value of LDH level of BAL fluid in differentiating benign from malignant solitary pulmonary nodules

Serum lactate dehydrogenase [LDH] concentration is an indicator for tissue injury. It may be secreted locally in many conditions. For the first time, this study was performed to investigate the value of LDH level in bronchoalveolar lavage fluid [BALF] in differentiation of benign from malignant single pulmonary nodules [SPNs] and to assess its relationship with serum LDH levels. This study was a prospective case-control clinical study. It included 59 patients with a SPN and 21 non-smoker healthy adult volunteers as controls. They underwent bronchoscopy with BAL, Transbronchial needle aspiration [TBNA], and transbronchial biopsy [TBB]. Both total serum and HAL LDFJ levels were measured. The range of the HAL LDH levels in the control group was 4.60 -26 mild/mI, in patients with benign nodule was 6- 83 rnlU/ml, and in those with malignant nodule was 33 -147 mIU/ml. Overall, the mean BALF LDI-I level was significantly higher in patients with a malignant pulmonary nodule [85.92 +/- 28.31] as compared with that of either patients with a benign nodule [19.08 +/- 18.35] [p<0.0001] or control group [12.16 +/- 6.18] [p<0.0001]. No significant difference between the absolute value of HAL LDH level in patients with benign pulmonary nodule and the control subjects was found [p=0.23]. There was no correlation between HALF LDH and serum LDFI level in patients with SPNs [p=0.595]. HALF LDH levels are increased in patients with malignant SPN, but had no significant rise in benign solitary pulmonary nodules. This factor is useful in differentiating benign from malignant SPNs. A low BAL fluid LDI-1 level in a patient with SPN who does not have a tissue diagnosis may be deemed acceptable for observation and follow up. This may save patients the need for operative procedures

[Epidemiological study of respiratory disorders induced by occupational inhalation of talc powder in rubber factory workers in Shiraz]

Talc powder is extensively used as a lubricant in rubber industry. However the nature of its respiratory effects, if any, has not been thoroughly investigated. The purpose of this study was to assess the pulmonary reactions associated with occupational exposure to talc dust. This is a analytical study in which 97 talc- exposed workers and 110 unexposed employees as the reference group were randomly selected from a local rubber industry. Standardized respiratory questionnaires were administered to the subjects. They underwent chest X-ray and were examined by a specialist for any possible respiratory abnormality to be diagnosed. Furthermore, Pulmonary Function Tests [PFTs] were performed just before and after the work shift. Moreover, to assess the extent of exposure to talc dust, using standard methods, inhale able and reparable dust concentrations were measured in different dusty worksites. The data were analyzed by standard statistical tests using SPSS software. The average [mean +/- SD] age [years], weight [kg], height [cm] and duration of exposure to talc dust [years] for the exposed group were 35.8 +/- 6.75, 73.1 +/- 9.2, 173.2 +/- 5.9 and 11.79 +/- 5.3 respectively. The corresponding values for the non- exposed group were 36.1 +/- 6.87, 73.36 +/- 8.1, 172.2 +/- 5.7 and 0 +/- 0, respectively. Atmospheric concentrations of inhaleable and respirable talc dust were found to be 41.8 +/- 23.52 and 19.8 +/- 8.04 mg/m[3], [mean +/- SD], respectively. Talc exposed subjects had a significantly higher prevalence of respiratory symptoms. Similarly, PFTs revealed that exposure to this lubricating agent was associated with significant decreases in the mean percentage predicted of vital capacity [VC], forced vital capacity [FVC] and forced expiratory volume in the first second [FEV1]. Moreover, there was a sharp reduction in some parameters of pulmonary function such as VC, FVC and FEV1, over the work shift. Chest radiographs of exposed workers showed evidence of chronic inflammatory process. These results which are in full agreement with the preliminary observations support the notion that occupational; exposure to talc is associated with both acute and chronic respiratory disorders and induces bronchitis and interstitial lung disease

Educational needs assessment of Mashad university of medical sciences' managers in management and leadership

Background: The first step in human resource development is educational need assessment. A sound knowledge of managerial roles and skills is vital for a successful management in the educational system

Purpose: To determine the educational needs of managers and directors of Mashad Medical University in filed of educational management and leadership

Method: A survey of a 40-person sample of the university managers including deans and vice deans for education of the faculties and the heads of educational groups the data were analyzed with SPSS

Results: The mean age of the sample was 47.2[+/- 7.5] and the mean duration of serving in managerial positions were 5.4[+/-3.6].The most needed items to be taught were identified as strategic planning in management, setting educational goals, deciding whether the ability to be a manager is inborn or must be acquired, main problems in educational planning and surveillance techniques, educational guidance, system analysis and educational evaluation. Characteristics of educational advisors were also of great importance

Conclusion: Our study showed that educational managers were aware of their need for further development of a sound basis of managerial knowledge

Diaphragmatic injuries after blunt or penetrating abdominal trauma

Traumatic diaphragmatic injuries are consequently associated in severely injured patients. It may result from blunt or open injury and it is commonly found on the left side of the diaphragm. Missing such injury when the patient is first seen is due to either delayed rupture or delayed detection. This study was done on 20 patients with blunt or peneterating diaphragmatic injuries seen at Al Azhar University Hospital and Al Azahraa Medical Center in Saudi Arabia, aiming that we can identify the pit falls in diagnosis and management. On exploration the diaphragm should be inspected, palpated and if there is diaphragmatic defect it should be immediately repaired with unabsorbable suture

Post-operative deep vein thrombosis: a comparison between spinal and general anesthesia

One hundred patients undergoing prostatectomy or surgical correction of fractured neck of femur, received either subarachnoid blockade [SAB] or general anesthesia [GA]. Post operative deep vein thrombosis [DVT], assessed by venography was found to be 6% in SAP group, which was significantly lower than the 18% incidence in group GA. Intra- operative blood loss was significantly lower in SAP group. Spinal anaesthesia offers a considerable advantage over general anesthesia in addition to other appropriate thromboprophylactic measures, in patients undergoing operations associated with a high risk of thrombolytic complications

Hypotonic double contrast oesophagography versus fibroptic endoscopy in reflux oesophagitis

In this study patients complaining of dysphagia, heart burn, sense of regurge, globus hystericus and hematemesis of whose conventional barium study of upper gastro-intestinal tract revealed no abnormality were examined by hypotonic double contrast esophagography and by fibrotic esophagoscopy. Reflux esophagitis was diagnosed in 30 patients staging of reflux esophagitis; correlation of findings between hypotonic double contrast esophagography and fibrotic endoscopy were discussed