Value of abdominal sonography in rapid assessment of acute abdominal pain in a peripheral health care facility in a village in El Minia Governorate

The aim of this study was to assess the role of portable sonar in improving the health outcome of acute abdominal pain patients through early diagnosis in a peripheral health care facility. All patients with the main complaint of acute abdominal pain and presented to the health center of a village in El Minia from January to March 2000 were interviewed for history taking about accompanying symptoms and were subjected to abdominal examination, blood pressure measurement and abdominal sonography, laboratory investigation [Renal function tests, liver function tests, blood glucose] as well as ECG. Patients with chronic abdominal pain were excluded from the study. It was recommended to supply some of the key peripheral health care facilities with such a screening package including portable sonar and to train primary health care providers to use it as indicated as to minimize the complications resulted from delayed diagnosis and referral. It will be useful to design a standard checklist for the common conditions to be used for the management of patients in peripheral health care facilities

Liver large cell dysplasia: a possible premalignant condition: a case report

There is still a debate about the role of liver cell dysplasia as a premalignant lesion. A 54 years old Egyptian man with chronic, liver disease was admitted for evaluation of his liver condition. He was diagnosed as liver cirrhosis, portal hypertension and hepatocellular failure. His serum hepatitis B surface antigen was positive and alpha fetoprotein [AFP] level was 200 ng/ml. The histopathological examination of liver biopsy showed liver large cell dysplasia [LCD], which was identified in all histological stenosis on lever power examination. Hepatitis B surface antigen was identified in hepatocytes by orcein stain. It was suggested that cirrhotic patient with liver large cell dysplasia, age above 50 years, hepatitis B surface antigen positive, advanced liver disease and raised AFP level could be major predictors of neoplastic transformation of HCC. Therefore, regular assessment by hepatic ultrasonography and AFP may identify early hepatocellular carcinoma