Predictors of forniceal rupture in patients with obstructing ureteral calculi: Analysis of multicenter data.

Background: Renal forniceal rupture (FR) is a unique complication of obstructive uropathy. This study aimed to identify the predictors of FR among patients presenting with renal colic due to obstructing ureteral calculi. Materials and Methods: After obtaining ethics approval, electronic records of patients from three National Guard hospitals in Saudi Arabia were reviewed between 2016 and 2020 to identify patients who presented with renal colic and were diagnosed with FR due to obstructive ureteric stones (FR group). An equivalent number of consecutive patients presenting with renal colic due to obstructing ureteric stones without FR was selected as a control group (non-FR group). Patients were grouped according to age group (<30, 30-40, 41-50, and >50 years), body mass index (BMI) class, gender, comorbidities, grade of hydronephrosis, location of the stone in the ureter, size of the stone (<3 mm, 3-7 mm, and >7 mm), and stone former status. Baseline patients' and stone characteristics were compared, and a regression analysis was performed to identify predictors of FR. Results: A total of 50 patients with FR were identified, and a control group of 50 patients without FR were selected. The baseline patients' and stone demographic characteristics in terms of age (P = 0.42), gender (P = 0.275), BMI (P = 0.672), comorbidity, grade of hydronephrosis (P = 0.201), and stone location (P = 0.639) were comparable between the FR group and the non-FR group. However, the stone size was statistically significant between both groups (P = 0.014). On multivariable analysis, it was found that the stone size was associated with a significantly higher increase in the incidence of FR (odds ratio [OR]: 6.5 [1.235-34.434]; P = 0.027). Furthermore, the age group between 30 and 40 years was potentially at a lower risk for FR (OR: 0.262 [0.069-0.999]; P = 0.049). Conclusion: This multicenter study showed that the stone size 3-7 mm had a six-fold increase in the chance of FR, and the age group between 30 and 40 years is potentially at a lower risk for FR.

ATTITUDES AND ACCEPTANCE OF NIGERIANS TOWARDS VASECTOMY--A COMPARISON OF MARRIED MEN AND WOMEN IN LAGOS.

BACKGROUND: Nigeria with a growth rate of 28%, accounts for over two thirds of the West African population. It also has one of the highest maternal mortality rates in the world with contraceptive prevalence among married couples less than 10%. Despite its safety and efficacy vasectomy appears to be unpopular in our environment. OBJECTIVE: To assess the perception and acceptance of married men and women towards vasectomy and the influence of the spouse on the man's decision to accept or reject vasectomy. DESIGN: A cross sectional questionnaire based study. SETTING: With an estimated population of 20 million, Lagos is the most cosmopolitan and urbanised city in Nigeria and accounts for 65% of all commercial activities in the country. Virtually all the tribes in Nigeria are represented in the city. SUBJECTS: Literate pregnant women recruited from the antenatal clinics and literate new fathers. All subjects were recruited from three health facilities in the Lagos metropolis. RESULTS: Twenty seven point five and twenty one percent of the men and women respectively had a good Knowledge of vasectomy while 49.1% and 19% of all men and women respectively with good knowledge would accept vasectomy (or agree for their spouses to have the procedure). Overall acceptance rates for men and women were 26 and 13.5% respectively while 92% of men who can opt for vasectomy will only do so if their spouses agree. Knowledge about vasectomy was the strongest single factor influencing the acceptance of vasectomy (p= 0.013) with stronger correlation among men than women (p=0.005 vrs p=.0.023). CONCLUSION: Knowledge and acceptance of vasectomy is significantly better in males than female Nigerians living in Lagos.

Sublinear scaling of the cellular proteome with ploidy.

Ploidy changes are frequent in nature and contribute to evolution, functional specialization and tumorigenesis. Analysis of model organisms of different ploidies revealed that increased ploidy leads to an increase in cell and nuclear volume, reduced proliferation, metabolic changes, lower fitness, and increased genomic instability, but the underlying mechanisms remain poorly understood. To investigate how gene expression changes with cellular ploidy, we analyzed isogenic series of budding yeasts from 1N to 4N. We show that mRNA and protein abundance scales allometrically with ploidy, with tetraploid cells showing only threefold increase in protein abundance compared to haploids. This ploidy-dependent sublinear scaling occurs via decreased rRNA and ribosomal protein abundance and reduced translation. We demonstrate that the activity of Tor1 is reduced with increasing ploidy, which leads to diminished rRNA gene repression via a Tor1-Sch9-Tup1 signaling pathway. mTORC1 and S6K activity are also reduced in human tetraploid cells and the concomitant increase of the Tup1 homolog Tle1 downregulates the rDNA transcription. Our results suggest that the mTORC1-Sch9/S6K-Tup1/TLE1 pathway ensures proteome remodeling in response to increased ploidy.

The prevalence of urinary tract infection, or urosepsis following transrectal ultrasound-guided prostate biopsy in a subset of the Saudi population and patterns of susceptibility to flouroquinolones.

OBJECTIVES: To study the prevalence of urinary tract infections (UTI), or sepsis secondary to trans-rectal ultrasound-guided (TRUS) biopsy of the prostate, the pathogens involved, and patterns of antibiotic resistance in a cohort of patients. METHODS: This is a descriptive study of a consecutive cohort of patients who underwent elective TRUS biopsy at King Abdulaziz Medical City, Riyadh, Saudi Arabia between January 2012 and December 2014. All patients who underwent the TRUS guided prostate biopsy were prescribed the standard prophylactic antibiotics. Variables included were patients' demographics, type of antibiotic prophylaxis, results of biopsy, the rate of UTI, and urosepsis with the type of pathogen(s) involved and its/their antimicrobial sensitivity.  RESULTS: Simple descriptive statistics were used in a total of 139 consecutive patients. Urosepsis requiring hospital admission was encountered in 7 (5%) patients and uncomplicated UTI was observed in 4 (2.8%). The most common pathogens were Escherichia coli (90.1%) and Klebsiella pneumoniae (9.1%). Resistance to the routinely used prophylaxis (ciprofloxacin) was observed in 10 of these patients (90.9%). CONCLUSION: This showed an increase in the rate of infectious complications after TRUS prostate biopsy. Ciprofloxacin resistance was found in 90.9% of patients with no sepsis.

Parasympathomimetic effects of mono sodium glutamate.

The effects of Mono sodium glutamate on smooth muscles were studied using the guinea-pig isolated ileum. Mono sodium glutamate produced spasmogenic effect. Atropine blocked the contractile response elicited by Mono sodium glutamate whereas mepyramine and hexamethonium failed to do so. These findings suggest a cholinergic involvement at post ganglionic site of action.

Certain observations in electrocardiogram and enzyme variation in dogs, following scorpion venom injection.

The effect of scorpion venom of Buthus Tamulus species on blood pressure, ECG, enzyme and electrolytes were studied in dogs. Venom was given in doses of 2 and 4 mg/kg body weight. Hypotension and tachycardia were observed with low dose and bradycardia was significant with high dose. ST segment depression, T wave changes, shortening of PR interval were the important ECG changes apart from ventricular extrasystoles. With high dose, QRS amplitude was reduced and duration prolonged. QTC interval was also significantly prolonged. Significant increase in SGOT, SGPT and LDH levels were observed but no change in serum electolytes was seen.

Juvenile mammary hypertrophy: is reduction mammaplasty always feasible?

Juvenile mammary hypertrophy is a rare disorder, and till date only 21 cases have been reported in the literature. The management of this condition includes screening for hormonal imbalance and reduction mammaplasty. However, we believe that the following case is worth reporting not only because of the rarity of the condition but also because it is the only case in which a bilateral subcutaneous mastectomy was performed instead of a reduction mammaplasty procedure because of massive intraoperative bleeding.