Background: Transcatheter arterial embolization can be used for patients with recurrent bleeding from the upper gastrointestinal tract after failed endoscopic treatment. Our aim to identify the clinical and technical factors that influenced the outcome of transcatheter embolization for therapy of upper gastrointestinal bleeding after failed surgery or after failed endoscopic treatment in high risk surgical patients.
Methods: We performed a prospective study to analysis of the 15 patients who underwent Transcatheter arterial embolization for nonvariceal upper gastrointestinal bleeding at Alshifa hospital from January 2015 to March 2019.
The following variables were recorded: demographic data, time from bleeding start to TAE, units of packed red cells before TAE and units of packed plasma before Transcatheter arterial embolization and we analysis 30 days rebleeding rates and mortality.
Results: Patients treated with Transcatheter arterial embolization (median age: 62 years, range: 14–79 years).The technical success rate of the embolization procedure was 100%. Time from bleeding start to TAE was 2.1 (1-4) days , units of packed red cells before Transcatheter arterial embolization was 12.8 (4-22) packed and units of packed plasma was 3.2 (2-5) packed. Following 30 days after embolization, 2 (13%) patients had repeated bleeding and 3 (20.0%) patients died.
Conclusion: In our experience, arterial embolization is a safe and effective treatment method for upper gastrointestinal bleeding and a possible alternative to surgery for high-risk patients.
A 79 years old woman presented with one-day history of pain, redness, pain and swelling without discharge in her left ear, later her right ear started with the same symptoms as in her contralateral ear spreading around the scalp and the forehead (Figure 1), she denied fever, or other constitutional symptoms.
23-year-old man had a 2-year history of ketamine abuse and presented intermittent abdominal pain, urinary urgency and dysuria for one year. Two weeks ago, laboratory analysis showed within normal limits. This time, he visited our emergency department due to hematuria and bilateral flank pain. CT scan and MRI revealed bilateral hydronephrosis, hydroureter, irregular thickened wall of urinary bladder, and fusiform common bile duct with distal stenosis
A 58-year-old hypertensive man presented to our insti-tution with acute chest pain and dizziness. Electrocardiogram revealed inferior wall myocardial infarction with suspected right ventricular involvement (Figure 1A). Computed tomographic aortography (CTA) depicted ascending aortic dissection (AAD) with involvement of bilateral carotid, subclavian, and right common iliac arteries (Figure 1B). Replacements of aortic valve and ascending aorta with CABG (Ao-RSVG1-LAD and Ao-RSVG2-RCA) were conducted.
Tadao Tsuji*, G Sun, A Sugiyama, Y Amano, S Mano, T Shinobi, H Tanaka, M Kubochi, K Ohishi, Y Moriya, M Ono, T Masuda, H Shinozaki, H Kaneda, H Katsura, T Mizutani, K Miura, M Katoh, K Yamafuji, K Takeshima, N Okamoto, Y Hoshino, N Tsurumi, S Hisada, J Won, T Kogiso, K Yatsuji, M Iimura, T Kakimoto and S Nyuhzuki
Treatments via the minor papilla is effective where the deep cannulation via the major papilla is impossible in such cases as [1] the Wirsung’s duct is inflammatory narrowed, bent or obstructed by impacted stones [2] pancreatic duct divisum (complete or incomplete) [3], maljunction of pancreatico-biliary union with stones [4], pancreatic stones in the Santorini’s duct. In [1,2] cases, the pancreatic juice flow via the major papilla decreases, while that of the minor papilla increases. Then the size of minor papilla and its orifice shows corresponding enlargement. This substitutional mechanism is an advantage when undertaking our new method. Since the pancreatic juice flow is maintained via the minor papilla in these cases, accurate and careful endoscopic skills are necessary to prevent pancreatitis due to the occlusion of the Santorini’s duct after this procedure. We have experienced 135 cases treated via minor papilla in these 27 years, so we would like to report about its safety and efficacy.
The effects of storage of Ogbona seed flour (Irivingia gabonensis and Irivingia excelsa), at ambient condition (30±20C, 65-74% RH) for 0-4 months on some physical characteristics were investigated. The samples were subjected to storage in air tight polyethylene bags for up to four months. Samples were removed at intervals of 0, 1, 2, 3 and 4 months for analysis. The chemical: proximate constituents, free-fatty acids and peroxide values; selected functional properties: water/oil absorption capacity, foam capacity and viscosity and sensory attributes of the samples were investigated. The result shows that there was no observable change in the chemical composition, selected functional and sensory properties of the two varieties of Ogbona seed flours when stored up to two months but decreased from third to fourth month during storage at ambient temperature. Therefore, storage at ambient temperature (30±20C, 65-74% RH) could extend the shelf life of the samples for up to two months in air-tight polyethylene bags of 0.7mm thickness without losing its quality characteristics.
A study was undertaken the effect of pretreatments and drying methods on quality parameters of tomato slices with respect to storage using two factors as treatments i.e. 5 pre-treatment levels (P1-Peeled by hot water dip blanching, P2-Peeled by hot brine dip blanching, P3-Unpeeled by hot water blanching, P4-Unpeeled by hot brine blanching, P5-Control- No peeled and no blanched) and 2 drying methods i.e. (D1-Tray drying, D2-Sun drying) with completely randomized design of factorial concept with three repetitions at Post Graduate Laboratory of Horticulture Department, College of Agriculture, Junagadh Agricultural University, Junagadh. The quality was evaluated on the basis of physicochemical (i.e. drying time (h) and moisture content (%) at 1, 20, 40, 60 and 80th day of storage. Result of study depicts that the pretreatment P2 i.e. peeling of tomato by hot brine dip blanching followed by tray drying (D2) recorded minimum (14.50 h) drying time and the minimum changes in moisture content (4.00%-6.54%) observed in treatment P1 at 1st to 80th day of storage, respectively.
Effect of drying methods (sun-drying and cabinet oven drying) on the physicochemical properties and fatty acid composition of oils extracted from moringa seeds was investigated. Oil from the seeds was extracted using solvent (hexane) after drying. Drying increased the yield from 30.30-33.11%. The oil samples were less dense than water with specific gravities of 0.9032, 0.9075 and 0.9030 respectively. A significant difference exists in the moisture contents (0.11-0.21%); smoke point (202-2250C), flash point (310-3170C) and fire point (360-3690C). Sun-drying and cabinet oven drying brought about a decrease in the acid value (1.80-1.08mgKOH/g), saponification value (174.87-105mgKOH/g), Iodine value (16.10-13.90wijs) and peroxide value (11.24-2.3-Meq/kg). The decrease is an indication of quality improvement of the oils. More unsaturated fatty acids were present in the samples between 76.61% and 81.66%. Oleic acid was predominant (44.92% raw, 45.71% sundried and 43.60% cabinet oven dried). Sun-drying and cabinet oven drying did not have much significant effect on the physical, chemical and fatty acid compositions of the oil. The results obtained from this study showed that the three oil samples are good as edible oil and for commercial purpose.
This study was carried out to evaluate the effect of pretreatments and drying methods on the chemical quality and microbial density of wild edible oyster mushroom. The mushroom samples were pretreated by steeping in 0.5% citric and sodium metabisulphite at room temperature for 10 minutes before being subjected to sun and cabinet drying until a constant weight was reached. The dried samples including the control samples (Samples not pretreated with chemicals) were evaluated for proximate, mineral composition and microbial density. The proximate analysis (protein, ash, fat, moisture and fibre) showed that untreated mushroom samples (both sun and cabinet dried) had the overall best results followed by samples pretreated with 0.5% sodium metabisulphite while samples pretreated with 0.5% citric acid had the lowest values. The mineral analysis (calcium, sodium, magnesium and potassium) of the mushroom samples followed the same trend as the proximate analysis. The microbial density of the samples showed that samples pretreated with 0.5% citric acid had the lowest count followed by samples pretreated with 0.5% sodium metabisulphite while the untreated samples had the highest microbial density. This implies that pretreatment with citric acid and sodium metabisulphite reduced the microbial density which may invariably extend the storage life of the edible oyster mushroom.
Noodles are strips or strands cut from a sheet of dough made from flour, water and either common salt or a mixture of alkaline salt. Noodles consumption represents about 40% of the total wheat flour which are mainly consumed by school children. The use of composite flour has been encouraged since it reduces the importation of wheat. Utilization of locally available, inexpensive materials like cocoyam that can substitute a part of wheat flour without adversely affecting the acceptability of the product will be a product development. This study therefore studied the chemical composition and organoleptic properties of instant noodles from the blend of wheat and cocoyam starch. Cocoyam starch was substituted into wheat flour at 20, 40, 60 & 80%. Analysis revealed higher carbohydrate (63.50-70.05)%, moisture (4.54-5.07)% and vitamin A (10.01-30.47) mg/100g, B1 (11.43-32.15) mg/100g but lower protein (4.56-8.79)%, phosphorus (0.34-0.52)%, calcium (1.83-0.98)%, iron (0.15-0.32) % and ash (1.19-3.20)%. The composite noodles revealed higher carbohydrate and mineral but lower protein than the commercial noodles. The sensory analysis revealed that 20% cocoyam compared favourably with the commercial noodles in terms of all the sensory attributes evaluated. This shows the possibility of producing noodles from cocoyam tubers which serves as novel food. This will further help to promote and improve utilization of cocoyam tuber.
The seasonal nature of most fruits available in the market coupled with inadequate storage and processing facilities has limited their consumption by majority of the people in the country. Jams made from fruits are good bread spread rather than any other food products because they serve as adequate balance diet and it contains antioxidant such as vitamin C and A which play an important role in preventing cancer, cardiovascular problem and improvement of eyesight. Pawpaw and watermelon fruits have been reported to be nutritive and high in antioxidant properties that can scavenge free radicals, thereby improving the antioxidant status of the body. It is therefore deemed fit to produce jam from these perishable commodities in other to make them available all through the year and as well as adding to varieties of food products. The aqueous extracts of watermelon with pawpaw juice were processed into jam and the physicochemical properties of the jam samples were analysed. The resulting jam samples showed moisture content ranging between 30.60-35.30%, protein 0.40-0.80%, fat 0.20-0.40%, ash 1.20-1.70%, crude fibre 0.10-0.30%, carbohydrate 62.10-67.16%, β-carotene 610-1350µg/100g and ascorbic acid 9.60-15.40mg/100g. The jam samples were found to be very nutritive and high in antimicrobial and antioxidant properties that can scavenge free radicals, thereby can improve the antioxidant status of the body. Sensory evaluation tests showed that the samples were acceptable and compared favourably with the commercial imported brand while sample AA had the highest preference in all the sensory attributes evaluated by the panellists. Microbiological examination also showed that the jam samples had total plate count ranging from 4.10x101 to 2.00 x101 cfu/g, yeast and mould count ranged from 2.10x101 to 1.00 x101cfu/g with no observable coliform count.
The quality characteristics of selected black gram varieties viz., VBN 5, VBN 7, ADT 3, T9 and CO 6 and were evaluated for their suitability for the preparation of thick pancake. The foaming stability and foaming capacity were found to be maximum in VBN 5, CO 6 and T9. Maximum rise in volume was recorded in CO 6 (149 ml) followed by VBN 5 (148 ml) and T9 (147 ml) which is an indication good quality of thick pancake. Thick pancake prepared using 5 black gram varieties were analyzed for the physicochemical and microbial load. The texture profile viz., springiness, cohesiveness, chewiness and gumminess was evaluated for VBN 5, CO 6, T9 and VBN 7 respectively. The protein content was higher in thick pancake prepared from VBN 5 (25.47/100 g) compared to CO 6 (24.66 g/100g). Among the selected varieties, CO 6, T9 and VBN 5 had good batter content, texture, and microstructure and were found to be most suitable for thick pancake preparation.
The study aimed to identify possible environmental risk factors for breast cancer among women in Gaza Strip and conducted in 2010. A case- control study design was used with face to face interviews by structured questionnaire with breast cancer patient women as well as healthy women. Statistical Package of Social Science (SPSS) was used to analyze the collected data. The study population was 288 women, 144 were women with breast cancer (cases) and 144 were healthy women (controls) with response rate 100% for cases as well as controls. The study was carried out in the two main hospitals in Gaza Strip (El-Shifa and European Gaza) and on cases who had a regular follow up in each hospital, while controls have been chosen from women who had no history of breast cancer by mammogram or by self-examination. In this study the main statistically significant risk factors were; marital status, educational status, physical trauma on breast, medication for infertility treatment, eating red meat 500g or more weekly, eating canned food, eating chicken skin, eating raw and cooked vegetables, using oils with saturated fats in cooking, living in or beside a farm, dealing with crops with naked hands, working in a farm during pesticides application or during 24 hours of pesticides application, cleaning pesticides’ equipment, living with people working in a farm or a agricultural field, and application of pesticides personally. In contrary, no statistically significant differences were found between cases and controls in relation to area of residency, exposure to X-ray in the past, having radiation therapy, getting contraceptive pills, using hair dyes, using anti-deodorant underarm, using facial cosmetics, using hair removal ointment, washing vegetables and fruits, buying and transporting pesticides, and wearing protective tools during pesticides mixing and application.
Objective: This study aimed to investigating of the epidemiological aspects of infertility and related risk factors in infertile women.
Materials and methods: This cross-sectional study, carried out on 330 infertile women referred to two infertility treatment center of Imam Khomeini Hospital and Mother center in Sari, Iran, from April 2015 to March 2017.
Results: 54.5% of these women were in the age of 30-39 years, infertility duration in 55.2% was 1-5 years, Body mass index (BMI) in 44.5% of samples was 26-30 kg/m2, 54.5% had diploma and associate degree. 63.6% lived in urban areas. 74.5 % of patients reported primary infertility. History of polycystic ovarian syndrome (PCOs) and pelvic inflammatory disease (PID) and poor ovarian reserve were the most common causes and risk factors for the infertility with prevalence 19.42%, 16.81% and 13.91%, respectively. Most underlying disease was thyroid disorders (54.5%). There was found statistically significant relationship between residents of urban areas and infertility duration, endometriosis and educational levels, miscarriage with thyroid. Data analysis performed using IBM SPSS 21 software and Chi-Square test (p < 0.05).
Conclusion: The results showed that women with infertility in north of Iran were more likely to be older, less educated, and also had overweight. They are more possible to have ovarian disorders. In these area, thyroid disease more common like Iodine deficient regions. Future research should be focused on the reasons why majority of women don’t seek treatment for the underline significant diseases that may be effects on ovarian function and fertility.
31 year old female presented with abdominal pain and respiratory distress in the third trimester of her second pregnancy. Her blood workup revealed a lipemic sample (Figure 1) due to markedly elevated serum triglycerides of 8178 mg/dl (Glycerol Phosphate Oxidase method). Total cholesterol and Low Density Lipoprotein were elevated at 1701 mg/dl and 788 mg/dl respectively. There was no family history of lipid disorders. Diagnosis was consistent with gestational hypertriglyceridemia with acute pancreatitis (Serum Amylase-50 U/L, Serum Lipase- 96 U/L), though genetic tests to rule out pre-existing primary hypertriglyceridemia was not feasible. In view of the life threatening condition, she was initiated on Insulin-Dextrose infusion and offered one session of Plasma Exchange. Figures 2,3 depict membrane plasma separation with the obtained effluent as lipemic plasma. Her serum triglycerides showed a declining trend and was discharged in good health (serum triglycerides at discharge-651 mg/dl).
The nutritional compositions of sorghum stem sheath-Spondias mombin extract were evaluated. The enriched stem sheath extract were obtained by mixing sorghum stem sheath and Spondias mombin (iyeye) extract in varied proportions at 100:0; 0:100; 95:5; 90:10 and 85:15. The five samples were subjected to analysis: proximate, mineral, vitamin C, antinutrient composition. Data obtained were analysed using descriptive and inferential statistics. The result showed that observable increases were noticed in proximate, vitamin C and mineral composition from 5% inclusion of Spondias mombin extract in sorghum stem sheath drinks. The anti-nutrient compositions: tannin, oxalate and saponin, ranged from (0.144 to 0.442, 0.303 to 0.385, 0.070 to 0.198) mg/100 ml, respectively for sorghum stem sheath- Spondias mombin extract which were within consumable safe limits. The study concluded that nutritious enriched drinks could be produced from sorghum stem sheath and Spondias mombin extract at ambient temperature.
Internet has become an important part of our life, including during pregnancy where it is broadly used to find information (84%). The aims of this study were (1) to describe the proportion of women using Internet Social Networks (ISN) concerning their pregnancy, during pre or postpartum hospital stay, (2) to define how ISN users refer to their pregnancy and delivery on these social networks, (3) to compare anxiety level, social sustain level, sociodemographic characteristics of the both population (4) and to determine profiles of the ISN users with multiple correspondence analysis.
Methods: 399 questionnaires were distributed in the postpartum wards of two academic hospitals in Paris, and 258 fully filled were retrieved. Tools: Anxiety scale (STAI- A and B), Cutrona Social Provisions Scale, sociodemographic and obstetrical questionnaire.
Results: 76% (n = 195) were ISN users. We compared ISN users versus ISN non users women. Demographically, the two populations were comparable. Anxiety scores were similar in both groups, whereas social support scores showed a statistical difference in social integration.
In the global population, 84% use Internet for information concerning pregnancy; this rate is higher for ISN users than ISN non users (tendency 0.058).
ISN were used in priority for sharing with relatives, and 10% with other pregnant women. Concerning pregnancy, patients posted in priority the birth announcement (28%), the pregnancy announcement (23%), and the newborn’s pictures (12%). 6% posted their fetuses’ ultrasound pictures.
Three clusters of ISN users were extracted with statistically different social support scores (p = 0.019) and comparable anxiety scores. The third one, with at risk profile, used ISN as social support. For all women, but specifically for younger and more socially fragile women, Internet gives to professional new perspectives to develop information and prevention tools during the perinatal period.
Following the COVID-19 proliferation beyond China’s borders at the beginning of 2020, containment measures have been taken by different countries around the globe. Citizens were forced to stay at home. Specifically, on March 19th, the Argentine Government decided to implement the “Social, preventive and mandatory isolation”, strategy that unfortunately impacts on the lifestyle, the practise of physical activity and on the nutritional aspect of the population. The aim of this study was analize eating habits and lifestyle changes during the COVID-19 lockdown on the 9 de Julio city, Bs. As., Argentina. The survey was conducted using Google Form. The questionnaire was divided into different sections: sociodemographic data, eating habits, physical activity and concepts and emotions associated with isolation. The research reached 287 responses with a medium socioeconomic level. During isolation, the frequency of purchases decreased. It was observed an increase in the consumption of pasta, bread and cakes. Concerning the physical activity, approximately 70% declared to train before the COVID-19 lockdown, decreased by 13% during the lockdown. Other activities conducted during the COVID-19 lockdown; the most mentioned were cleaning the house, cooking, watching television, series and movies. A percentage greater than 50% of the surveyed population associated the situation of lockdown with positive emotions (share with my family, stay at home); while only 24% associate it with negative emotions (anxiety, anguish, fear). It is expected that most habits will return to normal, however, it would be interesting to know which of those developed, adopted and implemented during lockdown will remain in the new normality.
Episiotomy is a most commonly performed minor procedure. There are various type of episiotomy suturing, in this study two most common types of episiotomy suturing techniques were compare in terms of healing rate. This study concluded that the continuous method of episiotomy suturing is although faster, cosmetically better and associated with less post-operative pain but it heals significantly better than interrupted method of suturing.
During the last few decades painstaking efforts have been made to eliminate iodine deficiency throughout the world. Todays in regions where dietary iodine intake is adequate or borderline, the main focus is increasing dietary iodine supply in the target population during pregnancy and the first years of life.
Objective: The aim of this study was to obtain longitudinal data on urinary iodine excretion and the changes of maternal thyroid parameters in two groups of healthy women with mild-to-moderate iodine deficiency and iodine sufficiency residing in an iodine replete area of Tehran capital city of IR Iran, for more than one decade.
Research designs and methods: The present study is part of a cohort study, investigating the relative influences of iodine intake on thyroid size and function of mothers and their infants during and after pregnancy. A total of 500 pregnant women enrolled from two mother-child health care centers and was divided into group I, with median urinary iodine excretion (MUIE) < 150 µg/L, and group II with MUIE ≥ 150 µg/L. Sonographic thyroid volume measurement, urinary iodine excretion and thyroid function tests were measured sequentially in all pregnant women during the three trimesters (T) of pregnancy.
Results: The mean ± SD age of the participants was 25.1 ± 5.1 years. The MUIE in group I and II in the first, second and third trimester were 123 and 250 µg/L, 127 and 166 µg/L, 120 and 150 µg/L, respectively. The MUIE in the third trimester of pregnancy in group I did not differ significantly from the values in the first and second trimesters (p = 0.67), but it did decline significantly in group II (p < 0.001). The median thyroid volume of subjects, in the first, second and third trimesters were 7.8, 8.2 and 8.1 ml in group I and 7.5, 8.0 and 8.4 ml in group II, respectively. No difference in thyroid volume was found between two groups in each of the three trimesters of pregnancy (p > 0.05). The mean (± SD) TSH concentration of subjects in first, second and third trimester was 2.3(± 2.6), 2.1(± 1.8), 2.3(± 1.7) mIU/L in group I and 2.1(± 3.1), 2.1(± 1.8) and 2.0(± 1.3) mIU/L in group II, respectively. The trend of TSH rising in group I was 26.7% and in group II it was 13.3%. The mean TSH value in three trimesters did not differ significantly in either groups (p > 0.05). The mean (± SD) total T4 concentrations of subjects in first, second and third trimesters were 13.2(± 3.4), 13.8(± 3.3), 13.0(± 2.9) µg/dl in group I and 13.1(± 3.2), 13.7(± 2.9), 13.4(± 3.2) µg/dl in group II, respectively. The mean total T4 value in three trimesters did not differ significantly in either groups (p > 0.05). There was no correlation between the thyroid volume and three observed parameters (UIE, total T4 and TSH) during the pregnancy in either groups.
Conclusion: Even in areas with well-established universal salt iodization program, pregnancy could be a risk of having iodine deficiency and systematic dietary fortification needs to be implemented in this vulnerable group.
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