Does addition of endobronchial ultrasound improves the classification of suspicious lesions detected by autofluorescence bronchoscopy?

Autofluorescence bronchoscopy [AFB] may improve sensitivity at the cost of specificity when it is used to identify suspicious bronchial mucosal lesions not seen by conventional white light bronchoscopy. Thus, it seems useful to study these lesions additionally with endobronchial ultrasound [EBUS] for further classification of dignity of suspicious lesions aiming in improving the positive predictive value [PPV] of AFB. This study aims to answer the following question: Does addition of EBUS improves the classification of suspicious lesions detected by AFB? Fifty five subjects with suspected lung cancer referred for AFB examination for different indications were recruited for this study. Rigid and Fiberoptic bronchoscopic examination were done followed by AFB then EBUS and finally samples from suspicious sites were taken for histopathological examination. The addition of EBUS to AFB improves PPV from 72.7% in AFB alone to 100% in AFB+EBUS in case of benign suspicious lesions detected by AFB with a negative predicted value [NPV] of 60% and with a sensitivity and specificity of 75% and 100% respectively for AFB+EBUS. While EBUS addition to AFB improves PPV from 60.6% in AFB alone to 95.2% in AFB+EBUS in case of malignant suspicious lesions detected by AFB with a NPV of 100% and with a sensitivity and specificity of 100% and 92% respectively for AFB+EBUS. Thus, the addition of EBUS improves the classification of suspicious lesions detected by AFB with its great implication on further patient management and combining AFB [for tumor localization] to EBUS [for depth estimation] may provide a reliable method of staging and choice of treatment modality of lung cancer

Selective amygdalohippocampectomy for temporal lobe epilepsy management

Epilepsy surgery has a proven treatment effect on patients with medical intractable partial seizures, presumably through its resection of epileptogenic zone. This prospective and nonrandomized controlled study examines whether minimal invasive microneurosurgical interventional through frontolateral trans-sylvian approach for a high selective amygdalohippocampectomy would reduce the frequency of epilepsy and antiepileptic drugs [AEDS], for patients who have had long history of poor response on pharmacotherapy, via measuring over one year the clinical, activity of daily living and EEG outcomes. Our inclusion/ exclusion criteria for selected cases and according to the definition of ILAE are, intractable temporal lobe epilepsy [TLE] either right or left side origin, all patients had a history of treatment for more than 13 years by AEDS polytherapy and according to our inclusion criteria they should have at least 4 seizures a month. Selective amygdalohippocampectomy was done for 17 patients and all of them were followed up for one year. The study confirmed that selective amygdalohippo-campectomy reduces the seizures frequency and drugs doses in patients with mesial temporal lobe epilepsy [MTS]. However, amygdalohippocampectomy did not signify cessation of all AEDS, but all patients showed satisfactory seizure free outcome under monotherapy. There is also significant difference in epilepsy frequency postoperatively especially psychomotor component. The findings are important for the understanding of selective amygdalohippocampectomy role in the treatment of intractable TLE [MTS] with or without secondary generalization

Correlative study of fungal infections in peptic ulcer disease before and after treatment

25 patients were involved in this study, which showed the presence of fungal growth in 6 patients with duodenal ulcer before treatment. This number was reduced to 3 patients after treatment with H2-receptor blockers. Only one patient was negative before to turn positive after treatment. All positive cases with fungal growth proved to be yeast and among this Candida albicans was the most frequent. It was concluded from this study that the presence of fungal growth in patients with peptic ulcer disease was not related to the use of H2-Receptor blockers and that the healing rate and healing time were not affected by the presence of such growth