Role of peritoneal ports for treatment of intractable ascites

Ascites is a common complication of advanced malignancies and cirrhosis. Symptoms of marked abdominal distention, shortness of breath, diminished appetite, fatigue, and lower-extremity edema can significantly compromise a patient's everyday life. Treatment options for intractable ascites include serial paracentesis, peritoneovenous shunting, transjugular intrahepatic portosystemic shunt [TIPS] creation, and tunneled peritoneal catheters that may be external or, more recently, attached to subcutaneous ports. It is therefore appropriate to evaluate a port specifically designed for peritoneal access as a mean of controlling intractable ascites. We present a minimally invasive treatment for palliative drainage of symptomatic ascites in patients with advanced malignancy. The aim of this work is to evaluate the percutaneous implantable access system specifically designed for peritoneal access as a method to control intractable ascites as regards complications and patency. This is a prospective intervention study will be conducted on 40 patients with intractable ascites referred from the oncology clinic to the diagnostic imaging department for percutaneous placement of peritoneal portcath as a palliative treatment for the patient. Good technical success rate [100%] in insertion was found with removal of ascites gradually. Immediate relief of symptoms [100%]. There were no major complications. There was one minor complication [2.5%], a leakage at the port placement site in a patient with pancreatic carcinoma. The leakage stopped spontaneous with removal of ascites and the patient underwent conservative management. peritoneal port systems for treatment intractable ascites is efficient way to avoid ascites related morbidity with increases patient compliance, satisfaction by decreased hospital visits as the drainage and patients monitor can be done in their homes. Port aspiration can be performed in some cases by patients or family members without nursing assistance. In comparison with tunneled peritoneal catheters with external components, the complication rate appears to be minimal

[In vitro comparative study on the load deflection rate of fiber reinforced composite and nickel titanium archwires]

Esthetic orthodontic archwires [fiber reinforced composite archwires] are considered as the latest addition to orthodontic's world, and the load deflection rate is thought to be the most important mechanical property of archwires which has strong effect clinically, and this property is affected by the cross section diameter and the material's type, for these reasons this study aims to investigate the effect of the material's type and the cross section diameter of orthodontic archwires on the load deflection rate of fiber reinforced composite [FRC] archwires with a diameter of 0.014 inch and 0.016 inch which are suitable for the leveling and alignment stage, and to compare these new materials with Nickel titanium [NiTi] arch wires. This in vitro study used 60 wire specimens which were divided equally in to two major groups [FRC Group and NiTi Group], and each major group was divided equally into two subdivision groups according to arch wires diameter [0.014 inch group and 0.016inch group]. Three points bending test was used to execute this study and was modified by adding two brackets. The applied forces and the produced force were measured. Partial Eta square had been used to estimate the effect of material's type and cross section of the arch wire on the load deflection rate. [P<0.05] for all studied stages. Values of partial eta square for material's type and cross section of the arch wire respectively were 0.965, 0.96 in stage 1, 0.912, 0.908 in stage 2 and 0.837, 0.843 in stage 3. There is a large impact of the cross section and material's type on the load deflection rate of FRC and NiTi arch wires

[Gene expression profiling in breast cancer]

Gene expression profiling has been increasingly used to determine new cancer markers. This technology holds major promises for improving the management of patients with breast cancer in which traditional clinicopathologic parameters do not account for all the heterogeneity of this disease and its distinct prognostic groups. Gene expression profiling has resulted in new classification of breast cancer and new assays are being developed and commercialized as prognostic and predictive tests. However, the use of these tests in a clinical setting presents many issues. The accuracy of this new technology is often overestimated and its limitations should be addressed. Although early results are promising, further validation and well designed clinical trials are required before incorporating these tests in routine clinical practice

[Flat epithelial atypia of the breast]

"Flat epithelial atypia" is the adopted term by the WHO working group on breast tumor referring to an early neoplastic breast lesion affecting the terminal duct-lobular units. Pathologists have described this lesion under a variety of names including columnar cell lesions and low-grade clinging carcinoma in situ. It is usually encountered on breast biopsies performed for mammographically-identified microcalcifications. Because of its relatively frequent association with carcinomas, its recognition in biopsy specimens is important. This review will focus on the histopathologic features, differential diagnosis, biologic potential, clinical significance and management of this lesion

[ study of geographic distribution and redictable causative factors of cleft lip and palate in a sample of the Syrian Arab community]

Cleft lip and plate is one of the most important developmental disorders. Treatment Complexities, poor esthetics, complications, and problems associated with occurance of the cleft show the importance of prevention. Prevention is originally based on knowledge of the risk factors, thus, the aim of this research was to investigate of the most important genetic and environmental causative factors, and geographic distribution of patients. Study sample consisted of 146 patients visited orthodontic department in Damascus University during the academic year 2004-2005, and after reviewing their records, we achieved the required data for statistical analysis. Results of study showed that the highest percentage of patients was in Damascus Province [42.22%], and that smoking during pregnancy and alcohol consumption and psychological factors and pollution are considered important risk factors, while age of pregnant mother is not considerd as an important risk factor. We can conclude from this study that the role of environmental factors was more important than genetical factors

Mayer-rokitansky-kuster-hauser syndrome with hyperprolactinemia

Mayer-Rokitansky-Kuster-Hauser Syndrome in association with hyperprolactinemia is very rare. An 18-year-old, Saudi, single, virgin female was accompanied by her mother seeking medical advice regarding absent menses. She had normal breasts, normal axillary and pubic hair, normal vulva, urethra, and labial folds, however, the vagina was blind, approximately 2 cm length. Pelvic magnetic resonance imaging showed normal appearing ovaries, a small uterus and small cervix and vagina. Investigations showed initial high serum prolactin of 1,517 mIU/L. Cranial MRI was normal. The patient was diagnosed as mullerian hypoplasia class I American Fertility Society. After an extensive literature search, we present a unique case of concomitant occurrence of MRKH, in the form of mullerian hypoplasia, and hyperprolactinemia

Epidural angiopomatosis of the thoracic spine: Case report and literature review

Spinal epidural angiolipomatosis [SEA] is a rare benign neoplasm of adipose tissue with a prominent vascular component. Classified as either idiopathic or secondary to chronic steroid therapy it accounts for 0.14% of all spinal axis tumours. The clinical and radiological features and treatment of a case in a 24-year-old male are described and discussed together with a review of the literature and previous reports

Health research priority setting in developing countries of the Eastern Mediterranean Region: partnering with the Cochrane Collaboration

Healthcare research in the Eastern Mediterranean Region [EMR] is fragmented and often weak. A coordinated approach is required to strengthen and focus efforts. Given the low resource base, priority-setting is an essential component. Healthcare policy and programmes in the EMR should be underpinned by reliable evidence of "what works for whom and why", with special attention to the health needs of the disadvantaged. Collaboration with international health research organizations, such as The Cochrane Collaboration, is essential and would provide an opportunity to examine evidence, prioritize knowledge areas, and identify research gaps

Prevalence of B-thalassemia carriers among Egyptian school students

This study was carried out on randomly selected 550 students divided into 2 groups. For all students, complete medical history, thorough clinical examination and complete blood count were done. The results revealed anemia in 76/250 among group I and in 63/300 among group II, microcytosis in 39/250 among group I and in 56/300 among group II as well as high HbA2 in 41/250 among group I and in 27/300 among group II. Based on microcytosis and high HbA2, the results detected beta-thalassemia carriers in 41/250 among group I and in 27/300 among group II. Group I had a significantly higher prevalence rate of anemia, microcytosis, high HbA2 and beta-thalassemia carriers than group II. This might be due to the differences in the diet consumed, the prevalence rate of parasitic infestations and the higher rate of consanguineous marriage in group I that may lead to the propagation of the recessive traits

Poems syndrome presenting as plasmacytoma and polyneuropathy

We report a 52 year old woman presented with a solitary plasmacytoma in the left 4

h rib and chronic demyelinating polyneuropathy. Patient had associated lymphadenopathy, hepatosplenomegaly and hyper pigmentation of the skin. Serum electrophoresis and lmmuno fixation revealed M band [lgG, Lambda light chain]. With the above constellation of clinical findings patient was diagnosed to have POEMS syndrome [polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes]. Radiation to the plasmacytoma resulted in significant improvement. Hence we suggest that all patients with cryptogenic polyneuropathy be investigated properly for this potentially treatable condition

Culture and research instruments: the performance of the eating attitude test questionnaire in Arabic culture

The paper assesses the cross-cultural validity of the eating attitude test questionnaire in the Arabic culture. The author reports her findings from two studies conducted on Arab female students where the EAT was the main screening instrument for eating morbidity in this culture. The EAT performed reasonably well in this population with high degree of sensitivity and specificity. The paper discusses as well the results of a confirmatory factor analysis of the EAT carried out by the author on a sample of Egyptian school girls. The analysis yielded three factor structure in conformity with the factor structure reported by the authors of the questionnaire the themselves. The dieting factor attracted the highest reliability but doubts were raised in connection to the bulimia factor. The results offered some support for the continued use of the EAT in future eating disorders research in this part of the world, particularly for some aspects of eating pathology, namely dieting and concerns about weight and shape

Recovery from rabies in man: a case report

A human survival from clinical rabies was presented, the diagnosis was supported by an epidemiological, clinical and laboratory evidences. Perhaps this case is the fourth reported recovery from clinical rabies in the world

use of more than one biochemical test to improve their predictive value for the diagnosis of malignant ascites

A battery of 4 tests, including serum carcino-embryonic antigen [CEA] ascitic fluid fibronectin, total protein and cholesterol, was studied to assess the diagnostic value of the tests individually and combined in ascetic patients. 40 subjects were included, 15 with non malignant ascitic, 15 with malignant ascitic and 10 healthy control subjects. Mean serum and CEA ascitic fluid fibronectin were significantly higher [P < 0.01] in patients with malignant ascitic when compared to those with non malignant ascitic. The predignant ascites were 70% for serum CEA, 76% for ascetic fluid febronectin and 81% for ascetic fluid cholesterol. A combination of more than one test was found to improve the predictive value. Thus it was 92% for ascetic fluid fibronectin and serum CEA_., 95% for ascetic fluid febronectin and cholesterol and 92% for serum CEA and ascetic fluid cholesterol. It thus seems prudent to make a combination of two tests to achieve a better diagnostic yield