Comparative study of the different procedures for management and prevention of post. E.R.C.P. infective complication

Selected 240 cases with obstructive jaundice. 120 cases calcular obstruction and 120 cases with malignant obstruction were studied of idenfication of the main causes of post E.R.C.P. infective complications. The clinical, laboratory and endoscopic findings are discussed. It was found that the most important infective complications after E.R.C.B are biliary bacteremia, cholangitis, pancreatitis and septicemia, and the most important predisposing factors for these complications are inadequate instruments sterilization, calcular biliary obstruction or stricture, incomplete drainage of the biliary channels, the occurrence of mucosal lesions during the procedure, or overfilling of the biliary channels during the procedure and any cause of decreased patient immunity. It was found that intravenous injection of a suitable antibiotic gives the best results for prevention and control of these complications rather than the intraductal injection or washing only without antibiotic, Somatostatin proved to he of no benefit in that respect in our study. Thus we recommend T.V injection of a suitable antibiotics in these cases

use of collagenase enzyme versus conventional methods in the treatment of recent deep burns

Sixty patients [thirty-six females and twenty-four males] with second and third degree recent burns ranging from 10% to 40% were selected, their age ranged from two to fifty years. The burn injury was due to flame in 40 patients and scalding in 20 patients. The patients were classified into three groups, each included 20 patients. The first group was treated by collagenase clostridiopeptidase A as a local debriding agent in recent burn, the second group was treated by povidone iodine, while patients of the third group were treated by collagenase clostridiopeptidase A for one extremity and povidone for the other. Patients selected for this study had comparable size, percentage, degree and anatomically similar burn wound. All groups were observed for depth, percentage, the day of beginning sloughing, time needed for complete sloughing, day of grafting, the postoperative complications, the degree of graft success and the duration of hospital stay

Neuro-endocrinal differentiation in gastric and intestinal adenocarcinomas

This study included 113 cases of gastrointestinal tumors. Dyspepsia, intestinal obstruction and bleeding per rectum were the most important symptoms recorded. It was found that 17 cases were positive with silver stain and the staining distribution of argentaffin positive cells in adenocarcinoma was as followed: Rare positive cells 58.8%, focal cells 17.6% and diffuse cells 23.6%. The rectal tumors were more positive for this stain 21.4%, while the colon was 17.3% and the stomach was 8.3%. The Churukian- schenk gave the best results 29.9%, while the Grimelius stain was positive in 19.5% of the cases. The staining distribution in silver stain positive cells revealed that 54.5% were rare, while focal staining was found in 27.3% and the diffuse cells were 18.2%. NSE positive tumors were 34.8% of all cases, the stain was agranular and diffuse in the cytoplasm with change in density, while the chromogranin A [CGA] was positive in 28.2% of cases, it was granular in the cytoplasm with fixed density. According to the mode of staining, differentiation adenocarcinomas were classified into five groups: Pure exocrine [65.5%], exocrine with occasional endocrine cells [19.4%], mixed exocrine and endocrine [7.9%], pure endocrine [2.7%] and non-exocrine and non-endocrine [4.5%]