Anatomical Variations Of Inca Bone In Adult Human Egyptian Skulls

Background: The Inca bone is integral part of the occipital bone of the skull in its interparietal region andappears during radiological examination of the skull.Aim of the work: This study aimed to estimate the incidence rates and variations of interparietal (Inca) andpreinterparietal bones in adult human Egyptian skulls .Materials and methods: In the present study 60 dry human Egyptian skulls (37 males and 23 females) wereexamined to determine the incidence rates of Inca and preinterparietal bones with detailed measurements forInca bone in mm using electronic digital caliber.Results: The incidence rates of Inca and preinterparietal bones were higher in male skulls than female skulls andthe interparietal or Inca bone was observed in only 4 skulls ( 6.66% ) while the preinterparietal bone wasobserved only in 2 skulls ( 3.33 %) .Conclusion: The presence of the Inca and preinterparietal bones was rare in the human Egyptian skulls andtheir incidence rates were higher in male skulls .

The prophylactic effect of intravenous magnesium infusion on postoperative sore throat after thyroid surgery. A randomized clinical trial / Efecto profiláctico de la infusión de magnesio en dolor de garganta postoperatorio luego de una tiroidectomía. Un ensayo clínico aleatorizado

BACKGROUND: The reported incidence of postoperative sore throat (POST) varies widely from 14.4 to 100% with maximum severity at 4th to 6th postoperative hour. Nonetheless, it has increasingly become a common clinical problem particularly in thyroid surgery. Although POST usually resolves spontaneously in few days, it is likely to be the most common complaint. OBJECTIVES: Driven by the increased number of patients with post-intubation sore throat following thyroid surgery, the aim of the present study was to evaluate the effectiveness of perioperative magnesium infusion in attenuating POST after thyroidectomy. METHODS AND MATERIAL: 80 female patients undergoing thyroid surgery, were preoperatively randomized into one of 2 groups. The magnesium group received magnesium sulfate (30 mg/kg) in 100 ml of isotonic saline over 15 min before induction of anesthesia, followed by a continuous magnesium sulfate infusion (10 mg/kg/h) for the duration of the operation. The control group received the same volume and rate of isotonic saline. RESULTS: This study showed that perioperative magnesium infusion had significantly reduced the overall incidence and severity of POST. The incidence of POST at rest (patients who recorded non-zero POST score after thyroid surgery) in the control group was 75% while the incidence of POST in magnesium group was 37.5% which is lower and that was highly significance. Higher sedation scores were encoun tered on arrival to PACU in Magnesium group when compared to controls. CONCLUSIONS: We concluded that perioperative magnesium sulphate infusion effectively decreased overall POST incidence and severity after thyroidectomy with better hemodynamic stability, albeit higher risk of post operative sedation.

La incidencia reportada de dolor de garganta postoperatorio (POST) varía ampliamente de 14,4 a 100% con severidad máxima en la 4ta a 6ta hora postoperatoria. Sin embargo, se ha convertido cada vez más en un problema clínico común, particularmente en la cirugía de tiroides. Aunque la POST generalmente se resuelve espontáneamente en pocos días, es probable que sea la queja más común. OBJETIVOS: Impulsado por el mayor número de pacientes con dolor de garganta después de la intubación después de la cirugía de tiroides, el objetivo del presente estudio fue evaluar la efectividad de la infusión perioperatoria de magnesio para atenuar la POST después de la tiroidectomía. MÉTODOS Y METERIAL: 80 pacientes mujeres sometidas a cirugía de tiroides, fueron asignadas al azar preoperatoriamente en uno de los 2 grupos. El grupo de magnesio recibió sulfato de magnesio (30 mg/kg) en 100 ml de solución salina isotónica durante 15 minutos antes de la inducción de la anestesia, seguido de una infusión continua de sulfato de magnesio (10 mg/kg/h) durante la operación. El grupo control recibió el mismo volumen y tasa de solución salina isotónica. RESULTADOS: Este estudio mostró que la infusión perioperatoria de magnesio había reducido significativamente la incidencia general y la gravedad de la POST. La incidencia de POST en reposo (pacientes que registraron una puntuación POST distinta de cero después de la cirugía de tiroides) en el grupo de control fue del 75%, mientras que la incidencia de POST en el grupo de magnesio fue del 37,5%, que es menor y de gran importancia. Se encontraron puntajes de sedación más altos al llegar a la UCPA en el grupo Magnesio en comparación con los controles. CONCLUSIONES: Llegamos a la conclusión de que la infusión perioperatoria de sulfato de magnesio disminuyó efectivamente la incidencia general de POST y la gravedad después de la tiroidectomía con una mejor estabilidad hemodinámica, aunque un mayor riesgo de sedación postoperatoria.

Role and incidence of parasitic infection in adult Egyptian patients with acute appendicitis

Background: Appendicitis is the most important acute surgical condition of the abdomen, and appendectomy constitutes one of the most common surgical operations worldwide. Many factors can cause appendicitis but the intestinal parasitic infections are one of the most important causes

Objective: The present study aimed to evaluate and detect the role and incidence of various parasitic infections in appendectomy specimens from Egyptian adult patients with acute appendicitis attending the General Surgery Emergency room at Al-Azhar University Hospitals, Cairo, Egypt [Al-Hussein and Sayed Galal Hospitals]

Patients and methods: The present study was carried out on 200 patients undergoing appendectomy with a provisional diagnosis of acute appendicitis during the period from December 2015 to November 2016. The removed appendices were fixed in 10% buffered formalin, sectioned, stained with HandE and examined for histopathological changes and presence of parasites. Stool examination was also done by direct smear, formol ether concentration techniques as well as CBC examination for all patients

Results: Stool examination revealed 120 [60%] out of the total 200 appendectomy patients were positive for parasitic infections, while CBC examination revealed leucocytosis among 167 [83.5%], and eosinophilia in 40 [20%] as well as anemia in 43 [21.5%] in all the studied patients. Histopathological examination revealed parasitic infections in 6 [3%] of appendectomy specimens. The presence of E. vermicularis worms and their eggs as well as Schistosoma ova were observed in 4 [2%] and 2 [1%] of cases respectively. Features of acute suppurative appendicitis were observed in 143 [71.5%] of cases, of which, 98 [49%] cases had luminal obstruction by fecalith and 45 [22.5%] showed patent lumen. Non suppurative appendicitis were presented in 57 cases [28.5%] which included lymphoid hyperplasia in 21 cases [10.5%] and neuronal hyperplasia in 6 cases [3%] as well as granulomatous appendicitis with features consistent with appendiceal Crohn's disease [CD] in 30 cases [15%]

Conclusion: The study concluded that parasitic infections constitute 3% of the surgically removed appendices where Schistosoma eggs and E. vermicularis [adults and eggs] were the parasites recorded. So differential diagnosis of parasitic infections in the etiology of acute appendicitis should be made properly which can save patients from a negative laparotomy, morbidity and even mortality

study of endometrial perfusion in unexplained infertility

Background: Infertility in itself represents a wide spectrum of disorders explaining the inability to conceive. Series of investigations are required to depict the potential cause of infertility, yet there exist a small percentage [10 -25%] of couples in which no obvious cause is delineated. these groups of patients are classified as 'unexplained infertility. The endometrium has dynamic features: cyclical growth, desquamation and regeneration. Its main function is to provide the possibility of the time-limited support of implantation of the embryo for further development. Most part of the menstrual cycle, the endometrium is resistant to the embryo but acquires special receptive properties in a limited space and time interval of the luteal phase, known as the ''implantation window''

Aim: The aim of this study was to evaluate the uterine perfusion, particularly the endometrial blood flow in women with unexplained infertility

Methodology: The patients recruited from women presenting to the outpatient clinic at Ain Shams University Maternity Hospital seeking fertility compared to other fertile group coming to hospital with non specific gynecological problems or for routine checkup at the same period. The study conducted on two groups of women: Group1 [study group] 40 women with unexplained infertility, Group 2 [control group] 20 fertile women who had normal physical and pelvic examination, regular menstrual cycles, didn't have intrauterine device or oral contraceptive, and gave a birth year ago

Results: As regard the mean, the resistance index in the study group was 0.69 ranged from 0.39 to 0.96, while the resistance index in the control group was 0.61 ranged from 0.58 to 0. 73 and the difference between both groups was statistically significant pulsatility index in the study group was 1.3 ranged from 0.51 to 1.99 while the pulsatility index in the control group was 1.16 ranged from 0.88 to 1.7 and this difference between both groups was statistically significant. From the results of our study we could say that uterine perfusion, particularly the endometrial blood flow in women with unexplained infertility different from that in fertile women

Recommendation: We recommend further study on large numbers of women and the possible role of perfusion enhancer's drugs in improving utero-ovarian circulation as a treatment of unexplained infertility

Carotid intima-media thickness assessment in obese patients with chronic renal failure

Background/Aim: measurement of carotid artery intima-media thickness [CIMT] is reliable for early detection of atherosclerosis, one of obesity's complications, which is a leading cause of mortality among patients with end-stage renal disease. The study aimed to evaluate CIMT in relation to obesity, chronic renal failure [CRF] and both, for the early prevention of cardiovascular problems

Patients and methods: this cross-sectional study included 118 adult individuals of both sexes, aged 30-60 years. Patients with CRF were gathered from the renal dialysis unit of King Fahd Hospital-Kasr El Einy Hospital, and the obese without CRF from the 'Management of Visceral obesity Unit', in' Medical Excellence Research Center [MERC]', National Research Centre, during the period spanning from June 2015 to April 2016.They were grouped into three groups: a case group, which included 45 obese individuals with CRF, and two control groups: one comprised 39 nonobese patients with CRF and the other group comprised 34 obese patients without CRF. Anthropometric assessment, lipid profile, and ultrasound measurement of CIMT were performed for each patient

Results: CIMT was greater in all groups than the normal range [0.06-0.08 cm], particularly in the obese group without renal failure. CIMT had a highly significant correlation with waist circumference and insignificant correlation with BMI and lipid profile in different groups

Conclusion: the increase in CIMT was related to obesity and renal failure, but it was more prominent with obesity. CIMT had highly significant correlation with central obesity in cases wherein obesity and renal failure were coexisting together and insignificant correlation with lipid profile

Immobilization of horseradish peroxidase on Fe3O4 magnetic nanoparticles

Background: Iron magnetic nanoparticles have attracted much attention. They have been used in enzyme immobilization because of their properties such as product is easily separated from the medium by magnetic separation. The present work was designed to immobilize horseradish peroxidase on Fe3O4 magnetic nanopraticles without modification. Results: In the present study, horseradish peroxidase (HRP) was immobilized on non-modified Fe3O4 magnetic nanoparticles. The immobilized HRP was characterized by FT-IR spectroscopy, scanning electron microscopy, and energy dispersive X-ray. In addition, it retained 55% of its initial activity after 10 reuses. The optimal pH shifted from 7.0 for soluble HRP to 7.5 for the immobilized HRP, and the optimal temperature shifted from 40°C to 50°C. The immobilized HRP is more thermostable than soluble HRP. Various substrates were oxidized by the immobilized HRP with higher efficiencies than by soluble HRP. Km values of the soluble and immobilized HRP were 31 and 45 mM for guaiacol and 5.0 and 7.0 mM for H2O2, respectively. The effect of metals on soluble and immobilized HRP was studied. Moreover, the immobilized HRP was more stable against high concentrations of urea, Triton X-100, and isopropanol. Conclusions: Physical immobilization of HRP on iron magnetic nanoparticles improved the stability toward the denaturation induced by pH, heat, metal ions, urea, detergent, and water-miscible organic solvent.

3D ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis

Background: adenomyosis is a common benign gynecological affecting premenopausal woman, in which there is increased overgrowth of the endometrium with invasion of the underlying myometrium. The precise pathogenesis of adenomyosis remains unknown with many theories being proposed that consider it to be a pathology that initially affects the endomyometrial junctional zone [JZ]

Aim of the Work: the study aims to compare 3D transvaginal ultrasound with MRI in diagnosing adenomyosis in comparison with the gold standard histopathology

Patients and Methods: this cross-sectional study was carried out on 77 patients who were recruited from women presenting to the outpatient clinic at Ain Shams University Maternity Hospital planned to undergo hysterectomy [abdominal, vaginal or laparoscopic assisted hysterectomy] for adenomyosis according to the inclusion/ exclusion criteria

Results: out of 77 patients included in the study, 67[87%] were +ve for adenomyosis by 3D TVUS, confirmed in 46[59.74%] by histopathology, while 52[67.53%] were +ve by MRI, confirmed in 39[50.64%] by histopathology.3D transvaginal US was able to diagnose adenomyosis in 67[87%] patients and fibroid in 23[29.9%] patients, while MRI was able to diagnose adenomyosis in 52[67.5%] and fibroid in 36 [46.8%]

Conclusion: our study results indicated that, 3D transvaginal ultrasound is highly accurate as MRI in diagnosing adenomyosis and leiomyoma as a preoperative diagnostic tool

Recommendations: as the 3D ultrasonography is more available, cheaper, less time consuming and easier technique, it is recommended to be used in every day clinical practice, helping the clinicians to reach an accurate diagnosis, select an appropriate treatment, and individualize management for each patient to reach the best outcome therapeutic rates

Rotational versus standard quantitative coronary angiography: a comparative study

Standard coronary angiography [SA] has some limitations and complications. Technology has been developed to perform rotational coronary angiography [RA] that may overcome SA limitations and complications while keeping the diagnostic accuracy. RA is a technique that provides with one contrast injection, a panoramic or dynamic cineangiogram of the coronary tree, during up to 180 rotation of the gantry. The purpose was to compare RA and SA regarding diagnostic accuracy and patient safety. Our study included 20 patients with a clinical indication for diagnostic coronary angiography [CA] at Cardiology Department, El Minia University Hospital. Patients were subjected to: SA [4 fixed projections for LCA and 2 for RCA] and RA [2 projections for LCA [RAO 60- LAO 60- caudal and cranial] and [1 projection for RCA [RAO 30- LAO 90- cranial]]. Acquisition of additional static angiographic projections was done for better diagnostic assessment whenever needed after SA and/or RA. QCA analyses were performed on two views [first from SA and second from RA] showing a significant lesion. Radiation dose [RD], contrast volume [CV], total number of frames [TNF], total number of image acquisitions [TNIA], additional projections [AP], reference vessel diameter [RVD], minimal lumen diameter [MLD], lesion percent stenosis [LPS] and lesion length [LL] were evaluated and compared between the two angiographic techniques. We analyzed 38 lesions. Their distributions were: 19[50%] in LAD, 9[23.68%] in RCA, 7[18.42%] in circumflex and 3 [7.89%] in the diagonals. There were no statistically significant differences between SA and RA derived QCA data in MLD[1.197 +/- 0.651 Vs 1.175 +/- 0.642], RVD[2.8l9 +/- 0.961 Vs 2.752 +/- 0.99], LPS [65.495 +/- 16.225 Vs 64.989 +/- 16.426], and in LL [12.575 +/- 6.392 Vs 12.406 +/- 6.338], p ns for all. At the same time, RA derived QCA data strongly correlated with SA derived QCA data with correlation coefficient, 0.99 1, 0.975, 0.994, and 0.996 respectively. On the other hand, RD was 44% less [245.83 +/- 132.17 Vs. 442.23 +/- 272.55 mGy], CV was 45% lower. [24.28 +/- 10.78 Vs. 43.98 +/- 20.77 ml], TNF was 45% fewer [162 +/- 65.54 vs. 293.21 +/- 142.83], TNIA was 59% lower [1.82 +/- 0.67 vs. 4.46 +/- 1.88], and AP was 82% lower beyond the pre specified protocol [0.21 +/- 0.49 vs. 1.179 +/- 1.249] in the RA compared to the SA technique, p<0.0001 for all. RA-derived QCA has similar diagnostic accuracy and strongly correlates with SA derived QCA. Furthermore, RA has better safety as it leads to a significant reduction in radiation exposure and contrast use. In the future therefore, RA may replace SA and should be compared with MSCT CA in diagnosis of CAD especially if coupled with minimally invasive approaches such as radial access and use of 4 French devices

Expression of cytotoxic T-lymphocyte-associated antigen-4 [CTLA-4; CD152] on peripheral blood T lymphocytes in systemic lupus erythematosus children

Background: CTLA-4 [CD152] encodes cytotoxic T lymphocyte-associated antigen-4, a cell-surface molecule providing a negative signal for T-cell activation. CTLA-4/B7 is the most important costimulation-signaling pathway that regulates T cell responses and plays a critical role in maintenance and breakdown of selftolerance, and hence in susceptibility to autoimmune diseases

Objective: The aim of this study was to investigate and evaluate the expression of CTLA-4 on peripheral blood T-lymphocytes [PBTL] in children with systemic lupus erythematosus [SLE] in relation to clinical features; disease activity and severity

Methods: From December 2006 to August 2007, 32 pediatric patients [30 girls, 2 boys] fulfilled at least four of the 1997 revised criteria for the classification of SLE were enrolled in this study. Expression of CTLA-4 on freshly isolated PBTL was assayed by flow cytometry in all SLE patients during activity and remission in addition to 32 age- and sex-matched children serving as controls. Results were expressed as percentage of PBTL cells expressing surface CTLA-4 molecule in comparison to isotype-matched controls. CTLA-4+PBTL% were correlated with some SLE disease activity and severity variables

Results: CTLA-4 expression on freshly isolated PBTL was significantly higher in SLE patients during disease activity [median = 12; mean +/- SD = 10.45 +/- 8.3%] than controls [median = 4; mean +/- SD = 3.34 +/- 3.1%; p < 0.0001]. The patients' values were statistically comparable during quiescence [median = 14; mean +/- SD = 15.02 +/- 7.1%; p > 0.05] and activity. Among SLE patients, the median and mean +/- SD of CTLA-4+PBTL % of children with lupus nephritis was significantly higher than those without nephritis [15; 13.56 +/- 10.4% versus 10; 9.51 +/- 9.1%; p < 0.01]. CTLA-4 expression could be related to lupus severity but there was no correlation with disease activity. A positive correlation could be elicited between CTLA-4+PBTL% during lupus activity and the corresponding values during remission. CTLA-4+PBTL% correlated positively with the anti-dsDNA autoantibodies titers, serum creatinine, and 24 hours urinary protein excretion. On the other side, the percentages correlated inversely with the estimated creatinine clearance and serum C3 and C4 levels. CTLA-4 expression did not vary according to therapy

Conclusion: CTLA-4 surface expression on PBTL in SLE children was up regulated irrespective of lupus activity. The over expression was related to lupus severity and might have a significant role in the pathogenesis of lupus nephritis and cerebritis

Forearm versus upper arm tourniquet for intra venous regional anesthesia using lidocaine and magnesium

Intravenous regional anesthesia [IVRA] using a forearm tourniquet may be a safer technique than the traditional upper ann tourniquet. Also, addition of magnesium sulphate to lidocaine can offer better tourniquet tolerance and postoperative analgesia. This study was designed to compare the use of a forearm tourniquet versus traditional upper ann tourniquet and to evaluate the effects of adding magnesium sulphate to lidocaine in intravenous regional anesthesia. Sixty patients were allocated randomly into 4 groups. All groups received intravenous regional anesthesia [IVRA]. Group [UL]: received 10 ml lidocaine 2%. Group [ULM]: received 10 ml lidocaine 2% plus 15 ml magnesium sulphate 10%, both groups using upper arm tourniquet [UAT]. Group [FL]: received 5 ml lidocaine 2%. Group [FLM]: received 5 ml lidocaine 2% plus 7.5 ml magnesium sulphate 10%, both groups using a forearm tourniquet [FAT]. Results show that onset of sensory and· motor anesthesia occurred significantly earlier in forearm tourniquet groups compared to upper arm tourniquet groups. Also, onset of sensory and motor loss was hastened when magnesium was added to lidocaine compared non magnesium groups. Shortest times for complete sensory and motor blockade was in the forearm tourniquet group when magnesium was added to lidocaine. Pain scores were lower in forearm tourniquet groups than upper arm tourniquet groups, and were significantly lower when magnesium was added. Number of patients who asked for intraoperative fentanyl was significantly less in forearm tourniquet groups than in upper arm tourniquet groups; also it was significantly less with the addition of magnesium. Time to recovery of sensory blockade after tourniquet deflation was significantly prolonged in forearm tourniquet groups than upper arm tourniquet groups and was significantly prolonged with the addition of magnesium compared with non-magnesium groups. Motor blockade was also significantly prolonged after tourniquet deflation in forearm groups than upper arm groups; also it was more significantly prolonged in magnesium groups than in non-magnesium groups. First analgesic request was significantly delayed in forearm groups than upper arm groups, and more significantly prolonged in magnesium groups than in non-magnesium groups. No adverse events occurred in any of the 4 groups

Conclusion: IVRA using forearm tourniquet is more superior than upper arm tourniquet when indicated, also addition of magnesium to lidocaine improves quality of sensory and motor blockade and prolongs postoperative

Effect of nitric oxide, antioxidants and pravastatin on experimental atherosclerosis in male New Zealand white [NZW] rabbits

Atherosclerosis is considered one of the major causes of human morbidity and mortality all over the world. In this work, an attempt was done to investigate the possible role of nitric oxide [NO] on modulation of experimentally-induced atherosclerosis in male New Zealand White [NZW] rabbits. For this purpose, 64 male NZW rabbits were left for 2 weeks to acclimatize to laboratory conditions before being included in this experiment. Rabbits were then randomly classified into 8 equal groups. The first group [control, C] was fed commercial chow and the second group [atherosclerotic, A] was fed an atherogenic diet [containing 1% cholesterol]. The last 6 groups [VCA, AA, NSA, NA, PA and PNA groups] were fed the atherogenic diet in addition to the following respectively [vitamin C, L-arginine, Nigella sativa [NS], N-Nitro- L-arginine methyl ester [L-NAME], pravastatin and L-NAME with pravastatin]. The different feeding regimen and treatments were continued for 2 months. After 2 months, rabbits were killed to evaluate the severity of atherosclerosis and the effect of the different treatments given. The following parameters were assayed [plasma lipid profile, malondialdehydes [MDA], total antioxidant status [TAS] and nitrites; aortic tissue prostaglandin E[2][PGE[2]] and histological examination]. The atherogenic diet induced a significant increase in plasma total cholesterol [TC], triglycerides [TG], low density lipoprotein [LDL], high density lipoprotein [HDL] and MDA compared to C group. The TAS, nitrites and aortic PGE[2] were significantly decreased compared to control values. These atherogenic changes were reflected on the histopathological changes observed in aortic tissues from the A group. Vitamin C [500 mg/kg/day, orally] improved the atherogenic changes when given to atherosclerotic rabbits. There was a significant increase in TAS, nitrites and aortic PGE[2] associated with a significant decrease in MDA associated with improvement in the histopathological picture of aortic tissue of VCA group compared to A group. Administration of NS to atherosclerotic rabbits produced significant decrease in TC, TG, LDL and MDA and significant increase in HDL, TAS, nitrites and PGE[2] in NSA group compared with A group. These effects were associated with improvement in the histopathological picture of aortic tissue of NSA group compared with A group. L-arginine produced significant decrease in MDA and significant increase in TAS nitrites and PGE[2] in AA group compared with A group. In NA group, L-NAME aggravated atherosclerosis as evidenced by a significant increase in MDA, significant decrease in TAS, nitrites and PGE[2] and aggravation of the atherogenic changes in aortic tissue compared with A group. Pravastatin improved all atherogenic changes in PA group compared with A group. There were significant decrease in TC, TG, LDL and MDA with significant increase in HDL, TAS, nitrites and aortic PGE[2]. This protective effect of pravastatin was reflected on the histopathological picture of aortic tissue. In PNA group, L-NAME antagonized the protective effect of pravastatin. It was concluded that atherosclerosis is a multifactorial disease. The increase in free radicals [FR] and lipid peroxidation and the decrease in NO and PGE[2] are the main contributors of atherosclerosis. The antiatherogenic effects of pravastatin depend upon its plasma lipid lowering and antioxidant effects, in addition to increase intimal NO and PGE[2] production. L-NAME antagonized the antiatherogenic effects of pravastatin. The antiatherogenic effects of Nigel/a saliva and vitamin C depend mainly on their antioxidant action. Other mechanisms may contribute such as decrease in lipid profile [Nigella saliva] and increase in NO and PGE[2] production [Nigella saliva and Vitamin C]. These findings suggest that pravastatin is the most effective antiatherosclerotic agent followed by Nigella saliva and high dose of vitamin C. So, it is recommended that addition of Nigella saliva and/or antioxidant vitamins [such as vitamins C] to potentiate the antiatherogenic effects of pravastatin in atherosclerotic patients. This will also reduce the cost of treatment and side effects of drugs

Influence of gender difference on cold restraint gastric ulcer development in albino rats

The aim of the present work was to study the effect of sex difference on the development of gastric ulcer induced by cold restraint stress [CRS] in albino rats. The study is a trial to evaluate the role of gonadal sex hormones in the pathophysiologic mechanism of CRS-induced gastric mucosal lesions through either exclusion by gonadectomy or resupplementation by exogenous administration of sex hormones [testosterone, T; estrogen, E and progesterone, P]. For this purpose, 112 adult albino rats [48 males and 64 non pregnant females] weighing between 200-250 grams were used in this study. Male rats were randomly classified into 6 equal groups: control [CM], orchidectomized [OM], orchidectomized with testosterone supplementation [OT], stressed [SM], orchidectomized stressed [OSM] and orchidectomized stressed with testosterone supplementation [OST]. Female rats were randomly classified into 8 equal groups: Control [CF], ovariectomized [OF], ovariectomized with estrogen supplementation [OE], ovariectomized with progesterone supplementation [OP], stressed [SF], ovariectomized stressed [OSF], ovariectomized stressed with estrogen supplementation [OSE] and ovariectomized stressed with progesterone supplementation [OSP]. Bilateral gonadectomy was done; in either sexes; 2 weeks before exposure to CRS. Hormonal supplementations were given for 7 days by subcutaneous injections starting 2 weeks after gonadectomy in respected groups. In male rats, orchidectomy significantly increased gastric juice [GJ] volume and pH and gastric mucosal [GM] nitrates; while it significantly decreased GJ acidity in OM group compared with CM group. No ulcerative lesions were observed in CM and OM groups. Injection of T significantly decreased GJ volume and pH and GM nitrates but significantly increased GJ acidity in OT group compared with CM and OM groups. T administration induced ulcerative lesions in OT group achieving an ulcer index [UI] of 11.33. CRS significantly reduced GJ volume, pH and mucin concentration [MC] and GM nitrates while it significantly increased GJ acidity and pepsin concentration [PC] and GM peroxides in SM group compared with CM group. CRS induced ulcerative lesion in all male rats achieving an UI of 21.25 in SM group. Orchidectomy before exposure to CRS significantly increased GJ volume and pH and GM nitrates and significantly decreased GJ acidity and GM peroxides in OSM group compared with SM group. Orchidectomy exhibited considerable protection against CRS ulcer development achieving U1 of 16.5 and protective index [PI] of 22.4 % in OSM group. Injection of T significantly reduced GJ volume and pH and GM nitrates and significantly increased GJ acidity and GM peroxides in OST group compared with OSM group and aggravated the ulcerative lesions achieving an UI of 22.6 and PI of 36.97% in OST group. In female rats, ovariectomy, significantly increased GJ acidity and MC; while it significantly decreased GJ pH and PC and GM nitrate in OF group compared with CF group. No ulcerative lesions were observed in CF and OF groups. Administration of E significantly decreased GJ volume, acidity and MC; while it significantly increased GJ pH and PC and GM nitrates in OE group compared with both CF and OF groups. E induced ulcerative lesions achieving an UI of 9.66 in OE group. Administration of P significantly increased GJ volume, pH and MC and significantly decreased GJ acidity, and PC and GM nitrates in OP group compared with both CF and OF groups. No ulcerative lesions were observed in OP group. CRS significantly increased GJ acidity and PC and GM peroxides; while it reduced significantly GJ volume, pH and MC and GM nitrates in SF group compared with CF group. CRS induced ulceration in all rats achieving an UI of 18.3 in SF group. Ovariectomy before exposure to CRS significantly decreased GJ pH and PC and GM nitrates; while it significantly increased GJ volume, acidity and MC and GM peroxides in OSF group compared with SF group. Although GM lesions were noted in OSF achieving an UI of 13.3, ovriectomy exhibited protection against CRS-induced GM ulceration and the PI was 27.34. Administration of E significantly decreased GI volume, acidity and MC and GM peroxides; while it significantly increased GJ pH and PC and GM nitrates in OSE group compared with OSF group. E aggravated GM lesions in OSE group achieving an UI of 20.9 and PI of - 56.9. On the other hand, giving P significantly decreased GJ acidity and PC and significantly increased GJ volume, pH and MC in OSP group compared with OSF group. P imparted a protective effect against CRS GM lesions achieving an UI of 9.5 and PI of 12.6 in OSP

In conclusion, a gender difference in CRS-induced GM ulcer development has been found in the present work, being more predominant in male than in female albino rats. The male sex hormone; T is absolutely ulcerogenic and orchidectomy offered protection. The female sex hormone; P was absolutely protective, while E potentiated some aggressive factors and enhanced other protective mechanisms with the net effect being ulcerogenic. Ovariectomy offered gastric protection against CRS-induced ulceration. It is therefore, probable that the protective effect of P can restraint the ulcerogenic effect of E to some extent and therefore lower the gastric UI in females than in males

Tympanometric changes in asthmatic children

A high incidence of otitis media with effusion was recognized in pediatric patients with allergies, in particular asthma. This seems to be a reflection of a disease affecting the entire mucociliary system in the respiratory tract. The aim of this work was to determine the effect of bronchial asthma during and in between attacks on middle ear pressure as expressed by tympanometric changes twenty children [40 ears] who were diagnosed in pediatric department as having bronchial asthma were undergone tympanometric measurements during and in between attacks. Our results showed that 80 percent of patients showed abnormal tympanometric curves, namely types B and C curves reflecting different grades of otitis media with effusion during attacks of bronchial asthma, the majority of which were suffering from allergic rhinitis. While only 55 percent of patients showed abnormal tympanometric curves in between attacks, the majority of which were also suffering from allergic rhinitis. In conclusion there is a definite relation between bronchial asthma in children and a change of middle ear pressure towards negativity as expressed by the prevalence of types B and C curves tympanograms, especially in those who are suffering from concurrent allergic rhinitis

effect of endoscopic sinus surgery on Eustachian tube function

Twenty patients [40 ears] who have undergone endoscopic sinus surgery, were subjected to tympanometry measures, preoperatively and 1, 3, and 5 days after surgery. Tympanometric records displayed significantly increased negativity on the early post-operative days [p< 0.01] with a peak pressure of -70.3 daPa preoperatively, -135.8 daPa one day after surgery, and -112.7 daPa 3 days after surgery, while 5 days after surgery they returned to normal with a peak pressure of -48.1 daPa. Pressure changes are attributed to nasal pack pressure as well as postoperative surgical edema

Diagnostic value of bone marrow examination in haematological and non haematological diseases

In this study, 223 bone marrow biopsies and / or aspirations were performed. The main indications for bone marrow examination were diagnosis and management of acute leukaemia [45-20.2%], staging of lymphoma [29-13.1%], evaluation of pancytopenia [31-14.1%], thrombocytopenia [26-11.7%], anaemia [16-7. 2%], pyrexia of unknown origin [PUO] [14-6.1%], lymphadenopathy [16-7. 3%], hepatosplenomegaly [12-5.3%], to exclude metastasis [7-3.2%] and miscellaneous [25-11%]. The most common diagnosis encountered were: acute lymphoblastic leukaemia [35-15.7 %], idiopathic thrombocytopenic purpura [13-5.7%], acute myeloid leukaemia [12-5.7%], hyper8plenism [12-5.7%], chronic myeloid leukaemia [12-5.7%], megaloblastic anaemia [7-3.1%] and multiple myeloma [3-1.3%]. It was concluded that bone marrow examination is an important investigation for establishing the diagnosis in many conditions especially haematological neoplasms. The most common indication in this study was to confirm and manage acute leukaemia and the most common diagnosis was acute lymphoplastic leukaemia

Idiopathic thrombocytopenic purpura and helicobacter pylori

Helicobacter pylori [H. pylori] has been considered for many years as the aetiologic agent of gastritis, peptic ulcer, gastric cancer and mucosal-associated lymphoid tissue lymphoma. The prevalence of H. pylori infection and the effect of eradication in a series of 69 idiopathic thrombocytopenic purpura patients were investigated. H. pylori infection has been documented in 35 of 69 chronic ITP patients [50.7%] by 13C urea breath test and confirmed by histologic examination. There was a significant increase in the percentage of patients responding to corticosteroid therapy in uninfected group compared to infected patients with H. pylori [85 % vs 62.5%]. There was a significant increase in platelet count in all infected patients after eradication therapy for H. pylori infection. H. pylori eradication may provide a good option for treatment in some idiopathic thrombocytopenic purpura patients

Deliberate non-fatal self harm in patients attending a general hospital in Saudi Arabia

Though deliberate non-fatal self-harm [DSH] has become a rather common form of nonverbal communication in Western Countries, the impression from the developing countries has been one of being very rare. Arabic countries are among the ones with the lowest reported rates. Our aim in this study is to investigate the patterns of DSH in Saudia Arabia an Arabic country with a strong religious background. All patients attending the largest general hospital in Jeddah City, with a recognisable self-harm behaviour, were prospectively assessed by the psychiatrist. Their characteristic features and clinical data were analysed using chi square for any significant statistical differences. Only 55 patients were referred in a period of 9 months with a diagnosis of DSH, 45 females [81.8%] and only 10 males [18.2%]. Males were older than females and non-Saudis were significantly more older and presented with more serious high suicidal risk DSH behaviours. Though DSH rates in Arabic countries may still be considerably low, in comparison to those reported from the western countries, the current indications is that many of these countries may witness a considerable increase, unless they maintain their strong religious affiliations and emphasise the importance of preserving their traditional family structure

Lymphoma and leukemia in Zagazig University: two years follow-up

A total number of 80 cancer patients with a mean age of 35.8 +/- 1.6 years were studied in one year [1983] representing 4% of total cases managed in the medical section. The subjects were classified according to their type of malignancy into NHL [36.25%], ANLL [17.5%], ALL [15%], HD [13.75%], CLL [12.5%] and CML [5%]. Males predominate females and the age of onset of malignancy in these patients varied between 16.7 +/- 1.4 years for ALL and 57.3 +/- 3 years for ALL. Most of the patients presented in an advanced clinical stage [74 to 80%]. Response to chemotherapy varied according to the type and clinical stage of malignancy, a high rate was recorded in HD [100%], while the lowest was in NHL [34.5%]. Other malignancy conditions, varied in response between those extremes. Follow up data at the end of two years after treatment [1984-1985] for all 80 cases, revealed that 40 cases are still under control of the disease, 16 relapsed, 5 lost follow up, while 31 cases died either due to uncontrolled disease, relapse or disease activity