An unusual radiological manifestation of a mandibular central giant cell granuloma

Central giant cell granuloma (CGCG) is an uncommon benign osseous lesion of the jaw. We present the case of an aggressive CGCG in a 16-year-old boy with a 5-month history of facial swelling and nasal obstruction. He was referred for a radiology consult for multiple expanding swellings on the right hemi-face. The swellings were reported to have an insidious onset, slow progression and no association with paresthesia, nasal discharge, or systemic symptoms. Extra oral examination revealed a diffuse swelling on the right side of the face which obliterated the nasolabial fold causing facial asymmetry. A face and neck computed tomography (CT) showed expansile multi loculated lytic lesions of the right mandibular ramus which involved the condyle and hard palate. Similar lesions were also found in the skull base. Scans showed fine internal septations and internal ground glass haze. It also revealed involvement of several teeth roots and surrounding soft tissues. A pre-operative intra-oral biopsy of the lesion revealed multinucleated giant cells, comprising of both spindle-shaped and round cells. Differential diagnosis helped determine the lesions as CGCG. This case helps to demonstrate the wide variation in the clinical, radiological, and histopathological features of CGCG and the importance of thorough investigation for timely diagnosis.

The role of umbilical artery doppler indices in predicting perinatal outcome in preeclampsia

Background: Preeclampsia currently accounts for the majority of causes of perinatal morbidity and mortality. Umbilical artery Doppler (UAD) is a non-invasive effective method of antenatal fetal surveillance for early detection and prevention of potentially adverse perinatal outcome in preeclampsia. The objective of this study is to predict adverse perinatal outcome using UAD in Preeclampsia. Methods: This was a prospective cohort study in which 170 consecutively consenting women with preeclampsia were recruited. An UAD was done using Voluson P8 ultrasound. The pulsatility index, resistance index, systolic/diastole ratio. Reduced end diastolic flow, absent end diastolic flow and reversed end diastolic flow were measured. The participants were divided into two groups based on UAD indices findings. Both groups were followed up to determine their perinatal outcomes.The data was analyzed using SPSS version 20.0 for windows (IBM SPSS Inc, Chicago, IL, USA). Categorical variables were analyzed using Chi-Square ( 2) test and Fisher's exact test p<0.05 was considered statistically significant. Specificity, sensitivity, PPV and NPV were determined. Results: The sensitivity, specificity, PPV, and NPV of umbilical artery Doppler in predicting adverse perinatal outcomes was 68.5%, 59.7%, 74.7%, and 52.1% respectively. Conclusions: Although the use of UAD indices in this study showed modest predictive values for adverse perinatal outcome in preeclampsia, it’s use should be combine with other methods of antenatal fetal surveillance to prevent adverse perinatal outcome.

PLACENTAL ALKALINE PHOSPHATASE AS A THRESHOLD CONCEPT FOR EARLY DETECTION OF PRIMARY LUNG CANCER

The biochemical existing tool of diagnostic methods to lung cancer cases need to be improved. In order to validate an early screening of primary tumor patients, a developed a simple procedure or technique was demanded. The aims of this study were to provide an overview of alkaline Placental Alkaline Phosphatase activity in lung cancer. Using heating inactivation method regarding the measurement of Placental Alkaline Phosphatase activity as an early diagnosis marker in lung cancer cases. Total alkaline phosphatase and Placental alkaline phosphatase activity were measured in patients of Lung cancer patients who were classified according to the site of tumor by histological picture. ALP isoenzymes were identified by heat inactivation, and compared with the most frequently applied method (ELISA). Monitoring of the Total ALP and Placental ALP activity in the studied groups using two different methods were shown a highly performance of heating method by an experimental assessment to confirm the accuracy and validity of the proposed method. The distribution of serum placental ALP isoenzyme activity in patients and control groups which was measured by two different methods were found to be (20.2-43.1) IU/L respectively (measured by heating method) and (394.3- 454.5) pg/mL measured by ELISA method) respectively. Placental ALP isoenzyme showed a high significant activity in lung cancer patients than healthy control with p value less than (0.05). That application of the heat inactivation method yields similar indication to the ones obtained by the highly and specific enzyme-linked immunosorbent assay. The results of detection Placental alkaline phosphatase in serum were in excellent agreement and could have a potentially extensive application for Placental alkaline phosphatase quantification.

Association of IL-1ß +3954 G>A and IL-6 -174 G/C polymorphisms in congenital toxoplasmosis / Asociación de polimorfismos de IL-1ß +3954 G>A e IL-6-174 G/C en la toxoplasmosis congénita

Toxoplasmosis is caused by infection with the protozoan parasite Toxoplasma gondii, that has the capacity to infect all warm-blooded animals worldwide. The purpose of this investigation was to determine the distribution of genotypes and alleles in miscarriages woman as a result of Toxoplasma gondii infection associated with interleukin-1β and interleukin-6 polymorphisms. A total of 125 miscarriage women suspected of toxoplasma infection and 50 healthy pregnant without previous miscarriage as control were enrolled in this study. The cases were screened for anti-toxoplasma IgM and IgG by ELISA test. Among the 125 miscarriage women, only 50 were positive to anti-Toxoplasma gondii IgG and IgM antibodies. The present study focused on assay the genotypes at IL-6 -174 G/C and IL-1β +3954 G>A to establish the associations between genetic polymorphisms and infection with Toxoplasma gondii. Results showed that the altered IL-1β GA, AA genotypes were high significant elevated in miscarriage women with toxoplasmosis (P=0.03), OR = 10 and 95 percent confidence intervals (1.32-81.48); (P=0.0007), OR = 0.07 and 95 percent confidence interval (0.01-0.32). The genotype GC at IL-6 (G/C) appears to be highly correlated with infection (P=0.01); OR = 3.18 and 95 percent confidence interval, (1.22- 8.30). In terms of allelic heterogeneity, C alleles were significantly more common in infected than uninfected cases for IL-6, while A allele is common in IL-1β single nucleotide polymorphisms (P =0.050). Furthermore, this study demonstrates that there is a strong and highly significant association between two forms of single nucleotide polymorphisms and the increased risk for toxoplasmosis. Genotypes of these polymorphism should be considered when evaluating genetic effects on toxoplasmosis incidence. However, to improve the prediction of this disease predisposition, a further study based on a larger cohort of patients is warranted(AU)

La toxoplasmosis es causada por la infección con el parásito protozoario Toxoplasma gondii, que tiene la capacidad de infectar a todos los animales de sangre caliente en todo el mundo. El propósito de esta investigación fue determinar la distribución de genotipos y alelos en mujeres con abortos espontáneos como resultado de la infección por Toxoplasma gondii asociada con polimorfismos de interleucina 1β e interleucina 6. Se inscribieron en este estudio un total de 125 mujeres con aborto espontáneo sospechosas de infección por toxoplasma y 50 embarazadas sanas, sin aborto espontáneo previo, como control. Los casos se examinaron para detectar IgM e IgG anti-toxoplasma mediante la prueba ELISA. Entre las 125 mujeres que sufrieron un aborto espontáneo, solo 50 fueron positivas a anticuerpos IgG e IgM anti-Toxoplasma gondii. El presente estudio se centró en analizar los genotipos de IL-6-174 G/C e IL-1β +3954 G>A para establecer las asociaciones entre polimorfismos genéticos e infección por Toxoplasma gondii. Los resultados mostraron que los genotipos alterados de IL-1β GA, AA fueron significativamente elevados en mujeres con aborto espontáneo con toxoplasmosis (P = 0,03), OR = 10 e intervalos de confianza del 95 por ciento (1,32-81,48); (P = 0,0007), OR = 0,07 e intervalo de confianza del 95 por ciento (0,01-0,32). El genotipo GC de IL-6 (G/C) parece estar altamente correlacionado con la infección (P = 0.01); OR = 3,18 e intervalo de confianza del 95%, (1,22- 8,30). En términos de heterogeneidad alélica, los alelos C fueron significativamente más comunes en los casos infectados que en los no infectados para la IL-6, mientras que el alelo A es común en los polimorfismos de nucleótido simple de IL-1β (P = 0.050). Además, este estudio demuestra que existe una asociación fuerte y altamente significativa entre dos formas de polimorfismos nucleótido simple y el mayor riesgo de toxoplasmosis. Se deben considerar los genotipos de estos polimorfismos al evaluar los efectos genéticos sobre la incidencia de la toxoplasmosis. Sin embargo, para mejorar la predicción de esta predisposición a la enfermedad, se justifica un estudio adicional basado en una cohorte más grande de pacientes(AU)

Transverse Cerebellar Diameter as a Sonographic Parameter for Estimating Gestational Age: an Experience From Yemeni Population

@#Introduction: Estimation of gestational age (GA) is clinically crucial for managing pregnancy and assessing the foetal anatomy, growth and development. Transverse cerebellar diameter (TCD) has been reported as an accurate tool for dating the pregnancy. This study aimed to determine the accuracy of foetal TCD for dating the pregnancy and to construct a reference chart for GA of Yemeni foetuses. Methods: We conducted this prospective cross-sectional study among 400 Yemeni pregnant women between 18 and 40 weeks of gestation provided that they were with known last menstrual period and singleton normal pregnancies. Sonographic TCDs were measured for each foetus. The mean TCD was measured for gestational weeks separately, and a polynomial regression model was then used to predict the GA by TCD. Results: There was a robust correlation between GA and TCD (r = 0.995, p <0.001). The coefficient of determination was 0.989, which indicates that the TCD explains 98.9% of GA change. Conclusion: TCD is an accurate tool to estimate the GA in second and third trimesters, including final weeks, among Yemeni pregnant women as in developed countries. The narrow range between the 5% and 95% percentiles is a significant indication of the accuracy of the TCD in estimating the GA. Therefore, clinicians are recommended to use TCD for estimating the GA and should be trained on measuring it accurately.

Frequency of Gallbladder Stones Among Patients Underwent Abdominal Ultrasound in a Tertiary Hospital in Sana’a City, Yemen

@#Introduction: The Gallbladder stone (GBS) disease is most commonly asymptomatic that may lead to several complications such as ascending cholangitis and obstructive jaundice. In this study the frequency of gallbladder stones among patients referred for abdominal ultrasound at the University of Science and Technology hospital (USTH), Sana’a – Yemen, have been estimated during the period between January and June 2013. Methods: This study is a record-based and conducted at the radiology department in USTH, on cases underwent abdominal ultrasound during the period from January – June 2013. Information were collected from abdominal ultrasonography reports. Results: In this study 4935 patients’ records are included. Of them, 2541 were males and 2394 were females. The frequency of patients with GBS was 5.53%. Multiple stones were observed in 3.57% of patients and 4.34% patients had large stones with size ≥ 5 mm. Females had significantly higher frequency of GBS (8.0%: 191/2394) than males (3.2%: 82/2541) (P < 0.001). It was found that, no significant difference between males and females in harboring small stones (< 5mm) (P = 0.251). However, significantly higher frequency of large GBS (≥ 5 mm) was found among females compared to males (P < 0.001). The frequencies of GBS, small size of GBS and large size of GBS have significantly increased with increasing age (P < 0.001). Conclusion: In this study it was found that females had significantly higher frequency of GBS than males. No significant difference between males and females in harboring small stones. There was a significantly higher frequency of large GBS was found among females compared to males. The frequencies of GBS, small size of GBS and large size of GBS have significantly increased with increasing age.

Improving Salt Stress Tolerance of Pineapple cv. Queen Using Cobalt In vitro

This investigation aimed to focus on how cobalt can avoid the damage caused by salinity stress (NaCl) on Pineapple cv. Queen in vitro. Multiplicated pineapple explants (10 – 12 mm) were subjected for eight weeks to different NaCl conc. (0, 65, 135 or 200 mM) half of them were treated firstly with 5 mg/L Cobalt sulphate. Vegetative growth parameters (no.of shoots, no. of leaves, and shoot length/explant), mineral composition (N, P, K, Na, Cl, Fe, Mn, Zn, Cu and cobalt), proline and protein content were determined. Molecular characterization using PCR based RAPD was carried out to describe the genetic differences resulted from the studied treatments, (salinity and salinity combined with cobalt sulfate). Results show that, pineapple explants growth under salt stress wasn’t prohibited completely specially below 135 mM of NaCl, but it affected negatively with the highest salt stress 200 mM of NaCl. Explants treated with cobalt before subjected to salinity scored the highest significant percentage of vegetative growth characteristics compared with those untreated. Explants treated firstly with cobalt resulted in a significantly decrease of Na+ and Cl-. Cobalt has a positive effect on Macro and Micronutrients, proline and protein content. A total of 34 DNA fragments varying from 186-1456 (bp) were amplified, of which 16 were polymorphic and seven observed as a unique markers that revealed 64.03% polymorphism.

Prevalence of generalized anxiety disorder in patients with rheumatoid arthritis and its relationship with disease activity

Background: rheumatoid arthritis [RA] is a lifelong disease with a progressive disabling course and individuals with RA experience higher levels of psychological distress than general population

Objective: The objective of the present study was to assess the prevalence of generalized anxiety disorder [GAD] in RA patients and determine its relationship with disease activity

Patients and Methods: The study included 200 RA cases. Psychiatry examinations of all cases were performed according to Hamilton scale. Patients who suspected to have GAD were further assessed by the most recent diagnostic criteria for GAD in diagnostic and statistical manual of mental disorders fifth edition [DSM-5] and psychiatry assessment sheet [PAS]

Results: The prevalence of GAD in RA cases was 38.5% [n=77] assessed by psychiatry assessment sheet [PAS]. RA patients with GAD significantly showed higher disease activity measures than those without GAD [P value <0.001]. It was found that GAD did not related to disease duration [r=0.617; p value >0.05] or RF positivity [r=0.058; p value >0.05]

Conclusion: Generalized anxiety disorder [GAD] is common to occur in RA cases. Disease activity was significantly higher in RA cases with GAD than RA cases without GAD. GAD was found to be not related to disease duration

Glanular closure during the tubularized incised plate procedure: a prospective randomized study

Hypospadias is reported in 1:200 live births. The introduction of the tubularized incised plate [TIP] procedure has revolutionized the treatment of hypospadias. The method of glanular closure during the TIP procedure, whether in single or double layers, has not been evaluated in the literature. To evaluate the optimal technique of glanular closure during the TIP repair of the distal hypospadias. Sixty-six infants and children with distal penile hypospadias were treated primarily with the TIP procedure. Age ranged between 9 months and 4 years with a mean age of 20.8 months at time of repair. Patients were randomly subdivided into two equal groups. In group A, the glans was repaired in a single layer, while in group B, the glans was closed in two layers. All cases were subjected to the same protocol of urethral stenting, penile bandage, and catheter removal by the third postoperative day. Both groups were followed up and compared with regard to the results of TIP repair and the incidence of complications. In group A, two cases developed glanular disruption versus none in group B. this was found statistically significant [p<0.05]. No statistical difference was found in between groups with regard to meatal stenosis, fistula formation, or in the overall cosmetic and functional outcomes. Medium-term follow up showed excellent results in 82.9% while good results were obtained in 17.2%. On the mid-term follow up, the TIP procedure continues to prove itself as the gold standard in treatment of the distal hypospadias. The double-layered glanuloplasty seems to hold an improved morbidity profile, with significantly lower glanular disruption rate, when compared to the single layered repair. Large-numbered studies are still needed to provide further evidence for the superiority of the double-layered glanuloplasty.

Anion gap estimation in the diagnosis and prognosis of pregnancy-induced hypertension

To identify the role of the anion gap estimation in the diagnosis and prognosis of pregnancy-induced hypertension. This Cohort study included 224 pregnant women that have attented the antenatal clinic. These comprise 101 women who had developed pregnancy-induced hypertension and 123 healthy pregnant women. Serum electrolytes including sodium, potassium and chloride, blood gases including bicarbonate level, serum albumin and 24 hour-proteins in urine were estimated. Anion gap was then calculated and consequently correlated to the clinical and laboratory data in both groups. Anion gap was significantly decreased in the hypertensive pregnant women than the healthy ones [P < 0.001]. This observation was more severe in the proteinuric hypertensive women than the non-proteinuric women [P< 0.01]. The value of the anion gap was negatively correlated to the severity of the disease. Anion gap depression was significantly increased with the development of placental abruption, intrauterine growth restriction, intrauterine fetal death as well as prematurity [P < 0.05] but this correlation was not observed on the cases of fetal distress. Anion gap estimation could be a reliable test as a diagnostic adjunct in women with pregnancy-induced hypertension as well as a good prognostic test for the development of the complications

Comparative study of hypertonic saline versus normal saline nasal wash in pediatric chronic sinusitis.

The objective of this study was to compare the effect of nasal wash with hypertonic saline [HS] [3.5%] versus normal saline [NS] [0.9%] on CS. Thirty patients with chronic sinusitis [CS] aged 3-16 years were studied. They were randomly divided into two treatment groups matched in age and severity of the disease. Each individual was treated with either HS or NS for four weeks. All patients were evaluated by two clinical scores [cough and nasal secretions/postnasal drip, PND] and by a radiology score at the beginning of the study and after four weeks. The results showed that the HS group was significantly improved in all scores [average +/- SD], e.g. cough score from 3.6 +/- 0.51 to 1.6 +/- 0.74, nasal secretion/PND score from 2.86 +/- 0.35 to 1.6 +/- 0.74 and radiology score from 8.06 +/- 1.28 to 2.66 +/- 1.04. The NS treatment group showed a significant improvement only in the PND score [from 2.66 +/- 0.49 to 1.53 +/- 0.83], but no significant change was reported in both cough score [from 3.53 +/- 0.52 to 3.33 +/- 0.49] and the radiology score [from 8.13 +/- 1.25 to 7.86 +/- 0.91]. It was concluded that HS nasal wash is an efficient treatment of CS

Estimation of postmortem interval based on the third component of complement [C3] cleavage in the blood of albino rats

To estimate postmortem interval [PMI], the spontaneous conversion of the native third component of complement [C3] to its derived fragments in whole blood was studied by immunodiffusion method. Thirty adult albino rats with average weight ranging from 380-400 g were used in this experiment. Immediately after death by decapitation, the collected blood samples were incubated at 37°C, 23°C and 14°C. Sera from each sample were removed every 12 h at 37°C until 60 h, every day at 23°C until the fifth day, and every two days at 14°C until tenth days. The percent age of cleavage of the third component of complement [C3] were assayed. Statistical analysis of the results showed that the incubation of whole blood at a higher temperature led to a faster conversion of beta IC [native C3] to beta IA [C], the cleavage% age at 37°C was about 3 times as that at 14°C [360 mg%. 258 mg% respectively]. Also, there was a significant positive correlation between the percent ages of C3 cleavage and PMI, at the temperatures of [37, 23, 14°C], the correlation coefficients [r] were 01981, m 01.99436, 0.9549 respectively. Therefore, the percent age of C3 cleavage could be used as a marker for estimation of the time passed since death, and this unusual approach could be a step towards the development of an accurate method for determining PMI

Lingual approach for removal of impacted mandibular third molars: incidence of postoperative sequelae

This technique described in this study relies on the development of a mucoperiosteal flap lingual to the third molar. Forty-one patients of impacted mandibular third molar were employed in this study. The result of the study were discussed

use of collagen implant [zenoderm] in the treatment of oro-antral communications and fistulae

Although several methods of surgical repair of oro-antral fistulae have been described, only few have received wide acceptance. The most commonly used methods of closure rely on the mobilization of soft tissue flaps and require a degree of surgical expertise that may not be available at the time of creation of an oro-antral communication. In this study, a collagen implant material [Zenoderm], in a thin sheet form was used for closure of OAC [eight cases] and OAF [two cases]. A simple surgical procedure was used. Closure was achieved successfully in all the cases involved in this study

management of oral hemangiomas by cryosurgery electrosurgery

Hemangiomas can present difficult management problems to the oral and maxillofacial surgeon when their removal is indicated. The present study was under taken to evaluate clinically the applications of cryosurgery and the use of electrosurgery in the management of soft tissue hemangiomas. The clinical material consisted of 12 cases of soft tissue hemangiomas of intra oral region. Amoils B.M.S. 40 cryoapparatus with a tonsillar probe was used with all cases. A high rate of cure was achieved by careful attention to adequate freezing of the tissues and to follow up after treatment at regular intervals; favorable results and high acceptablility strongly support more frequent use of this surgical technique in the management of soft tissue hemangiomas

Crude extracts from lawsonia intermis anti-dermatophyte activity

Ether extract of Lawsonia intermis is found to have invitro inhibitory effect on 31 isolates of dermatophytes. The MIC is 303 [micro] g/ml. results obtained in this study are promising since henna paste does not contain allergenic or skin irritating components. There are no records of side effects. Popularity of henna, in this country may be due to its therapeutic significance in skin infections