Histological and morphometric effects of CdCl2 and ginger on osteoporosis induced by bilateral ovariectomy in adult albino rats

Cadmium is a widespread environmental pollutant. Low-level environmental cadmium exposure induced osteoporosis especially in postmenopausal women. Ginger is a strong antioxidant that may play an important role in bone formation. The purpose of the present study was to assess the effects of cadmium chloride and ginger on osteoporosis induced by bilateral ovariectomy in adult albino rats. Seventy-two adult albino rat females were used in the present study. They were divided into non-operated groups and operated groups. Cadmium chloride was received at a dose of 3.5 mg/kg daily by subcutaneous injection for 8 weeks, and ginger was fed on a diet containing 5% ginger for 8 weeks. Rats were sacrificed; femurs were dissected out, fixed and decalcified. Serial transverse and longitudinal sections from the diaphysis and metaphysis of femurs were stained by haematoxylin and eosin (H&E) and Masson trichrome stainings and examined using light microscopy. Femurs of Cd-treated, ovariectomized non-treated, and ovariectomized +Cd-treated groups showed histological and morphometric osteoporotic changes that were marked and exaggerated in the ovariectomized +Cd-treated group. Whereas Cd+ginger, ovariectomized +Cd+ginger and ovariectomized+ginger treated groups showed less bone resorption, more bone formation, and improvement in bone structure and morphometric parameters compared to other groups. Cadmium chloride exposure is a risk factor for osteoporosis, especially in postmenopausal women. Ginger effectively ameliorated cadmium and ovariectomy-induced osteoporosis in rats, and is a promising candidate for the prevention and treatment of postmenopausal osteoporosis (AU)

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Morphometric study of sacral hiatus in adult human Egyptian sacra: Their significance in caudal epidural anesthesia.

BACKGROUND: The reliability and success of caudal epidural anesthesia depends on anatomic variations of sacral hiatus (SH) as observed by various authors. SH is an important landmark during caudal epidural block (CEB).The purpose of the present study was to clarify the morphometric characteristics of the SH in human Egyptian dry sacra and pelvic radiographs and identification of nearest ony landmarks to permit correct and uncomplicated caudal epidural accesses. METHODS: The present study was done on 46 human adult Egyptian dry sacra. The maximum height, midventral curved length, and maximum breadth of each sacrum were measured and sacral and curvature indices were calculated. According to sacral indices, sacra were divided into 2 groups (22 male and 24 female sacra). SH was evaluated in each sacrum according to its shape, level of its apex, and base according to sacral and coccygeal vertebrae, length, anteroposterior (AP) diameter at its apex, and transverse width at its base. Linear distances were measured between the apex of SH and second sacral foramina, right and left superolateral sacral crests. The distance between the 2 superolateral sacral crests also was measured. RESULTS: The most common types of SH were the inverted U and inverted V (in male) and inverted V and dumbbell shaped (in female). Absent SH was observed in male group only. The most common location of SH apex was at the level of S4 in all groups of dry sacra and S3 in all groups of lumbosacral spine radiographs, whereas S5 was the common level of its base. The mean SH length, transverse width of its base, and AP diameter of its apex were 2.1±0.80, 1.7±0.26, and 0.48±0.19 cm. Female sacra showed narrower SH apex than male. The distance between the S2 foramen and the apex of the SH was 4.1±1.14, 3.67±1.21, and 4.48±1.01 cm in total, female and male sacra, respectively. CONCLUSION: Sacrum and SH showed morphometric variations in adult Egyptians. The equilateral triangle is an important guide to detect SH easily and increases the success rate of CEB. Insertion of a needle into the SH for caudal block is suggested to be done at its base to avoid the anatomic variations of its apex.

Obstetric performance of a patient with multiple uterine and cervical fibroids and expectant management of retained placenta.

The aim of this case report is to describe the obstetric performance of a patient with multiple uterine and supravaginal cervical fibroids. A 36-year-old, gravida 3 para 0+2 with multiple uterine and cervical fibroids presented with inevitable abortion at 17 weeks gestation. She had a spontaneous rupture of membranes followed by expulsion of fetus as breech with entrapment of aftercoming head by a cervical fibroid. Oxytocin infusion and digital traction were able to deliver the fetus. The placenta, however, was trapped in the fundal area and could not be delivered under general anesthesia because of mechanical obstruction by the fibroid. Expectant management was successful in expulsion of the placenta within 7 days without complication.

Disseminated intravascular coagulation and massive obstetric hemorrhage. Management dilemma.

OBJECTIVE: The objective of this retrospective study is to reflect on our experience on an optimal management for major postpartum hemorrhage, which would prevent the occurrence and complications of disseminated intravascular coagulation and minimize maternal mortality and morbidity. METHODS: Ten cases out of the 30,000 of total deliveries of severe obstetric hemorrhage associated with disseminated intravascular coagulation were studied. This study was carried out over a 7 year period, October 1988 through to September 1995, at the Obstetric Unit, King Khalid University Teaching Hospital, Riyadh, Kingdom of Saudi Arabia. RESULTS: All of the 10 women received packed red blood cells, 8 had fresh frozen plasma, and 6 received platelet transfusion. The 10 cases developed disseminated intravascular coagulation following medical and surgical management, all women needed hysterectomy, 4 subtotal, 6 total, and 5 women had relaparotomy and pelvic packing. Two had bladder injuries. There was no maternal death. CONCLUSION: An early resort to hysterectomy when conservative measures fail, will minimize maternal morbidity and mortality. In case of continuous bleeding after hysterectomy, pelvic packing proved to be effective.