Paravertebral nerve block vs general anaesthesia in cancer breast surgery

The aim of this study to evaluate the effect of thoracic paravertebral nerves block[PVB] as an alternative for general anaesthesia [GA] in cancer breast surgery on haemodynamic, stress responses, pulmonary function tests[PFT] and postoperative pain relief. Fifty patients undergoing for elective simple mastectomy and clearance of axilla allocated for 2 groups. Group 1 [GAG] and group II [PVB]. All patient premedicated by fentanyl 1micro g/kg and 40 micro g midazolam. Group 1 [GAG] received general anaesthesia by propofol 2 mg/kg and 80 mirco g / kg vecuronium and anaesthesia was maintained by gas, oxygen and isoflurane. In PVB group single injection of 0.3 mg/kg bupivacain 0.5% at T4 spine and the patients were sedated by propofol infusion. PVB decreased HR, MABP, blood glucose and plasma cortisol significantly when compared with GAG and significantly improved pulmonary functions tests [FVC and FEVI]. PVB produced significant increase in duration of analgesia and decreased visual analogue scale scores [VAS] when compared with GA. PVB with bupivacain 0.5% at T4 in conjunction with intraoperative sedation was safe and effective for surgical anaesthesia in patient undergoing major breast surgery and attenuated the stress response to surgery and provided complete pain relief postoperative

Serum and tissue CEA in gastric mucosa of patients with hepatosplenomegaly

This work was carried out to clarify the possibility of neoplastic transformation in patients with atrophic gastritis complicating endemic hepatosplenomegaly and to identify those with or at a special risk of developing premalignant or malignant gastric lesions. Estimation of CEA in the gastric tissue and serum of these patients will be our tool. This study was carried out on 3 groups. The study group included 35 patients having endemic hepatosplenomegaly associated with atrophic gastritis, the control group one comprised 10 normal individuals and control groups II included 18 patients with gastric adenocarcinoma. After detailed history, full clinical examination all study groups were subjected to complete urine and stool analysis and gastric biopsies were taken by endoscopy and stained by H and E. Paraffin section were further stained by tissue CEA and lastly serum estemation of CEA level was evaluated. These results were statistically analysed tissue CEA was positive in [37.1%], study group compared to 0% in normal individuals and [100%] in control group in having gastric adenocarcinoma while serum CEA was insignificantly higher than in normal group and significantly lower than control group II. No significant association was found between serum CEA and degree of mucosal atrophy. More over no significant association was found between serum CEA and tissue CEA in study group. These data conclude that atrophic gastritis complicating hepatosplenomegaly have increase incidence of tissue CEA than normal. Twenty per cent of those patients had level serum CEA higher than the cut off value denoting that these patients are at higher risk of developing carcinoma

Hematological aspect of occupational electromagnetic field exposure

The current study was performed to evaluate the effect of occupational hazards of exposure to electromagnetic field [EMF] on the different blood cell count of the workers in Cairo Electricity Distribution Company. Exposure to magnetic field was calculated to be ranged from 4 to 90 milligauss, and electric field from 0.019 to 8.76 Kv/m. The study showed stimulating effect of [EMF] exposure on blood forming cells manifested by increased erythrocytic count and white blood cell count [WBC]. Red blood cell [RBC] were less in hemoglobin content [MCH] and cell volume [MCV], i.e. erythrocytosis with relative microcytic hypochromic cells. The [WBC] showed leucocytosis with relative neutrophilia and lymphocytopenia. There was significant correlation between time of exposure and [WBC] HB%, and [MCV]. The study recommended periodical blood cell count to the exposed to detect early changes apart from the basal count

Hisopathological, biochemical and teratogenic effects of sodium nitrite [antimicrobial agent] on chicken

The present work deals with the histopathological, biochemical and teratogenic effect of sodium nitrite at two doses of 50 or 100 mg/kg b.wt. in chicken. The present results revealed that sodium nitrite exert histopathological effects on the liver and kidney tissues of chicken. The liver tissues of the treated chicken showed laceration of blood sinusoids and some of the central veins in addition to to cellular damage. Also, the kidney tissues of the treated chicken manfested deformation of the structure of the glomeruli and blocking of the renal tubules with a mucous substance. The toxic effects of either of the two doses of sodium nitrite on serum activities of glutamate oxaloacetate transminase [SGOT], glutamate pyruvate transminase [SGPT] and creatinine concentration [SCR], were also studied. It was found that the repeated doses of 50 or 100 mg/kg b.wt. of sodium nitrite induced a general increase in SGOT and SGPT activities and SCR concentration. Sodium nitrite induced various teratogenic effects in developing embryos on the 16th day of incubatio. Resorption, deaths and growth retardation were significant in the experimental groups as compared with the control one. The total body weights of the embryos treated with two doses of sodium nitrie were statistically highly significnat. Moreover the total length of treated chick embryos were reduced, it was statistically highly significnat. Furthermore, sodium nitrite induced skeletal mal formations respresented by the reduction in ossification of the bones of the skull, ribs, vertebrae and limbs

Neuropathic arthropathy in Egyptian diabetic clinical, radiological and histopathological study

This study was carried on 80 patients suffering from diabetes mellitus. The patients subjected to full clinical and neurological examination, radiological survey for the affected joints, estimation of fasting and postpr and ial blood sugara, urine analysis with particular interest for acetonuria and glucosuria, and synovial biopsy from affected neuropathic joint. The cases were classified into two groups according to the line of treatment into insulin dependent diabetics forming the first group. They were 40 patients, [17 males and 23 females], their ages ranged from 20 to 65 years [mean 47.3 years, SD +/- 11.3], the duration of diabetes mellitus ranged from 24 to 336 months [mean 151.3 months, SD +/- 81.5]. The second group consists 40 non insulin dependent diabetics [10 males and 30 females]. Their ages ranged from 40 to 67 years [mean 51.3 years, SD +/- 6.8]. The duration of diabetes mellitus ranged from 12 to 240 months [mean 76 months, SD +/- 57.9]. Neuropathic joints were found in three patients out of 40 [7.5%] in the insulin dependent group, in the knee [one patient], ankle joint [two patients] and metatarsal joints [two patients]. Non were affected in the second group. Histopathological study revealed excessive fibrosis with foci of classification in the synovial joints of the affected patients

Serum and cerebrospinal fluid cortisol and ACTH levels in patients with tuberculous meningitis

In this study, there was a trial to provide additional information concentration concerning the behavior of adrenal cortical hormones at the blood brain barrier. 50 patients diagnosed as having tuberculous meningitis were included in the study. Another 15 healthy subjects undergoing spinal anesthesia served as controls. Blood and CSF samples were taken from each of these patients on admission, 2 months and 4 months after initiation of therapy. Cortisol and ACTH levels were determined in their samples using enzyme immunoassay method and radioimmunoassay method respectively. No significant differences were found between plasma and CSF levels of ACTH in these patients on admission or at 2 or 4 months. The results suggest that, the stress caused by the presence of Mycobacterium tuberculosis has significant deleterious effects on the function of adrenal glands which are responsible for the regulation of the cortisol levels. This effect disappears shortly after treatment. The study also shows that the same infection has no effect on the function of the pituitary gland responsible for ACTH production

Medical students attitudes towards smoking

Two hundred and Eighty male University medical students were randomly selected for a study of the student's smoking heabits and attitudes towards smoking. Questionnaires dealt with personal data, current smoking habits and attitudes towards smoking. Data about parents were also included. It was found that 57.1% of the students were cigarette smokers for an average 5 to 10 years duration. Seventhly per cent of them smoked more than 20 cigarettes per day. Imitation to parents or friends was the commonest cause of starting to smoke [75%]. The various risk factors studied were analysed and were found to confirm similar studied carried out in other countries before. The importance of developing effective antismoking programs to combat this epidemic of smoking among students was discussed