Non-invasive assessment of liver fibrosis in patients with hepatitis C: shear wave elastography and colour Doppler velocity profile technique versus liver biopsy

Background and study aims: Determination of the presence and degree of liver fibrosis is essential for the prognosis and treatment of patients with chronic hepatitis C. Non-invasive methods of assessing fibrosis have been developed to reduce the need for biopsy. We determined the efficacy of shear wave elastography [SWE] and colour Doppler velocity as non-invasive methods for the assessment of liver fibrosis compared to liver biopsy among patients with chronic hepatitis C virus [HCV] infection

Patients and methods: In total, 117 patients with chronic HCV infection and 50 healthy age- and sexmatched control subjects were included. For each patient and control, abdominal ultrasonography, Doppler ultrasonography of the right portal vein [PV], and SWE were performed, whereas liver biopsy was performed for patients

Results: The mean value of the right PV maximum velocity was lower in patients with different stages of fibrosis than in controls [p < 0.001]. The mean value of liver stiffness determined by SWE was significantly higher in patients with different stages of fibrosis than in controls. Cutoff values for liver stiffness determined by SWE for assessing fibrosis stages were F2 >/= 4.815, F3 >/= 6.335, and F4 = 7.540 with a sensitivity of 84.6%, 96.2%, and 100.0%; specificity of 88.5%, 93.8%, and 100.0%; positive predictive value [PPV] of 93.6%, 98.0%, and 100.0%; negative predictive value [NPV] of 74.2%, 88.2%, and 100.0%; and overall accuracy of 85.9%, 95.6%, and 100.0% [area under the ROC curve [AUC]: 0.89, 0.96, and 1.0], respectively. Cutoff values for the right PV maximum velocity for assessing fibrosis stages were F2 < 23.4, F3 < 21, and F4 < 20 with a sensitivity of 65.0%, 57.4%, and 57.1%; specificity of 59.8%, 76.4%, and 75.5%; PPV of 33.8%, 58.3%, and 32.0%; NPV of 84.4%, 75.7%, and 89.7%; and overall accuracy of 61.1%, 69.5%, and 72.5% [AUC: 0.614, 0.696, and 0.625], respectively

Conclusion: SWE is effective for the non-invasive assessment of liver fibrosis in patients with HCV infection. SWE provides a more accurate correlation with liver fibrosis stage than colour Doppler velocity profile for the assessment of liver fibrosis, especially in advanced stages [F3 and F4]

Antimicrobial properties of 3 medicinal plants from Saudi Arabia against some clinical isolates of bacteria

To examine the in vitro antibacterial activity of the ethanol extract of fresh fruits of Solanum incanum L., fresh leaves of Ricinus communis L. and Allium ampeloprasum var. porrum L., and to determine and quantify the phenol compounds of the investigated plant parts. This study was carried out at the Faculty of Science, King Khalid University, Abha, Kingdom of Saudi Arabia from July 2011 to September 2011. Nine clinical strains of bacteria and 3 ethanol extracts of 3 plant species were used for the antimicrobial study. Thirty grams of each sample was ground, filtrated, and each filtrate mixed with 100 ml ethanol and placed in a shaker for 48 hours. The ethanol was evaporated from the sample, weighed, and subjected to an antibacterial activity test using the agar diffusion method. The high-performance liquid chromatography was used to identify and quantify the phenols extracts of investigated samples. Ethanol extract of the investigated plant parts showed antibacterial activities against different pathogenic bacteria. Leaf extracts of Ricinus communis showed the highest antibacterial activity, followed by the leaves of Allium ampeloprasum var. porrum, while the fruits of Solanum incanum showed the least activity. The amounts of main phenols detected in Ricinus communis leaves were higher than those of Solanum incanum fruits and Allium ampeloprasum var. porrum leaves. The ethanol extract of the tested plants could be considered as an alternative source of new antibacterial drugs

Study on hymen: morphology, injuries of neonate and knowledge among students of faculty of nursing and education

Hymen is a thin membrane that surrounds the opening to a young Woman's Vagina, can present in different shapes. The most common hymen is shaped like a half moon. This shape allows menstrual blood flow out of girl's vagina [Adams, 2002]. Most Women are born with hymen, a thin piece of skin that partially covers the opening of the vagina [or introitus]. Hymen morphology has a medico-legal importance. Pediatricians are some times confronted with the challenge of documenting evidence of acute or chronic accidental or non accidental trauma to the hymen [Ann Saudi Med, 2001]. Identification of different types and percentage of hymen. Assess Knowledge of students about hymen in both Faculties Nursing and Education in Assiut University and Comparison between student's Knowledge indifferent years the [1st and 4th] years Faculty of Nursing to assess the improvements in their knowledge with program of study. A descriptive, analytic and retrospective design was used for this study The sample of this study was divided into three categories: A total of 220 consecutive girls [210 At birth 36 to 42 weeks of gestation and 10 from 8 to 12 month] were examined at labor ward, to observe hymnal configuration. A total of 20 defloration injuries who were recorded in statistical records from 3 December 2004 up to 3 December 2005. A total of 800 students were recruited for the study included [300 students from 1st year of faculty of Educations] and [500 students include 300 from the 1st year and 200 students from 4th year of faculty of Nursing]. Structured interviewing questionnaires Examination sheet of the hymen [At birth and one year of age] which include Gestational age Age of infant. Shape of hymen. The study result showed that annular configuration is the most common shape [79%] followed by posterior rim [12.7%], sleeve-like, fimbriated and cribiform hymen.-Distribution of defloration injuries who are recorded in statistical record 20 defloration injuries. Results of these students indicated that their mean age was [18.73 +/- 1.42] years. [64%, 55.5%, 50%] of the [1st and 4th grade]students Faculty of Nursing and the students Faculty of Education were residents in rural areas respectively-Regarding to the student's knowledge about the female genital organs, it was found that more than three quarters of the students [83.1%] had correct answer about female genital organs. The source of knowledge about female genital organs and hymen, it was found that [91. 4%] of the students had their knowledge from study books, mass media and teachers few students got their from house and relatives family. The student's knowledge about hymen, it was found that more than three quarters of the students [79.8%] know hymen. Beliefs about hymen, it was found that [72%] of the students defined it a thin membrane allows menstrual blood, [93.4%] that a sign of virginity and more than half of the students [55.5%] that has a different shapes of hymen. The causes of hymen tearing before marriage, it was found that [80.8%] of students mentioned that the main cause of hymen tearing before marriage was masturbation followed by illegal sexual relation, hard sports and [39.4%] by horse riding. Regarding to use of traditional method to rupture hymen in the wedding day, it was found that [100%] of the students didn't agree on use of traditional method to rupture hymen.-Regarding to relation between student's knowledge and parent's education, it was found that when parents were more educated, their daughters were bad information, it seems that education of the parents creates more barriers between their and their daughters, it also indicates that the education of the parents didn't necessarily to improve their knowledge. The comparison between class 1 and 4 of Faculty of Nursing, it was found highly percentage of knowledge about hymen in class 4 more than class 1 of Faculty of Nursing Finally the students need to know more information about hymen [definition, site, morphology, causes of hymen tearing before marriag

Antibacterial activity of the latex of Argemone ochroleuca sweet

To investigate the antibacterial effect of the crude latex of Argemone ochroleuca [A. ochroleuca] as antibacterial potential against a range of human pathogenic bacteria. This study was carried out at King Khalid University, Abha, Kingdom of Saudi Arabia from January to March 2010. Seventeen ml of fresh latex from A. ochroleuca Sweet was collected, and the antibacterial activity of crude and diluted latex were examined using one ml of standardized inoculum suspension, and using the agar diffusion method test against Bacillus subtilis, Enterobacter aerogenes, Micrococcus luteus, Escherichia coli, and Staphylococcus aureus. All inoculated plates were incubated aerobically at 29 [degree sign] C for 48 hours. The diameter of the zones of inhibition was measured to the nearest mm. the crude latex of A. ochroleuca exhibited a potent antibacter effect on all bacterial strains examined. The zones of inhibition against the tested bacteria were found in the range of 9.30 - 40.3 mm along with their respective minimum inhibitory concentration values 100 micro l/ml. The observable inhibition on selected bacteria by latex of A. ochroleuca makes it a promising alternatives as a potential source of natural antibacterial

Radiological evaluation of total knee arthroplasty

X-Ray analysis of a subset of TKA performed using a standard posterior cruciate ligament [PCL] retaining cemented technique to study the component malposition, overall post-operative alignment and mechanical loosening with respect to components positioning during follow-up period. This is a prospective study where we radiographically evaluated twenty-six primary TKAs [15 right and 11 left] in 20 patients [six patients received two stage bilateral total knee replacement] performed between July 2004 and December 2005. There were a total of 13 women and 7 men. The mean age at the time of the operation was 68 years and the follow-up period ranged from 18-32 months. The indication for knee replacement in all cases was advanced osteoarthritis. Radiographs were done immediately postoperative, at 6 weeks, at 3 months, at 6 months and then every year after surgery, and each time were compared to the postoperative controls. The overall alignment was acceptable in 19 knees, 3 had excessive valgus and 4 had varus alignment. At the last follow-up which was up to 32 months in some cases, none of the cases developed loosening as evidenced by non appearance of radiolucent zones or shifts in the position of the components. Moreover, the seven cases with joint malalignment didn't show signs of aseptic loosening within the available follow-up period. For the patellar angle, the mean tilt angle was 12° +/- 6°. In 17 knees the patellar prosthesis was displaced superiorly, and in seven cases there was medial displacement of the patellar prosthesis. Evaluation of total joint arthroplasty must be clinical, radiological and with annual intervals, in order to discover early failure signs. Proper alignments are critical for achieving good results thus keeping loosening to a minimum. Concerning the present study, aseptic loosening was not a complication of the toted knee arthroplasty evaluated at a follow-up period of up to almost three years in some cases, including those cases with documented postoperative joint malalignment

Assessment of the range of motion after total knee arthroplasty for osteoarthritic knees

A prospective study was performed to evaluate the range of motion after total knee replacement for osteoarthritis, one year postoperatively, by comparing it to baseline value. Forty-two knees [23 right and 19 left] primary TKAs in 36 patients [six patients received two stage bilateral total knee replacements] were performed between July 2004 to September 2006. There were a total of 22 women and 14 men. The mean age at the time of the operation was 68 years [range 53 - 82 years]. The average duration of follow-up was 18 months [range 14-22 months]. All prostheses were cemented preserving the posterior cruciate ligament Three different models were used namely: P.F.C. SIG-MA[R] Total Knee System from DePuy, AGC[R] Total Knee System from Biomet, and Columbus[R] Total Knee System from Aesculap. The diagnosis of osteoarthritis was established in all cases. The parameters evaluated were age, sex, preoperatlve knee flexion and extension range, preoperative flexion arc, tibiofemoral angle, and implant design. Advanced age, female gender, and good preoperative flexion and flexion arc were related to better postoperative flexion. Preoperative tibiofemoral malalignment had no significant effect on postoperative flexion. Advanced age, female gender, and good preoperative flexion and flexion arc are related to better postoperative range of motion particularly the degree of flexion

Comparative study among post cesarean section care women's in Assuit University Hospital, King Fahd Gizan Hospital and ideal nursing care

The care of the woman after a cesarean birth, is nurses responsibilities it is a combine aspects of surgical and maternity care. For this, the aim of this study was to assess the actual post Cesarean Section Care for women in Assuit University Hospital and King Fahd hospital in Gizan and their relation to the ideal nursing care. A sample of 267 mothers 220 and 47 mothers from Assuit and Gizan respectively] who inter for delivery unit in both hospital for CS. Delivery Data were collected using observation at check list The result showed that mean age for women was 27.80 +/- 5.57 28.3 +/- 6.02 in Assuit and Gizan respectively. While [36.4% and 34.02%] from the sample was illiterate in Assuit and Gizan respectively but only[7.3% and 8.5] of sample in Assuit and Gizan respectively had university education: Also found that the majority of the sample [86.4% and 95.74%] in Assuit and Gizan respectively as a house wife. For the causes of CS. It was found that [30.9% and 31.9%] of Assuit and Gizan respectively due to bleeding while [15.4% and 8.5%] of Assuit and Gizan respectively due to pelvic disproportion But for Measuring vital signs every 15,30 and every hour during 4 hour,observe I and O chart, do exercise [breathing, leg] it was found that the care not done in both hospital Assuit and Gizan.As regard check fundal level and learn mother how to carry baby to initiate breast feeding it was found that done [100%] in Gizan hospital only. As regard observe bleeding from vagina, check hardness of uterus, add some medication as doctor orders and encourage women for early ambulation it was found this care done accurate [100%] in both hospitals with mild statistical significant P=0.04. Finally the percentage of post CS. Care in Assuit university hospital was 52.9% and 41.1% in King Fahd hospital in Gizan

Study of the effect of maternal iron depletion on neonatal iron metabolism

Maternal nutritional and hormonal state from as early as the first days after fertilization can influence the growth rate of the fetus and also the length of gestation. was firstly; to study iron indices [serum iron, ferritin, and soluble transferrin receptors "STFR"] in neonates, and their relation with gestational age, birth weight and gender. Also, to assess the value of utilization of STFR and STFR/ Log ferritin index to evaluate the effects of maternal anemia, iron status, and iron supplementation, on neonatal iron indices at birth. Serum Iron, ferritin, STFR, and haemoglobin [Hb] concentration were measured and STFR-Log ferritin index was calculated in 40 cord serum [20 preterm "PT", and 20 full term "FT" neonates], and from their maternal serum. Seventeen mothers were anemic "Hb < 10 gm%", [5 mothers of FT, and 12 of PT babies]. Twelve mothers had depleted iron stores "serum ferritin <10 micro g/1" [4mothers of FT, and 8 PT babies]. Non of FT babies had anemia, while 9 PT had anemia, Fullterm neonates and neonates weighing >/= 2.5 Kg had significantly higher cord blood Hb, serum iron and ferritin, compared to PT neonates and neonates weighing < 2.5 Kg. Neonates weighing >/- 2.5 Kg had significantly lower STFR/Log ferritin, compared to neonates weighing < 2.5 Kg. No difference in iron indices was found between male and female neonates, also, between neonates delivered to mothers with iron supplementation during pregnancy and those without, and between neonates delivered vaginally and those by cesarean section. There was no difference in iron indices between neonates with either maternal anemia or depleted iron stores, and those with normal maternal indices. There is no relation between maternal iron status and neonatal iron indices, except for serum ferritin. Cord serum ferritin correlates positively with maternal ferritin. So, cord serum ferritin, but neither STFR nor STFR/Log ferritin, is a good indicator of neonatal iron stores at birth. Maternal iron depletion is not associated with neonatal anemia. The fetus has normal indices on the expense of his mother's iron stores. So, maternalsupplementation with iron during pregnancy is a must

Effect of colchicine on schistosoma induced hepatic amyloidosis in Syrian golden hamsters

This study comprised 80 Syrian Gold hamsters, 70 of them were infected with Schistosoma mansoni and 10 uninfected hamsters served as negative controls. Of the schistosome infected hamsters, 10 served as positive controls [infected but untreated] and the rest [60 hamsters] received treatment for 9-week duration. In 30 hamsters treatment was given early [9 weeks after infection], before the appearance of hepatic amyloidosis, and in the other 30 hamsters treatment was given late [15 weeks after infection] after the appearance of hepatic amyloidosis. Each treatment group was subdivided into three subgroups [ten hamsters each], in which treatment was either colchicine alone, combined colchicine and praziquantel, or praziquantel alone. All hamsters were sacrificed nine weeks after treatment, liver biopsies were taken and evaluated semiquantitatively for amyloid deposits. In the group with combined therapy there is significant reduction in hepatic amyloid deposits, together with reduction of proteinuria serum bilirubin, SGPT with an increase of total serum protein and serum albumin. This improvement was nearly complete with early treatment and only partial when treatment was given late. When colchicine was given alone, a partial, but insignificant reduction of hepatic amyloid deposits was documented. It was concluded that, colchicine is effective for the prevention and reduction of schistosome induced hepatic amyloidosis in Syrian Gold hamsters

Secondary school girls knowledge and practice about menstruation and menstrual hygiene in Assiut

The aim of this study is to assess secondary school girls, knowledge about menstruation and its hygiene and their practices and habits during menstruation. This was carried out in the form of questionnaires on200 randomly selected secondary school girls aged 15 to 17 years from all governmental and private secondary schools of Assyut. The study showed that girls had limited information about anatomy and physiology of female genital tract, menstruation and menstrual hygiene. About three fifths of students do not got haemorrhage. To get rid of menstrual pain, nearly one third of students use pharmacological agents; half of them take analgesics and the other half antispasmodics; while the majority drink fluids. Different house hold activities and visits were avoided and nearly one fifth reported that they do not study their lessons during menstruation. The mothers' education did not effectively influence the amount of girls' knowledge about the anatomy of female genital tract, menstruation and menstrual hygiene. However, mothers' education influenced positively their girls practices. The mother was found to be the primary source of information to her daughter, while few students received their information from their teachers at school, their sisters, friends and magazines. These results are discussed

Cross-leg flaps in children

Ten children of ages ranging between 4 and 11 years sustaining road traffic accidents that resulted into crushing and devitalizing injury to the shin of the foot, with exposure of and variable degree of damage to underlying structures, were treated by cross-leg flaps. The flaps were transferred immediately without any prior very much than delay. The paper exposes three new findings: First, the children can tolerate the immobilization without any adverse effects be used during the period of transfer and, third, flaps of slightly bigger than width could be transferred immediately in such young age

Fibrosarcoma of the breast a report on three cases

Three cases of fibrosarcoma of the breast were found below the age of 40. Two cases had recurrence after lumpectomy and they were of the differentiated type and the third case was of the highly undifferentiated variety. Subfascial extended simple mastectomy was done for two cases and a latissimus dorsi myocutaneous flap was mandatory for one of them. The presentation, examination, procedures and late follow up is recorded