Laparoscopic intra-ovarian platelet rich plasma injection for ovarian rejuvenation: a new hope for infertile women

This case report was presented to show the outcome of bilateral laparoscopic platelet rich plasma intra-ovarian injection for 34-year old woman who had primary infertility secondary to premature ovarian insufficiency and had two previously failed attempts of ICSI. One month after the procedure, the patient had menses and her hormonal profile was improved with increased serum AMH and E2 and decreased serum FSH and LH. On the eleventh day of the menstrual cycle, folliculometry detected good follicle measuring 18×20 mm, on the fifteenth day, trans-vaginal ultrasonography assured ovulation and timed intercourse was ordered, and she got pregnant. At the thirty fifth gestational week, she had premature preterm rupture of membrane and urgent cesarean delivery was performed and the newborn was admitted to neonatal intensive care unit. As conclusion, intra-ovarian PRP injections could be safe, productive, and a natural treatment for women with POI. Laparoscopic injection allowed perfect under-vision intra-ovarian injection and can be conducted as one-day procedure and this can be considered a novelty of the applied procedure.

Nutritional value and microbiological profile of some locally prepared weaning-food mixtures

Malnutrition is one of the most serious nutritional diseases among children especially during the weaning period. Ten weaning-food mixtures were prepared by using faba beans [vicia faba L.] variety Giza; rice [Oryza sativa]; corn [zea mays] variety 320; lentil [Lens culinaris] were obtained from Agricultural Research Center, Giza, Cairo. Meanwhile, karish cheese [Cottage cheese]; apple [Malus domistica] and yellow carrots [Daucus carrota] were obtained from the local market, El-Obour City, Qalubia, Egypt. Chemical composition of food materials [g/100g on dry weight basis] indicated that: karish cheese powder recorded the highest percentage of protein [31.6%] followed by lentil [26.2%], faba bean [24.5%], respectively. Meanwhile, carrots showed the highest percentage of crude fibers [6.9%], followed by apple peel [4.0%]. Rice had the highest percentage of carbohydrates [88.5%]. The highest value of calories was found in corn [411.5 kcal], followed by rice [401.7 kcal]. Cereals are rich in carbohydrates and are the main source of energy. Moreover, consuming 100g from any of the ten prepared formulae could cover the daily requirements for infants [6-12 months] from proteins and about half or more of the required energy according to FAO/WHO, [1989], which recorded that babies need from [13-14g] protein and [650-850 kilo calories]. Total bacterial counts of all formulae mixtures ranged between [31 and 61], while psychrophilic bacteria ranged between [22 and 44]. Microbiological evaluation showed that all the formulae were in the permissible limits according to the recommendations of Egyptian organization for standardization and quality control. Also, results showed that the total bacterial counts were less than 1000 cell/g in all formulae. Coliform bacteria, fungi and yeasts were not detected in all samples and had a negative presumptive test for the presence of coliform bacteria, fungi and yeasts. These results may partially be due to the effect of heat treatment during the preparation of mixtures and mainly due to heat sterilization of final food mixtures

Application of hazard analysis and critical control point [HACCP] on mango pulp and mango juice

HACCP plan was established for mango pulp production and mango juice processing lines. Results showed that the number of aerobic, anaerobic bacteria, Bacillus cereus decreased from 5.0 x 10[4] CFU/g and 7.0 x 10[3] CFU/g to -ve, -ve, -ve respectively after HACCP in the mango pulp. Mold and yeast, Coliform group, E. coli and Staph. aureus were not found in mango juice either before or after HACCP. Aerobic and anaerobic bacteria were found before HACCP in mango juice. Verification procedures of cleaning and disinfection plan, controlling of critical control points[CCPs] and HACCP system through the microbiological tests were conducted. The results revealed that the microbial load was significantly decreased to the acceptable levels at all processing steps

values of serum and ascetic fluid tumor necrosis factor-Alpha [TNF-alpha], TNF-receptor 1 and C-reactive protein [CRP] in patients with cirrhotic ascites

Spontaneous bacterial peritonitis [SBP] is defined as an infection of initially sterile ascitic fluid [AF] without a detectable, surgically treatable source of infection. It is a frequent and severe complication of cirrhotic ascites. Because of the high morbidity and mortality of SBP, the rapid and accurate diagnosis is required. The present study aimed to measure the levels of tumor necrosis factor-alpha [TNF-alpha], tumor necrosis factor receptor [TNF-r p55] and C-reactive protein [CRP] in both ascetic fluid and serum of patients with sterile and infected cirrhotic ascites to show their diagnostic values as compared to ascitic fluid culture and polymorphnuclear leukocyte [PMN] count. TNF-alpha, TNF-r p55 and CRP were measured in both ascetic fluid and serum of 20 patients with spontaneous bacterial peritonitis [SBP], in addition to 22 patients with sterile cirrhotic ascites. The results of clinical examination showed a significant difference as regard abdominal pain, fever jaundice, upper GIT bleedings, encephalopathy and Sclerotherapy among both groups. The serum levels of CRP and TNF-alpha were significantly higher in patients with SBP as comparing to patients have sterile ascites, but TNF-r p55 serum level showed no significant difference. On evaluation of ascetic fluid parameters, total leucocytic count [TLC], plymorphnuclear [PMN] count, CRP, TNF-alpha, TNF-r p55 are significantly higher in SBP patient group than group of sterile ascites. Sensitivity and specificity of ascitic fluid PMN [cut-off value >250 cells/ mm[3]] in discriminating infected ascites from sterile ascites were 70% and 86.4%, respectively. Sensitivity and specificity of ascitic fluid CRP [cut-off value >1.0 mg/dL] in discriminating infected ascites from sterile ascites were 85% and 72.7%, respectively. Sensitivity and specificity of ascitic fluid TNF-alpha [cut off value >12 pg/ml] in discriminating infected ascites from sterile ascites were 80% and 63.6%, respectively. Sensitivity and specificity of TNF-r p55 [cut-off value >6.2 pg/ml] in discriminating infected ascites from sterile ascites were 75% and 68.2%, respectively. We concluded that, the elevated serum and ascetic fluid levels of CRP, TNF-alpha and TNF-r may suggest their role in the pathogenesis of ascetic fluid infection and their higher sensitivity and specificity make them to be good discriminators in ascetic fluid infection [especially a cheap and easy ascitic fluid CRP levels]. Thus may help in rapid diagnosis and early start empirical antibiotic therapy without waiting the culture results

Evaluation of oxidative stress and apoptosis in breast cancer

Reactive oxygen species are important in the pathogenesis of many diseases, including breast cancers. In this study, we aimed to evaluate oxidative stress in patients with breast cancer and to investigate its relationship with apoptosis. Our results showed that, the median levels and positivity rates of Malondialdehyde [MDA], Nitric Oxide [NO], Total Antioxidant [TAO], caspase-3,%DNA fragmentation and MDA/TAO ratio measured in breast cancer tissues by colorimetric methods were higher in the malignant group as compared to benign control group. Moreover, MDA, NO and%DNA fragmentations were over produced in advanced grade and stage P<0.05. Furthermore, a significant positive correlation was found between MDA/TAO ratio and positive lymph node metastasis. Also, there were significant positive correlations of caspase-3 and%DNA fragmentation with positive estrogen receptor and NO. Moreover, the total antioxidants were positively correlated with positive progesterone receptor. In Conclusion; oxidative stress, NO and apoptosis are highly detected in breast cancer tissues especially with advanced grade and stage

Combination of zygote andembryo morphology scoring couldaccurately aid to predict the outcomeof intra-cytoplasmic sperm injectionprocedures

This study was designed to examine the relationship between zygoteand embryo morphology as judged by Z-scoring and Embryo scoring systems, and to test whether these scores could be used to predict accurate-ly the outcome of cycles of intracytoplasmic sperm injection[ICSI] judged by detection of chemical pregnancy. The study comprised 78 infertile couples that had undergone ICSI. After ICSI procedure, oocytes were cultured and assessed for the presence of pronuclei after 16-18 h of incubation. Zygotes were scored for the position of pronuclei, position and type of nucleoli and cytoplasmic morphology, each parameter was awarded a scoreof 5 points. Embryos were scored for the blastomere volume and synchrony of cleavage, the level of multinucleation and the extent of fragmentation, each of parameter was awarded a score of 5 points. Zygotes and embryos awarded score of 15 were categorized as Z1 or E1, those scored10-14 were categorized as Z2 or E2 and those scored <10 were Z3 or E3.The establishment of a chemical pregnancy was considered as a positive beta-hCG test >20 IU/L at 12 days after embryo transfer and was consid-ered for evaluation of the predictability of the outcome of ICSI procedure. The mean number of oocytes retrieved was 7.1+/-2.6_patient and succeeded fertilization was reported in 422 of a total of 536 oocytes [80.6%].There were 113 zygotes [26.16%] of Z1 score, 186 zygotes [43.06%] of Z2 score and 133 zygotes [30.78%] of Z3 score; whereas, 101 embryos [23.38%] were of E1 score, 187 embryos [43.29%] were of E2 score and144 embryos [33.33%] were of E3 score. There was a positive significant correlation between the determined zygote and embryo scores, [p<0.001].Pregnancy was diagnosed in 19 patients [24.35%], 10 females [52.63%] had embryos morphologically graded Z1E1, 4 females [21.05%] had embryos' graded Z2E2, 2 females [10.52%] had embryos graded Z1E3 and the other 3[15.79%] had their embryos graded Z1E2, Z2E1 and Z3E1, respectively. Morphological scoring depending on both zygote and embryo scoring could predict the outcome of ICSI with specificity 91.77% and ac-curacy rate of 90.05%, while depending on zygote score alone the specificity and accuracy rates were 75.79% and 73.15%, respectively and depending on embryo score only specificity and accuracy rates were 78.4%and 77.77% with a significant difference in the predictability depending on combined scores compared to that depending on either zygote score[p<0.001] or embryo score [p<0.01]. It could be concluded that morphological scoring using combination of zygote and embryo scores aid to predict accurately the outcome of ICSI procedures

Assessment of three methods of airway maintenance during pedodontic surgery

Airway management during pedodontic operations were evaluated by using three different methods in fifty four patients ASA class I and rate 1 according to Frankl Behavioral Rating Scale with multiple decayed teeth. These patients were divided into three equal groups. In the first group; airway maintained by using nasal mask over a nasopharyngeal airway. In the second group airway maintained by using nasotracheal tube, and the third group arranged to maintain their airway by using flexible laryngeal mask. Anesthesia was induced with intravenous propofol. The mean induction time was significantly longer for nasotracheal group 8.692+/-0.221 minutes and laryngeal mask group 6.885+/-0.221 minutes compared to nasal mask over a nasopharyngeal airway group 3.615+/-0.221 minutes. The mean oxygen saturation levels during the different stages of anesthesia revealed no significant differences between groups regarding the pre-induction base-line levels. Nasotracheal group reported the lowest oxygen saturation levels during insertion. Also flexible laryngeal mask group revealed significant decrease in oxygen saturation levels during the insertion. There were significant decrease in mean oxygen saturation levels in these two groups compared to nasal mask group. During surgical procedures, the nasotracheal group reported the highest oxygen saturation level; followed by the nasal mask group. Flexible laryngeal mask group reported the lowest oxygen saturation level. Surgical access was better in both nasotracheal group and nasal mask group, but there was more interruption of surgery in laryngeal mask group. There was incidence of epistaxis in the nasotracheal group [30.76%] and nasal mask group [17.34%] compared to flexible laryngeal mask group. Sore throat was reported in both flexible laryngeal mask group [61.54%] and nasotracheal group [46.15%]. There was a significantly greater incidence of jaw pain after operation in laryngeal mask group [76.92%] compared to nasotracheal group [23.08%] and nasal mask group [15.38%]. In conclusion, nasal mask over a nasopharyngeal airway was effective as laryngeal mask in maintaining the airway. Both can be inserted without use of muscle relaxants. The time for induction of anesthesia was shorter in the nasal mask over a nasopharyngeal airway. Both flexible laryngeal mask and endotracheal intubation required deep level of anesthesia and longer lime of induction. Endo- tracheal intubation performed through the nose was the safest anesthetic technique. It provided an excellent airway and good surgical access. Better arterial oxygen saturation, and airway maintenance were found in this group. Surgical access was better in both nasotracheal group and nasal mask group, but more interruption for surgery was found in laryngeal mask group

Severity and pattern of enamel opacities in a group of Egyptian children with chronic renal failure and microabrasion technique for treatment of this defects

Every year approximately 450 children in the united kingdom suffer rum chronic renal failure, in Egypt we are far from this number we have more than thousands, of these about 10% under 15 years of age develop endstage renal failure. Increase survival rates occurred due to successful dialysis, technology and transplantation but secondary effects occur on enamel and delayed eruption of teeth occurred, in this study we compared 105 children with CRF with another 100 healthy control group regarding the enamel opacities using the DDE index also the severity and pattern of the defects were noticed. we concluded that the children with CRF have significantly more enamel defects and opacities than normal control group as 30% only in the control group has enamel opacities while all children in patients group suffer from some degree of enamel opacities, also the enamel defects tends to be generalized in permanent teeth while it tends to be localized in primary teeth, micro- abrasion and esthetic treatment has been done to those patents especially in the adolescent age. There is a potential for enamel opacities with CRF and modification to dental treatment is needed or the timing as well as the most appropriate antibiotics and the interception for esthetic correction of enamel defects in this young people, also this study high light for further study in the relation to other drugs lead to enamel opacities

Relation between palmar plantar hyperkeratosis and aggressive periodontitis in Egyptian children

Aggressive periodontitis describe three of the diseases formally classified as early onset of periodontitis as localized juvenile periodontitis, generalized juvenile periodontitis and rapidly progressive periodontitis. This study was conducted oil children with age range from seven to fifteen years while mean age was 10.2. Fifteen boys and fifteen girls. Five of them were having Papillon - Lefevere syndrome [group I], tell had only ectodermal dysplasia [group II] and the rest of the children were normal healthy children with no obvious systemic disease [group III]. All the children undertaken medical and dental history. Complete dental examination and basic periodontal examination [BPE] were conducted using WHO probe. Mobility and furcation involvement were also measured to detect any sign of aggressive periodontitis. Any children had diabetes or other systemic conditions rather than ectodermal dysplasia was excluded from the study. The results showed that all children with Papillon - Lefevere syndrome had generalized type of aggressive periodontitis with grade three or four mobility and furcation involvement. While in group II. Children with ectodermal dysplasia only two of ten children had generalized type of aggressive periodontitis and six had sign of gingivitis with no obvious sign of aggressive periodontitis either localized or generalized and two had only bleeding oil with no signs for periodontitis. In group III [normal healthy children], no one of them showed pocket formation or any other sign of localized or generalized aggressive periodontitis and only mild to moderate gingivitis was noticed. From this study we concluded that there are strong relation between generalized aggressive periodontitis and Papillon - Lefevere syndrome and there is some relation between ectodermal dysplasia and generalized aggressive periodontitis. Aggressive periodontitis is a disease that needs a special care from the pediatric dentist to detect it as early as possible and differentiate it from other periodontal disease and know its relation to other systemic syndrome and genetic disorders

Correlation between dietary habits and dental caries prevalence among primary school children with different socio-economic levels in Ismailia City

This study was conducted to determine prevalence of dental caries and to assess the correlation between dietary habits and caries prevalence among primary school children in Ismailia City. A total of 2317 primary school children, ageing from 6 to 11 years of high and low socio-economic levels were examined to detect dmfs. DMFS and to calculate number of sugary snacks /week. Correlations between number of sugary snacks /week and number of affected surfaces in primary and permanent teeth were studied. The results of this study showed that: In permanent teeth the prevalence of dental caries increases with age. There is no significant difference in caries experience between boys and girls. Children of low socio-economic level had higher caries scores than children of high socio-economic level. There is a strong and significant correlation between number of sugary snacks taken by children and dental caries prevalence in both primary and permanent teeth