Maternal serum CA 125 in first trimester threatened abortion

The aim of the present work was to evaluate serum level of CA125 as a predictor of the outcome of early pregnancies complicated by vaginal bleeding. 88 patients suffering from vaginal bleeding during the first trimester of pregnancy were recruited from the out patient clinic of Suez Canal University Hospital. They were followed up till the 20[th] week of gestation. Serial Ultrasound examination and measurement of serum level of CA125 was done, using the IMMULITE Analyzer forming an immunometric Assay Analysis: Patients were classified into two groups according to the outcome of their pregnancy; Group [I] those who continued pregnancy up till 20 weeks and Group [II] those who eventually abort aborted before that. The results of the study showed that the mean serum level of CA125 was [76.59 and 137.45 U/ml] for both groups respectively and was found to be significantly higher in group [II]. The cut off level of 120 U/ml has a specificity of 90.91, a sensitivity of 79.55, a positive predictive value of 89.74 and a negative predictive value of 81.63. The results also showed that there was statistically significant negative correlation between CA125 serum level and duration of gestation showing a notable regular drop as pregnancy advances. There is a statistically significant difference in the mean level of serum CA125, being higher in cases that aborted compared to those who continued pregnancy. A cut off level of 120 U/ml could be considered as a predictive level for pregnancy outcome for cases with 1st trimester bleeding

Shisha smoking and Reinke's edema

This study was done on 21 females, with age above 35 years, living in Saudi Arabia. All patients were suffering from dysphonia in the form of low pitched deep rough voice. They have only one common habit, i.e. shisha smoking more than 10 years. Indirect laryngoscopy revealed polypoidal swellings of both vocal folds. Microlaryngoscopy was applied for them and proved the nature of the lesions, Reinke's edema. The lesions of both vocal folds were removed in one setting operation following Kleinsasser trend. The treatise coincides with the studies, suggesting smoking as the underlying cause of Reinke's edema, but the pathophysiology is still obscure

Bupivacaine lidocaine epinephrine infiltration as local anaesthetic in middle ear surgery. arrhythmogenic and analgesic potential

Cooperation of patients undergoing middle ear surgery under local anaesthesia provides feed back stat guide, whereas integrity of facial nerve as well as hearing can be tested. Yet, infiltration of epinephrine to produce haemostasis, carries the danger to produce cardiac arrhythmia. This study was conducted to evaluate the arrhythmogenic and analgesic potential of bupivacaine - lidocaine - epinephrine infiltration as local anaesthetic in middle ear surgery. One hundred adult patients of either sex scheduled for middle ear surgery were included in this study. Local anaesthesia was achieved by injection of 5-10 ml of a mixture of bupivacaine, lidocaine epinephrine [1:50.000]. Patients were monitored as regard heart rate, systolic and diastolic blood pressures. Post operative analgesia was, also assessed. There were insignificant increase in heart rate and systolic blood pressure 5 minutes after infiltration which declined gradually near basal value. No arrhythmia was detected. Postoperative analgesia was excellent. In conclusion, bupivacaine - lidocaine epinephrine local infiltration provides excellent surgical anaesthesia, stable haemodynamics and eventual post operative course with high degree of analgesia