Treatment of Malrotation and Limb Length Discrepancy in Osteogenesis Imperfecta Patients: Report of Two Cases

@#Malunion of recurrent fractures in Osteogenesis Imperfecta (OI) patients causes limb length discrepancy and malrotation. These cause added difficulty for OI patients to ambulate. Lengthening with distraction osteogenesis using an external fixator in OI patients is challenging. Acute lengthening with autologous bone graft is a known method in a normal bone but not a known procedure in OI patients. We present two clinic cases of adolescent OI patients with limb length discrepancy and externally rotated lower limb that underwent acute lengthening and rotational correction using a locked intramedullary nail and ipsilateral autologous iliac bone graft. Both patients obtained union and improvement of ambulatory capability without recurrence of fracture within five years of follow-up. Acute lengthening by 2cm and rotational correction with intramedullary nail improved the gait efficiency in the OI patients. Harvesting large amounts of the tricortical iliac bone graft, followed by controlled weight-bearing is a safe procedure.

Taurine as a Drug for Protection of Liver and Kidney against Toxicity of Dinitrotoluene on Male Rats (Applicable Study)

Technical grade dinitrotoluene (tg-DNT) [CH3C6H3 (NO2)2] nitroaromatic agents which are manufactured in theindustries and applied in both commercial and military in all over the world and Egypt. DNT causes malfunctions inkidneys, heart, liver, testes and mammary glands in animals and human beings, which may be considered as carcinogenic inexperimental animals and human. Moreover, taurine, a free β-amino acid with remarkable antioxidant activity, hasimportant beneficial effects on the human body; hepatoprotection, nephroprotection, cardiovascular protection,hypoglycemic impact and hypolipidemicaction. Currently, taurine level in the serum is used as early marker of breast,endometrial and colon cancers. The current research was aimed to explore the potential impacts of the antioxidantproperties of taurine as a protecting material on tg-DNT induced toxicity in the liver and kidney in male rats. 100apparently healthy male rats in 4 groups were included; the first is Frank control group, mouth feeding via gavage withdistilled water; the other groups were administered as following, taurine alone, tg-DNT alone (toxic group), taurine + tgDNT (protective group) in the second, third and fourth groups, respectively. In these groups, blood biochemistry and taurineconcentrations in serum were measured for all animals. Furthermore, histopathological examination studies for liver andkidney were done for all groups. The results showed that, the protective group has marked improvement in most biochemicalparameters than the toxic group. Histological studies revealed a significant marked disturbance in the histopathologicalarchitectures of the kidney and liver in all toxic rats. However, marked improvements in histological architectures wereobserved in protective group. The results support the ameliorative effect of taurine as a protective agent against tg-DNTtoxicity in experimental rats.

Effects of vitamin E administration on Plasmodium berghei induced pathological changes and oxidative stress in mice

Abstract. The effects of daily intraperitoneal doses of 1000 i.u/kg body weight of vitamin E on the course of Plasmodium berghei NK 65 infection and the parasite-induced anemia as well as alterations in the relative weight of some selected organs and antioxidant status in mice were investigated. The number of parasitized red cells were not initially affected by the vitamin administration but were persistently lowered after 11th day post infection to the termination of the experiment. The P. berghei infection was found to induce anemia, significantly (P<0.05) increased the relative weight of liver, spleen and kidney but significantly decreased (P<0.05) the relative brain weight. However, all the parasite-induced changes in these parameters were significantly (P<0.05) ameliorated by the vitamin administration. Furthermore, malonydialdehyde concentration in the serum, liver and brain of infected animals was significantly (P<0.05) increased whereas superoxide dismutase and catalase activities were significantly (P<0.05) decreased by the infection. But vitamin E administration was found to, a significant degree (P<0.05), reversed the disease-induced alterations in these oxidative stress markers. It was concluded that vitamin E at the dose and route used prevented P. berghei induced anemia as well as alterations in relative organ weight and antioxidant status in mice

Histological changes of some organs in the offspring of mice due to mother malnutrition

This work aimed to evaluate the effect of low carbohydrate diet during pregnancy and lactation on the histological pictures of some organs in the offsprings. The animals were classified into two groups: The first one was kept as a control group; the second group was fed with a 30% low carbohydrate diet from the mating with male to 21 day after delivery. The specimens were examined histologically. The skin of fetuses fed maternally with low carbohydrate diet showed on aggregration of granules in stratum granulosum that became discontinuous, and a decrease in the epidermal thickness. Kidneys of fetuses fed maternally with low carbohydrate diet showed patchy areas of vacuolar degeneration in the tubular epithelium that became accompanied with hemorrhage later on. Pancreatic tissue from fetuses fed maternally with low carbohydrate diet showed lack of basal basophilia of acinar cells and increase in size of islets of Langerhans. It is concluded that getting a balanced diet by pregnant and lactating mother is very important as our work revealed a great effect of the decrease of carbohydrates on the development of some important organs, which may have a relation to some diseases in the adulthood

effect of hysterectomy on psychiatric morbidity [anxiety and depression]

To evaluate the psychiatric morbidity [anxiety and depression] in women underwent an abdominal and vaginal hysterectomy of a benign indication. This is a prospective observational study which was done in the Obstetric and Gynecology and Neuropsychiatry Departments, Sohag University Hospital. One hundred and two women were scheduled for undergoing hysterectomy after fulfilling the inclusion criteria. All women underwent a thorough history taking, clinical examination and complete psychiatric history. General health questionnaire [GHQ-28] was used to assess women with psychiatric co-morbidity before and after the operation. All women with psychiatric co-morbidity were re-evaluated by Beck depression inventory [BDI] and Hamilton anxiety scale [HAMA] before and after hysterectomy. On screening for psychiatric co-morbidity using the GHQ-28 for the 96 women who completed the follow up protocol of the study 35 [36.46%] scored >/= 4 [Group I] with psychiatric co-morbidity, and 61 [63.54%] scored <4 [Group II] without psychiatric co-morbidity. GHQ-28 was reapplied to all women in group II [post-operatively] where 48 [78.69%] scored >/= 4 [group IIa] and 13 [21.31%] scored <4 [group IIb. Severe anxiety and depressive symptomes were the most common presentation after the operation and represented 8 [40%] and 8 [53.3%], of patients of group I, respectively. In patient, of group II [without psychiatric morbidity] after hysterectomy, depressive and anxiety symptoms was the most common presentation in nulliparous women and was found in 7 [63.64%] and 3 [27.27%], respectively. However, the least depressive and anxiety symptoms was observed in women with parity >/= 5 and was found in 12 [38.7%] and 9 [29.03%], respectively. It is not worthy that the majority of women free from psychiatric co-morbidity was observed in women with parity >/= 5 and represented 10 [32.5%] of patients. It was clear that there was a definite significant relation between hysterectomized women and psychiatric morbidity of a depressive and anxiety nature. So we recommend that before hysterectomy in benign conditions, gynecologists should exhaust great effort of using the available recent less invasive modalities of treatment as first option

Prophylactic B-lynch suture during elective cesarean section in high risk cases of postpartum hemorrhage

This study was aiming at comparing prophylactic B-Lynch suture and classic ecbolics during elective cesarean section [CS] in high risk patients for postpartum hemorrhage. This is a prospective randomized controlled study which was conducted at Sohag University Hospital during the period from July 2005 to April 2007. Twenty three patients with a valid indication for elective CS, who have one or more risk factors for postpartum hemorrhage such as placenta previa, repeated CS, or previous history of postpartum hemorrhage, were recruited. Patients were randomly allocated into two groups. Group A [12 patients] was subjected to B-Lynch suture during their elective CS, and group B [11 patients] received classic ecbolics such as IV oxytocin and rectal prostaglandins El analogue [Misopristol 200 mcg tab.]. Both groups were compared regarding intra- and postoperative blood loss, need for blood transfusion, maternal and neonatal morbidities and mortalities. Both groups were similar with regard to the indication of elective CS, risk factors for postpartum hemorrhage, and preoperative hemoglobin level. Intraoperative blood loss and the need for blood transfusion was significantly higher in group B compared to group A. Also, postoperative blood loss through the weight of a special disposable bed linen was significantly higher in group B than in group A in the first 24 hours. Only one patient in group B had subtotal hysterectomy secondary to severe uncontrollable postpartum hemorrhage. All women underwent C.S. with B-lynch in group A were menstruated and one pregnancy occurred at the end of a year of follow up. B-Lynch suture is an appropriate prophylactic technique [safe, effective, and simple] during elective caesarean section in women with potential high risk of developing postpartum hemorrhage

Six strategies for effective and relevant medical education as adopted in Gezira Medical School

The undergraduate medical curriculum adopted at the Gezira Medical School is described, emphasizing: [1] making students learn by solving problems; [2] early involvement of students in community health matters and identification of community problems; [3] an integrated three-phase curriculum instead of one based on traditional separate academic disciplines; [4] active co-operation between non-university health workers and academic staff in educating students and giving them practical experience