Improved outcome of carotid endarterectomy: role of preoperative cardiac assessment

Thirty-five patients indicated for carotid enderterectomy CEA were exposed to a battery of noninvasive cardiac assessment including clinical history and examination [CE], treadmill exercise testing [TET], and myoview nuclear scanning [MS]. As' a gold standard reference technique, coronary arteriography was' per/armed for each patient after noninvasive evaluation. The sensitivity of CE was low [6/%], Treadmill exercise testing proved to be more sensitive [69%] and highly .specific [89%] but feasible only in [63%] with total accuracy of [77%]. Myoview .scanning demonstrated higher .sensitivity [87%] and less specificity [82%] with high feasibility [94%] and diagnostic accuracy [85%]. Thirteen patients [37%] required coronary revascularization prior to CEA; two of them were clinically classified at moderate risk with false negative TET and MS. There was no postoperative [one month] cardiac death and overall survival after 3 years' was 85.7%. Combined modality approach for cardiac risk assessment is reliable for identification of patients who will benefit from coronary revascularization prior to carotid endarterectomy, and may thus improve the perioperative outcome

Case control study of giardiasis in diarhoeas versus non diarrhoeal children aging 6-12 years

The aim of this work is to study the prevalence, the clinical presentation and the different methods of diagnosis of giardiasis among school children aging 6-12 years suffering from acute diarrhea. The prevalence of giardiasis was 26% and 6% in diarrheal and non- diarrheal children, respectively. Children with giardiasis were younger, without sex difference and in lower socioeconomic status that those without giardiasis. Simple stool analysis detected 43.8%, simple flotation method detected 68.8% while, duodenal aspiration detected 81.3% of giardia cases. Stools in giardiasis was offensive, pale whitish and not bloody. Offensive stool was the commonest manifestation [87.5%] followed by diarrhea [81.3%]. It was concluded that the clinical picture of giardiasis is suggestive and duodenal aspiration is a good diagnostic methods. Large scale study and duodenal biopsy are recommended