Carbamoylethylated cassia gum as thickener in printing linen fabrics

Galactomannan gum isolated from the Cassia seeds was subjected to carbamoylethylation which involved the reaction of the gum with acrylamide along with sodium hydroxide as a catalyst. Four carbamoylethylated Cassia gum samples having different nitrogen content [2.78 to 4.28%] were prepared via changing the amount of the etherifying agent used [25 to 100g acrylamide/ 100g dry gum]. Modification of Cassia galactomannan gum via carbamoylethylation converts the gum into a water soluble derivative and increased its stability to storing. The results related with the rheological characterization of the carbamoylethylated Cassia gum derivatives showed that it exhibited non-Newtonian pseudoplastic behaviour irrespective of the degree of carbamoylethylation. Increasing the extent of carbamoylethylation was accompanied by an enhancement in the apparent viscosity. Storing of the pastes for three days caused a decrease in their apparent viscosties, which may be due to partial hydrolysis of the modified gum molecules. It can be concluded that carbamoylethylated Cassia gum derivatives could be used successfully as suitable thickening agents in reactive printing of linen fabrics

Evaluation of the effect of sildenafil citrate in pre-eclampsia

This study was undertaken to evaluate the effect of Sildenafil citrate [Viagra] on clinical course, biochemical parameters as well as Doppler ultrasound indices in cases of mild pregnancy-induced hypertension [PIH] and to evaluate the role of Sildenafil, if any, as a new therapeutic modality in mild PIH. The present study was conducted on 60 mild pre-eclamptic pregnant women; they were divided into 2 groups: Group I: included 40 cases and were subdivided into 2 subgroups: Group I A [20 cases] received 100mg sildenafil citrate in 2 daily divided doses for 1 week Group IB [20 cases] received 100 mg sildenafil citrate in 2 daily divided doses for 2 weeks Group II [control]: included 20 cases and were subjected to placebo [iron preparation] and bed rest for 1 week. Both groups were subjected to clinical, biochemical and Doppler ultrasound to assess the changes in blood pressure, uric acid, serum creatinine, serum proteins, serum albumin, ultrasound assessment of amniotic fluid index [AFI] and Doppler ultrasound indices [RI, Pl, S/D ratio] respectively before and after the treatment. The study revealed that there was significant decrease in systolic and diastolic blood pressure measurements and all Doppler indices after the use of 100 mg sildenafil for 1 week in group I A and a more significant reduction after longer duration of treatment in group IB without significant change of all these parameters in group II that was subjected to placebo and bed rest for 1 week. Such discussion is still controversial; the subject is still open for much future validation on larger study groups. It is too early for such preliminary study to arrive at sharp conclusions regarding the clinical utility of sildenafil for amelioration of pregnancy-induced hypertension. However it is convenient to report that at least in the current series, significant lowering of blood pressure and improvement of blood flow indices by Doppler ultrasound was attained by 100 mg sildenafil citrate- The possibility of cumulative effect is still hopeful based on more marked effect of the drug with longer duration of administration

Renal cell carcinoma: the experience of Kuwait Cancer Control Center, Kuwait

This retrospective study was undertaken to analyze the profile of patients presenting with renal cell carcinoma [RCC] and treatment outcomes. Subjects and Records of 49 patients [36 male, 16 female, 21-75 years] treated at the Kuwait Cancer Control Center, Kuwait for RCC during the period 1993-1998 were analyzed. Forty-one patients had a nephrectomy, 18 postoperative radiotherapy and 1 patient also received adjuvant immunotherapy with interferon. Patients with metastatic disease were treated with a variety of agents including interferon, chemotherapy [vinblastine] or a hormonal agent [megestrol acetate]. Data analysis was performed using SPSS statistical software package. Overall survival and disease-free survival were calculated using the Kaplan-Meier method. Twenty-nine patients presented with symptoms classically associated with RCC. Metastases at diagnosis were seen in 9 patients [18%], with lung being the most frequent site. The commonest tumor subtype was clear cell carcinoma [32.6%]. Thirty-nine patients [80%] achieved a complete response to treatment and relapse was documented in 10 patients [26%]. The majority of failures were distant, with lung metastases being the most common. Response to salvage treatment was poor. Overall survival was 83% at 2 years. The disease-free survival was 68 and 45% at 2 and 5 years, respectively. Although many patients presented with advanced local disease, a majority achieved complete response after radical surgery with or without postoperative radiation therapy. Salvage of metastatic disease proved difficult with interferon, chemotherapy

Prolonged total parenteral nutrition to tunnel or not?

The effects of subcutaneous catheter tunneling on the incidence of catheter sepsis and catheter life-span was studied in 30 patients who received prolonged total parenteral nutrition [TPN] and long-term chemotherapy. The effects of catheter tunneling were compared with conventional venous catheters inserted in 120 surgical patients. The total number of catheters inserted was 235. Catheter life span range was 30-180 days in tunneling group and 8-15 days in the non-tunneling one. Catheter sepsis occurred in 39 cases in the non-tunneling group, while it was suspected in only one case in the tunneling one. It was concluded that tunneling should be considered in chronic venous access because it increases catheter life span and diminishes the incidence of catheter-related sepsis, especially in critical surgical patients where nursing care is suboptimal

Anaesthetic and surgical considerations of hepatotoxic effects of organophosphorous pesticides pollution on human and rabbit's liver

This work included clinical and experimental study to clarify the toxic effects of organophosphorous compounds [OPC]. The clinical work was done on 20 adult male patients known to be in contact with OPC passively or actively and scheduled for elective cholecystectomy under general anesthesia. Preoperative, operative and postoperative serum hepatic transaminase, alkaline phosphates, bilirubin and liver biopsy were studied. The experimental work included 24 rabbits allowed to inhale airline, rosepher and their mixture for five hours daily for seven successive days. Serum liver transaminase, alkaline phosphatase, bilirubin and liver biopsy were studied to clarify the histopathologic effects of OPC. This study proved that serum hepatic transaminase and alkaline phosphatase showed higher level than base level after anesthesia and postoperatively in clinical work. Liver biopsy revealed mild to moderate histopathologic changes in the form of fatty infiltration associated with focal steatosis. However, the experimental study showed marked and significant higher levels of serum hepatic transaminase and reduction of alkaline phosphatase level. Liver biopsy showed marked ballooning degenerative massive venous congestion and marked lymphatic infiltration

role of ultrasound and computerized tomography in the diagnosis of thyroid swellings

This work aimed to assess the value of ultrasonography and computerized tomography as guidance to the management of different thyroid disease. In this study, 36 cases of suspected thyroid swellings were evaluated by ultrasound [US] and computed tomograph [CT] and the value of these techniques was discussed. Ultrasonography is generally a safe method of examination which permits an excellent visualization of the thyroid parenchyma and anatomy. It is widely used for evaluation of thyroid nodules and detection of small nodules. It also can define the exact number and the nature of focal lesions whether solid or cystic. Computed tomography offers excellent resolution of the thyroid relative to other soft tissue structures in the lower neck. It can demonstrate the entire neck and chest and readily show retrosternal extension of a goiter, airway compression and displacement of the trachea. Lymph node enlargement and infiltration of the surrounding structures in cases of malignant tumors can be also detected

Testicular swellings simulating malignancy. Clinical pitfalls, sonographic and histopathological correlation

The final diagnosis of twenty-eight consecutive male patients presented with unilateral testicular swelling, underwent inguinal orchiectomy due to suspected testicular malignancy was correlated with the results of the clinical and sonographic examinations. A high index of suspicion arose primarily from the patients history, clinical examination of the swelling and its appearance on scrotal ultrasonography. Histopathological examination proved the existence of testicular malignancy in 2 cases [7.1%]. The final diagnosis of the remaining 26 cases, based on histopathological examination, was tuberculosis in one case [3.6%], testicular infarction in 2 cases [7.1%], neglected torsion in 6 cases [21.4%], filariasis in one case [3.6%], chronic nonspecific orchitis in 9 cases [32.1%] and granulomatous orchitis in 7 cases [25%]. All were found to simulate malignant tumors either in their clinical presentation, local examination or ultrasonographic appearance. Benign testicular swellings simulating malignancy are not rare and hence differential diagnosis of testicular tumors should be expanded to include chronic and granulomatous orchitis, testicular infarction, neglected torsion as well as tuberculosis and filariasis. The decision of orchiectomy should be properly judged in view of the under-estimated incidence of benign swellings simulating malignancy

Primary tension - free epigastric hernioplasty: procedure and outcome

Between January 1992 and May 1998, we operated upon 110 patients with large epigastric hernias [3cms or more] performing a primary pure prosthetic tension-free repair using the onlay polypropylene mesh graft technique, aiming to reduce the expected high recurrence rate after other repairs [1,4]. This group is retrospectively reviewed. There were 77.3% females and 22.7% males. Only elective repairs were included. All recurrent cases, the pediatric age group and those with ascites were not included. 7 patients [6.4%] has other types of hernia while 13 [11.8%] had more than one epigastric hernia. 8 patients [7.3%] presented with diastases [divarication] of recti in addition to their hernias. No perioperative mortality. Removal of the mesh, mesh extrusion or deep mesh infection did not occur in any case. Recurrence rate was 2.7% [3 cases] and was attributed either to emergence of a new hernia [in 2 cases] or to a correctable technical error [in one case]. Total complication rate was 18% while, complication rate related to mesh application was 10.7%. All complications were not serious and easily controlled as they necessitated minor surgical reintervention in only 4.5% of cases. It is to be concluded that the results are gratifying and the technique used is simple, durable and has a few and easily treatable complications. So, we recommend this repair as the primary repair of all epigastric hernias 3 cm or more to reduce the high recurrence rates noticed with other repairs

Laparoscopic vagotomy in treatment of chronic duodenal ulcer [Posterior truncal vagotomy associated with anterior highly selective vagotomy]

To evaluate the safety of laparoscopic vagotomy this study included 20 patients with chronic duodenal ulcer, admitted in Al-Zahraa university hospital in the period between 1994-1997. Preoperatively, full history, clinical examination upper gastrointestinal endoscopy, abdominal ultrasonography and barium meal were done to all patients. Laparoscopic posterior truncal vagotomy associated with anterior highly selective vagotomy was done to all patients and any operative or postoperative complications were recorded. Postoperatively clinical evaluation and endoscopy were repeated to compare with the preoperative data and to assess ulcer healing. 90 to 180 minutes [mean 135 mm.]. Intraoperatively there was minimal bleeding in 2 cases and was controlled by diathermy and clips, two cases of arrthymia and one case of hypercapnoea improved spontaneously after temporal desufflation of co2. Postoperatively scapular pain, diffuse abdominal pain and mild fever were noticed in 6,2 and 2 patients respectively. Postoperative stay in the hospital was ranged from one to 5 days [mean 3 days]. Two patients were still complaining of dyspepsia and were improved by medical treatment. Six months follow up by endoscopy revealed that 19 cases were completely free and one case still had an ulcer which also was improved by medical treatment. One patient developed a very small hernia at the site of laparoscopic port above the umbilicus. However laparoscopic vagotomy is a new promising, minimally invasive technique. Its simplicity, safety, efficacy, minimal scarring and early mobilization support its wider use, but it will be necessary to validate this initial experience with a large number of patients and adequate long term follow up. So we concluded that laparoscopic vagotomy should not be developed so as to avoid or be contrary to the established principles of open surgery, but rather it should be designed as a continuation of classical surgery with new and different techniques

role of colour doppler sonography in the differential diagnosis of breast lesions [in correlation with Mammography, conventional ultrasonography and histopathology]

To evalute the role of colour doppler sonography [CDS] in the differential diagnosis of breast lesions prospective study of 104 patients who underwent breast imaging diagnostic techniques from January 1995 to December 1997 was done. A good history and clinical examination were conducted to all patients. Mammography and conventional ultrasonography were done firstly as a preliminary test, then colour doppler sonography was done to all patients for examination of all lesions detected by mammography and/or ultrasonography and completed by examination of the whole diseased breast and the contralateral breast especially the corrosponding area to the lesion as a control. All the detected breast lesions were excised surgically and their pathological results were obtained and proved that 38 lesions were benign while 66 ones were malignant. Mammography showed an accuracy of 84.2% for benign and 83.4 for malignant lesions with a 6% false positive and 3% false negative. Ultrasonography showed an accuracy of 78.9% for benign and 74.2% for malignant lesions with a 7.6% false positive and 10.5% false negative. Colour doppler sonography showed an accuracy of 76.3 for benign and 77.3% for malignant lesions with a 3% false positive and 5.3% fasle negative. Malignant lesions were characteristically more vascular than the benign ones because they stimulate the growth of new blood vessels by secreting angiogenesis factors. Most malignant lesions had more than 3 blood vessels either within the lesion or at its periphery while the benign ones even the largest had no more than 3 vessels. Malignant vessels are usually tortuous, larger, and occur away from the site of normal vessels. The maximum velocity of blood flow was much higher in malignant lesions [mean 31.2 cm/sec] than benign ones [mean 18.9 cm/sec]. Systolic/diastolic [S/D] ratio and resistance index [RI] of the flowing blood were estimated for all lesions and were non specific in all values. We concluded that colour doppler sonography is a new promising technique, non invasive, fast, easy and safe. Its of great value in differential diagnosis of breast lesions and helps in diagnosis of their local and distant extention to lymph nodes. A triple imaging technique [combined use of mammography, conventional ultrasonography and colour doppler sonography is considered an ideal pathway in differential diagnosis of breast lesions, with an accuracy nearly to 100%, helps to avoid the false positive and negative results and reduces the number of unnecessary biopsies. It can be used as a routin procedure in the programs of screening, early detection and diagnosis of breast lesions

Is it worthy to do CT to diagnose acute appendicitis

20 patients have been evaluated by CT, if they have appendicitis either proximal or distal. the changed occurred in CT has been documented by many radiologist. Our purpose is to find, is it worthy to do CT to diagnose appendicitis in Egypt. Appendicitis historically has been diagnosed clinically, with only occastional use of diagnostic imaging. Reported rates of negative findings at diagnostic laparotomy in patients diagnosed clinically range between 6.5% and 45% [average, 20%] [1-3]. Reported clinical false - negative ranges between 7% and 33% [average, 20%] [4.5] when clinical impression alone was relied on for diagnosis, a normal appendix was removed in approximately every fifth patient who underwent appendecetomy and the diagnosis was over looked in every fifth patient who actually has appendicitis but was clinically evaluated and sent home

Diagnostic value of CT in pancreatic carcinoma a retrospective study

Abdominal CT scans for 15 patients proved to have carcinoma of the pancreas were revised. The main primary CT features were, the presence of a mass lesion and assocaited dilated common bile duct and/or pancreatic ducts. Secondary features of malignancy were surface irregularity, organ invasion, lymph node enlargement and liver deposits. CT is valuable in diagnosis of the presence of the tumour, its site and size and staging of pancreatic carcinoma. Also CT helps in tumour resection after demonstrating its size

Diagnostic aspects of renal masses a retrospective study

Imaging diagnostic modalities as ultrasonography and computed tomography beside the conventional urographic procedures were used to study 15 different mass lesions. The value of those different diagnostic modalities was determined with their accuracy and relative merits

Diagnostic value of CT in pancreatic carcinoma a retrospective study

Abdominal CT scans for 15 patients proved to have carcinoma of the pancreas were revised. The main primary CT features were, the presence of a mass lesion and assocaited dilated common bile duct and/or pancreatic ducts. Secondary features of malignancy were surface irregularity organ invasion, lymph node enalrgement and liver deposits. CT is valuable in diagnosis of the presence of the tumour, its site and size and staging of pancreatic carcinoma. Also CT helps in tumour resection after demonstrating its size

Evaluation of body mechanics of top class Bahraini soccer players

Forty-three top-class Bahraini football players and fifty randomly selected male Bahraini university students were studied to investigate the occurrence of postural deviations specific to football. The standing posture of the subjects was measured utilising the Skan-a-graph posture test and the New York State Posture Rating test from photographs and in vivo. The comparison between active players and the control group revealed no significant difference between the two groups. The results of these data suggest that a longitudinal study is necessary to establish both the cause and the time when postural deformities appear during the growth period of the long bones

Twenty meter blind swimming: a test of underwater work symmetry

The mechanical movements by swimmers were investigated to determine the amount of deviation that occured due to asymmetric limb forces. Five Bahraini National Junior Swimming Team members swam 20 metres wearing opaque goggles and the same distance wearing ordinary goggles. The mean deviation distance was 0.775 m. The correlation between deviation distance and best time over 50 metres was R = 0.95 [P < 0.01], suggesting that the test is a valid predictor for asymmetric forces. The results revealed that there were hidden forces causing a loss of energy and efficiency

Echocardiography in pericardial effusion

This study included 14 patients [eight males and six females, ranging in age between 16-54 years with an average of 27 years] with pericardial effusion of different etiology. All patients were studied echocardiographically besides clinical, radiological and electrocardiographic examinations. It was found that echocardiography is the best available diagnostic mean to diagnose pericardial effusion and it gives also good information about the quantity of pericardial fluid