Multiple intracranial germinomas: A case report

Les germinomes sont des tumeurs malignes dérivant des cellules primitives germinales occupant les structures de la ligne médiane au niveau cérébral telle la région pinéale et/ou sellaire. Nous rapportons un cas de localisation multiples chez un patient de 38 ans, révélé par un syndrome d’hypertension intracrânienne et une baisse de l’acuité  visuelle.L’IRM cérébrale a permis de voir les trois localisations: pinéale ; sellaire et au niveau de l’angle ponto cérébelleux droit .Les marqueurs tumoraux étaient positives. Le patient a bénéficié d’un shunt interne et a entrepris aussitôt un traitement complémentaire enchainant  chimiothérapie et radiothérapie avec une très bonne évolution clinique et radiologique.A notre connaissance aucun cas similaire n’a déjà été décrit dans la littérature africaine. Germinomas are malignant tumors arising from primitive germ cells. They may be solitary or multiple and can be situated along the midline structures or in other intracranial regions. We report on one case of multiple intracranial germinoma. A 38 year-old male patient presented with signs of increased intracranial pressure and bilateral dimunition of visual acuity. A brain MRI showed multiple lesions at the level of the pineal region, the suprasellar region and in the right pontocerebellar angle. Tumor markers were positive. He underwent radiation therapy and chemotherapy with good recovery. To the best of our knowledge no similar case was described in the African literature before

L’hemangiopericytome (a propos de 8 cas)

Description L’hémangiopéricytome est une tumeur rare, mésenchymateuse, qui prend naissance au niveau des péricytes de Zimmerman. Il est souvent confondu avec le méningiome. Objectif Faire le point sur cette entité histologique souvent méconnue. Méthodes Une étude rétrospective de 8 cas d’hémangiopéricytome colligés au Service de Neurochirurgie de l’hôpital Ibn Rochd de Casablanca au Maroc, entre 2000 et 2008. Résultats Il s’agissait de 6 hommes et 2 femmes. L’âge moyen de nos patients était de 50 ans. Le délai moyen de diagnostic était de 4,75 mois. Le tableau clinique était dominé par les signes d’hypertension intracrânienne. Le bilan neuroradiologique a objectivé le caractère unique des lésions, une taille moyenne de 6,33 cm. Tous nos patient ont été traité par chirurgie avec résection subtotale dans 5 cas et totale dans le reste. Un patient a bénéficié de la radiothérapie post opératoire. L’évolution a été marquée par l’apparition d’une récidive, 3 cas de reprise évolutive et un décès. L’apparition de métastases n’a pas été notée dans notre série. Conclusion L’hémangiopéricytome se caractérise par son potentiel malin, son taux élevé de récidive et de métastase à distance. Son évolution est imprévisible nécessitant une surveillance prolongée.Mots clés : Cellules de Zimmerman, Hémangiopéricytome, Méningiom

The ameliorative effect of curcumin on cryptorchid and non-cryptorchid testes in induced unilateral cryptorchidism in albino rat: histological evaluation

Background: Cryptorchidism, one or both hidden testes, is the most common abnormality of male sexual development. Subfertility or infertility is associated with both unilateral and bilateral cryptorchidism. In this study, we investigate the possible ameliorative effect of curcumin (Cur) on the induced-unilateral cryptorchidism testicular injury in both cryptorchid (Cryp) and non-cryptorchid (non-Cryp) scrotal testes through histological, immunohistochemical and morphometrics.Materials and methods: Forty adult male albino rats were divided into: control group, Cur control group, Cryp group, and Cryp+Cur group. The rat model was surgically established by fixing the left testis in the abdomen. The treated groups were subjected to surgically induced-unilateral cryptorchidism on the left side then were given Cur (80 mg/kg) orally, for 20 days. Histological analysis using haematoxylin and eosin and periodic acid Schiff’s reaction was done. Immunohistochemistry was performed for proliferating cell nuclear antigen (PCNA); to estimate the proliferation in the germinal epithelium, and vimentin; to evaluate Sertoli cells. The results were confirmed by statistical evaluation of the spermatogenic epithelium height, the seminiferous tubules diameter, the basement membrane thickness, the number of PCNA immunostained cells and the area per cent of vimentin immunostaining.Results: Distorted seminiferous tubules, substantial degeneration of the germinal epithelium, thickening of the basement membrane with a significant decrease in PCNA and vimentin immunostaining were observed in Cryp group; mainly in the cryptorchid testis. These structural changes were significantly reversed in Crypt+Cur group.Conclusions: Curcumin proved to be an important and effective medical line for protecting against the unfavourable sequels of cryptorchidism in a rat model

Stroke Awareness in the General Population: A Study from Jordan

Purpose: To assess the awareness level of the Jordanian general population regarding the definition, risk factors, signs and symptoms, and consequences of stroke.Methods: This was a cross-sectional study. The questionnaire was handed to participants by trained students, the participants were chosen randomly from public places, and the questionnaire used is subdivided into demographic data, questions of multiple choices to identify symptoms and signs, the definition of stroke, and risk factors of stroke. The data were entered and analysed by SPSS software version 16.using frequencies, Chi square and logistic regression. A level of significance of 0.05 was applied.Results: At least 1993 questionnaires were returned. Out which 40 were excluded for poor quality and 99 were excluded due to missing data. From the 1854 questionnaire used, 82% were residents of Amman, and only 17% were older than 47 years of age. Females were almost equally represented as males,who accounted for 57% of the total. More than 70% had an educational level higher than secondary school.. Only 1.5% experienced a previous stroke, and a relatively high proportion (63.8%) knew someone who suffered from stroke. The most recognized symptom was speech loss (54.7%). All other symptoms were recognized by < 50% of the population. Seventy five percent knew that the brain is the organ involved in stroke while 85% would contact the ambulance on noticing stroke signs, even if symptoms subsequently improved. In a bivariate logistic regression, no independent variables had true effect on knowledge.Conclusion: We concluded from the study that there are serious gaps in knowledge regarding stroke; an educational program on stroke may help reduce the stroke burden in Jordan.Keywords: Stroke, Awareness, Jordan

An Extended Investigation of High-Level Natural Radioactivity and Geochemistry of Neoproterozoic Dokhan Volcanics: A Case Study of Wadi Gebeiy, Southwestern Sinai, Egypt

High-level natural radioactivity, geochemical, geological, and radiological hazard assessment of the poorly investigated Wadi Gebeiy Dokhan volcanics rocks are discussed. Wadi Gebeiy Dokhan volcanics are located in Southwestern Sinai, Egypt, covering an area of ~1.3 km2. Dokhan volcanics rocks are represented by porphyritic dacite. Geochemically, they have medium-k characters and originate from calc-alkaline magma within a volcanics arc environment. Along the fault plane striking NNE-SSW, and at its intersection with the NW-SE fault plane, altered Dokhan volcanics occur with high radioactive anomalies. Radiological parameters (absorbed dose rate, radium equivalent, activity annual effective dose, external and internal hazard indices) are used to evaluate their suitability as an ornamental stone. Except for the absorbed dose rate, all the radiological hazard indices show that unaltered Dokhan volcanics can be used as an ornamental stone. Controversially, the applied radiological indices reveal that altered Dokhan volcanics have a higher content than the recommended values of UNSCEAR, reflecting their risk on human organs. © 2022 by the authors.H.M.H.Z. is funded by a scholarship under the Joint Executive Program between Egypt and Russia

Reforming Fiscal Institutions in Resource-Rich Arab Economies: Policy Proposals

This paper traces the evolution of fiscal institutions of Resource Rich Arab Economies (RRAEs) over time since their pre-oil days, through the discovery of oil to their build-up of oil exports. It then identifies challenges faced by RRAEs and variations in their severity among the different countries over time. Finally, it articulates specific policy reforms, which, if implemented successfully, could help to overcome these challenges. In some cases, however, these policy proposals may give rise to important trade-offs that will have to be evaluated carefully in individual cases

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Changes in oral-health related quality of life, oral hygiene status and body growth in children with special health care needs following oral rehabilitation under general anaesthesia

Aim: To assess changes in oral health related quality of life, oral hygiene status and body growth in children with special health care needs following dental treatment under general anaesthesia. Methodology: Twenty children with special health care needs undergoing dental treatment undergoing general anaesthesia at the Unit of Pediatric Dentistry and those with Special needs, Faculty of Dentistry, Cairo University were selected in this study. For each patient oral hygiene status (assessed by Plaque index), weight, height and body mass index were assessed at baseline and at 3,6 and 9 months. OHRQoL was assessed using the early childhood oral health impact scale (ECOHIS) at baseline as well as 3, 6 and 9 months intervals. Results: At follow up, there was a slight increase in body weight in 100% of patients, 87.5% in height, 25% in body mass index that their percentile curve had been changed while in 75% of cases remain the same percentile curve but higher BMI. The overall Early Childhood Oral health impact scale scores decreased significantly (P < 0.001) demonstrating large effect sizes, at baseline score was significantly higher than at 3, 6 and 9 months respectively.&nbsp