role of CT guided fine needle aspiration biopsy in the management of intra-abdominal masses

The evaluation of deep non-palpable abdominal masses or focal lesion is often difficult. Distinction between malignant and non-malignant lesions and particularly inflammatory lesions is vital for patient management, and is often suspected from imaging techniques; the diagnosis requires confirmation by biopsy. Fine needle aspiration cytology [FNAC] is a well established diagnostic technique. This study aimed at evaluation of CT guided FNAB in diagnosis of intra-abdominal masses and its impact on treatment planning. The study was conducted on thirty patients with intra-abdominal masses [clinically or radiologically diagnosed] admitted to the Department of Surgery, Faculty of Medicine, the Main University Hospital. FNAs were performed at the Radiology unit in the Main University Hospital with the pathologists assistance. Patients were subjected to surgical exploration according to the findings, aiming at resection of the mass. The impacts of CT and FNAB on the surgical decision were recorded The pathological findings of FNAB were compared with the final histo-pathological findings of the specimen. The study was carried but on 30 patients who had abdominal mass or masses. Each patient was subjected to CT guided FNAC. The age of the patients ranged between 18-70 years, with a mean of 48.57 +/- 13.69 years. with a male to female ratio 1:1. The Sensitivity for CT was 76% and for FNAB was 89%. Specificity for CT was 100% and for ENAB was 100%. Positive predictive value for CT was 90% while it was 95% for FNAB. Negative predictive value was 18% for CT and 40% for FNAB. CT guided FNAB is a relatively painless procedure. It is a safe method for obtaining a pathologic diagnosis. The overall accuracy of the CT guided FNA in intra-abdominal masses was 73.3%. CT guided FNAB helped in avoiding surgery in patients with metastatic or irresectable tumors. The accuracy was 100% in hepatic, pancreatic and pelvic masses. while it was less accurate in retroperitoneal and gastrointestinal masses. This accuracy increased with adenocarcinomas and benign tumors, but decreased with lymphomas, smooth muscle tumors, inflammatory and fibrotic lesions

Evaluation of the clinical usefulness of blood cultures in hospitalised patients with community acquired pneumonia

Pneumonia that develop outside the hospital is considered CAP. Bacteremia is a serious clinical condition and can lead to death. To give the best chance for effective treatment and survival, a BC is done as soon as an infection is suspected. The aim of this work is to evaluate blood culture in patients with community acquired pneumonia and to correlate it with clinical response to medical treatment. This study was conducted on 50 patients; 36 males and 14 females. Sputum and blood samples are collected, transported and processed immediately in the laboratory by a technician under the supervision of a bacteriologist where blood and sputum culture were done. This study revealed that Strept. pneumoniae and H. infleunzae represented 38% of positive cultures, while Staph aureus and E.coli represented 30%. In conclusion, there was a little clinical usefulness of both sputum and BCs in the management of CAP and the empirical therapy is important as it gave 96% success without any antibiotic modification after the results of blood and sputum cultures have been available

Primary hyperparathyroidism: clinical presentation and management

Nineteen patients with primary hyperparathyroidism were operated upon in the period from January 1994 till December 1998. Thirteen patients were females and six were males. The maximum age incidence occurred in the fourth decade. Bony lesions were the frequent presentation. They were in the form of localized pain and bone swelling [38.8%], pathological fracture [26.3%] and generalized bone ache [10.5%]. The diagnosis of primary hyperparathyroidism was established on basis of elevated levels of ionized calcium, 24-hours urinary caclium and PTH together with decreased levelof serum phosphorus. Preoperative ultrasonography correctly localized the parathyroid pathology in 73.7%. Bilateral exporation of the neck revealed a sizable solitary parathyroid adenoma in 18 patients. In a single case the adenoma was intra thyroid in location. A concomitant partial throidectomy was performed in 7 patients. The postoperative complications were trivial; 11 patients suffered from transient hypercalcaemia. The determined postoperative serum calcium and PTH were normalized although both attained a different pattern to do this after operation. Among the 15 patients presenting with bone cysts, only two were treated surgically. The majority responded to conservative treatment adopting rest and immobilization after parathyroid adenectomy. Moreover, the pathological fractures healed well conservatively after the adenectomy. Internal fixation was resorted to in only 2 cases having pathological fractures of the femur

Comparative analysis of the biochemical tests used to differentiate between pleural transudates and exudates

This study aimed to evaluate the diagnostic accuracies for pleural fluid tests that discriminate between transudative and exudative pleural effusion. A prospective evaluation of 78 patients with pleural effusion of different etiologies was done. The criteria showed the best results in this series, four effusions only were misclassified [three transudates and one exudate]. The number of misclassified effusions in other criteria was seven by PF cholinesterase [three transudates and four exudates], six by the P/S cholinesterase [four transudates and two exudates], six by PF cholesterol [one transudate and five exudates] and five by PF/S cholesterol ratio [two transudates and three exudates]. It was concluded that the criteria of Light et al. were the best method for distinguishing exudates from transudates

porguerene, ent - epiconcinndial diterpones and sterols from the red alga corallina officinalis L.

From the bioactive red alga C. officinalis L., two steroidal compounds and four terpenoidal compounds [1,. 6] were isolated. The structures of four compounds [1,. 4] were elucidated by spectroscopic means. They were identified as 7-oxo-cholest-5 [6]- en-3-ol, cholesterol, 15-bromo-2,16-diacetoxy-7-hydroxy-9 [11]- parguerene and ent-13-epiconcinndiol. These compounds, except cholesterol, were isolated for the first time from this algal species. The spectral analysis of the remaining two isolated terpenoidal compounds were presented, but they still need a further confirmatory analysis. The hexane extract/column chromatography fractions of the red alga C. officinalis L. had potential antimicrobial and anthelmintic activities

Peri-and regio-selectivity in cycloaddition reactions of 1-substituted pyridinium-3-oxide

1-methyl- and 1-phenylpyridinium-3-oxides [Ia and Ib] reacted with benzalacetophenone [II] to yield three types of bicyclic adducts. The first proceeded via 2 pi + 4 pi cycloaddition across the 2 6-positions of the pyridine ring to give single regioisomers in favor of endo-6-substituted azabicyclo [3.2.1] octenones [III] and [IV]. The second involved 2 pi + 8 pi, by addition across the C[4]-O, to give the dihydrofuro [2,3-c] pyridine [VII], and the involved C[2]-O to give substituted dihydrofuran V and VI. 1-[4,6-dimethylpyrimidin-2-yl] pyridinium-3-oxide [Ic] reacted with 4-nitrophenylisothiocyanate by addition across the C[2]-O to give the oxazole-2-thione derivative X. Structural assignments were deduced by elemental analysis and spectral evidence

Methylation of 3- [1-arylyhdrazono-L-threo-2,3,4-trihydroxybutyl] 6,7-dimeth yl-1H-quinoxalin-2-ones

Several N-methyl derivatives of 3-[1-arylhydrazono-L-threo-2, 3, 4- trihydroxybutyl]-6, 7-dimethyl-1H-quinoxalin-2-ones were prepared and converted to 3-[5-[acetoxymethyl]-1-arylpyrazol-3-yl]-1, 6, 7 -trimethylquinoxalin-2-ones. Upon deacetylation, compound VIII and IX gave products identical with those obtained by methylation of 3-[1- aryl-5-[hydroxymethyl]-pyrazol-3-yl]-6, 7-dimethyl-1H-quinoxalin -2- ones

Effect of soil conditioners on nodulation and seed yield of faba bean grown in newly reclaimed area

In a field trial, sandy soil from Salhia project [Entisols, Quartzipsamments], soil taxonomy [1975], was treated with bitumen, polyacrylamide, urea-formaldehyde and uresol at rates of 50, 20, 75 and 40 g/m2 respectively. The germination faba bean seedlings after 15 days increased in the following order: Bit >PAM >Ur >UF >Cont. While, at 30 days, it changed to UF >Bit >Ur >PAM >Cont. The application of soil conditioners to sandy soil induced significant increase in the nodulation, dry matter and N-content of faba bean plants [after 75 days]. The yield of seeds increased by 20, 18, 15 and 11% as a result of treating the soil with UF, Bit, PAM and Ur respectively. Nitrogen balance revealed higher gain of N due to soil conditioner treatments. Bitumen emulsion exerts the most beneficial effect on symbiotic N fixation than other conditioners containing nitrogen