Parathyroid Hormone Secreting Metaplastic Breast Carcinoma: A Case Report of Paraneoplastic Syndrome

Paraneoplastic syndrome (PNS) is a distant neurological manifestation of an underlying tumour. Humoral hypercalcaemia of malignancy is a form of paraneoplastic syndrome where there is an increased in calcium levels. In this article we report a 48 year old lady, with no known medical illness and presented with symptomatic hypercalcaemia. She presented to our institution complaining of a fungating and ulcerating mass over the right breast, measuring 11 X 15 cm and associated with gradual paraxial body weakness. Further investigations revealed the lesion to be an invasive breast carcinoma with metaplastic features. Computed tomography (CT) scan showed a locally advanced breast carcinoma with right axillary node metastasis, without evidence of distant metastasis. Serum calcium, i-PTH together with SPECT has confirmed the patient to have a humoral hypercalcaemia malignancy with elevated ectopic parathyroid hormone level. Bone scan did not reveal any evidence of metastasis. High volume intake and loop diuretics were employed in the management of hypercalcaemia, which was eventually resolved following mastectomy with axillary clearance of the ipsilateral side. Currently she’s she is under oncologist’s follow up for further management.

parasitic profile among school children in El-Wadi El-Gadded Governorate, Egypt

Parasitic infection is still a serious public health problem in the world, especially in developing countries including Egypt. It represents a major cause of morbidity and mortality in childhood and among high-risk groups in most parts of the world. This study detected the prevalence of parasitic infection among school children in El-Wadi El-Gadded [the New Valley Governorate]. A total of randomly chosen 1615 students aged from 6-16 years, [771 males and 844 female] from 12 primary schools and 12 preparatory schools related to four centers [El Dakhala, El Farfra, Paris and Platt] from the New Valley Governorate. Each child was subject to: A questionnaire sheet, Urine examination through sedimentation methods, Stool examination using: Direct smear, Simple sedimentation method and Modified Ziehl-Neelsen Stain, Blood samples were collected randomly from 450 children and examined for Seropositivity of toxoplasmosis using [On-SiteToxoIgG/IgM Rapid Test-Cassette] and examination of hair and clothes for ectoparasites [lice]. The overall prevalence of parasites was [39.1%] among primary and preparatory school children. The helminthes were E. vermicularis [15.2% and 17. 1%]; A. lumbricoides [1.3% and 1.9%] and then H. nana [0.9% and 0.6%] and the protozoa were E. histolytica [14.1% and 13.2%], Giardia lamblia [3.8% and 309%], and then Cryptosporidium parvum [0.09%] and seropositivity of toxoplasmosis was in [3.0% and 2.7%] among primary and preparatory school children respectively. Mixed infection was in [0.4%] among primary school children. Head lice infestation was more prevalent among primary school children than preparatory school ones with a ratio [3.5% and 0.2%] respectively, was nil among males

Role of parasites among chronic diarrheic patients

This work studied the role of parasitic infection among 85 chronic diarrheic patients in Delta region and cross-matched 20 normal controls. They were subjected to thorough history taking and clinical examination and stool examination by direct smear, formol-ether concentration, simple sedimentation, simple floatation and Kato-katz thick smear. Questionnaire sheet was obtained for each case included personal history, complaint, present as well as past history and family history. The results showed that 67.1% of patients suffered from parasites versus 20% in controls. They included giardiasis mixed with hymenolepiasis nana, ameobiasis; ascariaisis, S.mansoni, heterophyiasis, B. hominis, Taenia spp and enterobiasis respectively. Single infection represented 54.2 %, while mixed ones were 12.9% of total chronic diarrhea cases and non-parasitic causes were responsible for 32.9%. Mixed infection was common in A. lumbricoides with E.histolytica [18.18%] and H. nana with G. lambia [27.28%]. The diarrhea duration was longer in mixed infections [3 months], E.histolytica [2 months] and H.nana [1.5 months]. Commonest symptom other than diarrhea was abdominal pain mainly in mixed parasitosis. Parasitic diarrhea was more common in males than females [1.28: 1]. Chronic parasitic diarrhea was most prevalent among low social class [49 or 57.6%] followed by very low social class [20 or 23.5%], middle social class [10 or 11.7%] and finally high social class [6 or 7.1%] with significant increase in low social class as compared to high one, and most prevalent among positive cases in rural area than in urban area

Histopathological, histochemical and biochemical studies on hepatic hydatid cysts of some animals

Cystic echinococcosis is considered as a major cosmopolitan zoonotic disease affecting the health of man. Naturally infected hepatic cysts from camels, pigs, and sheep were collected from El-Basateen abattoir for histopathological, histochemical and biochemical, studies. Total proteins, uric acid, urea, cholesterol, triglycerides, AST, ALT, GOT, Alkaline phosphatase LDH, Na, K, and calcium showed a higher concentration in fertile cysts while creatinine only had a higher concentration in sterile ones. Dystrophic changes were observed in the infected liver specially around the cyst wall and around the portal areas this was accompanied with increased collagenous fibres. The cyst wall showed remarkable reaction for total proteins in camels and pigs associated with less stain affinity in the hepatocytes. A remarkable reaction for polysaccharides was detected in the cyst wall of all the studied animals comparing to hepatocytes

Varicella induced thrombocytopenia in adults

To describe the frequency and severity of thrombocytopenia associated with adult chickenpox patients admitted in the hospital. This was a hospital based descriptive study conducted from January 2005 to March 2008 at the Infectious Diseases Unit, Rashid Hospital Dubai, United Arab Emirates. The study was designed to record demographics, clinical information, hematological and biochemical changes observed in each patient. The data was entered into a structured proforma separately. Patients with history of chronic liver disease, immunocompromized status [HIV/Drugs], history of blood disorder, recent intake of drugs/conditions which can cause thrombocytopenia and active alcohol consumers were excluded from the study. Full blood count including platelet count was performed by an automated Beckman Coulter machine. To verify the hematological finding, the cases with low platelet count [thrombocytopenia] were subjected to peripheral smear examination. A total of 110 patients were recruited into the study. The mean age +/- SD of the patients under the study was 32.9 +/- 9.7 years and males outnumbred the females, 83.6%vs 16.3%. Forty six [41.8%] patients developed thrombocytopenia and their mean platelet count was 111.8 +/ -30.59x10[3] /ul [24-149x10[3] /ul]. High frequency of thrombocytopenia was observed in patients who also had associated varicella pneumonia, hepatic dysfunction and renal impairment. None of the patients with thrombocytopenia developed bleeding manifestations during the course of the disease. Platelet count returned to the reference range within 1-2 weeks of the treatment of varicella without platelet transfusion. Thrombocytopenia is frequently associated with chickenpox. The incidence of thrombocytopenia was observed higher in patients with the evidence of disseminated disease. Furthermore, low platelet count usually does not cause bleeding tendency and count improves with the treatment of varicelta

Hematological and biochemical changes in typhoid fever

The hematological and biochemical changes due to multi-organ involvement in typhoid fever are not uncommon. The aim of this study was to determine the frequency and severity of the above changes in adult patients admitted to the hospital because of typhoid fever. This was a hospital based descriptive study conducted at the Infectious Diseases unit and medical wards at Rashid Hospital Dubai, United Arab Emirates, from March 2005 to February 2008. The study was designed to include demographics, clinical information, hematotogical and biochemical changes observed in each patient. Only patients whose blood culture yielded Salmonella typhi were included in the study. Full blood count, liver function tests, blood culture, urea, electrolytes, malaria parasite and coagulation profile were performed for all the patients, whereas viral hepatitis serology and ultrasound abdomen were limited to those with disturbed liver function tests. The patients with ALT> 3 times of normal were screened for viral hepatitis [A, B, and C] serology, whereas the patients' with significant hematologicat changes were subjected to bone marrow examination. A total of 75 patients were enrolled into the study. The mean age +/- SD of the patients under the study were 28.4 +/- 8.7 years and males outnumbered the females, 81.3% vs. 18.6%. The most common hematological changes observed were; anemia [61.3%], thrombocytopenia [40%], leucocytosis [10.6%] and leucopenia [4%]. Whereas, the biochemical changes included; raised alanine aminotransferase [73.3%], aspartate aminotransferase [62.7%], bilirubin [30.6%], alkaline phosphatase [44%], prothrombin time [57.3] and blood urea [12%], but the serum albumin was found to be low in 40%. The patients with raised ALT had high frequency of thrombocytopenia [p <0.04], raised serum bilirubin [p <0.02], alkaline phosphatase [p <0.01] and prothrombin time [p 10-fold of normal levels in 8%, serum bilirubin was >3mg/dI in 10.3% and prothrombin time was 3 sec above the control in 8% patients. All the patients were discharged in good health once hematotogical and biochemical changes returned to reference range. Typhoid fever causes significant hematological changes as well as hepatic dysfunction. The involvement of liver was associated with high frequency of extrahepatic complications. Despite the high incidence and serious nature of the hematological changes and liver involvement, these changes are transient and respond favorably to the appropriate antimicrobial therapy

An anatomical study on pyramidal lobe of thyroid gland in Bangladeshi people.

The study was done to see the incidence of pyramidal lobe of thyroid gland including its position, attachment, length and incidence of its association with levator glandulae thyroidae in Bangladeshi population. Sixty postmortem tissue blocks containing thyroid gland and its related neighbouring structures were collected from 48 male and 12 female cadavers of different age groups and fixed in 10% formol-saline solution. Gross and fine dissection was carried out to study the incidence of presence of pyramidal lobe, its attachments, length, breadth and association with levator gladulae thyroidae. In the present study, findings were compared with those of Western and Bangladeshi researchers. It was evident that, fifty percent of the thyroids possesses pyramidal lobe. Incidence was more in male (52.1%) than in female (41.7%). It also appeared from the observations that, this lobe was commonly situated on the left side. In the majority of cases (56.66%), base of the pyramidal lobes were attached to the upper border of the isthmus with or without encroachment on the adjacent part of the left lobe. The range of length and breadth of the pyramidal lobe was from 1.8 to 35mm and 1.3 to 19mm respectively. In 73.33% cases, pyramidal lobe was associated with levator glandulae thyroideae and in only 26.66% cases pyramidal lobe was found independently.

Hepatic dysfunction is frequent in varicella infection

To determine frequency and severity of hepatic dysfunction in adult chickenpox patients admitted in our hospital. This was a hospital based descriptive study conducted from January 2005 to December 2007 at the Infectious Diseases Unit, Rashid hospital Dubai, UAE. The demographics, clinical information, radiological and biochemical changes observed in each patient were entered in a proforma. Full blood count, liver function tests, blood sugar, urea and electrolytes were done for all the patients, whereas, patients with clinical and/or biochemical evidence of hepatic dysfunction were subjected to viral hepatitis serology, coagulation profile, blood culture and ultrasound abdomen. Management was done as per standard guidelines for the management of chickenpox and its complications. A total of 105 patients were entered into the study. Serum alanine transaminases [ALT] levels were above the reference range in 50.9%. Among the 52 patients with raised serum ALT levels, 16 [30.7%] had levels > 3 times, 4 [7.6%] had > 5 times and 5 [9.6%] had > 10 times of normal levels. Serum bilirubin was increased above the normal value in 20% and was greater than 3-folds in 4.9%. High frequency of thrombocytopenia [p < 0.009], pneumonia [p0.004], impaired renal function [p < 0.01] and disturbed coagulation profile [p < 0.01] were observed in patients with hepatic dysfunction. Overall, five [4.9%] patients expired and two [1.9%] of them had acute fulminant hepatic failure. We observed that liver is frequently involved in adult chickenpox patients and the severity of hepatic dysfunction ranges from mild elevation of transaminases levels to acute fulminant hepatic failure

Effect of drying methods on the chemical and technological properties of the instant talbina powders

Talbina, cooked barley syrup, is made by cooking barley flour in water. It was subjected to different drying methods, freeze-drying, spray drying and under vacuum drying to produce instant Talbina powders [A], [B] and [C], respectively. Chemical composition, scanning electron microscope [SEM]; X-ray diffraction, differential scanning colorimeter [DSC] and color attributes of the barley flour and the produced instant Talbina powders were studied to see the effect of the drying methods. Reconstitution capacity of the instant Talbina powders was studied. Adding milk improved the organoleptic properties of the reconstituted instant Talbina powders, while adding vanilla deteriorated these organoleptic properties. Reconstitution capacity of the instant Talbina powder [B] recorded the highest score in aroma, taste and overall acceptability compared with reconstituted instant Talbina powder [A] and [C], respectively. Instant Talbina powder can be produced by spray drying of cooked solution of Talbina with big quantity, economic costs, high reconstitution capacity and good quality in color, aroma, taste and overall acceptability

Loa loa infection in non-endemic area: a case study and disease review

Loiasis is a cutaneous filarial parasite of humans caused by the filarial nematode Loa loa, which is transmitted to humans by day-biting Chrysops flies. Human loiasis is confined to the rain forest and swamp forest areas of Western and Central Africa; however; sporadic cases hove been reported from other parts of the world including India. United Arab Emirates is relatively free from arthropod-borne parasitic diseases, but the region remains vulnerable to the introduction of such infections from areas where they are endemic due to a high traffic of a large expatriate population. We report a suspected case of loaiasis in a patient from India who lived and worked in Dubai, UAE, for several years and who had never visited Africa in the past. We assume that this is the first case of loaiasis reported from the gulf region where transmission of the infection has occurred outside the endemic areas

Preparation and evaluation of instant noodles made from wheat, rice, sorghum flours and their blends

The suitability of using wheat, sorghum flour and their blends in the manufacture of instant noodles is evaluated from the chemical, physical and rheological point of views. Viscoelastic and thermal properties were elucidated using viscoamylograph and differential scanning colorimeter [DSC]. Other technological parameters like, cooking quality, colour attributes and sensory evaluation techniques were used to characterize the physicochemical properties of these noodles. Comparing between steam and microwave as a method of starch gelatinization. The microwave treatment of the [wheat + rice] and [wheat + rice + sorghum] blends gave the lowest values in cooking loss. Also this treatment lowered the colour attribute values towards more whitness [L], less redness [a] and less yellowness [b]. The panelists preference are directed towards wheat noodles and their blends [wheat + sorghum], [wheat + rice] and [sorghum + rice + wheat] which gave the best scores in colour, flavour, mouthfeel, elasticity and overall acceptability