Radical versus conservative methods in one-stage pilonidal abscess surgery: the experience of a tunisian center / Métodos radicais versus métodos conservadores em uma etapa da cirurgia de abscesso pilonidal: a experiência de um centro tunisiano

ABSTRACT BACKGROUND: Surgical treatment for pilonidal abscess is the gold standard, but not yet well codified. Different techniques proposed can be conservative or radical. AIMS: The aim of our study was to compare postoperative outcomes of both methods in one-stage treatment strategy. METHODS: This is a comparative study including patients operated on for pilonidal abscess, with a satisfactory postoperative follow-up, over a period of 4 years. We looked for the occurrence of postoperative recurrence in the medical records or by interviewing reachable patients. RESULTS: We analyzed 57 patients: 33 males and 24 females. The mean age was 26.9±10 years. The type of operation was excision in 46 (81%) cases and incision in 11 (19%) cases associated with curettage in three cases and drainage in 1 case. There was no statistically significant relationship between the type of surgery and the occurrence of postoperative surgical complications (p=1) and hospital stay (p=0.4). Excision of pilonidal abscess was significantly associated with a longer time to return to activity (p=0.04). Conservative surgery was significantly associated with faster healing of the surgical wound (p<0.001). The recurrence rate was 19% in radical surgery and 54% in conservative surgery. Radical surgery was significantly associated with a lower recurrence rate than incision procedure (p=0.02). CONCLUSIONS: Excision of pilonidal abscess was the common technique in our series, with a significantly lower rate of recurrence of the disease than after incision. However, the long convalescence following excision and the longer operating time, particularly in an emergency context, may sometimes lead to choosing conservative surgery.

RESUMO RACIONAL: O tratamento cirúrgico do abscesso pilonidal é a indicação habitual, mas ainda não está bem codificado. Diferentes técnicas propostas podem ser conservadoras ou radicais. OBJETIVOS: Comparar os resultados pós-operatórios de ambos os métodos, em uma única etapa da estratégia de tratamento. MÉTODOS: Estudo comparativo incluindo todos os pacientes operados por abscesso pilonidal, com um seguimento pós-operatório satisfatório, durante um período de 4 anos. Foi avaliada a ocorrência de recidiva pós-operatória nos prontuários médicos ou entrevistando pacientes. RESULTADOS: Foram incluídos no estudo 57 pacientes: 33 homens e 24 mulheres. A média de idade foi de 26,9±10 anos. O tipo de operação foi a excisão em 46 casos (81%) e a incisão em 11 casos (19%) associada à curetagem em três casos e a drenagem em um caso. A excisão do abscesso pilonidal foi significativamente associada a um tempo maior para retornar à atividade (p=0,04). A cirurgia conservadora foi significativamente associada a uma cicatrização mais rápida da ferida cirúrgica (p<0,001). A taxa de recidiva foi de 19% em cirurgia radical e de 54% em cirurgia conservadora. A cirurgia radical foi significativamente associada a uma taxa de recidiva menor do que o procedimento de incisão (p=0,02). CONCLUSÕES: A excisão do abscesso pilonidal foi a técnica comum nesta casuística, com taxa de recidiva da doença significativamente menor do que após a incisão. No entanto, a longa convalescença após a excisão e o maior tempo de operação, pode às vezes levar à escolha de uma cirurgia conservadora.

Protective Effects of Ginger Extract against the Toxicity of Cyclophosphamide on Testes: An Experimental Laboratory-Based Study

Background: Cyclophosphamide (CP) is a widely used medication in chemotherapy and can cause oxidative stress. Oxidative stress can affect testicular functions by reducing the sperm motility and concentration, changing the sperm morphology, and increasing DNA fragmentation in sperm. Ginger is one of the most widely used spices in various foods and is used as an herbal medicine in many countries due to its antioxidant effects. We aim to study the protective effects of ginger against CP-induced testicular toxicity in rats. Objectives: This study was conducted to investigate the role of ginger in preventing cyclophosphamide-induced adverse effects on the testicular histology of CP-treated male rats. Methods: The study was performed on 30 male albino rats with body weights of 300-350 g. The animals were divided into the following three groups (10/cage): Group 1 (control, untreated group), Group 2 (CP group, received a single dose of CP at 100 mg/kg-1 BW intraperitoneally), and Group 3 (CP+ginger, received ginger extract orally at 500 mg/kg for 35 days after CP injection). The morphological and histological structures of the testes were compared in the different groups of rats. Results: The CP-treated group showed a disorganized germinal epithelium compared with those of the controls. The CP+ginger-treated group showed a significant recovery of the organization of the germinal epithelium and the cellular attachments. Caspase-3-positive cells were significantly higher in the CP group and had remarkably lower levels in the CP+ginger-treated group. A reduction in the diameter of the seminiferous tubules and the destruction of connective tissue were observed in the CP-treated group; these changes were improved in the CP+ginger-treated group. Conclusion: Ginger extract can protect reproductive functions against CP-induced toxicity in rats.

Prevalence of Insulin Resistance among Cigarette Smokers in Sokoto Metropolis

Introduction: Cigarette smoking (CS) is a well-known risk factor for the development of metabolic diseases, various forms of cancer as well as insulin resistance (IR). IR is considered as an underlying derangement which very commonly aggravates metabolic syndrome. Aim: This study assessed the prevalence of IR in cigarette smokers in Sokoto metropolis using selected surrogate markers. Methodology: This cross sectional study was conducted in Sokoto among 108 subjects. Fasting venous blood samples were collected for plasma glucose, triglycerides and insulin estimation. Plasma glucose and serum triglycerides were analysed using enzymatic methods while insulin was assayed using ELISA method. Homeostasis model of assessment-IR (HOMA-IR), Quantitative insulin sensitivity check index (QUICKI), Mc Auley (McA) and fasting IR index (FIRI) were calculated using standard formula and IR cut-off of >2.5, <0.339, >5.8 and >2.3 respectively were used. Results: Based on the cut off mark, the prevalence of IR for HOMA-IR, QUICKI, McA, FIRI indices were 62(57.4%), 66(61.1%), 39(36.1%) and 60(55.6%) respectively. There was a significant correlation between HOMA-IR and FIRI (p< 0.05, r = 0.999). HOMA-IR also had a significant correlation with McA (p<0.05 r = -0.506). QUICKI had a significant correlation with McA (p<0.05 and r = 0.243). Conclusion: This study established a significantly high prevalence of IR among CS. Importantly, it can be concluded that cigarette smokers may be predisposed to the development of metabolic disease.

Vestibular assessment in chronic noise exposure subjects

Background: The damaging effect of noise on vestibular disturbance is well known, first described in 1890 by Haberman in tinkers with occupational hearing loss. Others have reported vestibular disturbances and abnormalities, such as balance disorders, dizziness, vertigo, and even spontaneous nystagmus in workers exposed to various kinds of occupational noise. Objective: To evaluate vestibular function in subjects with chronic noise exposure.Subjects and methods: Eighty subjects were included in the study, divided into 2 groups: 60 subjects exposed to noise in laundry with mean age 41.53±11.15 (study group) and 20 subjects not exposed to noise with mean age 38.60±6.48 (Control group). All subjects underwent audiovestibular evaluations (puretone audiometry, tympanometry, vedionystagmography, and posturography).Results: This study demonstrated elevated hearing threshold at audiometric frequencies 2-8 KHz (pv <0.001) and speech discrimination (pv <0.001). in addition, marked caloric weakness and reduced SOT composite scores (pv = <0.001), reduced SOT equilibrium scores in noise exposure subjects (pv<0.001), reduced SOT sensory scores in VEST and PREF (Pv <0.001). Furthermore, there was a positive correlation between duration of exposure and auditory and vestibular implications. Conclusion: this study revealed apparent effect of noise on auditory and vestibular system

Biowaiver studies of newly optimized meloxicam tablets

In this research work biowaiver studies of newly developed and optimized Meloxicam 7.5mg and 15mg water dispersible formulations were carried out at different dissolution media i.e. 0.1N HCl, phosphate buffer pH 4.5, pH 6.8, and pH 7.5 at 50 rpm. For this purpose reference [MA[9] and MB[9] and tests MA[2], MA[4], MA[6], MA[7] and MA[8] [15 mg] and MB[2], MB[4], MB[6], MB[7]and MB8 [7.5 mg] formulations were compared. In vitro patterns were analyzed by using model-independent and model-dependent methods. Results indicated that all formulation at pH 0.1N HCl and phosphate buffer pH 4.5 followed Weibull model, while at pH 6.8 and pH 7.5 all formulations followed Hixson-Crowell model. Similarly results of model independent methods demonstrated that all the reference formulations were found to be similar with the tests formulations. Results indicated that Biowaiver could be granted to all the optimized water dispersible meloxicam formulations of both batches, so waiver for bioequivalence study can be allowed

Role of Pancreatic Stent placement in prevention of post Endoscopic retrograde Cholangiopancreatography Pancreatitis: experience at a tertiary care hospital in Pakistan

Objective: To determine the frequency of Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis [PEP] in patients who underwent prophylactic pancreatic duct stenting

Study Design: Descriptive case series

Place and Duration of Study: This descriptive case series was conducted at the department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jul 2017 to Feb 2018

Material and Methods: One hundred and twenty consecutive patients were enrolled after they met inclusion and exclusion criteria. Endoscopic Retrograde Cholangiopancreatography Pancreatitis [ERCP] was performed by Olympus duodeno scope [TJF Q180V] by an endoscopist having at least 3 years experience of performingindependent ERCPs. An additional 4, 6, or 7cm long 5FrGeenen[registration sign] pancreatic plastic stent [Cook Medical] was placed in all cases where pancreatic duct was accidentally cannulated. Primary outcome variable was post ERCP pancreatitis. Data was recorded on a pre-designed proforma and analyzed by SPSS version 21.0

Results: Out of total 120 cases, PEP was found in 4 [3.3 percent] patients. All the 4 patients had mild pancreatitis

Conclusion: PEP is not an uncommon complication following ERCP. The rate of PEP appears to be lower with prophylactic pancreatic duct stenting

Mental health in the Americas: an overview of the treatment gap / La salud mental en las Américas: una visión general de la brecha de tratamiento / Saúde mental nas Américas: uma visão geral da lacuna de tratamento

ABSTRACT Objective To understand the mental health treatment gap in the Region of the Americas by examining the prevalence of mental health disorders, use of mental health services, and the global burden of disease. Methods Data from community-based surveys of mental disorders in Argentina, Brazil, Canada, Chile, Colombia, Guatemala, Mexico, Peru, and the United States were utilized. The World Mental Health Survey published data were used to estimate the treatment gap. For Canada, Chile, and Guatemala, the treatment gap was calculated from data files. The mean, median, and weighted treatment gap, and the 12-month prevalence by severity and category of mental disorder were estimated for the general adult, child-adolescent, and indigenous populations. Disability-adjusted Life Years and Years Lived with Disability were calculated from the Global Burden of Disease study. Results Mental and substance use disorders accounted for 10.5% of the global burden of disease in the Americas. The 12-month prevalence rate of severe mental disorders ranged from 2% - 10% across studies. The weighted mean treatment gap in the Americas for moderate to severe disorders was 65.7%; North America, 53.2%; Latin America, 74.7%; Mesoamerica, 78.7%; and South America, 73.1%. The treatment gap for severe mental disorders in children and adolescents was over 50%. One-third of the indigenous population in the United States and 80% in Latin America had not received treatment. Conclusion The treatment gap for mental health remains a public health concern. A high proportion of adults, children, and indigenous individuals with serious mental illness remains untreated. The result is an elevated prevalence of mental disorders and global burden of disease.

RESUMEN Objetivo Comprender la brecha en el tratamiento de la salud mental en la Región de las Américas mediante la revisión de la prevalencia de los trastornos de salud mental, el uso de los servicios de salud mental y la carga mundial de enfermedad. Métodos Se utilizaron datos de encuestas comunitarias de trastornos mentales de Argentina, Brasil, Canadá, Chile, Colombia, Estados Unidos, Guatemala, México y Perú. Se emplearon los datos publicados de la Encuesta Mundial de Salud Mental para estimar la brecha de tratamiento. Para Canadá, Chile y Guatemala, la brecha de tratamiento se calculó a partir de los archivos de datos. Se estimaron la brecha de tratamiento media, media ponderada, y mediana, y la prevalencia de 12 meses por gravedad y categoría de trastorno mental para las poblaciones generales de adultos, niños y adolescentes, e indígenas. Se calcularon los años de vida ajustados por discapacidad y los años vividos con discapacidad a partir del estudio Carga Global de Enfermedad. Resultados Los trastornos mentales y por consumo de sustancias representaron el 10,5% de la carga mundial de enfermedad en las Américas. La tasa de prevalencia de 12 meses de los trastornos mentales severos varió del 2% al 10% en los estudios. La brecha de tratamiento media ponderada en las Américas para los trastornos moderados a graves fue del 65,7%; en América del Norte de 53,2%; en América Latina de 74,7%; en Mesoamérica de 78,7%; y en América del Sur de 73,1%. La brecha de tratamiento para los trastornos mentales graves en niños y adolescentes fue superior al 50%. Un tercio de la población indígena en los Estados Unidos y el 80% en América Latina no recibieron tratamiento. Conclusión La brecha de tratamiento para la salud mental sigue siendo un problema de salud pública. Una gran proporción de adultos, niños y personas indígenas con enfermedades mentales graves continúan sin tratamiento. El resultado implica una prevalencia elevada de trastornos mentales y de la carga mundial de enfermedad.

RESUMO Objetivo Compreender a lacuna de tratamento em saúde mental na Região das Américas examinando a prevalência de transtornos mentais, o uso de serviços de saúde mental e a carga global de doença. Métodos Foram utilizados dados de inquéritos comunitários de transtornos mentais na Argentina, Brasil, Canadá, Chile, Colômbia, Guatemala, México, Peru e Estados Unidos. Os dados publicados na Pesquisa Mundial de Saúde Mental foram utilizados para estimar a lacuna de tratamento. Para o Canadá, Chile e Guatemala, a lacuna de tratamento foi calculada a partir de arquivos de dados. A lacuna de tratamento média, média ponderada e mediana, e a prevalência de 12 meses por gravidade e categoria de transtorno mental foram estimadas para as populações adulta, infantil-adolescente e indígena em geral. Os anos de vida ajustados por incapacidade e os anos de vida com incapacidade foram calculados a partir do estudo Carga Global de Doença. Resultados Os transtornos mentais e de uso de substâncias foram responsáveis por 10,5% da carga global de doença nas Américas. A taxa de prevalência de 12 meses de transtornos mentais graves variou de 2% a 10% entre os estudos. A lacuna de tratamento média ponderada nas Américas para transtornos moderados a graves foi de 65,7%; em América do Norte de 53,2%; em América Latina de 74,7%; em Mesoamérica de 78,7%; e na América do Sul de 73,1%. A lacuna de tratamento para transtornos mentais graves em crianças e adolescentes foi superior a 50%. Um terço da população indígena nos Estados Unidos e 80% na América Latina não recebeu tratamento. Conclusão A lacuna de tratamento para a saúde mental continua sendo uma preocupação de saúde pública. Uma alta proporção de adultos, crianças e indígenas com doença mental grave permanece sem tratamento. O resultado é uma elevada prevalência de transtornos mentais e de carga global de doença.

Transverse comparisons between ultrasound and radionuclide parameters in children with pelvi-ureteric junction obstruction

Pelvi-ureteric junction [PUJ] obstruction is one of the causes of an obstructive uropathy which may be congenital or acquired. Ureteropelvic junction [UPJ] obstruction is a blockage at the point where ureters attaches to the bladder. This blocks the flow of urine out of the kidney, Urine can build up and damage the kidney, so radiologic imaging is crucial in diagnosing UPJ obstruction. It seemed therefore interesting to determine if some US parameters could predict the radionuclide parameters and which ultrasound parameter most influencing the kidney function. The initial step was to grade the severity of hydronephrosis, calyceal dilatation and cortical thinning, although it was easy for us to classify the importance of hydronephrosis in three groups according to anteroposterior diameter [APD]. AP diameter of renal pelvis and differential renal function were the most effective parameters for surgical decision. These parameters can be used for appropriate management of antenatal hydronephrosis

Management of pseudo tumor cerebri by frequent tapping VS lumboperitoneal shunt

Background: The syndrome known as pseudotumor cerebri [PTC] is generally thought of as a condition characterized by increased intracranial pressure [ICP] without evidence of dilated ventricles or a mass lesion by imaging, normal cerebrospinal fluid [CSF] content, and papilledema occurring in most cases in young, obese women without any clear explanation

Aim of the Work: to highlight the early diagnosis, causes of visual deterioration of idiopathic intracranial hypertension, its pathophysiology will be discussed. Special emphasis will be given for trends in management of this disease especially frequent tapping and lumboperitoneal shunt and comparing results of both techniques

Patients and Methods: This prospective and retrospective study was conducted on 20 patients of special criteria confirmed to have pseudotumor cerebri by clinical presentation, radiological findings, fundus and visual field examination

Results: The papilledema of PTC was identical with that in patients with other causes of increased ICP. In most of cases it was bilateral symmetrical, however it was asymmetric in 1% of cases. In the frequent tapping patients group, results showed improvement of all symptoms in about 80% of patients. And in 20% of patients there were persistent complaints especially headache and blurred vision. In the lumboperitoneal shunt group, 65% of Cases showed improvement of all symptoms while 35% of cases showed shunt failure and complications

Conclusion: Concerning the category of patients participated in this study, and particularly with whom medical measures were failing, consideration should be given to investigation of the cranial venous outflow tract with a view to some therapeutic intervention if appropriate

Audiological profile in children with autism spectrum disorders

Background: Autism spectrum disorder is defined by the Diagnostic Statistical Manual of Mental Disorders V [DSM V] as a neurobehavioral disorder manifested by persistent deficits in social and communication interaction, deficits in developing, understanding and maintaining relationships, as well as abnormal and fixed interests and repetitive behavior. Symptoms must be present at early childhood and interfere with daily function. The majority of individuals with ASD demonstrate some degree of auditory dysfunction. The level and expression of this dysfunction ranges from deafness and increased thresholds to hyperacusis and difficulty listening with background noise

Objective: The purpose of this study was to characterize the findings of audiological and electrophysiological hearing assessment in individuals with autism and to compare these findings to those obtained in typically developing individuals

Subjects, Materials and Method: Forty one Autistic children are divided into two groups:- group [1] Mild to moderate autism were seventeen children and group [2] Severe autism were twenty four children] were enrolled in this study [Whose ages were 2-6.5 years old] compared with ten typically developing matching peers. All Autistic children in the study had a definite medical diagnosis of Autism according to DSM-5 and based on the severity of symptomatology, ASD children were assessed and divided using CARS score [Childhood autism rating scale]. Audiologic evaluation consisted of a case history, otoscopic examinatioin, behavioral free field evaluation, acoustic immittance measures [Tympanogram and Acoustic reflexes], speech audiometry, measurement of distortion product otoacoustic emissions and auditory brain stem response

Results: Our results support an association between ASD and higher DPOAEs S/N ratios at only 500 and 750 Hz. Moreover, ABR in ASD children showed a significant increase in waves III and V absolute latencies and IIII and I-V inert peak latencies [In both groups of ASD], with inter aural asymmetry as shortened right ear III-V and I-V inter peak latencies reflecting a more right ear advantage [mild to moderate group], in addition to a significant decrease in waves V/I amplitude ratio [Both ASD groups]

Conclusion: The OAE responses of children with ASD were highly significantly only at 500 Hz [Both groups] 750 Hz [Mild to moderate group]. ASD children [either mild to moderate or severe] had a significant increase in ABR waves III and V peak absolute latencies and I-III and I-V inter peak latencies. Asymmetrical ABR findings also noted in children with ASD [mild to moderate group] as shortened right ear III-V and I-V inter peak latencies [more prominent right ear advantage]. In ABR also the amplitude of peak I in response to 90 dB nHL click stimulation was greater than the amplitude of peak V significantly in both groups of ASD children than controls

Role of magnetic resonance imaging evaluation of anterior knee pain

Background: the term "anterior knee pain" is often used interchangeably with "Patellofemoral pain syndrome PFPS" or "runner's knee". PFPS can be defined as anterior knee pain involving the patella and retinaculum

Aim of the Work: to highlight the role of magnetic resonance imaging [MRI] in the diagnosis and grading of the most common causes of anterior knee pain

Patients and Methods: this study included fifty patients, their ages range between 10-60 years [average age 27 years]. All presented with anterior knee pain [AKP] and were referred to the Radiology Department of El-Demerdash Hospital for MRI examination after orthopedic consultation

Results: the role of MRI in the diagnosis and grading of the most common causes of anterior knee pain have been shown in this study. These causes have been classified in to five disease categories; Patellar abnormalities represented most of them [64% of the sample size] and they included chondromalacia patella, patellar instability, transient patellar dislocation and painful bipartite patella. Hoffa's diseases represented 12% of the sample size and they included Hoffa impingement syndrome and Hoffa fibrotic bands. Patellar tendon disorders represented 6 % of the sample size and they included Patellar Tendinopathy and Osgood Schlatter Disease. Quadriceps tendon disorders represented 4% of the sample size and they included Quadriceps Tendinopathy. Other causes represented 14% of the sample size and they included torn anterior horn of the lateral meniscus and cartilage injuries

Conclusion: many factors may cause anterior knee pain. MRI is generally safe, non-ionizing, non-invasive and valuable imaging technique which has been proven to be the modality of choice for establishing an accurate diagnosis of different knee pathologies that cause anterior knee pain in different age groups. It also allows to know the extent, severity, grades and types of the lesions, what will be necessary to decide appropriate treatment

Recommendations: further studies on a larger scale of patients are needed to confirm the results obtained by this work

Facile way for synthesis silver nanoparticles for obtaining antibacterial textile fabrics.

One pot synthesis of silver nanoparticles (AgNPs) with well-defined size using polyvinyl alcohol (PVA) as stabilizing agent and sodium borohydride (NaBH4) as reducing agent was successfully performed. Preparation of AgNPs was carried out under a variety of conditions including concentrations of AgNPs, PVA and NaBH4. UV-vis spectra and TEM images were employed to characterize AgNPs obtained under the said different conditions. Physical and mechanical properties of cotton/polyester fabric treated with the synthesized silver nanoparticles were measured. SEM and EDX were used to scanning and observe the morphology and elemental change pertaining to fabric surface. Antibacterial activity against E. coli (Gm –ve bacteria) and Staphylococcus aureus (Gm +ve bacteria) were successfully examined against the treated and untreated fabrics.

[Cloning and expression of muc-1 gene in prokaryotic host for early detection of breast cancer]

Background and Aim: Breast cancer is the second most common cause of death among women in the world. Normal mammary gland and breast carcinomas are under the control of regulatory factors, activators and inhibitors inside the breast tissue, as well as a number of growth factors, receptors and proteins outside the breast tissue. Levels of tumor-associated antigens can be used as a predictor in the treatment of this disease. Use of antibodies against MUC1 antigen which is over expressed in 90% of breast cancers is a modern method of treatment. MUC1 tumor antigen disturbs the function of E-cadherin as a cell adhesion molecule. The purpose of this study was to produce MUC-1 recombinant protein for early diagnosis of breast cancer

Material and Methods: A part of MUC-1 gene was amplified by PCR. Then it was cloned into plasmid pET28a in order to be expressed in prokaryotic system. Plasmid pET28a was entered into E.coli BL21DE3 using heat shock method. Cloning process by digestive enzymes and sequence determination were confirmed. Bacteria containing recombinant plasmids were induced by using IPTG and the protein expression was investigated by SDS-PAGE gel

Results: The gene was cloned in the plasmid and the method was confirmed by enzyme digestion and sequencing. Gene expression was confirmed by western blotting

Conclusion: A part of human recombinant MUC-1 gene was produced in E.coli bacteria which can be used as a suitable diagnostic candidate for breast cancer

Meconium Staining of Amniotic Fluid: A Clinical Study.

Aims: To identify the frequency of meconium aspiration syndrome among the total births who suffered from meconium staining of amniotic fluid, to find out risk factors during pregnancy, therapies and various complications associated with this condition and their effects on perinatal outcome. Study Design: Retrospective study. Place and Duration of Study: AL-Yarmouk Teaching Hospital, between 1st of December 2009 to 31st of May 2010. Methodology: Total number of live birth deliveries was 5965, live births with meconium staining of amniotic fluid were 286 and meconium aspiration syndrome cases were 13. Collection of information included gestational age, fetal presentation, mode of delivery, birth weight, sex, Apgar score, type of resuscitation, treatment, associated complications and outcome. Inclusion criteria for meconium staining of amniotic fluid cases were; gestational age of ≥30 wk, presence of meconium stained skin, umbilical cord or meconium in the trachea at birth. Results: Total number of live birth deliveries matching criteria of inclusion in the study was 5965. Of these, 286 (4.8%) cases had meconium stained amniotic fluid which included 13 (4.5% of MASF cases, 0.21% or total live births) cases of meconium aspiration syndrome. Babies who were term or normal for gestational age were more prone to meconium aspiration syndrome and meconium stained amniotic fluid (P = .0008 and .016, respectively). Emergency cesarean section was significantly associated with a decreased rate of meconium stained amniotic fluid cases (P .0001). Thick meconium was more risky than thin (P = .0009). Three neonates died due to meconium aspiration syndrome complicated by respiratory failure and pneumothorax. Mortality was 23.1% of total meconium aspiration syndrome cases and 1.04% of total meconium stain amniotic fluid cases. Conclusion: Babies at highest risk of meconium aspiration syndrome and meconium stained amniotic fluid were those who had completed their term and who had an appropriate birth weight for their gestational age. Moreover, Thick meconium is associated with low Apgar scores and higher morbidity than thin meconium. Finally, abnormal presentation is an important risk factor for MAS, whereas emergency cesarean section is significantly associated with a decreased rate of meconium stained amniotic fluid cases.

Giant adominal wall hernia in a patient with cryptogenic cirrhosis

Abdominal wall hernias are common problems found in patients with cirrhosis because of persistently high intra-abdominal pressure. When abdominal hernias are neglected in such patients, they may become larger and could result in cosmetic problems and pressure effects that are also difficult to treat. We found a voluminous mass in the anterior abdominal wall of a 40-year-old patient with cirrhosis. The patient was operated on for acute cholecystitis 12 years earlier. Abdominal computed tomography revealed an epigastric hernia presenting as a grossly distended hernia sac filled with serous fluid and intestinal loops. The patient was not operated on and was discharged with sodium-restricted diet and diuretics

Comparative study on the effect of factor V leiden and prothrombin gene polymorphism in preeclampsic cases

To identify polymorphism of Factor V Leiden and Prothrombin gene in women suffering from preeclampsia. From 142 pregnant women we identified 92 women suffering from preeclampsia and 50 healthy controls with normal pregnancy matched for age and socioeconomic status, preeclampsic patient classified as mild preeclampsia 42[45.7%] and severe preeclampsia 50[54.3%]. Blood samples were tested for DNA polymorphism affecting thrombophilia Factor V Leiden and Prothrombin gene polymorphism. Heterozygous AG genotype showed a significant high frequency among preeclampsic patients [20.7%] compared to controls [4.0%], [OR 6.2, P= 0.006] regarding to Prothrombin gene but: Factor V Leiden, AG genotype showed [8.7%] of preeclampsic patients which was absent in any of the controls

Comparative study on the effect of C667T and A1298C polymorphism in preeclampsic cases

To identify polymorphism of methylenetetrahydrofolate reductase gene in women suffering from preeclampsia. From 142 pregnant women we identify 92 women suffer from preeclampsia and 50 healthy controls with normal pregnancy matched for age and socioeconomic status, preeclampsic patient classified as mild preeclampsia 42[45.7%] and severe preeclampsia 50[54.3%]. Blood samples were tested for DNA polymorphism affecting thrombophilia methylenetetrahydrofolate reductase C677T and A1298C. Homozygous TT genotype, T allele of C677T polymorphism has a significantly higher frequency among preeclampsic cases compared to healthy controls [OR=21.7, 1.46, respectively]. Thus TT genotype and T allele may be considered as genetic risk factors for preeclampsic cases. On the other hand, non significant association in either genotype among preeclampsic cases compared to controls regarding to A1298C

Prevalence of Oral Mucosal Lesions in Patients with Type 2 Diabetes Attending Hospital Universiti Sains Malaysia

Objectives: Diabetes mellitus is associated with a greater likelihood of developing certain oral mucosal disorders. This study was aimed at assessing the prevalence of oral mucosal lesions (OMLs) in patients with type 2 diabetes (DM2) and to investigate the association of such lesions with metabolic control of the disease. Methods: This cross-sectional study involved 391 patients with DM2 and 391 non-diabetic control subjects. Demographic information and data on the duration and type of diabetes, glycosylated hemoglobin (HbA1c) values, medical history, and current use of medication were obtained from medical records. Detailed oral examination was performed in accordance with international criteria. Results: The prevalence of OMLs was significantly higher among diabetic patients (45.5%) than among control subjects (38.4%) (P = 0.042). Patients with diabetes had a higher prevalence of geographic tongue (GT) (P = 0.017), denture stomatitis (P = 0.018), and angular cheilitis (P = 0.006) than controls. Overall, diabetic patients with poor metabolic control had a significantly higher prevalence of OMLs and xerostomia than patients with moderately and well-controlled disease (P < 0.05). Conclusions: The prevalence of OMLs was significantly higher in diabetic patients than in control subjects. Higher occurrence of OMLs was significantly associated with poor metabolic control.

Fulminant hepatic failure due to primary hepatic lymphoma: a case report

Primary hepatic lymphoma is a rare malignancy usually presenting with symptoms of fever, hepatomegaly, jaundice and weight loss. This picture mimics infectious and inflammatory disorders and thus delays the diagnosis. Here, we present a 47-year old man with prolonged fever who underwent several investigations and, in the meantime, developed fulminant hepatic failure before the diagnosis could be reached