Life threatening liver laceration with arteria; hemorrhage complicating percutaneous treatment of hepatic hydatid cyst

We present a 76-year-old woman known to have a large right hepatic lobe hydatid cyst which recurred twice after surgical excision. CT-guided percutaneous alcohol ablation was conducted to scleroses the cyst, but the procedure was complicated by parenchyma liver laceration and active arterial hemorrhage from a branch of the right hepatic artery. Bleeding was controlled by both endovascular and surgical interventions. Liver laceration with arterial hemorrhage is a rare not previously reported serious complication of percutaneous treatment of hepatic hydatid cyst that may be potentially life-threatening

Normal serum alkaline phosphatase in the presence of extensive skeletal metastases of prostate cancer

Alkaline phosphatase [ALP] is a nonspecific tumor marker as it is neither organ or tumor specific. An elevation of the enzyme in relation to carcinoma of the prostate is usually due to boene or liver involvement, or both, by metastatic disease. We report the case of a 91-year-old man who presented with chronic urinary retention. Investigations revealed prostate specific antigen [PSA] of 831.4 ng/ml, biochemical evidence of moderate renal impairment, normal liver function tests and normal alkaline phosphatase. Whole body skeletal scintigraphy with 99mTC-MDF showed widespread skeletal metastases. Transrectal ultrasound of the prostate revealed a 40 gm prostate gland with a hypoechoic defect in the periphery of the gland. Prostate biopsy revealed prostate cancer [Gleason's score 8]. Total serum testosterone, zinc and magnesium were below the normal range. Bone densitometry revealed osteoporosis. Channel transurethral resection of the prostate was performed together with bilateral orchidectomy. Testicular histology revealed atrophic tests. Normal serum alkaline phospatase in this patient in the presence of extensive skeletal metastases may be due to the combination of the following factors: relative hypogonadism, osteoporosis, low serum zinc and magnesium. This case report may provide a possible explanation for the observation that about 10% of men with widespread skeletal metastases from prostate cancer may not have elevated serum alkaline phosphatase

Sectorial technetium-99m-dimercaptosuccinic acid scintigraphy for monitoring the effect of extracorporeal piezoelectric lithotripsy for calyceal calculi on regional renal function

To apply a semiquantitative method for analysis of technetium-99m-dimercaptosuccinic acid [99mTc-DMSA] renal scintigraphy for monitoring the effect of extracorporeal piezoelectric lithotripsy [EPL] in patients with calyceal stones on regional kidney function and to check whether EPL had caused any deleterious effect on the target calyceal renal parenchymal function. Patients and Forty patients [mean age 35 years] suffering from calyceal stones documented by abdominal plain radiography, intravenous urogram or abdominal ultrasound were studied. All patients were treated by EPL. 99mTc-DMSA scan was performed before and 4 weeks after EPL. Sector analysis involved calculation of the relative function of the target calyx to the function of the ipsilateral kidney and the relative function of the treated kidney to global renal function. The stone sizes were 6-11 mm in diameter and 11 were located in the upper, 13 in the middle and 16 in the lower calyx. After EPL, the overall stone clearance rate was 85% [100% for calculi in the upper and middle calyces, 62% for lower calyces]. The sector analysis did not show statistically significant change of the relative regional [calyceal] or whole kidney function between the pre- and post-EPL 99mTc-DMSA scans. Using sector analysis, EPL appeared to be a safe modality and its usage was not associated with any untoward effect on calyceal or whole kidney function. Sector analysis of 99mTc-DMSA renal scan is a simple semiquantitative method for monitoring regional changes of kidney function after EPL for treatment of calyceal stone

Assessment of ultrasound fetal weight equations in Egyptian pregnant women

Estimation of fetal weight [FT] by ultrasound [US], is one of the major outputs of diagnostic ultrasonography. Many equations have been generated to achieve this objective. The aim of this work was to assess the reliability of these equations, and determine which one will be more suitable to be applied in Egyptian population. Two hundred full term, normal Egyptian pregnants were selected. US examination was done in the latent phase of labor. After the routine scan, the biparietal diameter [BPD], abdominal circumference [AC] and femur length [FL] were measured. The estimated FW was calculated according to Shepard, Campbell, and Hadlock's equations. The differences between the actual and estimated FW by the 3 equations were statistically nonsignificant. These results indicated that either of the three equations can be used in estimating FW in Egyptian population

Assessment of ultrasonic fetal weight equations in Egyptian population

Fetal weight was estimated sonographically within two days of delivery in 200 cases, by measuring biparietal diameter [BPD], abdominal circumference [AC] and femur length [FL]. Three equations [Shepard, Campbell and Hadlock] were used to assess their applicability in estimating Egyptian fetal weight. There was no significant difference between any of the estimated and actual fetal weight using the three equations. This denoted the possibility of application safely of any of the three equations for estimation of Egyptian fetal weight

effect of the use of oxytocin in augmented labour on neonatal bilirubin levels

Fifty full term normally delivered females were included in this study to investigate the effect of oxytocin use for augmentation on neonatal bilirubin levels. Results were compared with 50 normally delivered control subjects following delivery and in the 3rd and 5th post-natal days. It was found that cord lactic acid mean values and bilirubin mean levels were statistically insignificant between both groups. A positive relationship between oxytocin administration and neonatal hyperbilirubinaemia above 12 mg% was found, but it was not a significant correlation

Knowledge and opinion of educated females about human sexuality

Nurses have to understand the psycho-social and cultural components of human sexuality in order to fulfill their role in sex counseling. The aim of this study was to identify sexual knowledge, opinion and behavior of a sample of 147 educated Egyptian females. The questionnaire used included data related to women's knowledge about human sexuality, time and source of acquiring such knowledge and problems related. Results reveal that sex is a subject avoided by Egyptian females and that females are inhibited in their sex practice. The main source of sex knowledge is outside the family. Males are considered more knowledgeable and can discuss their problems more openly. The role of health professionals in sex counseling is denied by respondents

Evaluation of maternal hematocrit, plasma viscosity and erythrocytic sedimentation rate as a prognostic parameters of neonatal outcome in toxaemia of pregnancy

Thirty, full term, primigravidae spontaneously delivered without complications were selected for this study. Out of this sample 10 were normal pregnant, 10 with mild pre-eclampsia and 10 with severe pre-eclampsia. For each subject maternal haematocrit, erythrocytic sedimentation rate [E.S.R.] and plasma viscosity in normal and pre-eclamptic patients and its relation to neonatal outcome were determined. The results of this study showed progressively increased values of haematocrit with the disease severity which were negatively but significantly correlated with neonatal birth weight, Apgar scoring at one and ten minutes. On the other hand both plasma viscosity and E.S.R. did not show any correlations with the neonatal parameters tested

Effect of labour on liver function in normal pregnancy

Fifty, normal pregnant primigravidae were selected at the latent phase of delivery to determine the effect of stress of labour on the liver functions. Serum alkaline phosphatase, S.G.O.T., S.G.P.T., total serum proteins and serum albumin were estimated before and after labour. Although there were no significant differences, the data for alkaline phosphatase and transaminases showed values above the upper limits of normal standard values. The results suggest that if the pregnancy is complicated by toxaemia or associated hepatic disease or if the liver is border line, this liver under the stress of labour, may fail

Histopathologic studies of the decidua in induced and spontaneous abortion

Histologic and histopathologic studies of the decidua early in gestation were carried out in 20 cases of induced abortion and 140 cases of spontaneous abortion. Decidual necrosis and vascular changes were demonstrated in cases of spontaneous abortion. The results observed were discussed. It is generally believed that the decidual necrosis observed in cases of spontaneous abortion was secondary to ischaemia resulting from obliterative changes in the decidual blood vessels. These vascular changes are believed to be the result of an antigen antibody reaction and this gives support to the immunological theory of spontaneous abortion. On the other hand, decidual necrosis will interfere with early histotrophic embryonal nutrition

Evaluation of a new oral contraceptive [SH. 70850]

A new contraceptive drug containing rgesterel as the prgestatinal gent was tried in 50 women chosen at random for periods varying from 9-10 months. Side effects and endometrial changes were studied and the results discussed

maternal oxygen tension in normal and abnormal pregnancy

The oxygen tension of the maternal arterial blood in 135 pregnant females in the third trimester was studied. 35 cases as normal control group and 100 cases of hypertension with pregnancy. 20 more cases of I.U.F. death were studied as well, of whom four cases of recent [2-7] days and 19 of prolonged [8 days- 8 weeks] duration of death. The maternal arterial P02 in normal pregnant cases was found lower than the accepted mean of non pregnant, again the maternal arterial P02 in hypertensive cases and I.U.F.D, cases were found significantly lower than in normal cases