Role of multidetector CT [MDCT] in preoperative resectability assessment of central cholangiocarcinoma

CT is an excellent imaging technique for evaluating the soft-tissue extent of hilar cholangiocarcinoma and the relation between the tumor and the hepatic vasculature. To assess the role of multidetector CT [MDCT] in preoperative resectability assessment of hilar cholangiocarcinoma. The study included 20 patients presenting with hilar cholangiocarcinoma. Informed consent signed by the patients. All patients subjected to proper history taking, clinical examination as well as routine laboratory investigations. Triphasic abdominal MDCT. Post-processing techniques including multi-planner reformation [MPR], maximum intensity projection [MIP] and minimum intensity projection [MinIP]. 11 patients with portal vein invasion, 10 patients with hepatic artery invasion. Four patients had type I obstruction; four patients, type II obstruction; two patients, type IIIa obstruction; four patients, type IIIb obstruction; and six patients, type IV obstruction. The tumors were considered resectable in 12 patients in the preoperative assessment. Multidetector CT provides important information on the preoperative assessment of central cholangiocarcinoma resectability and the extent of surgery

Factor V Leiden and prothrombin G20210A gene mutations in women with a history of thrombosis during pregnancy relation to pregnancy outcomes for mother and fetus

To investigate the presence of factor V Leiden [FVL], and prothrombin gene mutations [PRT], protein C and protein S in pregnant women with a previous history of thromboembolism, and evaluate their impact on maternal and fetal outcomes. This study was carried out at Ain Shams University Hospital, Cairo, Egypt between January 2006 to March 2008. The study included 15 pregnant females without a history of thromboembolism [control group], and 25 pregnant females with a history of previous thromboembolism during pregnancy, and puerperium [patient group]. Identification of FVL and PRT mutations by real-time quantitative polymerase chain reaction, and estimation of protein C and S activity by functional clotting assay were performed. Regarding the control group; one patient had FVL mutation [6.6%], and one had decreased protein C activity [6.6%]. As regard the patient group 13/25 [52%] bad normal genotype, and 12/25 [48%] expressed abnormal genotype either FVL or PRT G20210A, or both. Also 3/25 [12%] patients had decreased protein C activity, and 2/25 [8%] had decreased protein S. The intrauterine growth retardation [IUGR] less than the tenth percentile was more in the patients group [48%] compared to the control group [33%], while there was no statistically significant difference between both groups on preeclampsia, placental abruption, abortion, or IUGR less than the fifth percentile. The FVL was not associated with any adverse outcomes, while the PRT mutation was significantly associated with IUGR less than the fifth percentile. The results of this study shows that good monitoring of fetal growth is mandatory for all carriers of the PRT gene mutation

Patterns of aortic dissection: diagnosis by helical CT and its new applications

Acute aortic dissection is a challenging problem for cardiothoracic surgeons and radiologists. Early and accurate diagnosis is crucial to allow for adequate and proper management. Aim of the work: The aim of this study was to evaluate the role of helical computed tomography and its new applications in the evaluation of aortic dissection with its typical and atypical patterns. Between November 1999 and February 2003, 86 patients underwent helical CT examination of the entire aorta for clinically suspected aortic dissection, of them 32 patients were positive for the clinical suspicion [23 patients males and nine patients were females, male-female ratio of 2.6:1]. Typical aortic dissection was diagnosed in 21 patients [65.6%] with 94% sensitivity and 100% specificity. Out of the 11 patients that were atypical [34.4%], three showed intramural haematoma, one showed penetrating atherosclerotic ulcer and two cases had ruptured type B dissection. Atypical configuration of the intimal flap was found in five patients. Helica1 computed tomography with its new application including the multiplanar reconstruction [MPR] provides an early and accurate diagnosis of aortic dissection

impact of sonography and Alvarado score on the clinical management of patients with acute appendicitis

Purpose: To determine whether diagnosis by graded compression ultrasonography improves clinical outcome for patients with suspected acute appendicitis. Material and A total of 180 patients suspected to have acute appendicitis were included in the study. 90 patients were randomized to the intervention group and were subjected to a diagnostic protocol incorporating ultrasonography and the Alvarado score. A control group included 90 patients in whom the standard clinical management was applied. The appendix was visualized at US in 69 of 83 patients [83%]. Sensitivity, specificity and accuracy of ultrasound in the diagnosis of acute appendicitis were measured at 92%, 90% and 91% respectively. Patients in the intervention group had a statistically significant lower number of both non-therapeutic operations and perforated appendix. There was no statistically significant difference in between groups in the total number of operations performed. Graded compression sonography is a powerful imaging tool that substantially improves diagnostic accuracy in patients with clinically equivocal appendicitis

Determination of clorazepate dipotassium via its iodobismuthate complex

A spectrophotometric method and two titrimetric methods for the determination of clorazepate dipotassium via its Iodobismuthate complex are described. These methods depend on, the reaction of clorazepate dipotassium with potassium bismuth iodide which give an orange precipitate. Determination of clorazepate dipotassium in the precipitated complex is done iodometrically using standard potassium iodate solution or complexometrically using standard EDTA solution and xylenol orange indicator. Alternatively, the complex is dissolved in ethyl alcohol and its absorbance is measured at 322 nm. The three methods were successfully applied for the determination of authentic samples of clorazepate dipotassium in the concentration range of 5-25 mg [for the titrimetric method and 40-120 mcg [for the spectrophotometric method]. The mean percentage recoveries were found to be 99.61 +/- 0.81, 99.80 +/- 0.48 - and 99.97 +/- 0.50 for the three methods, respectively. The proposed methods described were successfully applied for the determination of clorazepate dipotassium in tranxene capsules and the validity of the suggested procedures was assessed by applying the standard addition technique

Some toxicological, biochemical and haematological studies of amitriptyline hydrochloride in albino rats

Toxicological studies including acute and subacute toxicity of amitriptyline hydrochloride, which is one of the tricyclic antidepressant drugs, were carried out on albino rats. The median lethal dose [LD50] of the test drug after a single intraperitoneal dose injection was estimated to be 283 mg/Kg body weight. Subacute toxicity study continued for 30 days with two different dose levels daily equivalent to 1/20th and 1/10th of LD50 of amitriptyline-HCL to evaluate its adverse side effects on liver enzymes and haematological picture.Both dose levels exerted a very highly and highly significant increase in the values of SGOT, SGPT and serum alkaline phosphatase through the period of the experiment. The values of erythrocytes, haemoglobin, packed cell volume, leucocytes, neutrophils and Lymphocytes showed a significant decrease with difference in degrees of significance by the two dose levels So those who use the drug should be aware of possible occurrence of hepatic damage and blood dyscrasias

Quick methods for the estimation of carbon monoxide in blood

The rapid semiquantitative estimation of carboxyhaemoglobin is performed in micro diffusion units through the extent of separation of metallic palladium from palladium salts, in solution, on indicating paper and indicating gel. In all these methods it is possible to distinguish 5,10,20,30 land 40 per cent carboxyhaemoglobin in 1 ml blood sample