Different methods of termination of second trimester pregnancy at Women′s Health Hospital, Assiut University: efficacy and complications

Background: Termination of pregnancy in second trimester is one of the greatest challenges in modern obstetrics practice and is more risky than during first trimester. Now the main concern of the obstetrician is to provide the most effective, safest, and cost-effective regimen with least or no complications. Describe the different indications, technique and complications of different methods of TOP used at Women’s Health Hospital, Assiut University.  Identify gap between current practice and guidelines and setting recommendations for filling gap to improve outcomeMethods: Studying the different methods used for all cases with gestational age 13-24 weeks attending at Women′s Health Hospital, Assiut University from the 1st July 2015 to the 1st June 2016, for second trimester termination of pregnancy who are eligible for termination of pregnancy, with exclusion criteria including any case with scared uterus, multiple pregnancy and rupture of membranes.Results: Of the 146 patients, 55 patients received misoprostol alone, 13 cases used foley’s catheter alone, 67 cases received misoprostol in combination with foley’s catheter and hysterotomy done in 9 patients (4 after failed induction and the rest as primary procedure). In present work the most common complication recorded was retained placental parts, 39 patients (26,5%) followed by surgical evacuation. Uterine perforation occurred accidentally in 3 cases during evacuation followed by laparotomy and repair of perforation without hysterectomy. Infection recorded in 3 cases (1.7%). Sever haemorhage occurred in 4 cases where they needed hysterotomy.Conclusions: All methods used in the department showed efficacy. Misoprostol induction was associated with a shorter induction-abortion interval but was associated with higher risk of retained placenta. Foley's catheter induction was more prolonged but it was associated with almost no complication. The most common complication was retained placenta except those who used Foley's catheter as they had no retained placental parts

Modeling and numerical investigation of the performance of gas diffusion electrodes for the electrochemical reduction of carbon dioxide to methanol

In this study, a model was built to investigate the role of Cu2O-/ZnO-based gas diffusion electrodes in enhancing the reduction of carbon dioxide into methanol inside an electrochemical cell. The model was simulated using COMSOL Multiphysics software and validated using experimental results. It showed reasonable agreement with an average error of 6%. The model demonstrated the dependence of the methanol production rate and faradic efficiency on process key variables: current density (j = 5-10 mA cm-2), gas flow rate (Qg/A = 10-20 mL min-1 cm-2), electrolyte flow rate, and CO2 gas feed concentration. The results showed a maximum methanol production rate of 50 -mol m-2 s-1 and faradic efficiency of 56% at -1.38 V vs Ag/AgCl. From the economic point of view, it is recommended to use a gas stream of 90% or slightly lower CO2 concentration and an electrolyte flow rate as low as 2 mL min-1 cm-2.The authors would like to convey special thanks to Prof. Mai Kamal El-Din for her willingness to share her knowledge and expertise that are of significant relevance to this work. J.A. gratefully acknowledges the financial support from the Spanish Ministry of Economy and Competitiveness (MINECO) under Ramon y Cajal program (RYC-2015-17080). The authors from ́ the Chemical Engineering Department, Cairo University, gratefully acknowledge the financial support provided by the Science and Technology Development Fund (STDF) of Egypt under project ID #11872. R.M.E.-M. acknowledges the support from the Oil and Green Chemistry research center and the Enhanced Oil Recovery Lab, Suez University, Egypt, and STDF (Science and Technology Development Fund) [Project ID 12395]

The impact of Digital Breast Tomosynthesis on BIRADS categorization of mammographic non-mass findings

Introduction: Mammography is the most used breast screening tool and was proven to reduce breast-cancer-associated mortality. The estimated sensitivity of mammography varies between 77% and 95%; however, sensitivity could be 26% lower in dense breasts than in entirely fatty breasts. The ability to represent the complex 3D breast architecture and early changes in anatomical structures in a 2D view is the biggest challenge for mammography. In Digital Breast Tomosynthesis (DBT), tomographic images are reconstructed from multiple projections acquired from different angles. This technique allows the generation of 3D data, reduction of tissue overlap and allows better evaluation of masses, architectural distortion, and asymmetries compared with conventional two-dimensional mammographic images.Objective: To evaluate the impact of Digital Breast Tomosynthesis on BIRADS categorization of mammographic non-mass findings.Methods: Prospective cohort for 180 women with mammographic non-mass findings who presented to Alexandria University Radio diagnosis Department either for screening or diagnostic purposes between July 2019 and August 2020 with mean age 51.44 ± 10.67 . Digital breast tomosynthesis and ultrasound was done for all patients. Lesions were evaluated on DM; DBT alone then combined DBT & DM. Comparison of results according to changes in BIRADS, diagnostic performance using histopathology as gold standard.Results: 208 non-mass findings were detected by conventional mammography (104 asymmetry, 35 architectural distortion, 69 micro calcifications), Tomosynthesis reduced the BIRADS 3 count by 32%, upgraded the count of BIRADS 4 lesions by 11.4% while upgraded the BIRADS 2 by 18.9% with consequent improvement of sensitivity and specificity, PPV, NPV and accuracy to 96%, 95%, 94%,97%, and 95.6%.Conclusion: Combined FFDM and DBT improved the diagnostic performance in evaluation of non-mass findings and proper BIRADS categorization

1,3-Dimethyl­benzo[b]dibenzothio­phene

The molecule of the title compound, C18H14S, is approximately planar (r.m.s. deviation = 0.029 Å). The crystal packing is stabilized by weak inter­molecular C—H⋯π inter­actions

5,7-Bis(1-benzothio­phen-2-yl)-2,3-dihydro­thieno[3,4-b][1,4]dioxine

In the title compound, C22H14O2S3, the dioxane ring is disordered over two sites [site occupancies = 0.623 (3) and 0.377 (3)]; both components adopt half-chair conformations. The two benzothio­phene ring systems are asymmetrically twisted away from the attached thio­phene ring [dihedral angles = 20.57 (3) and 6.70 (3)°] and are oriented at an angle of 26.83 (3)°. No significant hydrogen bonding or π–π inter­actions are observed in the crystal structure

Echocardiographic assessment of mitral valve morphology after Percutaneous Transvenous Mitral Commissurotomy (PTMC)

<p>Abstract</p> <p>Aims</p> <p>PTMC produces significant changes in mitral valve morphology as improvement in leaflets mobility. The determinants of such improvement have not been assessed before.</p> <p>Methods and results</p> <p>The study included 291 symptomatic patients with mitral stenosis undergoing PTMC. Post-PTMC subvalvular splitting area was a determinant of post-PTMC excursion in both the anterior (B 0.16, 95% CI 0.03 to 0.30, p < 0.05) and the posterior (B 0.12, 95% CI 0.01 to 0.24, p < 0.05) leaflets. Another determinant was the post-PTMC transmitral pressure gradient for anterior (B -0.02, 95% CI -0.04 to -0.005, p < 0.01) and posterior (B -0.01, 95% CI -0.04 to -0.005, p < 0.05) leaflets excursion. The relationship between post-PTMC MVA and leaflet excursion was non-linear "S curve". There was a steep increase of both anterior (p, 0.02) and posterior (p, 0.03) leaflets excursion with increased MVA till the MVA reached a value of about 1.5 cm²; after which both linear and S curves became nearly parallel.</p> <p>Conclusion</p> <p>The improvement in leaflets excursion after PTMC is determined by several morphologic and hemodynamic changes produced in the valve. The increase in MVA improves mobility within limit; after which any further increase in MVA is not associated by a significant improvement in mobility in both leaflets.</p

Systematic review and meta-analysis of the value of initial biomarkers in predicting adverse outcome in febrile neutropenic episodes in children and young people with cancer

Background: Febrile neutropenia is a frequently occurring and occasionally life-threatening complication of treatment for childhood cancer. Many biomarkers have been proposed as predictors of adverse events. We aimed to undertake a systematic review and meta-analysis to summarize evidence on the discriminatory ability of initial serum biomarkers of febrile neutropenic episodes in children and young people. Methods: This review was conducted in accordance with the Center for Reviews and Dissemination Methods, using three random effects models to undertake meta-analysis. It was registered with the HTA Registry of systematic reviews, CRD32009100485. Results: We found that 25 studies exploring 14 different biomarkers were assessed in 3,585 episodes of febrile neutropenia. C-reactive protein (CRP), pro-calcitonin (PCT), and interleukin-6 (IL6) were subject to quantitative meta-analysis, and revealed huge inconsistencies and heterogeneity in the studies included in this review. Only CRP has been evaluated in assessing its value over the predictive value of simple clinical decision rules. Conclusions: The limited data available describing the predictive value of biomarkers in the setting of pediatric febrile neutropenia mean firm conclusions cannot yet be reached, although the use of IL6, IL8 and procalcitonin warrant further study

Dicationic Alkylammonium Bromide Gemini Surfactants. Membrane Perturbation and Skin Irritation

Dicationic alkylammonium bromide gemini surfactants represent a class of amphiphiles potentially effective as skin permeation enhancers. However, only a limited number of studies has been dedicated to the evaluation of the respective cytotoxicity, and none directed to skin irritation endpoints. Supported on a cell viability study, the cytotoxicity of gemini surfactants of variable tail and spacer length was assessed. For this purpose, keratinocyte cells from human skin (NCTC 2544 cell line), frequently used as a model for skin irritation, were employed. The impact of the different gemini surfactants on the permeability and morphology of model vesicles was additionally investigated by measuring the leakage of calcein fluorescent dye and analyzing the NMR spectra of 31P, respectively. Detail on the interaction of gemini molecules with model membranes was also provided by a systematic differential scanning calorimetry (DSC) and molecular dynamics (MD) simulation. An irreversible impact on the viability of the NCTC 2544 cell line was observed for gemini concentrations higher than 25 mM, while no cytotoxicity was found for any of the surfactants in a concentration range up to 10 mM. A higher cytotoxicity was also found for gemini surfactants presenting longer spacer and shorter tails. The same trend was obtained in the calorimetric and permeability studies, with the gemini of longest spacer promoting the highest degree of membrane destabilization. Additional structural and dynamical characterization of the various systems, obtained by 31P NMR and MD, provide some insight on the relationship between the architecture of gemini surfactants and the respective perturbation mechanism