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

Effect of flumequine on the growth, residual measurements and chromosomal aberrations in tilapia fish

Flumequine [Flu] is a powerful antibacterial agents used against bacterial infections in fish farming because of their high potency against Gram-negative bacteria. The present work aimed to study the effect of different doses of flumequine [0, 6, 8, 10, 12 mg during 90 days and 12 mg therapeutic dose for 5 days] on growth performance, feed utilization, body composition, chromosomal aberrations and determination of flumequine residues in tissues of the tilapia fish. The results revealed that the dose of 10 mg/kg body weight/ day caused significant increase in final body weight, body length, weight gain, specific growth rate and feed intake. Moreover, it improved feed conversion ratio with the same dose whereas the other doses caused non-significant change in feed conversion ratio compared with control group. Also, he best protein efficiency ratio [1.95] was recorded by fish fed the diet with 10 mg/kg body weight/day]. Results of proximate analysis of whole fish body showed that, the fish with dose 10 mg/kg body weight/day gained the highest percentage of protein and the lowest percentage of moisture, fat and ash. Determination of flumequine residues in muscle of fish at the end of the experiment after three month showed negative results. Flumequine at dose of 10 mg/kg body weight/ day caused the lowest percentage in total chromosomal aberrations compared with the other doses that caused the highest percentage of total chromosomal aberration. In conclusion, this study recommended the addition of flumequine to fish diets at a dose of 10 mg/kg body weight/ day as prophylactic dose in order to increase growth performance, feed utilization and decrease mortality of Nile tilapia

Non-invasive assessment of endothelial dysfunction in pre-menopausal systemic lupus erythematosus women at risk of atherosclerosis

To assess the endothelial dysfunction in patients with SLE by measuring endothelial reactivity in pre-menopausal female patients at risk of atherosclerosis without traditional cardiovascular risk factors. This study was conducted on 30 pre-menopause SLE patients and 25 age and sex- matched volunteers. All the patients and controls were free of traditional cardiovascular risk factors. We examined the endothelial function by brachial artery FMV, assessed by high resolution non-invasive ultrasound, where the diameter of the brachial artery is measured at rest and after reactive hyperaemia. The FMV of the brachial artery [endothelium dependent response] was significantly lower in patients than in control subjects [4.1 +/- 1.3 v13.2 +/- 2.0%; p<0.001]. Comparing the FMV with the different variables of the patients' group, we did not find any significant correlation between FMV and; patients' age, disease duration, systolic and diastolic blood pressure, Raynaud's phenomenon, vasculitis and ESR. While, there was a strongly significant difference in brachial artery FMV seen between 12 [40%] aCL positive patients compared to 18 [60%] patients with aCL negative and when compared with controls [4.0 +/- 0.7 v 11.3 +/- 0.6]%, p <0.001; 4.0 +/- 0.7 v 13.2 +/- 2.0%, p<0.001 respectively]. There was also a strongly positive correlation between SLEDAI disease activity score and baseline diameter and FMV [rs=0.42, p<0.001; rs= 0.44, p<0.001 respectively]. While there was a weakly positive statistical difference between FMV and the CRP [rs=-0.24, p=0.05]. The baseline value of FMV showed an inverse correlation with LDL cholesterol [r = -0.41, p<0.05]. When we compared the patients who had received corticosteroids, antimalarial, methotrexate and other medications with those who had not, we didn't find a significant statistical difference concerning the FMV. This study demonstrated that pre-menopausal patients with SLE free from cardiovascular risk factors and overt CVD have an altered endothelial reactivity which correlates positively with a CL positive subgroup of patients, SLEDAI disease activity score, serum CRP values, along with high LDL cholesterol concentration. This endothelial dysfunction indicates a higher susceptibility to the development of atherosclerotic disease