Diagnostic Accuracy of Imprint Cytology and Frozen Section for CNS Tumor.

The present study was a cross-sectional type of descriptive one carried out with the objective of determining the diagnostic accuracy of imprint cytology and frozen section of central nervous system tumors. A purposively selected sample of 33 clinically diagnosed patients with CNS tumors has been included for the study. The relevant data on CNS tumors were collected by using imprint cytology, frozen section and paraffin section. The sensitivity of imprint cytology was 75.0% and specificity was 55.17% respectively. On the other hand positive predictive value of imprint cytology was 18.75% and negative predictive value was 94.11%. The sensitivity of frozen section was 100% and specificity was 86.21% respectively. Comparing the findings of the frozen section to histopathology, the positive predictive value was 50.0% and negative predictive value was 100%. The sensitivity and specificity of imprint cytology was lower in comparison to frozen section and paraffin section. Still then imprint cytology is preferred, because it can be carried out rapidly and easily. It will also be a very helpful aid especially when facilities for frozen section are limited but neurosurgical-procedure is available. A well designed research with adequate sample size should be carried out to get better diagnostic accuracy of imprint cytology in central nervous system tumors.

Molecular phylogenetic characyerization of Echinococcus spp. hydatid cyst based on internal transcribed spacer genes in Assiut, Egypt

Hydatidosis is one of the most important parasitic zoonosis and remains a public health and economic problem all over the world. The disease is endemic in many parts of the world. Reports on the species and strains of Echinococcus present in Egypt appear controversial. In the present study hydatid cysts were collected from freshly slaughtered camel at local abattoir, Assiut, Egypt. Hydatid cysts were genetically characterized by polymerase chain reaction [PCR] amplification and sequencing of internal transcribed spacer genes one and two [ITS1 and ITS2] of nuclear ribosomal DNA [rDNA] by using specific primers. The lengths of ITS1 and ITS2 sequences were 583 bp and 517 bp respectively for hydatid sample sequenced. Comparisons of ITS sequences of the examined hydatid sample in the present study revealed that collected hydatid represented Echinococcus Canadensis, which provides foundation for further studies on Echinococcus in Egypt. The data obtained will facilitate the development of diagnostic tools necessary to study the population genetic structure and epidemiology of this enigmatic parasite

A Case Report on Angiomyxoma.

Aggressive Angiomyxoma (AA) is a rare variety of soft tissue tumour of pelvis and perineum occurring almost exclusively in adult females. AA is most often found in or in proximity to the lower pelvis, more specifically perineum, vulva, vagina or inguinal regions. Here we report a case of angiomyxoma. She is a 40 years old house wife, presented with a brownish, soft, multilocular, pedunculated nontender solid mass in the left side of the vaginal wall. Though initially it was provisionally diagnosed as a case of cervical polyp, ultimately histopathology proved it to be a case of Aggressive Angiomyxoma.

Kikuchi's Disease: A Case Report.

Kikuchi's disease is also known as histiocytic necrotizing lymphadenitis. Kikuchi-Fujimoto disease (KFD) or histiocytic necrotizing lymphadenitis, is a rare benign, self-limiting cervical lymphadenitis of unknown etiology. It predominantly affects young women and can closely mimic infective and immunological disorders. Recognition of this condition is crucial, specially because it can easily be mistaken for tuberculosis, lymphoma, or even adenocarcinoma. We report an 18 years old girl who presented with fever and cervical lymphadenopathy. She had multiple enlarged cervical lymphadenopathy. Examination of other systems was normal. Laboratory investigations were also normal. Fine needle aspiration cytology of the cervical node was not done. The patient took a course of oral antibiotics. Since the patient did not respond, lymph node biopsy was done and the histological features suggested the diagnosis of Kikuchi's disease. The Patient was treated symptomatically and complete remission occurred in few weeks. Although the incidence of Kikuchi-Fujimoto disease is rare, clinicians should be aware of this condition as early recognition of the disease will minimize potentially harmful and unnecessary evaluations and treatments.

Treating Asthma in Pregnancy - An Update.

Asthma is one of the most common chronic medical conditions affecting the lungs during pregnancy. At any given time, up to 8% pregnant women have asthma. During pregnancy, asthma not only affects the woman, but it can also cut back on the oxygen to fetus. But this does not mean that having asthma will make pregnancy more difficult or dangerous to fetus. Pregnant women who have asthma that is properly controlled generally have normal pregnancies with little or no increased risk to pregnant women or their developing babies. Currently available national guidelines for the treatment of asthma during pregnancy emphasize the objective measurement of control, patient education, motivation, caution and medication adherence. The article reviews the available literature highlighting the appropriate selection of medications in the treatment of asthma during pregnancy, and to identify those factors which may influence the asthma care provider's ability to successfully manage this condition, and also illustrate that maintaining asthma control with long term medications in pregnancy is safer than the risk of uncontrolled asthma or untreated exacerbations for both the mother and the fetus. Women's drug treatment during pregnancy should be regularly assessed in the light of asthma control criteria.

"Nonunion of Adult Humerus Fracture" - Management Using the Ilizarov External Fixator.

Humeral shaft fractures occur about three percent of all fractures in adults. A very high union rate is achieved with non-operative treatment, however when nonunion occurs conservative approach or after operative management they are often very difficult to treat, and often requires multiple procedures to achieve union. Even with multiple procedures, true pseudoarthrosis have only a 59% union rate. The aim of this study was to find out the results of such complicated cases treating with Ilizarov's external fixator. We conducted a prospective study of eleven patients with nonunion humeral shaft fracture in adult wherein the outcome of the treatment was analyzed. In our series we achieved union in all of the cases with a mean of 29.1 weeks with negligible complications like pin tract infections and in one case refracture occur due to forceful manipulation. So it can be concluded that Ilizarov's method is an excellent option for the treatment of nonunion of diaphyseal fracture of the humerus.

The Role of SPECT-Guided CT for Evaluating Foci of Increased Bone Metabolism Classified as Indeterminate on SPECT in Cancer Patients.

Planar and SPECT bone scintigraphy has played a major role in the staging of many cancers such as breast and prostate cancer, as well as in orthopedics. Integrated diagnostic CT combined with SPECT has helped improve localization and characterization of skeletal lesions, improving diagnostic confidence and helping management decisions, over traditional SPECT. A major advantage has been improved characterization of indeterminate bone lesions and differentiation of benign from malignant lesions due to additional CT information. In this treatise the role of SPECT-guided CT for evaluating foci of increased bone metabolism classified as indeterminate of SPECT in cancer patients is reviewed. Using this approach, the diagnostic confidence in differentiating malignant from benign bone lesions should better with the fused SPECT/CT image than with separate sets of bone scintigraphic and CT images.

Post-discharge surveillance of wound infections by telephone calls method in a Sudanese teaching hospital

Surveillance of wound infections has been shown to be a powerful preventive tool, and feedback to the clinical staff reduces wound infection rates. The main objectives of this study were to identify the applicability of telephone calls as a method of post-discharge wound infection surveillance, and to identify patients and procedures characteristics associated with loss for follow-up after hospital discharge. This was a prospective cohort study conducted in Khartoum Teaching Hospital, Sudan. Patients, aged >18 years admitted for elective clean and clean-contaminated surgery during March 1[st] to 31[st] October 2010 were recruited. 1-month surveillance of wound infections was conducted with telephone interviews. Overall 3656 patients were operated on. Of them 1769 [48.4%] were eligible [mean age 37.8+14 years; females, n=1472 [83.3%]]. The performed surgical interventions were 1814. Of these 1277 [70.4%] were clean-contaminated and 537 [29.6%] were clean. Patients who successfully completed the follow-up were 1387 [78.4%], while 368 [20.8%] were lost, and 14 [0.8%] died. The percentage of male patients [85.3%] who successfully completed the follow-up was significantly higher than females [77.8%]; [P=0.002]. Wound infection was detected in 15 [0.8%] cases during hospital stay and 110 [6.2%] others after hospital discharge. The majority of wound infections in the current study appeared in post-discharge period; this emphasis the need for establishment of surveillance program in the hospital. Surveillance of wound infections using telephone calls is applicable in this setting and can be used as an alternative method to clinic-based diagnosis of wound infections

Image analysis assessment of fibrosis from liver biopsy of chronic hepatitis patients

Liver fibrosis results from chronic inflammation of the hepatic parenchyma. Progressive accumulation of fibrous tissue eventually leads to cirrhosis and its complications. The severity of liver fibrosis defines the stage of chronic hepatitis and carries with it important clinical implications. Histological scoring systems such as Ishak provide descriptive evaluation of the liver tissue mainly in terms of architectural changes without measuring the amount of fibrosis. This study aimed to assess the theoretical advantage of image analysis morphometry for providing truly quantitative data with respect to the amount of fibrous tissue. A Lieca Qwin 500 image analyzer with a damaged area morphometry software was used applying the interactive method to measure the fibrous tissue area on the basis of different colors of hepatocytes and fibers following staining with Masson's trichrome stain. Forty-three patients [38 men and five women] were recruited into the study with a mean age of 45.5 years [range 15-58 years]. Of them, 40 had chronic viral hepatitis and three had chronic nonviral hepatitis. Morphometric measurements of fibrosis obtained with the image analyzer were highly correlated with results obtained using the Ishak method. The correlation was found to be statistically significant using the chi2-test [P<0.0001]. Quantitative image analysis for estimation of the percentage area of liver fibrosis is a simple and accurate method for evaluating fibrous tissue in patients with chronic hepatitis, aiding therapeutic approaches

Abdominal Tuberculosis in Surgical Practice in Northern Nigeria

Background: Abdominal tuberculosis is a common complication of pulmonary tuberculosis. With the rising incidence of HIV; tuberculosis has become a major public health problem particularly in developing countries. Methods: This is a retrospective study involving patients whose surgical specimens were processed at the central histopathology laboratory of the Ahmadu Bello University Teaching Hospital (ABUTH) Zaria - Nigeria; between January1975 to December 2006. Results: There were 68 males and 49 females; aged 12-70 years (mean 28.6yrs 11yrs). While paroxysmal dry cough was present in about 20 patients; abdominal pain and distension were very common. Concomitant pulmonary tuberculosis was confirmed in 15 patients (14). The findings at Surgery in 66 patients are presented in fig.2. Multiple deposits on the peritoneum and momentum were the commonest findings (48.7and 26.2) respectively. Conclusion: Abdominal tuberculosis is not uncommon and there is need to establish an early less invasive diagnostic protocol

Blood pre-donation deferrals--a teaching hospital experience.

Blood donor selection contributes to the safety of both the donor and the recipient. The objective of this study was to identify the number and causes of blood pre-donation deferrals at the Hospital Universiti Sains Malaysia (HUSM). A retrospective study was carried out to retrieve data regarding deferred blood donors at the HUSM in the year 2006. A total of 4,138 blood donors donated blood at the Transfusion Medicine Unit, of whom 231 were deferred or rejected as donors. The percentage of deferred donors was 5.6%. The main reason for deferral was a low hemoglobin (40.7%), with females constituting the majority of those deferred. This was followed by high blood pressure (29.4%) and male donors were predominant in this group. Medical illness caused 15.6% of donor deferrals. The majority of deferred donors were regular donors (64.1%). We recommend setting new hemoglobin criteria for donor deferral according to the reference range obtained for the particular population. Most of the other deferrals were preventable by proper health care education and awareness.

Trends in hepatitis B virus infection among blood donors in Kelantan, Malaysia: a retrospective study.

The objective of this study was to determine the prevalence and trends in hepatitis B infection among blood donors attending the Transfusion Medicine Unit at the Hospital Universiti Sains Malaysia, Kelantan, Malaysia. A retrospective study was carried out by reviewing the results of HBsAg among blood donors for the years 2000 to 2004. During this period, 44,658 blood donors were studied. We noted that there was a significant difference in the prevalence of hepatitis B infection between regular and first time donors. There was also a decreasing trend noticed in both study groups. The mean prevalence was significantly different between first time (1.83%) and regular donors (0.45%) (p < 0.005). There is a need to improve public awareness programs to lower the incidence of hepatitis B infection in the general population and consequently first time blood donors. Future studies are also required to determine the trends and outcomes of these programs.

Identification of hemoglobin AC heterozygote status in a Malay family: a decision between hemoglobin electrophoresis and high performance liquid chromotography.

Thalassemia is a common public health problem among Malays. Hemoglobin C (Hb C) is a hemoglobin beta variant resulting from a single base mutation at the 6th position of the beta-globin gene leading to the substitution of glycine for glutamic acid. Hb C is commonly detected in West Africans and in African American but has not been reported in Malaysia. It can be falsely diagnosed as HbE trait in the Malaysian Thalassemia Screening Program which utilizes cellulose acetate hemoglobin electrophoresis. This is the first reported case of Hb AC heterozygote status in a Malay family, with unusual splenomegaly in one of the family members.

Thalassemia among blood donors at the Hospital Universiti Sains Malaysia.

The aim of this study was to screen and identify the types of thalassemia among blood donors at the Hospital Universiti Sains Malaysia (HUSM). Thalassemia screening was performed by hemoglobin electrophoresis. A total number of 80 blood samples were obtained from donors at the Transfusion Medicine Unit, HUSM. The ethnic origins of the donors were Malays (n=73, 91.3%) and non-Malays (n=7, 8.75%). Males comprised 88.1% of the donors. Thalassemia was detected in 16.25% (n=13) of the blood donors. Of those with thalassemia, 46.2% (6/13) were anemic. Microcytosis and hypochromia were detected in 84.6% (n=l1) and 84.6% (n=l1) of these donors, respectively. The types of thalassemias detected were Hb E, 11.25% (n=9/80) and beta thalassemia trait, 5% (n=4/80). Among the thalassemias detected, the Hb E hemoglobinopathy was comprised of Hb E/ alpha-thalassemia (38.5%: n=5), Hb E /beta-thalassemia (23.1%: n=3), Hb E trait (7.6%: n=1) and beta-thalassemia (30.8%: n=4). In conclusion, screening for thalassemia trait should be included as part of a standard blood testing before blood donation. Further studies are required to look at the effects of donated thalassemic blood.

The prevalence of human cytomegalovirus seropositivity among blood donors at the Unit of Blood Transfusion Medicine, Hospital Universiti Sains Malaysia.

Human cytomegalovirus (HCMV) is a species-specific DNA virus of the Herpetoviridae family. After a primary infection, HCMV persists in a latent form most probably in bone marrow progenitor cells or in peripheral blood monocytes. The virus can reactivate to result in shedding of the virus leading to virus dissemination and new infections. Immunocompromized patients are the ones most vulnerable to serious diseases occasionally acquired in blood transfusions. In a human population, HCMV seropositivity increases steadily with age to become approximately 100% in adults. This study was performed to detect seropositivity among regular blood donors in The Hospital of the Universiti Sains Malaysia, in the state of Kelantan. Using an enzyme immunoassay, it was found that 97.6% of blood donors were HCMV-positive. HCMV is highly prevalent and may be endemic in Kelantan. Hence, long-term strategies are required for the reduction of disease dissemination, and to prevent the exposure of immunocompromized patients to the virus.

Anaemia in hospital patients in southern Sudan.

A random survey involving 1847 patients attending Juba Teaching Hospital irrespective of complaint revealed presense of anaemia in 79.53% of cases. The prevalence in children under 9 years was 94.83%.

Prevalence of blood groups in tribals of South Sudan.

Prevalence of ABO blood groups and Rhesus-factor in Southern Sudanese is shown in the Study. 42.81% were group A. group AB was the least common. Only 0.47% were negative for RH-factor.