A Case of Sub Hepatic Perforated Appendicitis Presented as Multiple Gas Containing Subcapsular Hepatic Abscesses.

Appendicitis is the most common acute surgical condition of the abdomen. The diagnosis of acute appendicitis can often be made clinically. When the appendix is situated in an abnormal position, the diagnosis of acute appendicitis becomes difficult. Delayed diagnosis or misdiagnosis of subhepatic appendicitis might lead to perforations of the appendix, which is a clinical emergency. Liver abscess as a complication of appendicitis was first described in 1898 by Dieulafoy. The majority of pyogenic liver abscesses are caused by infection originating in the biliary or intestinal tracts. Pyogenic liver abscess is a rare complication of acute appendicitis. Multiple pyogenic liver abscesses are not frequently reported in the literature, but the overall mortality is high, if left with no treatment or not treated early. We have reported a case of subhepatic perforated appendix presented with multiple subcapsular liver abscesses.

Mycobacterium marinum skin infection

A forty-nine-year-old non-Bahraini housemaid misdiagnosed and inappropriately treated for more than 2 years as a case of uncontrolled hand eczema. On presentation to Dermatology Unit, she was confirmed to have Fish Tank Granuloma [FTG] and ultimately treated with a course of oral Doxycycline and showed excellent outcome

T-cell markers in lymphoma

Lymphoma is a general term for a group of cancers that originate in the lymphatic system. The lymphomas are divided into two major categories: Hodgkin lymphoma and all others lymphomas, called Non-Hodgkin lymphomas. is to study the peripheral blood immunophenotypic features of T- lymphomatous cells among patients with Non-Hodgkin Lymphoma [NHL] attending Menoufyia University Hospitals, compared to normal, by 2-color flow cytometry immunophenotyping. The ratios of the subsets of T-lymphocytes and NK cells in the peripheral blood were measured for 25 NHL patients receiving treatment and attending for follow up by the consultant of oncology department, Minoufiya university hospitals. They were compared with those of 15 healthy, agematched controls. The measurements were accomplished by flow-cytometry. The patients had significantly decreased ratios of CD4+, CD8+ T-cells and CD4/CD8. With non-significant increased ratio of CD56+ [NK-T cells] comparing to controls. The subsets of T-Lymphocytes [T-helper and T-Cytotoxic] are suppressed in patients of NHL who receiving treatments than in controls. Neither presence of NK-T cells nor their absence helps in identifying the NHL disease

Light microscopic study of the effect of zinc on liver in mice

The study demonstrated that zinc affected the liver cells by giving the mice particular doses of zinc as Znso4. The mice were divided into four groups of 6 mice each. Both of moderate and high dose groups showed various degrees of degenerative changes in the hepatocytes, such as increased size and the presence of spaces, dark appearance of the cytoplasm, whereas none of these changes were present in both group] [controls] and group II [low dose group]. According to previous studies, there is a correlation between certain doses of zinc and the changes that may occur in the liver cells. The study was conducted on mice, which were divided into four groups of six mice each. Group I received tap water during the entire period of experimentation [30 days], group II, group III and group IV were received 5 mg, 10 mg and 15 mg/Kg body weight zinc as Znso4 consecutively [orally and daily]. Sections of livers were made and examined by light microscope. Zinc affected liver cells [hepatocytes] in mice under certain doses. Group III and group IV animals which received 10 mg and 15 mg/kg body weight zinc as Znso4 consecutively showed various degrees of degenerative changes in the hepatocytes, such as increased size and the presence of spaces, dark appearance of the cytoplasm. The degree of these changes was more abundant in liver cells of high dose group in comparison with the changes in liver cells of moderate dose group, whereas none of these changes were present in both group I [controls] and group II [low dose group] which received tap water and 5mg/kg body weight zinc consecutively. Certain doses of zinc could cause damages to the liver cells

use of semi rigid ureteroscopy and lithoclast for proximal and distal ureteral calculi

Objectives: advances in endoscopic equipment have facilitated access to the proximal urinary tract and have expanded the indications for ureteroscopy. Our aim is to assess the safety and efficacy of ureteroscopy performed for proximal and distal ureteral calculi with the use of the lithoclast

Patients and Methods: eighty one patients underwent semi-rigid ureteroscopy for ureteral calculi at the Urology Department, Minia University hospital between January 2003 and February 2006 were included in this study. Thirty nine patients had distal ureteral calculi, 22 patients with mid ureteral calculi and 20 patients with proximal ureteral calculi. The lithoclast was the only available lithotripter in all the · patients

Results: complete fragmentation was achieved in all accessible calculi, all cases [39/ 39] 100% with distal, [18/22] 82% with mid and [16/20] 80% with upper ureteral calculi. The lithotripsy time was 8.5 minutes for stones< or =1 cm and 12 minutes for stones ranging from 1.1 to 1.8 cm. Completely fragmented stones cleared spontaneously within two weeks in 97.5% of cases and all patients were free of calculi one month after the procedure. Re-treatment with the lithoclast was required in four patients for large residual fragments. The mean hospital stay was 1.2 · days. Complications were minimal and were managed conservatively

Conclusions: ureteroscopic management of proximal and distal ureteral calculi is highly successful, and the difference in success rates has narrowed. Recently no greater risk is added to the patient for endoscopy of more proximal ureteral calculi. The addition of the flexible ureteroscope could make the success rate comparable. The lithoclast is a safe effective and reliable method of intracorporeal lithotripsy

Knowledge and attitude of physicians towards penicillin use

The aim of this work was to study the knowledge and attitude of physicians towards the use of penicillin to encourage its use in the treatment of infection. Physicians who accepted the penicillin use were 262, the i.m. route was preferred by 222 and crystalline penicillin was preferred by 116. Penicillin was considered to be effective by 230 and other antibiotics were used to treat tonsillitis by 227