Comparative study between 2D and 3D ultrasound cervicometry and digital assessment of the cervix before induction of labour

Background: labor is the physiological process by which the fetus is expelled from the uterus to the outside world. It is defined as increase in myometrial activity or more precisely, a switch in the myometrial contractility pattern from contractures [long-lasting, low-frequency activity] to contractions [frequent, high intensity, high frequency activity], resulting in effacement and dilatation of the uterine cervix

Aim of the Work: this study aimed to compare between 2D and 3D ultrasound cervicometry and digital assessment of the cervix before induction of labor

Patients and Methods:this study was carried out at Obstetrics and Gynecology Departments of Al-Hussien University Hospital and Al-Agoza Police Hospital from July 2016 to January 2018 on one hundred [100] women; their ages ranged from 18 to 35 years and the gestational ages ranged from 37-42 weeks. All patients had medical indications for labor induction

Results: there were highly statistically significant relations [HS] between mode of delivery and cervical length, bishop score and posterior cervical angle as p value [0.001].It was found that the more obtuse the angle, the higher the probability of vaginal delivery and the reverse for the cervical length. This means that Bishop Score and cervical length and posterior cervical angle had the same dependency in predicting successful labor induction

Conclusion: in this study we found that the successful induction correlated significantly with transvaginal ultrasonographic measurments of the posterior cervical angle and cervical length and Bishop Score. But, Bishop Score appeared to be specific and accurate than the ultrasonographic measurements in prediction of successful vaginal delivery

Recommendations: further studies on large number of participant with the same indication of induction and the same gestational age are recommended to assess Bishop Score and transvaginal ultrasonographic measurements and to evaluate each of them as predictors of successful labor induction

Vascular endothelial growth factor G1612A (rs10434) gene polymorphism and neuropsychiatric manifestations in systemic lupus erythematosus patients / Polimorfismo genético do fator de crescimento vascular endotelial G1612A (rs10434) e manifestações neuropsiquiátricas em pacientes com lúpus eritematoso sistêmico

Abstract Aim: To investigate the relation between vascular endothelial growth factor (VEGF) gene polymorphism in systemic lupus erythematosus (SLE) patients and lupus related neuropsychiatric manifestations. Patients and methods: Sixty adult SLE patients recruited from the Rheumatology and Neurology departments of Cairo University hospitals were classified into two groups; Group A: 30 patients with neuropsychiatric manifestations (NPSLE) and Group B: 30 patients without. For both groups the SNP G1612A (rs10434) of the VEGF gene was genotyped by real time polymerase chain reaction (RT-PCR). Results: Statistically significant difference was found in genotype and allele frequencies between both groups (AA [70% vs 13.3%, p < 0.001] and GG [10% vs 66.7%, p < 0.001]). Conclusion: Polymorphism in the gene coding for VEGF may be associated with increased incidence of neuropsychiatric lupus in SLE patients.

Resumo Objetivo: Investigar a relação entre o polimorfismo genético do fator de crescimento vascular endotelial (VEGF) em pacientes com lúpus eritematoso sistêmico (LES) e manifestações neuropsiquiátricas relacionadas com o lúpus. Pacientes e métodos: Foram recrutados 60 pacientes adultos com LES nos departamentos de Reumatologia e Neurologia de hospitais universitários do Cairo e classificados em dois grupos; grupo A: 30 pacientes com manifestações neuropsiquiátricas (LESNP) e grupo B: 30 pacientes sem manifestações neuropsiquiátricas. Genotipou-se o SNP G1612A (rs10434) do gene VEGF em ambos os grupos por reação em cadeia da polimerase em tempo real (RT-PCR). Resultados: Foi encontrada diferença estatisticamente significativa nas frequências genotípicas e alélicas entre os dois grupos (AA [70% vs. 13,3%, p < 0,001] e GG [10% vs. 66,7%, p < 0,001]). Conclusão: O polimorfismo no gene que codifica o VEGF pode estar associado ao aumento na incidência de lúpus neuropsiquiátrico em pacientes com LES.

socio- psychological adjustment among adolescents aged [is- 18] Yrs. old a comparative study between children of working and non- working mothers

Objectives: The researcher drives at exploring the socio-psychological adjustment of the working and non-working mothers' children aged [15-18] years

Sample: A sample of working and non-working mothers, divided into] 122 from governmental body, and 122 from the private sector. They represent different educational levels. A sample of 244 [Male/ Female] children, aged [15-18] year olds from governmental and experimental schools, representing various educational grades

Tools: Scale of children Socio-psychological Adjustment [by the researcher], Mothers' Personal, Social, and Cultural Data Form [Faiza Youssef Abdel Megeed]

Results: There is a significant statistically difference in the degree of psychological adjustment and social compatibility and compatibility prisoners and score college depending on the type [Male/ Female] at the 0.01 level of significance in favor of males, There is significant statistically difference in the degree of psychological adjustment and social compatibility and compatibility family and total score in adolescents according to the educational level of the mother and social, There are no significant statistically difference in the degree of psychological adjustment and social compatibility and overall compatibility of family and score depending on the type of mother's work [Special-Governmental], There are a significant statistically difference in the degree of psychological adjustment and social compatibility and overall compatibility of family and score depending on the type of work the mother or non-working-working mother when the level of significance is less than 0.05. For the benefit of the mother is working, There are no a significant statistically difference in the degree of psychological compatibility and overall compatibility of family and score depending on the type of school [Government-Experimental], while no difference between them in the social consensus at 0.05 level for the experimental schools

Assessment of immunological changes in Epstein-Barr virus co-infection in Egyptian chronic HCV patients

Epstein-Barr virus (EBV) plays a major role in liver pathology. Similar to other members of the herpesvirus family, EBV establishes a persistent infection in more than 90% of adults. The aim of this study was to evaluate the impact of EBV and chronic hepatitis C co-infection (HCV) on biochemical and immunological responses in patients. The study was conducted in 62 patients and 33 apparently healthy controls. Patients were divided into three groups: group I, consisting of 31 patients with chronic hepatitis C infection (CHC), group II, consisting of eight patients with EBV infection and without HCV infection and group III, consisting of 23 patients with EBV and chronic HCV. The percentage of CD3+ cells, helper CD4+ cells and CD19+ B-cells was measured by flow cytometry. Human interferon-γ (IFN-γ) and interleukin (IL)-15 levels were measured by an ELISA. The levels of liver alanine aminotransferase and aspartate aminotransferase enzymes were higher in EBV/HCV patients compared to that in EBV and HCV mono-infected patients. EBV/HCV patients had significantly reduced percentages of CD3+ and CD4+ cells compared to EBV patients. Serum IFN-γ levels were significantly reduced in EBV/HCV patients (3.86 pg/mL) compared to CHC patients (6.76 pg/mL) and normal controls (4.69 pg/mL). A significant increase in serum IL-15 levels was observed in EBV/HCV patients (67.7 pg/mL) compared to EBV patients (29.3 pg/mL). Taken together, these observations suggest that HCV and EBV co-infection can potentiate immune response dampening in patients.

Effect of chickpea substitute in the quality characteristics of biscuits and cake

Chickpea [Cicer arietinum L.] is considered the fifth valuable legume in terms of worldwide economic stand point. lt is planted in southern and western area of Asia and Mediterranean. This study was undertaken to study the effect of supplementation of wheat flour with different percentages of chickpea [5, 10, 15, 20, 30%] on the chemical composition, physical and organoleptic properties of biscuits and cakes. Cake and biscuits were prepared using different percentage of chickpea flour. Substitute the wheat flour in their formula. Chemical composition, physical measurements as well as sensory evaluation were carried out on the tested samples. The results showed that chickpea flour is a good source of protein [22.82%], crude fiber [2.90%] and ash [3.33%]. Also, chickpea is rich in potassium, magnesium and iron. Supplementation of wheat flour with chickpea flours in biscuits results in increasing protein, lipid, fiber and ash. The specific volume were in the range of [38.83 - 44.13cc/gm], specific lightness were in the range of [41-25 cc/gm.] and spread factor ranged between [100-114.21%] for control samples and biscuits that contain 30% of the chick pea flour. This biscuit which contain chickpea flour at all the supplement ratio were accepted by the panelist. The cake prepared with supplementation of wheat flour with chickpea flours at different percentage [5, 10, 15, 20, 30%] had a higher protein, lipid, crude fiber and ash content with less percentage of carbohydrates. lncreasing the ratio of chickpea flours in cake has led to a slight increase in volume and specific gravity. Sensory evaluation of the cake was accepted at all the different supplementation ratios of chickpea with the higher score for the cake samples that contain chickpea flours at ratio 10 -15%. Generally prepared cake and biscuits samples with chickpea flour as a supplement to wheat flour in their formula lead to increasing protein, crude fiber and mineral content with improving the physical properties and organoleptic characteristics

[Appendiculoureteroplasty: about 6 cases]

Through this work we want to specify the place of ureteroappendiculoplasty as an important technical procedure for ureteral substitution. Between January 1997 and September 2002, 6 patients had an appendiculoureteroplasty. four women and two men with a mean age of 37 years [range 12 to 55 years] had a lesion of the right ureter. The decision is use the appendix was taken preoperatively in front of the difficulties associated with other procedures. The mean length of ureteral loss was 12 cm [6- 15 cm], the pelvic portion of ureter was more damaged than other segments [4 cases]. The appendix was suspended between the 2 ureteric extremities in 2 cases and between the ureter and the bladder in 4 cases. After a mean follow-up of 3 years [1 - 5 years], we noted a recovery of the kidney function in all cases. auto transplantation of the appendix can be considered a simple procedure that allows sometimes to reestablish the continuity of the ureter with good results

comparison of different physiological mortality risk prediction scores in critically III children in pediatric intensive care unit

This is a prospective observational study, comparing between three general physiology based prognostic scoring systems, which have been primarily developed to measure severity of illness and predict patient's outcome in pediatric intensive care unit [PICU]: Pediatric index of Mortality score [PIM], Pediatric Risk of Mortality score [PRISM] using both the original and current coefficients; in addition to evaluating the type and number of Organ System Failure [OSF]. The main goal was to assess the performance of each score. We prospectively collected data of 750 patients [447 males and 303 females] consecutively admitted to PICU with crude mortality rate of 5.6%. The study demonstrated that PIM score had good performance as evidenced by good discrimination and calibration in both the overall population as well as in two different subgroups [neonates and nonsurgical], but not in surgical, in addition to it is free and simple to use. It has also been demonstrated that PRISM score [original coefficients] had a poor performance in the overall population, as well as in nonsurgical and neonates but not in surgical subgroup. Meanwhile, PRISM [current coefficients] score showed good performance in the overall population, as well as in two subgroups [surgical and non surgical] but not in neonates. This is indicating the need to update and recalibrate prognostic scoring systems to maintain good performance over time. The new coefficients used in PRISM [current coefficients] in this study to compute mortality risk estimates were just developed to show the change in mortality risk over time and do not constitute a new pediatric mortality prediction scoring system. This study found also that organ system failure [OSF] is an important independent risk factor of death and patients with multiple organ system failure [two or more organ system failures] are more likely to die than those with one or less organ system failure

Role of serum nitrate and soluble E-selectin in infants and children with atopic dermatitis

The pathogenesis of atopic dermatitis [AD] is still unknown. A recent study has shown that inducible nitric oxide synthase [i NOS] is expressed in the atopic skin lesion, suggesting the involvement of nitric oxide [NO] in the skin inflammation of AD. Soluble E-selectin [sE-selectin] is also known to be a serological marker in AD which reflects disease activity. Therefore, the aim of this study was to evaluate the role of serum nitrate and sE-selectin concentrations in the pathogenesis, relation to the disease severity and clinical course of infants and children with AD. Serum Nitrate and sE-selectin levels were assessed in 54 patients with AD [28 boys and 26 girls] aged 4-84 months: median 17months, and 16 nonatopic controls [9 boys and 7 girls] aged 6-60 months; median 18 months. Serum nitrate was measured by an enzymatic one step assay with nitrate reductase and serum sE-selectin was measured by radioimmunoassay. Serum nitrate and sE-selectin concentrations in patients with AD were significantly increased as compared to non-atopic controls and there were also significant differences between subgroups of AD [mild, moderate and severe] as compared to controls and among subgroups themselves. The levels of both markers were significantly diminished after treatment of severe cases of AD. Significant correlations were present between serum nitrate levels, sE-selectin levels, disease activity and eosinophilic count, but no correlation was found between serum nitrate and sE-selectin levels. Our results indicate that NO may be involved in the pathogenesis of vasodilatation and erythema in AD skin, also sE-selectin may be a useful parameter in the monitoring of AD. NO and sE-selectin are good and useful markers for assessment of the severity and clinical course of AD in infants and children

Interleukin-18 and unbound vascular endothelial growth factor [VEGF] in human milk

Human milk is rich in cytokines. It contains interleukin-18 [IL-18], which is a new cytokine that induces IFN-gamma production by T cells and also contains the potent permeability and angiogenesis-promoting agent vascular endothelial growth factor [VEGF], which is a multifunctional cytokine active on blood vessel cells. The present study measured IL-18 and unbound vascular endothelial growth factor [VEGF] in the aqueous phase of human milk and examined how the concentration varied with gestational age and the duration of lactation after birth. The concentrations of IL-18 and unbound VEGF were measured by ELISA in the breast milk samples from healthy women delivering term neonates [n=69] and in colostrum from healthy women delivering preterm infants [n=18]. The highest percentages of expression for both IL-18 and unbound VEGF beyond the level of detection were observed in colostrum of fuII-term [94.4% for both cytokines] and preterm [100% and 88.9% respectively]. Colostrum contained significantly higher levels of lL-18 and unbound VEGF compared with transitional [early] milk and mature milk of full term [P< 0.001 for both cytokines]. We found also that colostrum from mothers with preterm delivery contained significantly higher concentrations of lL-18 compared with those with delivery at term [P< 0.005], but the reverse was observed as regards to unbound VEGF [P< 0.001]

Conclusion: IL-18 and unbound VEGF are present in high concentrations in breast milk, especially colostrum and may play important roles in nutrition and host defense [immunity] of high riskneonates

Study of brainstem auditory evoked response in neonatal asphyxia

The present study was undertaken to evaluate the effect of neonatal asphyxia on brainstem auditory evoked responses [BAER] and the possible reversibility of abnormal BAER on follow up after 3 months of age. Prospective case control study was done in the neonatal special care unit and neurology departments, at EI-Minia University Hospital. The duration of study was from September 1999 to January 2001. Twenty five term neonates with 5-minute Apgar score < 6 and clinical signs of hypoxic-ischemic encephalopathy [HIE] underwent BAER testing with follow up at 3 months. Twenty normal neonates severed as controls. Denver development screening test [Denver II] was performed at 3 months of age. The mean latencies of various waves in BAER were significantly higher in cases as compared to controls [p<0.01 in latency I and <0. 001 in latencies II, III, IV and V]. However, the difference in the mean interwave intervals in cases and controls was not statistically significant [p >0.05 in all interwave interval differences]. Twelve out of twenty five neonates [48 %] with birth asphyxia showed abnormalities on initial BAER. The commonest abnormalities seen were raised threshold of interside latency difference in 8/12 neonates [66.7%], followed by prolongation of latencies of various waves in 6/12 neonates [50%]. Other abnormalities observed were prolonged intervene interval [16.7%] and prolonged interside interval difference [8.3%]. There was a significant association of BAER abnormalities with duration of neurological tindings more than 5 days and stages of HIE. On follow up of 12 cases at 3 months of age, abnormalities in BAER reverted back to normal in 11 cases [91.6%]. The Denver Developmental Screening Test [Denver II] was suspected in 3 cases only

Conclusion: BAER abnormalities in neonatal asphyxia are transient and revert back to normal in most cases on follow up at 3 months of age and BAER is simple, non invasive tool but does not appear to be a useful one for early detection of neurological handicaps

Soluble thrombomodulin and protein c plasma levels in neonatal sepsis

Sepsis is a systemic response to infection, and it constitutes a major cause of morbidity and mortality in Intensive Care Nursery Unit. Sepsis is associated with endothelial cell activation, a hemostatic profile characterized by activation of the coagulation pathway, and subsequent activation of the fibrinolytic system, which is then followed by the inhibition of the fibrinolytic system. Thrombomodulin [TM] is a membrane glycoprotein in the vascular endothelium and it plays an important physiological role as a cofactor in the thrombin catalyzed activation of protein C [PC]. It is also a specific parameter of endothelial cell injury. The aim of this study was to assess the plasma levels of soluble TM and PC and to clarify their relationships with the severity and outcome of neonatal sepsis. This study was carried out on 40 preterm neonates [20 septic and 20 controls] and 40 fullterm neonates [20 sepstic and 20 controls]. It was done in the Neonatal Intensive Care Unit at El-Minia University Hospital and Biochemistry Department, from December 2001 to May 2002. All neonates were subjected to full history taking stressing upon the risk factors for infection and thorough clinical examination for assessment of gestational age and detection of the clinical signs and severity of sepsis. The laboratory investigations included CBC, CRP, blood cultures and estimation of TM and PC in the plasma by ELISA technique. In this study, plasma levels of TM were significantly higher and plasma levels of PC were significantly lower in neonates with sepsis than those in the controls, in preterm than fullterm both septic and controls, in preterm cases than preterm controls and in fullterm cases than fullterm controls [all p<0.05], but no significant differences of both markers were reported between positive and negative cases of blood cultures [all p >0.5]. There was also a significant increase of TM and decreased PC plasma levels in survivors rather than non survivors both fullterm and preterm cases and in severe, complicated rather than non severe, non complicated septic cases [all p<0.05]. Significant negative correlations were reported between TM and PC in both preterm and full term cases [r=-0.46, p<0.03 and r=-0.51, p <0.02 respectively]; also between TM levels and platelet numbers in both preterm and fullterm cases [r=-0.53, p< 0.01 and r=-0.42, p<0.04 respectively]. The correlations between PC levels and platelet count were significant [r=0.5, p<0.02 for preterm cases and r=0.56, p<0.01 for fullterm cases respectively]; but there were no significant correlations between both TM and PC levels with Hb % and Ieucocytic count [all p>0.05]

Conclusion: The elevation of plasma TM is frequently seen in neonatal sepsis and circulating TM is a useful marker for evaluating endothelial tissue damage. Protein C serves as an early and highly sensitive marker for hypercoagulable state of sepsis.Both markers are useful indicators for detecting the severity and outcome of neonatal sepsis

Stability of aflatoxins in processed ras cheese during manufacture and storage

Processed Ras-cheese was made from Ras cheese naturally contaminated with aflatoxin B1, B2, G1 and G2, secreted from toxigenic strains of Aspergillus flavus and Aspergillus parasiticus. The processing of the cheese blend at 90-92 centigrade for 5 minutes reduced its total aflatoxin content by 18.7%, while aflatoxins B1, B2, G1, G2 were reduced by 18.8, 21.3, 16.3 and 20.3% respectively. The storage of processed Ras-Cheese for 60 days at 4 +/- reduced its total aflatoxins by 14.1%, whereas the levels of B1, B2, G1 and G2 were reduced by 13.0, 11.5, 17.2 and 13.8% respectively. The data indicate that the processed Ras-cheese manufactured from contaminated cheese will not be safe for human consumption