Immunological aspects of cystic echinococcosis in Erbil

Ecbinococcus granirtosus exists as a complex of different strains that differ in a wide variety of criteria that impact on the epidemiology, immunology, pathology and control of hydatid disease. This study was undertaken to investigate both humoral and cellular immune responses that are developed against hydatid cysts in Erbil. Thirty patients [9 males and 21 female] with surgically confirmed cystic echinococcosis and 10 apparently healthy individuals were included in this study. IgG ELISA was performed to assess humoral immune responses. CD4/ CD8 ratio, eosinophil count and lymphocyte transformation response were done to asses the cellular immune responses. The level of IFN-gamma and TNF-alpha was also assayed. The sensitivity of ELISA to detect anti-hydatid antibodies was shown to be 83.33%. CD4 / CD8 ratio was significantly [P< 0.001] decreased in patients with cystic echinococcosis as compared to normal control group, while eosinophil count [P< 0.001], lymphocyte transformation response [P< 0.001] and IFN-gamma level [P< 0.01] were significantly increased. In contrast the level of TNF alpha was non- significantly changed in echinococcosis patients. The current study showed that the local strain of Echinococcus granulosus induces both cellular and humoral immune responses, and the number of peripheral blood CD8 T cells was significantly increased in cystic echinococcosis patients. However, hyporesponsivness to hydatid specific antigens has not been induced

new approach for thyroidectomy [isthmus first]: a preliminary study

Doing surgery for a huge goiter is always time consuming with difficulty to deliver goiter to the operating field which might increase morbidity. Therefore, this study was carried out to demonstrate a new technique in dealing with huge goiter. A total of 287patients with huge goiter admitted to Al-Ramadi general hospital, Al-Anbar governorate, during Feb. 1993 to Dec. 2002 were included in the study. Two types of surgical techniques were differentiated, the conventional one versus isthmus first. Out of the total patients 133 [46.3%] were underwent conventional thyroidectomy and 154 [53.7%] were underwent isthmus first technique. A significant reduction in operation time in isthmus first than in the conventional one was observed. Significant reduction in postoperative bleeding, temporarily Hypoparathyroidism, and external laryngeal nerve injury was noticed. Simple multinodular goiter, toxic goiter, neoplastic goiter and Hashimato's thyroiditis were the histopathological diagnosis of goiter underwent thyroidectomy in both surgical techniques. Isthmus first provides less operating time and surgical invasiveness and easily handling goiter than the conventional one

Retroperitoneal tumors: types and presentations

The retroperitoneal tumors is usually confined to lesions arising from tissues [muscles, fat, lymph nodes, nerves, and, developmental remnant] of this compartment but excluding origin from the retroperitoneal organs [panaceas, kidney, ureters and adrenals]. The aim of the study is to focus a light on the types of retroperitoneal tumors, ways of the investigations and the presentations. A prospective review study of 25 patients with retroperitoneal tumors has been collected in the Medical City Teaching Hospitals During the period between Jan 2001 to Mar 2004. The data included age, gender, risks factors, clinical presentations, diagnostic modalities and results ofhistopathology. 14 males [56%] and 11 females [44%_ patients. The highest incidence of patients were in the [51-60 years] age group [10/25, 40%]. The most common presenting feature was abdominal mass [20/25, 80%]. u/s and CT scan were the most reliable investigations in the diagnosis. The most common tumors were sarcomas [15/25, 60%] and lymphomas [5/25, 20%]. Although retroperitoneal neoplasms account for 0.1 - 0.2% of all malignancies [s], it seems that from our findings most of the tumors were malignant, where the sarcoma represents the common tumor among them, the presentations and the diagnostic modalities especially u/s and CT have a similarity with most of the studies reviewed

The incidentally discovered asymptomatic adrenal tuberculous mass mimicking malignancy.

Tuberculous adrenal mass without any tuberculous changes in other sites is a rare entity. In this study we describe such a case. A male patient of 47 years with 6 months history of anorexia and weakness was presented. Ultrasonography and computed tomography revealed a mass in the right adrenal gland. It was mistaken as a malignant neoplasm and the diagnosis was confirmed by surgical exploration.