Pancreatic insufficiency in giardiasis

To study pathological mucosal changes, gut bacteriological spectrum [bacterial overgrowth] and some pancreatic exocrine function in Giardiasis. 50 Patients having Giardia lamblia infection proved by stool examination beside, 20 healthy controls of matched age, sex and socioeconomic status. All patients and controls were subjected to thorough history and clinical examinations. Stool examination for diagnosis of giardia and study of fat contents, liver function tests, renal function tests, glucose tolerance curve, plain x-ray abdomen and abdominal ultrasonographly. Pancreatic function tests in the form of trypsin and amylase activities in duodenal aspirate, besides serum amylase and trypsin concentrations Upper GIT endoscopy for taking duodenal biopsy Also, parsitological and bacteriological examination for the duodenal aspirates. Both amylase and trypsin activities were lowered in patients than controls [t = 9.256] [t =7.284] and in patients with severe mucosal abnormalities than in patients with minor or no abnormalities [t = 7.462] and [t = 6.567] respectively. On the other hand, both serum amylase and trypsin concentrations showed significant elevation in patients than controls [t = 8.676] and [t= 7.827] and in patients with severe mucosal abnormalities than in patients with minor or no abnormalities [t =7.541] and [t = 7.623] respectively Giardia infection leads to a state of pancreatic exocrine insufficiency which resulted mainly from duodenal mucosal changes rather than bacterial overgrowth

Evaluation of intra-rectal ultrasonography in pre-operative staging of cancer rectum.

Intra-rectal ultrasonography was used in the preoperative staging of 20 patients with rectal cancer, using a 4 MHz radial scanner. The results of ultrasonic staging were compared with clinical examination including EUA, operative and subsequent histological staging. The lesion could not be felt by digital examination in 6 patients. In the remaining 14 patients ultrasound examination matched the digital examination and EUA and was sometimes superior to it. As regards the degree of invasion of the rectal wall layers, ultrasonography corresponded with the histopathologic findings in 10 of the resected 11 tumors [accuracy rate 90.9%]. Concerning regional lymph node infiltration, the accuracy rate of endorectal sonography was 85% with only one false positive and two false negative cases. Intra-rectal ultrasonography is a highly accurate preoperative staging tool for rectal cancers both in delineating the depth of tumor invasion and subsequently its resectability, and in assessing regional lymph nodes. It is particularly valuable in tumors non reachable by the examining finger