Pelvic floor electrophysiology patterns associated with faecal incontinence

Pelvic floor electrophysiological tests are essential for assessment of patients with faecal incontinence. The present study was conducted to determine the patterns of pelvic floor electrophysiology that are associated with faecal incontinence. The present study included 40 patients with faecal incontinence and 20 apparently healthy subjects as a control group. All patients were subjected to history taking, clinical examination, proctosigmoidoscopy, anal manometry and electrophysiological studies. Electrophysiological studies included pudendal nerve motor conduction study, pudendo-anal reflex, needle electromyography of the external anal sphincter and puborectalis muscles, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The control group was subjected to electrophysiological studies which include pudendal nerve motor conduction study, pudendo anal reflex, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The most common pelvic floor electrodiagnostic pattern characteristic of faecal incontinence was pudendal neuropathy, abnormal pudendo-anal reflex, denervation of the external anal sphincter and puborectalis at rest, incomplete interference pattern of the external anal sphincter and puborectalis at squeezing and cough and a localized defect in the external anal sphincter. There were characteristic pelvic floor electrodiagnostic patterns for faecal incontinence

Prediction of small-for-gestational age infents by quantitative assessment of diastolic notch in uterine artery flow velocity waveforms

To assess the performance and clinical usefulness of the notch depth index [NDI] in predicting small-for-gestational age infants [SGA] in comparison to the previously defined abnormalities in uterine blood flow velocity waveforms; peak systolic over protodiastolic velocities [A/C] ratio. Presence of protodiastolic notch and resistance index [RI]. This prospective clinical study included evaluation of pulsed Doppler abnormalities uterine artery velocity waveforms in 673 nulliparae with normal singleton pregnancies at 16-18 weeks and at 26 weeks gestation. Main outcome measures: Delivery of small for gestational age [SGA] infants. SGA developed in 11% of nulliparae. Although early Doppler screening was associated with high false positive results, yet two-stage screening avoided false negative cases. NDI was found to be a better predictor than other Doppler indices [A/C ratio, protodiastolic notch and RI]. NDI improved, both sensitivity and PPV as determined by other Doppler indices. NDI measurements were clinically useful in predicting for gestational age infant than other conventional Doppler indices

Role of vasoconstrictor in intraligamentary anaesthetic solution on the incidence of dry socket

A clinical study was performed to investigate the role of vasoconstrictor in intraligamentary anesthetic solution on the incidence of dry socket. A total of 286 m and ibular first molar extractions were under investigation. The results indicated that intraligamentary anesthetic solution with adrenaline resulted in a higher incidence of dry socket [3.2%] than that without adrenaline [2.7%]; however, this was statistical insignificant. Also, a nonsignificant difference between intraligamentary anesthetic technique [3.04%] and inferior alveolar nerve block [2.4%] was statistically observed