Relationship between aminopyrine breath test score and post-operative morbidity in schistosomal patients

The aminopyrine breath [ABT] was done in 25 patients with hepatosplenic schistosomiasis scheduled for splenectomy and left gastric artery ligation and in 15 patients with normal livers and spleens requiring upper abdominal surgical intervention. The relevant radiological and laboratory investigations indicate significant liver involvement in the schistosomal patients. The mean ABT score correlated well with the Child's class where the mean score for class A> class B> class C. However, in this group the mean score for patients with pure schistosomal fibrosis was very close to normal while that for patients with mixed cirrhosis was 40% lower. The incidence of post-operative complications was much higher in schistosomal patients who had lower ABT scores. For determining the probability of postoperative morbidity, the ABT may be of value in the framework of an overall clinico laboratory regime for diagnosis

Evaluation of internal mammary venography in staging of cancer breast

This study was carried out on 20 patients with cancer breast in an attempt to find a correlation between the clinical stage, internal mammary venographic findings, the histopathology of axillary and internal mammary lymph nodes and the primary growth. By comparison of the internal mammary venography of the controls with that of the cancer breast patients consistent changes were found indicating affection of the internal mammary lymph nodes. The incidence of internal mammary lymph node metastases was 40%, which was influenced by the tumor site, size and whether the axillary lymph nodes were affected or not

Comparison between two antibiotic regimens for the treatment of diabetic foot ulcers

Twenty patients with diabetic foot ulcers were studied. Ten were given clindamycin and aztreonam [group A antibiotics], while the other ten were given cefamandole and metronidazole [group B antibiotics] simultaneously with bacterial culture from the ulcer. The patients were given antidiabetic treatment and the ulcers were dressed with saline together with debridement when needed. The effect of the antibiotics was evaluated both clinically and bacteriologically. In view of the fact that Gram-negative strains were the predominant one [20 isolates out of 33], regarding the period of antibiotic administration, and clinical response, together with 90% cure in group A antibiotics against 60% cure with group B antibiotics, it was found that the former group of antibiotics was much better than the latter group

Acute phase reactant proteins in acute abdomen

The acute phase reactant proteins [APR] [alpha-1-antitrypsin, alpha-1-acid glycoprotein and complement component C3] were estimated in 20 patients with acute abdomen together with 10 healthy control subjects. There was a significant increase in the mean serum levels of all three components of APR. The degree of this increase was proportional to the severity of the condition being significantly higher in patients with peritonitis; the rise being attributed to increase liver synthesis

Effect of the calcium antagonist [verapamil] on some hepatic bile constituents and pH

Twenty patients with chronic cholecystitis were submitted to cholecystectomy and the common bile duct was cannulated. On the second postoperative day hepatic bile was collected for 30 minutes, after which 5 mg verapamil was injected i.v. and 5 minutes later another 30 minutes sample was taken. Both samples were analyzed for their content of phospholipids, bilirubin, cholesterol, sodium and potassium content and pH. It was found that sodium and potassium were significantly changed. The pH also showed a significant change towards the alkaline side. This may be due to decreased hepatic bile flow

Gastric acidity, endoscopic findings and histopathological picture of the stomach in non-ulcer patients with gastric dyspepsia

Fifty patients with non-ulcer gastric dyspepsia were presented. The highest age incidence was in the fifth decade of life and 33 were males. Dyspepsia was common to any type of meal and hot spices [64%]. The commonest presented symptoms were heart burn [90%], epigastric discomfort [48%] and hematemesis [22%]. There was no significant difference in the acidity studies. Endoscopically, 21 showed evidence of gastritis, 14 showed reflux esophagitis and 13 were free. Histopathologically, 14 showed chronic superficial gastritis, 6 atrophic gastritis, 6 congested hyperaemic mucosa, while 22 specimens showed normal mucosa

Study of glyco protein in gallbladder bile of patients with schistosomal hepatic fibrosis

This study was carried out on 30 patients classified into two groups. Group I included 20 patients with schistosomal hepatic fibrosis [12 were non bleeders and 8 were bleeders]. Group II included 10 non schistosomal patients as controls. The aim was the study of changes in the amount of glycoprotein in gall bladder bile in patients with schistosomal hepatic fibrosis and its possible role in lithogenesis of bile. The study revealed a significant increase of gall bladder bile glycoprotein in schistosomal patients, which is a potent nucleating factor for gallstone formation

Pit falls of common bile duct drainage

This work included the results of a study of 130 patients with T-tubes drainage after choledochotomy. There were 11 patients with wound infection, 2 patients had bile leak, one patient had postoperative jaundice, one patient had too long tube, one patient had kinked tube, one patient had difficulty in removal of the tube and 2 patients had retained stones. From this study it was concluded that T-tubes should be of latex or rubber and used only once

Fournier's gangrene of the breast: case report

Fournier's gangrene is a disease first described to affect all the skin of the scrotum and is characterized by a progressive relentless course ending with complete sloughing of the affected skin. The process is promoted by a progressive endarteritis of the small arteries and arterioles of the skin. The causative organism is usually a mixed one, mainly hemolytic streptococci associated with other organisms

Pharmacotherapeutics of a calcium antagonist [verapamil] in simple goitre

The present work was carried out to study the possible beneficial effect of verapamil in cases of simple goiter. Verapamil was administered orally in doses of 240 mg daily [80 mg t.d.s] for three months. The body weight, T3, T4 and TSH levels were measured before and after the drug intake. Verapamil had a significant inhibitory effect on TSH release and serum T3 levels, whereas no significant effect on serum T4 level could be detected. It might be suggested that verapamil may be of some value in cases of simple goiter dependent on increased serum TSH level and probably also in cases of post thyroidectomy thyrotoxicosis due to increased TSH level

Intralesional corticosteroid therapy for haemagioma

Thirty patients [female to male ratio 3:1] with cutaneous hemangioma were the subject of this study. Twenty-seven patients were under the age of one year. The most common site was the head and neck. The hemangioma was cavernous in 14 patients, capillary in 12, mixed in 3 and cirsoid in one patient. Intra-lesional injection of corticosteroid was used for treatment of hemangioma, it gave definite effect in 86% of cavernous hemangioma, while it showed no effect in 92% of capillary cases. Side effects of intra lesional corticosteroids are minimal compared to systemic corticosteroids

Effect of varicelectomy on testicular functions

Thirty patients with primary varicocele were subdivided into two groups: Group I [15 patients] subjected to ligation of the internal spermatic vein in the inguinal canal through an inguinal approach and group II [15 patients] subjected to ligation of internal spermatic vein above the level of the internal inguinal ring through retroperitoneal approach. Patients were examined daily in early postoperative period to detect the immediate complications including wound infection, scrotal edema, scrotal hematoma, edema of the scrotal contents and orchalgia. Also, follow up of the cases was performed for three months for the incidence of delayed complications, such as testicular atrophy, hydrocele formation, inguinal hernia and recurrence of residual veins. It was found that there was an increase in incidence of immediate and delayed complications in the inguinal approach than in the retroperitoneal approach. There is an affection of the testicular function in almost all cases of primary varicocele as most patients showed improvement in the parameters of semen analysis postoperatively. The severity of this affection is not related to the degree of varicocele or its duration. Ligation of the internal spermatic vein alone is the rational treatment of varicocele. Ligation of the internal spermatic vein in the retroperitoneal space is to be preferred than its ligation in the inguinal canal as it is followed by less complications

Role of the spleen in immunodepression involving T-lymphocytes in chronic schistosomal patients

The present study was carried out on 20 patients with chronic schistosomiasis and splenomegaly who were admitted for elective splenectomy and 10 healthy non-schistosomal subjects as controls. Every patient was subjected to detailed history taken, thorough clinical examination, peripheral hemogram and liver function test. Two systemic blood samples, venous and arterial, were withdrawn from each of the controls and patients in the preoperative period. During splenectomy operation two other blood samples were withdrawn from the splenic artery and vein. A portion of the removed spleen was precessed for T-lymphocyte assay. Ten days after operation another systemic blood samples [arterial and venous] were withdrawn from each patient. All blood samples were assayed. The results obtained showed that, chronic schistosomiasis is associated with depressed numbers of T-lymphocytes. There is increase in the percentage of T-lymphocytes in the splenic venous blood as compared with splenic arterial blood. There is rapid increase of the percentage of T-cells following splenectomy thus suggesting a role of the spleen in immunodepression in chronic schistosomal patients