Rectus abdominis endometriosis. A descriptive analysis of 10 cases concerning this rare occurrence

To report 10 cases of rectus abdominis endometrioma, emphasizing the clinical presentations, imaging investigations, cytohistological findings, and surgical treatment employed. This is a descriptive analysis of 10 surgically-proven cases of rectus abdominis muscle endometriosis, seen over a 5-year period from 2007 to 2012 at Sohag University Hospital, Sohag, Egypt and Najran Armed Forces Hospital, Najran, Saudia Arabia. All patients had undergone ultrasonography. Computerized tomography [CT] and magnetic resonance imaging [MRI] were performed in some cases. Surgical excision was the way of treatment in all patients. This study was carried out in 10 women with a mean age of 33.9 years. Nine cases had previous history of cesarean section [CS] while one patient had laparoscopy converted to laparotomy for ovarian cyst. All patients were presented with abdominal pain but only 3 had a palpable mass. Ten lesions within the rectus abdominis muscle were detected with automated ultrasound and MRI depicted one lesion, which was missed by ultrasound in a patient who had 2 concomitant lesions. Preoperative fine needle aspiration [FNA] was carried out in 2 patients. Wide surgical excision was performed in all cases. Histopathology was confirmatory in each instance. No complications or recurrence were recorded on follow-up [6-24 months; mean 13.2 months]. This disease is not as rare as previously thought, and should be included in the differential diagnosis of abdominal wall masses in reproductive-age females

Evaluation of partitional algorithms for clustering medical documents

There are large quantities of information about patients and their medical conditions. The discovery of trends and patterns hidden within the data could significantly enhance understanding of disease and medicine progression and management by evaluating stored medical documents. Methods are needed to facilitate discovering the trends and patterns within such large quantities of medical documents. Clustering medical documents into small number of meaningful clusters is one of these methods; because dealing with only the cluster that will contain relevant documents should improve effectiveness and efficiency. The produced clusters must be in high-quality because it will be used for further processing to discover the hidden trends and patterns. The focus of this paper is to experimentally evaluate the clusters' quality of partitional clustering algorithms that use different criterion functions in the context of clustering medical documents. Our experimental results show that E1 leads to the best solution using repeated bisection as clustering method in term entropy. And I1 is the best using direct clustering methods in term of both entropy and purity

Cross-reaction of antigen preparations from adult and larval stages of the parasite Setaria equina with sera from infected humans with Wuchereria bancrofti

Crude antigenic preparations from Setaria equina were used in ELISA and Western blotting to examine cross-reaction with human sera from areas endemic for bancroftian filariasis. Sera from normal subjects from non-endemic areas were included as negative controls. Cross-reaction was found between 5. equina antigens and antibodies in the sera of Wuchereria bancrofti-infected patients, with the highest levels observed between sera of chronic infected patients and Setaria spp. crude female worm surface antigen [CFSWA]. In the absence of active transmission of Setaria spp. infection, CFWSA is useful to detect chronic W. bancrofti infection before patients become symptomatic, particularly when chronic patients are known to be amicrofilaraemic. In the presence of active 5. equina infection, antigens from the adult and microfilaraemic stages showed the highest degree of cross-reaction with human sera

[Obstructive anuria due to fungus balls. Report of 3 cases]

Fungus balls as a cause of upper urinary tract obstruction are rare, with less than 60 cases reported in the literature. We herein describe three cases or secondary anuria caused by Candida infection of the upper urinary tract. The first case was observed in a patient with a transplanted kidney, the second in a diabetic patient and the third in a. patient suffering from chronic Kidney failure. The treatment consisted of urinary drainage, identification of the infectious organism and appropriate antifungal treatment.

[Intraabdominal seminoma]

We herein present a rare case of germ-cell tumor in an intra-abdominal testis of a 39-year-old patient. Cryptorchidism is one of the most important risk factors predisposing to testicular cancer. Our case underlines the importance of performing a prophylactic orchidectomy for all ectopic testes not brought down by the second year of life. The treatment of seminoma consists of inguinal orchidectomy possibly in combination with radio- or chemotherapy depending on the tumor stage

[PSA doubling time: methods of calculation and importance]

PSA doubling time is a mathematical tool which gives a dynamic value to PSA [prostatic specific antigen]. The diversity of methods applied for its calculation constitutes a real problem for urologists. We reviewed the literature and selected two simple methods used to calculate the PSA doubling time. We also evaluated the importance of PSA doubling time in contemporary urological practice

[Mature retrovesical cystic teratoma in the adult. Case report]

A teratoma is a tumor with components resembling normal derivatives of the three germ layers [ectodermal, endodermal and mesodermal]. In most cases it is located in the testis and in the sacrococcygeal region. Diagnosis mainly depends on ultrasonography and MR imaging and will be confirmed histologically. Treatment consists of surgery, aiming at complete excision of the tumor. The prognosis varies according to the age of the patient and the location of the tumor. We herein present a new case of a retro-vesical cystic teratoma in a 24-year-old patient and describe the classification, treatment and prognostic factors related to this type of tumor

[Partial cystectomy for primary neurosarcoma of the urinary bladder: a case report]

Genitor-urinary sarcomas are rare. Leiomyosarcomas and rhabdomyosarcomas are the histological types most frequently observed. The nervous origin of these sarcomas is exceptional. Early diagnosis and a complete resection of the tumor are necessary to improve the prognosis. We herein report the case of a primary neurosarcoma of the urinary bladder treated by partial cystectomy. At 9 years follow-up the patient is disease-free and has completed two pregnancies without any adverse events

[Closure of patent ductus arteriosus by indometacin in the preterm infant a case report]

We report the case of a preterm neonate presenting with a respiratory distress syndrome and hemodynamic failure. Cardiac examination reveals a continuous murmur. Echocardiography showed a patent ductus arteriosus. This newborn received indometacin during three days. A spectacular improvement was noticed. Echocardiographic control revealed the closure of the ductus

Creamatocrit-based breast milk supplementation among the preterm, is there a need?

To detect the accuracy of creamatocrit [CRCT] technique, to detect variability in lipid and caloric content of the breast milk of mothers of preterm [BM'pr] and to assess the need for supplementation of BM'pr. Creamatocrit [CRCT] of BM-pr was measured prospectively among mothers of 38 preterm and 38 term neonates within the first 2 weeks. CRCF was measured: [Fresh: foremilk. hind-milk, composite milk]. Lipid and Caloric contents were also measured using volumetric [Gerber Method] and calorimetry respectively. T-test and chi square were used to detect difference between preterm and term values. Regression analysis for the relationship between CRCT and laboratory fat and caloric contents was conducted. Linear regression equations were used for fat and caloric estimation. Mean CRCT among preterm was 5.15 +/- 1.4%, mean Lipid and caloric concentration were 34.73 +/- 11.65 g/L and 507.5 +/- 86.31 Kcal/L respectively. Compared to 9.34 +/- 2.1%, 56.4 +/- 9.3 g/L and 880.02 +/- 88.01 kcal/L among term respectively, p<0.0001 for all differences. Hind milk values for CRCT, Lipids and calories were statistically higher than foremilk. p<0.0001, 0.027, <0.0001 respectively. There was a significant linear correlation between CRCT and lipid and caloric contents: r=0. 827, p< 0.003, r=.798, p<0.006 respectively. The linear regression equations for lipid and caloric estimation were Lipids [g/L]: 1.268 + 6.497CRCT and Calories: 213.07+53.287 CRCT respectively. CRCT is a simple and reliable technique for energy assessment that can be performed in every NICU. Preterm'BM is deficient in lipids and calories. Hind-milk is higher in lipids and calories compared to foremilk. Since there is a big variability among samples, we recommend CRCT measurement prior to feeds and instant supplementation upon need. Standardized supplementation is not recommended

Laparoscopic repair of ventral hernia: an initial experience

With the evolution of minimally invasive surgery, it is thought that a potential is present to reduce the postoperative complications of ventral hernia repair. Theoretical advantages of laparoscopic repair include faster recovery less postoperative pain, less morbidity, and a better cosmetic result. The purpose of this study is to report the results of our initial experience with laparoscopic tensionfree repair technique using polypropylene mesh in patients with primary ventral hernia. From March 1996 to December 1998, laparoscopic ventral hernia repair was performed on 22 patients. There were 14 women and eight men. Age of patients ranged between 28 and 55 years [mean 46.4 years]. Type of hernia included ten para-umbilical and 12 incisional hernias. Body mass index of patients was ranging between 24 and 49 kg/m[2] [mean 31 +/- 9.7 Kg/m[2]] The size of the hernia defect ranged between 20 and 160 cm[2] [mean 96 cm[2]]. Polypropylene mesh was used in all cases and the mesh size was varying from 6x6 to 20x20 cm [median 12x12 cm].There were no deaths. In two patients [9%] conversion to open surgery was mandatory. Six complications [30%] were recorded among the twenty patients who completed the laparoscopic procedure. Most of them were minors and only one patient [5%] developed intraabdominal abscess and needed surgical intervention. No complications related to intestinal adhesion or fistula formation were recorded. The mean operating time was 90 minutes. It was 105 minutes in the initial 10 patients and decreased in the subsequent 10 cases to a mean of 85 minutes. The mean hospital stay was 2.5 days [range: 1-12 days]. After a mean of 15 months follow up [range 12 to 23 months], no recurrence was recorded.Laparoscopic ventral hernia repair offers advantages over the conventional open mesh repair and may decrease the hernia recurrence rate. When properly performed, the laparoscopic approach does not compromise the principles for successful mesh repair of ventral hernias.Also decreased hospital stays postoperative pain, and wound complications, are benefits of this technique.Regarding the type of mesh, good results can be obtained using polypropylene mesh

Effect of protein malnutrition on the immune system of normal rats treated with some immuno depressant drugs

The aim of the present work is to investigate the influence of protein malnutrition on the immuno-toxicological effect of cyclophosphamide [15mg/kg body weight /day for 5 days] and azathioprine [5mg/kg per day for 6 days] treatment on male rats. Two diet groups were used, each of 40 rats, a protein standard diet and a protein malnourished one. Protein malnutrition was induced by restricting the amount of casein in diet to 5% instead of 20% which is the approximate ideal concentration. Histopathology of spleen and thymus, body weight, organ weight and circulating immunoglobulin were chosen as parameters for this study. Histologically, the splenic haemopoeisis was reduced and was a loss in the follicular cells after cyclophosphamide and azathioprine treatment in the normal protein group. The tyniphoid follicles became more structurally disorganized and contained fewer cells in protein malnourished treated group. Thymuses from all treated groups revealed severe loss of lymphocyts but more depletion was obtained in malnourished rats after cyclophosphamide and azathioprine treatments. Significant decrease in circulating immunoglobulin, body weight and organ weight in treated groups was also noticed

Hemostatic changes after extracorporeal circulation

A number of hemostatic parameters [prothrombin time, activated partial thromboplastin time, thrombin time, activated clotting time, fibrinogen, fibrinogen degradation products and factor VII] were studied in 36 patients [15 males and 21 females]. Patients undergoing open heart surgery for repair of rheumatic heart disease or acyanotic heart disease, were the subject of this study. The decrease in coagulation factors can be explained by dilution with priming solution, mechanical destruction, fibrinolysis and preoperative liver congestion due to valve lesions. The increase in the activated clotting time was attributed to platelets dysfunction. Hypofibrinogenemia secondary to hyperfibrinolysis after cardiopulmonary bypass [CPB] may explain the frequent occurrence of pos C.P.B. nonsurgical bleeding

role of ultrasonography in the diagnosis of dysthyroid eye disease

Thirty cases of Dysthyroid eye disease [DED], were studied, together with eleven cases of thyroid hyperfunction without clinical eye manifestation, and ten cases of normal controls. The cases were evaluated clinically: form the ophthalmic and medical points of view, and were examined by ophthalmic ultrasound. It was found that ultrasonographic extraocular muscles manifestations in the form of thickened muscle belly and internal echoes were found in cases with exophthalmos, and in some cases of hyperthyroidism without exophthalmos. The retrobulbar fat showed some changes in the form of internal vacuolation and irregular posterior limitant, and the optic nerve showed disk oedema and exaggeration of the sheathes, in few cases. Ultrasound was found to be very useful in diagnosing eye pathology in DED, and could be helpful in treatment follow up

differential diagnosis of retinal detachment [an electroretiongraphic and an ultrasonographic study]

This work was done in Ain Shams University Hospital in the last two years. Sixty patients of retinal detachment and allied conditions were diagnosed clinically, and studied by ultrasonography electroretinography. The role of each of these two tests is discussed and evaluated in each condition. The results showed that both tests are complementary in confirming the diagnosis doubtful cases

value of ultrasonography and fluorescein fundus angiography in the differential diagnosis of optic nerve head oedema

Fifty six eyes with optic nerve head oedema were studied. Since all cases had clear media, fluorescein fundus angiography and coloured fundus pictures were taken; ultrasonography as well as performed. Cases included pleuro-cephalic oedema, acute anterior ischemic optic neuropathy, acute hypotony due to trauma or uveitis, acute papilHtis and giant drusen. Ultrasonography could only confirm the clinical differential diagnosis in cases with giant drusen while could not differentiate between other cases which gave same pictures. On the other hand, fluorescein fundus angiography differentiated only acute anterior ischaemic optic neuropathy from other lesions

Identifying indigenous methods used in menstrual hygiene among preparatory school girls in Alexandria

The study was conducted to identify indigenous methods used in menstrual hygiene among preparatory school girls in Alexandria. The study was carried out at four preparatory schools. The sample comprised of 282 girls who were convinced to participate in the study. The results revealed that some students tended to prohibit varieties of activities. About two thirds of the girls tended to use some indigenous methods during menstrual period. Mothers, grandmothers and sisters were the source of information among the girls