Accuracy of Ultrasound in the Prediction of the FIGO Classification of Placenta Accreta Spectrum.

OBJECTIVES: To evaluate the accuracy of greyscale ultrasound (US) and colour Doppler detecting placenta accreta spectrum (PAS) based on the newly recommended International Federation of Obstetrics and Gynaecology (FIGO) grading system. METHODS: This prospective study was conducted on women diagnosed with placenta previa or low-lying placenta involving the anterior uterine wall and associated with PAS as identified by the US. Transabdominal and transvaginal greyscale US was performed on admission between 34 and 36 weeks of gestation and compared to clinical grading and histopathological examination after cesarean hysterectomy. RESULTS: In total, 36 pregnant females who underwent a cesarean hysterectomy due to placenta previa complicated by PAS were included in this study. All patients had a history of previous cesarean deliveries, ranging from 1 to 5 deliveries. The US has an overall sensitivity of 33%, 55%, and 84.62%, and specificity of 100%, 75%, and 60% in detecting the 3 degrees of PAS, respectively. US cannot differentiate between the different subtypes of PAS grade 3 (a, b, and c). CONCLUSION: The overall US evaluation was highly significant in predicting the FIGO diagnosis of PAS; however, all ultrasonographic signs were equally relevant in diagnosing grade 1 and/or 2 PAS and were inaccurate in differing the subtypes of PAS grade 3.

A method to improve prediction of secondary structure for large single RNA sequences.

The function of a particular RNA molecule within an organic system is principally determined by its structure. The current physical methods available for structure determination are time consuming and expensive. Hence, computational methods for structure prediction are often used. The prediction of the structure of a large single sequence of RNA needs a lot of research work. In the present work, a method is introduced to improve the prediction of large single sequence RNA secondary structure obtained by Mfold program using the concept of minimum free energy. The Mfold program contains a constraint option that allows forcing some helices in the predicted structure. In our method, some of the firstly formed hairpins that are expected, by a statistical study, to be present in the real structure are forced in the Mfold predicted structure. The results show improvement, toward the real structure, in the Mfold predicted structure and this gives evidence to the RNA kinetic folding.

Blockade of Renin Angiotensin System Ameliorates the Cardiac Arrhythmias and Sympathetic Neural Remodeling in Hearts of Type 2 DM Rat Model.

OBJECTIVE: The present study was designed to investigate the effects of renin angiotensin system (RAS) blockade on cardiac arrhythmias and sympathetic nerve remodelling in heart tissues of type 2 diabetic rats. METHODS: Thirty-two male Sprague Dawley rats were randomly allocated into 4 equal groups; a) normal control group: normal rats, b) DM group; after type 2 diabetes induction, rats received 2ml oral saline daily for 4 weeks, c) DM+ ACEi: after type 2 diabetes induction, rats were treated with enalapril (10 mg/kg, orally for 4 weeks) and d) DM+ ARBs: after type 2 diabetes induction, rats were treated with losartan (30 mg/kg, orally for 4 weeks). RESULTS: In type 2 diabetic rats, the results demonstrated significant prolongation in Q-T interval and elevation of blood sugar, HOMA-IR index, TC, TGs, LDL, serum CK-MB, myocardial damage, myocardial MDA, myocardial norepinephrine and tyrosine hydroxylase (TH) density with significant reduction in serum HDL, serum insulin and myocardial GSH and CAT. On the other hand, blockade of RAS at the level of either ACE by enalapril or angiotensin (Ag) receptors by losartan resulted in significant improvement in ECG parameters (Q-T), cardiac enzymes (CK-MB), cardiac morphology, myocardial oxidative stress (low MDA, high CAT and GSH) and myocardial TH density. CONCLUSION: RAS plays a role in the cardiac sympathetic nerve sprouting and cardiac arrhythmias induced by type 2 DM and its blockade might have a cardioprotective effect via attenuation of sympathetic nerve fibres remodelling, myocardial norepinephrine contents and oxidative stress.

Effects of exercise and stevia on renal ischemia/reperfusion injury in rats.

BACKGROUND: The present work was designed to study the effects of methanolic stevia extracts and aerobic exercise and combination of both on renal I/R injury in male rats. METHODS: 60 adult male Sprague-Dawley rats were subdivided into five equal groups as sham, control, exercise, stevia, and stevia plus exercise group. After 5 weeks of exercise and stevia, animals were exposed to 45 min of left renal ischemia and right nephrectomy followed by reperfusion. Serum creatinine, creatinine clearance, fractional Na excretion (FENa+), malondialdehyde (MDA), reduced glutathione (GSH) and catalase (CAT) levels in kidney tissues were measured. Also, renal histopathology and the expression of caspase-3 by immunohistochemical examination were done. RESULTS: The results showed that stevia, exercise or combination of stevia and exercise caused a significant decrease in serum level of creatinine (p < 0.001) and FENa+ (p < 0.001) and an increase in creatinine clearance (p < 0.001). Moreover, this caused a significant decrease in (MDA; p < 0.046) and an increase in GSH (p < 0.01) and CAT (p < 0.01), as well as causing a significant decrease in caspase 3 expression compared to the control group. CONCLUSIONS: Pretreatment with either stevia or exercise of combination of both seem to have protective effects on renal I/R injury. However, the protective effect of exercise against renal I/R injury seems to be less than stevia. These effects might be due to attenuation of oxidative stress and apoptosis in kidney tissues.

Adrenalectomy for solitary recurrent hepatocellular carcinoma five years after living donor liver transplantation: A case report.

INTRODUCTION: The adrenal gland is a rare site for hepatocellular carcinoma (HCC) recurrence after living-donor liver transplantation (LDLT). Solitary adrenal recurrence can be managed by surgical excision, with expected better survival outcomes. We describe a rare case of successful left adrenalectomy of solitary recurrent HCC in the left adrenal gland 5 years after LDLT. PRESENTATION: 59 years male patient with HCC complicating chronic HCV infection received a right hemi-liver graft from his son. The actual graft weight was 1208 g and GRWR was 1.5. The patient started oral direct acting antiviral drugs for recurrent HCV 2 years after LDLT. A left adrenal mass was detected on follow up radiology. No other metastatic lesions were detected on metastatic workup. Left adrenalectomy was done by an anterior approach. The postoperative course was uneventful and was discharged a week after operation. Postoperative pathological and immune-histochemical examinations confirmed the metastatic HCC nature of the mass. The patient is under regular follow up with no recurrences 6 month after resection. DISCUSSION: There is no consensus regarding the management of HCC recurrence after LDLT. Most patients had multi-organ recurrences and usually offered palliative or supportive care. Solitary HCC recurrence offers a better chance for more aggressive therapy, offering better prognosis. CONCLUSION: Solitary adrenal recurrence of HCC after LDLT is extremely rare. Strict follow up protocol is necessary to allow early detection of tumor recurrence. Curative surgical resection is a safe option associated with low morbidity and expected to have a good long-term survival.

Unexpected radiation hazard in dyes of textiles.

Textile dyes are among the most problematic pollutants because of their toxicity on several organisms and ecosystems. Many of the chemicals used in the textile industry may represent some health concerns. The determination of the radioactivity in textile dyes is therefore very important for both human health and environment. The study was designated to determine, for the first time, the values of (238)U, (232)Th and (40)K in nine different dyes employed in the textile industry using gamma spectrometry with a Hyper Pure Germanium (HPGe) detector. The mean activity concentrations of (238)U, (232)Th and (40)K were 29.37 ± 4.48, 1.15 ± 0.13 and 565 ± 4 Bq/kg, respectively. The calculated radium equivalents for all samples were lower than the maximum admissible value (370 Bq/kg). The absorbed dose rates due to the natural radioactivity of the investigated samples ranged from 2.94 ± 0.05 to 166 ± 3 nGy/h. So, the absorbed dose rates for all samples of textile dyes were lower than the international recommended value (55 nGy/h) except the yellow dye (166 ± 3 nGy/h), which recorded a significant radiological hazard. The external hazard index was also calculated. Conclusively, the results have indicated that the textile dyes may possess a measurable amount of radioactivity that should be taken into account. Therefore, safety rules and precautions should be applied for dyes used in the textile industry and for people working in this field.

Behavior and environmental impacts of radionuclides during the hydrometallurgy of calcareous and argillaceous rocks, southwestern Sinai, Egypt.

The hydrometallurgy of radionuclides means getting the radioelements from the rocks into solution by leaching, getting the radionuclides from the solution by extraction process, and then precipitation of the desired elements to obtain concentrate. The follow-up of the radionuclides during these processes is the main target of this work to identify the identity of the original samples, pregnant solutions (leachates), residuals and the concentrate. Six samples were chosen to achieve this work. The leaching process was carried out under the conditions; 20-30% acid (H(2)SO(4)) concentration, 1:3 solid/liquid ratios, 60 min stirring time at room temperature. The activity concentrations of (238)U, (235)U, (234)U, (226)Ra, (214)Pb, (214)Bi, (232)Th and (40)K were measured in the original samples, residuals and U-concentrate (Bq/kg), and leachates (Bq/ℓ). The results indicate that, the radionuclides before (226)Ra in the (238)U decay series are more leachable (released) than those from (226)Ra to (214)Bi in the order; (234)U>(238)U=(235)U >> (226)Ra>(214)Pb>(214)Bi. (232)Th and (40)K are immobile under the present conditions. The radiological hazards of natural radioactivity in the original samples, leachates, residuals and U-concentrate were calculated and compared with the internationally recommended values and were found to be much higher than the world average values.