Determinants of spontaneous abortion: a hospital based case-control study in Ajman, UAE

Objective: The association between various factors and the occurrence of spontaneous abortion among women in the reproductive age group attending GMCH, Ajman, UAE was determined in this study

Materials and Methods: It was a case-control study conducted among women admitted to the OBG department of GMCH, Ajman, UAE. The cases were 60 women hospitalized for spontaneous abortion and controls were 180 women who had normal delivery. The subjects were interviewed after obtaining consent from them. Their age, parity, gestational age, nationality, occupation, level of education, history of previous abortion, previous gestational diabetes, congenital anomalies, hypertension during or after pregnancy, history of spontaneous abortion and the factors associated with spontaneous abortion were collected. Data were analyzed using SPSS-21. Chi-square was used to test the association between various factors and spontaneous abortion. Logistic regression was used to assess the degree of association. Statistical significance was set at p

Results: A total of 60 cases and 180 controls participated in the study. Most of the women among cases [61.7%] and controls [52.2%] were between 21 and 30 years of age. Majority of the cases [53.3%] were from Eastern Mediterranean region as compared to controls [49.4%]. No significant association was observed between socio-demographic characteristics and spontaneous abortion. A significant association was observed between regular exercise especially walking at moderate pace and spontaneous abortion. Type of diet, sleep pattern, and tobacco use had no significant association with spontaneous abortion. Walking at moderate pace was a protective factor against spontaneous abortion [AOR =0.22] with confidence interval of 0.11-0.41. Women who walk regularly during pregnancy are 78% less likely to have a spontaneous abortion than those who do not. Soft drinks consumption had a protective effect [AOR=0.32] with 95% confidence interval of 0.12-0.87. Women who consume soft drinks during pregnancy are 68% less likely to have spontaneous abortion than those who don't

Conclusion: This study concluded that there was no association between spontaneous abortion and any of the socio-demographic characteristics, reproductive health history, sleep pattern, and dietary habits. Walking at moderate space and consuming soft drinks showed an association with spontaneous abortion and was found to be protective. From the observations made, the authors recommend to conduct a nationwide research for more generalizable results

[First and second order generalized estimating equations and it's application in analyzing longitudinal microleakage data]

Longitudinal data are frequently obtained in medical studies. When the main aim of a study is marginal modeling of the mean and the correlation structure is considered as a nuisance parameter, the first- order generalized estimating equations [GEE1] is usually an appropriate option. However, when the modeling of correlation structure is considered the aim of a study, the second- order generalized estimating equations [GEE2] may be the first choice for analyzing the available data. The aim of the study was to evaluate application of first- and second-order generalized estimating equations to analyze longitudinal microleakage data. In this study, GEE1 and GEE2 methods were used to analyze data obtained from a study of microleakage in two root- end filling materials [CEM and MTA] in two different thicknesses and two diameters at three different times of measurement [one day, one week and one month after treatment]. The obtained results from these statistical approaches were compared in continuous and binary [presence of absence] microleakage data. The results from the GEE1 and GEE2 methods showed that time of measurement, material type, diameter and thickness of filling material had significant effects on [continuous] microleakage rate. In addition, in binary microleakage data, these methods revealed that only time and material type were the significant factors. The correlations between measurements were not significant in continuous data, while they were significant in binary response microleakage data. Since the correlations between pairs of measurements were not significant in continuous microleakage data and the obtained estimates were similar in both GEE1 and GEE2 methods, so the simpler GEE1 method seems to be adequate for these data. In contrast, in binary microleakage data, significant correlations were found between measurements. Therefore, in this case the GEE2 methodology may be used to estimate the correlation structure more efficiently

[Psychological experiences of patients with surgical stoma [cholostomy]: a phenomenological study]

There is little information regarding the psychological experiences of patient with surgical stoma in Iran. Since preventing adverse psychological effects of surgical stomas is important in planning nursing care programs, exploring the experiences of these patients seems necessary. This was a phenomenological qualitative study. A purposeful sample of seventeen hospitalized patients was selected through convenient sampling. They had undergone colostomy surgery in hospitals affiliated to Isfahan Medical University. Data was gathered by means of in-depth semi-structured face-to-face interviews. Data analysis was conducted using the phenomenological analytic method defined by Colaizzi. Seven main themes were obtained related to psychological experiences including depression, feelings of being a burden on family, feelings of worthlessness, distrust, dishonor, non-acceptance and dependency. Based on our findings, psychosocial problems were of the most important experiences mentioned by patients. This finding is congruent with previous similar studies. In a holistic approach, nurses as essential members of health care system should consider patient's psychosocial needs in their care planning

Root and canal morphology of the mesiobuccal root of maxillary first permanent molars in a part of population of Qazvin

The root canal morphology of teeth is often extremely complex. Of particular interest is the complexity of mesiobuccal root of maxillary first molar. The purpose of this study was to evaluate the root canal configuration of maxillary first permanent molar in a part of population of Qazvin. In this descriptive-analytic study, 114 extracted maxillary first permanent molar were collected from different dental clinics in Qazvin. The crowns of all specimens were sectioned from the CEJ. The teeth with depressions on their mesiobuccal roots and with two separate orifices and two apical foramens were selected. On these specimens, the length of mesiobuccal roots in buccal and palatal aspects, the length of mesiobuccal and mesiopalatal canals, and the maximum mesiodistal width [in three parts: midroot, 1 millimeter apical and coronal to the midroot] of buccal and palatal aspects of mesiobuccal root were measured using a micrometer. Indian ink was injected into the pulp system of all mesiobuccal roots. The specimens were rendered clear by demineralization, dehydration, and immersion in methyl salicylate. The evaluation of root canal system was based on Vertucci's classification. Data were analyzed using SPSS version 12 and T test. The mean length of mesiobuccal roots in buccal and palatal aspects and the mean length of mesiobuccal and mesiopalatal canals were 14.30, 13.34, 14.84, and 14.09, respectively. Statistically, there was a significant difference in length between the buccal and palatal aspects [p<0.000]. Also, the mean mesiodistal width of midroot, 1 millimeter apical and coronal to the midroot, in buccal and palatal aspects of mesiobuccal root were 3.09, 3, 3.26, 2.24, 2.11, and 2.31 millimeters, respectively. Similarly, a statistically significant difference in width between the buccal and palatal aspects was found, [p<0.000]. Based on Vertucci's classification, the mesiobuccal root canal anatomical system consisted of 21.9% as type I, 58.8% type II, 0.8% type III, 21% type IV, 2.6% type V, and 2.6% type VI. Based on data found in our study, a considerable variety of root canal configurations were found in mesiobuccal root of maxillary first molars. The mesiobuccal root often contains a double root canal system

Effect of suneem oil on the biological aspects of spodoptera littoralis [boisd] with reference to the histopathological changes of the larval midgut

Suneem oil was assessed against the Egyptian cotton leaf worm, Spodoptera littoralis to clarify its possible action on biology, food metabolism and histopathological changes on the mid gut epithelium layer of the 5[th] larval instar. Two concentrations of suneem oil were used [1000 and 100 ppm]. The results showed that all estimated metabolic parameters were less than those of control. Biological parameters [larval duration, pupal duration,% emergency, fecundity, and hatchability] were also affected by the treatment. The histopathological changes cleared hypertrophy of epithelial cells, vacuolation of cell cytoplasm and fat body, destruction of microvilli, and disappearance of pretrophic membrane

Gender-related differences of risk factors among patients undergoing coronary artery bypass graft in Ahwaz, Iran

To evaluate the major risk factors among male and female patients with severe coronary artery diseases undergoing coronary artery bypass graft [CABG]. This randomized clinical trial was performed on 897 [655 male and 242 female] patients from March 2001 to March 2006 in the Department of Cardiovascular Surgery, Golestan Hospital, Ahwaz, Iran, with male to female ratio approximately 2.7. The mean age was 54.37 +/- 0.3 years. The major risk factors were diabetes mellitus, smoking, hyperlipidemia, hypertension, obesity, familial history of coronary artery disease, past medical history of myocardial infarction and heart failure before surgery. The results show that the rate of risk factors among the males and females was age [male=54.01, female=55.35 years], smoking [P=0. 00001], previous myocardial infarction [P=0. 00004], heart failure [P=0.05], diabetes mellitus [P=0.0001], hyperlipidemia [P=0.00001], obesity [P=0.03], historical familial background [P=0.01] and hypertension [p=0. 000001]. The risk factors were revealed significantly higher in females than males. The incidence of the risk factors among the females showed higher than males patients

Mitochondrial mutation in Egyptian patients with type 2 diabetes mellitus

Mitochondrial gene mutation plays a role in the development of diabetes mellitus. An A to G substitution at base pair 3243 in the mitochondrial tRNAleu[UUR] gene [mt3243] is commonly associated with maternally inherited diabetes and deafness and other diseases. The aim of this study is to detect A to G substitution at base pair 3243 in mitochondrial RNAleu[UUR] in the plasma of patients with type 2 diabetes mellitus, and to evaluate insulin sensitivity in all cases. This study, included 41 patients [Group I, 31 cases with type 2 diabetes mellitus and maternal history of diabetes mellitus-and Group II, 10 cases with type 2 diabetes mellitus, bilateral SNHL, maternal history of diabetes mellitus with or without SNHL. Other10 healthy control group was included. Patients and controls were subjected to full medical history and clinical examination. Serum measurements for liver and kidney function tests, fasting and postprandial blood glucose as well as C-peptide levels, in addition to lipid profile were collected. Audiological evaluation for all patients with SNHL was also done. Genetic investigation, for mDNA analysis, done by polymerase chain reaction restriction fragment length polymorphism [PCR-RFLP], to determine the mutation in the mitochondrial gene at position 3243. Results of the study showed that glycemic indices [FPG, 2hPPG and HbA1c], liver enzymes and blood urea were significantly higher among patient group compared to control group [P<0.05]. There was no significant difference for values of creatinine and uric acid between cases and controls. Lipid profile was significantly higher among patient group compared to controls [P<0.05], except for HDL-C which was higher in controls however, it did not reach statistical significance. C-peptide values were not significantly different between studied groups. Age at onset of diabetes was relatively earlier in group II than group I. mDNA was present in all plasma samples of patients and controls. mDNA 3243 mutation was detected in the plasma of three patients with diabetes and SNHL with a rate of 7.3% of all diabetic patients and 30% of diabetic patients associated with deafness. The presence of mDNA mutation allowed 294 bp product to be cleaved into 180 and 114 bp fragments and were seen as two bands. The A 3243 G mutation is present in Egyptian population and is considered as a cause of maternally inherited diabetes and deafness at a rate of 7.3% of all diabetic subjects and a rate of 30% of diabetics associated with deafness. mDNA mutation is present and detectable in plasma. Maternally inherited diabetes and deafness differs pathophysiologically from the more common forms of type 2 diabetes in that, insulin resistance does not seem to be a major factor

Contribution to application of some natural silicate, sulfate and carbonate minerals as inserts on the fracture resistance and hermetic seal of composite resin restorations

The use of natural and bio-inserts in composite resin restorations was introduced in an attempt to reduce polymerization shrinkage, by minimizing the volume of the composite material used, which is the forerunner of composite failures. The question ,whether they can bond perfectly to composites to prevent them acting as stress raisers, was always in mind. Also their influence on the fracture resistance and leakage of the restorations was to be tested accounting for their influence on minimizing shrinkage. A group of natural silicates, sulfates and carbonates beside biogenic aragonite derived from fish bones were used as natural inserts. The used silicate minerals were represented mainly by Quartz [Tectosilicates] while the sulfates were represented by celestite [SrSO4], and the used carbonates minerals were biogenic aragonite, magnesite and dolomite. These inserts were treated with silane and Vivadent bonding agent to improve the bond strength with the associated composite material. Shear bond strength of the inserts, after the different treatments, to composites was evaluated. The treated samples were subjected to Petrographic, and SEM investigations to evaluate their effects on the hermetic seal of the composite resin restorations. The fracture resistance of the teeth with the class five composite restorations was tested. The study also included testing micro-leakage in class V composite restorations including the inserts inside using the image analysis system and stereomicroscope. It was concluded that the use of natural and bio-inserts in composite restorations enhanced the fracture resistance of the tooth restoration complex and minimized micro-leakage, which can be secondary influences to lower polymerization shrinkage. Silane treated inserts were more efficient in achieving their goal than the ones treated with dentin bonding agents. The aragonite inserts were statistically significantly more effective than the other four types

Evaluation of the hypotensive and sedative effects of rilmenidine versus clonidine in experimentally-induced hypertension in rats

Rilmenidine is proposed as a selective imidazoline receptor rather than [2 adrenoreceptor drug. It was reported that rilmenidine causes marked centrally-mediated hypotension, whilst the incidence of its adverse effects is quite low. Clonidine is another centrally acting antihypertensive agent characterized by its wide therapeutic range. The mechanism of its antihypertensive action appears to be through stimulation of postsynaptic [2-adrenergic receptors in the nucleus tractus solitari of the medulla oblongata. The present study aimed to investigate: [1] The antihypertensive effect of rilmenidine 1mg/kg i.v versus that of clonidine 0.03mg/kg i.v in experimentally induced-hypertension in rats by renal artery occlusion. [2] Study the possible sedative effect of rilmenidine 10mg/kg i.p versus that of clonidine 0.25mg/kg i.p. [3] Evaluate the effect of yohimbine 10mg/kg i.v on rilmenidine and clonidine actions. The results of the present study revealed that at equipotent doses; both rilmenidine and clonidne induced a transient significant [p<0.05] elevation of blood pressure followed by long-lasting hypotension and bradycardia. It was also found that yohimbine significantly [p<0.05] blocked the antihypertensive effect of clonidine but produced insignificant [p>0.05] effect on rilmenidine hypotensive action. On the other hand, rilmenidine had insignificant [p>0.05] effect on sleeping time induced by pentobarbitone 30 mg/kg i.p, whilst clonidine produced significant [p<0.05] increase in the sleeping time, an action which was significantly [p<0.05] attenuated by yohimbine. In conclusion, rilmenidine proved to has high efficacy as an antihypertensive drug with less sedative side effects compared with clonidine. This may be due to its main action on the central imidazoline receptors rather than on the alpha[2] adrenoceptors

Evaluation of terazosin action on experimentally-induced hypertension and insulin resistance in rats

Terazosin is an alpha 1 blocker indicated in therapy of mild to moderate hypertension, in peripheral vascular disease and in cases of refractory congestive heart failure. It is also used in benign prostatic hypertrophy. The present study was designed to investigate the effects of terazosin on blood pressure, renal blood flow parameters, insulin resistance, blood glucose, cholesterol and triglycerides in rats. Insulin resistance was induced experimentally by feeding rats l0% fructose in drinking water for 4 weeks. In vitro studies done to investigate terazosin site of action. In-vivo studies, terazosin significantly decreased systolic and mean arterial blood pressure and serum cholesterol but triglycerides showed insignificant change. Terazosin significantly improved insulin sensitivity. Doppler technique showed that Terazosin significantly decreased renal artery systolic pressure and blood flow velocity while it produced insignificant effect on heart rate. In-vitro studies on isolated rat aorta and isolated rat heart, terazosin had a significant cholinomimetic effect beside it's alpha 1 blocking action

Lipogram pattern changes in Nigella sativa extract-treated stressed rats

The present work detected the effect of ether and alcohol extracts of Nigella sativa on the lipogram pattern of non-stressed and stressed rats. Seventy-two adult male albino rats with weights ranged between 150-200 g were used in this work and were divided into three equal major groups. At the end of experiment, serum lipid profile was estimated

saftey of laparoscopic cholecystectomy for cholelithiasis in sickle cell disease

As surgery in sickle cell patients is associated with high morbidity, this study aimed to establish the safety of minimally invasive surgery in this high-risk group. The study included 41 sickle cell patients underwent laparoscopic cholecystectomy [LC] for cholelithiasis, three patients had asymptomatic gallstones and preoperative gastroscopy and endoscopic retrograde cholangiography were performed in nine and eight patients, respectively. Twenty-six patients were given simple transfusions, while three received partial exchange transfusions. The mean operative time was 10 minutes and the conversion rate was 4.8%. There were 14.6% postoperative complications, the majority of which were respiratory and wound related and the median hospital stay was 2.5 days. Laparoscopic cholecystectomy is safe in patients with sickle cell hemoglobinopathy who are particularly at risk of developing pigmented gallstones. Therefore, the use of minimally invasive surgery is encouraged in any sickle cell patient undergoing operative intervention with the advantages of short postoperative analgesia requirement, shorter hospitalization and remarkable reductions in perioperative morbidity

Management of segmental bone defects by Ilizarov technique

This study included 20 segments in 20 patients with segmental bone defects [16 tibial and 4 femoral] due to non-union, chronic osteomyelitis or pseudoarthrosis. All tibial segments were managed by intercalary bone transport while, in all femoral segments, immediate excision of pathological segments and acute gap reduction were done according to the soft tissues around. Then bone transport with or without lengthening was started. Our average age was 19.2 y [9-42 y]. Male to female ratio was 11: 9. Also, the average length of the regenerated segment was about 6.9 cm [4 - 14.5 cm] with an average fixator time of 10.6 m [5 - 18m]. All cases were followed up after fixator removal for about 13m [6 -22m]. Some complications were met, but satisfactory results were obtained in most cases

Revision of failed Austin Moore prostheses to total hip arthroplasty

In this work we evaluated the functional results of the revision of eleven failed Austin Moore hemiarthroplasties to cemented total hip replacements. There were four females and seven male patients, with age ranged between 43 and 64 years [average 52 years and 6 months]. Our patients had their femoral head originally replaced by Austin Moore prostheses following displaced femoral neck fractures, but their implants failed after an average period of 11 months [range: 8-21 months] before considering revision. The causes of failure were either due to loosening [6 patients], protrusio i.e. acetabular wear [3 patients], or both loosening and protrusio [2 patients]. Harris hip rating score of our patients before revision was poor for a minimum of six months. Cemented Muller total hip prostheses were used for revisions. We reported either good or excellent results in ten patients, and only one patient scored a fair result after a follow up period of an average of 14 months [range 13: 38 months]

new four in one stabilizing operation for anterior recurrent dislocation of the shoulder joint

A preliminary study of a new surgical technique included eight male patients with recurrent anterior dislocation of the shoulder, all managed operatively after failure of the rehabilitation program. The new surgical technique included four main steps done in one operation, namely imbrication of the redundant capsule, anterior bone block by using the coracoid process, muscular dynamic buttress for anterior and inferior capsule and finally imbrication of the upper half and lower half of the subscapularis muscle. Our average age 27.88 years ranged from 22 - 40 years. All achieved satisfactory results [excellent to good]. Bony union of the transferred coracoid process has occurred in all patients. No recurrence of dislocation has happened after an average follow up period of 3.15years ranged from 8 months to 6 years