[Pet scan in internal medicine]

The nuclear medicine techniques represent an important role in infections and inflammation's evaluation. 18-fluorode soxyglucose [18F-FDG] is a tracer of glucose metabolism, recently produced in Morocco, which provides functional sensitive and high resolution images thanks to Positron Emission tomography [PET]. The indications of FDG-PET in internal medicine include the diagnosis management of certain inflammatory diseases, vasculitis of large vessels, such as temporal arteritis, especially in its systemic presentation, and Takyasu's arteritis. It is also useful for staging sarcoidosis, for differential diagnosis and the therapeutic's evaluation in multiple myeloma. The 18-FDG PET is the most effective for the diagnosis of paraneoplastic syndromes, or carcinomas of unknown primary. In case of fever of unknown origin, it facilitates the identification of the site of the infection and guides investigations conducting to the confirmation of the diagnosis. All, situations frequently found in internal medicine. This article will focus on the role of 18-FDG PET in the pathology specific to internal medicine. However, large scale prospective studies are needed before incorporating FDG-PET in clinical routine, because it is expensive and not available in our country

Antenatal care in primary health care centres in Medina, Saudi Arabia, 2009: a cross-sectional study

This study evaluated antenatal care [ANC] services for pregnant women attending primary health care centres in Medina city, Saudi Arabia in 2009. A cross-sectional survey collected data on ANC tasks performed at visits by 394 pregnant women attending 7 clinics. ANC was assessed in 3 domains: clinical assessment [at the initial visit and return visit], health promotion and care provision. The mean duration of initial visits was 10.3 [SD 2.3] minutes and of return visits was 9.1 [SD 1.1] minutes. Overall performance on ANC tasks was fair. The significant predictors of ANC performance of tasks were: size of population served per centre; presence of more than 1 physician carrying out ANC at the centre; physician's age, mother tongue, nationality and qualifications; and woman's education and employment status. Having more physicians available for ANC in primary care centres could improve the standard of care

Study of paraoxonasel activity and lipid peroxidation in selected male patients with the metabolic syndrome

Today, the metabolic syndrome is one of the major public health concerns as its prevalence increases worldwide with a subsequent predisposition to type 2 diabetes and cardiovascular disease and even mortality. Paraoxonasel [PONI] is a high-density lipoprotein HDL]-associated enzyme capable of hydrolyzing diverse substrates including oxidized phospholipids. The reactive oxygen species induced oxidative stress may play a role in the development of insulin resistance. The oxidative stress causes increased tissue/cellular damage manifested by lipid peroxidation. Was to study PNO1 activity and lipid peroxidation in male patients with the metabolic syndrome. The patients were neither diabetic nor hypertensive apart from mild to moderate hypertension. They were also free from coronary artery disease. 45 male patients the criteria of the metabolic syndrome according to the National Cholesterol Education Program/Adult Treatment Panel III [NCEP] were chosen in the study. They were chosen also to be nondiabetic, nonsmoker, non hypertensive or with mild to moderate degree of hypertension and not suffering coronary artery disease. 15 apparently healthy male, not fulfilling the criteria of the metabolic syndrome and age and culture matched, constituted the control group. All the chosen subjects underwent thorough clinical examination specially measuring waist circumference and the blood pressure. Fasting and postprandial serum glucose. high and low density lipoproteins, serum triglycerides, paraoxonasel activity and malonaldehyde were assayed. Compared with the controls, the patients bad significantly higher level of serum triglycerides, low-density lipoprotein-cholesterol [LDL-C], fasting and postprandial glucose and fasting insulin. There were also significant higher measurements of waist circumference and systolic and diastolic blood pressure. However the patients had lower high density lipoprotein-cholesterol [HDL-C]. They were more insulin resistant as measured by HOMA index. Patients had higher serum malondialdhyde level and lower serum paraoxonasel [PNOl] activity when compared with the controls. There were positive correlations between HOMA index and waist circumference, fasting and postprandial serum glucose, serum triglycerides, serum malondialdhyde level. HOMA index was negatively correlated with HDL-C and PONT activity. There were positive correlations of PONT activity with HDL-C and serum triglycerides and no correlation waist circumference, while there were negative correlation of PONI activity with blood pressure and serum glucose levels. There were negative correlations of PONT activity with HOMA index and serum malondialdhyde level. Serum malondialdhyde level showed positive correlation with waist circumference, blood pressure levels, serum glucose levels, serum triglycerides. Serum malondialdhyde level showed negative correlation with PONT activity and HOMA index. It showed no correlation with HDL-C. Male patients with MetS, who were normotensive or not severely hypertensive and not yet developed DM or cardiovascular complications of MetS, had diminished serum paraoxonasel activity and increased lipid peroxidation. These were correlated with the degree of insulin resistance. These results pointed strongly to increased oxidative stress, The increased oxidative stress along with their atherogenig lipid profile indicated a proatherogenic state. We recommend that clinicians should deal with these hidden factors aiming to avoid MetS complications

Intrabursal vein abrasion and thrombosis: an unusual complication of femoral osteochondroma

A 21-year-old female with right distal femoral pedunculated osteochondroma is presented. She was admitted for severe lower limb pain, and swelling of one week duration. Clinical findings supported deep vein thrombosis [DVT] but Doppler ultrasound, and venography were normal. Surgical exploration revealed a large bursa around the tumor with a big vein abraded and thrombosed inside the bursa

Detection of carcinoembryonic antigen [CEA] in breast cancer tissue and it's relation to some prognostic histological features

Carcinoembryonic antigen was searched for in tissue sections from 34 radial mastectomy specimens with breast carcinoma. These sections were stained using unlabelled peroxidase-antiperoxidase technique and polyvalent rabbit antiserum to CEA. The positivity of CEA staining in carcinoma cells was 44.11 percent of the total. Correlating this to the histological type and grading of tumour, lymphoid infiltrate in tumour bed and the auxillary lymph nodes metastases, no clear significant relation was detected between them