Prevalence of microscopic colitis in patients with chronic diarrhea in Egypt: a single-center study

Microscopic colitis [MC] is diagnosed when a patient with chronic watery non-bloody diarrhea [CWND] has an endoscopically normal colon, but colonic biopsies show unique inflammatory changes characteristic of lymphocytic or collagenous colitis. MC is a disorder of unknown etiology. Studies comparing the prevalence of the disease in developing countries as compared to developed countries may shed more light on the possibility of a post-infectious etiology. Most data on the incidence and prevalence of MC are from developed countries where it accounts for 4-13% of cases of CWND. There are only a few reports from developing countries. Two studies from Peru and Tunis, with high prevalence of infectious gastroenteritis, revealed MC in 40% and 29.3% of cases of CWND, respectively. The aim of this study was to investigate the prevalence of MC in patients presenting with CWND in Egypt. A total of 44 patients with CWND of unexplained etiology who had undergone full colonoscopy with no macroscopic abnormalities between January 2000 and January 2010 were assessed retrospectively. The histological appearance of MC was identified in 22 [50%] patients. Twelve [55%] patients were male and 10 [45%] female. Mean age was 40 years [range: 20-65 years]. Twenty [91%] of MC cases had lymphocytic colitis and 2 [9%] had collagenous colitis. The prevalence of MC in Egyptian patients with CWND is high when compared to that in developed countries. MC mainly affects young and middle-aged patients and it is more commonly of the lymphocytic type

Hyperacute soft tissue infection in diabetics

Hyperacute soft tissue infection is an uncommon infection entity, which mostly affects immunocompromized individuals, mainly diabetics and poses difficult diagnostic and therapeutic management decision. This study addresses the presentation, evaluation and management of 27 diabetic patients with acute necrotizing fasciitis treated throughout the period between August 1993 and July 2003 by the main author. Extremities, trunk and perineum were the most commonly involved sites with an incidence of 37%, 29.6% and 26% respectively. All patients presented with cellulitis, which was associated with edema in 74% of cases, skin gangrene in 48% of cases and brown echymotic patches in 29.6% of cases. skin vesicles, tenderness and creiitations were present in 15%, 11% and 11% of cases respectively. Streptococci, Staphylococci and E-Coli were the most commonly encountered organisms, which affected 70% of cases, either alone or in combination. Anaemia and hypoalbuminaemia were the most commonly encountered laboratory findings in 74% and 85% of cases respectively. The mortality rate in the27 patients included in this study was 44% [12 cases]; in 8 of them infection was located in the truk. Once necrotizing fasciitis is suspected, exploration of the fasica is mandatory with pathological assessment of tissue specimens. Radical debriement of the affected area, maintenance of adequate nutritional support and systemic antibiotic therapy should be implemented at once to reduce mortality and insure safe recovery of patients

Hepatocellular carcinoma insitu does this lesion exist? A histopathological study of ultrasonography guided needle biopsies of focal solid defects within cirrhotic livers

Guided needle biopsies were taken from solitary or multiple solid focal hepatic defects [FHDs], detected during imaging of cirrhotic livers by ultrasonography [US] in 216 patients. In 198 patients [91.7%] the biopsies revealed primary hepatic malignancies, predominantly conventional hepatocellular carcinoma [HCC]. In 3 cases [1.4%] the biopsied lesions were macroregenerative nodules with or without mild atypia [MRNs] and in the remaining 15 cases [6.9%] the biopsies revealed macroregenerative modules with diffuse cytological atypia including nuclear irregularities, increased nucleocytoplasmic [N/C] ratio and scattered nucleolar prominence accompanied by thickening of some liver cell plates but without concomitant histological structural changes of hepatic carcinomas. It was suspected that these atypical macroregenerative nodules [AMRNs] may correspond to in situ malignant changes and it was tentatively suggested the term "hepatocellular carcinoma in situ" [HCIS] for these lesions. Similar AMRNs were also detected in association with 6 of the cases readily diagnosed as HCC

Mast cells in polyps of the vocal folds [Vocal cords]: a clinicopathological study

This study was carried out on 30 surgically excised polyps of the vocal folds. Sections from each polyp were stained with hematoxylin and eosin as well as toluidine blue pH 4. The same stains, were applied to sections from 5 control specimens. In 22 polyps, the mean number of mast cells/high power field was 0-4. Similar to control specimens, but in 8 polyps [26.7%] the mean count of mast cells/high power field was high. Eosinophils were detected in 25% of the polyps with high counts of mast cells and marked oedema was observed in 50% of these polyps. The results of the present study suggested that hypersensitivity reactions may play a role in the pathogenesis of at least some of the vocal fold polyps. A trial of medication with antiallergic drugs suggested before surgery is decided