Total versus subtotal abdominal hysterectomy influence on the urinary bladder function

To evaluate lower urinaiy tract flinctions in asymptomatic patients after subtotal abdominal hysterectomy and total abdominal hysterectomy. Forty mtdtiparous premenopausal patients, subjected to subtotal and total abdominal hysterectomy for non malignant causes, and with no urinary complains, were divided into two groups: Group A: Twenty patients in whom subtotal abdominal hysterectomy was performed. Group B: Twenty patients in whom total abdominal hysterectomy was undertaken. Urodynamic data [cystometry, uroflowmeny, and abdominal detrusor leak point pressure] were collected preoperatively, at the 4[th] week, and at the 4[th] month postoperative in both groups. The mean age of group A and B were 42.58 +/- 12.09 years and 43.9 +/- 13.21 years respectively. The mean parity of group A and B were 2.01 +/- 1 1.08 deliveries and 2.61 +/- 1 1.36 deliveries respectively. The mean body mass index of group A and B were 31.25 +/- 12.85 kg/m[2] and 30.7 +/- 1 3.01 kg/m[2] respectively. There were no statistically significant differences between both groups as regards the age, parity, and body mass index. Four weeks postoperative, patients of group A and B complain of frequency [in 20% and 40%], urgency [in 5% and 25%], urge incontinence[in 5% and 20%] respectively. After 4 months of the operation, frequency persisted in [10% and 25%]; urgency persisted in [5% and 20%], However, urge incontinence disappeared in the only one case of group A, which suffered from, while diminished in group B to 10% of the cases. Stress incontinence had never occurred in both studied groups postoperatively. No statistical significant differences were found in the bladder capacity and detrusor muscle activity preoperatively compared with follow up at 4 weeks and at 4 months postoperatively in both groups. Also, No statistical sign[ficant difference was found in residual urine volume preoperative compared with follow up at 4 weeks and at 4 months postoperatively of group [A]. However, significant postoperative increase in the residual urine volume is observed in patients of group [B]. Insignificant urinary complainsand functions changes, except, urgency and residual urine volume are significantly complicating total hysterectomy more than subtotal hysterectomy, with improvement occurred 4 months after the operation

Serum adiponectin levels in coronary artery disease

Coronary artery disease [CAD] refers to a lack of oxygen due to inadequate perfusion of the myocardium, which causes an imbalance between oxygen supply and demand. Many generalized or systemic risk factors predispose to development of atherosclerosis. Atherosclerosis of the coronary arteries commonly causes acute coronary syndromes. Adiponectin is one of the adipokines secreted by adipocytes. Adiponectin may play anti-atherogenic and anti-inflammatory roles. The aim of this study is to investigate whether concentrations of serum adiponectin constitute a significant coronary risk factor. Serum adiponectin was measured in 50 patients with CAD and in 20 control subjects. Patients were divided into three groups according to condition type: Acute myocardial infarction [AMI] group [n=20], unstable angina pectoris [UAP] group [n=15], and stable angina pectoris [SAP] group [n=15]. Serum concentrations of adiponectin in patients with CAD were significantly lower than in control subjects [p<0.000]. There was a significant negative correlation between adiponectin and triglyceride and significant positive correlation with HDL in patients. The findings suggest that measurement of serum concentrations of adiponectin may become a predictor risk factor for CAD and may be related to the development of acute coronary syndromes

Serum leptin in patients with chronic renal failure on different modes of management

To study serum leptin level in chronic renal failure [CRF] patients on different modes of management and to analyze the impact of the mode of therapy on serum leptin level. This study was conducted on 64 patients [33males and 31 females] with chronic renal failure divided into three groups: group I: Twenty-six patients treated conservatively and did not start dialysis yet [predialysis], group II: Twenty-four patients treated by hemodialysis, group III: Fourteen patients treated by continuous ambulatory peritoneal dialysis [CARD]. Twenty healthy subjects were included as control group. All patients and controls were subjected to full clinical examination including height and weight to calculate body mass index [BMI]. Blood urea and serum creatinine were measured as renal function tests. Serum leptin was measured by EAS1A and so serum insulin. In predialysis and CAPD groups, there is a significant increase in leptin, leptin/BMI and insulin in patients in comparison to control subjects. In hemodialysis group, there is a significant increase in leptin and leptin/BMI and a non-significant increase in insulin level in patients in comparison to control subjects. Insulin is significantly correlated with leptin in the first group, while in the second and third groups there is no correlation. The highest leptin level is found in the CAPD group of patients followed by the predialysis one then the hemodialysis group. Leptin level is significantly higher in females than males in all groups. This difference remained after adjusting leptin level to BMI. No correlation was found between leptin level and age or between leptin level and renal function in the three groups of patients. No correlation was found between leptin level and the duration of dialysis in the hemodialysis and CAPD groups. Serum leptin is elevated in CRF patients irrespective of the type of management they are undergoing. Dialysis, has no significant effect on leptin level. The two main predictors of serum leptin level are sex and BMI in CRF patients and in healthy subjects, Leptin level may serve as a valuable clinical marker for body adiposity

Left ventricular diastolic dysfunctions in chronic renal failure patients on healmoodilysis

Left ventricular structure and function abnormalities are frequent in individuals with chronic uremia. This disorders are frequent in patients who has increased risk of cardiovascular diseases. The aim of this study is to study the leading alteration in left ventricular diastolic function and factors related to it, using simple indices of diastolic function obtained with pulsed Doppler studies. This study was conducted on -40 patients who had end stage renal disease. They were on regular maintenance haemodialysis 3 times / week compared to 29 age and sex matched healthy subject, served as control group. All of them were subjected to the following:- full history and clinical examination including age, sex, duration of dialysis, causes of renal failure laboratory investigations were done and include: renal functions [urea, creatinine], full blood, picture blood, sugar, serum inorganic phosphorous, parathyroid hormone [PTH], alkaline phosphatase, serum albumin and total protein. Echo cardiography for assessment of left ventricular end diastolic dimension [LVEDD], left ventricular end systolic dimension [LVESD], posterior wall thickness in diastole [PWT], inter ventricular wall thickness in diastole [IVS], fraction shortening [FS%], ejection fraction [EF%]. Echo doppler examination including peak flow velocity in early diastole [E-wave], peak flow velocity in late systole [A-wave] E/A ratio, acceleration time [AT], deceleration time [D.T], and isovolumic relaxation time. Result showed that: there were a significant increase in left atrial diameter [P<0.01], left ventricular posterior wall thickness, [p <0.01] interventricular septum thickness, [p<0.001] left ventricular mass [p<0.001] in ESRD patients when compared with control group. There were highly significant increase in A-wave [p<0.01] deceleration time [p<0.05] and isovolumic relaxation time [p<0.01] while there were no significant difference in aortic root diameter, left ventricular end systolic dimension, E wave, fractional shortening and ejection fraction, in patients compared with control group. There were significant positive correlation between left atrial diameter and systolic blood pressure, positive correlation between left ventricular mass and both systolic and diastolic blood pressure, positive correlation between parathyroid hormone level and E-wave, negative correlation between left vetricular end diastolic dimension and hemoglobin concentration, negative correlation between left ventricular posterior wall thickness and hemoglobin concentration and negative correlation between parathyroid hormone level and ejection fraction. Cardio vascular complications are frequent in patients with ESRD. Echo cardiography and echo doppler cardiography are recommended in all patients with ESRD

Cell membrane transferrin receptor expression [TER] in bilharzial bladder cancer

This work was carried out upon tissue specimens obtained from 22 patients with non malignant urologic lesion and 34 patients with bladder carcinoma. All were subjected to transferrin receptor [TFR] identification on the cell membrane In all non malignant cases there was negative expression of [TFR] while it was manifested in 94% of malignant cases [32 out of 34]. In two of the malignant cases [6%] there was negative expression of [TFR] as both cases were verrucous carcinoma because of the very low grade and degree of the malignant process in such cases can be expected

Effect of varicocele on the epididymal function

On attempt to study the effect of varicocele on the epididymal activity we measured the level of two epididymal markers [alpha-1,4 glucosidase and total carnitine] in the seminal plasma of 10 normal controls [group I] and 26 patients with varicocele subdivided into group II [with normal seminal count], group III [with oligospermia] and group IV with [severe- oligospermia]. The level of both markers [glucosidase and camitine] was diminished in varicocele patients with oligospermia and there was a significant correlation between the level of these markers and the severity of oligospermia. Estimation of these markers is easy and available and can be used to assess the epididymal activity as well as the infertile patients with subclinical varicocele

Seminal plasma electrolyte differences in fertile and infertile males

The concentration of seminal plasma electrolytes Na, K, Ca, Mg, Zn and Cu were determined in 15 fertile males, 20 infertile males without varicocele and 20 infertile males with varicocele. We did not find any statistical differences between the concentration of these electrolytes in the seminal plasma of the fertile and both infertile groups except the copper. Copper concentration in the seminal plasma of the infertile males with varicocele was highly statistically increased than that of the fertile males [P < 0.001]. This finding may indicate an important role of the Cu in the infertility problem and its measurement may be an index for the presence of subclinical varicocele