Multidetector CT [MDCT] Findings of primary hepatic lymphoma

Objective: The aim of this study was to describe the triphasic multidetector CT [MDCT] finding of primary hepatic lymphoma [PHL]

Materials and Methods: This retrospective study included eighteen patients. Each patient presented with primary hepatobiliary lymphoma without associated lymphadenopathy or other visceral involvement. Triphasic CT scanning was performed on one of two systems [64 MD CT] in 12 patients and [6 MDCT] in 6 patients. All eighteen patients underwent ultrasound percutaneous trucut liver biopsy using 18-gauge biopsy needle. Pathology was confirmed on all cases

Results: Four of eighteen patients presented with a single focal lesion. Thirteen of eighteen patients presented with multiple well defined focal lesions. One patient presented with a diffuse hepatic involvement. On triphasic CT, three patients showed gradual progressive contrast enhancement. Lesions remained isodense to the liver on the arterial phase with mild enhancement in the portal phase and showed washout on the delayed phase in two patients. The remaining thirteen patients showed multiple hypodense non-enhancing lesions

Conclusions: PHL presents a wide spectrum of imaging findings on triphasic MDCT with no characteristic imaging pattern. MDCT can be used for detection of the lesion and biopsy is used for diagnosis. PHL should always be considered in the differential diagnosis of a liver focal lesion either single or multiple

Effect of nursing intervention on eliminating radiology induced oral mucositis in head and neck cancer patients

Oral health is often affected by medical conditions and some cancer treatments. This is often underreported, undiagnosed as problematic and inadequately treated. The study aimed to portray the effect of nursing interventions on eliminating radiology induced oral mucositis in Head and Neck Cancer Patients. The study was conducted in Mansoura Main University Hospital, Medical Oncology Department. A convenient sample of sixty adult head and neck cancer patients were randomly assigned to a study [A] and control groups [B] of 30 patients each. Oral care intervention protocol has been designed and used to reduce the incidence and duration of oral mucositis [OM] in the study group. The study results revealed improvement in oral health status in the 7th day of observations in the study group after oral care intervention. There were nearly equal alterations in both groups in the 1st day of observation [36.66%with mild and 63.33% with severe alterations in study group and 33.33% of mild and 66.66% of severe alterations in the control group respectively. Moreover; there was no significant differences among both groups prior to oral care interventions performed to the study group in the 1st day, [p = 0.79]. However, on the 4th day of observation, there were significant differences among both groups [p = 0.3]. Patients in oral care intervention group showed an improvement on the 7th day. According to the results observed, professional and home oral hygiene should be used and adhered also evidence-based clinical practice guidelines presented as a benchmark for nurses to use for routine care for appropriate patients and as a springboard to challenge clinical investigators to conduct high quality trials in oral hygiene and oral care .Nursing management must take an integrated approach as well; nursing care research must be conducted to achieve high quality nursing management of mucositis and other oral complications

How to write meaningful standards: establishing a standards for clinical skills of adult nursing department faculty of nursing, Mansoura university- Egypt

There are many challenges found in the educational system of the Faculty of Nursing. One of these challenges is a learning programme that is not well established by some of the faculty departments. Neither the under graduates students nor the faculty staff have updated or develop the competencies of nursing students' skills due to lack of standard. In order to ensure quality, standards must be established to control practice which then can control and guarantees quality of care. Standards once set, enable the nursing teachers to use them to identify deficiencies in the performance as in the outcomes of nursing care It can also compare the service presently provided with the service required. Standards can be written in a procedure format. This implies that all procedures should contain structure, process and outcome standards. In the assessment of student and staff performance, the result shows that the students and staff nurses are in need to enhance their skills to meet accreditation standards. As a result, the authors aimed to write a standard for clinical skills and procedures for the second year adult care nursing department. Questionnaire Format and Structured Interview sheet was developed by the researchers to update clinical procedures used for adult nursing students. Standards for second year clinical procedures developed. The study recommended to implement the developed standards, and other standards should be developed for all procedures in all scientific departments in Nursing Faculties

High prevalence of micro albuminuria [MA] in type 2 diabetic patients

Microalbuminuria represents the earliest clinical evidence of diabetic nephropathy and Its a marker of increased cardiovascular morbidity and mortality. Its early detection allows the implementation of individualised and aggressive intervention programmes to reduce cardiovascular risk factors. This work aimed to study the characteristics of Diabetes Mellitus [DM] patients type 2 and to highlight the increased prevalence of microalbuminuria [MA]. This cross-sectional study carried out in EI-Fahaheel primary health care center, EI-Fahaheel district, Kuwait; between June 2006 and May 2007. A total sample of 550 diabetic patients was approached by diabetologists, out of-which 440 patients [80%] agreed to enroll. All patients completed an interviewer-administered questionnaire and underwent medical assessment. First morning blood and urine collections were obtained and were tested for clinical proteinuria using urine dipsticks and for MA using the single Micral-Test II strips. MA was found in 58.2% of the sample population and was significantly more frequent in males [57.8% vs 42.5%] compared to femaler [p <0.05], and among overweight and obese compared to the normal weight individuals [81.6% vs 18.4%], [p <0.0001]. Of the total sample, 12.3% had clinical proteinuria. The presence of MA was statistically significantly associated with presence of chronic complications of DM such as cardiovascular complications [p <0.05], diabetic neuropathy [p <0.0001] and diabetic retinopathy [p = <0.05]. MA could lead to adverse outcomes in diabetic patients. Risk factors for MA and its clinical course are amenable to intervention. Provision of annual screening for MA in diabetic patients by the highly sensitive and cheap dip-stick technology is highly cost-effective

Liver functions of workers occupationally exposed to soluble nickel compounds

The present study investigates the liver functions among workers exposed to nickel during nickel-plating process. The liver functions were assessed in 57 workers who are exposed to nickel during nickel plating and considered as nickel-exposed workers; and 48 unexposed workers from administrative department away from the place of work of study group, were considered as control group. workers with a known history of liver disease, blood transfusions and diabetes mellitus were excluded of the study. The level of urine nickel was measured by using a flameless atomic absorption spectrophotometer, we determined serum markers of liver function tests. urine nickel levels were significantly increased in high-and moderate-exposure groups as compared to unexposed group. The levels of serum transaminases -viz, alanine transaminase and aspartate transaminase were significantly increased in nickel-exposed workers, who had high urine nickel levels as compared to unexposed group. The level of serum albumin was negatively correlated with urine nickel levels. The levels of serum transaminases and serum y- glutamyl- transpeptidase were positively and significantly correlated with urine nickel levels in exposed group. Results indicate that workers who had high urine nickel levels >10 micro g/g of creatinine, had a consistent effect on hepatocellular function

Determinants of default from pulmonary tuberculosis treatment in kuwait

To determine the prevalence and risk factors of default from pulmonary tuberculosis treatment in Kuwait. Retrospective study. We studied all patients who were registered for pulmonary tuberculosis treatment between 1[st] January 2004 and 31[st] December 2006 and admitted in TB wards in El Rashid Center or treated in the outpatient clinic in TB Control Unit. To examine the determinants and risk factors of default from treatment, we used a nested case control study design. For each case of default [110 cases], three controls were randomly selected [330 controls] from cases that cured or completed treatment, using computer-generated random numbers. Data were obtained from programme forms completed by physicians and from medical records. Patients who defaulted treatment were defined as those ho had failed to collect medication for more than 2 consecutive months after the date of the last attendance during the course of treatment. Demographic and clinical characteristics, including history, treatment and outcome, were compared between defaulters and non-defaulters. There were 110 [11.5%] patients who defaulted from treatment. Fifty six percent of those who defaulted did so in the first 2 months of treatment and 86.4% of them were still bacteriologically positive at the time of default. Key risk actors associated with non-compliance were male sex, low educational level, non Kuwaiti nations, history of default and history of concomitant diabetes mellitus, liver disease or lung cancer. Multiple drug resistance was also associated with default from treatment. Default from treatment may be partially responsible for the persistent relatively high rates of tuberculosis in Kuwait. Health professionals and policy makers should ensure that all barriers to treatment be removed and that incentives be used to encourage treatment compliance

Effect of commphora mukulextract on pituitary thyroid axis in rats

The aim of the work is to study the effect of Commiphora mukul [CM] extract on pituitary thyroid axis in rats. Twenty four adult male albino rats were used in this study divided into four groups equally [control, CM group [orally administered in a dose of 0.2 g/Kg b.w/d of CM extract], hypothyroid group [hypothyroidism was induced by adding thiouracil to the drinking water at concentration of 0.03%] and hypothyroid plus CM group].The result of the present work showed that oral administration of CM extract either in normal or hypothyroid rats produced significant increase of triiodothyronine [T[3]], thyroxin [T4], T3/T4 ratio and the activity of peroxidase and proteases enzymes, it also produced significant decreased in thyroid stimulating hormone [TSH], cholesterol and hepatic lipid peroxidation [LPO] when these results are compared to those of control, or hypothyroid group, with the exception of hepatic LPO which is insignificantly changed after oral administration of CM in hypothyroid rats, when this result is compared to hypothyroid group. We can conclude that thyroid stimulating effect of CM is different from that TSH and is probably not mediated through the pituitary, it acts directly on thyroid through increase the activity of peroxidase and proteases enzymes also enhance T3 more than T4 through decrease in lipid peroxidation in the liver

Effect of depo-provera on serum cortisol and the reserve capacity of suprarenal cortex

Depot-medroxy progesterone acetate [DMPA][Depo-provera] is a long acting [three months] contraceptive for intramuscular injection. The present study evaluates the effects of Depo-provera on the blood cortisol [morning samples] among twenty [20] multiparous users of Depo-provera injection prior to and after 7 days, one and 3 months of injection. The effect of this drug on blood corticosterone was, also, investigated in female albino rats prior to and after one, seven [7], and fifteen [15] days of its injection. The intra-peritoneal [IP] injection of the Depo-provera to female rats caused a significant gradual decrease of blood corti-costerone level after one, seven, and fifteen days of injection. Same results were obtained in women who were injected intramuscularly with the drug. The 5-h Synacthen [ACTH stimulation test] showed a significant gradual decrease in adrenal response in rats. These data show impairment of the response of pro gestin users to powerful or prolonged stress, such as long operative time, or any other life stressors

Effect of leptin on LH and FSH release in ovariectomized rats

We compared the estradiol/progesterone-induced luteinizing hormone [LH] and follicle-stimulating hormone [FSH] release between normally fed and leptin-supplemented starved ovariectomized female rats and studied also the effect of hyper-leptinaemia on the steroid-induced hormonal release in normally fed ovariectomized rats. Three days' starvation completely abolished steroid-induced LH and FSH release. Significant recovery of the hormonal release was shown in the leptin-supplemented starved group. The magnitudes of LH and FSH release in the normally fed animals with a higher dose of leptin were statistically the same as those in the normally fed group without leptin. These observations indicate that physiological concentrations of circulating leptin exert a stimulatory effect on steroid-induced LH and FSH release

Laparascopic varicocelectomy: preliminary report of 22 cases done in Kuwait

Less invasive laparoscopic surgery is replacing the conventional open operation for treatment of several conditions. We performed laparoscopic clipping of the internal spermatic vessels in 15 patients to treat varicocele of the testis. Four of our patients presented with infertility, six with scrotal swelling and all had varicosities. Seven patients had bilateral varicoceles and eight had unilateral varicocele. All operations were performed under general anaesthesia. The internal spermatic vessels were successfully clipped in the 22 varicocelectomies, the spermatic artery was preserved in all the procedures. Post operative physical examination with Doppler ultrasound showed that the venous reflux has disappeared in all patients. The semenogram improved in the 10 patients who had semen analysis done before and six months after the operation. Neither hydrocele nor testicular atrophy was documented postoperatively. Only one patient had scrotal emphysema which resolved completely on three weeks follow up. In conclusion, we found that laparoscopic varicocelectomy allows excellent identification of the anatomical structures with minimal surgical trauma. The decrease in post operative morbidity and the quick convalescence of patients have made this technique a viable alternative to routine open high ligation

Respiratory hazards among workers in acrylic textile industry

For this study, ninety two exposed and thirty control workers were chosen randomly from Queisna Menoutex Factory. Each worker was examined using a special questionnaire for respiratory symptoms, personal data, history of exposure, and clinical examination. Spiromelric measurements were done using a compact spirometer. Environmental study revealed levels of acrylic fibres and acrylonitrile vapours lower than their threshold limit values. The results revealed that chronic bronchitis was significantly more prevalent among exposed than the control workers. A significant decrease in mean pre shift spiromelric measurements was found in exposed when compared with control workers. There was a significant association between the time intensity factor [for acrylic fibres and acrylonitrile vapours] and either of the prevalence of other respiratory symptoms or the changes in spirometric measurements for the non smoking exposed workers. Significant increase in the prevalence of respiratory symptoms and a significant decrease in mean pre shift spirometric measurements were found among smoking than among the non smoking exposed workers. The mean post-shift spirometric measurement was significantly lower than that of the pre-shift measurement for all the exposed workers