comparative study of the diagnostic and prognostic value of squamous cell carcinoma antigen and alfa-foeto protien in hepatocellular carcinoma before and after therapeutic intervention

Background: hepatocellular carcinoma [HCC] is one of the most common malignancies worldwide and it is one of the major causes of death, because of its high frequency and poor prognosis. Hepatocellular carcinoma is now a common malignancy in Egypt which usually develops on top of liver cirrhosis secondary to viral infection, as hepatitis C viruses increased the risk of HCC in the Egyptian patients

Aim of the Work: was to verify the possibility of using the plasma squamous cell carcinoma antigen level as a tumor marker for hepatocellular carcinoma and to evaluate its prognostic value in management of HCC

Patients and Methods: the study included 60 subjects divided into three groups: group I was 30 patients with hepatocellular carcinomas, group II was 15 patients with liver cirrhosis and group III was 15 normal subjects serving as a control group

Results: the plasma SCCA level was significantly higher in group I patients [with HCC], than in the group II patients [cirrhosis] and control group. SCCA showed direct significant correlation with the most of laboratory data specially AST, INR, number and size of lesion

Conclusion: plasma SCCA is a sensitive and specific serum marker for the diagnosis of HCC and combination of AFP and SCCA in screening and diagnosis of HCC yielded a better sensitivity in diagnosis of HCC

Epidemiological evaluation and outcome of pure abdominal trauma victims who underwent surgical exploratory laparotomy

Objective: The aim of this study was to evaluate the epidemiological profile, surgical treatment, andoutcome of patients suffering from pure abdominal injuries who underwent exploratory laparotomy in the emergency department of Aswan University Hospital, Egypt

Patients and methods: This was an evaluation and assessment of observational and descriptive study with prospective approach through interviews of 80 patients with pure abdominal trauma who were subjected to surgical treatment in the form of exploratory laparotomy and evaluation of their medical records

Results: The most affected individuals were male patients younger than 49 years, most of them withlow educational level and single. There was a predominance of trauma in the rural areasthat mostly occurred at night time and evening. Blunt trauma was the most common type of abdominal trauma, and road traffic accidents were the most frequent mechanism of trauma.The upper abdomen was the most affected region. Pain was the most common presenting symptom, and the spleen was the most affected organ. The hospital stay ranged from 1 to11 days. Most patients were discharged with permanent sequelae; there were six deaths

Conclusion: Blunt trauma was the most common type of abdominal injury. Road traffic accidents were themost common mechanism of blunt trauma, and stab wounds were the most common type of penetrating injuries. A number of risk factors were identified in this study, which include the type of abdominal trauma, presence of chronic diseases, delay in early transport from the siteof trauma to the emergency department, and age of patient. Despite the magnitude of traumas,the outcome was satisfactory

Radiation dose measurements during hysterosalpingography

Hysterosalpingography [HSG] is an effective method to evaluate abnormalities of the uterus and fallopian tube using conventional X-ray or fluoroscopy. The aim of this study was to determine and evaluate the radiation dose for females undergoing HSG during the reproductive period. This study conducted in three radiology departments: Omdurman Teaching Hospital, Alneelain Diagnostic Center and Asia Specialized Hospital. A total of 50 patients was studied from three hospitals, 20 patients from Neelain Diagnostic Center in range of [25-40] years, 20 patients from Omdurman teaching Hospital in age range from [24 to 43] years. The study duration was carried out for a period of 3 months, from March 2011 to June 2011. Patient dose measurements were performed using unfors dosimeter. Organ dose and effective doses were estimated using National Radiological Protection Board software. The mean patient dose was 20.1 and 28.9 and 13. 6 Omdurman Teaching Hospital, Neelain Diagnostic Center and Asia Specialized Hospital, respectively. Ovaries and uterus have the highest dose compared to other organs. The results of this study are higher compared with previous studies

Computed tomography evaluation of paranasal sinuses lesions

The goal of this study is to evaluate the role of computed tomography scan in the diagnosis of sinuses diseases. This was a cross-sectional study design, conducted in different hospitals and clinical centers at Khartoum State. Totally 26 males and 24 females aged ranges from 10 to 70 years old with different symptoms were selected, axial and direct coronal cuts were done for all cases. The study revealed that most patients were affected in the both sides, with a history of sinuses diseases in their families, maxillary sinuses are the most affected area, and most patients suffer from headache. Chronic and fungal sinusitis the sensitivity of the coronal view was [77%, 61%, and 61%] respectively compared to axial that was [22%, 36%, and 38%] respectively In the nasal polyp and granulomatous diseases, the efficiency of the coronal view was [62% and 65%] respectively, while in axial was [37% and 34%] respectively. In benign and malignant tumor the efficiency of coronal was 57% and 32% respectively, while in the axial view was [42% and 21%] respectively. This study concluded that the two image planes are performed together and used as an essential technique of peripheral nerve stimulation

Transabdominal sonographic findings in the diagnosis of urinary bladder abnormalities

This study was to assess the diagnostic capabilities of Transabdominal Sonographic Findings in the Diagnosis of Urinary Bladder abnormalities. In a cross-sectional study design, was conducted in different hospitals and clinical centers at Khartoum State. A total of 110 patients with symptoms of urinary bladder diseases were included in this study who had been selected and scanned with ultrasound using the appropriate technique. The study confirmed that cystitis was the commonest vesical pathology and common in female than male, Hematuria 29.75%, dysuria 25%, and showed that shistosomiasis mainly involve the male. This study concluded that ultrasonography is the first line of investigation as well as laboratory test [urine general] since it is safe, accurate and not time consuming

Evaluation of renal functions using isotopic renogram and biochemical tests

Radionuclide renography is now very important diagnostic tool comparable to other diagnostic modalities for the evaluation of renal diseases. This study was carried out to assess the role of radionuclide renography and biochemical test in the evaluation of the renal function. A total of 50 samples with a history of renal disease were included in this study. Out of a total 50, 31 were males and 19 were females, their age ranged between 9 and 79 years and most of the patients were in the age group above 46 years, weight ranged from 22 to 97 kg, mean [standard deviation [SD]] 67.32 [17.203]. Height ranged from 125 to 185 cm, mean [SD] 163.07 [12.573]. Radionuclide renography and biochemical test were done for all patients in the Radiation and Isotope Center of Khartoum in the period from March 2011 to October 2011. In case of radionuclide renography, total glomerular filtration rate [GFR] ranged from 6.64 to 130.70, mean [SD] 65.87 [31.30] and the biochemical test showed that [10%] of patients with abnormal serum creatinine level and [12%] with abnormal serum urea level. The serum urea level was normal in 44 patients, but in the renogram 19 patients were abnormal [both kidneys GFR], 14 patients were abnormal [right kidney GFR] and 8 patients were abnormal [left kidney GFR]. A total of 45 patients had normal serum creatinine level, but in the renogram 18 patients were abnormal [both kidneys GFR], 16 patients were abnormal [right kidney GFR] and 8 patients were abnormal [left kidney GFR]. It is concluded that both isotopes renogram technique and biochemical test are very important in the evaluation of renal function

Assessment of commercial specific IgE assays for detection of allergens in allergic patients

Allergy is a serious health problem throughout the world, affecting people of all ages. Allergic diseases such as asthma, rhinitis and atopic dermatitis are becoming epidemic in all countries. The cost of investigating these diseases is increasing and becoming very expensive. There are many ways to explore allergenic antibodies to assess the presence and the amount of specific IgE. These are: Skin test [Prick], Specific IgE [ELISA], RAST Sp. IgE and Elimination Challenge methods. Skin test produces pain, local or anaphylactic reaction and patient discomfort. Other procedures are expensive to the patient. So, a modified procedure, based on the same principle of previous tests, was studied in Allergy and Immunology laboratory of Ain Shams University. The procedure has suitable cost for all patients; it is very simple, accurate, cheap and does not produce any problems for patients. It depends on ELISA technique and measures the quantitative amount of the following different allergens: Food and Drug allergens such as, Milk, Eggs, Banana, Maize, Fish, Chocolate, Wheat, Nuts, Strawberry, Shrimps, Spices and Aspirin as a drug allergen. Inhalants, as House dust, Mite, Mixed Pollens, Mixed Moulds, Hay dust, Wool, Latex and Cat Hair. The results of this test for 150 allergic patients were compared with those of national specific IgE kits [ELISA], Sp.IgE [RAST], Skin test and elimination challenge test. Statistical results of sensitivity showed respectively: 88.9%, 89.6%, 91.2%, 71.4%, 93.1%. As regards specificity, the results were 93.1%, 94.7%, 95.3%, 65.5%, 91.6%, respectively. These results conclude that the test is in line with all other standard tests. It can also be noted that it is not only the cheapest and most commercial technique using the immediately available, locally prepared reagents, plates and other requirements found in any standard laboratory, but, additionally, probably it can be unique in using foods, drug and inhalants allergens at the same time. Now, it is applied successfully in Allergy and Immunology unit in Ain Shams university hospitals in Egypt. The test has also been recently introduced at the Center for Advanced Bio Medical Research and Innovation [CABRI] at the Gulf Medical University, Ajman, UAE, using a commercial system from Phadia. About two hundred different IgE levels against specific antigens are tested using the Immunocap 100. The allergen of interest, covalently linked to the Immunocap is incubated with the serum being tested. The unbound IgE is washed away and the bound specific IgE is detected using a fluorescent reader. The concentration is calculated using a calibration curve

Local reference ranges of thyroid hormones in Sudanese normal subjects using RIA

The current study aimed to establish a local reference range of thyroid related hormones using Radio-immunoassay [RIA] in healthy adults Sudanese volunteers. Serum levels of thyroxine [T4], triiodothyronine [T3] and thyroid-stimulating hormone [TSH], were measured in 40 healthy subjects. The reference range of thyroid related hormones level [mean +/- 2SD] was found to be as follows: T3 =1.38 +/- 2 [0.5] n mole/ L, T4= 132.5 +/- [44.0] nmol/L and TSH= [mean +/- SD] 1.20 +/- 0.82 mU/L. The results showed that no correlation was found between thyroid related hormones versus body height, and weight. A local reference range of thyroid related hormones was established and could be used instead of those were in use before

Evaluation of thyroid nodules in patients with goitre using nuclear medicine, biopsy and ultrasound in Sudan

Goiter is a common thyroid disorder in Sudan. Most of thyroid nodules are benign, but a small percentage can be cancerous among the other pathology. The aims of this study were to assess the value of scintigraphy, ultrasound [US] and biopsy in the detection of nodules and to determine the prevalence of thyroid nodule among patients with thyroid goiter in Sudan. A total of 100 patients were investigated. 58 patients were investigated with biobsy in addition to the aforementioned techniques. Scintigraphic examination involved the intravenous injection of 2-5 mCi of Tc[99m] followed in 15 minutes by 300 kC at the neck, US was performed using an instruments with a 7.5 MHz and biopsy was carried either by Fine Needle Aspiration Biopsy [FNAB] or open operation. The majority of the patients were females [81%]. Scintigraphy revealed that 58% of the patients had nodular goiter while the rest had diffuse goiter. The highest incidence of nodules was shown in the age group between 40-60 [23%]. US revealed that 48% of the nodules were solitary. Furthermore, 78% the nodules none vascularized, 29% were calcified and 28% were hypoechoic. The biopsy results showed that 14% of nodular patients were malignant, 88% follicular adenocarcinoma. 36% had nodular goiter with cystic or degenerative changes. The highest percentage of malignancy could be attributed to the fact that patients referred to the hospital in a late stage of the disease. All patients with giotre should undergo US and NM investigation in order to detect the morphology and function of the thyroid

Rubber band ligation for 550 patients of symptomatic haemorrhoids out of 2200 patients retrospective study

This retrospective study was conducted to elucidate the results of the treatment for symptomatic haemorrhoids using rubber band ligation [RBL] method. Method: a retrospective study for 550 patients who came to the colorectal unit from June 1998 to June 2006, data was retrieved from archived files. Forty four patients with haemorrhoid had liver cirrhosis.RBL was performed using the Mc Gown applicator on an outpatients basis. The patients were asked to return to out-patient clinic for follow up at 2 week, 1, 6, months and through telephone call every 6 month for 2 years]. After RBL 496 patients [90.18%] were cured with no difference in outcome for first, second or third degree haemorrhoids [P value = 0.31]. symptomatic recurrence was detected in 16.03% after 2 years then repeated RBL or surgery were done for them. A total of 88 patients [16%] had 155 complications from RBL which required no hospitalization. Complications were registered; pain in 10.37%, rectal bleeding in 8.36% and vaso-vagal symptoms in 7.81%. RBL is a safe and successful method for treating symptomatic haemorrhoids, even in cirrhotic patients

Comparative study between biofeedback retraining and botulinum neurotoxin in treatment of anismus patients

Anismus is a significant cause of chronic constipation. This study came to revive the results of biofeedback BFB retraining and botulinum toxin A BTX- A injection in treatment of anismus patients. Forty eight patients with history of constipation underwent anorectal manometry, balloon expulsion, defecography, and electromyography. All patients had a non relaxing puoborectalis muscle. The patients were randomized into 2 groups. Group I patients receive biofeedback, two times per week for one month. Group II patients were injected with BTX- A. Follow up was conducted weekly in the first month then monthly for one year. In BFB training group 3 patients quite before the end of sessions with no improvement, initial improvement was recorded in 12 patients [50%] while long term success was recorded in 6 patients [25%]. In BTX-A group, initial improvement recorded in 17 patients [70.83%] with long term improvement in 8 patients [33.3%] There is a significant difference between BTX-A group and BFB group as regarding the initial success, but this significant difference disappeared at the end of follow up. Biofeedback retraining has therapeutic effect on patients suffering from anismus also, BTX-A injection is successful for temporary treatment of anismus and need repeated injection. Initial improvement is better after BTX-A injection

Evaluation of laparoscopy in management of acute appendicitis

Acute appendicitis is one of the most common problems requiring emergency surgery. It has been estimated that the accuracy of the clinical diagnosis of acute appendicitis is only between 75-90%. Thus, accurate diagnosis of acute appendicitis is still difficult. This prospective study was aiming to evaluate the role of laparoscopy in management of suspected acute appendicitis. This study included thirty patients having suspected acute appendicitis. The usual clinical and laboratory assessment were done for all patients. Then patients had inclusion criteria were managed laparoscopicaly. Evaluation was made based on the comparison of clinical, laboratory and laparoscopic findings with histological examination of removed specimen. This study included thirty patients, their sex was 18 females and 12 males with mean age was 28.73 +/- 8.39 years. Laparoscopy was able to settle the correct diagnosis in 29 patients with high diagnostic accuracy [96.6%]. There was one patient [3.3%] who developed internal hemorrhage that easily controlled after conversion to open procedure. Laparoscopic assessment was advantageous in cases of diagnostic uncertainty especially if combined with the clinical findings, so can save patients from unnecessary explorations. It has fewer complications, diminished pain, shortened convalescence, decreased wound infection rate and mostly reduced hospital stay

effect of higlyintensive training load on the immunoglobulin concentrations in blood serum for wrestlers

The giant leap that happened in the sports field recently is very remarkable and deserves a far greater attention. Through the physiological knowledge and information concerning sports training, it is possible now to develop sports training and ration its loads. High intensity training load is between 90-100% of the maximum physical ability of the athlete, reaching 180 pulses/mm and above. As the training load reaches that level, it affects most of the athlete's body system, among which the cardio-pulmonary system and the immune system, especially immunoglobulins concentrations in serum. These immunoglobulins include IgA, IgM, and IgG. The present study aimed at identifying the effect of high-intensity training load on the serum concentrations of these immunoglobulins for wrestlers. Sample included [10] wrestlers purposefully chosen from "23rd July Sports Club-Mahalla Kobra" wrestling team. The researcher used the experimental approach. Blood samples were taken before applying the training unit and [4] weeks after finishing it to evaluate the values of immunoglobulins concentrations in serum before and after application. The major finding of this research was that rational physical training that considers the correct model of loading using the high-intensity loads and the correct time distribution has led to improving IgM and IgG immunoglobulins in serum, while IgA did not reach any significant level of improvement