Clinical significance of LncRNA-MIAT as a non-invasive diagnostic marker of nonHodgkin's lymphoma associated with occult hepatitis C virus infection

Aims: the current research aimed to investigate LncRNA-MIAT in patients with nonHodgkin lymphoma (NHL) and to assess its correlation with clinicopathological features and treatment protocols of NHLs among Egyptian patients with Occult hepatitis C virus (HCV) infection (OCI). Patients & Methods: This study was conducted on 20 patients with NHL and 30 healthy subjects as the control group. All subjects were screened for HCV-RNA in both plasma and PBMCs. RT-PCR determined lncRNA-MIAT. Results: lncRNA-MIAT relative expression level was upregulated in NHL groups (2.73±0.86) compared to controls (1.06±0.07), P ˂0.001*. Among NHL, patients with OCI (3.2±0.63) had significantly higher levels of lncRNA-MIAT compared to HCV (2.6±1.08) and non-HCV (2.4±0.4), P ˂0.001*. Additionally, the relative expression levels of lncRNA-MIAT were significantly positively correlated with laboratory and clinicopathological features of NHL. Interestingly, concerning the treatment of DLBCLNHL, there were significantly higher levels of lncRNA-MIAT in no treatment subgroup (n=10, 3.31±0.95) compared to successfully treated subgroups [CHOP (n=7, 1.58±0.34) and R-CHOP (n=3, 11.16±0.21), P ˂0.001* Conclusions: lncRNA-MIAT level was upregulated in NHL patients, particularly patients with OCI. Thus, circulatory lncRNA-MIAT may serve as a promising non-invasive diagnostic marker for NHL associated with OCI

The fourth dose: My “me-first” experience

Vaccine inequality is the biggest obstacle to curbing the Covid-19 pandemic and accelerating socio-economic recovery in the developing countries. Many people, including myself, living in developing countries, were initially inoculated with the WHO-approved vaccines unwelcome to developed countries, such as Sinovac. Presently, governments in developing countries are offering the third and fourth doses of mRNA vaccines to facilitate cross-border travel. This creates a devastating burden on ongoing Covid-19 vaccination in developing countries, increasing the injustice and inequality between the developed and developing countries. Here, I share my thoughts as a public health specialist while I was receiving the fourth dose of the Covid-19 vaccine to fulfil travel requirements.

The prognostic roles of PYCR2 and ZBTB18 expression in tissues of colorectal carcinoma and non-neoplastic tissues: an immunohistochemical study

Background: It is important to detect novel biomarkers responsible for the progression and spread of colorectal cancer (CRC) to better evaluate the prognosis of the patients, provide better management, and foster the development of therapeutic targets. In humans, pyrroline-5-carboxylate reductase 2 (PYCR2) is encoded on chromosome 1q42.12, and its metabolic activity has been linked to oncogenesis in many cancers. Zinc finger and broad-complex, tramtrack, and bric-à-brac (BTB) domain-containing protein 18 (ZBTB18), a zinc finger transcriptional repressor, has been found to have a tumor-suppressor role and to be methylated in CRCs. To date, the prognostic roles of PYCR2 and ZBTB18 in CRC patients have not been thoroughly studied. Objective: To evaluate the tissue protein expression of PYCR2 and ZBTB18 in CRC and adjacent non-neoplastic intestinal tissues, to detect their roles in CRC carcinogenesis, progression and metastases. Patients and methods: After applying the inclusion criteria, 60 CRC patients were included in the study. Tissue samples from the tumor and the adjacent non-neoplastic tissues were stained with PYCR2 and ZBTB18. The patients were followed up for about 30 months (range: 10 to 36 months). We performed a correlation regarding the expression of the markers, and clinicopathological and prognostic parameters. Results Upregulation of PYCR2 and downregulation of ZBTB18 were found to be higher in CRC tissue than in the adjacent non-neoplastic colonic mucosa (p = 0.026 and p < 0.001 respectively). High expression of PYCR2 and low expression of ZBTB18 were positively correlated with large tumor size, higher tumor grade, advanced tumor stage, presence of spread to lymph nodes, and presence of distant metastases (p < 0.001). High PYCR2 and low ZBTB18 expressions were significantly associated with poor response to therapy (p = 0.008 and 0.0.17 respectively), as well as high incidence of progression and recurrence (p = 0.005), and unfavorable overall survival (OS) rates (p = 0.001). Conclusion: High expression of PYCR2 and low expression of ZBTB18 were independent predictors of CRC, progression, poor prognosis and unfavorable patient OS and progression-free survival (PFS) rates. (AU)

A Mixed Method Study to Assess Notification of Tuberculosis Patients by Private Practitioners in New Delhi, India

Background: A staggering one million tuberculosis (TB) cases are missing from notification, most of them being diagnosed and treated in the private sector. To curb this issue, the Government of India declared TB as a notifiable disease and NIKSHAY was launched in 2012. However, even after years of implementation, as per the report published by TB India 2020, the proportion of private case notification of total TB cases is very low. Objectives: The objectives of the study were to assess the current practices related to TB Notification being followed by private practitioners of Delhi and to explore the enablers and barriers to TB notification among private‑sector treatment providers. Methods: This cross‑sectional study was done from January 2019 to January 2020. Six hundred doctors were line listed under the chosen TB unit, 375 gave consent and in depth interview was conducted among them. Data were collected on the reporting status and facilitators and barrier toward NIKSHAY reporting were assessed. For the qualitative component, focused group discussions were done. Results: Out of 375 private practitioners, over two‑third (68%) practitioners reported that they were not treating TB patients. Out of 108 doctors treating patients only 50% were reporting the cases. Major reason cited for not reporting was “don’t know how to” and major barrier considered was “lack of training.” Conclusion: Strategies such as training and retraining, and one‑to‑one sensitization of private practitioners to address barriers may enhance TB notification.

Extensor indicis brevis muscle: report of a rare muscular variant and classification proposal / Músculo extensor corto del índice: reporte de una rara variante muscular y propuesta de clasificación

SUMMARY: The current report presented a rare variant of extensor indicis brevis muscle, replacing extensor indicis, in the left hand of an adult male cadaver. The origin of the muscle was reported, for the first time, to be from the distal margins of radius and ulna. The muscle is inserted into the extensor expansion of the index. A new classification for extensor indicis brevis muscle was proposed based on its origin. Awareness of rare anatomical variations would help clinicians and surgeons in accurately managing suspected cases and planning surgical procedures.

RESUMEN: Este informe presenta una variante rara del músculo extensor corto del índice, que reemplaza al extensor del índice en la mano izquierda de un cadáver masculino adulto. Se informó por primera vez, que el origen del músculo se realiza en la parte distal de los márgenes del radio y la ulna. El músculo se insertaba en la expansión extensora del índice. Se propuso una nueva clasificación para el músculo extensor corto del índice basada en su origen. El conocimiento de las variaciones anatómicas raras es útil para los médicos y cirujanos al abordar los casos sospechosos y planificar los procedimientos quirúrgicos.

Can bone marrow aspirate improve mandibular fracture repair in camels (Camelus dromedarius)?A preliminary study

Background@#Mandibular fractures are common in camels, leading to considerable economic losses. This study explored methods of improving mandibular fractures repair, adjuvant with interdental wire, or bone plate fixation. Autologous bone marrow (BM) injection enhances osteogenesis and rapid healing. @*Objectives@#To investigate the effect of autologous BM aspirate as an adjuvant treatment for repairing mandibular fractures in camels with interdental wire, or bone plate fixation. @*Methods@#Thirty dromedary camels aged 5–8 years and of both sexes were randomly divided into 4 treatment groups: group 1 (n = 10) treated with stainless steel wire fixation and BM injection at the fracture line, group 2 (n = 10) treated with plate fixation and BM injection at the fracture line, group 3 (n = 5) treated with stainless steel bone wire fixation and placebo saline injection at the fracture line, and group 4 (n = 5) treated with plate fixation and placebo injection at the fracture line. The mandibular fractures were followed weekly for 12 weeks postoperatively to assess improvement and healing based on clinical evaluation, radiographic union scale, and bone turnover markers (i.e., bone alkaline phosphatase, osteocalcin, pyridinoline, and deoxypyridinoline). @*Results@#Compared to other groups, elevated bone turnover markers in group 1 were demonstrated (p < 0.05) on the seventh postoperative day. Likewise, compared to other groups, both clinical findings and radiographic union scale significantly improved (p < 0.05) in group 1 on the 56th postoperative day. @*Conclusions@#BM aspirate has a promising beneficial osteogenic effect on mandibular fracture repair in camels, most notably when combined with interdental wire fixation.

Pattern of changes in liver enzymes SGPT, SGOT level during Dengue infection in hospitalized pediatrics patients in tertiary care centre

Background: Hepatic involvement is not an uncommon in dengue viral infection, which presents with elevation in serum aminotransferases due to reactive hepatitis. The study is aimed to know the pattern of changes in hepatic enzyme levels in dengue infection in pediatric patients and to assess it with clinical presentation of dengue in particularly patients without and with shock.Methods: Pediatric patients with serologically confirmed Dengue viral infection were enrolled in the study and divided clinically into a shock group and a non-shock group. SGPT and SGOT levels were measured from day one of fever onset till 7 days and within 3 days after shock in the shock group. Student t-test was used to analyze the statistical data.Results: 100 patients with a mean age of 8'2.6 years were included in the study. The incidence of abnormal SGOT and SGPT levels were 96.9% and 51.1% in the shock group, and 92.2% and 45% in the non-shock group respectively. 30% and 17.9% of the patients in shock group and only 9.9% and 4.2% in non-shock group had the respective SGOT and SGPT levels > 200 U/L. Patients in shock group had statistically higher levels of Serum aminotransferase compared to the non-shock group. SGOT tended to increase starting from one day before shock and continued to increase within a few days whereas SGPT was less likely to be affected.Conclusions: Pediatric patients with Dengue infection have raised Aminotransferases in particular SGOT, which is higher than SGPT level. Aminotransferase levels in shock patients are significantly high and increases up to 3 days.

Clomiphene citrate plus N-acetyl cysteine versus letrozole for induction of ovulation in infertile patients with polycystic ovarian disease: a randomized clinical trial

Background: Polycystic ovarian disease (PCOD), a common endocrine disorder with multisystem affection, is the most common cause of anovulatory infertility. Our objective is to evaluate the effect of using clomiphene citrate (CC) plus N-acetyl cysteine (NAC) versus letrozole in ovulation induction in infertile patients with PCOD.Methods: Reproductive-aged infertile women either primary or secondary diagnosed as PCOD according to Rotterdam criteria, 2003 were considered for enrollment. Eligible women for were recruited and randomized (1:1) to receive either CC 100 mg plus NAC 600 mg (CC+NAC arm) or letrozole 5 mg (NCT03241472, clinicaltrials.gov). All medications were started from day 3 of the menstrual cycle for 5 days. The primary outcome was the ovulation rate in both groups. Secondary outcomes included the mid-cyclic endometrial thickness, ovarian hyperstimulation, and clinical pregnancy and miscarriage rates.Results: One hundred ten patients were enrolled and randomized to CC+NAC arm (n=55) or letrozole (n=55). The ovulation rate in patients in letrozole arm was significantly higher than CC+NAC arm (71.8% versus 53.2%, p=0.01). Additionally, endometrial thickness was higher in letrozole arm (mean±SD: 11.46±1.61 versus 9.0±1.13, p=0.031). However, no statistical significant difference with regarding the ovarian hyperstimulation rate (1.8% versus 3.6%, p=0.157), clinical pregnancy rate [3/19 patients (27.3%) versus 19/55 (34.5%), p=0.409] and miscarriage rate [4/15 patients (26.7%) versus 19/55 (15.8%), p=0.317] in CC+NAC versus letrozole groups respectively.Conclusions: Addition of NAC to CC in ovulation induction leads to comparable pregnancy rate as letrozole. However, letrozole produces high ovulation rate and the better mid-cyclic endometrial thickness.

Evaluation of Podocalyxin level in pre-eclampsia with severe features' patients: a cross-sectional study

Background: This study aims to evaluate the level of podocalyxin (PCX) in preeclampsia with severe features patients and correlate it with the results of laboratory tests.Methods: The current study was a cross-sectional study conducted in Assiut Women Health Hospital between April and October 2018.  The study included 60 patients divided into two groups; Group (A): 30 patients diagnosed to have preeclampsia with severe features and Group (B): 30 patients as normal control group. Complete laboratory investigations with measurements of the PCX level was performed for all study participants.Results: No statistically significant difference between the study group and control group according to blood urea (p= 0.339) and serum creatinine (p= 0.801).There was statistically significant difference between the study group and control group according to PCX level (p= 0.001); the mean PCX was 3340.0 ± 2394.6 in the study group versus 1083.5±1400.2 in the control group. Univariate analysis revealed podocalyxin was not correlated with clinical data or laboratory investigations.Conclusions: Podocalyxin levels were significantly elevated in preeclampsia.

In-vitro bioequivalence, physicochemical and economic benefits study for marketed innovator and generic ciprofloxacin hydrochloride tablets in Saudi Arabia.

The objective of the present study was to compare and evaluate the economic benefits and in-vitro bioequivalence of different marketed generic ciprofloxacin tablets against the innovator tablet formulation that are present in the local market of Saudi Arabia. The comparative bioequivalence and physicochemical study of five ciprofloxacin marketed tablets were performed through the assessment of the uniformity of weight, hardness, disintegration, dissolution, and content assay of the products. In order to compare the dissolution profiles of all generic tablet formulations and the innovator, a model independent approach of similarity factor (f2) and difference factor (f1) was employed in the in vitro dissolution studies. Deviations were noted in two generic products, these deviations caused significant differences in disintegration time and dissolution profile in only one of the generic products. All tested generic products passed USP monograph dissolution testing except one product which failed to pass both similarity factor (f2) and difference factor (f1) tests required by FDA bioequivalence testing. The majority of generic products in Saudi Arabia which had lower prices showed comparable quality to innovator.

Hematological and biochemical changes associated with ectopic pregnancy in Jazan Area Saudi Arabia

Objective: Ectopic pregnancy [EP] is an implantation of fertilized ovum outside the intrauterine cavity. Many cases of EP are not associated with a clinical signs at early stages that makes its diagnosis is difficult. The confirmation of EP needs several investigations as ultrasonography and repeated measurements of serum beta-hCG levels every 48 hours that make it very expensive and take a long time so, rupture may be occurred that leads to increased maternal morbidity and mortality rates. Thus, the aim of this study was to investigate the alterations of some hematological and biochemical parameters associated with normal and ectopic pregnancy in addition to evaluate their efficacy in early diagnosis of tubal ectopic pregnancy [TEP] among women living in Jazan area, Kingdom of Saudi Arabia

Subjects and methods: this retrospective study was carried out on 200 women with their ages ranged from 25-37 years old at the Obstetric and Gynecology Department of King Fahd Central Hospital and Sabiya General Hospital during the period between March 2010 and March 2014. The subjects were divided into three groups. Group [1] consists of 69 cases ruptured EP; Group [2] consists of 61 cases non-ruptured by visual examination during surgery and subsequently histopathological examination, where as group [3] consists of 70 women representing the control group having a normal intrauterine pregnancy. Hematological and biochemical measurements were done on all groups

Results: the hematological findings revealed a significant increase in mean platelet volume [MPV], total leukocytic count [WBC] and erythrocyte sedimentation rate [ESR] among TEP patients especially in ruptured cases in comparison with those of normal pregnancy control. A significant decrease in hemoglobin [Hb] and packed cell volume [PCV] in TEP cases either ruptured or non-ruptured and a non-significant changes in total erythrocytic count [RBC]. The biochemical findings revealed a significant increase in serum creatine kinase [ CK] but a significant decrease in serum beta-hCG in both ruptured and non-ruptured TEP

Conclusion: it could be concluded that the WBCs, MPV count and ESR were significantly increased in TEP especially in ruptured cases. The MPV can differentiate between TEP and normal pregnancy but has less clinical significance to differentiate between ruptured and non-ruptured cases. On the other hand, the level of beta-hCG is an important indicator of TEP. Moreover, serum CK cannot be used as a tool for diagnosis of TEP but may differentiate between ruptured and non-ruptured cases

Human papillomavirus (HPV) in Egyptian females: study by cytology, histopathology, colposcopy and molecular diagnosis of high risk types

Objectives: In Northern Africa, the region Egypt belongs to, about 10.7% of women are estimated to harbour cervical human papillomavirus (HPV) infection and 78.4% of invasive cancers are attributed to HPVs 16 or 18. We aimed at comparing HPV detection by ISH-PCR tissue with other conventional available cheaper techniques, finding which of them can be relied upon in a developing country like Egypt for HPV detection. Methods: Sixty patients were included. For them colposcopy, PAP smear, histopathology and detection of HPV using ISH PCR tissue and PCR swab were achieved. Results: PCR-ISH tissue was positive in 53.33%, 46.6% were negative. Pap smear was negative in 26 cases (43.33%) and 43 cases (56.67%) were positive. LSIL with perinuclear halo represented nearly half of the positive cases (16/34; 47.05%), 10 cases were diagnosed as HSIL, 4 cases as ASCUS and 4 as AGC. Histopathology was negative in 12 (20%) cases and 48 (80%) cases were positive. CIN I and CIN I+ koliocytosis represented half of the cases (30/60) and more than half of positive cases (30/48; 62.5%). Comparing the results of pap smear, histopathology, colposcopy and PCR swab with ISH PCR tissue, highly significant results were seen with sensitivity of 87.5%, 100%, 62.5% and 56.2% respectively but the specificity were 78.6%, 42.9%, 28.6% and 100% respectively. Conclusion: Conventional cytology and histopathology were sensitive tests for detection of HPV. This may help for early detection of cancer cervix in a developing country like Egypt. PCR swab showed the highest specificity and the lowest sensitivity.

Chemical modification of Aspergillus niger β-glucosidase and its catalytic properties

Aspergillus niger β-glucosidase was modified by covalent coupling to periodate activated polysaccharides (glycosylation). The conjugated enzyme to activated starch showed the highest specific activity (128.5 U/mg protein). Compared to the native enzyme, the conjugated form exhibited: a higher optimal reaction temperature, a lower Ea (activation energy), a higher Km (Michaelis constant) and Vmax (maximal reaction rate), and improved thermal stability. The calculated t1/2 (half-life) values of heat in-activation at 60 °C and 70 °C were 245.7 and 54.5 min respectively, whereas at these temperatures the native enzyme was less stable (t1/2 of 200.0 and 49.5 min respectively). The conjugated enzyme retained 32.3 and 29.7%, respectively from its initial activity in presence of 5 mM Sodium Dodecyl Sulphate (SDS) and p-Chloro Mercuri Benzoate (p-CMB), while the native enzyme showed a remarkable loss of activity (retained activity 1.61 and 13.7%, respectively). The present work has established the potential of glycosylation to enhance the catalytic properties of β-glucosidase enzyme, making this enzyme potentially feasible for biotechnological applications.

Epidemiology of fractures and dislocations among urban communities of eastern Saudi Arabia

Background and Objective: Fractures and dislocations are a signifi cant public health and economic burden for any country, but current knowledge on the basic epidemiology of fractures in Saudi Arabia is very limited. This retrospective analysis was performed to determine the patterns of incidence of traumatic fractures and dislocations in the urban population of the Eastern Province of Saudi Arabia

Materials and Methods: Data were collected on all fractures and dislocations admitted to the orthopaedic wards between January 1, 2004 and December 31, 2009. The inclusion criteria were all patients admitted after trauma. The data collected included was the type of accident, fracture and dislocations sustained, surgery undertaken either emergency or elective, implants used, associated injuries, complications, status of the union of the fracture at the time of the final review and complications

Results: There were 1428 patients with 2056 fractures and dislocations. Five-hundred and eighty-four [40.89%] of the injuries were sustained in road traffic and motorcycle accidents. Lower extremity fractures were 830, upper extremity fractures were 555 and spinal fractures were 323. Of these, 202 [14.4%] patients had dislocations, a majority of which were hip joint dislocations. The overall complication rate was 166 [11.69%] and infections formed the majority. Delayed union occurred in 32, nonunion in 24 and malunion requiring surgery occurred in 17. Twenty-seven [1.31%] of fractures were missed

Conclusions: This analysis shows that road traffi c accidents are still a major cause of trauma in an urban population and lower extremities form the common site of fractures. Fractures and dislocations due to trauma are steadily increasing and the young are the most affected. We believe that injury prevention programs should be made mandatory to limit muskuloskeletal injuries resulting from trauma. In the coming years, the number of these injuries will rise considerably with the increase in population

role of wide bore needle biopsy in establishing confidential diagnosis of mammary carcinoma

Fine-needle aspiration [FNA] is a rapid, safe, minimally invasive, and inexpensive way of diagnosing malignancy in women with palpable breast tumors. This study was used the wide bore needle technique to obtain optimal results and can used instead of core needle biopsy. Fine-needle aspiration cytology is a rapid, safe, inexpensive and minimally invasive technique for diagnosis of breast malignancy. This study was an attempt to use wide bore needle instead of core needle biopsy to obtain optimal results. Thirty five females with breast lumps underwent FNA aspiration cytology in the department of Al-jamhuri Teaching Hospital in Mosul city. The study was achieved by using 19 gauged needle, part as routine cytology and other part as tissue block. Immunohistochemical stain for ER, PR and HER2 markers was performed on tissue blocks from 17 malignant cases. The cytology findings included 24 malignant cases [22 ductal carcinoma and 2 lobular carcinoma], 7 benign lesions and 4 suspicious cases. On the other hand, in tissue blocks the diagnosis of malignancy was given in 28 cases, 25 ductal carcinomas and 3 lobular carcinomas. Seven benign lesions, 6 were previously diagnosed as such by cytology and one suspicious case turned to be benign on wide bore needle. The four cytologically suspicious cases turned to be malignant in 3 cases and benign fibrocystic changes in the fourth case. Immunohistochemical analysis including ER, PR and HER-2 on seventeen cases of breast carcinomas. Seven out of 17 were shown positivity for ER while 3 cases were PR positive and Her2-neu was positive in 12 cases. It is preferred to use wide bore needle in the diagnosis of breast lesions to obtain more tissue material and optimal results. As well, to a certain extent the wide bore needle might substitute the core needle biopsy for diagnosis and immunohistochemical assessment because the latter is rather expensive and, at time is not available in our laboratories now

Evaluation of phytoconstituents and assessment of adaptogenic activity in vivo in various extracts of Rhododendron arboreum (leaves).

Natural products particularly of plant origin with antistress property and nutraceutical value have become the focus of scores of scientific investigation in recent times. Against this background the present study was carried out to analyse the phytochemical components and adaptogenic activity of Rhododendron arboreum which grow in high altitudes. Adaptogenic activity of the plant extract was evaluated in vivo in rat and mice animal models. Methanol, hydroethanol and aqueous extract of the leaves were prepared and preliminary screening of the phytochemical constiteunts was carried out. The important phytoconstituents viz. flavonoids and phenolics were estimated and amount of gallic acid and quercetin were evaluated by HPTLC. Adaptogenic activity of the extract was studied in vivo using rat and mice as test animals. The criteria taken were forced swimming test in rat and mice and tail suspension test in mice. Methanol extract showed the presence of diterpenes, triterpenes, flavonoids, steroids, tannin, phenolics. Hydroethanol extract showed the presence of diterpenes, triterpenes, saponin, glycosides, alkaloids, tannin and aqueous extract showed the presence of tannin, glycosides, triterpenes, flavonoids, diterpenes. Quantitative analysis exhibited that the methanol extract have the highest amount of flavonoid and phenolics. The HPTLC profile of methanol extract showed the presence of highest amount of quercetin. Gallic acid was detected only in methanol extract. In vivo study in test animals revealed that the methanol extract of R. arboreum exhibited potent anti stress activity. Hence, presence of these compounds which are known to have strong anti-oxidant activity in high quantity might be responsible for adaptogenic activity.

Long-term outcome of transobturator suburethral tape procedure for treatment of female stress urinary incontinence

The aim is to evaluate the long-term safety and efficacy of transobturator tape [TOT] procedure in the treatment of women with stress urinary incontinence [SUI] by subjective and objective measures. A total 48 women with SUI underwent the TOT procedure during the period from December 2005 to February 2008. The follow-up period ranged between 60 and 84 months [mean 71 months]. Mean age was 44.21 +/- 7.52 [range: 30-58]. Preoperative and early postoperative data were retrieved from the patient's medical files. Follow-up evaluation was carried out every 3 months during the 1st year and yearly afterwards by history taking [including incontinence and quality-of-life questionnaire], clinical examination, urine analysis, abdominopelvic ultrasonography, and urodynamic studies when indicated. At 12-month follow-up, the cure, improvement, and failure rates were 3[patients [81.25%], 5 [10.42%] and 4 [8.33%], respectively. The corresponding rates at the last follow-up were 38 [7[.15%], 5 [10.42%] and 5 [10.42%] respectively. The postvoid residual urine and peak flow rates did not differ significantly between the preoperative values and at the last follow-up. The complication rates after a mean 71-month included one patient with voiding difficulty and two patients with de novo urgency. No case was recorded with retention of urine or erosion. Transobturator tape procedure appeared to be effective minimally invasive procedure for SUI with low rate of complication and good long-term outcome

Study of benefits and hazards of Ranitidine on patients admitted in Pediatricm Intensive Care Unit

Objectives: Patients admitted in intensive care unit [ICU] are at high risk of developing stress gastric ulceration and so are liable to be exposed to ulcer prophylaxis drugs side effects. The aim of the present study was to study the benefits and possible side effects of Ranitidine as acid suppressive drug used in pediatric ICU [PICU]

Methods: This study was carried out on forty patients admitted in PICU at Alexandria University Children's Hospital [AUCH]. patients were divided into 2 groups each was 20 in number, Ranitidine was given only to one group. Both were subjected to full clinical evaluation. Duodenal aspirate was obtained via upper gastrointestinal [GI] endoscopy and examined for bacterial overgrowth in patients received Ranitidine. Stool was examined for occult blood to detect possible mucosal injury for all patients in both groups

Results: Out of 20 children received Ranitidine 9 [45%] showed bacterial colonization in their duodenal aspirate. Fifty five percent of cases who did not receive Ranitidine suffered from stress gastric injury in our study. Mechanical ventilation and shock are possible risk factors for stress gastric injury

Conclusion: Patients admitted to PICU are at high risk to develop stress gastric injury, so acid suppressive therapy is needed. Ranitidine is a good prophylactic drug against stress gastritis with possibility to develop small intestinal bacterial overgrowth [SIBO]

Different Types of Breast Lump in Relation to Different Age Groups.

This prospective observational study was carried out in the inpatient and outpatient department of surgery at Shaheed Ziaur Rahman Medical College Hospital, Bogra, during the period of 01.07.2008 to 31.12.2008 with a view to find out the incidence of breast carcinoma, fibroadenoma or other pathology in different age group. A total 130 patients with palpable breast lump were included in the study. Age of the patients was between 11 to 70 years. In most of the patients with breast lump Fine Needle Aspiration Cytology and biopsy were done. Sometimes ultrasonography, mammography and other routine investigations were also done. Among the study population 53.85% had benign lesions, Breast carcinoma accounted for 46.15% cases, fibroadenoma for 40.76% and fibroadenosis were in 10% cases. Fibroadenoma was common in second and third decade, while carcinoma of breast was common in third and fourth decade in this study. Here we attempted to find out the age incidence of breast lump and its correlation with clinical features, FNAC findings and histopathological report to improve the accuracy of diagnosis and management of breast disease.