Extracorporeal shockwave lithotripsy in the management of a large proximal ureteric stone: a case report

Urinary stone disease still persists as a major health care problem due to its high prevalence. The management of patients with ureteral stones still remains under debate in several areas. There are different therapeutic approaches for ureteral stones depending on stone size, location, anatomical variations of the urogenital tract and patient performance. Extracorporeal shockwave lithotripsy [ESWL] being the main stay of treatment of choice for the stones, the management of large stone remains a point of discussion. With the latest advance in technology coupled with knowledge, there have been recent changes in therapeutic options for ureteric stones. Therefore, the treatment approaches may be individualized in order to achieve optimum outcomes. This article reports on a case of a large proximal ureteric stone with acute flank pain and hematuria managed by ESWL

Effect of maternal active and passive smoking during pregnancy on maternal and neonatal thyroid function

The influence of maternal active and passive smoking on the maternal and neonatal thyroid function was evaluated in 45 mother-neonate pairs. The sample was divided into three groups: Active smokers [n = 16], passive smokers [n = 17] and nonsmokers as a control group [n = 12]. Sera from mothers and umbilical cord of their neonates were analyzed for nicotine metabolite, free thyroxin [free T4] and thyrotropin [TSH] using IMMIULITE immunoassay method. The study concluded that smoking during pregnancy whether active or passive may be responsible for maternal and neonatal thyroid hyperfunction. Other mechanisms than fetal thyroid hyperfunction are responsible for the retarded growth observed in these infants

Maternal and fetal prolactin levels in relation to maternal smoking during pregnancy

In this study, the maternal and serum cord prolactin and nicotine metabolite levels were measured at birth using the IMMULITE immunoassay method in 40 apparently healthy mother-neonate pairs. In 20 of them, the mothers were smokers during pregnancy and the remaining 20 were nonsmokers and not exposed to passive smoking from a household smoker and with no chronic disease prior to pregnancy, drug- induced pregnancy, ingestion of drugs known to alter prolactin secretion, twin gestations, prematurity, malformations, complications during pregnancy or labor. The findings indicated that maternal smoking during pregnancy lower the serum prolactin level in mothers at delivery with the expected short period of breast feeding, which makes their infants susceptible to the drawbacks of artificial feeding, in addition to the disturbance of the endocrine status of the fetus as shown by the lower fetal prolactin level

Relationship of anti 22 - glycoprotein 1 antibody to pregnancy loss in patients with antiphospholipid antibodtes

The lupus anticoagulant [LA] and anticardiolipin antibodies [aCL] are clinically relevant because of their association with thrombosis and pregnancy loss. The group of antiphospholipid antibodies [aPL] includes antibodies primarily directed against various phospholipid-binding proteins, mainly beta 2-glycoprotein 1 [beta 2GP1]. Some studies suggest that there is an association between the presence of anti beta 2GPl antibodies [a beta GPl] of IgG issotype and thrombosis. Therefore, aPL defined according to the plasma protein to which they are directed appear to be more appropriate for the evaluation of their clinical importance. Using home-made ELISAs we evaluated the presence of a beta 2GP1 of both isotypes [IgG and IgM] in 80 patients with LA and/or aCL. The patients were divided into 2 groups group 1: 40 patients with history of pregnancy complication and group II: 40 patients without a history of pregnancy complication. The study demonstrated that the presence of a beta 2GPl-IgM correlates well with a history of pregnancy loss [OR 2.6; 95% CI 1.1 - 6.1]. So, the present study concluded that the measurement of a beta GP1 of both isotypes could help to identify a PL-positive patients with higher risk for pregnancy loss, although this association should be confirmed by other studies

Diagnosis and management of failed ovum pickup, a postulated cause of unexplained infertility

To study the ovum pickup mechanism and the fimbrio-ovarian relation in fertile and cases of unexplained infertility and to design a method for investigation and anticipation of the state of ovum pickup. Prospective clinical study. Department of Obstetrics and Gynecology Kasr El Aini Hospital, Cairo University, Egypt. Fifty fertile and twenty five cases of unexplained infertility. In all cases the fimbrio-ovarian relation is studied by determining the length of the ovulation border, the site of ovulation on that border and the length of the firnbria ovarica. It is also determined by a simple test [The fimbrio-ovarian accessibility test]. The fimbrio are held by non-traumatizing grasper and their ability to reach and/or to cover the ovulation site are taken as prove for successful ovum pickup. In addition, cases having suspected failed ovum picking are treated by controlled superovulatton, drilling of the ovary at an accessible site to the fimbrio ovarica and also by freeing short fimbrio ovarica, or partial bisection of the ovarian ligament using bipolar diathermy to allow for more ovarian accessibility to the fallopian tube and hence improving the fimbrio -ovarian juxtaposition. The ovulation site is found to be usually accessible to the fimbrio end of the tube [94%] in the fertile cases and not accessible [92%] in the infertile cases. Correction of the fimbrio-ovarian relation in the infertile cases was associated with a cumulative ongoing pregnancy rate of 68%. Failed ovum pickup should be considered as one of the important causes of unexplained infertility. The suggested "firnbrio - ovarian inaccessibility" should be considered in these cases. Correction of the fimbrio-ovarian relation, to make ovum pickup possible, should be considered as a method for treating such cases

Controlled neutralisation of gastric acid in cases of hemorrhagic gastritis

In this study a simple and safe method of non-surgical treatment for the control of massive acute gastric mucosal haemorrhage was used. This procedure was based on the hypsiological concept that the presence of gastric HCL plays an important role in the development of this syndrome. The results showed that the bleeding, in 25 out of 32 cases could be controlled [78%]. The technique has been described. This is a preliminary report but this procedure deserves further trials to establish its effectiveness in controlling massive gastric mucosal haemorrhage