Mycotoxins in milk: Occurrence and evaluation of certain detoxification attempts.

Milk contaminated with mycotoxins is a significant issue affecting human health, especially in infants. The current study aimed to investigate the presence of mycotoxins in milk collected from women farmers' vendors (WFV), and to evaluate certain herbal plant fibers as green mycotoxin binders. Moreover, explore the binding efficiency ratios of mycotoxins using shaking or soaking process incorporated with herbal extracts. Furthermore, compare the taste evaluations of tested milk are enriched with herbal extracts. Results indicated that the fumonisins were not detected in the collected cow milk samples but realized a 25% occurrence ratio in buffalo's milk samples. A high occurrence ratio of aflatoxin M1 (aflaM1) was observed in buffalo and cow milk samples. The soaking process of plant fibers in contaminated milk overnight significantly degrades and adsorbs mycotoxins particles. The shacking process incorporated with plant fibers exhibited more effectiveness in mycotoxins degradation than soaking or shacking processes alone. The speed of shacking process played an important role in the mycotoxin's binding process. All the tested plant fibers effectively reduced all mycotoxin presence in contaminated milk, especially green tea, during the soaking or shacking process. Moreover, the shacking process incorporated with plant fibers promoted and supported the mycotoxins degradation process.

Extracorporeal shock wave lithotripsy in impacted upper ureteral stones: a prospective randomized comparison between stented and non-stented techniques.

OBJECTIVES: To assess the need for pre-extracorporeal shock wave lithotripsy (pre-ESWL) stenting in management of impacted upper ureteral stones of size < or = 2 cm and to verify whether stenting would influence the success of therapy. METHODS: Between 2007 and 2008, a total of 60 patients with solitary, radio-opaque impacted upper ureteral stones measuring < or = 2 cm were divided into 2 equal groups: a stented group with a Double-J stent fixed pre-ESWL and a non-stented group treated by in situ ESWL. All patients were treated by ESWL using Dornier Doli S lithotripter. Results were compared in terms of clearance rates, number of shock waves and sessions, morbidity, and incidence of complications. Pretreatment KUB (kidneys, ureters, and bladder) and intravenous pyelogram and post-treatment KUB were used to evaluate fragmentation and clearance. RESULTS: Overall stone-free rate was 88.3%. No significant statistical difference was observed in stone-free rate between the stented and non-stented groups being 90% and 86.7%, respectively (P = .346). One session was required in 28.3% of patients, whereas multiple sessions were required in 71.7% of patients. No significant statistical difference was noted in re-treatment rate in the 2 groups. Patients in the stented group significantly complained of side effects attributable to the stent predominantly dysuria, urgency, frequency, and suprapubic pain. CONCLUSIONS: ESWL is an effective and reasonable initial therapy in the management of impacted upper ureteral stones measuring < or = 2 cm. Pre-ESWL ureteral stenting provides no additional benefit over in situ ESWL. Moreover, ureteral stents are associated with significant patient discomfort and morbidity.

Percutaneous nephrolithotomy in horseshoe kidneys: is rigid nephroscopy sufficient tool for complete clearance? A case series study.

BACKGROUND: this study represents a case series to evaluate how successful is the rigid percutaneous nephroscopy as a tool for clearance of all stones in various locations in horseshoe kidneys. METHODS: Between 2005 and 2009, we carried out PCNL (percutaneous nephrolithotomy) for calculi in horseshoe kidneys in 21 renal units (17 patients) in our department. The indications were large stone burden in 18 units and failed SWL(shock wave lithotripsy) in 3 renal units. All procedures were done under general anesthesia; using fluoroscopic guidance for localization and standard alkan dilatation followed by rigid nephroscopy and stone extraction with or without stone disintegration. We analyzed our results regarding the site and number of the required access, the intra and postoperative complications, the presence of any residual stones, as well as their location. RESULTS: The procedure was completed, using a single access tract in 20 renal units, with the site of puncture being the upper calyx in nine units and the posterior middle calyx in eleven units. Only in one renal unit, two access tracts (an upper and a lower calyceal) were required for completion and a supracostal puncture was required in another case. There was no significant intraoperative bleeding and no blood transfusion was required in any patient. A pelvic perforation occurred in one case, requiring longer PCN (percutaneous nephrostomy) drainage. One patient with infection stones suffered urosepsis postoperatively which was successfully managed. Three cases had residual stones, all located in the renal isthmus, all residuals were un approachable with the rigid instrument; resulting in a overall stone-free rate of 85.7% at discharge. CONCLUSION: Percutaneous nephrolithotomy is generally safe and successful in the management of stones in horseshoe kidneys. However, location of the stones in these patients is crucial to decide the proper tool for optimal stone clearance result.