects without previous chest illness and the pulmonary function test. Also, there was a relationship between the PEFR values and the stats of respiratory discomfort and exhaustion during the daily labor

Masturbation in infants, a case report

Masturbation is not uncommon in infants. This is a rare report of a 6 month old Saudi girl who masturbated from the age of 3 months following diaper dermatitis