Background: Shoulder dystocia followed by permanent brachial plexus injury or mental impairment is one of the leading causes of malpractice allegations. Prompt assessment and management of shoulder dystocia and preparation to maximize the efficiency of shoulder dystocia maneuvers are critical. Study design: Prospective cross sectional study of a reference group of healthy pregnant women and a test group of women with risk factors for shoulder dystocia. Outcome measures were difficulties with delivery of shoulders and correlation with maternal body weight and birth weight. Objectives: To determine the best Sonographic parameters in prediction of shoulder dystocia in delivery at term. Patients and Methods: The study included 60 selected pregnant women within two weeks of delivery at Tanta University hospital. The chosen cases were divided into two groups. The first ”reference” group (GI) composed of 20 women with singleton normal pregnancy at 38-42 weeks. The second test group (GII) composed of 40 women at risk. Risk factors include maternal obesity (Body mass index ’BMI’ > 30), excessive prenatal weight gain (weight gain > 20 kg), previous macrocosmic baby, history of difficult delivery, clinical suspicion of large baby and diabetic women. Three ultrasonic parameters were used for comparison between the two groups. 1. Difference between the abdominal diameter and biparietal diameter (AD-BPD difference). 2. Difference between chest diameter - biparietal diameter (chest- BPD difference). 3. Humerospinous distance measurement. Results: During the study period, 45 women were admitted to spontaneous labor, 10 underwent an induction of labor, and 5 had an elective cesarean section. All cases of shoulder dystocia (n=10) occurred among women who delivered vaginally with significant ADBPD difference (P>0.05). Comparing the groups with and without shoulder dystocia, significant differences were found in maternal weight, weight gain, birth weight and AD-BPD difference, while in other sonographic parameters measured (chest- BPD, Humerospinous distance) the significant difference was only detected at a cutoff value 2.6cm for AD-BPD difference (AD-BPD difference> 2.6). Conclusion: Since some of these risk factors are known prior to delivery, each woman especially those at high risk, with significant AD-BPD difference should be counseled on her individual risk of severe perinatal morbidity before a decision on the mode of delivery is taken.
Reactive oxygen species have been implicated in seizure-induced neurodegeneration and there is a correlation between free radical level and scavenger enzymatic activity in epilepsy. It has been suggested that pilocarpine-induced seizures is mediated by an increase in oxidative stress. Current research has found that antioxidant may provide, in a certain degree, neuroprotection against the neurotoxicity of seizures at the cellular level. L-Carnitine has a powerful antioxidant action. The objective of the present study was to evaluate the neuroprotective effects of L-Carnitine (L-CAR) in rats, against oxidative stress caused by pilocarpine-induced seizures. 30 min prior to behavioral observation, rats were treated with (0.9% saline i.p., control group), L-CAR 300 mg/k alone (L-CAR 300 mg/kg i.p., L-CAR group), pilocarpine (400 mg/kg, i.p., P400 group) and the combination of L-CAR (300 mg/kg, i.p.) and pilocarpine (400 mg/kg, i.p.). After the treatments all groups were observed for 6 hr. The enzymatic activities, lipid peroxidation and nitrite concentrations were measured using speccitrophotometric methods and these data were assayed. In P400 group rat there was a significant increase in lipid peroxidation and nitrite levels. However, no alteration was observed in superoxide dismutase (SOD) and catalase activities. In the L-CAR and pilocarpine co-administered rat, antioxidant treatment significantly reduced the lipid peroxidation level and nitrite content, as well as increased the SOD and catalase activities in rat hippocampus after seizures. Our findings strongly support the hypothesis that oxidative stress occurs in hippocampus during pilocarpine-induced seizures, indicate that brain damage induced by the oxidative process plays a crucial role in seizures pathogenic consequences, and imply that strong protective effect could be achieved using l-carnitine. In conclusion: Lcarnitine could enhance activities of SOD and reduce the MDA level and could reduce seizure period, inhibit neuronal damage as free radical scavenger.
Background: In type1 diabetes (T1D) The most important genes are located within the major histocompatibility complex(MHC) HLA class II region on chromosome 6p21, a locus termed Insulin Dependent Diabetes Mellitus (IDDM), which alone accounts for approximately 40-45% of the genetic susceptibility to T1D. Association between autoimmune diseases and alleles of genes in the MHC region is among the most consistent findings in human genetics. Genes in the region are involved in the immune response e.g. by presentation of antigenic peptides to T lymphocytes. But even though the function of the proteins encoded by these genes is well known, their specific contribution to the pathogenesis and the exact mechanisms by which the locus confers susceptibility to immune- mediated destruction of the pancreatic islets is still not clear. AIMES: The aim of our study was to confirm the contribution of HLA-DDRB1 polymorphisms to T1D genetic susceptibility for the Egyptian children population. Patients and methods: Twenty IDDM children of 14 boys and 6 girls with another twenty matched healthy subjects12 boys and 8 girls (as Control) were studied. Using standard operating procedure (SOP) for peripheral – blood-mononuclear cells (PBMC) (Isolation and cryopreservation, Protocol used at KFSH&RC, Cross-Network Version 1:04 November2005) to determine and comparing the frequency of HLA-DRB1*04 alleles(DRB1*0401,DRB1*0403 DRB1*0409 ,DRB1*0417, DRB1*0428 ,DRB1*0436)(Table7) using Sequence Specific Primer-Polymerase Chain Reaction (SSP-PCR). Results: Three different significant alleles,DRB1*0401,OR: 7.364 , P=0.013 ,DRB1*0403 ,OR:6.000,P=0.028 and DRB1*0428 , OR: 0.064, P=0.003. DRB1*0409, DRB1*0417, DRB1*0401(Table7) Conclusion: This study demonstrates that the susceptibility and protective human lymphocyte antigen (HLA) alleles play an important role in T1DM in the Egyptian children population.
Purpose: The purpose of this study was to determine the diagnostic accuracy of ultrasonography for suspected osteomyelitis. Patients and Methods: The use of ultrasound in osteomyelitis has been studied in seventeen patients clinically suspected of osteomyelitis. The patients were investigated prospeclively with high - resolution ultrasonography for the presence of subperiosteal fluid or cortical irregularity. A sonographic diagnosis of osteomyelitis was made if fluid was present in direct contact with the bone, without intervening soft tissues. Results: Ultrasonographically 15 patients were found to have osteomyelitis; diagnosis was established by surgery and positive culture of the fluid found inta-operatively. Two patients had soft tissue abscess. No cortical irregularity can be found. Conclusion: Ultrascnographic results may help the diagnosis apart from the importance of clinical judgment and results of other tests. Two ultrasonograpbic studies were false - positive, and diagnostic accuracy of ultrasound diagnostic procedure was 92%.
جميع البيانات التي يتم تسجيلها على النظام هي ملك للجهة صاحبة هذه البيانات
لا يتم الاطلاع على هذه البيانات من قبل مهندسي المركز إلا للضرورة القصوى ولغرض الدعم الفني وبالاتفاق مع الجهة صاحبة البيانات شفوياً أو كتابياً
لا يتم إعطاء أي بيان من بيانات النظام لأي فرد او جهة فرعية تنتمي للجهة صاحبة البيانات او لأي جهة أخرى إلا بموافقة كتابية من الجهة صاحبة البيانات
يمكن استخدام البيانات المسجلة على النظام بهدف عمل إحصائيات يستفاد منها فى قياس اداء النظام وكفاءة استخدامه من قبل مستخدميه
يتم تأمين جميع البيانات الخاصة بالنظام من خلال تأمين الحاسب الخادم الذي يستضيف البيانات ومن خلال تأمين انتقال البيانات بين جهاز المستخدم والحاسب الخادم وكذلك تأمين واجهة النظام التي يستخدمها المستخدم
كل مستخدم للنظام مسئول مسئولية كاملة عن كلمة المرور الخاصة به وعليه اتخاذ كافة الاحتياطات الممكنة حتى لا يستطيع أى شخص آخر الحصول عليها
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