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Background@#Inflammatory bowel disease (IBD) is a chronic inflammatory immune-mediated condition that affects the gastrointestinal system and alters bone growth and bone mineral density (BMD). Here we aimed to study the prevalence and predictors of a low BMD in pediatric patients with IBD. @*Methods@#This retrospective cross-sectional analytical study included pediatric patients with IBD in whom BMD was evaluated using dual energy X-ray absorptiometry of the total body and lumbar spine. Osteoporosis was defined as a BMD Z-score ≤-2, osteopenia as -2 to -1, and normal as >-1. Clinical and laboratory findings were compared between patients with and without osteoporosis. @*Results@#Of the 48 patients, 30 (62.5%) were males, 35 (72.9%) had Crohn’s disease, and 13 (27.1%) had ulcerative colitis. The mean age at diagnosis was 9.9±2.8 years. The median age at the time of the BMD scans was 11.9 (interquartile range, 9.9–14.3) years. Total body BMD scans identified 13 (27.1%) and 16 (33.3%) patients with osteoporosis and osteopenia, respectively. Spinal BMD scans revealed that 17 (39.5%) and 14 (32.6%) patients had osteoporosis and osteopenia, respectively. A low body mass index (BMI) Z-score (p=0.038), ileocolonic disease location (p=0.008), and a low calcium level (p=0.008) were significant predictors of osteoporosis on the total body BMD scans. A low BMI Z-score (p=0.039), decreased hemoglobin level (p=0.018), low calcium level (p=0.033), and infliximab use (p=0.019) were significant predictors of osteoporosis on the spinal BMD scans. @*Conclusions@#This study showed a high prevalence of low BMD among pediatric patients with IBD. A low BMI, ileocolonic disease location, low hemoglobin and calcium levels, and infliximab use were significantly associated with osteoporosis.
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Abstract Introduction: Although many surgical techniques exist to manage obstructive concha bullosa, there continues to be a drive to find the least invasive technique with the fewest complications and best results. Objectives: The purpose of this study is to describe and assess the short- and long-term efficacy of a modified crushing technique for concha bullosa management. Methods: Patients who met inclusion criteria underwent a detailed nasal examination and cone beam computed tomography imaging prior to and after septoplasty with crushing surgery for obstructive concha bullosa. Patients were divided into short- and long-term groups based on their followup period such that the short-term group had a mean followup of 15.14 months (range 6->22 months) and the long-term group had a mean followup of 56.66 (range 29->80) months. Results: Twenty-four cases of obstructive concha bullosa were included in this study with 13 short-term and 11 long-term follow-ups. All patients showed a significantly decreased postoperative CB size (p< 0.001). There was no correlation between age and postoperative CB change in area (p = 0.39) and no significant difference in the amount of postoperative CB area reduction between the short-term and long-term groups (p = 0.35). No patients experienced bleeding, synechia, conchal destruction, or olfactory dysfunction on followup evaluations. Conclusion: Our modified crushing technique is a simple, effective, and lasting treatment option for concha bullosa. From our experience, there have been no complications and no instances of concha bullosa reformation during the follow-up period.
Resumo Introdução: Embora existam muitas técnicas cirúrgicas para o tratamento da concha bolhosa, ainda se busca encontrar uma técnica menos invasiva com menor número de complicações e melhores resultados. Objetivos: Descrever e avaliar a eficácia em curto e longo prazo de uma técnica de esmagamento modificada para o manejo da concha bolhosa. Método: Os pacientes que preencheram os critérios de inclusão foram submetidos a exame nasal detalhado e tomografia computadorizada de feixe cônico antes e após septoplastia com cirurgia de esmagamento de concha bolhosa. Os pacientes foram divididos em grupos de curto e longo prazo de acordo com o período de seguimento, de modo que o grupo de curto prazo teve um seguimento médio de 15,14 meses (intervalo de 6 a 22 meses) e o grupo de longo prazo teve uma média de seguimento de 56,66 (variação de 29 a 80) meses. Resultados: Vinte e quatro casos de concha bolhosa foram incluídos neste estudo, com 13 seguimentos de curto prazo e 11 de longo prazo. Todos os pacientes apresentaram uma redução significante no tamanho da concha bolhosa no pós-operatório (p< 0,001). Não houve correlação entre a idade e a mudança na área da concha bolhosa no pós-operatório (p = 0,39) e nem diferença significante na redução da área da CB no pós-operatório entre os grupos de curto e longo prazo (p = 0,35). Nenhum paciente apresentou sangramento, sinéquia, destruição da concha ou disfunção olfatória nas avaliações de seguimento. Conclusões: Nossa técnica de esmagamento modificada é uma opção de tratamento simples, eficaz e duradoura para a concha bolhosa. Com base nessa experiência, não houve complicações e qualquer caso de recorrência na formação da concha bolhosa durante o período de seguimento.
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@#Recent reports of natural human infection by Plasmodium cynomolgi indicate the increased risk of zoonotic transmission by this simian parasite. The P. cynomolgi Duffy binding protein 2 (PcDBP2) has a potential role in the invasion pathway of host erythrocytes, and it is a possible vaccine candidate against cynomolgi malaria. This study investigates the genetic diversity, haplotypes, and natural selection of PcDBP2 region II from isolates collected from wild macaques in Peninsular Malaysia. Blood samples from 50 P. cynomolgi-infected wild macaques were used in the study. Genomic DNA extracted from the blood samples was used as template for PCR amplification of the PcDBP2 region II. The amplicons were cloned into a plasmid vector and sequenced. MEGA X and DnaSP ver.6.12.03 programmes were used to analyse the DNA sequences. A genealogical relationship of PcDBP2 region II were determined using haplotype network tree on NETWORK ver.10.2. Result showed high genetic diversity (ð = 0.017 ± 0.002; Hd = 1.000 ± 0.001) of the PcDBP2 region II. The Z-test indicates a purifying selection, with population expansion as shown in Tajima’s D analysis. A total of 146 haplotypes of PcDBP2 region II were observed. Phylogenetic tree analysis showed that these haplotypes were grouped into three allelic types (136 for Strain B type, 9 for Berok type, and 1 recombinant type). In the haplotype network, PcDBP2 region II revealed no geographical groupings but was divided into two distinct clusters.
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@#In recent years, increasing cases of Plasmodium vivax complications had been reported all over the world. This former benign Plasmodium species is now recognized to be one of the human malaria parasites that can produce severe disease. In this article, we report two cases of sub-microscopic P. vivax malaria confirmed by PCR. Both patients were asymptomatic before treatment. They showed unusual presentations few days after initiation of antimalarial treatment. Both patients had subsequently completed antimalarial treatment and recovered completely.
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@#Enteral myiasis or intestinal myiasis is acquired by ingesting food or water contaminated with dipteran fly eggs or larvae. Here, we describe a patient with intestinal myiasis presenting with acute dysentery caused by the larva of Hermetia illucens. The larva was identified morphologically, and its species confirmed through molecular analysis using polymerase chain reaction and sequencing based on mitochondrial cytochrome c oxidase subunit I gene (COI).
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@#Paragonimiasis is an infection caused by Paragonimus, a lung fluke and is acquired by eating raw or undercooked crustaceans containing the infective metacercariae. Herein, we report a case of paragonimiasis in a Malaysian man who presented with incidental findings from chest radiographs. Examination of his biopsied lung tissue and sputum specimen revealed Paragonimus sp. eggs, whereas stool examination showed the presence of Giardia cysts. Patient was succesfully treated with praziquantel and metronidazole respectively.
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Background: Basal cell carcinoma is the most common form of skin cancer worldwide. It has a specialized microvasculature system that can be targeted by the pulsed dye laser using the theory of selective photothermolysis. Objective: To evaluate the efficacy and safety of single session versus two sessions of pulsed dye laser in the treatment of basal cell carcinoma. Methods: A total of 22 patients with basal cell carcinoma were collected in this randomized controlled trial. The patients were divided into two groups: Group I – 11 patients were treated by one session of pulsed dye laser, and Group II – 11 patients received two sessions of pulsed dye laser 2 weeks apart. The patients were assessed clinically and histopathologically after end of the treatment. Results: There was a significant improvement of basal cell carcinoma clinically and histopathologically. Maximal histological clearance rate was achieved in superficial basal cell carcinoma type, small-sized basal cell carcinoma <0.7 cm and in cases with strong inflammatory response after laser treatment. Treatment of basal cell carcinoma with two sessions of pulsed dye laser was more effective than one session treatment. Limitations: The small sample size of patients and the limited location of the lesions on the head compared with trunk and extremities. Also, the lack of adequate study power may prevent generalization of results. Conclusion: Pulsed dye laser proved to be a safe, effective and noninvasive modality for the treatment of basal cell carcinoma that can be used as a monotherapy in small-sized lesions. Also, it can be used to debulk large-sized lesions before surgery.
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Background: Diabetes mellitus and thyroid diseases are the most prevalent metabolic disorders in Sudan. The value of HbA1C reflects the glycemic status over the last 2-3 months. So, in this study, an insight for thyroid hormone regulation of glucose metabolism is investigated. Is to study the association between thyroid hormones levels, fasting blood sugar (FBS) and HbA1c in healthy adults.Methods: A cross sectional study was performed in a healthy Sudanese cohort in the period between September 2017 to November 2018, involving 610 healthy adult Sudanese aged 20 to 60 years. HbA1c, fasting blood sugar (FBS), T3, T4 and TSH were measured.Results: The study results demonstrated a significant association between the median concentration of T3 and T4 with plasma level of HbA1c. A significant linear correlation between serum concentration of T3 and fasting blood sugar (FBS) was observed. Inverse correlation was detected between serum TSH and HbA1c, FBS in study population.Conclusions: The present study concluded that FBS and HbA1c levels were increased with increasing of both T3 and T4. Based on this study all the thyroid patients’ especially hyperthyroid patients should have regular checkup of their glucose levels.
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Background: Hazards of graphene particles, as novel application in biomedicine and industry of electronics, have attracted extensive attention Large number of toxicological studies have evaluated the interactions of graphene nanomaterials with living systems Although many studies have been performed on graphene-induced toxic effects, toxicological data for the effect of graphene materials on the nervous system are lacking Aim: To follow whether graphene oxide nano-sheets (GONs) affect malonaldehyde (MDA), glutathione (GSH) and nitric oxide (NO) contents, also, mice brain neurotransmitters levels upon using different increasing doses at different time intervals Materials and methods: The present study focused on the biological effects of GONs, at 10, 50, 100, 250 and 500 µg/kg bw, on mice brain content of GSH, MDA and NO after 7, 28 and 56 days of injection Moreover, dopamine (DA), norepinephrine (NE) and 5-hydroxytryptamine (5-HT) levels, in mice brain, were also evaluated Results: Data obtained revealed significant decreases in GSH content coupled with significant increases in MDA and NO contents after GONs injection and these changes was dose and time dependent Meanwhile, DA and 5- HT levels s in mice brain revealed fluctuating responses, NE level showed significant elevations at different time intervals
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ABSTRACT Response surface methodology was used to optimize lincomycin production by Streptomyces lincolnensis NRRL ISP-5355 in submerged fermentation. Screening of fermentation medium components to find their relative effect on lincomycin production was done using Plackett-Burman design. Malt extract, dextrin, soluble starch and (NH4)2SO4 were the most significant nutrient influenced on lincomycin production. Central composite design was applied to determine optimal concentrations of these factors and the effect of their mutual interactions. The interaction between soluble starch and (NH4)2SO4 was found to enhance the production, whereas malt extract and dextrin exhibited an influence independent from the other two factors. Using this statistical optimization method, maximum lincomycin concentration of 1345 μg/ml was obtained which represented a 40.5 % increase in titer than that acquired from the non-optimized medium. This statistically optimized medium was employed for lincomycin production through immobilization of Streptomyces lincolnensis by adsorption on synthetic cotton fibers. Immobilization technique improved the concentration to 1350 μg/ml higher than that produced from free cells cultures and could be maintained for longer than 17 days in a repeated batch system.
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Background: Carotid artery stenting [CAS] had become widely used as an alternative to carotid endarterectomy [CEA] in revascularization therapy of carotid artery stenosis, especially in some high risk patients for surgical intervention
Objective: The purpose of this study was to evaluate the outcome and follow up of cases that undergo extracranial CAS at the Neuroendovascular Unit of Ain Shams University Hospital
Methods: During a 30 month period, 50 cases were enrolled and underwent carotid artery stenting with open cell [Protege [registered] - EV3] or closed cell [Wall stent[registered] - Boston scientific] stents. A filter device for embolic protection [Spider filter[registered] - EV3] was used. Clinical assessment with the National Institute of Health Stroke Scale [NIHSS] together with post procedural diffusion-weighted magnetic resonance imaging [DW-MRI] was used to determine cerebral embolization
Results: CAS was performed in 50 cases; 40 [80%] symptomatic and 10 [20%] asymptomatic. A similar number of open-cell and closed-cell stents were used. New acute cerebral emboli were detected with DW-MRI in 12% [6/50] of cases after the procedure. Three [3/50] cases [6%] showed corresponding clinical deterioration in NIHSS; two cases developed minor stroke and the third case developed a major stroke
Conclusion: CAS at Ain Shams Neuroendovascular Unit showed a high technical success rate and good short term clinical outcome
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Endovascular Procedures , Stents , Diffusion Magnetic Resonance Imaging , Treatment Outcome , Intracranial EmbolismABSTRACT
<p><b>OBJECTIVE</b>In this study, the ameliorative effects of gold nanoparticles (gold NP) on the renal tissue damage in Schistosoma mansoni (S. mansoni)-infected mice was investigated.</p><p><b>METHODS</b>High-resolution transmission electron microscopy was used for the characterization of NP. The gold NP at concentrations of 250, 500, and 1000 μg/kg body weight were inoculated into S. mansoni-infected mice.</p><p><b>RESULTS</b>The parasite caused alterations in the histological architecture. Furthermore, it induced a significant reduction in the renal glutathione levels; however, the levels of nitric oxide and malondialdehyde were significantly elevated. The parasite also managed to downregulate KIM-1, NGAL, MCP-1, and TGF-β mRNA expression in infected animals. Notably, gold NP treatment in mice reduced the extent of histological impairment and renal oxidative damage. Gold NP were able to regulate gene expression impaired by S. Mansoni infection.</p><p><b>CONCLUSION</b>The curative effect of gold NP against renal toxicity in S. mansoni-infected mice is associated with their role as free radical scavengers.</p>
Subject(s)
Animals , Male , Mice , Drug Evaluation, Preclinical , Gold , Therapeutic Uses , Kidney Diseases , Parasitology , Metal Nanoparticles , Therapeutic Uses , Schistosomiasis mansoni , Drug TherapyABSTRACT
This is the first Malaysian study to determine the trend and risk factors of Toxoplasma gondii infection in HIV and non-HIV among prisoners in terms of socio-demographic and behavioural characteristics, clinical presentations and haematological distributions. Blood samples from 303 participants, comprising 133 HIV positive and 170 HIV negative inmates were collected in EDTA and plain tubes. Two mls of each blood sample in plain tubes were centrifuged at 1500 rpm for 10 minutes and the sera obtained were subjected to ELISA for detection of Toxoplasma IgM and IgG antibody towards Toxoplasma antigen. Seropositive samples for Toxoplasma IgM or both Toxoplasma IgM and IgG were further tested with Novalisa Toxoplasma gondii IgG avidity test to rule out acute from latent infections. Blood in EDTA tubes were sent to Clinical Diagnostic Lab (CDL), University Malaya Medical Centre (UMMC), Kuala Lumpur for complete blood count and differential count analysis. Overall seroprevalence of anti-T. gondii antibodies was detected in 41.9% (127 out of 303) of the participants. Anti-T. gondii antibodies was detected in 63.2% (84 out of 133) of HIV positive subjects and in 25.3% (43 out of 170) of HIV negative subjects. Seroprevalence of anti-T. gondii antibodies was significantly higher in HIV positive than in HIV negative subjects (OR = 5.06; 95% CI = 3.09-8.30; p < 0.001). The rate of T. gondii seropositivity increased significantly in those aged 40 years and above, HIV positive individuals and those with history of drug abuse. White blood cells (WBCs), neutrophils and basophils counts decreased significantly in those infected with Toxoplasma. Creating awareness about T. gondii infection and follow-up of their status is recommended. Moreover, screening of T. gondii infection in HIV-infected individuals should be considered for better treatment and management, including control and prevention.
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Aims: Detect the incidence of urinary tract infection caused by candida species and to determine their antifungal susceptibility, biofilm formation and its minimal biofilm inhibitory concentration. In addition, detect the importance of multiplex nested polymerase chain reaction (PCR) in detection of candidemia in serum of patients with candidurea. Methodology: Study was carried out by collecting urine samples from 200 patients admitted in the intensive care unit inMenoufia university hospitals and suspected to have hospital acquired urinary tract infection. Isolation, identification and antifungal susceptibility testing were done. Biofilm formation and Minimum biofilm inhibitory concentration testing were detected. Patients with positive candiduria were tested for the presence of candida in serum by multiplex nested PCR. Results: Candida spp. were isolated from urine of 38(19%) patients, 78.9% of them were catheterized, C. albicans was isolated from 18(47.3%) samples as detected by Analytical profile index (API system). Antifungal susceptibility show that Flucytosmine, Amphotericin B, Voriconazole were more effective antifungal agents against Candida spp (100%, 84.2% and 84.2% respectively). A total of 26 (%68.4) out of 38 Candida species isolates produced biofilm. 72.2% of the tested C. albicans, were resistant to fluconazole and had MBIC > 640 μg/mL while only 27.8% were sensitive to fluconazole and had MBIC < 10 μg/mL. 26.3% out of 38 patients with candiduria had candidaemia as detected by multiplex nested CR. Conclusion: Candida albicans is the most common Candida spp that show biofilm production. There is increased in the percentage of the resistance to fluconazole in candida isolates in this study. The incidence of candidemia among patients with candidurea was high in our study.
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Objective: determine the efficacy and safety of the non-cultured melanocyte-keratinocyte transplantation procedure in the treatment of stable resistant generalized vitiligo. Design: A simpler and modified method based on that of Olsson and Juhlin [1998] was performed this method uses a shaved biopsy skin sample one tenth the size of the recipient area. The skin sample is incubated, and the cells are mechanically separated using trypsin-EDTA solution and then centrifuged to prepare a suspension. Cell suspension is then applied to the derma braded depigmented skin area, and a collagen dressing is applied to keep it in place
Patients: twenty one patients with stable generalized vitiligo of different sites and sizes were treated with NMKT and followed up for 6 months
Intervention: Autologous, non-cultured melanocyte keratinocyte cell transplantation
Main Outcome Measure: initial pigmentation was observed. Regimentation was graded as excellent with 75 to 100% pigmentation, good with 50% to 74% fair with 25 to 49%, and poor with <25% pigmentation, assessment by modified vitiligo area scoring index, color match ,patient satisfaction and adverse events were assessed
Results: 9.66% showed excellent response, 11.50 % showed good response, 40.38% showed fair response and 38.46 % with poor response. Average percent change in VASI was 24.56% +-33.71. The color matching was excellent to good in 65.4% and poor in 34.6% of lesions, 3.8% of patients only were very satisfied and complications were minimal. Limitations: Limitations include small sample size, lack of control group and short follow-up period
Conclusions: NMKT is an easy economic technique, which may be used in resistant areas of stable vitiligo. The smaller the size of the lesion and the longer the stability duration the higher the percentage of regimentation response obtained. Results tend to be better over the trunk and proximal limbs than elbows, knees and distal extremities. Complications are minimal the most common is post inflammatory hyperpigmentation of the donor area
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OBJECTIVE: There is growing evidence for a gut-brain connection associated with autism spectrum disorders (ASDs). This suggests a potential benefit from introduced digestive enzymes for children with ASD. METHODS: We performed a double-blind, randomized clinical trial on 101 children with ASD (82 boys and 19 girls) aged from 3 to 9 years. ASD patients were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision (DSM-IV-TR) diagnostic criteria. Structured interviews of at least one hour each both with the parents and the child were performed. Later on, another two hours-session was conducted applying the Childhood Autism Rating Scale (CARS). ASD patients were randomized to receive digestive enzymes or placebo. RESULTS: The ASD group receiving digestive enzyme therapy for 3 months had significant improvement in emotional response, general impression autistic score, general behavior and gastrointestinal symptoms. Our study demonstrated the usefulness of digestive enzyme in our population of ASD patients. CONCLUSION: Digestive enzymes are inexpensive, readily available, have an excellent safety profile, and have mildly beneficial effects in ASD patients. Depending on the parameter measured in our study, we propose digestive enzymes for managing symptoms of ASD. Digestive enzyme therapy may be a possible option in treatment protocols for ASD in the future.
Subject(s)
Child , Humans , Autistic Disorder , Autism Spectrum Disorder , Diagnostic and Statistical Manual of Mental Disorders , Enzyme Therapy , ParentsABSTRACT
Childhood attention deficit hyperactivity disorder [ADHD] is a chronic disorder thatcarries an immense amount of suffering for its victims, their families, and communities.The efficacy of behavioral parent training in the treatment of ADHD has beensupported in several studies.To evaluate the efficacy of a predesigned culturally sensitive psychosocial interventionprogram for parents of ADHD children in Alexandria, Egypt.A pretest-post-test intervention study was carried out at the Child Mental Health Clinicfor School Students affiliated to the Health Insurance Organization, Alexandria. Theintervention aimed at improving parents' knowledge of ADHD, building their skills ineffective parenting, stress management and problem-solving, as well as providing socialsupport. All the participants [50 parents] were assigned to groups, each of five to eightparents. They received a total of eight sessions on a weekly basis. The program wasevaluated immediately after completion and 2 months later using the Arabic Versionof Conners' Rating Scale to identify ADHD and to assess its severity, Home SituationsQuestionnaire, Parenting Scale, the Arabic Version of Depression Anxiety Stress Scales [DASS], and parental ADHD-related knowledge questionnaire were used.There was a statistically significant decrease in the mean total scores recordedby parents on Conners' Rating Scale [P<0.001], Home Situations Questionnaire [P<0,05], Parenting Scale [P< 0.001], and DASS [P< 0.001] immediately afterprogram completion and 2 months later compared with Jjiat reported before programinitiation. The total scores of participants on the ADHD-related knowledgequestionnaire increased significantly after attending the program [P< 0.001].Provision of a psychosocial intervention program for parents of ADHD children proved tobe effective in reducing perceived severity of the symptoms and problem situations, aswell as improving parents' knowledge, discipline practices, and psychological well-being
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Humans , Male , Female , Child , Surveys and QuestionnairesABSTRACT
BACKGROUND: Anterior interbody fusion has previously been demonstrated to increase neuroforaminal height in a cadaveric model using cages. No prior study has prospectively assessed the relative change in magnetic resonance imaging (MRI) demonstrated neuroforaminal dimensions at the index and supradjacent levels, after anterior interbody fusion with a corticocancellous allograft in a series of patients without posterior decompression. The objective of this study was to determine how much foraminal dimension can be increased with indirect foraminal decompression alone via anterior interbody fusion, and to determine the effect of anterior lumbar interbody fusion on the dimensions of the supradjacent neuroforamina. METHODS: A prospective study comparing pre- and postoperative neuroforaminal dimensions on MRI scan among 26 consecutive patients undergoing anterior lumbar interbody fusion without posterior decompression was performed. We studies 26 consecutive patients (50 index levels) that had undergone anterior interbody fusion followed by posterior pedicle screw fixation without distraction or foraminotomy. We used preoperative and postoperative MRI imaging to assess the foraminal dimensions at each operated level on which the lumbar spine had been operated. The relative indirect foraminal decompression achieved was calculated. The foraminal dimension of the 26 supradjacent untreated levels was measured pre- and postoperatively to serve as a control and to determine any effects after anterior interbody fusion. RESULTS: In this study, 8 patients underwent 1 level fusion (L5-S1), 12 patients had 2 levels (L4-S1) and 6 patients had 3 levels (L3-S1). The average increase in foraminal dimension was 43.3% (p 0.05). CONCLUSIONS: Anterior interbody fusion with a coriticocancellous allograft can significantly increase neuroforaminal dimension even in the absence of formal posterior distraction or foraminotomy; anterior interbody fusion with a coriticocancellous allograft has little effect on supradjacent neuroforaminal dimensions.
Subject(s)
Female , Humans , Male , Intervertebral Disc Degeneration/diagnosis , Lumbar Vertebrae , Magnetic Resonance Imaging , Prospective Studies , Spinal FusionABSTRACT
Synovial sarcoma is a malignant mesenchymal neoplasm which commonly occurs in extremities of adults. We report on a 12-days-old boy who presented to the department of paediatric surgery at Khartoum teaching hospital with a biphasic synovial sarcoma in the lateral aspect of his left ankle. The tumor was treated with total excision and adjuvant chemotherapy.Histopathologic examination of the excised tumor revealed a biphasic synovial sarcoma. There was no evidence of local recurrence or distant metastasis of the tumor at follow-up examination 24 months postoperatively
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To observe the topographic localization of the brachial artery termination. This study was conducted at the Department of Anatomy, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia from December 2011 to February 2013. The bifurcation level of the brachial artery was determined in relation to the neck of the radius. Normal and abnormal terminations of the brachial artery were recorded. In 13 cases [21.7%], the bifurcation of brachial artery was normal. In 33 cases [6%], the bifurcation level was a few centimeters below the neck of the radius. In 7 cases [11.7%], the bifurcation level was above the radial neck in the area of cubital fossa. In 6 cases [10%], the termination of the brachial artery was found to be above the middle of the front of the arm. In one of the previous cases, the radial artery arose from the brachial artery on the medial side of the ulnar artery. In one case [1.7%], the radial and the ulnar arteries originated directly from the axillary artery, the brachial artery was absent. Morphological variations of the brachial artery are common findings and should be considered by surgeons when performing procedures in the brachial artery area