Polyradiculoneuritis revealing an acute monoblastic leukemia 5

Acute polyradiculoneuritis has been frequently reported in association with malignant disorders, especially those of the lymphoid system. To date, there have been no reported cases of acute monoblastic leukemia associated with this polyradiculopathy. The authors tell us about a very rare case of leukemia presenting as acute monoblastic leukemia 5 (AML5) in a 28 years old patient from Morocco

A stochastic Model for Predicting Irrigation Water Requirements (IWR)

The main objective of this paper is to develop a stochastic time series model with trend, periodic and irregular components using a ten years IWR decade data for three different types of cotton crops cultivated in Gezira Scheme, SUDAN. The model was applied to cotton Brackat and then used to Shmbat & Akala cotton. In the analysis of IWR time series the correlogram technique was used to detect the periodicity which then smoothed by Fourier series method. The series is then tested for stationary and the dependent part of irregular component is found to be well expressed by the first order autoregressive model for all the crops. The developed model superimposes a periodic-deterministic process and an irregular componen

Excavated pulmonary nodules: an unusual clinical presentation of lung metastasis in two cases

<p>Abstract</p> <p>Background</p> <p>Excavated pulmonary metastasis are rare. We present two cases of excavated pulmonary nodules proved to be metastases from osteosarcoma and gallblader lymphoma.</p> <p>Case presentation</p> <p>The first one is 39-year-old man in whom cholecystectomy made the diagnosis of primary non-Hodgkin's lymphoma of the gallbladder. He presented in chest CT scan excavated nodules that had been biopsied and confirmed the diagnosis of non hodgkin lymphoma. He underwent 8 courses of chemotherapy CHOP 21 with complete remission. The second one is an 21 years old man who presented a right leg osteoblastic osteosarcoma with only excavated pulmonary nodules in extension assessment. He had 3 courses of polychemotherapy API (doxorubicin, platinum, and ifosfamide) with partial response. Unfortunately, he died following a septic shock.</p> <p>Review of the literature shows that excavated pulmonary nodules as metastasis are rare but we should consider this diagnosis every time we are in front of a cancer. Chest computed tomography is the best diagnosis imaging that could make this diagnosis. Differential diagnosis between benign and malignant bullous lesions is important because surgical excision affects survival in some malignancies.</p> <p>Conclusions</p> <p>Although pulmonary nodules are the most common cancer metastasis, a differential diagnosis of a concurrent primary malignancy should always be considered every time we have excavated lesions, even in patients with known malignant disease. Thorough chest evaluation is important, as multiple primary malignancies may occur concomitantly.</p

Imaging of blunt pancreatic trauma : the value of initial and sequential CT examinations

Background: The purpose of the study was to assess the value of initial, repeated and sequential computed tomography (CT) in patients with blunt pancreatic trauma, and then define and correlate CT findings with endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP), ultrasound (US), both laboratory and surgical findings. Material/Methods: This retrospective study covers an eight-year period from 1999 to 2007. The material includes 21 patients (17 males and 4 females) with confirmed pancreatic injury. CT was performed on admission in all cases and in 15 cases follow-up CT was performed from 24 hrs to 14 days later. US was performed in 9 cases, ERCP in 8 cases and MRCP in one case. Serum amylase level was obtained at the admission in all cases. Results: The CT at admission was positive in 17 patients (81.0%); the diagnosis was missed in 4 patients (19.0%), all performed on single row spiral CT. In all these four cases repeated CT was positive. ERCP showed rupture of the main pancreatic duct in 7 cases, one was inconclusive. One MRCP was positive. The serum amylase was elevated in 14 cases (66.7%) Specific CT features in initial and repeated examinations together were: organ fracture - 33.3%, swelling - 38.1%, haematoma/contusion - 38.1%, fluid between splenic vein and pancreas - 19.0%. Non-specific features were: thickening of anterior-renal fascia - 23.8%, fluid in lesser sac - 28.6%, extra peritoneal fluid - 42.9%, associated splenic injury - 14.3% and intraperitoneal fluid - 38.1%. On retrospective analysis, two out of four false negative CT results could have been avoided. No correlation between the CT features and the outcome of surgical and conservative management could be found in this study. Conclusions: A proper technique and accurate reading of images are mandatory for the diagnosis of pancreatic injury. When CT performed on admission is negative and there is abdominal pain and an elevated serum amylase, CT examination should be repeated within 24-48 hours

Predictors of high calcium score in patients with negative myocardial perfusion imaging

Background: Coronary artery disease (CAD) is one of the major cardiovascular diseases. Myocardial perfusion imaging (MPI) using single photon emission computed tomography (SPECT) plays an important role in the diagnosis and prognosis of CAD.Objective: The aim of the present study was to reduce the generalization of doing calcium score for all coronary cardiac patients with negative myocardial perfusion imaging. Patients and methods: A retrospective cohort study analysis using data from Alfa Scan Center, a major outpatient radiology center in Cairo, Egypt, and conducted in Cardiology Department, Faculty of Medicine, Zagazig University that included a total sample of 1168 participants with negative myocardial perfusion imaging not known to have history of CAD, and age ranged between 20 to 80 years from both sexes. All patients were subjected for SPECT-MPI after the intravenous injection of 99mTc-sestamibi.Results: There was statistically significant difference between the two groups regarding age, gender, weight, chest pain, hypertension, dyslipidemia, diabetes, family history of CAD, beta blockers, aspirin, resting diastolic blood pressure (DBP), rest ECG abnormalities and exercise duration. Age, gender, diabetes mellitus and dyslipidemia were the predictors of any coronary artery calcification (CAC &gt; 0) in patients with negative myocardial perfusion imaging. Age, gender and Duke Treadmill Score were the predictors of significant coronary artery calcification (CAC &gt; 100) in patients with negative myocardial perfusion imaging.Conclusion: Calcium score for all not known coronary cardiac patients with negative MPI is a mandatory, particularly if they are old, male gender and have multiple risk factors

Non-Invasive Panel for Prediction of Large Esophageal Varices in Patients with HCV-Related Cirrhosis after DAAS Therapy

To study sonographic and laboratory parameters as diagnostic non-invasive Indices for prediction and screening of large varices in liver cirrhotic patients post hepatitis C virus after direct Actin antiviral drugs (DAAS). Introduction: All cirrhotic patients should be screened for esophageal varices (EV) via endoscopy, as recommended by the guidelines. However, repeated endoscopy is not well accepted by patients and is a costly procedure that places a heavy burden on the endoscopic unit. Therefore, noninvasive predictors of EVs and size discrimination for EVs are of particular importance.After dividing DAAS into three arms: arm 1 with Non-EV, arm 2grad1&2 EV (Small Vriceal arm), and arm 3 grade 3&4 EV (Large Variceal arm). medical history, physical examination, standard laboratory tests, abdominal ultrasound, and sonographic parameters such as portal vein velocity (PVV). Splenic Index (SI) Splenoportal Index (SPI), platelet count/spleen diameter ratio (PCSDR) and upper gastrointestinal endoscopy were performed for all participants.Results: The Noninvasive sonographic and laboratory parameters for prediction of the presence of EVs have demonstrated that low platelet count/spleen diameter ratio (PC/SD) at cut-off (CO) ≤ 1121.43 cu/mm, then high SPI at CO >3.98 cm /sec then high FIB4 at CO > 2.68 then high APRI at CO > 0.6 then PVV at CO ≤ 22.2 cm/sec then high SI at CO > 89.7 and lastly Child’s – Pugh’s score at CO > 6 respectively.. The Non Invasive sonographic and laboratory parameters for discrimination of the size of EVs showed that high SPI was found to be the most accurate parameter at CO less than >7.75 cm/sec Then low PC/SD at CO ≤ 514.08 cu/mm then high APRI at CO > 1.4 then high FIB4 at CO > 7,6 then high SI with AUC 0.821 at CO > 122.4 then low PVV at CO < 15 and lastly Child’s –Pugh’s score at CO> 6 respectively.Conclusions: The sonographic and laboratory indices are non- invasive parameters for the prediction of EV & discrimination of its size. And to determine when Upper Endoscopy is done for liver cirrhotic patients post-C after DAA

Safety of pregnancy in uterine fibroids

Uterine fibroid is one of the most common intrauterine masses among females at the reproductive age. Pregnancy and uterine fibroids are highly correlated. Pregnancy-related hormones influence the size of uterine fibroids, and fibroids have many impacts on pregnancy. Although most if the uterine fibroids are asymptomatic during pregnancy, serious complications may occur. The main complications include abortion, premature rupture of membranes, premature labor, abruptio placentae, peripartum hemorrhage, fetal malpresentation, fetal intrauterine growth retardation, small for gestational age infants, and fetal anomalies. The main risk factors for complications are related to the fibroid number, size, volume, location, and type. Large, multiple, retroplacental, submucosal, subserosal, pedunculated, or low-lying fibroids carries the highest risk for complications during pregnancy. This review will address the prevalence of uterine fibroids during pregnancy, its effects, and complications

Snake Bite in Gezira Revision of 63 Envenomed Child

&nbsp;&nbsp; Sixty three patients admitted to the Gezira National Center of Pediatric Surgery with snake bite were analyzed. All patients were envenomed and the snake was positively identified. In 39 patients (61.9%) the offending snake was (washash) (Echis carinatus) and in 24 patients (38.1%) (Abdafan) (atractaspis microlepidata) was identified. All patients were from rural Gezira where children are actively involved in agriculture and harvesting. The median age group was 9.3 years. Females were equally involved as males. The mean time elapsed since the bite was 56 hours. Quicker arrival at hospital was seen in severe envenomation. Fifty patients had already received native remedies which was observed to increase the local wound complications. Most bites (79%) occurred in the leg .The majority of the bites occurs in the early rainy summer months. All patients presented initially with progressive painful swelling. Local necrosis was observed in seventeen patients (26.9%). &nbsp;Fourteen patients (22.2%) developed compartment syndrome and three patients (4.76%) developed fingertip gangrene. one patient (1.6%) developed extensive bilateral common iliac vein thrombosis. DIC developed in 21 patients (33.3%). Two patients (3.2%) of theses developed intracranial haemorrhage. Four patients (6.3%) with local necrosis presented few month later with extensive chronic osteomyelitis.Treatment options included cardiovascular support, local wound debridement, fasciotomy and minor amputation. Patients with DIC were managed with fresh frozen plasma, blood transfusion and heparin. Antivenin was not administered to our patients. All patients eventually recovered except one child (1.6%) who succumbed of massive intracerebral haemorrhage. ملخص: &nbsp;تم تحليل البيانات لثلاث وستين طفلا تم تنويمهم بمركز الجزيرة القومي لجراحة الأطفال في الفترة من مارس 2001م الي ابريل2010م&nbsp; بعد أن شخصت حالتهم بلدغة ثعبان سام. في كل المرضى تم التعرف على الثعبان, في 39 مريض كان الثعبان اللادغ من نوع و شاش(echis carinatus) &nbsp;وفي 24 أبو دفان (atractaspis &nbsp;&nbsp;(micolepidata كل المرضي كانوا أطفالا من أرياف الجزيرة وجميعهم يعمل في الزراعة والحصاد. بلغ متوسط العمر لديهم 9.3 سنة. كانت الإصابة متساوية لدي الذكور والإناث, متوسط الوقت المنصرم منذ اللدغة بالثعبان وحتى ألمجي للمستشفي&nbsp; كانت 56 ساعة ,لوحظ إن ألمجي الباكر للمستشفي يكون في حالات التسمم الوخيم . المعالجة لهؤلاء المرضي تضمنت مساعدة الجهاز الدوري وانضار الجرح الموضعي و بضع اللفافة وإجراء البتر البسيط ,المرضي اللذين عانوا من التخثر المنتشر داخل الأوعية الدموية تمت معالجتهم بحقن المصورة المتجمدة الطازجة ونقل الدم الطازج واعطا الهبارين. لم يتم استخدام الترياق في أي من المرضي. كل المرضي تماثلوا للشفاء إلا مريضا واحدا توفي بسبب نزف جسيم داخل القحف.&nbsp;&nbsp;&nbsp;&nbsp

Media literacy and young people’s integrity in political participation: a structural equation modelling approach

The unethical activities related to weak political participation integrity on social media have influenced negative behaviours among supporters, particularly the young people. Social media transmits information on demonstration activities by enabling the creation, collection, and dissemination of false information or seditious libel, which exposes the country to external attacks and threats. Furthermore, young people’s negative political participation activities on social media, such as creating and disseminating false information, making harsh remarks, generating turmoil to acquire popularity or go viral, can potentially lead to cybercrimes. This research identified the impacts of media literacy competencies, namely access, analysis and evaluation, creation, reflection, and action, on political participation integrity among young people. This study distributed a survey to targeted university students in Melaka, Malaysia using the simple random sampling method. The students’ participation was purely voluntary. A total of 388 responses were successfully collected. The structural equation authenticated that four competencies significantly influenced the participants’ political participation integrity: access, analysis and evaluation, reflection, and action. In addition, young people who have media literacy skills showed a stronger preference to engage in political activities with higher moral conduct. The findings provided valuable insights about young people's political participation integrity on social media in Malaysia

High temperature drives topoisomerase mediated chromosomal break repair pathway choice

Cancer-causing mutations often arise from inappropriate DNA repair, yet acute exposure to DNA damage is widely used to treat cancer. The challenge remains in how to specifically induce excessive DNA damage in cancer cells while minimizing the undesirable effects of genomic instability in noncancerous cells. One approach is the acute exposure to hyperthermia, which suppresses DNA repair and synergizes with radiotherapy and chemotherapy. An exception, however, is the protective effect of hyperthermia on topoisomerase targeting therapeutics. The molecular explanation for this conundrum remains unclear. Here, we show that hyperthermia suppresses the level of topoisomerase mediated single- and double-strand breaks induced by exposure to topoisomerase poisons. We further uncover that, hyperthermia suppresses hallmarks of genomic instability induced by topoisomerase targeting therapeutics by inhibiting nuclease activities, thereby channeling repair to error-free pathways driven by tyrosyl-DNA phosphodiesterases. These findings provide an explanation for the protective effect of hyperthermia from topoisomerase-induced DNA damage and may help to explain the inverse relationship between cancer incidence and temperature. They also pave the way for the use of controlled heat as a therapeutic adjunct to topoisomerase targeting therapeutics