Abnormal Uterine Bleeding in Perimenopausal Age: Different causes and its relation with histopathology.

Background: Abnormal uterine bleeding (AUB) is the most common reason for gynecological visits for perimenopausal bleeding and may account for more than 25% of all hysterectomies. Objective: This study was aimed to review the causes of abnormal uterine bleeding in perimenopausal women establishing the correlation with ultrasonographic and histopathological examinations. Study Method: This descriptive study was conducted in the department of gynecology and obstetrics, Ibn Sina Medical College, Dhaka during January to December 2012. Two hundred and eleven women were selected for this study, who admitted into the hospital with abnormal uterine bleeding in perimenopausal age. The clinical, ultrasonographic and histopathological findings of these women were evaluated in this study. Results: Menorrhagia was the major symptom (52.6%) irrespective of age and parity. All these women underwent D&C followed by either medical management or hysterectomy depending upon the diagnosis. The histopathological findings of endometrium were analyzed and confirmed as fibroid uterus (58.28%) and DUB (17.58%) correlated well with transvaginal sonography (TVS) and histopathological examination. Hysterectomy conferred other uterine lesions as adenomyosis (18.71%), endometrial polyp (4.81%) and malignancy (1.06%). Conclusion: Abnormal uterine bleeding in perimenopausal age group is a common but ill-defined entity which needs proper evaluation. Accurate diagnosis of the causative factors of AUB in this age group is of utmost importance so that appropriate management can be established early that leads the minimization of the patients’ sufferings.

Risk factors of appendicular perforation in El-Thoura hospital, El-Bieda-Libya

Retrospective study for patients who underwent appendectomy, for appendicitis in El-Thoura Teaching Hospital, EL-beida-Libya. between January to October 2005 to evaluate the affect of the age, and duration of the symptoms on appendicular perforation. A total of 176 patients; 100[57%] males and 76[43%] females with age ranged from 2 to 60 years [mean 22.7 years], presented with right iliac fossa [RIF] pain [100%], anorexia [86.9%], nausea [85.8%] and vomiting [61.9%]. RIF tenderness in [100%]and abdominal rigidity in [55.7%] of patients. Overall appendicular perforation rate was [18.8%] and tend to be higher in children less than 10 years and in adults above 50 years. also perforation rate increase with increasing time interval from onset of the symptoms to time of the operation. The age, late presentation and delay in time of operation are the most risk factors for appendicular perforation

Effect of flumequine on the growth, residual measurements and chromosomal aberrations in tilapia fish

Flumequine [Flu] is a powerful antibacterial agents used against bacterial infections in fish farming because of their high potency against Gram-negative bacteria. The present work aimed to study the effect of different doses of flumequine [0, 6, 8, 10, 12 mg during 90 days and 12 mg therapeutic dose for 5 days] on growth performance, feed utilization, body composition, chromosomal aberrations and determination of flumequine residues in tissues of the tilapia fish. The results revealed that the dose of 10 mg/kg body weight/ day caused significant increase in final body weight, body length, weight gain, specific growth rate and feed intake. Moreover, it improved feed conversion ratio with the same dose whereas the other doses caused non-significant change in feed conversion ratio compared with control group. Also, he best protein efficiency ratio [1.95] was recorded by fish fed the diet with 10 mg/kg body weight/day]. Results of proximate analysis of whole fish body showed that, the fish with dose 10 mg/kg body weight/day gained the highest percentage of protein and the lowest percentage of moisture, fat and ash. Determination of flumequine residues in muscle of fish at the end of the experiment after three month showed negative results. Flumequine at dose of 10 mg/kg body weight/ day caused the lowest percentage in total chromosomal aberrations compared with the other doses that caused the highest percentage of total chromosomal aberration. In conclusion, this study recommended the addition of flumequine to fish diets at a dose of 10 mg/kg body weight/ day as prophylactic dose in order to increase growth performance, feed utilization and decrease mortality of Nile tilapia

Histochemical study of acidic mucin pattern in different mucin secreting epithelia in rabbits

Adult rabbits are studied in various organs of rabbits with the potential of differentiation between suifomucins and sialomucins and the recognition of their locations in the studied organs. Adult rabbits were sacrified under general ether anaesthesia and the trachea, small bronchus, parotid gland, stomach, gall bladder; duodenum; small and large intestine were dissected The organs were processed for paraffin sections and stained with combined alcian blue-alcian yellow technique. The results observed have concluded the predominance of sulfomucins which reacted very strongly with the histochemical stain. Sialomucins have been hardly detected. It has also been demonstralted that the plasma membranes and the epithelial secretions are the most reactive structures which suggest the complex carbohydrate entity of their nature. Sulfomucins have been proved to be the prime chemical component of this complex carbohydrates. The procedures employed in this study have been specific and reliable for studying epithelial mucins

Paradoxical response during chemotherapy of tuberculous cervical lymphadenitis: a report of four cases

Enlargement of tuberculous cervical lymph nodes during chemotherapy is referred to as a paradoxical response, and it causes anxiety during treatment. Although the exact mechanism is still obscure, studies suggest it may be due to alteration in nodal tissue due to an immunological response. We present four cases of paradoxical response during antituberculous chemotherapy

Praziquantel, oxamniquine, and metrifonate in the treatment of schistosomiasis in Riyadh

This study sought to compare the effectiveness and side effects of praziquantel versus oxamniquine in treating 200 patients with schistosoma mansoni infection and praziquantel versus metrifonate in treating 100 patients with S. haematobium infection. Praziquantel and oxamniquine were given in single doses of 40 mg/kg body weight and 25 mg/kg, respectively. Metrifonate was given doses of 10 mg/kg, and repeated three times at fortnight intervals. In s. mansoni infections, the cure rate was 96% for parziquantel and 91% for oxamniquine. In s. haematobium infections, the cure rate was 98% for praziquantel and 90% for metrifonate. Side effects were generally minor and temporary and were noted in 44% of patients treated with praziquantel, in 60% of patients treated with metrifonate, and in 70% of the patients treated with oxamniquine. The most common side effects were dizziness and abdominal pain. It is concluded that the drugs are effective against the species of Schistosoma present in our area. Praziquantel appears to be the drug of choice for S. haematobium. Praziquantel and low-dose oxaminquine [25 mg/kg] were comparable in their effect on S. mansoni

Fever of unknown origin: experience in Riyadh, Saudi Arabia

Fever of unknown origin constitutes a continual challenge to clinicians all over the world. The pattern of etiological factors varies from one geographic area to another. Over a 4-year period, 62 patients were diagnosed as having this syndrome in the University Hospitals, Riyadh, kingdom of Saudi Arabia. Of these, infection and neoplasms accounted for 71% of the cases. Tuberculosis, brucellosis, and lymphoma were the most common diagnoses. Infection by Schistosoma mansion and Salmonella typhi caused prolonged obscure fever in one patient. Our approach to diagnosis is discussed and compared with the experience in the literature. The application of noninvasive diagnostic methods such as ultrasonography, radioisotope scanning and improved microbiological techniques should further reduce the incidence of fever of unknown origin in the Kingdom. However of its epidemiological pattern in this area will assist practicing physicians in the judicious use of available diagnostic facilities