Role of percutaneous radiofrequency ablation in patients with hepatocellular carcinoma

Radiofrequency ablation [RFA] is a promising technique for local control of liver malignancy such as primary hepatocellular carcinoma. This technique has become the main stream of the treatment of non-surgical modalities in clinical settings. A study was conducted to assess the therapeutic efficacy of percutaneous radiofrequency ablation for small and medium sized hepatocellular carcinoma [HCC]. Patients and Thirty five cirrhotic patients [M:F; 28:7, age; 57.4 +/- 7.8 years] each with solitary HCC mass lesion [mean size; 3.01 +/- 0.82cm] were consecutively recruited at Assiut University Hospital between August 2007 and November 2009. HCC was diagnosed by raised alpha-fetoprotein [AFF] and contrast-enhanced CT. Lesions were stratified into 2 groups; "Group A ". lesions <3cm [n=22] and "Group B ". lesions 3-5cm [n=13]. Single session RFA was done and all patients were followed-up with AFP and contrast-enhanced CT after one month and 6 months post-procedure. Complete ablation was achieved in 77.1% [27/35] of patients after one-month [81.8% [18/22] in group A and 69.2% [9/13] in group B; p=0.3] Local recurrence was noticed in 3 patients after 6 months [one in group A and 2 in group B]. AFP levels were significantly reduced in both groups after one month and 6-months follow-up. No major complications occurred in all patients treated by RFA. RFA is less effective in ablating medium sized HCC [3-5cm] than in ablating small sized HCC <3cm. The procedure is safe, effective and without major complications

Colorectal cancer screening b non-invasive faecal biomarkers M2 -PK and faecal calprotectin

Colorectal cancer [CRC] is a disease with major impact on public health. Colonoscopy is a gold standard test for screening. However, the acceptance by the general population is very poor. Therefore evaluation of additional screening tools is of great interest. The use of M2-PK measurement in the feaces as well as the faecal calprotectin [FC] in persons undergoing routine health care check-up will provide a better screening tool for early discovery of colorectal cancer. In our study we measured these tests in patients with CRC, group of benign lesions esp IBD and controls. Comparison of faecal M2PK results between all studied groups demonstrated a significant difference between CRC and benign group, also with a significant difference between benign group and controls .The sensitivity, specificity, and positive and negative predictive values of the faecal M2PK assay in distinguishing between CRC and benign group at cutoff [3 U/ ml] showed a positive predictive value of 93.8 and negative predictive value 100 and sensitivity 93.8 and specificity of 96% with an accuracy of 97.5%. Comparison of faecal calprotectin results between all studied groups demonstrated a significant difference between CRC and benign group, also with a significant difference between benign group and controls .The sensitivity, specificity, and positive and negative predictive values of the fecal calprotectin assay in distinguishing between CRC and benign group at cutoff [200 microg/g] showed a positive predictive value of 100.0 and negative predictive value 92.6 and sensitivity 86.7 and specificity of 100.0 with an accuracy of 97%. Measurement of tumor M2-PK in faeces seems to be the most promising tool for CRC screening at the present time. In combination with colonoscopy, this test should hence be recommended for CRC screening programs

Study the changes of the levels of some trace elements and minerals in patients with ulcerative colitis and Crohn's disease

Inflammatory bowel disease [IBD] is a chronic inflammatory process that involves the colon in Ulcerative colitis [UC] and may involve any part of the entire gastrointestinal tract in Crohn's disease [CD]. The aetiology and pathogenesis of IBD are still unclear. Nutrition plays an important role in pathogenesis and treatment. The aim of the present study was to study the level of some minerals and trace elements in inflammatory bowel disease and correlate their levels with the disease activity. The study was carried out on patients of previously diagnosed IBD [included 10 CD patients and 10 UC patients] as a patient group and ten healthy volunteers as a control group. The disease activity in all patients were assessed according to Crohn's disease activity index [CDAI], and Truelove and Witts criteria for ulcerative colitis. Sample collection of some minerals and trace elements were done on fasting serum samples including:- Calcium [Ca], Phosphorus [Ph], Magnesium, Chromium, Copper, Selenium, and Zinc. The results of plasma concentrations of some minerals and trace elements in ulcerative colitis, Crohn's disease patients and controls showed a significant reduction of serum calcium [P=0.000], serum phosphate [P=0.01], serum magnesium [P=0.000], serum copper [P=0.000], serum selenium [P=0.004],and serum zinc [P=0.000] in patients with UC and CD than controls. However, chromium was significantly elevated in UC and CD patients than controls [P=0.03, P=0.000 respectively]. Using inter-groups comparison; only serum calcium level showed a statistically significant difference in CD patients than UC patients. we found that the assessment of patient with IBD should include a focus on nutritional aspects even minerals and trace elements. Plasma or serum concentration of antioxidants including trace elements could be used as a biomarker of oxidative stress which has been established in IBD

Effect of bowel preparation for colonoscopy or barium enema on serum carcino-embryonic antigen level

Carcino-embryonic antigen [CEA] is probably the foremost oncofetal antigen known. CEA was first thought to be a specific indicator for the presence of colorectal carcinoma, but it was found elevated in many benign conditions and other many causes. Of the study was to assess the effect of bowel preparation on CEA levels in patients undergoing colonoscopy or barium enema. The study included forty patients divided into two groups undergoing bowel preparation for colonoscopy and barium enema for different indications, excluding those with cancer colon and inflammatory bowel disease. CEA was measured before and after bowel preparation but before colonoscopy or radiology using ELISA technique. The cases were presented with bleeding pre rectum, diarrhoea, constipation and chronic abdominal pain. The mean level of CEA in patients prepared for colonoscopy was 4.8 +/- 5.20 ng/dl and was 6.6 +/- 6.28 ng/dl before and after preparation respectively, while in patients prepared for barium enema, the mean of CEA was 3.15 +/- 4.04 ng/dl and 11.62 +/- 10.10 ng/dl before and after preparation respectively. There was an increase in the level of CEA after bowel preparation in both groups, with more significant rise in patients prepared for barium enema group. The rise of CEA after bowel preparation is one of false positive causes of rise in serum CEA

Combustion air pollutants in Cairo Houses

Indoor air quality with reference to combustion generated air pollutants was examined in some Cairo houses representing different incomes. These houses are equipped with various appliances using gas and kerosene. Investigated pollutants include nitrogen oxides, carbon monoxide and smoke. Pollutant concentrations sometimes found to exceed air quality standards. For example, nitrogen dioxide exceeded the 100 ug/m[3] recommended limit for outdoor air. Furthermore, houses equipped with kerosene cookers were the most polluted premises. Pollutant concentrations decreased with distance from the kitchen. Moreover, better ventilation was found to greately improve indoor air quality. It is also concluded that Cairo inner city population using kerosene cookers are at high risk for the deleterious effects of combustion generated pollutants

Solubility and rates of heavy metals dry deposition over the complex industrial district, southern of Cairo

This work presents the outcome of a research project to evaluate the rates of heavy metals deposition over the heaviest industrial area in Egypt. Heavy metals such as lead, cadmium, nickel and zinc were analysed in both soluble and insoluble fractions of dustfall. The results show high rates of heavy metals deposition over the area. The highest rates of heavy metals deposition were found at locations close to iron and steel company and lead and zinc smelter. One of the intersting findings of this work is that the ratio between water soluble and insoluble metals were significantly different from one location to the other and also between the different investigated metals. Several other conclusions are included