Testicular embryonic rhabdomyosarcoma, case report with brief literature review

Rhabdomyosarcoma [RMS] is a malignant solid tumour arising from mesenchymal tissues which normally differentiate to form striated muscle. It can occur in a wide variety of sites. It is one of the most frequently occurring soft tissue sarcomas and commonest in children under age of 15 years 1. Approximately 350 new cases are diagnosed in the United States each year 2. Seven to 10% of primary genitourinary tumours are located in the para-testicular region. Scrotal rhabdomyosarcomas originating from paratesticular tissue are most frequently seen in childhood and young adults 3. Paratesticular rhabdo-myosarcomas are very rare, comprising only 1: 2,000 tumours of the male genital system 4. It constitutes 7% of all rhabdomysarcomas 5. The disease may be subdivided into embryonal [which accounts for about 60%], pleomorphic, alveolar and botryoidal types. Embryonal RMS is most commonly found in head and neck, genitourinary and retroperitoneal sites 6. The tumour is slightly more common in boys and males [11.8 per million] than in girls and females [10.3 per million]2. The age incidence varies from 21 months [Sabrazes et al, 1923] to 67 years [Prince, 1942]3. However, some had reported racial and gender differences in the incidence of RMS7. Here we report an adult male of paratesticular embryonal RMS. He was lost trace for a while till he present with advanced metastases to the retroperitonium and a multidisciplinary management was held later

Prospective randomised controlled trial of teaching medical students behavioural sciences

In the last few decades, medical professionalismcame upas a challenging issue to teach and assess. To compare the level of understanding of the medical professionalism, medical ethics and human rights among the first year and fifth year medical students at Omdurman Islamic University in Sudan. Prospective randomised controlled trial. Students were randomized in to four groups during teaching of behavioural sciences which was given at different spectra in the different groups. Responders were 365[91.25%], they were 143[39.2%] first year males, 141[38.6%] first year females split in two groups and 81[22.2%] fifth year mixed male and female.Conceptual understanding of medical ethics, professionalism, human rights and the religion values as part of the university requirement were assessed with a pretested questionnaire. Of the fifth year students 69[86.3%] were able to describe triggering organisational help for patients as an advocacy and 119[83.2%] first year male students were able to identify that availing medical facilities to the disabled and the vulnerable groupsas basic human right. The majority [>90%] of all students were described well professional integrity and 132[93%] of first year medical students were able mention correctly the differences between the Healer and the professional and 83[58.5%] of fifth year students specified the confidentiality issue in taking informed consent, respectively. However, the students' categorised the regulation of organ transplantation and tissue engineering has human rights followed by Religion Teachings bases. Teaching medical ethics, human rights, professionalism and University requirements to the first year medical students and gains during the practical experience of the clinical clerkship have a considerable impact on the student perception of these subjects. Gains are expected to improve if these issues are integrated in all areas of the curriculum

Mortality at Ibn sina surgical gastroenterology unit as predicted by possum with brief literature review

Failure to identify the high ris k factors for surgery and/or anesthesia is a serious medico-legal pitfall particularly if unexpected consequences ensue. Compare the mortality rate at Ibn Sina Surgical gastro-intestinal unit using POSSUM predicted mortality with the observed mortality. A prospective collection of data for patients admitted in 6-month period. Demographic data, symptoms, co-morbid illnesses, physical examination, results of investigations, operative findings were recorded as well as the follow up for one month. The data was fed to a POSSUM computer program to determine the predicted mortality. The univariate and multivariate analysis was done with SPSS. 252 patients were studied. They were 132 [52.4%] males. Mean [ +/- SD] age 49[ +/- 12.29] range 10-90 years. 216 [85.7%] patients underwent suigrey. The overall observed mortality was 32 [12.7%] patients. 10 [27.8%] patients died before surgery. The highest mortality was 9 [27.3%] in cases of carcinoma head of pancreas. Carcinoma of the stomach has observed mortality of 6 [42.9%] patients while its predicted mortality range from 1.7% to 35.7% with mean of 17.9%. Multivariate analysis showed that factors which have significant association with the observed mortality are the physiological score P 0.0001, age P 0.0001, predicted mortality P 0.0001 and inoperability P 0.0020. POSSUM has under-predicted mortality in gastric, oesophageal and cholangiocarcinoma. The out come of management of other types of cancer as oesophageal and colorectal cancer as well as the benign diseases of the gastrointestinal tract is consistent with the predicted values of the POSSUM. Therefore POSSUM is a good risk adjusted criteria for predicting mortality in GIT surgical diseases at Ibn Sina Hospital