Role of nucleated red blood cells in diagnosis of neonatal asphyxia in neonate with meconium stained and clear amniotic fluid

Background: Perinatal asphyxia has been defined as the lack of oxygen that occurs either before, during, or after birth. Many studies in recent past have suggested that an increased number of nucleated red blood cells (NRBC) in umbilical cord blood may be a useful marker to identify birth asphyxia.Objective: To find out the relationship between meconium-stained amniotic fluid and NRBC in umbilical cord blood.Patients and Methods: This was a comparative cross-section study, which was carried out at Obstetrics and Gynecology Department, Zagazig University Hospitals on 54 cases divided into 2 groups: (Group 1): included 27 pregnant females with meconium-stained amniotic fluid who gave birth to neonates (male 15 and female12) showing criteria of perinatal asphyxia, (Group 2): included 27 pregnant females with clear amniotic fluid who gave birth to neonate's apparently healthy full-term (male17 and female10) as control group with no obstetrical problems.Results: There was no statistically significant difference between case and control groups in basic characteristics or obstetric history. NRBC’s/100 WBCs and lactate were highly significantly increased in group 1. The mean value of lactate was increasing in relation to stage of hypoxic ischemic encephalopathy (HIE).Conclusion: There was a strong correlation between markers of acute asphyxia (i.e., umbilical artery blood nucleated red blood cells and lactate,) and meconium-stained liquor cases. These markers were significantly elevated in newborns with meconium-stained amniotic fluid

Prevalence Rate of Congenital Fetal Malformations in Second Trimester by Ultrasound Scanning in Zagazig University Outpatient Clinic

Background: All pregnancies are at a risk of producing congenital malformations, though only some of them are at a greater risk. Congenital anomalies its problem in which abnormalities of structure, function or body metabolism resulting in physical or mental disability or it may be fatal.Objective: This study aimed for early detection of major fetal anomalies to improve fetal and maternal outcome.Patients and methods: This cross-sectional study that include 422 pregnant females was carried out at the Ultrasound Unit and Obstetrics & Gynecology Department, Faculty of Medicine, Zagazig University during the period from December 2018 to July 2019. Results: Ultrasonography can identify at least 35-50% of major fetal malformations with a specificity of 90-100%. Though other methods of screening like biochemical markers and karyotyping are available, ultrasonography has the advantage of being non- invasive, safe, fast, accurate and reproducible with real time display, causing no discomfort to the patient at any time of gestation.Conclusions: The Prevalence of congenital fetal malformations (CFMF) among the study participants using ultrasonography scanning was 3.6%. The most prevalent anomalies were Hydrops fetalis and CVS anomalies. Therefore screening for congenital anomalies in obstetric sonography is an important component of primary healthcare for maternal and child health

The relationship between a new type of partogram and rate of cesarean section at Zagazig University

Background: The cesarean section (CS) rates have dramatically increased worldwide. The process of labor is associated with both maternal and fetal potential risks, regardless of the mode of delivery. Objective: The aim of this study was to investigate the value of the use of a new type of partogram and compare it with Fisher partogram in reducing the cesarean section rates. Patients and Methods: This cohort prospective study was carried out at the Department of Obstetrics and Gynecology, at Zagazig University Hospital and Menia Al-Kamh Central Hospital during the period study; year 2019. This study included 150 patients. We compared the efficacy of the two types of partograms during labor. Results: There were statistically significant differences between groups as regard newborns’ Apgar at 5th min, and as regard cesarean section rate, which in Group (A) according to Fisher partogram was 6 (5.8%) and according to new type of partogram was 3 (2.9%) while in Group (B) according to Fisher partogram it was 23 (48.9%) and according to new type of partogram was 14 (29.8%). Conclusions: The new partogram is more helpful in the recognition of the initiation of the acceleration stage during the active phase of labor and in the timely use of appropriate actions in order to achieve a safer delivery

Role of Cerebro-Placental Ratio in Prediction of Perinatal Outcome in Preeclamptic Patients with Intrauterine Growth Restriction

Background: The assessment of fetal hemodynamic status via Doppler flow is increasingly regarded as likely to aid in the detection of pregnancies at risk of developing adverse fetal outcomes. Doppler flow provides useful information beyond the ultrasound-based assessment of fetal growth alone. Objective: This study aimed to evaluate the role of cerebro-placental ratio (CPR) in prediction of perinatal outcome in preeclamptic patients with intrauterine growth restriction (IUGR). Patients and methods: This case-control study was conducted at Obstetrics and Gynecology Department, Zagazig University, on 50 pregnant women divided in to two groups: Group I (study group) that included 25 high risk pregnant women with IUGR. Group II (control group) included 25 high risk pregnant women without IUGR. The study was conducted during the period from December 2020 till July 2021. Results: The current study showed that CPR had 90.9% sensitivity, 78.6% specificity and 84 % diagnostic accuracy to predict newborns with low Apgar score, with statistically significant positive correlation. CPR also had 100% sensitivity, 100% specificity and 100 % diagnostic accuracy to predict stillbirth, with highly statistically significant positive correlation. The CPR had 100% sensitivity, 83.3% specificity and 92 % diagnostic accuracy to predict newborns with NICU admission, with statistically significant positive correlation. Other complications as meconium aspiration and neonatal death had no statistically significant to be predicted by low CPR. Conclusion: This study concluded that the Cerebro-Placental Ratio had high predictive value of perinatal out come in preeclamptic patients

HPLC-DAD-MS/MS profiling of phenolics from Securigera securidaca flowers and its anti-hyperglycemic and anti-hyperlipidemic activities

AbstractSecurigera securidaca (L.) Degen & Döefl., Fabaceae, has been widely used in the Iranian, Indian and Egyptian folk medicine as antidiabetic and anti-hyperlipidemic remedy. Phenolic profiling of the ethanolic extract (90%) of the flowers of S. securidaca was performed via HPLC-DAD-MS/MS analysis in the positive and negative ion modes. The total polyphenols and flavonoids in the flowers were determined colorimetrically, and the quantification of their components was carried out using HPLC-UV. Total phenolics and flavonoids estimated as gallic acid and rutin equivalents were 82.39±2.79mg/g and 48.82±1.95mg/g of the dried powdered flowers, respectively. HPLC-DAD-MS/MS analysis of the extract allowed the identification of 39 flavonoids and eight phenolic acids. Quantitative analysis of some flavonoids and phenolics (mg/100g powdered flowers) revealed the presence of isoquercetrin (3340±2.1), hesperidin (32.09±2.28), naringin (197.3±30.16), luteolin (10.247±0.594), chlorogenic acid (84.22±2.08), catechin (3.94±0.57) and protocatechuic acid (34.4±0.15), in the extract. Moreover, the acute toxicity, hypoglycemic and hypolipidemic effects of the extract were investigated using alloxan induced diabetes in rats in a dose of 100, 200, and 400mg/kgbwt. The ethanolic extract was safe up to a dose of 2000mg/kg. All tested doses of the flower extract showed marked decrease in blood glucose level by 31.78%, 66.41% and 63.8% at 100, 200 and 400mg/kgbwt, respectively, at p<0.05. Regarding the anti-hyperlipidemic effect, a dose of 400mg/kg of the flower extract showed the highest reduction in serum triacylglycerides and total cholesterol levels (68.46% and 51.50%, respectively at p<0.05). The current study proved the folk use of the flowers of S. securidaca as anti-diabetic and anti-hyperlipidemic agent which could be attributed to its high phenolic content

Key drivers for copepod assemblages in a eutrophic coastal brackish lake

The copepod assemblages and abiotic parameters were investigated at 11 stations in a large coastal lake (Lake Manzalah, Nile Delta) from 2009-2010 in order to verify any impacts of eutrophication and salinity on the copepod species composition. The environmental conditions and the copepod assemblages appeared to have changed in comparison with previous studies, possibly because of increasing eutrophication and invasions of non-indigenous species (NIS). The aim of the present study was the identification of species which can be used as ecological indicators of high trophic status. Among the nine copepod species of Lake Manzalah, Acartia tonsa, Mesocyclops ogunnus, and Apocyclops panamensis were reported for the first time. Acartia tonsa, a well-known NIS for the Mediterranean, numerically dominated the copepod assemblages in some portions of the lake. The distribution of Acanthocyclops trajani and Thermocyclops consimilis was insensible to eutrophication because they can stand high levels of nutrients and hypoxia. Compared with previous reports, the copepod assemblage of Lake Manzalah was richer in species. The invasions of NIS, in addition to the heterogeneous progress of eutrophication in the lake, created an environmental mosaic with many species in total, but with single areas suitable for only a small number of them

TOXICOLOGICAL AND PHARMACOLOGICAL ASSESSMENT OF GOLD NANORODS IN NORMAL RATS

Objective: assessment of acute, subchronic and chronic toxicity of pegylated gold nanorods (PEG-gold NRs) in Wistar rats of both sex in three routes of administration {intravenous (IV), intramuscular (IM) and subcutaneous (SC)}.Methods: in the acute toxicity study; PEG-gold NRs were injected once by three different routes, blood and tissue samples were collected after 14 d. In the subchronic and chronic studies; PEG-gold NRs were injected via three different routes, at 0.225, 0.45 and 0.9 mg/kg, once daily for 5 consecutive days, followed by a 23-day recovery period, for three and six months in the subchronic and chronic toxicity studies, respectively. Hematology, urinalysis, biochemical and histopathological examinations were conducted at the end of each study.Results: acute toxicity showed a significant decrease in serum triglycerides and cholesterol levels after single IV, IM and SC injection of PEG-gold NRs, while serum creatinine was significantly increased after IV and IM injection. Subchronic results revealed a significant decrease in serum triglycerides and cholesterol levels. The chronic study showed a significant decrease in serum triglycerides, sodium levels, total leukocytes count and significant increase in serum creatinine after IV injection. IM injection resulted in significant decrease in serum alkaline phosphatase, triglycerides, cholesterol, sodium levels and total leukocytes count. SC injection resulted in significant decrease in serum triglycerides, glucose, red blood cell count with increased creatinine and hematocrit.Conclusion: PEG-gold NRs at the three examined doses is apparently safe since no serious signs of toxicity were detected. IM and SC routes of injection were irritating, so we recommend the IV route.Â

Access and utilisation of primary health care services comparing urban and rural areas of Riyadh Providence, Kingdom of Saudi Arabia

The Kingdom of Saudi Arabia (KSA) has seen an increase in chronic diseases. International evidence suggests that early intervention is the best approach to reduce the burden of chronic disease. However, the limited research available suggests that health care access remains unequal, with rural populations having the poorest access to and utilisation of primary health care centres and, consequently, the poorest health outcomes. This study aimed to examine the factors influencing the access to and utilisation of primary health care centres in urban and rural areas of Riyadh province of the KSA

Factors associated with hospital service satisfaction in a sample of Arab subjects with schizophrenia

<p>Abstract</p> <p>Background</p> <p>Assessment of patients' satisfaction with health care services could help to identify the strengths and weaknesses of the system and provide guidance for further development. The study's objectives were to: (i) assess the pattern of satisfaction with hospital care for a sample of people with schizophrenia in Kuwait, using the Verona Service Satisfaction Scale (VSSS-EU); ii) compare the pattern of satisfaction with those of similar studies; and iii) assess the association of VSSS seven domains with a number of variables representing met and unmet needs for care, family caregiver burden, severity of psychopathology, level of psychosocial functioning, socio-demographic characteristics, psychological well-being and objective quality of life.</p> <p>Methods</p> <p>Consecutive outpatients in stable condition and their family caregivers were interviewed with the VSSS-EU and measures of needs for care, caregiver burden, quality of life and psychopathology.</p> <p>Results</p> <p>There were 130 patients (66.1%m, mean age 36.8). While over two-thirds expressed satisfaction with the domains of "overall satisfaction", "professionals' skills", "access", "efficacy", and "relatives' involvement", only about one-third were satisfied with the domains of "information" and "types of intervention". The later two domains were the areas in which European patients had better satisfaction than our patients, while our patients expressed better satisfaction than the Europeans in the domain of "relatives' involvement". In multiple regression analyses, self-esteem, positive and negative affect were the most important correlates of the domains of service satisfaction, while clinical severity, caregiver burden and health unmet needs for care played relatively minor roles.</p> <p>Conclusion</p> <p>The noted differences and similarities with the international data, as well as the predictive power of self-esteem and affective state, support the impression that patients' attitudes towards psychiatric care involve a complex relationship between clinical, personal and socio-cultural characteristics; and that many of the factors that impact on satisfaction with service relate to individual psychological characteristics. The weaknesses in the system, highlighted by the pattern of responses of the participants, indicate possible gaps in the provision of comprehensive psychiatric care in the country and obviate the need for public mental health education and development of services to enhance the quality of care.</p