Clinical value of screening serum squamous cell carcinoma antigen [SCCA] for HCC

Hepatocellular carcinoma [HCC] is the fifth most common malignancy in the world. In Egypt, HCC was reported to account for about 4.7% of chronic liver disease [CLD] patients. Squamous cell carcinoma antigen [SCCA] has been reported to be strongly expressed in HCC tissue hampering its extensive use in clinical practice. Study the value of serum squamous cell carcinoma antigen [SCCA] for screening of HCC. The study comprised of two groups. Group A included 60 patients with HCC diagnostically confirmed by spiral CT, elevated alfa-fetoprotein [AFP], and/or liver biopsy .Group B CLD patients diagnosed on clinical, laboratory, and ultrasonographical investigations; group B suclassified into three categories according to CHILD-PUGH score included 30 patients, matched for sex and age. All groups were subjected to thorough history taking, full clinical examination, and laboratory investigations including liver functions, viral markers, and AFP and SCCA estimation using ELISA technique. This study revealed a highly significant difference between patients with HCC and CLD regarding serum SCCA levels being higher in group A [10.35 +/- 20.677] than group B [1.64 +/- 2.462][p=0.02]. SCCA level was elevated in patients with HCC with normal AFP levels representing its useful role in early detection and follow-up of patients treated for HCC. The cut-off value was established at 2 ng/ml with sensitivity of 80% and specificity of 70%. SCCA could represent a useful tool as a marker for detection of HCC

Edoscopic sclerotherapy of oesophageal varices due to hepato-splenic schistosomiasis. A randomized controlled trial evaluating the effect of adjuvant propranolol therapy

The relative high incidence of rebleeding during the course of injection sclerotherapy requires attempts at its improvement. Forty consecutive patients with bleeding oesophageal varices underwent either injection sclerotherapy only or injection sclerotherapy with an adjuvant fixed daily dose of propranolol [40 mg tds] in a single-blind randomized controlled trial. They were injected on a weekly basis until varices were eradicated at which time propranolol was withdrawn. Patients were then followed-up for a period of two years. The results showed that ad to a decline in resting pulse rate by a median of 23.9% Patients undergoing injection sclerotherapy with adjuvant propranolol required fewer injection sessions for variceal eradication than patients undergoing injection sclerotherapy alone [8 versus 11: p > 0.05]. Patients undergoing injection sclerotherapy with adjuvant propranolol experienced more variceal recurrences than those undergoing injection sclerotherapy alone [25% versus l3.3%, p> 0.05]. Five of 20 patients undergoing sclerotherapy with adjuvant propranolol rebleed as compared to 6 of 20 y patients undergoing injection sclerotherapy only [p > 0.05]. The probability of rebleeding and survival was similar in both groups [p > 0.05]

External dacryocystorhinostomy versus endoscopic non-laser dacryocycstorhinostomy " A comparative study"

A retrospective study to compare outcomes after external dacryocystorhinostomy [Ex-DCR] and transnasal endoscopic assisted nonlaser dacryocystorhinostomy [End-DCR]. A total of 214 Ex-DCR performed to 208 operated from the 1996 to 2002 and a total 118 End-DCR of 116 patients were reviewed. The follow up period was at least One year. techniques were performed in each group. Patency of the drainage system was assessed by history and irrigation. A full success was in 86% of Ex-DCR group and 77.1% among End-DCR group by techniques. The operating time, difficulties, postoperative recovery time and complications were compared. The Ex-DCR has a higher success rate compared to the End-D CR. However, End-DCR has a shorter operative time, no external scar es. and more suitable for recurrent cases

Risk factors for anastomotic leakage after stapled colorectal surgery. A retrospetive and prospective study

One of the most significant surgical complications following colorectal surgery is anastomotic leakage. The aim of this study was to assess the performance and safety of stapled anastomosis in colorectal surgery and to identify factors that influence the occurrence of anastomotic leakage. Forty consecutive patients who had a stapled anastomosis were enrolled in the study. Anastomotic leakage occurred in 20% of patients and was not influenced by the presence of a protective stoma. However, the mortality from anastomotic leakage in the absence of a protective stoma was high, reaching 50%. Patients receiving blood transfusion of more than 2 units of blood suffered significantly more from anastomotic leakage in comparison to those receiving less amounts [39% versus 5%]. Anastomotic leakage was more frequent among male patients, patients with weight loss, after surgery of long duration, and in anastomosis performed less than 6 cm from the anal verge. In conclusion, anastomotic leakage is still the main problem encountered after stapled colorectal surgery and we recommend the use of a protective stoma among high risk patients to avoid the high mortality of unprotected anastomotic leakage

Endonasal endoscopic dacrocystorhinostomy with application of a self retaining tube

Endoscopic endonasal approach to do dacrocystorhinostomy was used to treat cases of post saccal obstruction with insertion of a T tube in the inferomedial wall of the sac. The study was conducted in Benha university hospital. ENT department. 10 patients were included in the study in age range from 16 to 45 years. Endonasal endoscopic dacrocystorhinostomy with application of a silicone self-retaining T tube in the inferomedial saccal wall removed after 6 months. 12 months follow up proved 90% success rate. The procedure used in this study proved to be simple. direct and physiological with relatively short operative time and got satisfactory success rate

Microbiological survey of medamis, taamia and their sandwiches

The present work was done to throw some light on the microorganisms which might contaminate some of the local Egyptian foods such as medamis and taamia. In this experiment five samples each of medamis fried taamia, sandwiches of medamis and taamia with salad collected from different markets in Cairo were analyzed microbiologically for total bacterial counts, sporeformers, molds, yeasts, Staphylococcus aureus, enteropathogenic E. coli and Streptococcus faecalis. The samples were also examined for the detection of Bacillus cereus, Salmonella spp. and Clostridium perfringens. The total viable bacterial counts of medamis, fried taamia and their sandwiches varies from 10 4 to 10 8 cells/g. The high numbers in general, were attained in sandwiches compared with either medamis or taamia samples. The same observation was noticed concerning sporeformers counts. Yeast and molds were also present in all investigated samples of medamis and taamia sandwiches. Staph. aureus was detected in 2 samples of medamis sandwiches and 3 samples of taamia sandwiches in range between 10 2 to 103 cells/g. All fried taamia samples were free from Enteropathogenic E.coli. All samples of medamis and taamia sandwiches were contaminated with EEC. Strep. faecalis was presented in most of the examined samples with averages ranged between 10 2-10 6 cells/g. Salmonella spp. was detected only in one sample of either medamis of taamia sandwiches, while, B. cereus and Cl. perfringens were not detected in any of the samples studied

Quality of formulated coffee substitute

The present study was planned to evaluate four recipes of coffee substitute prepared on a pilot scale. From the evaluation of resultant instant coffee substitute, two recipes were selected that were acceptable and low in price. Accordingly the two aforementioned recipes were produced on industry scale. Effect of concentration of liquid, feeding pump pressure and application of CO2 during spray on the physical properties of the resultant instant powder were evaluated. Bulk density, solubility, wettability, flowability and sieve analysis of resultant coffee substitute powder were improved when CO2 was used with high concentrate. Instant soluble coffee substitute powder, which was produced by one recipe with a concentrate contained 30% TSS, was better and more acceptable than those prepared by the other recipe