Background: Neonatal hypernatremia and hypernatremic dehydration is a potentially fatal condition which adversely affects the central nervous system, leading to devastating consequences like intracranial hemorrhage, thrombosis and death. Hypernatremia previously thought to be unusual in exclusively breast-fed neonate but recently the incidence of hypernatremia and hypernatremic dehydration is rising. Hypernatremic dehydration is the most dangerous form of dehydration because of complications of hypernatremia itself and of its therapy. Clinical presentation is variable. Some present with lethargy; others are alert and hungry. This study emphasized the importance of early recognition and timely intervention of neonatal breast milk hypernatremia significantly reduces the consequences. Aim: Assessment hypernatremia and hypernatremic dehydration in neonate’s receiving exclusive breastfeeding. Methods: It was a retrospective study carried out in the Neonatal Intensive Care Unit (NICU) of North East Medical College Hospital (NEMCH), Sylhet, Bangladesh during the period of January 2018 to June 2019 who were investigated and found to have hypernatremia and whose mother’s breast milk sodium and serum sodium was also done. Neonate who on exclusively breast feed with serum sodium ≥ 150 mmol/l, normoglycemic, normocalcemic, no clinical and laboratory evidence of sepsis were included in this study. Results: Elevated breast milk sodium strongly interrelated with neonatal hypernatremia in exclusively breast-fed neonates. Conclusion: This study concludes the need for early recognition of hypernatremia and judicious fluid management is essential for better prognosis and highlighted the elevated breast milk sodium is an important etiological factor.
Neonatal hypernatremia is a potentially lethal condition related with cerebral oedema, intracranial hemorrhage and convulsion. Hypernatremia was previously thought to be unusual in breastfed babies but the incidence of hypernatremia and hypernatremic dehydration is rising. This case report aimed to emphasize the importance of early recognition and timely intervention of neonatal breast milk hypernatremia significantly reduces the consequences. A 13 days old female neonate, weighing 2.1 kg was admitted to the Neonatal intensive care unit (NICU)with complaints of lethargy, unable to breast feed for 3 days before admission and the baby was not urinating adequately for 20 hours before admission. Mother was 31 years primigravida healthy, pregnancy was uneventful. Baby’s birth weight was 3.3 kg on exclusive breast feeding. On examination the baby was sick, lethargic, markedly wasted and had clinical evidence of severe dehydration. On admission laboratory findings showed severe hypernatremia. The initial serum sodium was 175.9 mmol/L, serum creatinine 1.98mg/dl. Initially the patient was given bolus of isotonic saline 20 ml/kg. Then hypernatremia was managed by gradual and slow correction over 72 hours with baby saline. Mother’s serum electrolytes were within normal limits. Breast milk electrolytes results showed sodium 95 mmol/L (normal; 13 mmol/L), potassium 7.1 mmol/L, and chloride 75 mmol/L. Under constant supervised management serum sodium and creatinine returned to normal at 4th day of admission. Initial twenty-four hours baby was nothing per oral then naso-gastric feeding started with expressed breast milk. Initially parents refused to give breast milk but assuring that this high breast milk sodium decreases as time progresses, and then they agreed to give breast milk. The baby was on exclusive breastfeeding at 4th day of admission and discharged at 6th day of admission. Discharged weight was 2.9 kg. Final diagnosis was severe hypernatremia with hypernatremic dehydration. The cause of hypernatremia was due to breast milk.
Cardiomyopathy is a severe disease. There's generally no cure for the situation in children, but it can be treated. Way of life changes, medicines, and surgically implanted devices can help to manage symptoms and occasionally stop the disease from getting worse. In serious cases, a heart transplant may be needed. Cardiomyopathy is the most common cause for heart transplants in children. If the condition isn't managed, it can lead to a life-threatening arrhythmia, heart valve problems, heart failure etc. The case study illustrates a 10 months old baby presented with recurrent respiratory infection. After thorough clinical examination, all necessary investigation including chest X-ray, ECG, Color Doppler Echocardiography have been done and diagnosed as dilated cardiomyopathy with pneumonia and heart failure. The child was treated with antibiotics, diuretics, digoxin, ACE inhibitors, vitamin with minerals and also relevant drugs to relieve other symptoms. Then the patient discharged with a maintenance dose of these drugs with regular follow-up. After 6 months, the patient was improved clinically and also all investigation reports showed normal findings.
Treatment of schizophrenia with antipsychotic medications may be associated with increased risks for metabolic disorders such as weight gain, dyslipidemia, and insulin resistance. This study was conducted to determine the prevalence of dyslipidaemia in patients with schizophrenia on antipsychotic medications and the risk factors associated with it. Fifty two patients diagnosed with schizophrenia were evaluated for lipid profile abnormalities. Study sample had a mean of 26.42±10.8 years, 62.4% were males. Mean values of total cholesterol (TC), low density lipoprotein (LDL), and triglycerides (TG) were significantly higher in patients compared to subjects in controls. Dyslipidaemia was present in 26.9% of the total study sample. The risk of hyperlipidaemia is higher with all typical or atypical class of antipsychotic medications. Chances of hyperlipidaemia and weight gain were higher with long duration of antipsychotic medication use. Treatment with antipsychotic medications is associated with significantly increased risk for hyperlipidaemia.
Postoperative cognitive dysfunction (POCD) is associated with poor postoperative outcomes and these patients are at greater mortality risk compared to patients without neurocognitive decline. A prospective observational study involved 82 trauma patients undergone orthopedic surgery under general anesthesia. Perioperative cognitive assessment using neurocognitive tests and measurement of serum glial fibrillary acidic protein (GFAP) and interleukin-6 (IL-6) were performed. At the 7th day after surgery 13 (15.8%) patients had criteria for POCD diagnosis. Comparisons between patients with or without POCD at 7 days after surgery showed significantly increase in serum levels of GFAP and IL-6 in patients displaying POCD at the end of surgery and 24 hours after surgery respectively.
We provide further evidence that fluorescein disodium has low toxicity in humans. The safety profile of a single oral dose of 100 mg fluorescein disodium in healthy adults was consistent with the previously reported literature. There were no clinically significant differences in vitals, clinical laboratory findings, or AE incidents between baseline and 14 days post-randomization measurements. Furthermore, we show that urine sample authenticity can be ascertained using a fluorophore. The fluorescein assay was performed at four time points (10, 15, 20, and 30 minutes). The sensitivity of the assay was 100% for urine samples taken at or after 15 minutes. The results of this study further the development of fluorescent-based urine specimen identification protocols for clinical use however, future larger trials are required for greater statistical power and to optimize the assay’s cut-off time points.
Background: Uremic pruritus (UP) is a common and burdened symptom for patients with End Stage Renal Disease (ESRD) affecting up to 46% of hemodialysis patients. The pathophysiology of uremic pruritus is not well known and is multifactorial. Aim of the study: To evaluate soluble Erythropoietin receptor in the serum of HD patients, and to clarify its possible role in pathogenesis of pruritus and correlate its level with the severity of itching in HD patients. Subjects and methods: Across section case control study was carried out on sixty ESRD patients on regular HD, thirty patients with UP group (A) and thirty patients without UP group (B), and thirty apparently healthy age and sex matched subjects as control. Assessment of itching severity by 5-D itch scale (degree, duration, direction, disability and distribution). Serum Urea, Creatinine, Calcium, Phosphorus and Parathyroid Hormone levels, Serum (s-EPOR) were measured in both patients and healthy controls. Results: There was significant increase of s-EPOR level in serum of HD patients in comparison with control group and significant increase of its level in patients with pruritus more than patients without pruritus. The Severity of pruritus according to 5-D scale in group (A) was (50%) mild, (43.3%) moderate and (6.7%) severe. There were no significant relation between s-EPOR level and severity of pruritus, duration of dialysis, or pruritus. Conclusion: The study concluded that elevated serum level of soluble erythropoietin receptor in HD patients with pruritus more than those without pruritus.
Background: Unstable pelvic fractures are commonly as a result of high energy trauma. and the management of unstable pelvic fracture is difficult and need multidisciplinary team. all the unstable patterns carry a high risk of severe hemorrhage and are life-threatening. open reduction and internal fixation of displaced pelvic fracture has become more accepted as clinical experience and certain technologies had improved, and it is considered the most stable form of stabilization. Sacroiliac(SI) disruption reflects a massive, disruptive energy force with concurrent soft tissue injury. Management of SI joint disruption is dependent on the degree of instability. The SI joint fracture dislocation can be fixed after the reduction by different methods one of them is fixation with plate. Specific objectives: To determine the clinical and functional outcome of plate fixation of the sacroiliac joint dislocation or fracture dislocation. Patients and methods: This is a cross sectional hospital based study done on patients withsacroiliac joint dislocation and fracture dislocation in Khartoum north teaching hospital over period of three years from November 2016 to October 2019. Results: The total number of patient was 20 with 21 joints the age ranged from 15 years to60 years the mean is 35 + 15 years Stander deviation. The outcome at 6 months according to post-operative reduction on x-ray; there were 6 patients (30%) with excellent reduction the results were 5(25%) excellent and 1(5%) good. There were 13 patients (65%) with good reduction the results were 10(50%) excellent and 3(15%) good. There was one patient with fair reduction the result was (5%) excellent. (P-value 0.03). Conclusion: These injuries are the result of high-energy trauma, which places patients atrisk of multiple life-threatening injuries. The fixation of SI joint with plate is an effective, safe procedure and hasgood results and can use as an alternative to SI screw.Early surgery for unstable pelvic fracture and early rehabilitation give thebest results Functional outcomes of unstable pelvic fracture following surgical treatment are extremely encouraging. The age of the patients significantly influence the outcomes. p-value 0.02. Tile‟ type C showed the best outcome with plate fixation of SI joint. p-value 0.04 the associated injury influence the outcome at 3 months (p-value 0.03) and 6 months (p-value 0.06) not influence the outcome.
Background: Ilizarov introduced recently in Sudan for treatment of major devastating limbs injuries, correction of complex deformities, lengthening, infected nonunion, joint fusion and some other conditions. The result seems reasonable but Pin tract infection has always been the main drawback for use of these frames. And this fact necessitates defining and evaluates our current protocol and calculates the related incidence rate of pin tract infection. Methods: A descriptive, prospective hospital based study of the outcome of pin tract care for patients who were treated with Ilizarov for different indications in north Khartoum hospital over a period of two years from December 2016 to December 2018, data was collected by questionnaires and analyzed by SPSS. Result: 31 consecutive patients underwent Ilizarov frame application, for different indications, in north Khartoum hospital, involve 19 male and 12 female, the Minimum age was 5 years and maximum age was 60 years (mean age 32.5 years), minimum Ilizarov application period is 5week and maximum Ilizarov application period is 35 week (mean 20 week ) pin tract infection rate is (71%), the infection is superficial (86.36%) in the majority of infected cases involving shanz screws more frequent than smooth wires and located in the metaphysis more than the diaphysis. Conclusion: Ilizarov pintract infection, is a common complication associated with Ilizarov frame application and the incidence rate was 71%, most of infection is superficial and this will not plague the device. our current local protocol is valid in minimizing the incidence of pin tract infection and reducing the magnitude of the problem.
Background: The mechanism of osteoporosis in rheumatoid arthritis (RA) is multifactorial. Autoimmunity and chronic inflammation, among pathogenic factors, are closely related to bone resorption. However, the contribution of B cells to bone resorption in patients with RA is still controversial. Aim: This study aimed to assess the expression of CD19+CD5+ lymphocytes frequency in the peripheral blood of RA patients and their correlation with disease activity, bone resorption and bone density to determine whether this cell has a role in RA and its related bone loss. Subjects and methods: A prospective cross-sectional observational study was carried out on 34 RA patients fulfilling the ACR/EULAR (2010) criteria and 20 healthy age and sex matched healthy controls. Blood was analyzed using flow cytometry to determine the percentage of B lymphocytes expressing cell surface markers CD19+ CD5+. Rheumatoid factor (RF), anti-citrullinated protein antibody (Anti CCP) and bone resorption marker C-terminal telopeptide of type I collagen (CTX-1) were determined from the patients’ sera. Disease activity was assessed by disease activity score (DAS28-ESR) and bone mineral density (BMD) was determines by Dual Energy X-ray Absorptiometry (DEXA). Results: The percentages of circulating CD19+ CD5+ B lymphocytes were significantly higher in RA patients compared to healthy controls (1.60 % Vs 0.90% respectively; P = 0.002) and in RA patients with high activity compared to those with low activity (p=0.013). The percentages of circulating CD19+ CD5+ B lymphocytes in RA patients was positively correlated to ESR (r = 0,449, P = 0.008), DAS28-ESR (r = 0.515, P = 0.002), and RF (r = 0.389, P=0.023) and negatively correlated with BMD at left forearm (r = -0.573, P = 0.000) but not at lumbar spine, total left femur or bone resorption marker (CTX-1) in RA patients. Conclusion: The frequency of CD19+CD5+ B lymphocyte were higher in Egyptian RA patients compared to normal controls and correlates positively with disease activity parameters and inversely with BMD measurement at forearm site but not at lumbar spine, femur or bone resorption marker (CTX-1) in RA patients suggests a possible role of CD19+CD5+B lymphocyte in RA pathogenesis. However, it's weakly associated with RA related bone loss and for better clarification of the role of CD19+CD5+ B lymphocyte on bone mass in RA, larger scale longitudinal are recommended.
Aim: To assess the cognitive functions in patients with rheumatoid arthritis (RA) and its correlation with patients’ characteristics. Methods: We conducted a prospective cohort study that included 30 adult females with Rheumatoid Arthritis (RA). We collected the following data from eligible participants: demographic characteristics, disease duration, drug intake, disease activity measured by the disease activity score in 28 joints (DAS28), visual analogue scale (VAS) for global pain assessment, and cognitive function assessment findings.The cognitive assessment was conducted using Montreal cognitive assessment scale (MOCA) and p300 event related potential (ERP). Results: The mean ages of the included patients and control group were 44.97 (±9.58) years and 45.37 (±8.38) years, respectively (p=0.119). In addition, the mean patient global assessment and DAS28 was 5.43 (±2.01) and 5.31(±1.36), respectively. The primary outcome of the present study, showed that the mean MOCA score in patients with RA was 26.43 (±1.92), compared to 28.8 (±0.88) in control group. Similarly, there was a statistically significant difference in p300 ERP between patients with RA and control 413.87(±51.22) versus 278.9 (±29.7) p <0.001). The correlation analysis showed that the p300 ERP values correlated positively with DAS28 (r =0.424, p =0.02), age (r =0.396, p =0.002), and ESR (r =0.482, p =0.007). On the other hand, the MOCA score correlated negatively with patient global assessment scale (r= -0.415, p =0.022). Conclusion: In conclusion, cognitive dysfunction represent another cause of burden in RA. The present study shows that patients with RA had significantly lower cognitive performance and processing than the general population.
Background and Purpose: The purpose of the current research was to establish a link between gamma-glutamyl transferase (GGT) and creatine phosphokinase (CPK) and magnetic resonance imaging (MRI) for hippocampal atrophy and their correlation to recurrent seizures and clinical symptoms among epileptic kids. Methods: This study included male epileptics with tonic-clonic seizures and without them. Patients were chosen depending upon their therapy profile with Valproic acid (Depakine, 500 mg/day) and Carbamazepine (Tegretol, 400 mg/day) or combined therapy treatment. Axial T1 and T2 weighted images and FLAIR images were used for the MRI acquisitions. Results: Our study revealed that MRI of patients with tonic-clonic seizure had a relative dilation of the right temporal horn and right hippocampal abnormal outline with slightly atrophic changes and volume loss compared with a left region. Furthermore, gamma-glutamyl transferase (GGT) and creatine phosphokinase (CPK) has been slightly correlated with the extended seizure and rate of convulsions. Carbamazepine monotherapy is more effective in its role in reducing convulsions, which were improved in combination therapy (p < 0.01) than the Valproate. In addition, MRI flair and the increased signal intensity with T2-weighted protocol have a potential role in hippocampal atrophy and hippocampal sclerosis predictions. Conclusion: The hippocampal atrophy can be considered as one of disorder threat factors for convulsive tonic-clonic seizure, and the combined polytherapy of carbamazepine and Valproate can be considered as the combined polytherapy drugs of choice to decrease the convulsion rate among epileptic children.
Aim of the work: to evaluate the role of 18F-FDG PET/CT in the assessment of extrahepatic metastases in patients with liver cirrhosis and hepatocellular carcinoma pre liver transplantation. Patients and Methods: analysis of 80 patients retrospectively with cirrhotic liver and HCC. All patients are histopathologically proofed to have HCC. All patients were subjected to triphasic CT and whole-body 18F-FDG PET/CT. All of them were received chemotherapy and radio frequency ablation. Results: the studied patients were 75 males (93.8%) and 5 females (6.3%), the mean age of 54.45+10.19 years. Seventy patients with poorly differentiated hepatocellular carcinoma, 2 of them had moderately differentiated hepatocellular carcinoma, 8 of them had well-differentiated HCC, alpha-fetoprotein was (100-400 ng/ml) in 10 patients and >400 ng/ml in 70 patients, 68 patients had extrahepatic sites, bone metastases, and adrenal metastases.
Background: This study was designed to explore the role of Foxp3+ Treg cells in chronic HCV infection by investigating its correlation with HCV load by PCR and its relation to the liver structural injury scored by the grades of activity and stages of fibrosis. Subjects and methods: A prospective cross-sectional observational study was carried out on 50 adult patients with compensated chronic HCV infection and 50 age and sex matched apparently healthy subjects as control. Peripheral blood FoxP3+ Treg cells was detected by three-color flowcytometry. Quantitive HCV PCR was done to determine the viral load. The stages of fibrosis and the grades of activity were determined by per-cutaneous needle liver biopsy. Results: The mean level of Foxp3+ Treg in patients with chronic HCV was significantly higher than the age and sex matched healthy control (136.2 ± 60.8 versus 37.13± 14.76 respectively) P < 0.001. The level of Foxp3+ Treg was significantly higher in patients with high viremia compared to those with moderate viremia and was correlated positively with the level of viremia detected by PCR (r= 0.503 and p value < 0.001). However, no significant difference detected in the level of Foxp3+ Treg in patients with various stages of activity or grades of fibrosis. Conclusion: FoxP3+ Treg cells have essential role in the establishment of chronic HCV infection. Targeting FoxP3+ Treg cells in patients chronically infected with HCV could represent a promising approach to restore functional antiviral immunity and clearance of infection.
Background: Previous studies revealed the potential value of the soluble CD30 level (sCD30) a marker for T helper 2-type cytokine-producing Tcells as biomarker for the risk of acute rejection and graft failure after renal transplantation. Aim of the Work: We examined the predictive value of pre-transplant and post-transplant sCD30 levels for kidney transplantation outcome. Methods: This is an observational study of renal transplant patients receiving triple immunosuppressive therapy, we examined whether sCD30 can be used as a predictor of renal graft rejection. 40 patients were participating in our study, 32 males and 8 females aged 17 to 62 years old. We examined the predictive value of pre-transplant and post-transplant sCD30 levels for kidney transplantation outcome. SCD30 was measured by ELISA in serum taken day 0 before and day 30 after transplantation. Results: Our study revealed that Serum levels of sCD30 decreased significantly in samples post-transplantation compared with pre-transplantation the range of CD30 level day 0 before transplantation which was 17-277 ngm/ ml, there was significant positive relation between level of CD30 after transplantation and the early outcome of the patients, also there was significant inverse relation between level Cd30 after transplantation and the age of recipients P-value< 0.041 and finaly reverse realtion between Cd30 after transplantation and the transient ischemia during operation (P-value 0.024). Conclusions: Our results did not suggest that the measurement of sCD30 may be used as a valuable biomarker in renal transplantation. Increased levels may be related to a decrease in its renal elimination.
Background: Rheumatoid arthritis (RA) is an autoimmune disease characterized by autoantibodies against citrullinated antigens. Anti-CCP is a test commonly used for the diagnosis of rheumatoid arthritis, anti-mutated citrullinated vimentin (Anti-MCV) is another anti-citrullinated antibody reacting with mutated citrullinated vimentin. There are many studies in comparing anti-MCV and ACCP antibodies for their diagnostic value in rheumatoid arthritis. Anti-MCV especially correlates with higher levels of DAS28 core and joint damage. The aim of this study was to determine the sensitivity and specificity of anti-MCV antibodies in comparison with other inflammatory markers and disease activity in Egyptian rheumatoid arthritis patients. Patients and Methods: Fifty female rheumatoid arthritis patients, were allocated from Rheumatology outpatient clinic and inpatients Internal Medicine Department, Al-Zahraa University Hospital. Their ages ranged from 18 to 74 years with a mean ± SD was (44.6±12.5) years, and fifty healthy volunteers served as a control group. Rheumatoid factor (RF) was measured by latex agglutination, high Sensitive C- Reactive Protein (hs-CRP), Anti-Cyclic Citrullinated Peptides (ACCP) and Anti-Mutated Citrullinated Vimentin (AMCV) were estimated by ELISA. Results: There was statistically highly significant increase in AMCV level with mean ± SD (61.8±47.1 ng/ml) in the patients compared to the control group (8.3±2.9 ng/ml). There was a highly statistically significant correlation between anti-MCV and anti-CCP in the patients (P= 0.001). Also, there was a highly statistically significant correlation between anti-MCV and DAS28 (P= 0.009). The sensitivity of anti-MCV was 92% with 92% specificity, positive predictive value 92%, and negative predictive value 92%. The sensitivity of anti-CCP was 84% with 100% specificity, positive predictive value 100%, and negative predictive value 86.2%. Conclusion: There was a highly significant correlation between anti-MCV and anti-CCP of patients, also highly significant correlation between anti-MCV and DAS28 score. Anti-MCV being more sensitive than anti-CCP while anti-CCP is more specific.
Objectives: Patients with Rheumatoid arthritis (RA) have immunological abnormalities encompass T and B lymphocytes cell dysfunctions which lead to the production of pathogenic autoantibodies. According to the presence or absence of CD5 B1 lymphocyte cells are subdivided into: B-1a (CD5+), which participate in the innate immunity and B-1b (CD5-), which involved in acquired immunity. The B-2 lymphocytes are known to play an important role in the development of RA. The aim of the study is to assess the frequency of circulating CD5+ CD19+ B1a lymphocytes in Anti-cyclic-citrullinated protein antibody (Anti-CCP) positive versus Anti-cyclic- citrullinated protein antibody (Anti-CCP) negative in RA patients. Methods: In a prospective study which included 16 RA patients with positive Anti-citrullinated protein antibody and 15 patients with negative Anti-citrullinated protein antibody. Another group consisted of 16 apparently healthy subjects serving as a control group. The CD5+ CD19+ B1a lymphocyte cell in blood levels in patients with RA and normal controls was measured using flow cytometry. Results: In a comparison between RA patients with +ve ACPA and RA patients with Anti-CCP –ve groups, we showed a significant elevation in Anti-CCP (P=0.0001), CD19+% (p-value =0.0003), and B1a% lymphocyte (p-value< 0.0001) in RA patients with positive Anti-CCP. Also, there was a significant elevation of ESR (p-value= 0.028), and in DAS-28 (P = 0.045) in RA patients with positive Anti-CCP. But we found a significant reduction of absolute lymphocyte counts (p=0.031) and RA patients with positive Anti-CCP than RA patients with negative Anti-CCP. There was no significant difference of Anti-CCP (p-value= 0.921), CD-19+ % (p-value= 0.421), B1a % (p-value= 0.0544), or absolute lymphocyte cell count (p-value= 0.256) when compared between RA patients with -ve Anti-CCP group and control group. However, we found a significant reduction of WBCs (p-value= 0.000) in RA patients with –ve Anti-CCP group and control group. There were significant elevation of both CD19+ % (p-value= 0.000), and B1a (p-value= 0.001) in RA patients with +ve Anti-CCP group in comparison to the control group. Conclusion: Our result reported that the frequency CD5+ CD 19+ B1a lymphocyte in peripheral blood were elevated in rheumatoid arthritis patients with positive Anti-CCP. Therefore this study adds to the growing evidence of CD5+ CD 19+ B1a lymphocyte in the pathogenesis of seropositive rheumatoid. Recommendation: Therefore, targeted elimination of the CD5+ CD19+ B1a lymphocyte in RA patients mainly who had Anti-CCP postive may be useful for treatment.
Liver diseases are considered as the foremost cause of morbidity and mortality around the world, especially in developing countries and classified into acute and chronic liver disease. Further, hepatocytes synthesize the cholinesterase (ChE) and enhances their catalysis through hydrolysis mechanism of the acetylcholine to into choline and acetic acid. This study aims to give a comprehensive account of the vital prognostic and diagnostic marker role of cholinesterase of liver cirrhosis over other known liver function tests (LFTs) like ALT, AST, serum albumin and serum bilirubin. Subjects and methods: this study was conducted on 60 livers cirrhotic Egyptian patients, divided into three groups according to their Child-Pugh score and 30 healthy volunteers as a control group. Serum biomarkers for the liver disease were measured (cholinesterase, AST, ALT, Serum Albumin, Serum Bilirubin) in parallel with an abdominal ultrasound examination was made for all participants. The results: There was a highly significant decrease in serum cholinesterase levels in all patient groups diagnosed with liver cirrhosis compared to control and more in decompensated patients. Conclusion: the present study concluded that the blood cholinesterase can be used as an imaging profile for the degree of liver damage and prognostic level of cirrhosis.
Gestational hypertension (GH) or pregnancy induced hypertension (PIH) is a condition characterised by high blood pressure during pregnancy. PIH can lead to serious condition called Pre-Eclampsia or Toxemia. The condition prevents placenta from getting enough blood resulting in low birth weight. Present study is a prospective case control study elucidating the effect of various demographic, clinicopathological and obstetric parameters on PIH. A total of 120 females with PIH and 150 normotensive pregnant females were included in the study. The survey was conducted using an interviewer administered questionnaire. The mean systolic and diastolic Blood Pressure (BP) of subjects with PIH was found to be 148.2 ± 5.5 and 96.2 ± 5.8 respectively. PIH was found to be statistically associated with occupation, socio-economic status, history of PIH, previous miscarriage, family history of hypertension and diabetes (P≤0.05). The results of the present study clearly pinpoint the cluster of factors that are associated with gestational hypertension. Identifying these factors may provide a window to clinicians and help them to recognize mothers who have higher chances to develop hypertensive disorders.
Background: Breast self-examination (BSE) is one of the accepted and cost-effective breast cancer screening methods, which can effectively contribute to the prevention and early detection efforts. The present study aimed to assess the level of knowledge of BSE's trainees about features for early detection of the breast lumps in Qurayyat, Northern Saudi Arabia. Methodology: This is a descriptive study that included 626 Saudi women volunteers living in the city of Alquriat, Northern Saudi Arabia. Participants were randomly selected by simple random method regardless of age, gender, education level or occupation. For BSE, only those agreeing to participate in the breast self-examination workshop were included. Results: Inquiries regarding features of breast lesions covered; Do you know the signs that you can consider during doing BSE”, 64.7% stated “Yes” and the remaining 35.3% stated “No”; “Can you identify a present breast lump”, 95.4% stated “Yes” and the remaining 4.6% stated “No”; “Can you distinguish the differences in the appearance of the two breasts” 87.5% stated “Yes” and the remaining 12.5% stated “No”. Conclusion: There is a relatively higher level of knowledge of breast signs that can be measured in the course of BSE. Accidental detection of 5.3% of breast lesions in this randomize sample, necessitate the importance of a primary screening program, as well as, implementation of BSE training programs in Northern Saudi Arabia.
