Large solitary luteinized follicle cyst of pregnancy and puerperium

Solitary luteinized follicle cyst is a rare cause of ovarian enlargement during pregnancy and puerperium. Only rare cases of this clinical condition have been reported in the literature. We report a case of a large solitary luteinized follicle cyst arising in a 32-year-old multipara four days post partum which required postpartum surgical intervention. The perinatal outcome is usually good, with liveborn infants being delivered at or near term. The complications of the disease include ovarian torsion, intra-cystic haemorrhage, and rupture. The condition should be included in the differential diagnostic workup whenever a growing simple cyst is encountered during pregnancy and puerperium.Key words: luteinized follicle cyst; pregnancy; puerperium

A space-time pseudospectral discretization method for solving diffusion optimal control problems with two-sided fractional derivatives

We propose a direct numerical method for the solution of an optimal control problem governed by a two-side space-fractional diffusion equation. The presented method contains two main steps. In the first step, the space variable is discretized by using the Jacobi-Gauss pseudospectral discretization and, in this way, the original problem is transformed into a classical integer-order optimal control problem. The main challenge, which we faced in this step, is to derive the left and right fractional differentiation matrices. In this respect, novel techniques for derivation of these matrices are presented. In the second step, the Legendre-Gauss-Radau pseudospectral method is employed. With these two steps, the original problem is converted into a convex quadratic optimization problem, which can be solved efficiently by available methods. Our approach can be easily implemented and extended to cover fractional optimal control problems with state constraints. Five test examples are provided to demonstrate the efficiency and validity of the presented method. The results show that our method reaches the solutions with good accuracy and a low CPU time.Comment: This is a preprint of a paper whose final and definite form is with 'Journal of Vibration and Control', available from [http://journals.sagepub.com/home/jvc]. Submitted 02-June-2018; Revised 03-Sept-2018; Accepted 12-Oct-201

Bipolar versus fixed-head hip arthroplasty for femoral neck fractures in elderly patients

Between 2002 and 2007, fifty elderly patients with displaced femoral neck fractures were treated with hip replacement at Emergency Hospital, Mansoura University. Patients were randomly selected, 25 patients had either cemented or cementless bipolar prosthesis, and another 25 patients had either cemented or cementless fixed-head prosthesis. There were 34 women and 16 men with an average age of 63.5 years (range between 55 and 72 years). All patients were followed up both clinically and radiologically for an average 4.4 years (range between 2 and 6 years). At the final follow-up, the average Harris hip score among the bipolar group was 92 points (range between 72 and 97 points), while the fixed-head group was 84 points (range between 65 and 95 points). Radiologically, joint space narrowing more than 2 mm was found in only 8% (2 patients) among the bipolar group, and in 28% (7 patients) of the fixed-head group. Through the follow-up period, total hip replacement was needed in two cases of the bipolar group and seven cases of the fixed-head group. Bipolar hemiarthroplasty offered a better range of movement with less pain and more stability than the fixed-head hemiarthroplasty in elderly patients with displaced femoral neck fractures

Safety Pin Suture for Management of Atonic Postpartum Hemorrhage

Objective. To assess the efficacy of a new suture technique in controlling severe resistant uterine atonic postpartum hemorrhage. Patients and Methods. This is a retrospective observational study that included thirteen women with uterine atony and postpartum bleeding that did not react to usual medical management. All these women underwent compressing vertical suture technique in which the anterior and posterior walls of the uterus were attached so as to compress the uterus. The suture is transfixed at the uterine fundus, thus eliminating the risk of sutures sliding off at the uterine fundus (safety pin suture). Results. safety pin uterine compression suture was a sufficient procedure to stop the bleeding immediately in 92.2% of the women. None of the women developed complications related to the procedure. Conclusion. A new safety pin suture is a simple and effective procedure to control bleeding in patients with treatment-resistant, life-threatening atonic postpartum hemorrhage with the advantage of eliminating the risk of the sutures sliding off at the uterine fundus

Improved pain and quality of life outcomes after percutaneous vertebroplasty for thoraco-lumbar non-osteoprotic compression fractures

Introduction: Vertebroplasty is a minimally invasive technique in which percutaneous injection of bone cement under fluoroscopic guidance Percutaneous vertebroplasty (PVP) has been widely and successfully accepted in the treatment of osteoporotic and neoplastic vertebral compression fractures to control pain refractory to medical treatment. However, using of vertebroplasty as primary line treatment for traumatic, non-osteoporotic compression fractures still not widely accepted and considered a debatable issue. Patients and methods: This prospective comparative study was conducted at Neurosurgery department, Mansoura university hospital and Mansoura emergency hospital through the period between January 2015 and March 2016. 20 patients complaining of back pain due to single level thoracolumbar vertebral compression non-osteoprotic fractures were admitted to the study. Patients were divided into two groups 10 patients each, PVP group and conservative group. Outcome were assessed as regard pain improvement using Visual analogue scale VAS and quality of life using short form 36 scale (SF36). Results: Ten patients in the PVP group received Vertebroplasty, eight males (80%) and two females (20%) the age ranged from 29 to 62 years with mean age of 44.2+8.3 (mean+SD) years. The conservative group included ten patients seven males (70%) and three females (30%) the age ranged from 31 to 64 years with mean age of 45.1+9.2 (mean+SD) years. The level of injury ranged from D6 to L4. VAS and SF36 results showed significant improvement in post injection results compared to preinjection and to the conservative group Conclusion: Percutaneous vertebroplasty is safe and effective procedure to improve pain and quality of life in non osteoprotic patients complaining of traumatic compression fractures of thoraco-lumar region it decreases pain, and provide early ambulation of patients which improve their quality of life without significant morbidity

Prediction of preterm birth by evaluating the fetal adrenal gland volume and blood flow: a pilot study

Background: The aim of the current study was to estimate the risk of preterm birth (delivery < 37 weeks of gestation) by evaluating the fetal adrenal gland volume and blood flow at Women’s Health Hospital, Assiut University, Egypt.Methods: A pilot prospective cohort study included pregnant women presented to our hospital with threatened preterm labor between December 2016 and May 2018. All women were recruited consecutively at the emergency unit of Women’s Health Hospital at Assiut University. The fetal adrenal gland volume was assessed using 3-dimensional images of the fetal adrenal with the aid of Virtual Organ Computer-Aided Analysis (VOCAL) software. Doppler evaluation of the fetal adrenal blood vessels was carried out. The RI, PI and S/D ratio was calculated for every case. The neonatal outcomes at delivery were assessed and compared with respect to the duration of actual delivery from the time of evaluation. The obtained data were analyzed by SPSS software (version 22.0) and p<0.05 was taken as the significant level.Results: The study included 30 pregnant women at the final analysis. Women were classified according to the time of actual delivery into two groups. Group (I, n=13) those who delivered within 7 days and group (II, n=17) those who delivered 7 days or more. No difference between both groups regarding the baseline characteristics. No difference regarding the mode of delivery (p=0.708). All Doppler indices were statistically in-different between both groups. The fetal adrenal gland volume was significantly lower in group II than group I (p=0.001). On ROC analysis, the area under the curve (AUC) for prediction of preterm birth based on the fetal adrenal gland volume was (AUC= 0.873). The ROC curve shows that the best cut off value using the volume was ≥0.461 with 76.92% sensitivity and 88.24% specificity for prediction of preterm birth with an overall accuracy of 83.3%.Conclusions: Fetal adrenal gland volume was identified as a significant predictor of delivery in pregnant women who had spontaneous preterm births with intact membranes

A Parabolic Transform and Averaging Methods for General Partial Differential Equations

Averaging method of the fractional general partial differential equations and a special case of these equations are studied, without any restrictions on the characteristic forms of the partial differential operators. We use the parabolic transform, existence and stability results can be obtained

Diagnostic performance of alpha-fetoprotein, YKL40 and GP73 in hepatocellular carcinoma Egyptian patients

Background: Hepatocellular carcinoma (HCC) is a primary malignancy of the liver. It is responsible for a large proportion of cancer deaths worldwide. Diagnosis of HCC often requires more sophisticated modalities and represents a challenge for physician.  Methods: This study aimed to compare the diagnostic performance of AFP, YKL40 and GP73 in patients' serum with hepatocellular carcinoma (HCC) in high-risk population in an attempt to justify the new, sensitive, specific and rapid measure for the diagnosis and detection of HCC. Serum YKL40, GP73 and alpha-fetoprotein (AFP) were compared in a total of 60 human subjects in this study, including 20 healthy adults, and 40 patients with HCC, The main outcome measures were the specificity and sensitivity of YKL40 and GP73 in patients at risk for the development of HCC.Results: Using 4.4 relative units as a cut-off value, the sensitivity and specificity of serum GP73 for HCC were 85% and 90% compared with 77% and 60% for YKL40 using 21.06 ng/ml as a cut-off value. On the same context, the sensitivity and specificity of serum AFP at 8.5ng/ml cut-off were 82% and 95%. While that for the AFP and GP73 combined detection was up to 92% and 96%, justifying that the combined detection could prevent the false negative diagnosis by any marker alone and significantly improve the detection rate of HCC.Conclusions: The current evidence indicates that serum GP73 has HCC diagnostic efficacy inferior to that of AFP and YKL40 and the clinical implementation of serum GP73 measurement as a standard test for HCC is recommended alone or in combination with AFP.

Dibromido(2,9-dimethyl-1,10-phenanthroline-κ2 N,N′)zinc

The reaction of equimolar amounts of zinc bromide and 2,9-dimethyl-1,10-phenanthroline in dry methanol provided the title compound, [ZnBr2(C14H12N2)], in good yield. The ZnII ion is coordinated in a distorted tetra­hedral environment by two N atoms from the chelating 2,9-dimethyl-1,10-phenanthroline ligand and two bromide ions. There is inter­molecular π–π stacking between adjacent phenanthroline units, with centroid–centroid distances of 3.594 (3) and 3.652 (3) Å