Role of multislice computed tomography in evaluation of colo-rectal neoplasm

Computed tomographic [CT] colonography is a noninvasive, rapidly evolving technique that has been shown in some studies to be comparable with conventional colonoscopy for the screening of colorectal cancer. The addition of intravenous contrast material to CT colonography can aid differentiation of true colonic masses from pseudolesions such as residual stool and improves the depiction of enhancing masses that might otherwise be obscured by residual colonic fluid. The aim of this study is to assess the role of multi detector computed tomographic colonography in staging of colo-rectal neoplasm and detection of synchronous lesons such as adenomatous polyp. The study included fifty-five patients with suspected colo-rectal neoplasm and underwent MDCT colonography and fibro-optic colonoscopy on the same day. The MDCT colonography with IV contrast media has 94% accuracy for identifying tumor wall invasion by colorectal carcinoma and 71% accuracy for identifying regional lymph nodes involvement and the sensitivity of both MDCT colonography and fibro-optic colonoscopy equal in detection of polyps more than 5 mms. The contrast enhanced MDCT colonography is an excellent investigating tool in staging of colo-rectal neoplasm in detection of synchronous adenomatous polyps more than 5 mms

Ultrasonographic measurement of inferior vena cava diameter as an index of ultrafiltration adequacy in dialysed uraemic patients

This study was designed to assess the adequacy of ultrafiltration during dialysis by ultrasonographic measurement of inferior vena cava [IVC] diameter in both normotensive and hypertensive dialysed uraemic patients and to determine whether control of extracellular fluid volume by ultrafiltration is correlated with blood pressure control. Fifty patients were studied; 25 normotensives [group I] and 25 hypertensives [group II]. The patients of the later group were followed for 8 month with gradual increase in ultrafiltration and decrease in the dose and the number of anti-hypertensive agents. In addition to thorough clinical examination including blood pressure body weight sampling for estimation of blood urea pre and post dialysis and calculation of Kt/V which is defined as the rate of urea removal normalized for body surface, serum creatinine, haemoglobin concentration and ultrasonographic measurement of IVC diameter predialysis and 2- hours post dialysis were done. Results showed that body weight and IVC diameter were significantly [p<0.001] higher in group II compared with group I and were significantly lower at post dialysis time compared to predialysis time in both groups while haemoglobin levels and Kt/V showed insignificant changes. At the endof the follow up period for group II patients: 10 patients [group IIa] normotensives with ultrafiltration only without antihypertensive drugs, 9 patients [group IIb] became normotensives with ultrafiltration plus antihypertensive drugs and 6 patients [group IIc] remained hypertensives despite ultrafiltration and hypertensive drugs. A significant negative correlations was observed between the duration of dialysis in years and both the systolic and diastolic blood pressures, body weight and Kt/V and IVC diameter and Kt/V. In conclusion ultrasonographic measurement of IVC diameter assessment of adequacy of ultrafiltration to control hypertension in dialysis patients. Thus avoiding the side effects of antihypertensive drugs and decrease the cost. Routine sonographic assessment of IVC diameter in dialysis patients is recommended

Assessment of gastrointestinal lymphoma by abdominal computed tomography

To clear up the role of abdominal computed tomography [CT] as a non invasive technique in evaluation of the extent of intra abdominal disease in lymphoma patients and to determine its role in staging of gastrointestinal lymphoma. Eighty patients, already having lymphoma were selected in our study and referred from oncology, surgery and internal medicine department to radiology department from the period of June 1999 to June 2001. All patients underwent full clinical examination, laboratory investigation, routine chest X-ray, abdominal sonography and abdominal computed tomographic examination. Twenty patients [25 percent] were HD and the other sixty patients [75 percent] were NHL. Fourty eight were males [60 percent] and thirty-two were females [40 percent]. The patients age ranged from 5 years to 60 years in HD group and between 2 years to 60 years in NHL. From our study we found that CT is well tolerated, non invasive technique to detect the hidden lymph nodes, that are not routinely visualized by other modalities for example, retrocrural lymph nodes [40 percent in HD and 20 percent in NHD L] mesenteric L.Ns, splenic, renal and hepatic hilum lymph nodes as well as infiltration of the intestinal wall and adjacent structures. From our study we clarified that abdominal CT is a simple non invasive investigation, should be used routinely for staging, planning of therapy and follow up of lymphoma patients

Hemodynamic changes in patients with liver cirrhosis and tense ascites after large volume paracentesis

The aim of this study was to assess the short-term effects of a single 5-L paracentesis without albumin replacement on the systemic and portal hemodynamics. Thirty patients with liver cirrhosis and tense, diuretic resistant ascites were studied before and 24 hr after a single 5-L paracentesis without albumin infusion. An abdominal duplex Doppler examination and echocardiographic study were carried out for all patients. Heart rate and blood pressure were measured. The mean arterial pressure was calculated. Serum sodium, potassium, blood urea and creatinine were also measured. There were no significant changes from the baseline values for heart rate, mean arterial pressure and cardiac output. As regards portal hemodynamics, there were no significant changes in portal vein diameter, portal flow velocity and portal blood flow before and 24 hr after large volume paracentesis. The study concluded that single large volume paracentesis without albumin replacement is safe and satisfactory short-term option for the management of patients with cirrhosis and tense, diuretic resistant ascites

Post polio sequelae in Upper Egypt an overview

The main objectives of the present study were to diagnose post polio patients among polio survivors, develop the awareness communication and education between polio survivors and medical professional and support polio survivors through giving recommendations. A total of 150 patients [90 men and 60 women] with different educational and socioeconomic levels were examined clinically and electromyographically and completed a questionnaire on their ambulatory status and related musculoskeletal and respiratory symptoms. Their ages ranged from 17-40 years. The age of patients at the onset of polio ranged from 6-18 months. The patients were collected from Assiut University [doctors, employees and medical students] and crippled girls and boys centers in Assiut Governorate, Upper Egypt. Of the 150 patients, 80.7% complained of post polio syndrome symptoms with no specific electrodiagnostic findings. 2% were excluded from the analysis because they had other chronic health problems as rheumatic fever. Fatigue was most commonly reported [63.6%], followed by joint pain [52.9%], muscle pain [52.1%] problems of sleeping [52.1%] and muscle weakness [41%]. No one complained of respiratory problems. There were functional problems

Comparative study between magnetic resonance imaging [MRI] and arthroscopy in evaluation of curciate and menisical injuries of the knee

Over a period of one year 42 patients with knee joints trauma were evaluated by MRI and arthroscopy. The study was performed at Radiology Department and cases were referred from Orthopedics Department, Assiut University Hospital. Fourty patients were males and 2 were females. The age of the patients ranged from 19 to 48 years with mean age 29.3 years All the patients had a history of trauma to the knee joint and they were presented with joint pain, swelling, clicking or sense of instability. MRI and arthroscopy were done for all patients. Correlation of the findings of MRI and arthroscopy were done in all cases. The arthroscopic diagnosis was positive in 39 cases and negative in 3 cases. The positive cases include 18 cases of ACL, 5 cases of PCL tears, 8 MM tears and 8 LM tears. The MR was positive in 42 cases. These include 18 cases of ACL tears. 5 cases of PCL tears, 10 cases MM tears and 9 cases LM tears. Both MRI and arthroscopy have the same results in diagnosis of ACL, PCL tears, but they differ in the diagnosis of some cases of meniscal tears where arthroscopy is more accurate. We concluded that MRI is accurate in the diagnosis of cruciate and meniscal injuries of the knee and its accuracy should decrease the need for arthroscopy as a diagnostic tool and direct its use for therapeutic use