feasibility and safety of laparoscopic liver resections

Objective: To assess the feasibility and safety of laparoscopic liver resections

Methods: A prospective study of laparoscopic liver resections was undertaken in San_camillo hospital, Rome Italy, Anam hospital, Seoul South Korea and Assiut University Hospitals. in the period from July, 2012 till, Augest 2014 in patients with preoperative diagnoses including benign lesion, hepatocellular carcinoma with compensated cirrhosis, and metastasis of colorectal and noncolorectal origin, the tumor had to be 5 cm or smaller. Surgical technique included CO2 pneumoperitoneum and liver transection with a harmonic scalpel, with without portal triad clamping or hepatic vein control. Portal pedicles and large hepatic veins were led. Resected specimens were placed in a bag and removed through a separate incision, without fragmentation

Results: From July 2012 to Augest 2014 undertaken in San_camillo hospital, Rome Italy, hospital, Seoul South Korea and Assiut University Hospitals. 80 liver resections were included. Median follow up was 19 months ranging from 6 to 24 months. There were hepatocellular carcinoma [HCC; n=32], colorectal carcinoma liver metastasis [CRCLM; n=19] metastatic neuroendocrine tumor [NET;n=1], non-CRCLM [n=6], intrahepatic cholangiocarcinoma [n=4], lymphomas [n=1] and uncertain preoperative diagnosis [n=1] mostly pseudo inflammatory tumour, Mean tumor size was 3.6 cm. There were three conversions to laparotomy [3. 75%]. There were anatomical liver resection [n=31]. Four major hepatectomies [5%] were performed [3 segments or more], including 1 right hepatectomy and 3 left hepatectomies, 2 of them with caudate lobectomy. Mean blood loss was 129.50 mL. Mean surgical time was 115.36 minutes. There were no deaths. Complications occurred in 4 cases [5%]. two cirrhotic patients developed postoperative ascites. No port-site metastases were observed in patients with malignant disease

Conclusion: Laparoscopic resections are feasible and safe in selected patients with left-sided and right-peripheral lesions requiring limited resection. Young patients with benign disease clearly benefit from avoiding a major abdominal incision, and cirrhotic patients may have a reduced complication rate. For liver resections, unlike other areas of abdominal surgery, the laparoscopic approach has not been widely developed. The reasons are presumed technical difficulties and the intraoperative hazards of bleeding and gas embolism. Another concern is the potential risk of tumor seeding in patients with malignant disease, who constitute the majority of candidates for liver resections. However, technologic refinements in laparoscopic instruments, experience in laparoscopic and hepatic surgery, and the application of the principles of oncologic surgery have led some groups, to explore the place of laparoscopic liver resections. Initial laparoscopic procedures on the liver included staging of tumors to select patients for open resection [Rahusen F, et al 1999] and treatment of nonparasitic cysts by unroofing. [Morino M,et al 1994] More recently, there have been advancement of laparoscopic liver resections up to living donor hepatectomy for liver transplantation. [Quirino Lai, et al 2012] We initiated a prospective evaluation of laparoscopic liver resections in selected patients, and we report the results in our first 80 patients]

JAK2 V617F mutation in myeloproliferative neoplasms

Myeloproliferative neoplasms [MPNs] are clonal hematopoietic stem cell Malignancies characterized by excessive production of blood cell :they include polycythemia vera [PV],essential thrombocythemia [ET],Myelofibrosis [MF] and chronic inyeloid leukemia [CML].A somatic mutation in the Janus Kinase gene on chromosome 9: a guanine to thymine point mutation at nucleotide 1849 in exon 14,results in substitution of valine to phenylalanine atfcodon 617 this mutation contributes to the expansion of the MPN clone by increasing tyrosine phosphorylation activity providing hematopoietic [dh with a proliferative and survival advantage. The present work aimed to study the expression of JAK2 V617 F mutation by Real time PCR in myeloproliferative neoplasms patients. This study included /5 MPNs patients ;19 cases were diagnosed as PV 10 cases were diagnosed as ET16 cases were diagnosed as MF .20 age and sex matched individuals were also included as a control group. In MPNs patients,JAK2 mutation was expressed in 62%, in P V, ET an d MF patients 79%, 60% and 44% of cases had JAK2 mutation respectively. There was highly significant relationship between JAk2 mutation expression and patients' laboratory findings as regards hemoglobin level, total leucocytic count in PV positive JAK2 mutation patients and platelets count in ET positive JAK2 mutation patients. JAK2, mutation expression was associated with increased risk of MPNs .We concluded from this study that JAK2 mutation plays a fundamental role in the palhogenesis and development of MPNs ,and its detection is very useful to confirm the diagnosis and help in treatment and follow up of MPNs patients

Awake craniotomy versus general anesthesia for managing eloquent cortex low-grade gliomas

To compare awake craniotomy using conscious sedation technique versus conventional general anesthesia [GA] for excision of low-grade glioma encroaching on eloquent brain. This prospective study included 40 patients ASA classification 1 and 2, aged 23-55 years, harboring low-grade glioma encroaching on eloquent brain. The study was carried out in the Neurosurgical Theatre in Kasr El-Aini Hospital, Cairo, Egypt, from January 2007 to November 2008. Twenty patients [group 1] received GA with endotracheal intubation and controlled ventilation. In group 2, awake craniotomy was carried out using local anesthetic infiltration, and intravenous injection of propofol and fentanyl. Forty patients completed the study. In the awake group, none of the patients received GA, 2 patients developed intraoperative agitation, 5 patients were over-sedated, and none of the awake patients developed intraoperative nausea or vomiting. Four patients in the GA group developed post-operative nausea and vomiting compared to one patient in the awake group, and this difference was statistically significant [p=0.039]. The neurological outcome regarding motor power and/or speech was found better or with no fresh deficits, immediately postoperative in 90% of the awake group patients. This is compared to 40% in the GA group. The difference was statistically significant. At 6 months follow up, the results were 90% and 60%, but the difference was not statistically significant. Gross total tumor resection was achieved in 10 cases of the GA group versus 8 in the awake group; however, the difference was not statistically significant. Compared to GA, awake craniotomy is a relatively simple non-expensive procedure that allows tumor removal guided by physiology rather than anatomy

[Study the chemical and physical characteristics of starch granules in some Iraqi wheat varieties]

The study showed significant differences in percentage of small starch granules in four Iraqi wheat varieties Tammoze 3, Abugraib, Rabiaah and Maxibac. Tammoze 3 gave the highest value compared to other varieties in percentage of the starch granules. Whereas the lowest percentage of the starch granules was found in Maxiback. Percentage of wheat amylase was superior in Maxiback while the lowest was found in Tammoze 3. At 90°C, the swallow values of small starch granules for all varieties were not the same, Tammoze 3 gave the highest value whereas Abugraib showed the lowest. The reverse was found in terms of the solubility of the starch granules

Expression of adhesion molecule CD44V6 in salivary gland tumors

Salivary gland tumors are a morphologically and clinically diverse group of neoplasms which may present significant diagnostic and management challenges. Cell adhesion molecules [CAMs] are glyco-proteins that are present on the external surface of the cell membrane. CD44 is a cell adhesion molecule belonging to systemic IgCAMs family, and is remarkable for its ability to generate alternatively spliced forms, many of which differ in their activities. This remarkable flexibility has led to speculation that CD44, via its changing nature, plays a role in some of the methods that tumor cells use to progress successfully through growth and metastasis. To investigate the expression of CD44v6 in different types of salivary glands tumors and to correlate the results with some established prognostic factors. Sixty cases were studied. 21 were pleomorphic adenomas,, 9 Warthin's tumors, 6 monomorphic adenomas, 9 mucoepidermoid carcinomas, five adenoid cystic carcinomas, in addition to 10 normal controls. Clinical data were obtained from the referring clinical departments. The biopsy specimens were obtained by excision, true cut needle biopsy, or punch biopsy. Cases were selected by reviewing the hematoxylin and eosin [H and E] stained slides. Immunohistochemistry was done using the CD44v6 mouse monoclonal antibody raised against human species. CD44v6 was +ve in 46/60 [76, 7%] of salivary gland tumors studied; 35/40 [87.5%] benign salivary glands tumors and 11/20 [55%] malignant salivary gland tumors and this difference was statistically significant [P < 0.01]. CD44v6 was +ve in 16/21 [76%] of pleomorphic adenoma, in 9/9 [100%] of Warthin's tumors and in 6/6 of monomorphic adenoma. CD44v6 was +ve in 5/ 9 of mucoepidermoid carcinoma; 4/5 [80%] of low and intermediate grade mucoepidermoid carcinoma and in 1/4 [25%] of high grade malignant mucoepidermoid carcinoma. The 4 studied high grade malignant mucoepidermoid carcinoma were lymph node metastasis +ve. CD44V6 was +ve in 4/5 [80%] of adenoid cystic carcinoma. There was a statistically significant decrease in CD44v6 positivity [P < 0.03] in high grade malignant salivary gland tumors compared to low and intermediate grade tumors. There was also a statistically significant decrease in CD44v6 positivity [P < 0.01] in malignant salivary gland tumors received with lymph node metastasis compared with those lymph node metastasis negative cases. 1] Down regulation of CD44v6 plays an important role in malignant transformation of salivary gland tumors. 2] The degree of down-regulation is correlated, with progression towards higher grades and also with lymph node metastasis

Laboratory screening for rhabdomyolysis among beginners practicing vigorous exercises

The objectives of this study were: screening for cases of exertional rhabdomyolysis among beginners in practicing vigorous exercises, and finding out reference laboratory values for the students who will exercise for the first time. The study was conducted in Assuit university hospital on 222 male students of first year of faculty of sports, who practiced vigorous exercises for one hour with maximal load, for the first time, and 20 apparently healthy subjects as a control group [GI]. Twenty four hours after vigorous exercise [24hs AVE], blood samples were collected and the students were classified according to [CK] levels into two groups, group II [GII] :125 students, with total CK<183U/L[cut off value] and group III [GIII]: 97 students, with total CK>183U/L. One month after vigorous exercises [I m AVE], blood samples were collected from [GIII] which represent the follow up group [GIV, baseline]. All participants were subjected to medical history, clinical examination including body mass index [BMI], and quadriceps circumferences. Laboratory investigations included peripheral haemogram, kidney and liver function tests, blood minerals, and specific tests including: total CK, CK-MB and CK-MM isoenzymes, LDH, and serum myoglobin. This study revealed statistically highly significant elevation of total CK, CK-MM, CK-MB, AST and serum myoglobin when comparing [GIII] with each of [GI] and [GII] while a high significant reduction was found when comparing [GIV] with [GIII]. No significant difference could be detected when [GIV] compared with [GI] and [GII] compared with [GI]. There was a significant reduction in serum Na+ and serum Ca+ + level and highly significant elevation in serum K+ and phosphorus in GIII when compared with GI. No statistical significance in [BMI] was detected. Twenty four hours after vigorous exercises, 16 students [7.2%] showed total CK level more than 5 times the cut off value [183 U/L]. These students showed no signs and symptoms of rhabdomyolysis except muscle pain. The participant students who showed total CK values five times or more than the cut off value [183 U/L], are considered by some authors to be suspicious of having rhabdomyolysis. Laboratory values of the students who did not show rhabdomyolysis, could be taken as reference values for students and untrained persons who will practice exercise vigorously for the first time

epidemiological study of nosocomial infections in surgical departments in Assiut University Hospitals

Nosocomical infection is a localized of systemic condition that results from adverse reactions to the presence of an infectious agents[s] or its toxin[s] that was not present or incubating at the time of admission to the hospital [CDS, 2003]. Nosocomial infection usually appears three days after a patient is admitted to a hospital or other health-cure facility. One third of all nosocomial infections are preventable. We determine the incidence of nosocomial infection among the studied patients and the risk factors of nosocomial infection among them. The study was a hospital-based prospective study conducted for one year in Neurosurgery Department and unit Cl from General Surgery Department at Assiut University Hospitals. The total number of patients that was enrolled in the study 1377 patients. Data collection through personal interviews with all patients admitted in the selected departments immediately after admission. Daily follow up of these patients to detect the development of nosocomial infection. The incidence rate of nosocomial infection was 15% Nosocomial infection was higher among rural than urban residents with significant difference. According to the wards, unit Cl, Neurosurgery Department and Neurosurgery ICU, it was 48.5%, 29.4%, 22.2% respectively. 94.7% of patients undergo operations, 99.5% of patients exposed to invasive devices and 61.0% of patients with contaminated wounds acquired infection. The incidence of nosocomial infection increased significantly with those exposed to general anesthesia, trauma, multiple procedures, implants and complicated surgery. As regard the type of organisms, Klebsiella was the most common organism followed by E.coli and Enterococci then proteus [28.0%, 16.0% and 14.0%] respectively

Prognostic value of matrix metalloproteinase-2 expression in gastric carcinomas

Matrix metalloproteinases [MMPs] might be involved in invasion and metastasis of tumors by degrading extracellular matrix and basement membrane. Controversial data exist concerning the progrnostic value of MMP-2 in gastric carcinomas, so this study was done to evaluate prognostic value of MMP-2 expression in gastric carcinomas and comparing its expression with known prognostic parameters [cancer cell differentiation, depth of invasion and different histological subtype] and to determine its value in detecting metastatic potential [by evaluation of its expression in correlation with vascular permeation and lymph node metastasis]. This retrospectiver study included 25 cases of gastric carcinomas, all cases were formalin-fixed, paraffin-embedded tissues, Immunostaining for MMP-2 was done using Avidin-biotin peroxidase method. MMP-2 espression in tumor tissues was studied with semiquantitative evaluation [Score 0.3]. 20/25 cases [80%] of gastric carcinoma showed immunoreactivity and 5/25 cases [20%] were negative. 10/12 cases [83.3%] of the well-differentiated tumor, 5/7 cases [71.4%] of the moderately differentiated and 5/6 [83.3%] of the poorly differentiated tumor showed immunoreactivity [P = 00.568]. As regarding the depth of invasion, 2/4 cases [50%] of T[b] 5/7 cases [71.4%] of T[2], 7.8 cases [87.5%] of T[3] and 6/6 cases [100%] of T[4] showed MM-2 expression [P = 0.0001]. According to WHO classification 1/2 cases [50%] of papillary carcinoma, 7/8 cases [87/5%] of tubular carcinoma, 7/9 cases [77.7%] of signet ring carcinoma and 5/6 cases [83.3%] of the undifferentiated carcinoma showed immunoreactivity [P = 0.727]. According to vascular permeation 11/15 cases [73.3% without vascular invasion and 9/10 cases [90%] with vascular invasion showed positive staining and 77.7% of them were of [score-3] [P = 0.0001]. According to lymph node metastasis 11/16 cases [68.7%] without lymph node metastasis and 9/9 cases [100%] with lymph node metastasis showed MMP-2 expression and [88.8%] of them were of [score-3] [p = 0.0001]. mmp-2 expression in gastric carcinomas has prognostic value as it correlated significantly with the depth of invasion, vascular permeation and lymph node metastasis. high density of staining [score 3] can help in selecting cases with high metastatic potential

Growth retardation and malformations induced in albino rat fetuses after treatment with diazepam

Thirty-six pregnant albino rats were included in this study and divided equally into three groups: A control group, low dose diazepam [LDD] group and high dose diazepam [HDD] group. LDD [0.45 mg/kg b. w.] and HDD [0.9 mg/kg b. w.] were administered daily intragastrically by gavage from day 6 through 15 of gestation. The fetuses were collected by cesarean section on day 20 of gestation. An external examination of the fetuses was done before and after their fixation in Bouin's solution. An internal examination of the transverse sections of the fetuses was done using Wilson's technique. A histological examination [H and E] was done for expected abnormal transverse sections of the fetuses and for the placentae. The study concluded that the prenatal exposure of the pregnant rats to clinically relevant therapeutic doses of diazepam during the embryonic period results in mild proportionate IUGR in low dose; whereas in high dose it leads to marked disproportionate IUGR and an increased incidence of resorptions and fetal malformations. These results indicated that the effects of diazepam are dose-dependent

Bone turnover markers in relation to menopause in rhematoid arthritis patients

Biochemical markers of bone turnover are extremely useful for the management of generalized osteoporosis associated with rheumatoid arthritis [RA]. They provide information that is different and complementary to bone mass measurements. We assessed the effect of menopause and disease activity on bone turnover markers in RA patients by measuring two bone formation markers ;Bone Alkaline Phosphatase [BAP] and Osteocalcin [OC] as well as two bone resorption markers by measuring urinary pyridinoline [PYD] and deoxypyridinoline [D-PYD]. The present work was done on 80 females aged between 35-65 years. They were divided into two groups: Group I normal controls [NC] constituted 20 females; 10 premenopausal [Pre NC] and 10 postmenopausal [Post NC]. Group II RA patients: 30 premenopausal RA [Pre RA] and 30 postmenopausal RA [Post RA]. Among bone formation markers, both BAP and OC were significantly lowered in RA than in NC [p<0. 05 each] particularly in postmenopausal period. On the other hand bone resorption markers urinary PYD and D -PYD were increased in RA in comparison to NC during both premenopause and postmenopause [p<0. 05 each] and menopause exaggerated this condition. Meanwhile, RA activity altered bone formation markers with increased OC in premenopausal [p<0. 05] and decreased BAP in postmenopausal period [p<0. 05]. On the other hand, RA activity exaggerated the increased bone resorption markers PYD and D-PYD especially in the postmenopausal period [p<0. 05 each]. Both RA and menopause accelerated osteporosis by inducing a disequilibrium between bone formation markers [BAP and OC] and bone resorption markers [PYD and D-PYD]. While bone formation markers were reduced, bone resorption markers were exaggerated. RA activity further altered bone formation markers and exaggerated bone resorption markers which should be considered during management of osteoporosis. Furthermore, biochemical markers of bone turnover are simple, cost effective, non-invasive methods that offer an alternative to bone imaging techniques

Glycemic control and cardiopulmonary dysfunction in asymptomatic patients with insulin dependent diabetes mellitus

The study was undertaken to evaluate the cardiopulmonary functions in asymptomatic patients insulin dependent diabetes Mellitus [IDDM] and also to investigate the relationship of cardiopulmonary dysfunction to chronic glycemic control and the duration of diabetes. Thirty-three diabetic patients with mean age 26 +/- 7 years, with no history or physical findings of ardiovascular or respiratory disease, were compared with fifteen healthy non diabetic control subjects. According to the level of glycosylated hemoglobin [HBA1c], patients were classified into hyperglycemic [group A n=17] with elevated HbA1c levels and normoglycemic [group B n=16] who had near normal HbA1c levels. Pulmonary function via spirometry and Doppler echocardiogram were performed in all patients and control subjects. The results revealed significant reduction in forced vital capacity [FVC] in patients versus control and in hyperglycemic than normoglycemic patients [58.9 +/- 8.6% vs 67.0 +/- 2.8% respectively'; forced expiratory volume in the first second [FEV1] was also significantly diminished in patients versus control and in hyperglycemic than normoglycemic patients [60.9 +/- 11.0% vs 72.1 +/- 2.9% respectively. Ejection fraction [EF] was significantly diminished in patients versus control and in hyperglycemic patients versus normoglycemics [64.3 +/- 2.4% vs 65.9 +/- 3.0%, respectively. Also fractional shortening [FS] was significantly diminished in hyperglycemic than normoglycemic patients [32.9 +/- 6.1% vs 33.4 +/- 5.6% respectively]

Prognostic value of epidermal growth factor receptor in human breast cancer

Epidermal growth factor receptor [EGFR] expression has been proposed as potential prognostic parameter in breast carcinoma. In this study EGFR was evaluated by immunohistochemistry in a series of 54 cases of infiltrating duct carcinoma, 11 cases of in situ ductal carcinoma and 20 cases of adjacent non-malignant breast tissues. Out of 54 case of infiltrating duct carcinoma, 23 cases were received with lymph node metastasis. EGFR was expressed in all cases of non-malignant breast tissues. The infiltrating duct carcinoma and in situ ductal carcinoma showed a nearly similar expression 21/54 [38.9 percent] and 4/1 1 [36.4 percent] respectively. The stromal cells were negative for staining in non-malignant breast tissues and found in stroma of infiltrating duct carcinoma [33.3 percent], however [72.7 percent] of the myoepithelial cells showed EGFR expression. The expression of EGFR in invasive breast carcinoma showed a significant value between grade III [77.8 percent], grade II [41.7 percent] and grade I [8.3 percent] [P<0.01 percent], also between cases with lymph node metastasis [82.6 percent] and those without lymph node metastasis [6.5 percent] [P< 0.001]. However no significant value could be detected for stromal cells EGFR expression. High intensity of staining was found to be associated with lymph node metastasis, stromal cell staining and high grade [grade III]. So EGFR expression is considered as good prognostic parameter in breast carcinoma and the high intensity of staining in association with stromal cells staining can help in predicting cases with high metastatic potential

Damage of the superior gluteal nerve after the lateral transgluteal approach of the hip. anatomical, clinical and electrophysiological study

Twenty-two patients who had undergone unilateral hip athroplasty using the transgluteal approach of Hardinge were studied. The abductor muscles of the hip joint were assessed electrophysiologically and clinically by Trendelenberg test six months after the operation. Electrophysiological evidence of damage of the superior gluteal nerve was found in two patients, while positive Trendelenberg was present in seven cases. In an effort to understand the mechanism of injury of the nerve, ten Egyptian cadavers were bilaterally dissected to expose the superior gluteal nerve. The course, pattern of branching and distribution of the nerve were evaluated. Two patterns of nerve distribution were recorded. The spray pattern in 90% of cadavers and the transverse neural trunk pattern in the remaining 10%. In both patterns all branches lied deep to the middle third of the undersurface of the gluteus medius muscle. A safe area devoid of any neural branches was detected in all cadavers. It is safe to extend the incision up to 4.8cm in a cephalic direction from the tip of the greater trochanter, before reaching the lower most branch of the superior gluteal nerve

Evaluation of the donor site after harvesting the central third of the patellar tendon

The purpose of this study was to evaluate the donor site after use of the central third of the patellar tendon, as a free autograft for anterior cruciate ligament [ACL] reconstruction. Twelve consecutive patients were evaluated clinically and serially imaged with magnetic resonance image [MRI], two years after operation. The tendon defect was not closed primarily, but the paratenon [peritendon] was approximated. Examination of knee walking ability and assessment of the anterior knee sensitivity were made in order to evaluate donor site discomfort and the function of the infrapatellar nerves. 75% of the patients had disturbed anterior knee sensitivty with a median value of 16 cm2. Knee walking ability was unpleasant or difficult in 67% of cases. In the MRI evaluation the following measurements were performed: tendon width, defct width, tendon thickness and tendon length. All measurements were compared to the contralateral unoperated patellar tendon. Complete closure of the tendon defect was detected in four cases, while the mean tendon defect was 2mm [range 0-5mm]. Tendon width was increased [p=0.022]. Tendon thickness was also increased [p=0.035], but tendon length was noted to be decreased [p= 0.017]. Degenerative changes of the lateral third of the patellar tendon were detected in one case. The bony defect in the anterior surface of the patella and tibial tuberosity was present in all cares. The retropateller fat pad was found to be hypertrophied in six cases. Presence of a gap in the middle of the fat pad was detected in four cases. Presence of changes in the donor site after harvesting the patellar tendon autograft may explain the increased incidence of anterior knee pain after ACL reconstruction

Health related behaviors among adolescents and youth in Assiut governorate, Upper Egypt

A cross-sectional community-based study in rural and urban areas was designed to study the cultural norms and health related behavior about reproduction, female circumcision, STDs, smoking and leisure time use. The data were collected by a personal interview of 1660 adolescents and youth aged 15-24 years in two rural [1151] and two urban [509] areas. Three children were the ideal number of wanted children in 54.2% and more than half considered 35-40 years the ideal age for terminating child bearing. About one-fourth of married females got pregnant three times or more and this was depending on the number of living children and duration of marriage by using logistic regression analysis. Female circumcision was almost universal [98.5%] and decreased markedly by mother's education [82.5%] and 75.9% intended to circumcise their daughters. About-half of adolescents and youth [48.4%] knew about STDs. Of the aware group, 94.9% knew AIDS and 59.2% recommended sticking to religious teaching to protect themselves against STD/AIDS. 30% of males were smokers and the habit was much higher among working groups as free business, skilled workers and farmers. Leisure time use was underutilized, sports were practiced by 26.6%, reading as a hobby by 41.6% and only 12.2% were volunteers for public activities. Literacy and unemployment are major problems with gender disparities

Pulmonary tuberculous children and the Euthyroid Sick Syndrome.

This study was designed to investigate changes in the thyroid hormones in children with active pulmonary tuberculosis [TB] before and three months after starting antituberculous therapy. It was observed that the mean hemoglobin level was significant and lower in patients than controls. The mean serum albumin level was significantly lower in cases before treatment than three months after treatment and the control group. The mean serum level of AST and ALT was significantly higher in patients after treatment than before treatment and the control group. It was observed that the mean serum level of T3 was significantly lower in patients before treatment than after three months of antituberculous treatment or the control group. There were no significant differences in the serum levels of T4 or TSH between the control group and cases before and three months after starting antituberculous treatment. Cases with decreased serum T3 level had more severe clinical manifestations than those with normal serum T3 level

Late onset involuntary movements, clinical and laboratory study

This study aimed to find the relative frequency of movement disorders, its etiology and presentation in relation to other neuropsychiatric illnesses throughout a period of 12 months. This study revealed that over a period of one year about 3100 patients aged 40 years and more with neuropsychiatric illness attended out patients clinic of neuropsychiatry, Assiut University Hospital. Ceruloplasmin and total thiol were significantly diminished in all groups of patients with movements disorders compared with the control. Lipid peroxide was significantly increased in all studied groups compared with control. These biochemical indices indicated the important role of increased oxidant stress in the etiopathogenesis of movements disorders

relation between entamoeblasis infection and blood groups

This work included 287 persons from secondary school of nursing students and patients attending Assiut Endemic Diseases Hospital. Stool and urine samples were examined for parasitic infection. Fifty- seven were infected with Entamoeba histolytica and 230 were free from parasites. Every one was examined for ABO blood groups. Twenty-seven cases were of blood group A, fourteen, thirteen and three were of blood groups O, B and AB, respectively. Entamoebiasis was more common among urban 28 than rural 24 and semi-urban 5. The infection rates were higher among females 37 than males 20 and among the age group 10-20 and 20-30 years

In vivo and in vitro evaluation of the mutagenic potential of carbamazepine: does melatonin have antimutagenic activity?

The mutagenic potential of carbamazepine [CBZ] therapy has been evaluated invivo and in vitro. Analysis of chromosome aberrations [CA], sister chromatidexchanges [SCEs], mitotic and proliferation [PRI] indices were performed. Thein vivo was carried out on 30 patients with idiopathic epilepsy and undergoingtreatment with CBZ for different periods starting from 6 months up to 15years. Plasma CBZ levels were also determined for each patient. From theobserved results, it was suggested that CBZ monotherapy may lead to chromosomedamaging effects [genotoxic] and the use of melatonin as anti- mutagenic agentfor human protection against CBZ-induced chromosome damage should beconsidered