Prenatal diagnosis of congenital gastric outlet obstruction

A case of gastric outlet obstruction diagnosed prenatally at 22 weeks' gestation is described. The differential diagnosis and the clinical management of this rare condition are discussed, and an updated literature review is presented.     

Macroglossia: Prenatal ultrasonographic diagnosis and proposed management

A case in which macroglossia was the sole unusual prenatal sonographic finding in a fetus affected with trisomy 21 is presented. The differential diagnosis of fetal macroglossia is given, emphasizing its strong relationship to fetal aneuploidy, together with the principles for evaluation and management.     

Induction of fetal lung maturation with intra-amniotic thyroxine in multiple pregnancy

Two premature triplet pregnancies underwent repeated treatment aimed at acceleration of individual fetal lung maturity while administering intravenous tocolytic treatment. From the early third trimester, repeated amniocenteses were used for intra-amniotic administration of thyroxine to each sac, while the individual fetal lung maturation rate was determined by surfactant microviscosity until lung maturity was achieved.     

Distinctive effects of nano-sized permethrin in the environment

Pesticides are an essential tool in integrated pest management. Nanopermethrin was prepared by solvent evaporation from an oil-in-water volatile microemulsion. The efficacy of the formulated nanopermethrin was tested against Aedes aegypti and the results compared to those of regular, microparticular permethrin. The 24 h LC₅₀ for nanopermethrin and permethrin was found to be 0.0063 and 0.0199 mg/L, respectively. The formulated nanopermethrin was tested for toxicity against non-target organisms. Nanopermethrin did not show antibacterial activity against Escherichia coli (ATCC 13534 and 25922) or against Bacillus subtilis. Phytotoxicity studies of nanopermethrin to the seeds of Lycopersicum esculentum, Cucumis sativus, and Zea mays showed no restraint in root length and germination percentage. In the Allium cepa test, regular microparticular permethrin treatment of 0.13 mg/L showed a mitotic index (MI) of 46.8 % and chromosomal aberration of 0.6 %, which was statistically significant (p?<?0.05) compared to control. No significant differences were observed in 0.13 mg/L nanopermethrin exposure as compared to control (MI of 52.0 and 55.03 % and chromosomal aberration of 0.2 and 0 %, respectively). It was concluded that formulated nanopermethrin can be used as a safe and effectual alternative to commercially available permethrin formulation in agricultural practices.     

Late-onset isolated cystic hygroma: The obstetrical significance,management, and outcome

We add two cases of prenatally diagnosed late-onset isolated cystic hygroma to the eight cases reported previously in the English literature. The obstetrical significance, management, and outcome of this entity are reviewed. A retrospective study of late-onset isolated cystic hygromas delivered in one medical centre between 1978 and 1992 was made. The medical records of these newborns served as the basis of the present report. A Medline search of the English literature was carried out. Over a period of 15 years, we observed 11 cases of late-onset congenital isolated cystic hygroma, two of whom had prenatal sonographic diagnosis. In one case, a Caesarean section was performed due to a huge lesion. All cases underwent surgical excision with a favourable outcome. Of the eight prenatally diagnosed cases reported previously, one died at birth due to inability to ventilate and two required a tracheostomy. Late-onset isolated cystic hygroma should be differentiated from the early-onset nuchal cystic hygroma. The differential diagnosis is important, as late-onset isolated cystic hygroma does not require any prenatal intervention, but special awareness during labour and Caesarean section in extreme cases. Transport to a perinatal centre with expert neonatal, respiratory, and paediatric surgical care is recommended. The prognosis in general is favourable.     

Evaluating the effect of vehicle impoundment policy on illegal construction and demolition waste dumping: Israel as a case study

Construction and demolition (C&D) waste dumped alongside roads and in open areas is a major source of soil and underground water pollution. Since 2006, Israeli ministry for environmental protection enacted a policy of vehicle impoundment (VI) according to which track drivers caught while dumping C&D waste illegally have their vehicles impounded. The present study attempted to determine whether the VI policy was effective in increasing the waste hauling to authorized landfill sites, thus limiting the number of illegal unloads of C&D waste at unauthorized landfill sites and in open areas. During the study, changes in the ratio between the monthly amount of C&D waste brought to authorized landfills sites and the estimated total amount of C&D waste generated in different administrative districts of Israel were examined, before and after the enactment of the 2006 VI policy. Short questionnaires were also distributed among local track drivers in order to determine the degree of awareness about the policy in question and estimate its deterrence effects. According to the study’s results, in the district of Haifa, in which the VI policy was stringently enacted, the ratio between C&D waste, dumped in authorized landfill sites, and the total amount of generated C&D waste, increased, on the average, from 20% in January 2004 to 35% in October 2009, with the effect attributed to the number of vehicle impoundments being highly statistically significant (t = 2.324; p < 0.05). By contrast, in the Jerusalem and Southern districts, in which the VI policy was less stringently enforced, the effect of VI on the above ratio was found to be insignificant (p > 0.1). The analysis of the questionnaires, distributed among the local truck drivers further indicated that the changes observed in the district of Haifa are not coincident and appeared to be linked to the VI policy’s enactment. In particular, 62% of the truck drivers, participated in the survey, were aware of the policy and 47% of them personally knew a driver whose vehicle was impounded. Furthermore, the drivers estimated the relative risk of being caught for unloading C&D waste in unauthorized sites, on the average, as high as 67%, which is likely to become a deterrent on its own. Our conclusion is that the VI policy appears to have a deterring effect on truck drivers, by encouraging them to haul C&D waste to authorized landfill sites. As we suggest, the research methodology implemented in the study and its results may help policy makers in other regions and countries, which experience similar environment enforcement problem, to analyze policy responses.