Value of complexed prostate specific antigen [CPSA] in detection of cancer prostate

This study was carried on 90 males aged from 40 to 81 years old selected from Al-Hussein Hospital [Al-Azhar University] in the period from August 2005 to August 2006. cases in this study were classified into 3 groups; Group I: Included 20 persons who were apparently normal and without any prostatic disease and with normal digital rectal examination. Group II: Included 50 patients with benign prostatic hyperplasia. Group III: Included 20 patients histopathologically confirmed prostate cancer. The results revealed that there was statistically highly significant increase of complexed prostatic specific antigen[cPSA] in cancer prostate group in comparison to control group [p value 0.001]. A highly statistically significant decrease in Free/Total [F/T] ratio in cancer prostate group in comparison to control group. We found that cPSA is better in diagnosis of prostate cancer than total PSA but its performance was similar to that of F/T ratio except in sporadic cases in which performance of cPSA was better than F/T ratio. In addition, cPSA assay is a single test, measures a single analysis instead of two which is an economic advantage and decrease the chance of errors in diagnosis, it also uses a single set of kits with a single system of analysis. In addition, the complexed PSA is more stable than fPSA which is relatively unstable with long-term storage

Non-operative treatment for blunt liver trauma in children: a successful, safe, cost effective protocol

In this study, a protocol for managing hepatic trauma in hemodynamically stable children was proposed where specific criteria for pediatric ICU admission were applied and ultrasonography replaced CT scan for following up the process of hepatic healing. The study was carried out on 51 children with blunt hepatic trauma. Initial CT scan was done to 49 patients and identified the hepatic injuries and their grade in all patients. Intraperitoneal fluid was found in 26 of these patients. CT scan at discharge confined the ultrasound findings in 47 discharge patients. Four patients died, one due to grade VI liver injuries and the other three due to severe associated head injuries. Although the pediatric ICU was the standard location for initial nonoperative management of children with blunt hepatic injuries, yet a successful, safe and cost effective treatment could be achieved for properly selected hemodynamically stable patients. Ultrasonography was an effective alternative to CT for following up the healing process of these liver injuries

Laboratory assessment of osteoporosis among egyptian postmenopausal females

Osteoporosis has been a long recognized disorder even if its causes have not. The present work was a pilot trial to assess the,magnitude of the problem of osteoporosis among fractured cases at Al-Zahraa and El'Hussien U.H. Different lab. Factors which might affect bone mineral density [BMD] among postmenopausal females in Egypt were studied hoping to provide guidelines for prevention of osteoporosis .35 Postmenopausal women for at least 5 Years and free from any disease that may affect bone mineral desnity were selected and divided into two groups according to imaging techniques for assessment of osteoporosis 1.osteoporotic group induded 21 women.2.Borderline group induded 14 women.A third monosteoporotic group induded 15 women were taken as a control group.All cases were subjected to routine lab.investigations, seruam albumin, alkaline phosphatase total calcium, inorganic phosphate,serum ionized calcium was indirectly calculated in addition to determination of serum osteocalcin and F.S H. the level of alkaline phosphatase was Significantly higher in osteoporotic compared to borderline [rho<0.05] and non osteoporotic [rho<0.05]. Its level was higher in cases of vertebral fractures compared to nonfractured cases.There was no statistically significant difference between the three groups in all other studied biochemical parameters such as serum calcium, phosphorus, ionized calcium and osteocalcin

Challenges and dilemmas facing medical education, practice and research in a world of changing paradigms and unequal resources

Paradigm shifts towards interactive multidimensional models and rising costs threaten the sustainability of modern allopathic medicine and exposes areas of weakness in its health care orientation. These developments call for changes in teaching, practice and research and for introducing the Holistic interactive, multidisciplinary community involved approach to health. It involves a newly taught ability to interact and co-operate with all forces in the health care matrix as redefined by a wider understanding of the meaning of health, of life cycle and of quality of life

Management of cystic hepatic lesions in children

Cystic hepatic lesions in children pose diagnostic and therapeutic dilemmas. During 1996 and 1997, 12 children with liver cysts were managed at Al Noor Specialist Hospital, Makkah, Saudi Arabia. There were 7 boys and 5 girls with a mean age at presentation of 6 years [range 8 months to 13 years]. Abdominal mass was the main presentation. The diagnosis of these lesions has been aided by serological tests for hydatid disease and by abdominal ultrasonography and Computed Tomography. Total surgical excision was the definitive treatment for 7 patients and histopathological examination of the removed specimen proved that 3 were hydatid cysts, 3 mesenchymal hamartomas and 1 simple solitary non-parasitic cyst. No mortality occurred in our operated cases. The remaining 5 patients were followed-up. Two had small simple intrahepatic asymptomatic solitary cysts. The third had childhood polycystic disease of the liver and died after 6 months due to hepatorenal failure. The fourth had adult-type polycystic disease of the liver and kidneys, the fifth had traumatic liver cyst and both are being followed up. Ultrasonography, C.T. and new serological tests for hydatid disease have simplified the diagnosis of these cases. Total surgical excision remains the mainstay of cure for large symptomatic hepatic cysts. Children with asymptomatic, solitary, small, intraparenchymal cysts and those with polycystic disease of the liver, are best managed conservatively

Pyloric and antral webs in infants and children: underestimated entity?

The true incidence of pyloric and antral webs in infancy and childhood is debatable. Some authors claim to be rare, others present it as a condition occurring in epidemic form. Form 1992 through 1994, 10 patients with pyloric and antral webs were managed at Ain Shams University Hospitals. There were 5 girls and 5 boys with ages ranging firm 5 days to 5 years. The main presenting symptom was repeated non-bilious vomiting, Upper gastrointestinal barium study confirmed the presence of gastric outlet obstruction in all cases but typical signs of pyloric and antral webs were identified in only 6 patients. All patients underwent incision of the web and pyloroplasty with eventual recovery postoperatively. The finding of these 10 patients within this period suggests that the condition is not as rare as previously thought. Though some authors believe the value of conservative management on the assumption that the condition is self limiting, in all our patients treatment was basically surgical due to severity and persistence of symptoms that failed to respond to conservative management