BackgroundEclampsia is a major cause of maternal and neonatal morbidity and mortality in low and middle income countries. The aim of this study was to assess the risk factors and maternal and perinatal outcome in patients with eclampsia in order to get reliable data that helps in reducing the incidence and improving the outcome in an area with high incidence of eclampsia.MethodsRetrospective study including 250 patients diagnosed with eclampsia at Minia Maternity University Hopsital, Minia, Egypt in the period between January 2013 and December 2014.We analyzed the data obtained from medical records of these patients including patient characteristics, medical, obstetric, current pregnancy history, data on hospital admission, treatment given at hospital and maternal and perinatal outcome. Statistical analysis was done using SPSS version 21.ResultsDuring the study period, 21690 women gave birth in the hospital; of which 250 cases of eclampsia were diagnosed (1.2%).Four women died (case fatality rate 1.6%). The main risk factors identified were young age, nulliparity, low level of education, poor ante-natal attendance and pre-existing medical problems. The most common complication was HELLP syndrome (15.6%). Magnesium sulphate therapy was given to all patients but there was lack of parenteral anti-hypertensive therapy. Forty six cases delivered vaginally (18.4%). Assisted delivery was performed in 22 (8.8%) cases and caesarean section in 177 (70.8%) cases; 151(60.4%) primary caesarean sections and 26 (10.4%) intra-partum. Perinatal deaths occurred in 11.9% on cases. Prematurity and poor neonatal services were the main cause.ConclusionMorbidity and mortality from eclampsia are high in our setting. Improving ante-natal and emergency obstetric and neonatal care is mandatory to improve the outcome.

Background:Balloon valvuloplasty was established as an alternative to surgery for treatment of aortic valve stenosis in childhood. Acute complications after balloon dilatation including aortic insufficiency or early death were described.Aim of Work:To analyze early outcome and midterm results of balloon aortic valvuloplasty (BAV) in Children’s Hospital, Mansoura University, Egypt.Subjects and Methods:Between April 2005–June 2008, all consecutive patients of age <18 years treated for aortic valve stenosis (AVS) with BAV were analyzed retrospectively. The study included 21 patients; 17 males, and 4 females. Their age ranged from the neonatal period to 10 years (mean age 5.6 ± 3.7 years). Patients with gradient ≥50 mmHg and aortic valve insufficiency (AI) up to grade I were included. All patients had isolated aortic valve stenosis except 3 patients (14.3%) had associated aortic coarctation. Six patients (28.6%) had bicuspid aortic valve. All patients had normal myocardial function except one (4.8%) had FS 15%. The duration of follow up was (mean ± SD: 18.5 ± 11.7 months).Results:Femoral artery approach was used in 20 patients (95.2%) and carotid artery in one neonate (4.8%). Balloon/annulus ratio was 0.83 ± 0.04. Significant reduction in pressure gradient was achieved (mean 66.7 ± 9.8 mmHg to 20.65 ± 2.99 mmHg) (P < 0.001). Nine patients (42.8%) developed grade I AI, 2 patients (9.5%) developed grade II AI and 1 patient (4.8%) developed grade III AI. Two early deaths (9.5%); one died due to heart failure caused by grade IV AI and a neonate died because of severely compromised LV function. One patient (4.8%) had femoral artery occlusion necessitating anticoagulation. Patients remained free from re-intervention during follow up.Conclusion:Balloon valvuloplasty of aortic valve stenosis significantly reduces gradient with low morbidity and mortality in children.

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Background: Medicinal plants have been known as one of the most important therapeutic agents for cancer treatment and prevention. Capparis spinosa L is a multipurpose plant that contains different bioactive phytochemicals including phenols and flavonoids.Aims: In the present study we explore the invivo antitumor activity of Capparis spinosa L extract and most potent constituents rutin and hesperidin against Ehrlich ascites carcinoma (EAC). Also study the side effect of treatments on different organs (liver, kidney and heart). Material and method: The antitumor effect was assessed by evaluating tumor volume , tumor cell count , survival time and increase in life span of EAC bearing mice. We assessed the effect of Capparis spinosa L extract , rutin and hesperidin on the level of malonaldialdhyde (MDA) and Catalase activity. Also, we estimated their effect on Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) , Albumin , urea , creatinine ,Lactate dehydrogenase activity (LDH), Creatine Kinase-MB activity (CK-MB). Apoptosis was assessed by BCL2 and caspase3 activity. Results : The Capparis spinosa L extract , rutin and hesperidin showed significantly decreased (p<0.001) in the volume of the EAC and in the count of EAC cells and increase the life span of EAC bearing mice. The treatment with Capparis spinosa L extract , rutin and hesperidin showed significantly decreased (p<0.001) the lipid peroxidation marker (MDA) and recovered catalase activity towards normal as compared to positive control. We founded that Capparis spinosa L extract , rutin and hesperidin treatment induced apoptosis demonstrated by an increased in Caspase 3 activity and decreased in BCL2 .The treatment of Capparis spinosa L extract , rutin and hesperidin significantly reduced the elevated levels of ALT , AST ,LDH ,CK-MB,Urea and Creatinine in positive control as compared with negative control. Also, they showed protection for both liver and kidney histopathologically. Conclusions: The present study demonstrated that Capparis spinosa L extract , rutin and hesperidin have potent antitumor activity against Ehrlich ascites carcinoma. The anti-tumor mechanism may be mediated by preventing oxidative damage and induction of apoptosis.

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