Background and aim
The close proximity of the urinary tract to the female genital system makes it vulnerable to
damage during pelvic surgical procedures. The objective of the current study was to evaluate
iatrogenic urinary tract injuries (UTIs) caused by obstetrical and gynecological procedures.
Patients and methods
The current study was conducted at Department of Obstetrics and Gynecology, Assiut University
Hospitals, in the period between March 2018 and March 2021. All women with UTIs secondary
to obstetrical or gynecological surgeries during the study period were recruited in the study.
Results
A total of 20 636 women were scheduled for different obstetric or gynecological surgeries,
and 170 (0.82%) of them experienced iatrogenic UTIs, 161 (94.7%) women had injury during
obstetric surgeries, whereas the other nine (5.3%) had gynecological surgeries. Operations
were repeated cesarean section (34.2%) and placenta previa (54.1%) in obstetric surgeries
and repeated section in gynecological surgeries (33.3%). Iatrogenic UTIs were detected
intraoperatively in 167 (98.2%) women, whereas in only three patients, detection was delayed.
Overall, eight (4.7%) patients had both bladder and ureteric injuries, whereas bladder injury
alone occurred in 154 (90.6%) patients and another eight (4.7%) patients had ureteric
injuries alone. ICU admission was needed in 43 (25.3%) patients.
Conclusion
Although frequencies of UTIs in obstetric and gynecological surgeries were found to be
relatively low, yet it may lead serious morbidity and outcome. Proper antenatal care and good
knowledge of pelvic anatomy may help in decreasing its frequency.
Keywords:
assiut, gynecologic, iatrogenic, obstetric, operation, placenta previa, procedure, recurrent
cesarean section, urinary tract injury

Abstract: Zinc (Zn) and copper (Cu) have been shown to have the potential to improve glucose metabolism through interactions with cytokines and signaling events with multiple genes. miRNA375 and the Calpin-10 gene are potential genetic biomarkers for the early prediction of diabetic nephropathy (DN). 128 healthy controls and 129 type 2 diabetic (T2DM) participants were matched for age and sex. Three subgroups were identified from the T2DM group: 39 patients had microalbuminuria, 41 had macroalbuminuria, and 49 patients had renal problems. Circulating miR375 expression levels were measured via qPCR. Calpain-10 SNP 19 (rs3842570) genotyping was assessed with allele-specific PCR in all the included participants. Spectrophotometry was used to measure the concentrations of serum copper, zinc, and magnesium, while ELISA was used to measure the levels of TGF-β and IL-17. There was significant up-regulation in the expression of miR375 and serum levels of TGF-β, IL-17, Cu, and the Cu/Zn ratio, whereas, in contrast to the control group, the Zn and Mg levels were lower in the T2DM group. The DN groups had significantly lower miR-375, TGF-β, IL-17, Mg, and Zn levels compared with the T2DM without nephropathy group. Furthermore, between TGF-β, IL-17, and miRNA-375, there were notable correlations. Calpain-10 SNP 19 genotype 22 and allele 2 were linked to a higher incidence of T2DM and DN. SignificantTGF-β, Cu, Cu/Zn ratio, HbAc1, and creatinine levels, but insignificant miRNA-375 levels, were associated with genotype 22 of Calpain-10 SNP 19. interactions between the Calpain-10 SNP 19 genotype 22 and IL-17, TGF-β, mineral levels, and miRNA-375 might contribute to the aetiology of DN and T2DM and may have clinical implications for diagnosis and management.

Background Serum adenosine deaminase (ADA) measurement is a biochemical test that is believed to play a role in diagnosing tuberculosis (TB). However, few studies have been conducted in this area and there have been contradictory reports on the diagnostic value of serum ADA in TB. Objective The aim of the study was to evaluate the usefulness of ADA measurement in the serum for diagnosing TB. Materials and methods In all, 97 participants were included in this study; 28 with pulmonary tuberculosis (PTB), 20 with extrapulmonary tuberculosis (EPTB), 32 with non-TB lung disease, and 17 heathy individuals. Serum ADA activity was determined in all participants using the semiautomated biochemistry analyzer ERMA AE600N (ERMA Inc.). Results We found that serum ADA levels were significantly high in patients with TB (PTB and EPTB) compared with non-TB lung disease cases and healthy control. The best cutoff value in this study of serum ADA in diagnosing TB was more than 21.1 IU/l for PTB and more than 21.2 IU/l for EPTB as obtained by the receiver operating characteristic curve with high sensitivity and specificity. Conclusion According to the results indicating high sensitivity for serum ADA level, this test is a helpful tool for the diagnosis of TB. On the basis of high specificity for serum ADA level, this test is also a useful test to rule out TB in questionable cases

Background: Chronic knee osteoarthritis is a common problem with increasing of the aging population. Pulsed radiofrequency and intraarticular platelet rich plasma injection are well evidenced beneficial modalities for pain alleviation in such groups of patients. Objective: The primary goal in this study was to compare the 2 modalities regarding pain alleviation evaluated by visual analog scale. The secondary goal focused upon the change of the Index of Severity for Osteoarthritis of the Knee by Lequesne. Study Design: Single-blind randomized interventional clinical trial. Setting: University hospitals. Methods: Two hundred patients with chronic knee osteoarthritis were equally and randomly distributed into 2 groups. Group PRF received pulsed radiofrequency, whereas the group PRP received intraarticular platelet-rich plasma. The visual analog scale and index of severity of osteoarthritis were evaluated before intervention, after one week (for visual analog scale only), then after 3, 6, and 12 months. Results: Visual analog scale was significantly lower in the PRF group compared to the PRP group at 6 and 12 months with P-values of 0.01 and 0.04, respectively. Regarding to the postinterventional index of severity of osteoarthritis, it was significantly lower in the PRF group than the PRP group with P-values of 0.001 at 3, 6, and 12 months follow-up. Limitations: Physical and analgesic therapy were not included in data collection, and there was no control group. Conclusion: Pulsed radiofrequency of the genicular nerves can be considered superior to knee intraarticular platelet-rich plasma injection for sustained pain relief and the lower severity index in patients with chronic knee osteoarthritis.

Background: Smokeless tobacco (ST) use is a public practice in different places of the world. In Upper Egypt, Madgha is one of the chewable used tobacco consumed by individuals of different age groups. Being available and inexpensive has led to high consumption. Objective: The current study aimed to examine the effect of Madgha on some hematological and biochemical parameters for Madgha users in Aswan. Methods: We collected blood samples from 180 apparently healthy subjects, Madgha users (n=90) and their controls (n=90). Standard methods were used to examine the hematological and biochemical parameters. Results: In a comparison of Madgha users with their controls, the results of hematological parameters showed a significant elevation in total white blood cell count, neutrophil and serum ESR, and a significant reduction in the percentage of lymphocytes and monocytes. Higher biochemical parameters like CRP, lipid contents, fasting blood glucose, and liver enzymes were observed in the blood samples of Madgha users. And a positive correlation between each of the white blood cell counts, platelet count, and CRP with the long duration of Madgha intake were reported in the study. Conclusion: The study concluded that the consumption of Madgha might have harmed both hematological and biochemical parameters. Awareness is immensely needed to stop Madgha’s usage and safeguard people’s health in Aswan.

Background: Health care workers (HCWs) wherever they work are at high risk of trapping infectious blood-borne pathogens, including hepatitis C virus (HCV). Epidemiological studies are needed to focus on HCWs' work profiles which represent the major threat to their health. Objective(s): To determine the prevalence and associated risk factors of HCV seropositivity among HCWs in Aswan University Hospital, Aswan city, Egypt. Methods: A cross-sectional study was carried out during the year 2018 on 206 HCWs selected randomly by proportionate allocation. Data were collected through direct interviews and blood samples were obtained for the detection of HCV antibodies by an enzyme-linked immunosorbent assay (ELISA) test. Results: Out of 206 screened HCWs, 14 of them were positive HCV-Ab giving a prevalence of 6.8%. Cleaning workers had the highest proportion of HCV seropositivity. The significant predictors of HCV-Ab seropositive test were infrequent hand washing after blood or body fluid exposure (OR= 5.12), inconsistent use of personal protective equipment (OR= 4.94), prolonged work duration (OR= 3.93), and having a family history of HCV infection (OR= 3.50). Conclusion: The seroprevalence of HCV among HCWs is alarmingly high. In view of our results, adherence to hand-hygiene, proper use of personal protective equipment and regular screening for HCWs should be strongly emphasized.