Independent predictors for non-alcoholic fatty liver disease in patients with treatment-naïve chronic hepatitis B

SUMMARY OBJECTIVE: There are limited data on non-alcoholic fatty liver disease in chronic hepatitis B virus infection. We aimed to determine the predictors for non-alcoholic fatty liver disease in patients with treatment-naïve chronic hepatitis B virus infection. METHODS: All consecutive treatment-naïve patients with chronic hepatitis B virus infection at the Haseki Training and Research Hospital between October 1, 2021, and September 31, 2022, were retrospectively enrolled. Chronic hepatitis B virus infection is defined by positive serum hepatitis B surface antigen for 6 months or more. Patients with significant alcohol consumption, prolonged steatogenic drug use, malignancy, monogenic hereditary disorders, patients co-infected with hepatitis D virus, hepatitis C virus infection, or human immunodeficiency virus were excluded. Demographic characteristics, anthropometric determinants, laboratory findings, and virological parameters were retrospectively collected from patients' charts and electronic medical records. RESULTS: A total of 457 patients with treatment-naïve chronic hepatitis B virus infection were included in the study. The three multivariate regression models revealed that age (p<0.028), body mass index (p=0.046), diabetes mellitus (p=0.030), hemoglobin (p=0.008), platelet (p=0.012), and triglyceride (p=0.002) in Model 1; body mass index (p=0.033), diabetes mellitus (p<0.001), hemoglobin (p=0.008), platelet (p=0.004), LDL (p=0.023), and HDL (p=0.020) in Model 2; and age (p<0.001), body mass index (p=0.033), hemoglobin (p=0.004), platelet (p=0.004), and HDL (p=0.007) in Model 3 were independent predictors. CONCLUSION: Non-alcoholic fatty liver disease was observed in about one-third of patients with chronic hepatitis B virus infection and was positively associated with older age, higher body mass index, presence of comorbid conditions including diabetes mellitus, increased levels of metabolic laboratory parameters, especially serum triglyceride and LDL, and decreased HDL.

The illustrations and terminology of Hamse-i Sânizâde written by Sânizâde Ataullah Efendi: the stomach / Las ilustraciones y terminología de Hamse-i Sânizâde escrito por Sânizâde Ataullah Efendi: el estómago

SUMMARY: The book "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân" written by Sânîzâde Mehmet Ataullah Efendi was the first illustrated anatomy book published in the Ottoman Empire. The aim of this study was to determine the similarities and differences between the terms and definitions of stomach anatomy used by Sânîzâde at that time and those used today. The stomach section of the "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân" was examined and related plates were translated into the Turkish language. Anatomical terms and definitions of stomach anatomy in this book were compared to the stomach terminology used in "Terminologia Anatomica" which is the reference book for terminology today. The stomach section was explained under the title "El-Babu-Sâlis fi Tesrihi'l-Mi'de" (Illustrated Stomach Anatomy) in this book. Parts, margins, arteries, veins, nerves and layers of the stomach were explained with the terms and definitions of that period. Terminologia Anatomica has 33 anatomical terms related to the stomach, while 15 terms were identified in the book "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân". Although more terms related to the stomach anatomy are used today, the fundamental information on stomach anatomy in Sânîzâde's book was compatible with much of the information used in modern anatomy books today.

El libro "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l- Insân" escrito por Sânîzâde Mehmet Ataullah Efendi fue el primer libro de anatomía ilustrado y publicado en el Imperio Otomano. El objetivo de este estudio fue determinar las similitudes y diferen- cias entre los términos y definiciones de la anatomía del estómago utilizados por Sânîzâde en ese momento y los que se utilizan en la actualidad. Se examinó la sección del estómago del "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân" y las placas relacionadas se tradujeron al idioma turco. Los términos anatómicos y las definiciones de la anatomía del estómago en este libro se compararon con la terminología del estómago utilizada en Terminologia Anatomica, el libro de referencia para la terminología utilizado actualmente. La sección del estómago se explicó bajo el título "El-Babu-Sâlis fi Tesrihi'l-Mi'de" (Anatomía del estómago ilustrada) en este libro. Fueron definidas las partes, márgenes, arterias, venas, nervios y capas del estómago con los términos y definiciones de esa época. Terminologia Anatomica tiene 33 términos anatómicos relacionados con el estómago, mientras que 15 términos fueron identificados en el libro "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân". Aunque hoy en día se utilizan más términos relacionados con la anatomía del estómago, la información fundamental sobre la anatomía del estómago en el libro de Sânîzâde era compatible con gran parte de la información utilizada en los libros de anatomía modernos en la actualidad.

Is There A System Inflammatory Effect of Cholesteatoma?

Abstract Introduction Inflammation causes squamous epithelial transformation of the mucosa in the middle ear cavity and plays a role in the onset, growth, spread, and recurrence of cholesteatoma. Objectives The objective of this study is to investigate the systemic inflammatory effect in chronic otitis with cholesteatoma. Methods The study included a total of 311 patients comprising 156 patients with a pathology diagnosis of cholesteatoma and a control group of 155 with no active inflammation. The Neutrophil-to-lymphocyte Ratio (NLR) was calculated by dividing the neutrophil value by the lymphocyte value. Results The mean NLR was 1.94 ± 0.91 in the patients with cholesteatoma and 1.94 ± 0.85 in the control group. We determined no statistically significant difference between the groups in respect of NLR (p = 0.983). We calculated the NLR as 2.01 ± 1.00 in patients with ossicle erosion and 1.82 ± 0.69 in those without ossicle erosion, 1.86 ± 0.85 in patients with bone erosion and 1.98 ± 0.95 in those without bone erosion. We determined no statistical difference between these values (p = 0.175). Conclusion The results of this study showed that NLR had no predictive value in respect of bone erosions and associated complications in patients with cholesteatoma. The inflammatory effect of cholesteatoma is not systemic but remains more local.

Assessment of Mechanical and Electrical Dyssynchrony in Cardiomyopathy.

Background: Cardiac resynchronization therapy (CRT) had shown great promise in improving hospitalization and mortality of the patients suffering from refractory heart failure (HF) inspite of optimal medical management. The goal of CRT is to reduce cardiac mechanical dyssynchrony, thereby enabling the heart to contract more efficiently. Mechanical ventricular dyssynchrony as estimated by electrical dyssynchrony, is assessed with the QRS duration. But electrical and mechanical dyssynchrony are not well correlated in all HF patients. The dyssynchrony might have been related to the underlying etiology of HF. Objective: To compare the concordance of mechanical and electrical dyssynchrony in both ischemic and nonischemic cardiomyopathy patients. Methods: Doppler echocardiography and strain echocardiography was performed in 76 patients presenting with heart failure due to ischemic cardiomyopathy (n=40) or nonischemic cardiomyopathy (n=36) with left ventricular ejection fraction<35% & New York Heart Association class III–IV, regardless of their QRS duration. Interventricular dyssynchrony was assessed by the time interval between preaortic and prepulmonary ejection times. Intra-ventricular dyssynchrony was assessed by using conventional Doppler and strain echocardiograpy. Obtained from the three standard apical view (TMinMax) and (2) the standard deviation of the averaged time-to-peak strain (TPS-SD, ms) and (3) time to peak myocardial systolic velocity (Ts-SD) of same segments. Result: The correlation coefficient between QRS duration and mechanical interventricular dyssynchrony was significant (r=0.57, P=0.001) in patients with non-ischemic cardiomyopathy and insignificant (r=0.175, p=0.281) in patients with ischemic cardiomyoparhy. The correlation coefficient between QRS duration and mechanical intraventricular dyssynchrony was significant in patients with nonischemic cardiomyopathy (r= 0.69, P = 0.001 for TMin Max; r=0.57, P= 0.001 for TPS-SD; r=0.48, p=0.003 for TS-SD) and insignificant in patients with ischemic cardiomyopathy (r=0.153; p=0.345 for TMin Max; r=0.178; p=0.273 for TPS-SD r=0.139; p=0.392 for TS-SD). Conclusion: This study showed that the relationship between electrical and mechanical dyssynchrony is dependent on the underlying etiology of heart failure.

Hodgkin lymphoma: a retrospective clinical and pathological analyses with correlation to treatment outcome

Aim of the work: the aim of the study was to analyze the correlation between several clinico-pathological prognostic factors in classical type Hodgkin lymphoma and its effect on response to treatment and survival rates [PFS and OS]. The primary endpoint is response rate and secondary endpoints are survival rates

Patients and methods: this study was performed on 76 patients diagnosed as classical Hodgkin lymphoma that were recruited retrospectively from January 2010 to December 2015 in Nasser Institute Oncology Centre and Ain Shams Clinical Oncology Department. Patients' risk factors in the whole group were analyzed using univariate and multivariate regression analysis. They included age, sex, pathological type, B symptoms, performance status, stage, extranoadal disease, bulky disease, inflammatory markers and their correlation on complete response rate [CR], progression free survival [PFS] and overall survival [OS]

Results: nodular sclerosing type was the most common in 44.7% of patients followed by mixed cellularity in 21.1% of patients followed by lymphocyte predominant in14.4% of patients, while unclassified classical constituted 19.7%. Early disease [Stage I, II] constituted 68.4% of patients and late disease [Stage III, IV] was found in 31.6% of patients. Bulky and extranodal diseases were found in 28.9% and 21.05% of patients respectively. All of patients received first line ABVD with 59.2% of patients received consolidative or palliative radiotherapy. CR rate was 65.8% being 71.2% in the early versus 52% in the advanced stage [p=0.07] with a relapse rate of 7.8%. The CR was negatively correlated with pathological type being worse in nodular sclerosing subtype than mixed cellularity [p=0.02], poor performance status [p=0.016], bulky disease [p=0.004], extranodal disease [p=0.0381], elevated LDH [p=0.045] and leucocytosis and lymphopenia [p=0.005]. Median PFS was 17.5 months with a range of 1 to 75 months. 5 year PFS was negatively correlated with advanced stage than early stage [p=0.019], Bulky disease than non bulky [p=0.003], extranodal disease than nodal [p=0.014], leucocytosis and lymphopenia [p= 0.002]. Median overall survival is 28 months with a range of 6-81 months with 5 years survival rate of 82.9% and mortality rate of 17.1%. 5 year overall survival was negatively associated with bulky rather than non bulky [p=0.05] and extranodal more than nodal [p=0.007]

Conclusion: this study concluded that both overall and progression free survival and response rates were negatively affected by stage, bulky and extranodal disease mainly. Pathological subtype and elevated ESR and LDH negatively affected CR rate. Leucocytosis and lymphopenia had a significant negative effect on response rate and progression free survival. This allowed the use of risk adapted treatment at several stages tailoring treatment to each patient separately

Carotid artery disease in Sudanese diabetic patients asymptomatic for cerebrovascular disease

Diabetes is a risk factor in the development of atherosclerosis and likewise carotid artery disease which can be detected usingcarotid ultrasound examinations. The study undertaken in a group of asymptomatic type 2 Sudanese diabetic patients to assess the prevalence of carotid artery disease. Intima-media thickness [IMT], the presence and degree of carotid artery stenosis were assessed by ultrasonography in 63 diabetic subjects. The findings of ultrasound examinations were correlated to the patients' clinical information. Abnormal IMT found in 65% of the studied subjects a degree of carotid artery stenosis in 31.7%. More than 50% carotid artery stenosis in 14.3%. The results also showed association between the abnormal findings increasing age, female gender, prolonged duration of the disease. Presence of carotid artery disease in diabetic patients asymptomatic for cerebrovascular disease, the increasing frequency of these abnormalities with increasing subject's age, and duration of illness was also investigated and it was found to decrease when the concentration is increased

Wilms' tumor in children: a single institution 10-year experience

To evaluate the disease characteristics and treatment outcome of children with wilms' tumorat King Hussein Medical Center over a period of 10 years. We conducted a retrospective review of the medical files of children [< 14 years] withwilms' tumor who were managed at King Hussein Medical Center -Jordan in the interval between June,2000 until June, 2010 . Patients' and disease characteristics, treatment modalities and outcome wereanalyzed. Staging and histopathological classification were preformed according to the system of theNational Wilms Tumor Study Group [NWTSG]. Descriptive analysis using frequencies was used todescribe the study variables. A total of 61 patients [54.1% female] with wilms' tumor with a median age of 40 months wereidentified. Their ages ranged between seven months and 7.8 years. The stage frequencies of our caseswere: stage I [27.9%], stage II [34.4%], stage III [16.4%], stage IV [11.5%] and stage V [9.8%] . The 3- year relapse-free survival rate was 100%, 81%, 70%, 57.1% and 83.3% for stages I, II, III, IVand V, respectively. Favorable histology accounted for 86.9% [53 cases] of our patients . The 3-yearrelapse-free survival rate was 84.9% for the favorable histology and 62.5% for the anaplastic histology.The 3- year relapse-free survival rate for the entire group was 82%.Combined modality management including surgery, chemotherapy and radiotherapyresulted in satisfactory loco-regional and systemic control and better relapse-free survival in pediatricpatients with wilms' tumor . Stage and histopathologic classification of the disease were important asprognostic factors

Osteoarthritis prescribing habits in the western region of Saudi Arabia

Objective: Osteoarthritis prescribing habits in Western Region of KSA and whether they match the guidelines or not

Methods: Qualitative using structured questionnaire via face to face interviews, the study included 100 doctors interfering with OA management. Interviews were conducted in Jeddah and Mecca Hospitals between July and December 2012

Results: 71% of doctors mentioned that they depend on their personal experience and don't follow International Guidelines [p value < 0.05]. All doctors use both Non-pharmacological and Pharmacological measures in the treatment of OA. Non-pharmacological measures are weight reduction [96%], patient's education [74%], exercise [73%], heat / ice application [39%] and rest [31%]. 81% of doctors mentioned that they start treatment with mono-therapy in the form of NSAIDs [36 - 44.44%] which is not matching the guidelines, followed by Paracetamol [32- 39.51%] and Celecoxib [10- 12.35%]. 14% mentioned that they start treatment with combined therapy. The most common combination is Glucosamine + Diclophenac/ Celecoxib [4-28.57%] followed by Paracetamol + NSAIDs [3 - 21.43%], Ibuprofen/ Diclophenac + Celecoxib [3-21.43%] and Paracetamol + Celecoxib [2 - 14.29%]

Conclusions:Non-pharmacological measures recommended by doctors are weight Reduction, patient education, physiotherapy, exercise, heat application, and ice therapy, which match the international guidelines. Pharmacological measures in form of NSAIDs whether selective or non-selective are the 1st line choice for doctors unlike the international guidelines that recommend Paracetamol as 1st line

Implementation of the reaching every district [RED] approach: experience from North Sudan

The purpose of this evaluation was to assess the extent and quality of implementing the Reaching Every District [RED] approach in North Sudan and its impact on immunization coverage. The evaluation was conducted in all 70 districts of North Sudan, excluding Darfur. District RED implementation data for 2006 were collected from district staff and used to quantify implementation by calculating Implementation Scores [IS] using a 10-point scale, with 10 being fully implemented. Overall RED IS ranged from 1.6 to 8.9. The percentage of districts with diphtheria-pertussis-tetanus [DPT] 3 coverage >/=80% increased as the overall RED IS increased, 78%, 87%, and 96% in low-, medium-, and high-scoring groups respectively. The degree of RED implementation varied across districts. Although it is not possible to directly attribute the overall increase in DPT3 coverage to RED implementation, RED implementation quality might be associated with improved DPT3 coverage

Value of transesophageal echocardiography in assessment of left atrial appendage function

In AF, cardiogenic emboli are the sources of transient ischemic attack [TIA] and stroke in 20-40% of patients, and the left atrial appendage [LAA] is almost always the site of thrombus formation [Hart and Halperin, et al., 2001]. To evaluate the value of transesophageal echocardiography [TEE] in assessment of left atrial appendage function The study will include sixty consecutive patients with indication for TEE assessment to detection of left atrial appendage [LAA] thrombi at BAB AL-SHE>RYIA University Hospital - Al-Azhar University, between December, 2009 to April, 2010 ,30 patientswith history of ischemic stroke, 30 patients with dilated left atrium ,A11 subjects will be subjected to the followings:-Full history- Clinical examination -12 leads resting ECG- TranSoesophageal echocardiography used to to visualize the LA, LAA and RAA. LAA area [LAA a] and volume [LAA v] was obtained by area length method [Pollick and Taylor, 1991]. will show highly statistically significant values between patients groups in the following LAA emptying velocity [LAA vel] ,LA appendage AM wave [LAA AM] and with no significant values in LAA area [LAA a], LAA volume [LAA v] LA appendage EM wave [LAA EM], LA appendage SM wave[LAASM] The LAA end diastolic tissue Doppler velocity [LAA AM] is a parameter that allows evaluate the LAA myocardial function with stress on TTE as non invasive test

Novel finding in BRCA1 from Malaysian breast cancer patients

The aim of the present study was to [1]. Investigate and analyze the role of genetic factor in breast cancer from Malaysian patients with either early-onset breast cancer [at age

study of the possible influence of biphenyl dimethyl dicarboxylate [DDB] on the social behavior developed by the sensory contact model in mice

The sensory contact model allows forming different psychopathological states produced by repeated agonistic interactions in male mice. It gives the opportunity of using animals with behavioral pathology to investigate the action of novel [along with widely used] psychotropic drugs and to conduct their screening in the simulated clinical conditions. Due to wide use of Biphenyl Dimethyl Dicarboxylate [DDB] together with its neurobehavioral effect, the present work aimed to investigate the possible effects of DDB on social behavior by studying its protective and medicative effects on the process of transformation to aggressive and submissive behaviors using the sensory contact model. Besides, measuring behavioral changes [using the open field test and the elevated plus maze test], neurotransmitters [serotonin, norepinephrine, and dopamine] and immunological changes [total leucocyte count, differential leucocytic count, and evaluation of bone marrow lymphocytes count and viability assessment] were evaluated. The work was conducted using adult male Swiss mice. DDB was administered orally in a dose of 100 mg/kg/day for two weeks and in two regimens. First as a protective treatment: it was applied for two weeks from the fifth day to the last day of the sensory contact model. Second, as a medicative treatment: DDP was administered after the end of the sensory contact model where the animals were kept in comfortable housing condition without daily interaction and received the treatment for two weeks. The present results concluded that, administration of DDB to the sensory contact model involved animals was showen to be associated with significant impacts on the animals' behavior, brain contents of neurotransmitters as well as the examined immunity related parameters. The produced effects were developed on the frame of DDB administration, whether it is administred as a possible protective agent or as a possible medicative one

Chronic hepatitis C virus infection: prevalence of cryoglobulinemia and renal affection in the Egyptian patients

The association between mixed cryoglobulinema [MC], chronic hepatitis C virus [CHC], and renal insufficiency was documented. This paper aimed to determine the prevalence of cryoglobulinemia [CG], and renal affection drug-naive Egyptian patients suffering from CHC-in a cross-sectional study So, 53 patients with CHC and 20 healthy controls were included. Parameters investigated covered; HCV antibodies, HCV RNA, liver profile [AST, ALT, serum albumin, total bilirubin, prothrombin time], renal profile [urea, uric acid, creatinine clearance, urinary albumin], CG, C3, .C4, and three MDRD equations to calculate the GFR. The results showed that CG was found in all patients, but none in controls. The renal markers showed that none of the patients suffered frank nephropathy, but were at increased risk for developing kidney disease

Synthesis, antimicrobial and anti-inflammatory activities of some new N-substituted sulphonyl indole-3-heterocyclic derivatives

A series of I-substituted sulfonyl indole -3-pyrazolines [4a-j and 5-a-j] and isoxazolines [6a-j] were prepared and tested for their antimicrobial and anti-inflammatory activities. The preparation of compounds 4-6a-j was achieved by treatment of the corresponding chalcones 3a-j with hydrazine hydrate in absolute ethanol, hydrazine hydrate in the presence of glacial acetic acid, and with hydroxylamine hydrochloride in absolute ethanol. The purified products were screened for their antimicrobial activity towards Gram positive, Gram negative bacteria and fungi and also for their anti-inflammatory activity using the carrageenan-induced rat paw oedema. Evaluation of the compounds revealed remarkable antibacterial activity reflected by their ability to inhibit Gram positive and Gram negative bacteria, and also revealed remarkable anti-inflammatory activity reflected by their ability to reduce the carrageenan-induced inflammation in rats

Prevalence of hepatitis C, hepatitis B and human immunodeficiency virus infection among blood donors at Fatimid center Multan

To find out the prevalence of Hepatitis C, Hepatitis B and HIV infection among blood donors at Fatimid Center, Multan., determine whether the laboratory methods to be used for the detection of HBV, HCV and HIV infection and disseminate the findings of the study for the constitution of proper screening programme at blood transfusion centers. This cross-sectional study was designed to know the screening pattern of Hepatitis B, Hepatitis C and human immunodeficiency virus in blood donors at Fatimid Center Multan during the period from November 2001 to December 2001. Hepatitis C, Hepatitis B and HIV infection is commonly transmitted via blood, blood products and unsafe sex from one person to another in the community. 1014 blood donors were screened for Hepatitis B, Hepatitis C and HIV antigen. 79 were found reactive for HBV, 37 reactive for HCV and HIV reactive was found none. The recipients of Hepatitis C and Hepatitis B reactive blood are 20 times more likely to have evidence of post transfusion Hepatitis C and Hepatitis B infection than recipient of Hepatitis C and Hepatitis B non reactive blood. This study was carried out with the objectives to see prevalence of Hepatitis C, Hepatitis B and HIV infection in blood donors, Hepatitis B Hepatitis C and HIV infection association with parentraI therapies, etc. Blood donors record for HBV, HCV and HIV was collected from blood bank of Fatimid Center Multan. Among 79 Hepatitis B reactive blood donors 30 [37.97%] had history of previous blood transfusion, 7 [8.86%] had parentral therapy, 2 [2.53%] had history of drug addiction, 2 [2.53%] had history of sexual contact while 37 Hepatitis C reactive blood donors 5 [13.51%] had history of previous blood transfusion and 20 [54.05%] had history of parentral therapy. None had history drug addiction, 9 [24.32%] had history of sexual contact. Luckily no HIV infection reactive case was found. The results of the present study underline the dire need to have a national comprehensive plan with multidisciplinary approach for HBV, HCV, HIV prevention is the community. It is suggested that blood and blood products should be screened for HCV, HBV, HIV infection before transfusion and use of disposable syringes, other sterilized instruments during hospital stay and use of disposable razors at barbers shop must be kept in mind

Weaning practices in urban and rural areas of Pakistan

Weaning practices varies in different communities and affected by beliefs. Family feeding order, attitudes towards weaning nutrition, geography, economic status, climate etc. Detailed knowledge of above factors is essential to improve the child nutrition. The growth of an infant and a young child is almost totally dependent on the nutrition he is getting. Improper feeding practices and poor nutrition of a young child can lead to ill health and malnutrition. It is essential to explore the knowledge, customs, beliefs and their effects to overcome malnurition and growth retardation. It is also necessary to know about the knowledge, attitude and practices relating to weaning in different communities and factor influencing these. The study is conducted on mothers of children at the age of weaning from both unban and rural origin. Simple random sampling technique is adopted for the study purpose. A questionnaire prepared to evaluate knowledge, beliefs, customs, and dietary habits relating to weaning and effect of economy, demography, literacy etc. on the believes, customs and practices. After collection of data, analysis done to draw conclusions. The study shows that 65% children are weaned at the age of 4 to 6 months in urban population while 50% in rural areas. In both population middle class weaned their children early, education also improved the situation. Weaning before the age of 3 months existed to some extent in both populations. Mixed feeding prevalent in both communities. Trend towards introduction of processed foods is more in both populations, food fads and to boos are also present, but more prevalent in rural areas, due to these high energy and protein foods are usually prohibited for a young child. In urban areas, children of working mothers also affected due to improper look after by the servants and relatives. The study shows that many children in both rural and urban population do not receive the right food to eat in their early childhood. This is resulted in growth retardation, and ill health in most children. This is true more in rural areas as compared to urban areas, but there are no significant differences in both populations, Predisposing factors include low income of the family, illiteracy, delayed weaning, late introduction of high-energy foods, protein and other nutrients for infant growth. In case the weaning foods are introduced to the infant at the right age, their frequency is less than required number of feeds per day

Effect of hemodialysis on total, free and percent-free prostate-specific antigen

Objective: To evaluate the effect of homodialysis on serum total, free and percent free prostate specific antigen [PSA]

Patients and Methods: This study included 34 men with chronic renal failure [mean age 58 years, range 45-80] who received hemodialysis with low flux membranes. We measured pro- and post-hemodialysis total PSA [tPSA], free PSA [fPSA] and hematocrit [Htc] at one dialysis session. Additionally, the percent fPSA to tPSA [f/t PSA] ratio was calculated before and after dialysis. Htc was measured before and after dialysis to determine the degree of hemoconcentration and the correlation between PSA levels and Htc

Results: There were statistically significant increments in the mean values of tPSA [pre-dialysis 1.2, post-dialysis 1.4 ng/ml] and f/tPSA ratio [pre-dialysis 28.2%, post- dialysis 35.2%]. In addition, a significant increase in Htc was noted after dialysis. The mean pro-dialysis fPSA was 0.4 and the post-dialysis value was 0.43 ng/m [difference not statistically significant]. The degree of hemoconcentration was not statistically correlated with the elevation in the values of tPSA, fPSA and fitPSA

Conclusions: Although the increment in tPSA was statistically significant, it was not clinically meaningful. The most likely explanation for the increment in tPSA and fPSA after hemodialysis is volume contraction, and hemodialysis with low flu] membranes appears to have no effect or PSA clearance. Pre-dialysis determination of tPSA probably provides no false positive results. Therefore, we advocat that serum PSA determination is done in conjunction with digital rectal examination [DRE] and/or transrectal ultrasonography [TRUS] in patients on dialysis, especially those who are candidates for renal trans plantation, to rule out prostate cancer

Iatrogenic cholesteatoma following tympanoplasty for non-cholesteatomatous chronic otitis media

Iatrogenic cholesteatoma is a form of recidivism that results from squamous epithelial seeding or entrapment as a result of the surgical. They may occur after tympanoplasty, whether or not cholesteatoma was originally present. Incidence of iatrogenic cholesteatoma resulting from ear surgery for non cholesteatomatous otitis media is around 5%. In this retrospective study we describe the site of origin and time of occurrence of iatrogenic epidermoid cysts or cholesteatoma following a series of cases that underwent tympanoplasty for CSOM without cholesteatoma by the author at the Ear Nose and Throat Teaching Hospital. The significance of this information is to help us predict the type character, site and postoperative time of appearance of iatrogenic cbolesteatoma. Managed in the right time, this step is hoped to prevent the development of a more extensive disease and thus reduce the incidence of recurrent active cholesteatoma. A series of 180 tympanoplasties with or without Mastoidectomy, for COM without cholesteatoma were included. Eight cases of iatrogenic cholesteatoma [4.4%] were identified in the form of epidermoid cysts [pearls] [n=8] or frank open cholesteatoma [n=2]. Postoperative time of detection was 4-12 months for the pearls and 4 and 5 years for the open cholesteatoma Site of recurrence for pearls were mainly related to the annulus and the handle of the malleus. While cholesteatoma of the open type originated in the posterior bony wall of the external auditory canal eroding the bone and invading the mastoid where they extended to the antrum and attic. Suggestions for prevention early detection and management of these recurrences are presented

Ultrasonographic diagnosis of pre-term versus term infantile hypertrophic pyloric stenosis

To evaluate the determinants of ultrasonographic measurements of pyloric length and muscle thickness in pre-term versus term infants with hypertrophic pyloric stenosis [HPS]. fifty infants 920 pre-term and 30 term] were operated upon for hps at Assiut University Hospital over 2-year period. Ultrasonographic measurements of pyloric length and muscle thickness were related to age, history of prematurely, weight, sex and family history of H.P.S. Pyloric length in infants with HPS was significantly greater at those born at term compared to those born prematurely [18.4mm SD 2-1 vs 17.1 mm SD 3], P = 0.042, this was explained by body weight and length increasing by 1.1mm [SD 0.34] per 0.042, this was explained by body weight and length increasing by 1.1mm [SD 0.34] per kilogram [P = 0.002]. There was no significant relationship with measured muscle thickness. Ultrasonograhic measurement of pyloric length is strongly correlated with the weight of the infant irrespective of other factors. The relationship of length and weight may be useful in confirming the presence of HPS in small and pre-term infants

Frequency and patterns of gastrointestinal wall thickening in patients with liver cirrhosis by contrast enhanced CT

To evaluate the frequency and patterns of gastrointestinal wall thickening at contrast material-enhanced computed tomograhy CT in patients with liver cirrhosis. Three radiologists retrospectively assessed the contrast-enhanced abdominal CT scans of 150 patients with cirrhosis and 100 patients without cirrhosis for gastrointestinal wall thickening from the stomach through the descending colon. The frequencies of wall thickening were determined in the cirrhosis and in the control groups. The segmental distribution, symmetry, and enhancement pattern were evaluated in all patients with cirrhosis and compared with the control group. Gastrointestinal wall thickening was seen in 98 patients [65.3%] with cirrhosis and in nine [9%] control subjects [P <0.005]. The jejunum and ascending colon were the most common sites of gastrointestinal wall thickening; each was involved in 64 [42.6%] patients. The scans of 60 [40%] patients with gastrointestinal wall thickening showed multisegmental distribution. Gastrointestinal wall thickening was concentric and homogenous in all patients with liver cirrhosis. Gastrointestinal wall thickening is common on contrast-enhanced abdominal CT scans in patients with cirrhosis. Multiple segments were involved. Frequently, the jejunum and ascending colon are the most common sites of involvement