Capsule endoscopy: single center experience

Objective: capsule endoscopy [CE] has revolutionized the evaluation of small bowel disorders, particularly obscure gastrointestinal bleeding [OGIB]. The aim of this study was to determine the findings and the diagnostic yield of CE in a large series of patients with suspected small bowel disease mainly OGIB; as well as to compare our results to that of other reported centers

Methods: data on 230 patients who underwent capsule endoscopy for suspected small bowel related symptoms and/ or signs mainly overt [81 patients] or occult [66 patients] OGIB were obtained by retrospective chart review and review of an internal computer database of capsule endoscopy patients. Data presented as percentages, p value used to show differences whenever relevant

Results: out of 230 patients investigated for small bowel related symptoms and /or signs, 7 patients excluded mainly due to improper preparation, of the remaining 223, 128 [57.3%] had some lesion detected by CE,80 [35.8%] had definite lesions detected that could unequivocally explain patients' complaints. Patients with overt GI bleeding had the highest diagnostic yield [64.1%], this was significantly greater [P < 0.001] compared to that in patients with occult bleeding [43.9%] as well as those with abdominal pain and/or diarrhea [33.3%]. Angiodysplasia is the most common cause of OGIB [26.5%]

Conclusions: the yield of clinically important findings on CE in patients with OGIB is 55% and is greater in patients with obscure-overt than obscure-occult GI bleeding. Angiodysplasia account for the majority of significant lesions in both groups

Synchronous haematogenous colonic metastasis from a primary renal cell carcinoma: an unusual cause of colonic haemorrhage: [case report]

Background: renal cell carcinoma [RCC] represent 2-3% of all malignant tumors in adults. Clear cell carcinoma is the most frequent histological type, and 25-30% of renal carcinoma have metastasis at the time of diagnosis. RCC very rarely metastasize to the colon. The objective of the present study is to report synchronous haematogenous solitary colonic metastasis that presented as severe recurrent lower gastrointestinal haemorrhage which required right hemicoloectomy and right nephrectomy plus chemotherapy

Clinical Case: we report the case of a 46-year old male patient who presented with multiple episodes of severe haemotochezia and anemia. He had a right flank mass. CT scan of the abdomen showed a large right kidney mass together with a lesion in the ascending colon, not connected to the renal mass. It also showed hepatic metastasis, lung metastasis and ascites. Colonoscopy revealed an ascending colonic mass. The patient was managed by right nephrectomy and right hemicolectomy. The pathology report of the colonic mass showed clear cell carcinoma with involvement of the colon from serosa to mucosa. It indicated the presence of haematogenous spread of the RCC as the mechanism of metastasis. The colonic haemorrhage did not recur. the patient survived close to a year after surgery

Conclusion: RCC metastasis to the colon is very rare and can be synchronous with the primary renal tumor and can be metachronous after nephrectomy. Also, it can be the result of direct invasion, haematogenous spread or after local recurrence following nephrectomy. Metastatic RCC requires surgery, immunotherapy, tyrosine kinase inhibitors, and mammalian target rapamycin inhibitors. Surgery is the first step for disease control and control bleeding from colonic metastasis. Metastectomy is indicated in localized disease and when surgically accessible

Benign parapapillary choledochoduodenal fistula associated with ampullary carcinoma: case report and literature review

Parapapillary and periampullary choledochoduodenal fistulas [CDF] are rare conditions. We here report a case of benign parapapillary choledochoduodenal fistula associated with early ampullary carcinoma [pT1NoMo]. A 54-year-old Jordanian man had recurrent cholangitis without clinical jaundice. He had marked elevation of the alkaline phosphatase [AP] and Gamma Glutamyl Transferase [GTT]. Abdominal ultrasonography showed distension of the gallbladder with dilatation of the common bile duct [CBD]. Duodenoscopy showed a swollen ampulla with no intraduodenal growth. Cannulation the orifice of the papilla of Vater failed. But endoscopic biopsy revealed adenocarcinoma. Magnetic resonance cholangiopancreatiocography showed a dilated bile duct with a filling defect in its most distal part. With the diagnosis of ampullary carcinoma, the patient underwent pylorus-preserving pancreatico-duodenectomy [PPPD]. The gross and microscopic examination of the resected specimen showed a dilated CBD, a small-sized benign choledocho-duodenal fistula to the CBD above the tumor, and a non-dilated pancreatic duct that opened above the tumor. The smallsized fistula was missed by all used diagnostic procedures. This communication presents a unique case of association between ampullary carcinoma with benign small sized parapapillary CDF that caused cholangitis with marked elevation of AP and GTT but without clinical jaundice. The benign CDF may cause cholangitis and together with the high bilio-pancreatic junction may increase the risk of biliary cancer

Laboratory diagnosis and molecular characterization of bacterial bloodstream infections

Bloodstream infections [BSI] represent an important complication in patients receiving chemotherapy for neoplastic diseases. To identify and characterize the isolated bacteria from blood of pediatric cancer patients with fever, blood cultures were done and identification was carried out by conventional methods and API [for Gram negative bacteria], then molecular characterization by Pulsed Field Gel Electrophoresis [PFGE] was done. This study was conducted on fifty pediatric cancer patients with fever. We found that only 22% of patients were positive for BSI, Gram positive bacteria were more commonly isolated than Gram negative bacteria and Coagulase negative Staphylococci [CONS] were the most commonly isolated species. There was a significant association between the presence of neutropenia with the increased incidence of BSI. The analysis of PFGE patterns produced showed identical profiles for most of the isolated bacterial strains. This means that those isolates have a common source of infection and strict infection control measures are needed inside our institude for prevention of HAI especially with those immunocompromised risky patients

Diversity of bacteria nesting the plant cover of north Sinai deserts, Egypt

North Sinai deserts were surveyed for the predominant plant cover and for the culturable bacteria nesting their roots and shoots. Among 43 plant species reported, 13 are perennial [e.g. Fagonia spp., Pancratium spp.] and 30 annuals [e.g. Bromus spp., Erodium spp.]. Eleven species pos-sessed rhizo-sheath, e.g. Cyperus capitatus, Panicum turgidum and Trisetaria koelerioides. Microbiological analyses demonstrated: the great diversity and richness of associated culturable - bacteria, in particular nitrogen-fixing bacteria [diazotrophs]; the majority of bacterial residents were of true and/or putative diazotrophic nature; the bacterial populations followed an increasing density gradient towards the root surfaces; sizeable populations were able to reside inside the root [endorhizosphere] and shoot [endophyllosphere] tissues. Three hundred bacterial isolates were secured from studied spheres. The majority of nitrogen-fixing bacilli isolates belonged to Bacillus megaterium, Bacillus pumilus, Bacillus polymexa, Bacillus macerans, Bacillus circulans and Bacillus licheniformis. The family Enterobacteriaceae represented by Enterobacter agglomerans, Enterobacter sackazakii, Enterobacter cloacae, Serratia adorifera, Serratia liquefaciens and Klebsiella oxytoca. The non-Enterobacteriaceae population was rich in Pantoae spp., Agrobacterium rdiobacter, Pseudomonas vesicularis, Pseudomonas putida, Stenotrophomonas maltophilia, Ochrobactrum anthropi, Sphingomonas paucimobilis and Chrysemonas luteola. Gluconacetobacter diazotrophicus were reported inside root and shoot tissues of a number of tested plants. The dense bacterial populations reported speak well to the very possible significant role played by the endophytic bacterial po-pulations in the survival, in respect of nutrition and health, of existing plants. Such groups of diazotrophs are good candidates, as biopreparates, to support the growth of future field crops grown in deserts of north Sinai and irrigated by the water of El-Salam,canal

Effect of chronic lead intoxication on the distribution and elimination of amoxicillin in goats

A study of amoxicillin pharmacokinetics was conducted in healthy goats and goats with chronic lead intoxication. The intoxicated goats had increased serum concentrations of liver enzymes (alanine aminotransferase and gamma-glutamyl transferase), blood urea nitrogen, and reactivated delta-aminolevulinic acid dehydratase compared to the controls. Following intravenous amoxicillin (10 mg/kg bw) in control and lead-intoxicated goats, elimination half-lives were 4.14 and 1.26 h, respectively. The volumes of distribution based on the terminal phase were 1.19 and 0.38 L/kg, respectively, and those at steady-state were 0.54 and 0.18 L/kg, respectively. After intramuscular (IM) amoxicillin (10 mg/kg bw) in lead-intoxicated goats and control animals, the absorption, distribution, and elimination of the drug were more rapid in lead-intoxicated goats than the controls. Peak serum concentrations of 21.89 and 12.19 microg/mL were achieved at 1 h and 2 h, respectively, in lead-intoxicated and control goats. Amoxicillin bioavailability in the lead-intoxicated goats decreased 20% compared to the controls. After amoxicillin, more of the drug was excreted in the urine from lead-intoxicated goats than the controls. Our results suggested that lead intoxication in goats increases the rate of amoxicillin absorption after IM administration and distribution and elimination. Thus, lead intoxication may impair the therapeutic effectiveness of amoxicillin.

Effect of diminazine aceturate on the pharmacokinetic of a long acting oxytetracycline formulation in lactating goats

Oxytetracycline [OTC] and diminazene aceturate are commonly administered to diseased ruminants with mixed bacterial and protozoal infections. We were therefore interested in characterizing the pharmacokinetics of a new long acting OTC formulation after IV or IM administration, and whether concurrent administration of diminazene altered the pharmacokinetics. Ten clinically healthy lactating female Baladi goats were used in a sequential order. Goats received the treatments in sequential order with a 2 week wash out period between each study: 1] a single dose of OTC [30 mg/kg BW] by TV or TM injection in non-treated and diminazine aceturate pre-treated goats [3.5 mg/kg BW] 2 hours before OTC treatment. Blood, milk and urine samples were collected periodically and OTC concentration was assayed using a microbiological method. The extent of protein binding in serum and milk was determined using an in vitro ultra filtration method and assayed using the same method as serum Pharmacokinetic analysis indicated that serum OTC concentrations after IV administration could be fit to a two-compartment model, and that pre-treatment with diminazene aceturate increased serum OTC concentrations. Following IV injection [t[0.5] beta] was 25.9 +/- 5.1 and 24.5 +/- 2.7 hours, and [Vd[area]] was 22.0 +/- 0.8 and 23.7 +/- 0.4 L.kg[-1], in non-treated and diminazine pre-treated goats, respectively. The maximum OTC concentration after IM injection [1.25 +/- 0.02 micro g ml[-1] and 1.39 +0.04 micro g ml[-1] was obtained at 1.8 +0.3 hours and 2.4 +/- 0.4 hours in non-treated and diminazine pretreated goats, respectively. Moreover, effective milk concentrations were detected for 24 to 48 h, and effective urine concentrations were detected for 96 to 120 h after IM injection. The LA-OTC formulation was moderately bound to goat serum protein [46.0 +3.2% for OTC alone and 40.0 +/- 2.3% for OTC +diminazine]. The binding of the LA-OTC formulation was lower in milk [29.3 +/- 3.6%] than plasma. We conclude that concurrent administration of LA-OTC and diminazine aceturate alters the serum concentration-time profile and pharmacokinetics of a new long acting OTC formulation and could therefore potentially alter treatment efficacy

Isolation and identification of C. perfringens from field chickens suspected to be infected with Necrotic Enteritis in relation to season

Examined field chickens with signs and lesions of natural infection with necrotic enteritis [NE] revealed the isolation of Clostridium perfringens [C. perfringens] from positive chickens at the rate of 63.33%, 30%, 30% and 66.66% in autumn, winter, spring and summer; respectively. The overall positive samples were 57 out of examined 120 chickens with incidence of 47.5%. Regarding chicken breed, isolation rate in autunm were 65% and 60.0%, in winter 35.0% and 20.0%, in spring 25.0% and 40.0%, in summer 85.0% and 30.0% was recorded out of broilers and layers; respectively. C. perfringens isolates were serologically typed into 24 type A, 3 type C and 30 nontoxigenic isolates. Type A isolates were 5, 2, 6 and 11 in autumn, winter, spring and summer; respectively. While type C isolates were 2 in autumn and 1 in spring. C. perflingens Type A recovered from broiler and layer were 2 and 3, 2 and 0, 4 and 2, 10 and 1 in autumn, winter, spring and summer; respectively. Only 2 isolates of type C were recovered in autumn and I in spring

Assessment of gastric emptying in normal Jordanian individuals

To obtain normal values of gastric emptying in normal Jordanian individuals using a simple and standardized method. The study was performed during 2005-2007 at Jordan University Hospital. Gastric emptying in 36 normal healthy subjects without gastrointestinal symptoms was assessed using standardized radioisotope scintigraphy with egg-based meal. Measured points were obtained at one hour, two hours and three hours. Lag phase and half time were calculated using a modified power exponential function. Results were analyzed for correlation of gastric retention with gender, body mass index and smoking. Median gastric retention at the first, second and third hour was 67%, 30% and 11.7% respectively. The median for lag phase and T1/2 was 15.7 minutes and 89.3 minutes respectively. For all variables examined smoking was the only factor that affected significantly gastric emptying; however its effect was limited to the first and second hours [P value 0.007, 0.026 respectively]. We obtained normal gastric emptying parameters using a simple standardized technique in Jordanian population. Our results represent the basis for future clinical and research studies in this part of the world

Prevalence of elevated hepatic transaminases among Jordanian patients with type 2 diabetes mellitus

Since the extent of elevation of liver transaminases in type 2 diabetics in Jordan and most of the Middle East is unknown, we estimated the prevalence of elevated liver transaminase levels among patients with type 2 diabetes and determined associated risk factors. This study was performed on 1014 consecutive type 2 diabetic outpatients who attended the National Center for Diabetes, Endocrinology and Genetics in Amman, Jordan. The patients' age ranged between 26-85 years with a mean age of 56.8 [+9.8]. Three- hundred and fifty three [54.5%] were males with a median age of 58 years [ranging between 26-82 years], and four hundred and sixty one [45.5%] were females with a median age of 57 years [ranging between 28-85 years]. Body mass index, waist circumference, lipid profile, and hepatic transaminase levels were recorded. Ultraonography was performed in those with elevated alanine transaminase levels. Overall, the prevalence of elevated alanine transaminase [ALT] level was 10.4% [n=105] with the gender-wise prevalence being 12.8% [n=71] in men and 7.4% [n=34] in women. The prevalence of elevated aspartate transaminase [AST] levels was 5.4% [n=56] with the gender-wise prevalence being 5.6% [n=31] in men and 5.4% [n=25] in women. Only 4.5% [n=44] showed elevated levels of both ALT and AST. Male gender [OR=2.35, Cl: 1.5-3.8] and high waist circumference [OR=1.9, Cl: 1.2-3.2] were associated with increased risk of elevated ALT levels. Younger patients had a higher tendency to have elevated ALT compared to those over 65 years [OR=12.4 for patients aged 25-45years, and OR=5.8 for those who were 45-65 years old]. Non-insulin use was associated with a high odds ratio for elevated ALT levels [OR=1.7, Cl: 1.1 -2.9]. Elevated ALT and AST levels are found in 10.4% and 5.4% of our type 2 diabetic patients respectively. Male gender, younger age, higher waist circumference; as an indicator of central obesity, as well as non insulin use are independent predictors of elevated liver transaminase levels

Selective analytical determination of cinchocaine hydrochloride in presence of its degradation products or in its binary mixture with hydrocortisone

Cinchocaine HCI was degraded by refluxing with 2N HCI for 4 hr. The degradation products were isolated and their structures were confirmed by IR and mass spectrophotometry. Cinchocaine HCI was then determined in presence of its degradation products by spectrophotometric and spectro-densitometric techniques. For the spectrophotometric methods, cinchocai ne HCI was determined by first derivative spectrophotometry [Dl] at 333.6 nm or by first derivative ratio spectrophotometry [DDI] at 301.6 or 332 nm in concentration ranges 5-80 microg/ml. For the spectro-densitometric method, silica gel plates were used together with benzene: acetone: methanol: 25% NH3 [5:3:0.5:0.1, v/v] as developing solvent and the Rf values were 0.55, 0.12 and zero for cinchocaine HCI and its degradation products, respectively. Cinchocainc HCI and hydrocortisone binary mixture can be determined by the aforementioned densitometric method in concentration ranges 2-20 microg/spot and 2-16 microg/spot for cinchocaine HCI and hydrocortisone, respectively. Alternatively, cinchocaine HCI can be determined spectrophotometrically at 327.8 nm without any interference from hydrocortisone, while hydrocortisone was determined by third derivative spectrophotometry [D3] at 254 and 275.8 nm in concentration ranges 10-100 microg/ml and 5-35 microg/ml for cinchocaine HCI and hydrocortisone, respectively. The proposed methods were successfully applied for the analysis of laboratory prepared mixtures containing cinchocaine HCI and different percentages of its degradation products or cinchocaine HCI and hydrocortisone. These methods were also applied for the analysis of pharmaceutical dosage forms and the results obtained were assessed by the standard addition technique. Local anesthetics produce anesthesia by blocking sodium channels in the axonal membrane, reducing sodium conductance; this in turn reduces the rate and degree of depolarization of the nerve cell and prevents propagation of the action potential.[1] The local anesthetics should be soluble in water and should be effective when injected into tissue or when applied topically to mucous membranesi[2]. Local anesthetics are available as gel, ointments, creams and spray to provide reversible block of conduction along cutaneous nerves[3]. Cinchocaine HCI is a local anesthetic that was formerly used as nerve block and spinal anesthesia, but now, it is available only in topical form[4]. Hydrocortisone is a famous anti-inflammatory agent and it is incorporated with cinchocaine HCI in pharmaceutical preparation for treatment of haemorrhoid[3] Several methods have been described for the determination of cinchocaine HCI. These include spectrophotometric methods [5-15], fluorimetric methods [16-18] HPLC [19-22], TLC [23-27], GC [28-29] NMR [30-31] polarographic methods [32-33] and titrimetric methods [34-37] This work describes spectro-densitometric and spectrophotometric methods for the selective determination of cinchocaine HCI in presence of its two acid degradation products or in combination with hydrocortisone

Determination of methomyl insecticide residues in tomato and cucumber fruits by high performance liquid chromatography: kinetic study

A sensitive high performance liquid chromatographic method using ultraviolet detector has been developed for the determination of methomyl insecticide residues on tomato and cucumber fruits. The developed method consisted of extraction with ethyl acetate, adsorption clean up [by adsorbing mixture consisting of charcoal/celite in ratio 2: 1], followed by high performance liquid chromatographic determination using methanol: water [1: 1] as a mobile phase and UV detection at 233 nm. The range of percentage recovery was between 88.2% and 90.4% for both plant samples. [These recoveries are good for those types of extraction of pesticides traces from plant materials, refer to [1] to compare recoveries]. The method was applied to determine residues and rate of decline of methomyl from fruits of tomatoes and cucumber [open field and greenhouse treatment, with methomyl formulation [Lannate 90% SP] for 100 liter water]. The insecticide incorporated into the plants decreased rapidly with a half-life around 1 day in winter and 0.5 day in summer

Relation between seric triglycerides and malondialdehyde and perinatal outcome in preeclampsia

In the maternal circulation lipid peroxides contribute to the maternal endothelial dysfunction which is responsible for all the systemic manifestations of preeclampsia including hypertension and proteinuria. In preeclampsia there is hyperlipidemia and hyper-triglycerdemia which aids the production of lipids peroxides. Malondialdehyde [MDA] is an important biomarker of lipid peroxides. The aim of this work is to study the relation between seric triglycerides and MDA with the outcome of pregnancy in preeclampsia. A case control study included 20 cases of normal pregnancy and 44 cases of preeclampsia. Estimation of seric triglycerides and MDA for both control group and preeclamptic patients were done. Estimation of seric triglycerides and MDA for both control group and preeclamptic patients showed that the average seric triglycerides were 179.35 +/- 41.33 mg/dl in normal pregnancy and 271.32 +/- 18.61 mg/dl in preeclamptic patients [P<0.05]. Average seric MDA in normal pregnancy was 1.54 +/- 0.18 nmol/ml and 2.73 +/- 0.43 nmol/ml in preeclampsia [P<0.05]. When the blood pressure [BP] was < 150/100 average seric triglycerides was 242.48 +/- 4.20 mg/dl and MDA was 2.4 +/- 0.30 nmol/ml. When the BP was >/= 150/100 average seric triglycerides and MDA were 281.45 +/- 3.6 mg/dl and 3.12 +/- 0.8 nmol/ml respectively. The differences between the two groups were significance [P<0.05]. When the gestational age at delivery was < 34 weeks average seric triglycerides and MDA were 359.54 +/- 5.9 mg/dl and 3.11 +/- 0.8 nmol /ml respectively. When the gestational age at delivery was < 34 weeks average seric triglycerides and MDA were 271.65 +/- 4.2 mg/dl and 2.1 +/- 0.3 nmol/ml respectively. The differences between groups were significant [P< 0.05]. When the birth weight was < 2500 gm average seric triglycerides and MDA were 360.53 +/- 6.8 mg/dl and 3.22 +/- 0.9 nmol/ml respectively. When the birth weight was >/= 2500gm average seric triglycerides and MDA were 261.15 +/- 3.2 mg/dl and 2.2 +/- 0.3 nmol/ml respectively. The differences between groups were significant [P < 0.05]. When the newborn needed admission to the neonatal intensive care unit [NICU] for resuscitation average seric triglycerides and MDA were 342.15 +/- 14.4 mg/dl and 3.2 +/- 0.5 nmol/ml respectively. When the newborns did not need admission to the NICU for resuscitation average seric triglycerides and MDA were 241.20 +/- 2.5 mg/dl and 1.8 +/- 0.4 nmol/ml respectively. The differences between groups were significant [P < 0.05]. These results prove that the average seric levels of triglycerides and MDA are in direct proportion to the degree of severity of preeclampsia and consequently to the perinatal outcome in these cases

Isolated pituitary sarcoidosis simulating macro adenoma

This is a 49 years old Yemeni female patient, presented to out patient clinic with a history of headache of 3 months duration with clinical features and investigation of hypothyroidism and hyperprolactinemia. Her magnetic resonance imaging of the brain showed macroadenoma. She was subjected to transphenoidal pituitary adenoma resection and histopathological study suggested neurosarcoidosis. Further evaluation supported that diagnosis. She was treated with prednisolone 40mg/day in addition to thyroxine 50 micro gm/day, and on follow up later on prednisolone was reduced to 5mg/day along with azathioprin l00 mg / day and she progressed well

Effect of aortic valve replacement on left ventricular function in chronic aortic regurge

The purpose of this study is to evaluate the effect of aortic valve replacement [AVR] on left ventricular function in patients with chronic rheumatic aortic regurge [AR]. This prospective selected study was conducted in the Department of Cardiothoracic Surgery, Mansoura University Hospitals from January 2005 to March 2007 including follow up period. The study involved 50 patients with chronic rheumatic AR for whom AVR was done. Group I [N = 25 patients] with FF > gt 50%. Group II [N= 25 patients] with EF 50% at the time of surgical intervention. So early surgery is recommended in these patients to provide faster and more significant recovery of the myocardial pump performance. Also, it is associated with shorter hospital and ICU stay and lower incidence of morbidity and mortality

Cardiac myxoma Mansoura experience, results of 17 cases

The study was conducted to evaluate our surgical results and operative outcome after complete excision of cardiac myxoma. This retrospective study was conducted in the Department of Cardiothoracic Surgery, Mansoura University Hospital from march 1996 to January 2007, the study involved 17 patients with intracardiac myxoma for whom excision was done. All patients were subjected to full history taking, clinical examination, routine laboratory and EGG examination. Echocardiography was performed preoperatively, prior to discharge and after a mean duration of 8.47 +/- 2.72 months postoperatively. Seventeen patients of cardiac myxoma were surgically treated. The mean patient age was 37.82 +/- 9.4 years and there was 9 [52.9%] male patients and 8 [47.1%] female patients. The most common preoperative symptom was dyspnea occurring in 7 [41.2%] patients. The mean interval from the onset of symptoms to surgery was 8.29 +/- 4.98 months. The tumor was in the left atrium in 15 [88.3%] patients, in the right atrium in one [5.9%] patient and bilateral myxoma was present in one [5.9%] patient. The heart was approached via median sternotomy in all cases, left atriotomy was done in 15 [88.2%] patients, right atriotomy in one [5.9%] patient while bilateral approach was used in one [5.9%] patient. The tumour was excised completely in all cases and the defective area was repaired directly in 11 [64.7%] cases, and with pericardial patch in 6 [35.3%] cases. The mean cardiopulmonary bypass and aortic cross clamp times were 38.3 +/- 2.36 and 26.4 +/- 2.1 minutes respectively. There was one [5.9%] case hospital mortality due to fatal arrhythmia and 2 [11.8%] cases morbidity in the form of pneumonia and superficial wound infection. All patients underwent echocardiography prior to discharge and at a mean follow up period of 8.47 +/- 2.72 months postoperatively. All survival 16 [94.1%] patients showed no evidence of tumour recurrence clinically or on echocardiographic examination, also ECG abnormalities that were present before surgery had disappeared. In conclusion, in our study there was no recurrence of myxoma after complete excision so surgical excision in considered to be the curative method for treatment of cardiac myxoma that quickly relieves symptoms and must be done early after diagnosis

Substantial progress in the development of A variety of microscopic methods for the diagnosis of intestinal parasitic infections

To assess the efficacy of parasep [a new faecal concentrator method] and potassium hydroxide [10% KOH] solution [as a direct wet mount method] and to re-evaluate other routine procedures conducted in parasitology outpatient of Theodor Bilharz Research Institute [TBRI]. The study also highlights, the prevalence of intestinal parasitic infections especially the newly emerging protozoa and the different staining methods used for their identification. Faecal samples collected from 259 cases were examined by direct mount preparation, once by using saline solution [9% Nacl] and the other by using 10% potassium hydroxide [10% KOH] solution and Merthiolate Iodine formaldehyde concentration method, [MIFC]. Only 100 samples were subjected to examination by parasep [SF] "parasite fecal concentrator". The 259 samples were fixed in methanol and permanently stained by Giemsa stain. Diarrheic stools [70 out of 259 samples] were stained by Modified Ziehl Neelson for diagnosis of coccidian parasites. Only 12 individuals agreed upon performing the analysis on 5 days. Out of 259 samples, 191 had parasites with a percentage rate of 73.74% parasitosis. Wet mount preparation using 9% NacI and 10% KOH solution showed 43.67% and 62.06% positivity rates respectively. The MIFC examination detected 77.5% of intestinal parasites. The parasep proved to be the most efficient technique in diagnosing G. lamblia, where the percentage of parasites detected was 90.9% compared to .63.6% and 45.45% when MIFC and direct methods were used respectively. However, certain parasites require specific techniques for their diagnosis, such as D. fragilis, B. hominis and the coccidian parasites [Cryprosporidium, Cyclospora and Isospora belli]. In our study, all stool samples were fixed with methanol and permanently stained with Giemsa stain. Eight samples were positive for D. Fragilis and 3 samples showed B. homnis, with a prevalence rate of 3.08% and 1.15% respectively. Modified Ziehl Neelson stain was performed on the 70 diarrheic stool samples. Ctyptosporidium was detected in 3 cases and Cyclospora in 2 samples [prevalence rate 4.28% and 2.85% respectively] and B. Hominis was accidentally identified in one sample. Microscopic examination of stool samples is the primary method to diagnose parasitic infection. The limitation of each procedure must be taken into consideration and a combination of direct, concentration method, permanent staining, and MZH will increase the sensitivity of stool microscopy

Evaluation of molluscicidal and schistosomicidal activity of two species of Egyptiana Plant in schistosomiasis inansoni

The present study showed that the two plants Artemisia absinthium and Artemisia inculta as cold or boiled water suspensions of their dry powder were nontoxic against Biomphalaria Alexandrina snails. On the other hand, the ethanol extracts of A. absinthium and A. inculta were effective as molluscicides against B. Alexandrina, and the LC9O being 250 ppm and 400 ppm respectively, after 24 hours of exposure. It was observed that these LC9O values killed Schistosoma mansoni ova after 15 minutes of exposure. The free living larval stages of S. mansoni [miracidia and cercariae]. were killed after 30 and 45 minutes of exposure to LC90 of A. obsinthium and A. inculta respectively. The use of A. absimthium and A. inculta ethanol extracts for treatment of murine schistosomiasis mansoni was studied using different doses of 500 mg I kg, 700 mg /kg and 800 mg I kg to investigate the effect of either extract against immature stages, each dose was given as single oral dose 24 hours post infection, then 7 days post infection and lastly 15 days post infection. To study the effect of A. absinthium and A. inculta against adult Schistosorna worms, each dose of the ethanol extracts was given 7 weeks post infection as single oral dose. The percentages of reduction in mean worm burden 9 weeks post infection in animals treated with either A. absinthium or A. inculta, 7 weeks post infection with a single oral dose of 800 mg/kg, were 39.5% and 38.7% respectively. Moreover, the percentage of reduction in mean number of worms 9 weeks post infection reached 77.32% and 74.9%, respectively by using the same dose [800 mg/kg] for three successive treatment schedule, 24 hours, 7 days and 15 days post infection. Also, the mean number of eggs excreted in stool was significantly decreased with the use of both plants for the all designated time intervals. It is concluded that treatment with the ethanol extracts of Artemisia plants showed high efficacy when given early and in repeated doses in murine schistosomiasis mansoni

role of probiotics in controlling giardia intestinalis in experimental animals

Efficacy of Lactobacillus acidophilus [Lactospore] for the control Research Institute Warak of Giardia intestianlis infection was evaluated in hamsters. Each El-Hadar Imbaba hamster was infected orally by 10.000 Giardia lamblia cysts. Animal were divided into five groups: Group A: control infected, untreate group. Group B: infected receiving Metronidazole. Group C: infected and receiving Lactospore. Group D: infected and receiving combination of Metronidazole and Lactospore. Group E: receiving Lactospore 7 days before infection acting as a prophylactic group. Groups B, C and D were given the appmpriate drug, three weeks post infection. Two weeks later stool analysis was performed and cysts/gm stool were counted, after which scarification of all groups took place. There was a highly significant difference between control and all treated groups. The highest percentage of reduction [cure rate] was in group D [98.6%]. followed by group B which gave a reduction rate of [93.8 1%]. The effect of the drugs on the vegetative [trophozoite] forms in the small intestine of sacrificed hamsters was studied. Combination of both drugs [group D] revealed a high significant cure rate [99.32%]. On the other hand when metronidazole and lactospore were given alone a reduction rate of 92.22% and 63.4% respectively was observed. The prophylaxis effect of Lactospore was highly noticed with 93.65% parasite reduction. Assessment of cure was also performed by electron microscopic and histopathological examination of the small intestine, peyer's patches and the spleen. Ultrastructural examination of the small intestine revealed remarkable destruction of the intestinal cell projection by Gardia cyst. Partial healing of the destructeci intestinal cell projection by Metronidazole was obvious, while complete healing could be detected in both groups D and E, Combined treatment with metronidazole and lactospore revealed remarkable activation of lymphocytes and macrophages. This easy flow through the endothelial cells lining the sinus in its way to the lumen to enhance their opportunity to overcome the infection could be detected. Histopathological examination revealed complete healing of the intestinal mucosa after the combined treatment while partial healing of the lining epithelium of the intestine was noticed after metronidazole treatment. The present study proves the efficacy of lactospore as a prophylactic agent for Giardiasis when given 7 days pre infection. This might be of considerable interest in eases of travelers diarrhea. In addition, it can strengthen the effect of metronidazole when both drugs are given together

Surgical management of endobronchial tumors: analysis of 24 patients

To evaluate the variable surgical options performed in the management of endobronchial tumors and the factors determining selection of the appropriate surgical technique. Retrospective study of a series of 24 patients with endobronchial tumors who were diagnosed and underwent surgery in the cardiothoracic surgery department, Mansoura university hospital from January 1985 to March 2006. Full history taking and complete clinical examination, routine laboratory investigations, chest x-ray, and computerized tomography, and bronchoscope were done for all cases. Surgery was the line of treatment for all patients. Close sex distribution with age ranges from 20-64 years. Cough with expectoration was the main presentation. Zonal opacity was the most common radiological finding. CT chest showed sensitivity of 79.2% for detection of endobronchial lesions. Bronchoscopic examination revealed endobronchial lesions in all patients. Benign tumors were detected in 5 patients and malignant lesions in 19 patients, 14 patients were neuroendocrine tumors and 5 patients were other malignant varieties. Surgical interference included bilobectomy [7 patients], lobectomy [5 patients] pneumonectomy [7 patients], and one patient underwent surgical exploration for open biopsy while 4 bronchoplastic procedure were performed. Endobronchial tumors occur over a wide range of age without significant sex differentiation. Endobronchial tumor should be suspected in case of prolonged chest complaint inspite of maximal medical treatment. Bronchoscope is the main diagnostic tool and is important for detection of the provisional plane for surgery. Early diagnosis and screening should be established for early detection of endobronchial tumors and more conservative resectional and bronchoplastic techniques