Bronchiectasis in COPD patients

COPD and brochiectasis are characterized by fixed airway obstruction and chronic cough. The finding of bronchiectasis on HRCT scan in the patient with COPD may indicate the presence of more advanced airway dysfunction, frequent exacerbation and bacterial colonization. The aim of this study to evaluate the incidence of bronchiectasis on high resolution computed tomography [HRCT] scanning in patients with moderate and severe COPD, and to relate this with the presence of lower airway bacterial colonization, exacerbation frequency, severity. This study was carried out on 69 patients diagnosed with COPD. All cases were subjected to through history taking, lung function test, sputum culture, HRCT scan of the chest to diagnose bronchiectasis, All the test were performed in a stable phase. 69 COPD patients, 32 patients had moderate COPD, 37 patients had severe COPD, 33 patients [47, 8%] presented with brochiectasis, [31.3%] of the patients with moderate COPD and 62.2% of the patients with severe COPD with statistically significant difference, the more severe functional impairment [FEV1

Atrial natriuretic factor in bilharzial hepatic fibrosis and posthepatitic cirrhosis

Elevated levels of plasma atrial natriuretic factor [ANF] were found in cirrhotic patients. Some investigators reported basal levels, while other reported low levels of ANF. This lead us to investigate the effect of bilaharzial periportal fibrosis [BPD] and bilharzial liver cirrhosis and posthepatic cirrhosis on plasma ANF. 27 patients were selected and divided into three groups. The first group comprized nine patients of bilharzial periportal fibrosis. The second group comprized 9 patients of mixed ANF was measured by radioimmunoassay. Abdominal and cardiac ultrasonography was used for measurement of liver size and echogenicity together with diameter of portal vein, splenic view and cardiac chambers. The results showed that ANF was induced in all group of patient except those developing ascites, they showed levels slightly more than the control group

Ultrasonic diagnosis of fetal central nervous system abnormalities

The fetal brain can be evaluated very effectively with high resolution real time ultrasound. The prenatal diagnosis of 26 cases among 3000 pregnant women examined over a period of 2 years included; 10 hydrocephalus, 8 anencephaly. 2 cephalic meningocele, 2 meningomyelocele, and 4 spina bidifa. The sonographic pattern of the CNS abnormalities and the role of ultrasound with its impact on further management were discussed

Ultrasonographic assessment of the portal vein in patients with portal hypertension

The aim of the present study was targeted toward the assessment of the state of the portal vein in cases of portal hypertension, to estimate the actual incidence of portal vein thrombosis in this cases and evaluate the role of this non invasive technique for the diagnosis and management of patients. The material of the present study comprised 54 patients clinically suggested to have portal hypertension 50 males and 4 females. Their age range from 20 to 65 years with mean value 39.71 years All patients were subjected to thorough history taking full clinical examination, routine laboratory investigations and ultrasonograghic examination The portal vein was dilated in 81% of the patients in the bleeder subgroup while in the non bleeder group all patients have dilated portal vein. On comparing the portal and splenic vein calibers in different groups we found that non ascitic have larger calibers than asctic subgroup. Also our patients with portal vein thrombosis have a larger portal vein diameter than non thrombolic cases and those with huge spleen caliber than those with moderately enlarged one. Our results perhaps could select the splenic vein caliber to be a more sensitive usher of bleeding rather than the portal vein. In our cases with portal hypertension we found that no cirrhotic patients had portal vein thrombosis except those subjected to pervious splenectmy or having a complicating liver cell carcinoma. Duplex Doppler ultrasonograghy had offered a confirmation of portal vein thrombosis and revealed 100% hepatoperal blood flow in the portal vein and 81% hepatofugal blood flow in the splenic vein. In conclusion, ultrasonograghic technique had definitely offered a non invasive method for assessement of the state of the portal vein, although it has mentioned some peculiar feature it have not answered much of questions that have been aroused as regard the syndrome of portal hypertension with its different intermingled parameters

Antihistaminics and congenital limb-reduction defects

This paper included 6 cases examined in our Genetics Unit because of their limb malformations. We used a detailed structured questionaire to be sure that the mothers were healthy during the 40 weeks of gestation and have never been exposed to any drug except antihistamine especially in the first trimester. For the 6 patients; careful clinical examination, pedigree analysis, radiological examination, chromosomal study, and metabolic studies were done. The karyotypes and metabolic investigations were normal. Clinical and radiological studies showed a specific defect which is congenital limb- reduction deformity. This indicates a possible teratogenic effect of antihistamines. Thus we recommend to stop using antihistamines during pregnancy especially in the first trimester

Ultrasound diagnosis of abdominal lymphadenopathy

In this work, the usefullness and limitations of U.S. as compared with lymphography, in the investigation of retroperitonial nodal disease were studied. 30 patients with suspected retroperitoneal nodal involvement were examined by both methods. The results and accuracy of each method was analyzed and discussed

Ileal replacement of the bilharzial ureter

Our 14 years experience with the use of isolated ileal segments, for replacement of the bilharzial ureter is retrospectively analyzed. Fifty two patients were subjected to this procedure. Follow up data are available for 38 patients in whom 52 ureters were repaired. The results are generally unsatisfactory because of the high rate of morbidity and mortality and the low percentage of functional improvement. The risk is higher in those with low creatinine clearance. We recommend avoiding this operation as far as possible. If the operation is unavoidable tapering of the ileal segment with antireflux ileovesical anastomosis may improve the outcome, although this has to be proved

Role of positive contrast orbitography in diagnosis of unilateral proptosis

The success of surgical removal of orbital tumours depends on pre-operative appraisal of the site, size and nature of the mass. Accurate clinical evaluation may be impossible in deeply seated retro-bulbar lesions, and even in superficial lesions with possible posterior extenion. Knowledge gained from plain radiography of the orbital space occupying lesions has its limitations. The changes that can be seen are; soft tissue shadow, bony erosions, osteoporosis, sclerosis or changes in the size of the orbit or orbital foramen. These suggestive changes were seen in 69% of the cases [Pfeiffer, 1943]. Most authors gave lower figures for diagnostic data gained from plain radiography; 46% by Mortada [1968] and 41% by Labib et al. [1970]. Those changes, mentioned above, are not specific and cannot indicate the exact site, size or nature of the tumour [Lombardi, 1971], particularly in cases of angioma of the orbit [Labib et aI., 1970]. The aim or this paper is to discuss the role of positive contrast orbitography in diagnosis and management of orbital space-occupying lesions