New approach for preservation of right ventricle during open cardiac surgery

Although, myocardial preservation by cold potassium [K[+]] cardioplegia and surface cooling are effective for left ventricle, they are less effective for maintaining right ventricle [RV] hypothermia all through the operation. To avoid R.V. ischemia and its dysfunction particularly in patients with pulmonary hypertension [PH], various techniques had been utilized to maintain R V. cooling. An intracavitary cooling of R.V. was don experimentally to maintain R.V. hypothermia. During open cardiac surgery, we evaluate the effectiveness of R.V. cooling all through the operation by continuous R.V. intracavitary infusion of cold saline in between cardioplegic time. Forty patients with multi-valvular lesions and pH were randomly classified into two groups. Group A twenty patients with whom R.V. intracavitary cooling is used in addition to cardioplegia and systemic hypothermia. Group B twenty patients control group. There is no statistical difference between groups as regard the mean ischemic time, in group A 90 +/- 5 min. and in group B 88 +/- 7 min. But there were statistical difference between both groups as regard: 1. The mean total bypass time group A 100 +/- 13 min., group B 160 +/- 19 min. 2. The post-perfusion ventricular arrhythmias group A. 5% and group B 10%. 3. The incidence of L.C.O.P.S. group A 10% and group B 4%. 4. The mortality rate, group A 5% and group B 20%

Evaluation of tricuspid valve replacement by round prosthetic valve designed for mitral position

616.126-089.84 A retrospective study was carried out for evaluation of cardiac performance after tricuspid valve replacement with fixed round prosthetic valve designed for mitral position. Tricuspid valve replacement was done for 15 patients from 1990 to 1994 in the National Heart Institute. 8 patients had history of previous cardiac surgery. All patients presented with severe right sided congestive heart failure. They were preoperatively prepared for surgery with intensive medical therapy: Massive diuretics, correction of A/G ratio and blood picture. 2 patients died 5 and 12 months postoperatively from intractable congestive heart failure and prosthetic endocarditis. One patient was lost from follow-up. The remaining 12 patients were followed-up for a mean period of 23.6 months. Echocardiography was done 6 months after surgery. There was functional tricuspid stenosis with reduction of ejection fraction of the right ventricle in all cases. No thromboembolic manifestations were noted in this series in either mechanical or biological prosthesis

Assessment of the fertility impact of family planning programmes in Egypt

The present study demonstrated the role of the Egyptian FPP during the period 1980 - 1988 in knowledge of FP, contraceptive use, attitude toward FP, availability, accessibility and satisfaction with methods. Four different evaluation methods have been employed for measuring the impact of FPP on fertility in Egypt: The st and ardization approach, the prevalence method, the multivariate areal analysis, and the log linear model. The st and ardization method should be applied primarily. Its effectiveness lies primarily in the capability of determining whether fertility, as measured by the CBR [or the GFR], has changed at all in the area and during the period under study, by decomposing the change in the GBR of its demographic component parts: Proportion of women of reproductive ages, age structure of women of reproductive ages, proportion of married women, and martial age specific fertility rates. The prevalence method provides direct impact measures of contraception either from program or/ and non-program use on fertility. It produces the number of births averted as well as the reduction in the natural CBR that results from the use of contraception. The multivariate areal analysis method is congruent in many ways with the problem of measuring the effect of the FPP on fertility, especially those countries which are characterized by a considerable variability within its geographical areas, such as Egypt. The last method applied is the log linear analysis. This method provides a systematic approach of analysis for discovering the kind of the relationships that may be found in contingency table