Clinical value of screening serum squamous cell carcinoma antigen [SCCA] for HCC

Hepatocellular carcinoma [HCC] is the fifth most common malignancy in the world. In Egypt, HCC was reported to account for about 4.7% of chronic liver disease [CLD] patients. Squamous cell carcinoma antigen [SCCA] has been reported to be strongly expressed in HCC tissue hampering its extensive use in clinical practice. Study the value of serum squamous cell carcinoma antigen [SCCA] for screening of HCC. The study comprised of two groups. Group A included 60 patients with HCC diagnostically confirmed by spiral CT, elevated alfa-fetoprotein [AFP], and/or liver biopsy .Group B CLD patients diagnosed on clinical, laboratory, and ultrasonographical investigations; group B suclassified into three categories according to CHILD-PUGH score included 30 patients, matched for sex and age. All groups were subjected to thorough history taking, full clinical examination, and laboratory investigations including liver functions, viral markers, and AFP and SCCA estimation using ELISA technique. This study revealed a highly significant difference between patients with HCC and CLD regarding serum SCCA levels being higher in group A [10.35 +/- 20.677] than group B [1.64 +/- 2.462][p=0.02]. SCCA level was elevated in patients with HCC with normal AFP levels representing its useful role in early detection and follow-up of patients treated for HCC. The cut-off value was established at 2 ng/ml with sensitivity of 80% and specificity of 70%. SCCA could represent a useful tool as a marker for detection of HCC

Will treatment of pilonidal sinus by elliptical rotation flap in selected cases prevent its recurrence?

Pilonidal sinus disease is a common, chronic intermittent disorder, with different theories regarding its etiology. There are different methods and procedures for the treatment. In current study, from January 2002 to January 2005, 32 patients were selected for the study. 2 cases were excluded. The surgical procedure is a vertical elliptical excision of the sinus and the diseased tissue and closure of the defect by rotational elliptical transverse flap without drain. There was neither recurrence rate nor other major complications. Mean follow up period was 14 months and hospital stay ranged from 12-24 hours. Elliptical rotation flap is recommended in selected cases for closure of the defect in case of pilonidal sinus disease with no recurrence rate and shorter hospital stay

Antimicrobial and phytochemical screening of three commonly used medicinal plants

In the present study, antimicrobial activities of nine extracts from three medicinal plants indigenous to Sudan and commonly used in traditional medicine, namely Terminalia brownie, Acacia seyal and Tephrosia opollinea, were tested against four standard bacterial strains: Bacillus subtilis, Staphylococcus aureus, Eseherichia coli and Pseudomonas aeruginosa, and three fungal strains: Aspergillus niger, Aspergillus flavus and Candida albicans. The results exhibited that the chloroformic and methanolic extracts had prominent activity against most of the tested microorganisms. On the other hand, the benzene extract was devoid of any antimicrobial activity against all tested organisms. Due to the prominent antimicrobial activity of Terminalia brownie, it was subjected to an in-depth phytochernical investigation. Column chromatography of the methanolic extract resulted in the isolation of a crystalline compound [Tb/1]. The chemical structure Tb/1 was elucidated by infra-red coupled with nuclear magnetic resonance [1HNMR and 13CNMR] and electron impact mass spectrophotometer [ElMS] as beta-Lupeol. This compound was not previously reported from T. brownii. It exhibited a high antifungal activity against C. albicans

Extracorporeal shock wave lithotripsy versus lasertripsy for the treatment of upper ureteric calculi

Objectives: To compare the efficacy, cost effectiveness and safety of both extracorporeal shock-wave lithotripsy [ESWL] and Holmium: YAG laser lithotripsy for the management of upper ureteric stones

Patients and Methods: One hundred and eight patients of various age groups and of both sexes who had primary or recurrent unilateral or bilateral upper ureteric stones underwent 108 primary procedures and 19 ancillary procedures [total: 127] including in-situ ESWL [60 patients] using the Dornier MPL 9000 machine and ureterorenoscopy [URS] combined with Holmium: YAG laser lithotripsy [46 patients]

Results: The overall stone-free rate was 93.75% for the patients subjected to URS ir] combination with laser lithotripsy and 91. 7% for the patients subjected to ESWL. For stones < 1 cm, the success rate was 100% in the laser and 95.65% in the ESWL group. For stones > 1 cm, the success rate was 90% in the laser and 78.6% in the ESWL group. For impacted stones, the success rate was 92.85% in the laser and 72.7% in the ESWL group. The efficiency quotient [EQ] for the laser and ESWL groups was 0.86 and 0.73, respectively. The complication rate was 12.53% in the laser and 11. 7% in the ESWL group. The average cost [in Egyptian pounds] was 1618.1 pounds E for Holmium: YAG laser treatment and 1069.1 pounds E for ESWL treatment

Conclusion: Apart from the treatment of impacted stones and stones larger than 1 cm, ESWL is the first choice as treatment modality for upper ureteric stones. However ESWL and URS combined with holmium: YAG laser lithotripsy may be complementary to each other in treating upper ureteric stones

Changing the window of shock wave application how it improves the results of eswl for renal calculi

Objectives: The aim of this work is to study the impact of using multiple windows of shock wave application on the results of ESWL therapy for renal calculi

Patients and Methods: Between January 1996 and October 2002, 676 patients with single pelvic stones

Results: For stones <15 mm we found no difference between the two subgroups regarding the total SW energy, number of sessions, pattern of disintegration and the complication and clearance rate. But the need for additional doses of analgesia was significantly decreased for the patients who were treated by multiple windows. For stones sized 15 - 25 mm, we found a statistically significant decrease in the total SW number, in the number of sessions and the need for additional doses of analgesia when multiple windows of coupling were adopted. Changing the window of coupling also resulted in a statistically significant improvement in the pattern of disintegration of the stones. The rate of complication, clearance and auxiliary measures was comparable in all subgroups

Conclusion: Changing the window of SW application improves the pattern of disintegration, reduces the number of shock waves necessary for effective treatment, decreases the number of sessions and the need for additional doses of analgesia when ESWL is done for renal pelvic stones > 15 mm

Distally folded onlay flap - a new technique for repair of hypospadias

Objective: This study was carried out to evaluate the cosmetic and functional results of this new technique for repair of hypospadias

Patients and technique: 28 patients [2-22 years] with distal penile hypospadias were included in the study. Eleven of them had had a failed previous repair. An unhealthy urethral plate and/or thin ventral penile skin were found in 17 patients. The technique follows the steps of the island onlay preputial flap or dorsal penile fasciocutanous flap except in that the length of the flap is, at least, 1 cm longer than the length of the urethral plate. The proximal part of the flap is used for urethral reconstruction. The distal free part of the flap is reflected back to be sutured to the edges of the glanular wings and the penile skin. The urethral stent is removed after 5 days. The patients were followed monthly up to 6 months

Results: In 26 patients an excellent cosmetic appearance of both the penile shaft and glans was achieved with a slit-like or elliptic neo-meatus resulting in a good urine stream satisfying both the patients and their parents. Partial disruption of one side of the suture line and urethrocutanous fistula was reported in one patient each. These two complications were corrected surgically with good results

Conclusion: We conclude that this new technique that we named distally folded onlay flap is easy and versatile with excellent cosmetic and functional results and a low rate of complications when used for the repair of distal and mid-shaft hypospadias in either virgin or redo cases. It should also be considered as a salvage procedure when other techniques are no feasible options

Study of the relationship between h. pylori and gastro-esophageal reflux disease in Egypt

Gerd is relatively uncommon in developing countries but H. pylori known to be the most common important cause of gastritis and associated with duodenal and gastric ulcers. The aim of our study was to find the relationship of H . pylori infection and GERD in Egyptian patients. The patients were selected and divided into two groups. Group I included 40 patients suffering from GERD [19 males and 21 females] and their ages ranged from [24 to 70] years; Group II, included 20 non GERD patients, with ulcerative or non ulcerative dyspepsia with H . pylori positive [12 males 8 females] and their ages ranged from [20] to [55] years. All patients were subjected to full history taking; clinical examination, laboratory investigation, endoscopic examination and three biopsies were taken from antrum of stomach to recognize H . pylori by R.U.T. and histopathological examination

Results of the present study showed that no significant positive association between H. pylori and pathogenesis of GERD where H. pylori positive with GERD occur in five patients [12.5%] especially in grade I reflux eosophagitis and H. pylori negative with GERD occur in [28] patients [70%]. There were seven patients [17.5%] with incompetent cardia and hiatus hernia hadpositive H. pylori without reflux eosophagitis. We conclude neither symptoms of GERD nor endoscopic grading of reflux eosophagitis has no relation with H. pylori infection

Effect of dietary phytate on some serum and tissues constituents, semen production and reproductive performance of sexually mature and immature male fowls

The effects of high dietary phytate on body and organ weights, zinc, copper and iron levels in serum and tissues and variable enzyme activities were investigated in sexually mature and immature male fowls. Zinc, copper and iron deficiencies were detected in male fowls receiving phytate from one day old till maturity. The sexually mature fowls showed resistance to such deficiencies. The reduction in the activities of ceruloplasmin and alkaline phosphatase in the serum, cytochrome oxidase and succinic dehydrogenase in the liver of the cockerels could by attributed to zinc and copper deficiencies. There was a reduction in haemoglobin associated with low levels of iron in serum, which would possibly indicate a defect in synthesis of haemoglobin. The reduction in semen volume, sperm concentration, sperm motility and sperm fertilizing ability, testicular weight in cockers and cocks, clearly demonstrated the potential adverse effects of high dietary phytate on the normal reproductive process in the male fowls