Preliminary reporting of emergency plain radiographic examination by the primary physicians in pediatric emergency center: feasibility study and observations

In a prospective study, preliminary reading of the plain radiographic films of pediatric emergency patients were compared with the reading of the same radiographs by the pediatric radiologists with the aim of evaluating the efficiency and accuracy of the initial reading by the treating physicians and to assess the effect on the overall patient management. Such readings may help those facilities where services of a qualified Pediatric radiologist are not immediately available. Our analysis indicates that in approximately 72% of patients, both reports are in agreement. However, there was a statistically significant difference in radiological observations in the patient group who had a discordant report [Kappa value=0.05]. Nevertheless, we did not come across any major discrepancy that needed altered management during the study period. Hence we conclude that under circumstances where expert help is not immediately available, primary physicians can be trained to read the plain radiographs without significantly affecting patient management

Comparative study between two nutritional regimens on wound healing of moderate burned patients

Burns are manifestations of injuries that are typically inflicted on the skin and other epithelial tissues. The metabolic disturbance and fluid imbalance are direct results of burn trauma and of fluid Losses from the burn wound. Hypermetabolism and hypercatabolism characterize the body's response to a burn injury resulting in increase in energy and protein requirements. This study aimed to determine the-effect of two nutritional regimens on wound healing of moderate burned patients. It was carried out at the burns unit of the Assiut university hospital, from October 2002 till December 2004. A sample included 100 adult recent moderately burned patients assigned sequentially into a group I [n=50] who their calculated caloric requirement form natural nutrients including the ordinary hospital diet, and group II [n=50] who received outline hospital diet and supplementation by commercial products rich in protein and carbohydrates [sustagen or Ensure. Monitoring the effect of two regimens was done by laboratory investigation, and anthropometric measurements. The main results reveal significant increase in weight gain in group II compared to group I at discharge. There was an increase in value of mid-arm muscle circumference [MAMC] body mass index [BMI] and triceps skin fold thickness [TSF] on discharge than on admission. In addition, a significant relation ship of serum transferrine, albumin and serum protein among patients groups

Endometrial biopsy during induction of ovulation with tamoxifen polycystic ovary syndrome

The dichotomy between ovulation rates and pregnancy rates for women with polycystic ovary syndrome [PCOS] treated with tamoxifen prompted the present study to determine the effect of tamoxifen on endometrial maturity. To compare endometrial histology of PCOS patients on induction of ovulation with tamoxifen with controls. Prospective case-control study. Bab El-Shareya University Hospital, Cairo, Egypt. Sixty-seven anovulatory women with PCOS on their third ovulatory cycle of tamoxifen were compared with controls [n=70] healthy but subfertile regularly ovulating women whose husbands had abnormal semen parameters. All subjects had an endometrial biopsy in the late luteal phase. Endometrial histology classified according to the classical Noyes criteria revealed out-of-phase endometrium in 11/67 [16%] of the tamoxifen group compared with 2/70 [3%] in controls [p<0.001]. The incidence of out-of-phase endometrium seems to increase with higher pre-induction LH levels. Tamoxifen treatment significantly increases the prevalence of out-of-phase endometrium and this could explain, in part, the large difference between ovulation and pregnancy rates. The higher the pre-induction LH levels, the more is the possibility of the endometrium being out-of-phasestandard 12 lead ECG, laboratory investigations including CPK, IMA, CRP, lipogram, kidney and liver functions were done. Twenty two patients were diagnosed as non ischaemic chest pain [NICP] and 51 cases as ACS. CPK and troponin levels were normal in all groups at presentations but 6 hours later CPK levels were significantly higher in ACS patients if compared with NICP or control groups [p<0.000]. on the other hand, IMA levels were statistically significantly high in ACS group only [p<0.000] with a good negative predictive value to diagnose NICP [86.3%]. Moreover, IMA levels were statistically significantly higher in patients finally diagnosed as unstable angina [UA] than those who diagnosed as non ST elevation myocardial infarction [NSTEMI] [p<0.04] meanwhile, it is insignificantly higher than that in STEMI patients. The sensitivity of IMA to predict ACS cases [94.1%] was higher than that of ECG [78.4%] and CPK at presentation [14.7%] and after 6 hours [54.7%]. On the other hand, the specificity of IMA, ECG, CPK at presentation and 6 hours later [86.4%, 90.9%, 86.4% and 97% respectively]. IMA can be used at the emergency setting to exclude the diagnosis of ADS. Moreover, the use of IMA as a diagnostic biomarker in addition to standard markers of myocardial injury is very useful for the evaluation of patients with suspected ACSMedical personnel are without doubt exposed to many biological and chemical agents [e.g., ionizing radiation, ultraviolet light rays, ultrasound, alkylating agents, anesthetic gases and antineoplastic agents] which are efficient inducers of chromosomal aberrations. X-ray and ultrasound are used extensively in many branches of modern medicine. X-rays, together with gamma rays and UV light are all part of the electromagnetic spectrum. Their interaction with biologic material depends on the frequency of wavelength of the radiation. At the short wavelengths of X-rays, electromagnetic radiation has sufficient energy to produce ionization as a result of the removal of electrons from atoms, and are thus called ionizing radiation. Ultrasound [term used to describe mechanical vibrations at frequencies above the human limit of audibility] has experienced phenomenal growth in medical diagnosis in recent years and it is usable in many sensitive circumstances where X-rays might be damaging. The aim of the present study is to assess genomic damage produced by occupational exposure to X-rays and ultrasound equipment using FISH technique using the whole chromosome paint probes for chromosome 1 and 2. Our study revealed chromosomal aberration in 2 personnel exposed to ionizing radiation, continuously for more than 10 years, in the form of absent signaling of chromosomes 2 which denotes total loss [monosomy] of this chromosome. In conclusion, our results may not provide significant proof of the cytogenetic damage caused by occupational exposure to ionizing radiation and ultrasound, however it may prove useful for future human population studies in this field and surely concluded that the necessity of following safety rules in fields dealing with radiations

Preoperative combined modality therapy for clinically resectable nonmetastatic rectal adenocarcinoma

The incidence of local recurrence [LR] following curative surgery for rectal cancer has been reported to range from 10 to 60%. Recently, data from several clinical trials have suggested that LR can be reduced by op to 40% with pre-operative radiotherapy and even further if combined with chemoradiotherapy. Seventeen patients were included in the study; all had adenocarcinorria of the rectum. Sphincter-preserving surgery could be achieved in 11 of the patients [64.7%] while the remaining 6 [35.3%] had abdomino-perineal resection [APR].Pathologic staging after preoperative combined modality therapy for the 17 patients who underwent radical surgery was: Tl-4 NO-2 MO. The incidence of failure was as follows: local, 5.8 % [1/17]; abdominal, 11.7% [2/17]; and distant, 17.6% [3/17].Treatment with preoperafive combined modality therapy followed by surgery and postoperative 5-FU based chemotherapy is an alternative to postoperative combined modality therapy for patients with rectal cancer.Purpose: To determine the local control rale and acute ioxicity in patients with clinically resectable adenocarcinoma of therectum treated with preoperative combined modality therapy

Corrosive oesophagitis and chronic malnutrition

This study was conducted on 30 children, 19 females and 11 males suffering from post corrosive esophageal stricture and 15 normal children. Careful history, socioeconomic evaluation, as well as some anthropometric measurement were done, in addition to estimation of Hb% aldosterone and cortical level as well as sodium and potassium serum levels. Showed the those victims are usually of low socioeconomic state, weight and skin fold thickness were severely affected, height was affected but not as much as weight, head circumference showed mild affection. Hemoglobin level was found to be lowered. Serum sodium and potassium levels were significantly lowered than normal levels. Cortisol level was higher than normal, while aldosterone level showed no significant difference. Some recommendations are stated to diminish the consequences of such accident