Frequency of Glomerular Dysfunction in Children with Beta Thalassaemia Major

Objectives: This study investigated the frequency of glomerular dysfunction in children with beta thalassaemia major (β-TM) by using different markers and correlating them with serum ferritin and iron chelation therapy. Methods: The study, carried out between August 2011 and May 2012, included 100 patients with β-TM, in two groups. Group Ia (n = 62) received chelation therapy (deferoxamine). Group Ib (n = 38) received followup care at the Pediatric Hematology Outpatient Clinic, Minia University Children’s Hospital, Egypt. Group II included 50 apparently healthy controls, age- and sex-matched to Group I. All patients underwent a thorough history-taking, clinical examination and laboratory investigations. Results: Compared to Group II, Groups Ia and Ib had significantly higher levels of cystatin C, serum creatinine and serum ferritin, and a higher albumin/ creatinine ratio in their urine, and a significantly lower estimated glomerular filtration rate (eGFR) and creatinine clearance (P <0.05). Moreover, Group Ιa had a significantly lower eGFR and creatinine clearance than Group Ib. Cystatin C had a highly significant strong negative correlation with eGFR and creatinine clearance and a significantly strong positive correlation with serum ferritin, and a higher sensitivity and specificity than serum creatinine and creatinine clearance for small changes in GFR. Conclusion: β-TM patients had a high frequency of glomerular dysfunction—possibly attributable to chronic anaemia, iron overload or chelation therapy. Periodic renal assessment is mandatory to detect renal complications. Cystatin C is a promising marker to monitor glomerular dysfunction, having a higher sensitivity and specificity than serum creatinine and creatinine clearance for small changes in GFR

Enhancing the Performance of Power System under Abnormal Conditions Using Three Different FACTS Devices

In this paper, a comparison between Flexible Alternating Current Transmission System (FACTS) devices including Static Synchronous Compensator (STATCOM), Static Synchronous Series Compensator (SSSC) and Unified Power Flow Controller (UPFC) for providing a better adaptation to changing operating conditions and improving the usage of current systems. The power system using FACTS devices is presented under different conditions such as single phase fault and three phase fault. A digital simulation using Matlab/Simulink software package is carried out to demonstrate the better performance including the voltage and the current of the presented system using FACTS that located between buses B1 and B2 under different faults types. The results obtained investigate that the presented system gives better response with FACTS as compared to not using them under abnormal conditions besides, the UPFC gives better performance of power system under several faults as compared to STATCOM or SSSC as It can absorb reactive power in a manner which significantly reduced the fault current. It is demonstrated that UPFC can reduce the peak fault current at bus B1 ‎to 63.85% of its value without ‎using FACTS devices under line to ground fault and 79.18% under three line to ‎ground fault whereas STATCOM and SSSC reduce it ‎to (75.21, 94.35%) and (75.40, 94.68%), respectively

THE RELATIONSHIP BETWEEN INTRUSIVE COGNITIONS AND DEFENSE MECHANISMS IN HEALTHY AND CLINICAL POPULATIONS

Purpose: to examine the relationship between defense mechanisms and intrusive cognitions in normal healthy individuals and psychiatric patients. Methodology: The study sample consists of a healthy group (n=60; 30 males & 30 females), whereas the clinical group (n=66; 34 males, 32 females) includes patients with major depressive disorder (12 patients, 5 males, 7 females), schizophrenia (31 patients; 14 males, 17 females), obsessive-compulsive disorder (23 patients; 15 males, 8 females). We used several scales to measure the following variables: intrusive cognitions, intrusive memories, and defense mechanisms. Finding: The results show that there is a positive correlation between defense mechanisms and intrusive cognitions in healthy and clinical groups. Intrusive cognitions were more common in the patient than in a healthy group. Furthermore, there was no significant difference between males and females in measures of intrusive thoughts and memories in both groups. Implications: These findings have implications for behavioral treatment. Treatments used for managing posttraumatic stress disorder can also be used for the treatment of a major depressive disorder, OCD, and schizophrenia. Originality: This investigation the relationship between intrusive cognitions and defense mechanisms in healthy and clinical populations and its implication on the cue exposure therapy that can be the treatment of intrusive cognitions and thoughts in with major depressive disorder, OCD, and schizophrenia

Prevalence of cesarean section on demand in Assiut Governorate, Egypt

Background: The current study aims to evaluate the prevalence of CS on demand in Women's health hospital, Assiut University and Abnob Central Hospital in Assiut Governorate, Egypt.Methods: A cross sectional study conducted in Assiut Women Health Hospital and Abnob central hospital from January 2017 to December 2017. The total number of cesarean section done was 180 cases and the number of CS on demand was 64 (35.6%). The demographic data were collected by one of the study investigators. Women were asked about the causes of requesting CS before surgery.Results: The study group was 64 women with age ranging from 18-40 years old, 40 primipara and 24 multipara. Of those 24 women, 21 of them previously delivered vaginally and only 3 women delivered by emergency CS. Twenty- six women had a history of previous abortion. Fear of pain was the main cause for CS on demand in the whole study participants (57.8%). In primipara, the main cause for requesting CS is fear of pain in 62.5% of participants followed by fear on the baby in 45 % of women. On the other hand, in multipara, the main cause for CS on demand was bad history of previous experience (60%) followed by fear of pain in 50% of cases. There was statistical significant difference between both groups in only two causes; fear of pelvic floor injuries (50% in multipara vs. 20% in primipara, p=0.02) and bad history of previous experience (60% in multipara vs. 0% in primipara, p=0.001). Other causes were not statistically different.Conclusions: The incidence of cesarean sections performed on request without medical indications is rising. The reasons for this are not only for perceived medical benefit, but also due to social, cultural, and psychological factors

Practical Needs in Assessing Response to Therapy in Operated Brain High Grade Glioma According to Response Assessment in Neuro-Oncology Criteria

Background: Tumors known as gliomas begin in the brain or spine's glial cells and might spread throughout the body.  An effort was made to improve tumor response evaluation and end point selection through the Response Assessment in Neuro-Oncology (RANO) working group. Objective: To standardize the assessment method and results reporting by applying MRI-RANO criteria in detecting glioma response to surgical treatment. Patients and Methods: This was a prospective cohort study included 12 patients (4 males and 8 females) whose mean age was 53.6 ± 15.1years. Included patients are those who were operated and pathologically proved as brain glioma grade IV (GBM). They underwent post-operative MRI within 48 hours and are available for follow up MRI after 3 months. Imaging modalities applied in both MRI exams were conventional magnetic resonance imaging, MRI diffusion weighted images, and contrast imaging. RANO criteria were applied. Results: According to RANO criteria, none of the lesions had pseudo response or pseudo progression. However, two thirds (66.7%) had progressive disease and one third (33.3%) had complete response. There was statistically significant association between MRI findings 3 months postoperative and RANO criteria as patients with compete response had statistically significant decrease on measurable solid components, diffusion restriction, post contrast enhancement and all lesions had grade I edema with no mass effect or midline shift compared to patients with progressive disease. 4 cases that showed complete response category had fulfilled all the RANO criteria, while 8 cases with category progressive disease had fulfilled more than one of the described RANO criteria. Conclusion: RANO criteria are an effective tool to be used in interpretation of MRI for follow-up of surgically operated glioma patients to detect their response