Changes in concentration of iron and lead in food due to rotting

To determine whether there is any change in concentration of iron and lead due to rotting process of food. The concentration of iron and lead in fresh samples of apple, precement [Japanese fruit], banana, grapes, potato and tomato and normally marketed cereal, brand name "cerelac", was determined, using atomic absorption spectroscopy. Samples were taken each week for six weeks. The highest concentration of lead [3.336microg/g], in fresh samples, was in precement, perhaps, its thin peel and soft internal tissue has greater diffusivity and is more absorptive for lead from environment. Cerelac had higher iron content. The change in concentration of iron and lead with respect to rotting time is inconsistent and does not follow any derived mathematical relationship. Initially, it increases, followed by a decline in value and then increases again, with variation depending upon the nature of sample. However, on the average, it is showing an increase. The inconsistency in concentration of metal ions at various rotting stages, perhaps, is due to different rotten products, with varied absorbency at different states of decay

Ameloblastoma in young persons: a retrospective study of the Clinocopathologic Features and treatment of 19 cases from a Semi-Urban Nigerian Teaching Hospital

19 cases of ameloblastoma of the jaws in children and young adolescents were reviewed. During the period of evaluation, 113 patients with ameloblastoma of the craniofacial region were managed of which 16.8% were in patients aged < 18 years. The mean [SD] age of patients was 14.7 [ +/- 2.5] years [range, 10-18 years]. Male to female ratio 2:1; and mandible to maxilla ratio 18:1. Duration of the tumours at presentation ranged from 8 months to 5 years, [mean: SD = 3.3:1.5 years], 73.7% were of the multilocular type on radiographs and the most frequent histologic pattern was the plexiform type [n-12, 63.2%]. Due to the large size at presentation, radical mandibulectomy was the method of treatment in 12 cases [63.2%]. Recurrence was noticed in 4 patients [21%] within 5 years after primary surgery. Ameloblastoma is relatively rare in Nigerian children, the clinical features, radiologic and histologic patterns however, were found to be similar to that of adults

Cushing's disease: results of Ibn Sina neurosurgical department and review of the literature

Cushing's disease in an excessive secretion of adrenocorticotrophic hormone [ACTH] by a pituitary corticotroph tumour, which is responsible for two-thirds of all cases of Cushing's syndrome. We attempt in this paper to present our results, and to review the literature for a better understanding of this pathology that poses many problems in diagnosis and treatment. The authors report 15 cases of Cushing's disease from a series of 174 pituitary adenomas admitted in Neurosurgical department of Ibn Sina hospital, between January 1987 and December 1999. These 15 corticotroph adenomas, only 13 of which have sufficient data and follow-up are retained in our survey. We noted a female preponderance [11/2], with a mean age of 33 years. In our series and by reason of selection methods, surgical treatment was indicated according to focal lesions on magnetic resonance imaging and not on clinical and biological findings alone. All of these patients underwent trans-sphenoidal approach as a primary choice. Five [5] patients developed recurrence of high level cortisol in blood: * 2 refused subsequent operations * 2 underwent irradiation * 1 underwent removal of tumour by successful sub-frontal approach. There was no mortality in this series and the only case of morbidity consisted of one rhinoliquorrhea that improved after surgical treatment

Phenotyping of peptidase a in hair root sheaths obtained from Egyptian population sample

In this study, peptidase A [pep A] was successfully typed in hair root sheaths obtained from 320 unrelated Egyptian population sample of both sexes using electrophoresis technique. In each case, hair sample was typed first for pep A and confirmed by typing blood from the same donor. Peptidase A activity was found in 300 of the samples and the other 20 samples showed no activity as they had no outer root sheath indicating that enzyme activity was present only in sheath material. Three phenotypes of peptidase A were controlled by two alleles. The most frequent phenotype was pep A1-1, while the least frequent one was pep A2-2. The most frequent allele was pep A*1 with a frequency of 0.806. The phenotypic distribution of peptidase A in the Egyptian population sample was in a close agreement with that predicted by Hardy-Weinberg equation

Typhoid ileal perforations: a study of 75 patients

The results of surgical treatment of 75 cases of typhoid ileal perforation are presented. Fifty-eight% of the patients were between 20 and 40 years of age. Seventy-five% of the patients were seen after an illness of 2-4 weeks. Most of the patients reported late to the hospital so upto 72% of the patients were explored 24 hours after the perforation occurred. At operation the peritoneal cavity was full of pus and small bowel contents. More than 85% of the perforations were located within 60cm from ileocecal valve. Only 16% patients had multiple perforations. Thirty-eight patients [50.7%] underwent simple closure of their perforations. Nineteen patients [25.3%], underwent wedge-excision of the ulcer and 2-layer closure and eighteen [24%] underwent exteriorization of the perforation as an ileostomy, mostly because of multiple perforations. Peritoneal toilet with warm saline was performed in all patients. The overall mortality was 12%. Chloramphenicol, genticyn and metronidazole were used in combination in all the patients. We recommended early limited surgery to improve results

Oral cholecystography or ultrasonography in the diagnosis of alcalculous gallbladder disease

A total of 300 patients with gallstone disease were studied in surgical unit-l, Nishtar Hospital, Multan during a period of 6 years [January 1986 to December 1991]. Diagnosis of gallstones was made by ultrasonography, oral cholecystography or both. Oral cholecystography [OCG] was performed in 105 patients. Ultrasound [USG] of the liver and gallbladder was obtained in 195 patients. Forty patients underwent both ultrasonography and oral cholecystography. The results were compared with the operative findings to find out the reliability of oral cholecystography and ultrasonography in the diagnosis of calculus gallbladder disease. The sensitivity for OCG was73% and the specificity was 60%; the respective figures for USG were 86% and 93%. The predictive value of positive OCG was 91%; the respective value for USG was 99%. A combination of OCG and had sensitivity of 95%, specificity 100% and the predictive value for positive test 100%. Ultrasound was of special help in the diagnosis of gallstones in patients with jaundice, pregnancy, vomiting, allergy to the contrast and acute cholecystitis. These observations suggest that OCG and ultrasound are very accurate but not infallible in diagnosing gallstone disease. We also conclude that ultrasound should be the initial imaging technique in patients suspected of having gallstone disease. When ultrasound fails or is inconclusive, a combined strategy of applying both the tests should be considered

Post-operative bile duct strictures: Management of eight patients

Management of eight patients with benign bile duct stricture following cholecystectomy is discussed. Seven patients had been operated for gall stones while one had undergone cholecystectomy and repair of hepatic duct confluence after blunt abdominal trauma. Five patients had undergone multiple operations before referral to this hospital on admission, all the patients had abnormal liver function tests. Three patients had low serum albumin, 4 had a history of previous major infection and one patient had associated cirrhosis and portal hypertension. Five patients had an external biliary fistula. All the patients were operated upon: 4 by mucosal graft operation [Bismuth type-IV], 3 by hepatico-jejunostomy by direct suture [Bismuth type-III and II] and one by choledocho-duodenostomy [Bismuth type-I]. There were no post-operative deaths in patients treated by hepaticojejunostomy. One of the 4 patients treated by mucosal apposition died in the immediate postoperative period; he had associated cirrhosis and portal hypertension. Six patients [75%] have a good result with a mean follow up of 3.5 years [range 2-8 years]. One patient has occasional attacks of jaundice and fever and persistently raised serum alkaline phosphatase. Factors influencing outcome were prolonged jaundice, site of stricture, number of previous attempts at stricture repair, associated cirrhosis and portal hypertension

Omental grafting in fore arm

A 45 years old female patient was admitted with extensive fore arm injury after a road side accident. There was loss of skin and muscles of the flexor compartment. Most of the flexor muscles were lost leaving the bones necked. Only a few muscles were left in the extensor compartment but the skin was totally lost. The skin on the dorsum of the hand was also lost. The remaining tendons were left necked. The finger tips were pale and cold. After 48 hours the finger rips became black. The greater omentum was mobilised through a mini lap to cover the extensive raw area to provide coverage to the bones and tendons and to bring nutrition to the ischaemic hand

Treatment of perianal fistula: analysis of 108 cases

One hundred and eight patients who underwent treatment for peri-anal fistula have been studied. Eighty-nine patients had a low anal fistula while 19 patients had high fistulae. Low fistulae were treated by fistulotomy achieving uniformly good results. The difficult high anal fistulae were treated by two stage fistulotomy [n=6], cutting seton [n=9], and re-routing technique [n=4]. The techniques and outcome of treatment are discussed

Incidence of gall stone disease, a hospital based study

Three hundred patients with gall stone disease admitted in Surgical Unit-1 Nishtar Hospital, Multan during a period of 6 years [January 1986 to December 1991], have been studied. Twenty-five were male [8.3%] while 275 were female patients [91.7%]. The male to female ratio was 1: 11. Peak incidence was between 30-50 years of age. Ninety patients presented with pain right hypochondrium [30%] and 54 with flatulent dyspepsia [18%]. Twenty-seven patients presented with acute cholecystitis [9%]. Thirteen patients presented with obstructive jaundice [4.3%]. Most of the patients had chronic cholecystitis [37%]. Fifteen patients had carcinoma of the gall bladder [5%]. Eighty-two% of the stones on analysis proved to be cholesterol stones while only 18% were pigment stones. Ultrasound was found accurate in 86% while Oral Cholecystography was accurate in 73% of the patients

Smith's mucosal graft operation in a case of external biliary fistula

A patient with external biliary fistula after cholecystectomy was admitted in Surgical Unit-1, Nishtar Hospital, Multan. The patient had fever and jaundice which was obstructive in nature. On exploratory laparotomy, bile was seen coming out of a track lined by fibrous tissue. After a tediouss dissection of the track, we ended up with the finding of the openings of right and left hepatic ducts in the porta hepatis. The common hepatic duct and the common bile duct could not be traced. A short distal stump of common bile duct was found after duodenotomy and probing of the ampulla of Vater. An end to end anastomosis of the duct was not possible. A mucosal graft operation was performed. The problems of management of this complication, are discussed

Smith's mucosal graft operation in a case of external biliary fistula

A patient with external biliary fistula after cholecystectomy was admitted in Surgical Unit-1, Nishtar Hospital, Multan. The patient had fever and jaundice which was obstructive in nature. On exploratory laparotomy, bile was seen coming out of a track lined by fibrous tissue. After a difficult dissection of the track, we ended up with the finding of the openings of right and left hepatic ducts in the porta hepatis. The common hepatic duct and the common bile duct could not be traced. A short distal stump of common bile duct was found after duodenotomy and probing of the ampulla of Vater. An end to end anastomosis of the duct was not possible. A mucosal graft operation was performed. The problems of management of this complication are discussed