Urodynamic outcome of parasacral transcutaneous electrical neural stimulation for overactive bladder in children

ABSTRACTObjective:To evaluate the urodynamic changes immediately after the first session (acute effect) and after the last session of parasacral TENS in children with idiopathic OAB.Materials and methods:We performed urodynamic evaluation immediately before and after the first session of parasacral TENS and immediately after the last session (7 weeks later). Only children with idiopathic isolated OAB were included. Patients with dysfunctional voiding were not included.Results:18 children (4 boys and 14 girls, mean age of 8.7) were included in the first analysis (urodynamic study before and immediately after the first session) and 12 agreed to undergo the third urodynamic study. Urodynamic before and immediately after the first session: There was no change in the urodynamic parameters, namely low MCC, low bladder compliance, presence of IDC, the average number of IDC, or in the maximum detrusor pressure after the first exam. Urodynamic after the last session: The bladder capacity improved in most patients with low capacity (58% vs. 8%). Detrusor overactivity was observed in 11 (92%) before treatment and 8 (76%) after. There was not a significant reduction in the average number of inhibited contractions after TENS (p=0.560) or in the detrusor pressure during the inhibited contraction (p=0.205).Conclusion:There was no change in the urodynamic parameters immediately after the first session of stimulation. After the last session, the only urodynamic finding that showed improvement was bladder capacity.

Lipoic acid, but not tempol, preserves vascular compliance and decreases medial calcification in a model of elastocalcinosis

Vascular calcification decreases compliance and increases morbidity. Mechanisms of this process are unclear. The role of oxidative stress and effects of antioxidants have been poorly explored. We investigated effects of the antioxidants lipoic acid (LA) and tempol in a model of atherosclerosis associated with elastocalcinosis. Male New Zealand white rabbits (2.5-3.0 kg) were fed regular chow (controls) or a 0.5% cholesterol (chol) diet+104 IU/day vitamin D2 (vitD) for 12 weeks, and assigned to treatment with water (vehicle, n=20), 0.12 mmol·kg-1·day-1 LA (n=11) or 0.1 mmol·kg-1·day-1 tempol (n=15). Chol+vitD-fed rabbits developed atherosclerotic plaques associated with expansive remodeling, elastic fiber disruption, medial calcification, and increased aortic stiffness. Histologically, LA prevented medial calcification by ∼60% and aortic stiffening by ∼60%. LA also preserved responsiveness to constrictor agents, while intima-media thickening was increased. In contrast to LA, tempol was associated with increased plaque collagen content, medial calcification and aortic stiffness, and produced differential changes in vasoactive responses in the chol+vitD group. Both LA and tempol prevented superoxide signals with chol+vitD. However, only LA prevented hydrogen peroxide-related signals with chol+vitD, while tempol enhanced them. These data suggest that LA, opposite to tempol, can minimize calcification and compliance loss in elastocalcionosis by inhibition of hydrogen peroxide generation.

Counseling validity on women compliance to self screening

Aim: To evaluate validity of counseling on women compliance to self screening

Study Question: Is counseling positively affect women compliance to self screening?

Justification: Many women did not seek care, but only when they have a disabling problem, they were unaware about symptoms of breast or genital disorders and its consequences. Early detection is the key in reducing mortality resulting from reproductive morbidity. Women who are health conscious are more likely to use screening measures. Many methods were used to increase women awareness and compliance to self screening measure, but local studies evaluating the effect of these method still largely required. So researchers planned to evaluate the validity of counseling on women compliance to self screening. A quasi-experimental study had been done at the out patient clinics of Ain Shams Maternity University Hospital. Four hundred and fifty four women fulfilling the study criteria were conveniently, included in the study. Inclusion criteria included, different age groups, can read and write, with a history of being sexually active, free from hand problems or infectious hand skin diseases Women affected with any condition that interfered with self screening abilities and those lost their dairies or dropped from follow up were excluded from the study. Women's knowledge and compliance to self screening tests were assessed after three and six months of an individual counseling session about self screening and its related procedures. Anatomical models were used to teach each woman screening tests as well as in three and six months assessment of accuracy of practicing tests. Five tools were used for data collection, structured interviewing questionnaire, Observation checklists to assess accuracy of practicing self-screening tests, three levels attitude scale [Likert], woman diary and written and pictured self screening instructions. A Pilot study had been done on 35 clients, accordingly tools and data collection plane were modified, those women were excluded from the sample. Results revealed that good knowledge scores were limited to 5.7%, while breast and vulval self screening were not done by 94.3% and 96.2% of women, meanwhile the correct practice of each tests were limited to 3.8% and 1.8% in the initial women's assessment. Women referred their non compliance to self screening to being busy 87%, do not know how to do it 87% and for being afraid to discover dangerous health problem 94.3%. Results indicated that counseling had positively changed women's knowledge, accuracy of practices, attitude and compliance to self screening. As highly statistical significant difference was proved between initial and 3 months scores, exactly the same was proved between initial and 6 months scores, but no statistical significant difference found between 3and 6 months scores. The insignificant decreased percent noticed in both self screening knowledge and compliance scores after six months than after the three months directed the researchers to recommend the development of follow up strategy to keep positive achievements gained through counseling other vise gains will be lost as time passes. and also to recommend more researches on the effect of more frequent follow up strategy up on women compliance to self screening. Limitations of the study included unavailability of suitable counseling places and too interruption during counseling session. Decreased sample size than the initially started one [454] to [408] due to inaccurate registration to women phone numbers, loosing their dairies, ignoring out patient clinic follow up visits as well as affection by conditions interfered with self screening abilities during the study period [46 women]