Acute spinal epidural abscess: clinical presentations and surgical management

Spinal epidural abscess is a serious condition affecting males more than females causing spinal cord compression. Risk factors include imunocomprimise, septic lumbar puncture, or haematogenous spread of remote infections. The aim of this study was to highlight the common risk factors for epidural abscess and its management based on eliminating these factors. All patients in the present study underwent plain x-ray, CT scan of affected spine, MRI of the affected area of the spine, and bone scanning when needed. Once neurological symptoms appeared urgent decompression and evacuation of the pus with subsequent culture and sensitivity was done. Liver diseases and Diabetes Mellitus. Were the most risk factors among our patients. The lumbar spine was commonly affected than other areas of the vertebral column. Posterior laminectomy and decompression were done for 24 cases. Fluid puss collection was found in 21 patients whereas 3 patients had a fibrous granulation tissue. Discectomy and partial corpectomy were done when affection of the anterior column was found. Staph. Aurues was found in about 60% of the culture obtained from the abscess. Epidural abscess is best treated by urgent decompression and giving the appropriate antibiotic

Tfg-Mi, a root-knot nematode resistance gene from fenugreek [Trigonella foenum-graecum] confers nematode resistance in tomato

Several root-knot nematode [Meloidogyne spp.] resistance genes have been discovered in different plants. For the first time, the Mi gene from fenugreek [Trigonella foenum-graecum] was detected in this study. A candidate root-knot nematode resistance gene [designated as Tfg-Mi] was isolated from the resistant fenugreek line Giza 3 by degenerate PCR amplification combined with the RACE technique. Also, another two candidate root-knot nematode resistance genes [designated as To-Mi11 and To-Mi12] were isolated from the resistant tomato [Lycopersicon esculentum] line Nemagard. Expression profiling analysis revealed that both genes were highly expressed in roots, leaves and flowers and expressed at a lower level in stems, but are not detectable in fruits. To verify the function of Tfg-Mi, a sense vector containing the genomic DNA spanning the full coding region of Tfg-Mi was constructed and transferred into root-knot nematode susceptible tomato plants. Sixteen transgenic plants carrying one to five copies of T-DNA inserts were generated from two nematode susceptible tomato cultivars. RT-PCR analysis revealed that the expression levels of Tfg- Mi gene varied in different transgenic plants. PCR assays showed that the resistance to root-knot nematodes was significantly improved in some transgenic lines compared to untransformed susceptible plants, and that the resistance was heritable

Comparison of dobutamine stress and atropine exercise stress test myocardial perfusion spect in patients with poor exercise capacity

Exercise stress test [E] is the main diagnostic stress modality used with myocardial perfusion SPECT [MPS]. However, its usefulness and accuracy depends on patient's [pt] ability to achieve target heart rate [THR], limiting its utility in pt with poor exercise capacity. We sought to study the safety and feasibility of atropine administration during exercise myocardial perfusion study [EMPS] as compared to standard dobutamine MPS. Thirty patients aged 51.4 +/- 8.3 years; 80% males referred for a diagnostic MPS study and failed to achieve their THR on E. Patients were divided in to 2 groups [G]; G I 15 pts continued E and atropine was administered in doses of 0.5 mg /min until THR achieved or ischemic ECG changes or a maximum dose of 2 mg. GII 15 patients were subjected to dobutamine MPS from the start. There was no significant difference between the two groups regarding pretest likelihood of ischemia, resting heart rate, systolic and diastolic blood pressures. All pts in GI reached THR after atropine injection. GII experienced more side effects [40% vs 0%, p=0.017]; varying from chest pain 33%, headache 6.7%, nausea and vomiting 6.7%. No difference was found in the frequency of ECG changes [37% vs 47%] or frequency of positive MPS [87% vs 80%]. Use of atropine as an adjunct to standard EMPS in pts with poor exercise capacity allows them to achieve THR and can help decrease the number of inconclusive tests. Atropine EMPS is better tolerated by than dobutamine MPS

Hematological changes in healthy elderly Egyptians

This study comprised 41 healthy Egyptians: 15 young healthy individuals and 26 healthy elderly individuals. Subjects were thoroughly examined and routine laboratory tests were done. Some hematological tests included, complete blood picture, platelet count, blood indices and assessment of phagocytic activity of neutrophils. The red cell count was found to be lower in elderly subjects but the difference was non- significant. Yet, a significant decline in the hematocrite% was found in elderly subjects. Blood indices did not show a significant difference between the two groups. The total white blood cell count showed a non - significant difference between the two groups. However, concerning the differential count: the eosinophilic count was found to be significantly lower in elderly subjects, while the segmented leucocytic count was significantly higher in the elderly group. The platelet count showed a decline with advancement of age. A highly significant decline in the phagocytic power of polymorphonuclear leucocytes was found in elderly subjects [P < 0.001]. The phagocytic index was also significantly lower in the elderly group in comparison to young subjects [P < 0.001]

Gastric suture operation for the management of bleeding esophageal varices in schistosomal hepatic fibrosis

This study was conducted on 35 patients with schistosomal hepatic fibrosis and history of bleeding esophageal varices. These patients were treated electively by splenectomy, devascularization of the upper stomach and lower esophagus with gastric suturing of full thickness of both anterior and posterior gastric walls. The mortality rate was 5.77%, the incidence of postoperative recurrent bleeding was 8.57%. Postoperative barium swallow showed disappearance of varices in 12 cases [36.37%], improvement in 14 cases [42.42%] while it remains unchanged in seven cases [21.21%]

Prediction of incisional hernia by radio-opaque markers

Thirty six cases with different abdominal operations were studied for prediction of incisional hernia by using radio-opaque silver markers. Interrupted chromic catgut sutures were used for closure of the external aponeurosis in 50% of cases and continuous nylon sutures for the other 50%. Postoperative wound infection occurred in six cases [16.67%] and separation of the markers was detected in five cases [13.89%], four of them were schistosomal patients. The responsible factors for wound dehiscence were discussed

Venographic and lymphangiographic study of twenty cases of varicocele

Twenty patients diagnosed clinically to have primary varicoceles were studied. Varicocelectomy was done by the high ligation operation after intratesticular injection with patent blue to delineate the cord lymphatics. Postoperative distal and proximal internal spermatic venography could be performed through catheters inserted within corresponding veins during the operation. One of the lymph vessels was dissected, isolated, and injected with ultrafluid lipiodol, than X-rayed just after the surgery and two days later. Proximal integrate venography, distal retrograde venography and lymphangiographic findings were studied

Study of serum calcium in short and long term pill users

In this study serum calcium was determined in twenty females using the combined pills Gynovlar. Ten females were short term users and ten females were long term users. The control group consisted of fie females not using pills. In the control group serum calcium was found to be significantly higher in the second half of the cycle compared to the first half. In short term users serum calcium was significantly higher in the first half of the cycle and significantly lower in the second half of the cycle compared to control group. In long term users no difference was found in the first half of the cycle and significant reduction was found in the second half of the cycle compared to the control group

Study of serum magnesium in short and long term pill users

In this study serum magnesium was determined in twenty females using the combined pills Gynovlar. Ten females were short term users and ten were long term users. The control group consisted of five females not using pills. Serum magnesium was found to be significantly lower in the first half of the cycle compared to the second half in the control group. In short and long term pill users serum magnesium was significantly lowered in the second half of the cycle compared to the control group. In the first half of the cycle significant reduction of serum magnesium was found in long term users only compared to the control group

Endoscopy in diagnosis of acute upper gastrointestinal haemorrhage

This study was carried out on 50 cases of acute upper gastrointestinal hemorrhage. Endoscopic examination was done for every patient early after admission in order to locate the site and source of the bleeding and assess the value and accuracy of early endoscopy in management of these cases. It was found that urgent endoscopy is the best available method of identifying the site of the bleeding and avoiding inappropriate medical or surgical therapy. Acute erosions and peptic ulcerations can possibly be cited as the eminent cause of non-variceal bleeding in patients with liver disease because cancer stomach and Mallory Weiss syndrome had not been found in our cases

Estrogen receptors in benign breast diseases

Twenty cases of benign breast tumors were analysed for their clinical and histopathological data. The estrogen receptor status was analysed using the dextran-coated charcoal technique. Seven cases [35%] were found to be estrogen receptor positive, and their values ranged from 12.5 to 185 femtomoles per mg. protein. The remaining 13 cases did not show any estradiol binding. The results obtained were discussed

Effect of propranolol on portal hypertension during active hematemesis, and its role in arrest of hemorrhage

The present work was done on 24 patients admitted to the hematemesis unit with an acute attack of bleeding esophageal varices as a result of schistosomal liver affection. Each of the twenty four patients received intravenous propranolol [Inderal] for two days in a daily dose of five milligrams in 150 ml saline drip infusion, and then maintained on oral propranolol of 40 mg. twice daily. The results obtained showed a statistically significant drop in the portal pressure after intravenous propranolol

Study of serum iron in short and long term pill users

In this study serum iron was measured in twenty females using the combined pills. Ten females were short term users [using pills from three months up to one year] and the other ten females were long term users [using pills for more than two years]. The control group consisted of five healthy fertile females. In short term users serum iron was significantly higher in the first half of the cycle compared to control group, while in the second half no significant change was found. In long term users significant rise of serum iron was found in the first and second halves of the cycle compared to control group