Role of magnetic resonance imaging in assessment of acetabular and femoral version in developmental dysplasia of the hip / Papel da ressonância magnética na avaliação da versão acetabular e femoral na displasia do desenvolvimento do quadril

Abstract Objective: To evaluate the role of magnetic resonance imaging (MRI) in the assessment of femoral and acetabular version in developmental dysplasia of the hip (DDH). Materials and Methods: This was a cross-sectional study of 20 consecutive patients with DDH (27 dysplastic hips) who were examined with MRI. In dysplastic and normal hips (DDH and comparison groups, respectively), we evaluated the following parameters: osseous acetabular anteversion (OAA); cartilaginous acetabular anteversion (CAA); femoral anteversion; osseous Mckibbin index (OMI); cartilaginous Mckibbin index (CMI); and the thickness of the anterior and posterior acetabular cartilage. Results: The OAA was significantly greater in the dysplastic hips. The CAA, femoral anteversion, OMI, and CMI did not differ significantly between the normal and dysplastic hips. In the DDH and comparison groups, the OAA was significantly lower than the CAA, the OMI was significantly lower than the CMI, and the posterior acetabular cartilage was significantly thicker than the anterior cartilage. Conclusion: Our findings confirm that MRI is a valuable tool for the assessment of femoral and acetabular version in DDH. Preoperative MRI evaluation has great potential to improve the planning of pelvic and femoral osteotomies.

Resumo Objetivo: Avaliar o papel da ressonância magnética (RM) na avaliação da versão femoral e acetabular na displasia do desenvolvimento do quadril (DDQ). Materiais e Métodos: Estudo transversal de 20 pacientes consecutivos com DDQ (27 quadris displásicos) que foram examinados com RM. Nos quadris displásicos e normais (grupos DDQ e comparação, respectivamente), avaliamos os seguintes parâmetros: anteversão acetabular óssea (AAO), anteversão acetabular cartilaginosa (AAC), anteversão femoral, índice de Mckibbin ósseo (IMO), índice de Mckibbin cartilaginoso (IMC) e espessura da cartilagem acetabular anterior e posterior. Resultados: A AAO foi significativamente maior nos quadris displásicos. A AAC, anteversão femoral, IMO e IMC não diferiram significativamente entre os quadris normais e displásicos. Nos grupos DDQ e comparação, a AAO foi significativamente menor que a AAC, o IMO foi significativamente menor que o IMC, e a cartilagem acetabular posterior foi significativamente mais espessa que a anterior. Conclusão: Nossos achados confirmam que a RM é uma ferramenta valiosa para a avaliação da versão femoral e acetabular na DDQ. A avaliação pré-operatória por RM tem grande potencial para melhorar o planejamento das osteotomias pélvicas e femorais.

Immunohistochemical expression of programmed death-ligand 1 and CD8 in glioblastomas

Background@#Glioblastoma is the most aggressive primary malignant brain tumor in adults and is characterized by poor prognosis. Immune evasion occurs via programmed death-ligand 1 (PD-L1)/programmed death receptor 1 (PD-1) interaction. Some malignant tumors have responded to PD-L1/PD-1 blockade treatment strategies, and PD-L1 has been described as a potential predictive biomarker. This study discussed the expression of PD-L1 and CD8 in glioblastomas. @*Methods@#Thirty cases of glioblastoma were stained immunohistochemically for PD-L1 and CD8, where PD-L1 expression in glioblastoma tumor tissue above 1% is considered positive and CD-8 is expressed in tumor infiltrating lymphocytes. The expression of each marker was correlated with clinicopathologic parameters. Survival analysis was conducted to correlate progression-free survival (PFS) and overall survival (OS) with PD-L1 and CD8 expression. @*Results@#Diffuse/fibrillary PD-L1 was expressed in all cases (mean expression, 57.6%), whereas membranous PD-L1 was expressed in six of 30 cases. CD8-positive tumor-infiltrating lymphocytes (CD8+ TILs) had a median expression of 10%. PD-L1 and CD8 were positively correlated (p = .001). High PD-L1 expression was associated with worse PFS and OS (p = .026 and p = .001, respectively). Correlation of CD8+ TILs percentage with age, sex, tumor site, laterality, and outcomes were statistically insignificant. Multivariate analysis revealed that PD-L1 was the only independent factor that affected prognosis. @*Conclusions@#PD-L1 expression in patients with glioblastoma is robust; higher PD-L1 expression is associated with lower CD8+ TIL expression and worse prognosis.

Multiple myeloma: a retrospective analysis of the patients treated at ain shams university clinical oncology department with a review of the literature

Background: multiple myeloma [MM] is a malignant neoplasm of plasma cells that accumulate in bone marrow leading to bone destruction and marrow failure. Multiple myeloma accounts for about 1.8% of all cancers and slightly over 17% of all the hematologic malignancies in the United States. It is more common in men and for unknown reasons

Objective: this study aims at analysis the epidemiological data of the patients treated from multiple myeloma at Ain Shams University together with reviewing the different lines of management according to recent recommendations

Patients and Methods: this retrospective analysis of 62 patients with multiple myloma data recorded at their files with follow up and reviews of the recent advances in the management of multiple myeloma

Results: we found that 96.8% of patients showing clinical improvement after treatment on other hand only 3.2% deteriorated, 61.35 of patients were alive, 9.7% died and 29% lost follow up, the mean time to DFS was 22.55 months, mean OS was 63.2 months with 87.8% of patients survived at the end of the study, as regard mean PFS was 54.9 months with PFS at end of study was 74.9% of patients, there was insignificant differences between OS and demographic data, laboratory studies, there was insignificant differences between PFS and demographic data, laboratory studies

Conclusion: Multiple myeloma [MM] is a heterogeneous hematologic malignancy involving the proliferation of plasma cells derived by different genetic events contributing to the development, progression, and prognosis of this disease

Role of medical imaging in cases of stress urinary incontinence

Background: traditional methods for evaluation of women with urinary incontinence include urodynamic studies with measuring the pressure in the abdomen, the bladder, and the urethra and urine flow analysis. In addition, cysto-urethroscopy, cysto-urethrography are used for visualization of the bladder and the urethra

Aim of the Study: urinary continence depends on a closed and empty urethra with high urethral pressure. High urethral pressure [Pura] depends on two factors; one is structural which is defined as damage and lacerations in the collagen chassis of the internal urethral sphincter [IUS], the second factor is acquired functional factor is having and maintaining high sympathetic tone at the IUS from toilet training

Patients and Methods: 40 women who from SUI are examined clinically and investigated with sonar scanning 3DUS. 20 cases control by 3DUS. Patients with primary infertility those who had no vaginal deliveries, did not suffer cognitive behavioral therapy. This study is done at Bab El-Sharia Maternity University Hospital during the period from January 2017 to June 2018

Result: the IUS, as it is a cylinder, the level and extent of the rupture along the cylinder will determine the type and the degree of urinary incontinence as well as the configurational shape seen on imaging [case with primary infertility two years ago]

Conclusion: we conclude that damage of the IUS leads low pura and stress urinary incontinence [SUI]. Childbirth trauma causes damage to the collagen layer [the frame] of the vagina that leads to redundancy of the vagina and vaginal prolapse

Variations occurring in intraocular pressure and refraction during pregnancy

Background: pregnancy represents an important challenge in the female's life that she needs close observation during it and also needs counseling by her physician about the changes that are going through her body in this stressful period

Aim of the Work: the purpose of our study was to detect the changes that occur in the women's eyes during pregnancy and postpartum period regarding intraocular pressure and refraction

Patients and Methods: we studied 40 pregnant healthy women whose ages ranged from 18 to 35 years and we exclude any ocular diseases such as keratoconus, amblyopia or diabetic retinopathy. We measured the intraocular pressure using a Goldmann applanation tonometer, best corrected visual acuity using the Snellen's chart and k reading using autorefractor-keratometer

Results: we found that the IOP decreases only in the 3rd trimester with more decrease in women with multiple fetuses and multiple pregnancies. We found that the BCVA decreases only in the 2nd and 3rd trimesters. We also found that the K reading increases only in the 2nd and 3rd trimesters. Intraocular pressure, best corrected visual acuity and k reading returned to the normal values after delivery

Conclusion: the physiologic changes that occur in the women's eyes during pregnancy and postpartum period are usually marked in second and third trimester; this is because at this period, hormonal activity is at its peak, and however these changes are transient because several weeks postpartum, all hormonal activities return to their prenatal levels

Image segmentation and particles classification using texture analysis method

Introduction: Ingredients of oily fish include a large amount of polyunsaturated fatty acids, which are important elements in various metabolic processes of humans, and have also been used to prevent diseases. However, in an attempt to reduce cost, recent developments are starting a replace the ingredients of fish oil with products of microalgae, that also produce polyunsaturated fatty acids. To do so, it is important to closely monitor morphological changes in algae cells and monitor their age in order to achieve the best results. This paper aims to describe an advanced vision-based system to automatically detect, classify, and track the organic cells using a recently developed SOPAT-System (Smart On-line Particle Analysis Technology), a photo-optical image acquisition device combined with innovative image analysis software. Methods The proposed method includes image de-noising, binarization and Enhancement, as well as object recognition, localization and classification based on the analysis of particles’ size and texture. Results The methods allowed for correctly computing cell’s size for each particle separately. By computing an area histogram for the input images (1h, 18h, and 42h), the variation could be observed showing a clear increase in cell. Conclusion The proposed method allows for algae particles to be correctly identified with accuracies up to 99% and classified correctly with accuracies up to 100%.

Vitamin D status in type 2 diabetic and pre-diabetic patients

To assess the serum vitamin D level in type 2 diabetic and pre-diabetic patients. A Cross-Sectional Study. National Center for Diabetes Endocrinology and Genetics [NCDEG], Jordan. All type 2 DM and pre-diabetes patients were eligible for inclusion in this study. The study was conducted from 1 October 2011 to 31 January 2012. The total sample size was 1,181 patients. Six hundred eighty-one patients had type 2 diabetes and 500 had pre-diabetes. Medical records and direct interview by the investigator or his colleagues were the sources of data. Three thousand seven subjects aged 13 years and above were selected as a control group from the data of the National Study of Vitamin D and B12, which was conducted in Jordan in 2009. The mean age was 53 [ +/- 10] years. Seven hundred fifty-eight [64.2%] were females, 681 [57.7%] were type 2 diabetic and 500 [42.3%] were pre-diabetic. Low serum vitamin D level [vitamin D and B12, which was conducted in Jordan in 2009. The mean age was 53 [ +/- 10] years. Seven hundred fifty-eight [64.2%] were females, 681 [57.7%] were type 2 diabetic and 500 [42.3%] were pre-diabetic. Low serum vitamin D level [vitamin D level were lack of sun exposure and milk consumption. Low serum vitamin D level is highly prevalent among type 2 diabetes and pre-diabetes subjects. The two most important risk factors for low serum vitamin D level were lack of sun exposure and low milk consumption

Serum interleukin-18 levels in patients with systemic lupus erythematosus: relation with disease activity and lupus nephritis

To further investigate the possible role of IL-18 in the pathogenesis of systemic lupus erythematosus [SLE] and development of lupus nephritis [LN], and to explore its relationship with pathological classes of LN, degree of acute renal activity and chronic damage. Forty-one SLE patients with LN, thirty-one lupus non-nephritis patients and fifteen age and sex matched healthy controls were enrolled in this study. SLE patients were subjected to disease activity assessment by SLEDAI, renal disease activity assessment by the Systemic Lupus International Collaborating Clinics [SLICC] Renal Activity Score, laboratory investigations including measurement of serum interleukin-18 using Enzyme Linked Immunosorbent Assay. Renal biopsy was obtained from LN patients and pathological classification was made according to World Health Organization [WHO] criteria. Analysis of activity and chronicity indices was done on these biopsy specimens. Serum levels of IL-18 were significantly higher in patients with LN than lupus non-nephritis patients and healthy controls [p < 0.001]. There were significant correlations between IL-18 and SLEDAI [p = 0.002], proteinuria [p = 0.027], renal activity score [p = 0.003] and activity index [p = 0.039] in patients with LN. There was no significant difference in the serum levels of IL-18 between WHO classes of LN IL-18 appears to have a pathogenic role in the development of SLE and plays a crucial role in triggering inflammation in LN. Serum IL-18 levels could be a useful biomarker to assess the activity of renal disease in SLE

Role of multislice computed tomography in evaluation of colo-rectal neoplasm

Computed tomographic [CT] colonography is a noninvasive, rapidly evolving technique that has been shown in some studies to be comparable with conventional colonoscopy for the screening of colorectal cancer. The addition of intravenous contrast material to CT colonography can aid differentiation of true colonic masses from pseudolesions such as residual stool and improves the depiction of enhancing masses that might otherwise be obscured by residual colonic fluid. The aim of this study is to assess the role of multi detector computed tomographic colonography in staging of colo-rectal neoplasm and detection of synchronous lesons such as adenomatous polyp. The study included fifty-five patients with suspected colo-rectal neoplasm and underwent MDCT colonography and fibro-optic colonoscopy on the same day. The MDCT colonography with IV contrast media has 94% accuracy for identifying tumor wall invasion by colorectal carcinoma and 71% accuracy for identifying regional lymph nodes involvement and the sensitivity of both MDCT colonography and fibro-optic colonoscopy equal in detection of polyps more than 5 mms. The contrast enhanced MDCT colonography is an excellent investigating tool in staging of colo-rectal neoplasm in detection of synchronous adenomatous polyps more than 5 mms

Lipid profile and foetal outcome in obese pregnant females

To compare lipid profile and foetal outcome in obese pregnant females to non obese women delivered in Alexandria. The study is a case control study of women registered at El-Shatby Maternity University Hospital at the time of delivery in the period between June 2009 and June 2010. The cases were 50 pregnant obese women [BMI>30Kg/ m2] aged 20-30 years. The controls were 50 normal pre-pregnancy weight women with [BMI 18.5-24.9 Kg/ m2] matched with cases as regards age and gestational age. Data were gathered from women who delivered in addition to their caring obstetricians involved as well as reviewing the medical records. Laboratory investigations included assessment of lipid profile [serum cholesterol, and serum triglycerides] at the time of delivery. Also, leptin hormone was measured in serum of patients using DRG Leptin [Sandwich] ELISA [EIA-2395] USA. Caesarean section rate was significantly higher among obese women [82% versus 30%; P<0.001]. The mean serum leptin concentration was significantly higher in obese women [BMI>30 kg/m2] than normal weight controls [p=0.013]. Neonates born to obese had a statistically significant increased birth weight than infants of normal weight participants [P=0.0001]. Additionally, neonates born to obese women had an increased risk of admission to Neonatal Intensive Care Unit OR [4.1], 95% [CI] 1.2-2.4, p<0.001. Obesity is associated with increased adverse maternal and perinatal complications

Percutaneous translumibal angioplasty and stenting in treatment of lower limb arterial occlusive disease

To evaluate the role and effectivity of percutaneous transluminal angioplasty [PTA] and stenting in treatment of lower limb arterial occlusive diseases, and to clarify the advantages and limitations of this procedures. 37 patients with chronic lower limb ischemia were included in this study, their age ranged from 42 to 76 years, 29 were males and 8 were females. 35 patients had unilateral lesions while 2 patients had bilateral lesions. The total number of lesions were 51 as there were multilevel affection in some limbs. The patients were suffering from intermittent claudication, ischemic rest pain or ulceration and/or gangrene. All patients were subjected to clinical examination, laboratory investigations, duplex scanning, ankle/brachial index [ABI] measurement and diagnostic arteriography before intervention. Percutaneous translurninal angioplasty [PTA] was done for 26 lesions and stent deployment was done for 25 lesions. Follow up was done for 32 patients [with 45 lesions] at 1, 6 and 12 months using colour Doppler and ABI in all cases and arteriography in recurrent cases. The relation between multiple variables and the patency rates were studied. 48 lesions out of 51 lesions were technically successful [94%] while 3 lesions [6%] were failed to respond. The technical success rate for percutaneous transluminal angioplasty [PTA] was 92.3% while that for stent deployment [96%]. The complication rate was 14.1% in the form of dissection in 2 lesions and inguinal hematoma in 4 limbs. The patency rates at 1, 6 and 12 months were 93.3%, 84.4%and 75.6%, respectively. The patency rates increased in single, short lesions hawing good distal run-off in absence of diabetes, smoking and hyperlipidaemia. The results of this study justify the continuing use of PTA and stent implantation as first line in treatment of chronic lower limb ischemia

Assessment of exhaled breath condensate ph in asthmatic children

Assessment of the Exhaled breath condensate [EBC] constituents has proven to be useful and non invasive method for monitoring airway changes. On the other hand, active airway inflammation was postulated to change the pH of the airway lining fluid. This work was conducted to study EBC pH in children with bronchial asthma compared to other airway inflammatory markers in those children. Methods: Thirty asthmatic children were recruited for this study while attending the Chest Clinic of Paediatric Hospital -Ain Shams University-Cairo, Egypt. Their ages ranged between 5-16y with mean value of [8.93 +/- 4.14 years]. Age and sex matched 10 normal children were selected as controls. All the children were subjected to history taking, thorough clinical examination, spirometric pulmonary function testing [for FEV1, FVC, FEF25-75%], collection of EBC was done to assess its pH and induction of sputum to determine differential cell counts. Our results showed that the mean values of EBC pH were significantly lower in asthmatic group when compared to controls with cut off value = 7.35 [specificity=70%, sensitivity= 89%]. The mean values of EBC pH showed significant positive correlations with pulmonary function measured parameters - FEV1, FVC, and FEF25-75%- [p<0.05, p<0.001, p<0.05 respectively] and significant negative correlations with sputum cell counts; total leucocytic counts, oesinophilic counts and neutrophilic counts [p<0.05]. Exhaled Breath condensate [EBC] pH is a simple, inexpensive and non invasive promising tool to evaluate pediatric asthma

Effect of dexmedetomidine added to spinal bupivacaine for urological procedures

To determine the effect of adding dexmedetomidine to bupivacaine for neuraxial anesthesia. Sixty-six patients were studied between April and May 2008 in the University of Jordan, Amman Jordan. They were randomly assigned into 3 groups, each receiving spinal bupivacaine 12.5mg combined with normal saline [group N] Dexmedetomidine 5ug [group D5], or dexmedetomidine 10ug [group D10]. The onset times to reach T10 sensory and Bromage 3 motor block, and the regression times to reach S1 sensory level and Bromage 0 motor scale, were recorded. The mean time of sensory block to reach the T10 dermatome was 4.7 +/- 2.0 minutes in D10 group, 6.3 +/- 2.7 minutes in D5, and 9.5 +/- 3.0 minutes in group N. The mean time to reach Bromage 3 scale was 10.4 +/- 3.4 minutes in group D10, 13.0 +/- 3.4 minutes in D5, and 18.0 +/- 3.3 minutes in group N. The regression time to reach S1 dermatome was 338.9 +/- 44.8 minutes in group D10, 277.1 +/- 23.2 minutes in D5, and 165.5 +/- 32.9 minutes in group N. The regression to Bromage 0 was 302.9 +/- 36.7 minutes in D10, 246.4 +/- 25.7 minutes in D5, and 140.1 +/- 32.3 minutes in group N. Onset and regression of sensory and motor block were highly significant [N vesus D5, N versus D10, and D5 versus D10, p<0.001]. Dexmedetomidine has a dose dependant effect on the onset and regression of sensory and motor block when used as an adjuvant to bupivacaine in spinal anesthesia

Electrochemical behavior of copper electrode in different solutions of adrenalin chydrogentatrate and catechol

Galvanic anodic polarization of copper electrode at different current densities in electrolytes of different pH values containing adrenaline hydrogen tartarte [AHT] and catechol [Cat.] have been studied. The effect of complex formation on the underlying anodic reactions and inhibition effect of these complexes on copper electrode is also studied. The cathodic deposition of copper in the prepared complexes on the surface of the cathode is involved to check their stability at different pH values and the effect of this stability on cathodic behavior of copper electrode

Synthesis and study of cytotoxic potency of novel coumarin derivatives against breast cancer cell line

New series of coumarin derivatives was synthesized and evaluated as antitumor agents against breast cancer in human cell line [MCF 7]. The key compound 8-acetyl-7-hydroxy-4-methyl coumarin [1] was synthesized and condensed with phenyl hydrazine to form the hydrazone derivative 2. Also, 1 condensed with different alkylating agents to give the corresponding sulphonyl derivatives 3a, b which further condensed with 2,4-dinitrophenyihydrazine to give the corresponding hydrazones 4a,b. One pot reaction of 5 with different aldehydes, ethylcyanoacetate and ammoniumacetate gave pyridone derivatives 6a-e. Also. compound 5 condensed with different aldehydes then cyclized to give the pyrazoline derivatives 9a,b and 10a,b. While, on condensation of 5 with thiosemicarbazide derivatives followed by cyclization the resulting product, gave the oxathiazoline 12 and thiazolidine 13. Some of these newly synthesized compounds showed noderate activity against breast carcinoma cell line[MCF7] in human

Synthesis of novel coumarin derivatives bearing heterocyclic substituents for chemoprophylactic evaluation

A series of coumarin derivatives bearing heterocyclic substituents was synthesized. Bromination of the key compound 8-acetyl-7-hydroxy-4-methylcoumarin [I] under varied conditions gave the brominated derivatives II, III and IV, Conversions of III by several cyclocondensations gave the corresponding thiazole V, quinoxaline VI, quinoxalinone VIII and furanone IX derivatives. Also, methylation and cyclocondensation of the methylene-active acetyl groups of II with several aldehydes gave the corresponding pyridone various amines gave the corresponding amino side chains. Some of these newly synthesized products were studied for their chemoprophylatic effect on Schistosoma mansoni infected mice. Compound Xc a showed moderate effect

Study of some haemostatic and inflammatory parameters in preeclamptic and normotensive pregnant females

Preeclampsia is an idiopathic multisystem disorder specific to human pregnancy characterized by gestational hypertension and proteinuria. It complicates many pregnancies and is the third common cause of maternal and neonatal mortality and morbidity. The aim of the present work was to elucidate the relationship between serum maternal levels of C-reactive protein [CRP] as an inflammatory marker and coagulation and fibrinolysis as haemostatic markers in preeclamptic and normotensive pregnant females compared to non-pregnant females. Sixty females were enrolled in the study divided into ten non pregnant healthy females as the control group [Group I], twenty five normotensive pregnant females [Group II], twenty five preeclamptic pregnant females [Group III]. The pregnant females all were primigravidae, in the third trimester of pregnancy. For all these females C-reactive protein was measured as an inflammatory marker. Haemostatic parameters included platelet count, prothrombin time, activated partial thromboplastin time and thrombin time as coagulation parameters while fibrinolytic parameter included euglobulin clot lysis time. The results showed a significant negative correlation between CRP and platelet count in preeclamptic group. It also showed a higher positive correlation between CRP and Euglobulin Clot Lysis Time [fibrinolysis parameter] in preeclampsia than in the normotensive and control groups

outcome of road traffic injuries

To study some aspects of road traffic accidents, and preventive measures to decrease the burden of this problem. A total of 476 medical records related to Road Traffic Accidents patients received and treated in the emergency department at Queen Alia Military Hospital during 2003 were reviewed. Patients were divided into seven age groups: -Below 15, 15-24, 25-34, 35-44, 45-54,55-64 and above 65 years. They were also divided into: Ivers, pedestrians and unknown. Developed trauma was classified as: Abdominal, head, chest, skeletal and multiple. Proposed initial causes of road traffic accidents were: High speed, close distance between vehicles, mechanical and environmental causes; seat belt use was also investigated. Age, gender, type of accident, and type of developed trauma were retrieved and analyzed. A total of 356 patients were males and 120 were females with a ratio of 3:1. Almost 60% [289 patients] were below 44 years, while 45% of them were below 24 years. The majority of victims [69%] were passengers, but pedestrians accounted for a considerable percentage [8%] of which [35%] were children. Two hundred and forty-nine patients [53%] developed multiple injuries, 113 patients [24%] skeletal injuries, 40 patients [9%] isolated abdominal injuries, 52 patients [10%] chest injuries and 22 [4%] developed head injuries, while 16 patients [3%] arrived dead or died in the hospital. None of passengers or drivers was wearing seat belt. More than 65% of accidents were reported to be resulted from speeding and almost one third [31%] of drivers were driving without a safe distance between vehicles. Road traffic accidents represent a major cause of morbidity and mortality, especially among reproductive male adults and children .We recommend that strict law, introducing seat belt, tough penalties and educational programs should be applied to minimize the impact of this frightening problem

Plasma homocysteine levels in obese children and adolescents

Homocysteine is derived from the metabolic conversion of the essential amino acid methionine. In the remethylation pathway of homocysteine to methionine, vitamin B12 and folate act as cofactors. One of the essential enzymes in the remethylation process is methylenetetrahydrofolate reductase [MTHFR]. Mild-to-moderate hyperhomocysteinemia has been shown to be associated with arterial thrombosis in several case-control and cross-sectional studies. The mechanisms by which hyperhomocysteinemia may predispose to arterial thrombosis are not entirely clear but consist of endothehal cell damage, inhibition of fibrinolysis, activation of the coagulation cascade, impaired generation of nitric oxide and prostacyclin, and enhanced collagen production by smooth muscle cells Major determinants of plasma homocysteine levels are folate, vitamin B12 and B6 intake, renal function, and to a lesser extent cigarette smoking, arterial hypertension, hypercholesterolemia, physical exercise, coffee consumption, and alcohol consumption. In addition, individuals homozygous for the thermolabile form of MTHFR also show higher levels of homocysteine, mainly in the presence of low folate. One further dietary determinant of plasma homocysteine level may be fat intake because fat intake is associated with higher homocysteine levels in healthy men, probably because of a lower intake of essential vitamins. High fat intake has been shown to be linked with childhood obesity, which is associated with an unfavorable profile of risk factors for coronary heart disease [CHD] such as hyperinsulinemia, hyperlipidemia, and elevated blood pressure. Currently no data are available that deal investigate a possible relationship among homocysteine levels, body composition, and metabolic risk factors for coronary heart disease [CHD] in childhood obesity. The aim of the present study was to investigate a possible relationship among plasma homocysteine levels, the methylenetetrahydrofolate reductase [MTHFR] polymorphism, body composition, blood pressure, folate and vitamin B12 levels, serum lipid parameters, and insulin

Surgical management of tuberculum sellae meningioma in a pregnant lady: Case report

Meningioma has an accelerated growth during pregnancy; this may become symptomatic, which may necessitate surgical treatment. We describe a 33 year old female pregnant patient who presented with deterioration in vision of the left eye during her 28[th] week of gestation, treated surgically with uneventful recovery. Vision should be saved anytime during pregnancy, especially in the second trimester when the surgery is relatively safe for both the mother and the fetus