Unilateral versus bilateral laparoscopic ovarian electrocautery in patients with polycystic ovarian syndrome: a prospective hormonal and clinical study

The aim of this work was to assess the efficacy of unilateral and bilateral laparoscopic ovarian electrocautery in correcting the endocrine abnormalities and inducing ovulation in infertile patients with clomiphene citrate resistant PCOS. Fifty patients were included in this study. They were randomly allocated to either unilateral [25 cases] or bilateral [25 cases] laparoscopic ovarian electrocautery. Serum LH FSH and testosterone [T] levels were estimated in the early follicular phase before and after the operation. The cases were followed postoperatively for 6 months to detect, the occurrence of ovulation and pregnancy. A highly significant postoperative fall of serum LH and LH/FSH ratio [P<0.0001] was detected following either unilateral or bilateral ovarian electrocautery. Also serum FSH increased significantly [P<0.05] and serum T decreased significantly [P<0.05]. Ovulation occurred in 72% of the patients following unilateral ovarian electrocautery and in 76% following bilateral ovarian electrocautery. It was found that neither the preoperative LH, FSH nor T level could be used to predict the occurrence of postoperative response. Unilateral ovarian electrncautery resulted in bilateral ovarian activity in all responders. Pregnancy occurred in 48% of the patients of unilateral ovarian electrocautery and in 56% of the patients of bilateral ovarian electrocautery. The less traumatizing technique of unilateral laparcscopic ovarian electrocautery resulted in endocrine and clinical effects nearly similar to that produced by bilateral ovarian elctrocautery with no statistically significant difference. It has the advantage of preserving one side of the pelvis away from possible postoperative adhesions

Virus B and C in cases of hepatocellular carcinoma

Fourty patients diagnosed as having hepatocellular carcinoma with hepatitis B and C viral infection. Twelve patients [30%] were HBS-Ag positive, 24 [60%] had antibodies to FIBS, HBC or both and 4 [10%] were negative for all hepatitis B virus serelogical markers. Prevalence of HCVAb was 65% [26 patients]. Hepatitis C virus RNA was found in 70% [28 patients]. Coinfection by the two viruses was confirmed. Hepatocellular carcinoma cases in our study are associated with hepatitis virus infections. Hepatitis C is more prevalent than hepatitis B virus in patients with hepatocellular carcinoma

Visceral leishmaniasis among hypersplenic patients in Dakahlia governorate, Egypt

In the present study, out of 22 human cases with hypersplenism and suggesting manifestations, four gave seropositivity for VL by the indirect hemagglutination tests [128 and more]. Two of these four patients gave seropositivity by dot-ELISA [1: 8000]. Amastigotes of Leishmania parasite were demonstrated in the splenic smears obtained during splenectomy. One culture obtained from these two cases grew promastigotes. Typing is ongoing. It was concluded that visceral leishmaniasis should be considered in the differential diagnosis of patients with hepatosplenomegaly or hypersplenism in Egypt

Cell mediated immunity in diabetes mellitus

The percentage of peripheral T lymphocytes was determined in twenty Insulin Non Dependent Diabetes Mellitus [N.I.D.D.M.] and twenty controls. The mean percentage of Erosette formation was lower in I.D.D.M. [68.75 percent] N.I.D.D.M. [69.9 percent] by comparison to the controls [73.6 percent]. I.D.D.M, [63.8 percent], N.I.D.D.M. [73.5 percent] had a significantly decreased mean response to phytohemagglutinin stimulation by comparison to the control subjects [80 percent]. These findings support the concept of depressed cell-mediated immunity in the diabetic and might explain the propensity of the uncontrolled diabetic to increased frequency and severity of bacterial infection

Umbilical cord alpha-1-antitrypsin in Egyptian newborns

Alpha-1-antitrypsin, a major alpha[1] globulin protease was estimated in cord blood, amniotic fluid and maternal blood of 20 normally grown full term, 18 premature and 12 small for their gestational age. Alpha-1-antitrypsin was reported to increase progressively during pregnancy. The lower level in mothers who delivered prematurely, may be gestational age-related indicating increased level with increasing duration of conception. The mean level of alpha-1-antitrypsin in the cord blood of premature newborns was significantly lower than that of full term. Alpha-1-antitrypsin was shown to be decreased in the cord blood and elevated in the amniotic fluid of premature infants especially by those suffering of respiratory distress syndrome [RDS]. So umbilical cord level of alpha-1-antitrypsin may serve as an indicator predicting the development of RDS deserve to be opened for speculations

Evaluation of detection of C-reactive protein by latex agglutination in diagnosis of meningitis

C-reactive [C-RP] determinations were performed by the latex slide agglutination test on cerebrospinal fluid [CSF], serum of 20 patients with symptoms and signs of cerebrospinal meningitis while the quantitiative estimation of CRP was done by an immunodiffusion methods. Serum CRP was low less than 6 mg/1 in all control patients. There was a significant increase of serum CRP in 13 of 14 patients with bacterial meningitis with a mean of 103 mg/1. In 4 of 6 patients, values were lower less than 6 mg/1, 2 patients had values of 66 and 71 mg/1. The CRP latex agglutination test was able to detect bacterial meningitis with a sensitivity of 93% [13 of 14], a specificity of 67% [4 of 6], a positive predictive value of 87% [13 of 15], and a negative predictive value of 80% [4 of 5]. CRP determination performed on CSF, serum useful and rapid clinical tests for exclusion of the presence of bacterial meningitis in a patient

curative and prophylactic propertics of sotalol and propranolol on adrenaline induced arrhysthmia

Sotalol is a non selective beta adrenoceptor blocking agent that differs from propranolol in having no membrane stabilising properties. In the present study the antiarrysthmic, effect of sotalol was shown when injected immediately after, or 2 minutes before adrenaline injection in anaesthetised dogs. 2mg/ Kg b.w. sotalol prevented as well as cured arrhythmic effect of even large dose of adrenaline while 0.2mg/ Kg b.w. propranolol was needed to produce the same effect. Sotalol was also evaluated clinically as regards its usefulness against the cardiac arrhythmia that may arise in patients after infiltration of adrenaline in the presence of halothane anaesthesia