Using blood pressure and urine output as a guide for the duration of magnesium sulphate therapy as a prophylaxis against seizures among patients with severe preeclampsia

To assess whether we can use blood pressure and urine output to adjust the duration at postpartum magnesium sulphate as a prophylaxis against seizures in patients with severe preeclampsia. This is a randomized control single blinded clinical trial held in Suez canal University hospital, Obstetrics and Gynecology Department. The study was carried on 150 of pregnant women attending the emergency delivery ward and are diagnosed as cases of severe preeclampsia distributed in three groups. The first group received magnesium sulphate as a 6 gm intravenous bolus loading dose then 1 gm/hour as a maintenance dose until the delivery time, then the regimen will be continued after delivery spontaneous onset of diuresis and, greater than 50% of the hourly postpartum blood pressures less than 150 mm Hg systolic and, less than 100 mm Hg diastolic [including the hour immediately before medication discontinuation], the second group received magnesium sulphate as a 6 gm intravenous bolus loading dose then 1 gm/hour as a maintenance dose until the delivery time then the regimen continued after delivery until the onset of diuresis only and the third group received a 48 gm of magnesuim sulphate. The results showed that no cases exposed to fits in group 1 and also no cases exposed to fits in group 2;: versus one case [3.3%] exposed to fits in group 3. There was only one as only one case that needed to reinitiate therapy in group 2 versus two cases needed to reinitiate therapy in group which is statistically insignificant. In group 2 there was one case needed to reinitiate therapy, so no effect on blood pressure or the need to reinitiate therapy by increasing the total dose as magnesium sulfate. There were no side effects at all from magnesium sulfate in group 1 and group 2, versus nine cases [30%] suffered from oliguria, two cases [6. 7%] suffered from hyporeflexia and three cases [10%] suffered from arrythmias in group 3. We can depend on diuresis alone as a dependable clinical parameter to withdraw magnesium sulphate safely without giving the patient unnecessary doses of the unsafe magnesium sulfate and without affecting the maternal outcome as no cases had postpartum fits and only one case needed to reinitiate therapy, although depending on diuresis and blood pressure to determine the duration of the therapy carries the same safety margin as diuresis alone and carries no more benefit over diuresis alone as magnesium sulfate not mainly an antihypertensive drug

Effect of preganglionic parasympathetic denervation on Nitric Oxide synthase in submandibular gland of adult albino rat

Adult albino rats were subjected to chorda tympani neurectomy on the right side and the left side served as the control. After different survival periods, the control and experimental submandibular glands were discected out and processed for histological and histochemical examinations. Chorda tympani neurectomy resulted in atrophic changes in about 90% of both seromucous acini and granular convoluted tubules of the submandibular gland. They showed statistically significant reduction in their mean diameters after denevation. The reduction in the diameter of the acini was more marked than that of the tubules. The atrophic acini became separated by wide spaces and their cells showed cytoplasmic vacuolation two weeks after chorda tympani neurectomy. At the third and the fourth weeks, an insignificant increase in the diameter was noticed in the tubules and acini. The interlobular striated ducts showed cytoplasmic vacuolation two weeks after denervation which became more prominent during the third and fourth week after chorda tympani neurectomy. After denervation, NADPH-d positive nerve terminals were absent around the majority of acini and the granular convoluted tubules and were seen around the remaining 7-10% of the acini and 10-23% of the tubules. Throughout the period of denervation, NADPH-d positive nerve terminals were found around the striated ducts, the interlobular ducts and the blood vessels. The majority of the NADPH-d positive nerve terminals around the acini and granular convoluted tubules are parasympathetic in origin derived from the chorda tympani. The origin of NADPH-d positive nerve fibers around some acini and granular convoluted tubules and in relation to the remaining duct system and blood vessels needs further investigation

Different treatment modalities and results of non-Hodgkin's lymhoma

In this study which was done on 85 cases, NHL reprsented 5.7% of total malignancies and 75% of all lymphomas, the intermediate grade was the most common type [71.8%]. About half of patients had advanced stage [III, IV] disease [49.4%]. Out of the evaluable 80 cases, 39 patients achieved CR, 17 achieved PR and 29 were primary refractory to treatment. Of the 39 cases who achieved CR to treatment, relapse occurred in 56.4% [secondary failure]. The median survival of our patients was 14 months with a survival rate of 17.5% after 3 years and 8.8% after 5 years. These low figures were due to high percentage of intermediate and high grade in relation to low grade cases as well as the relatively high incidence of advanced stages of disease [stage III and IV] which could be explained by the low medical and health awareness and the low socioeconomic status

Ten years experience in colorectal carcinoma [study of 180 cases]

In this study a retro-spective analysis was performed on 180 patients with colorectal carcinoma in clinical oncology and nuclear medicine department Mansoura university hospital during the period between 1980-1990 inclusive. The relative frequency incidence of colorectal carcinomas in relation to GIT malignant tumors was 50.54% and to all malignant tumors was 3.6%. Males were almost a double fold affected more than females with peakage incidence between 40-50 years. Bowel habit disturbances were the commonest symptoms at the time of diagnosis and found in 62.22%. Radical surgery was done in 100 patients [55.56%] out of 180 patients and most of them were Dukes' C [56 patients]. Adenocarcinomas were the most histopathological type of colorectal carcinoma and constituted [52.22%]. Liver was the most commonest site of metastases and present in 47/48 patient [97.915%] of metastastic colorectal carcinomas at the time of diagnosis. The failure rate was much higher with Dukes' C patients [76.79%] than with Dukes' B patients [22.50%] as well as with radical surgery plus chemotherapy [79.61%] than with radical surgery plus radiotherapy [33.33%]. Three years survival rate was 52.50% and 35.71% for Duckes' B and C lesion respectively. Three years survival rate is much improved with radical surgery plus radiotherapy [50.00%] than with radical surgery plus chemotherapy [29.17%]. Toxicity to chemotherapy was mild and was mainly on haemopiotic system and toxicity to radiotherapy was also mild and was mainly radiation dermatitis and dysuria. It seems from this analysis that radiotherapy is essential following surgery to decrease the incidence of local failure and so selection of patients is important to determine the effectiveness of treatment i.e. Dukes'A and early cases of Dukes' B are unsuitable for adjuvant treatment while late Dukes' B cases and Dukes' C cases are at high risk of recurrence and will be benefit with adjuvant treatment

Long term survival in breast carcinoma

One hundred and six previously treated patients, with breast carcinoma were studied from 1136 breast carcinoma cases attended the clinical oncology and nuclear medicine department, Mansoura university in the period from January 1991 till December 1995 inclusive. These 106 cases were followed up till december 2000. The aim of the study is to evaluate the results of different treatment modalities and assessment of different prognostic factors on recurrence rate [R.R] and recurrence free survival rate [R.F.S]. In both stages II and III, R.R was less and R.F.S was mere in the group received adjuvant chemotherapy or tamoxifen in comparison to the group did not receive adjuvant systemic treatment. Recurrence rate was less and recurrence free survival was more in the group with negative lymph nodes compared to the group with positive lymph nodes. The same results was found in evaluation the value of tamoxifen. Recurrence rate was found less in patients with grade I tumour in comparison with group with grade II or III. Also R.R. was less and R.F.S was more in cases with less number of positive lymph nodes

Study of heat treatment effect on some metallurgical properties of Al-Bronze containing 2.5% silicon

Aluminium bronze of composition 8.3 percent Al and 2.5 percent Si was prepared by melting and casting. Specimens were cut and prepared for heat treatment, metallography, hardness, adhesive wear and tensile tests. In order to determine the temperature range in which the beta-phase exists, quenching from different temperatures ranging between 600 and 1000 degree were carried out. Solution treatment at the selected temperature [800 degree] followed by tempering at 200, 350, 500, 600 degree were applied. Ultimate tensile strength [UTS] of as-cast alloy was 550 MPa, while after tempering at 500 degree the value jumped up to 850 MPa. Also, this alloy gave good wear resistance in the range 350-600 degree. This was attributed to the precipitation of kappa-silicon