Effect of the type of urinary incontinence in the Outcome of laser Therapy for Treatment of Female Stress Urinary Incontinence

Background:Female stress urinary incontinence (SUI) is common lower urinary tract symptom. It affect many women especially middle and elderlywomen and about 40% of them have mixed Urinary incontinence (MUI).There are surgical and non-surgical options for treatment of stress urinary incontinence. Laser therapy is seemed to be a promising minimally invasive option for treatment of female SUI. Objective:To determine the effect of the type of urinary incontinence in laser therapy outcomes. Patients and method(s): A prospective non-randomized study for female patients with SUI who were referred to the Urology Department, Sohag University Hospital from March 2017 to June 2018. The study was approved from Sohag University ethics committee. Patients were treated by the clinical protocol for SUI with non-ablative 2940 nm Er: YAG laser. Patients were evaluated at the baseline and every 3 months for 1 year by Validated International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-UI SF) Arabic version and the number of daily pads usage .The patients were classified according to their type into a pure SUI group and MUI group. Result(s):Our results included 32female patients. 20 patients (63 %) had pure SUI while 12 patients (37%) had mixed incontinence. the median duration of symptoms 3 years. There was a significant reduction in daily pads usage and ICIQ-UISF score (p value<0001) for both groups with more significant for pure SUI group. No serious side effects were reported. Conclusion:There was a statistically significant effect of the type of UI on laser therapy outcomes with better results related to pure SUI.On the other hand, No effect of type ofurinary incontinence on number of laser sessions needed by patients to achieve improvement of their incontinence

The effect of nitro-oleic versus losartan in diabetic nephropathy: modulation of parathyroid hormone-related protein

Background: Parathyroid hormone-related protein (PTHrP) involvement in the mechanisms related to angiotensin II (AngII)-induced renal injury has become an emerging concern. The current study was thus designed to compare the possible preventive and therapeutic effect of AngII antagonists, losartan and nitro-oleic (NO2-OA) acid, on diabetic nephropathy (DN) and evaluate their effect on PTHrP modulation as well as on the functional and histopathological parameters in the kidney of diabetic rats.  Materials and methods: Forty eight adult male Sprague Dawley rats were divided into control group, DN group, pre-diabetic nephropathy (pre-DN) losartan group, pre-diabetic nephropathy nitro-oleic acid (pre-DN NO2-OA) group, post-diabetic nephropathy (post-DN) losartan and post-diabetic nephropathy nitro-oleic acid (post-DN NO2-OA) groups. At the end of the study, systolic blood pressure (SBP), serum fasting glucose, glomerular filtration rate (GFR), urea, urea albumin excretion (UAE), serum angiotensin, renal PTHrP gene expression and correlations between PTHrP and SBP, serum glucose, AngII and kidney functions were evaluated. Histo- logical examination, Masson’s trichrome, periodic acid-Schiff staining as well as morphometric analysis and histopathological scoring for tubular and glomerular parameters have been carried out.  Results: Prophylactic losartan and NO2-OA were associated with improvement in SBP, serum glucose, urea, GFR, UAE, with reduction in serum AngII and PTHrP overexpression observed in diabetic kidney. Treatment with losartan and NO2-OA showed the same effect except that post-DN NO2-OA showed no significant effect regarding kidney function. Strong correlations were observed between PTHrP and SBP, serum glucose, AngII and kidney functions. Histopathological results revealed obvious improvement in glomerulosclerosis, vascular and tubular injury parameters in prophylactic groups especially with losartan.  Conclusions: Both pre and post-DN losartan, NO2-OA may have a potential role in protection and regression of DN through reduction of PTHrP overexpression.

The Effects of Capparis Spinosa Leaves on The Histological Findings Associated With The Exposure of Mice to Trichloroacetic Acid

The present work was conducted to study the possible protective role of Capparis spinosa leaves and their efficacy against hematological and histological alterations resulted in an animal model intoxicated with trichloroacetis acid ( TCA). Hundred male mice 20-26 gm were divided into 5 groups ; control group , group II treated oraly with honey ( 40 mg / Kg body weight for 3 weeks ) , group III treated orally with a mixture of Capparis spinosa leaves powder and honey ( 40 mg/ Kg for 3 weeks) , group IV treated with TCA in drinking water ( 500 mg / Kg fpr 3 and 6 weeks , then left for 3 weeks for recovery) and group V ( Regeneration group ) treated with TCA for 6 weeks then treated with a mixture of Capparis and honey ( 40 gm /Kg for 3 weeks). Histological examination of spleen sections of mice treated with TCA revealed obvious pathological findings including disorganization of lymphoid follicles , hyperplasia in white pulp , depletion of lymphocyts in red pulp with subcapsular edema , some necrotic cells in white and red pulp , increasing megakarycoytes, haemosiderosis and fibrosis in red pulp and in some lymphoid follocles. Administration of a mixture of Capparis spinosa leaves powder and honey lessened most of the pathological lesions in mice intoxicated with TC

Management of Extremity Venous Thrombosis in Neonates and Infants: An Experience From a Resource Challenged Setting

We aimed to evaluate the outcome of different treatment modalities for extremity venous thrombosis (VT) in neonates and infants, highlighting the current debate on their best tool of management. This retrospective study took place over a 9-year period from January 2009 to December 2017. All treated patients were referred to the vascular and pediatric surgery departments from the neonatal intensive care unit. All patients underwent a thorough history-taking as well as general clinical and local examination of the affected limb. Patients were divided into 2 groups: group I included those who underwent a conservative treated with the sole administration of unfractionated heparin (UFH), whereas group II included those who were treated with UFH plus warfarin. Sixty-three patients were included in this study. They were 36 males and 27 females. Their age ranged from 3 to 302 days. Forty-one (65%) patients had VT in the upper limb, whereas the remaining 22 (35%) had lower extremity VT. The success rate of the nonsurgical treatment was accomplished in 81% of patients. The remaining 19% underwent limb severing, due to established gangrene. The Kaplan-Meier survival method revealed a highly significant increase in both mean and median survival times in those groups treated with heparin and warfarin compared to heparin-only group (P < .001). Nonoperative treatment with anticoagulation or observation (ie, wait-and-see policy) alone may be an easily applicable, effective, and a safe modality for management of VT in neonates and infants, especially in developing countries with poor or highly challenged resource settings

Correlation of Total Cholesterol and Glucose in Serum of Iraqi Patients with Atherosclerosis and Diabetes Mellitus Type 2

Cholesterol is a fatty substance (lipid) classified as a waxy steroid of fat. It is absorbed by the intestine into blood stream and is packaged inside a protein coat a chylomicron. Blood glucose is a simple monosaccharide absorbed directly into the blood stream during digestion. The level of blood glucose normally represents a balance between the inflow of glucose into blood and it is uptake by the tissue. Atherosclerosis is a general term for a number of different medical conditions that affect the heart, this is occurs when the blood supply to a part of heart is interrupted, must commonly due to plaque, is build up in the coronary arteries consist of lipid cholesterol and calcium. It causes a damage of potential disease of heart muscle due to thickening and hardening of arteries. Diabetes mellitus is a disorder in which the level of blood glucose is persistently elevated above the normal range due to decrease secretion of insulin. The main objective of this study is to determine the concentrations of total cholesterol and glucose into blood serum of Iraq patients with atherosclerosis and diabetes mellitus type 2. This study included 60 specimens of patients with atherosclerosis and 60 patients with type 2 diabetes mellitus; their age range was 45-65 years. These patients were then matched by age and sex to 30 healthy individuals. Results revealed that there was highly significantly increased in the mean value of total cholesterol and glucose concentrations in patients of atherosclerosis (p<0.001) and diabetes mellitus (p<0.001) as compared with healthy individuals

Mutations underlying 3-Hydroxy-3-Methylglutaryl CoA Lyase deficiency in the Saudi population

BACKGROUND: 3-Hydroxy-3-Methylglutaric aciduria (3HMG, McKusick: 246450) is an autosomal recessive branched chain organic aciduria caused by deficiency of the enzyme 3-Hydroxy-3-Methylglutaryl CoA lyase (HL, HMGCL, EC 4.1.3.4). HL is encoded by HMGCL gene and many mutations have been reported. 3HMG is commonly observed in Saudi Arabia. METHODS: We utilized Whole Genome Amplification (WGA), PCR and direct sequencing to identify mutations underlying 3HMG in the Saudi population. Two patients from two unrelated families and thirty-four 3HMG positive dried blood spots (DBS) were included. RESULTS: We detected the common missense mutation R41Q in 89% of the tested alleles (64 alleles). 2 alleles carried the frame shift mutation F305fs (-2) and the last two alleles had a novel splice site donor IVS6+1G>A mutation which was confirmed by its absence in more than 100 chromosomes from the normal population. All mutations were present in a homozygous state, reflecting extensive consanguinity. The high frequency of R41Q is consistent with a founder effect. Together the three mutations described account for >94% of the pathogenic mutations underlying 3HMG in Saudi Arabia. CONCLUSION: Our study provides the most extensive genotype analysis on 3HMG patients from Saudi Arabia. Our findings have direct implications on rapid molecular diagnosis, prenatal and pre-implantation diagnosis and population based prevention programs directed towards 3HMG

The Importance of Preventive Medicine in Family Practice: A Review of Current Guidelines and Recommendations

Prevention is seen as a critical topic in family practice. Primordial prevention, primary prevention, secondary prevention, tertiary prevention, and quaternary prevention are all part of this strategy to disease prevention. To avoid the formation and development of risk factors, primary prevention focuses on addressing the fundamental causes and social determinants of disease. Primary prevention is the practice of preventing illnesses before they arise via the use of treatments such as immunizations and health education. Secondary prevention focuses on illness identification and intervention as early as possible to avoid disease development. Tertiary prevention addresses illness outcomes by restoring health and offering rehabilitation. Finally, quaternary prevention seeks to safeguard patients against needless medical treatments and the harm caused by over-medicating. Risks frequently rise in tandem with frailty and comorbidities. In contrast, advantages frequently drop as life expectancy increases. Preventive management strategies should consider the patient's viewpoint and be mutually agreed upon. Healthcare providers must prioritize the deployment of preventive care services, even when clinical treatments are required, in order to overcome preventive care hurdles. Healthcare practitioners may play a critical role in illness prevention and contribute to family well-being by investing in preventive care and executing these measures

Posterior reversible encephalopathy syndrome in a child with cyclical vomiting and hypertension: a case report

<p>Abstract</p> <p>Introduction</p> <p>Posterior reversible encephalopathy syndrome is characterized by headache, nausea and vomiting, seizures and visual disturbances. It has certain characteristic radiological features, which allow diagnosis in the appropriate clinical setting and enable appropriate clinical therapy to be instituted.</p> <p>Case presentation</p> <p>A 10-year-old Caucasian girl who was hospitalized due to recurrent vomiting was diagnosed as having posterior reversible encephalopathy syndrome after an initial diagnosis of cyclical vomiting and hypertension was made.</p> <p>Conclusion</p> <p>Posterior reversible encephalopathy syndrome is a rare disorder in children. Early recognition of characteristic radiological features is key to the diagnosis as clinical symptoms may be non-specific or mimic other neurological illnesses. To the best of our knowledge this is the first case to report an association between posterior reversible encephalopathy syndrome, cyclical vomiting and hypertension. Furthermore, in this case, the resolution of the abnormalities found on magnetic resonance imaging over time did not appear to equate with clinical recovery.</p

A critical perspective on second-order empathy in understanding psychopathology: phenomenology and ethics

The centenary of Karl Jaspers’ General Psychopathology was recognised in 2013 with the publication of a volume of essays dedicated to his work (edited by Stanghellini and Fuchs). Leading phenomenological-psychopathologists and philosophers of psychiatry examined Jaspers notion of empathic understanding and his declaration that certain schizophrenic phenomena are ‘un-understandable’. The consensus reached by the authors was that Jaspers operated with a narrow conception of phenomenology and empathy and that schizophrenic phenomena can be understood through what they variously called second-order and radical empathy. This article offers a critical examination of the second-order empathic stance along phenomenological and ethical lines. It asks: (1) Is second-order empathy (phenomenologically) possible? (2) Is the second-order empathic stance an ethically acceptable attitude towards persons diagnosed with schizophrenia? I argue that second-order empathy is an incoherent method that cannot be realised. Further, the attitude promoted by this method is ethically problematic insofar as the emphasis placed on radical otherness disinvests persons diagnosed with schizophrenia from a fair chance to participate in the public construction of their identity and, hence, to redress traditional symbolic injustices