Beyond the commonest: right lower quadrant abdominal pain is not always appendicitis

Background: Despite acute appendicitis is the most common underlying etiology of the acute abdomen, a considerable list of other pathologies should be considered; despite sharing almost the same clinical presentation. This study aimed to re-enhance the importance and sensitivity of CT scan as a solitary imaging tool, in the evaluation of patients with acute right lower abdominal pain. Patients and methods: It is a retrospective study of the last 1000 patients, referred with acute right lower abdominal pain for CT scan examination. Biphasic CT scan abdomen protocol was applied for all. Results: Cecal carcinoma was detected in three patients (0.3%), epiploic appendicitis in five (0.5%), omental infarct in two (0.2%), appendicular mucocele in two (0.2%), appendicular NET in one (0.1%), cecal diverticulitis in four (0.4%), Chron’s disease in six (0.6%), intussusception in one (0.1%) and FB in one (0.1%) and appendicular perforation in one (0.1%), acute simple appendicitis 398 (39.8%) and 577 (57.7%) were unremarkable. Conclusion: Despite acute appendicitis is the most common cause of the acute abdomen, many other surgical and non-surgical etiologies should also be considered, with a higher sensitivity of CT as a solitary diagnostic tool of imaging

Polyploidy in chronic lymphocytic leukemia with p53 deletion detected by fish: a case report

We report a case of chronic lymphocytic leukemia with a characteristic cytogenetics finding detected by fluorescent in situ hybridization. This case has deletion in p53 gene in 50% of interphase nuclei studied in the peripheral blood and polyploidy in 30% of cells. To our knowledge polyploidy is not commonly reported with chronic lymphocytic leukemia patients

Estimation of Parent-Sib Correlations for Quantitative Traits Using the Linear Mixed Regression Model: Applications to Arterial Blood Pressures Data Collected From Nuclear Families

A fundamental question in quantitative genetics is whether observed variation in the phenotypic values of a particular trait is due to environmental or to biological factors. Proportion of variations attributed to genetic factors is known as heritability of the trait. Heritability is a concept that summarizes how much of the variation in a trait is due to variation in genetic factors. Often, this term is used in reference to the resemblance between parents and their offspring. In this context, high heritability implies a strong resemblance between parents and offspring with regard to a specific trait, while low heritability implies a low level of resemblance. While many applications measure the offspring resemblance to their parents using the mid-parental value of a quantitative trait of interest as an input parameter, others focus on estimating maternal and paternal heritability. In this paper we address the problem of estimating parental heritability using the nuclear family as a unit of analysis. We derive moment and maximum likelihood estimators of parental heritability, and test their equality using the likelihood ratio test, the delta method. We also use Fieller’s interval on the ratio of parental heritability to address the question of bioequivalence. The methods are illustrated on published arterial blood pressures data collected from nuclear families

EFFECT OF MANAGEMENT PROGRAM ON HEAD NURSES, PERFORMANCE OF CONTROL AND SAFEGUARD REGARDING RESOURCES AT EL-MENSHAWY GENERAL HOSPITAL

Abstract Resources control is to know how to act in a responsible and recognized way to add economic value to the hospital units. it includes nursing practices that reducing the utilization of non-beneficial care and use of medical resources appropriately, without compromising the quality of the nursing care provided to the patient. Aim: The aim of the study was to determine the effect of management program on head nurses, performance of control and safeguard regarding resources at El-Menshawy General Hospital. Method: Design: Quasi experimental research Setting: Study was conducted at El-Menshawy General hospital affiliated to Ministry of Health and Population. It divided into three main big buildings A, B, and C which include twenty inpatient and outpatient units. Subjects: All (N=60) head nurses working in inpatient units, divided into head nurses (40) and in-charge nurses (20). Data collection tools: Tool (I) head nurses’ knowledge about control and safeguard regarding resources questionnaire. Tool (II) head nurses, performance of control and safeguard regarding resources observational checklist. Results; Preprogram more than half of head nurses had low level of knowledge regarding control and safeguard resources, changed to be none had low but all had high level of knowledge post program. Beside preprogram seventy percent of head nurses at morning shift, but all of them at afternoon and evening shift had unsatisfactory level of performance regarding control and safeguard resources, changed post program to be all head nurses at morning shift, most and majority of them at afternoon and evening showed satisfactory performance levels. There was a strong and highly statistically significant positive correlation between total head nurses’ high knowledge and satisfactory performance level post program than pre. Conclusion; The designed and implemented management program significantly improve head nurses’ knowledge and performance regarding control and safeguard resources. Recommendation; Maintain periodical in-service training program to improve nursing staff’ knowledge and practice regarding control and safeguard resources

Sickle cell anemia: Imaging from head to toe

AbstractSCA is hemolytic anemia with deformed RBCs leading to frequent hemolytic crisis, extramedullary hematopoiesis and multisystem repeated emboli.AimTo emphasize the role of different imaging modalities in early accurate diagnosis.Patients and methodsWe present different types of complications of SCA, encountered in patients of Eastern Province-KSA, between 2009 and 2013.ResultsComplication may involve any system of the body, thus different types of imaging modalities are needed for correct diagnosis.ConclusionBeing familiar with radiological signs of expected complications of SCA in different systems, helps much to control advance of the disease and protect against early organ damage

Knowledge, Attitude and Practice of Hepatitis B Virus Infection among Dental Students and Interns in Saudi Arabia

Hepatitis B virus (HBV) is a worldwide healthcare problem. Dental health care professionals are at a high risk of infection by HBV. The present study investigated the knowledge, attitude and practice of HBV infection among Saudi dental students and Interns in Saudi Arabia. This was a questionnaire-based cross-sectional study. A self-administered questionnaire consisting of questions on students? knowledge, attitudes, and practices regarding HBV was used. Data of 420 participants were analyzed using SPSS (Statistical Package for Social Studies) version 22.0. The response rate was 84%. Overall, the participants showed fair level of knowledge about HBV, with significant differences between final year students and the interns. Also, the subjects showed negative attitude toward HBV patients. The vast majority reported always wearing gloves (97.9%), gowns (92.1%), face masks (89.2%), disposable caps (87.1%) and protective eye wear (80.9%). The majority of participants (91.4%) had been vaccinated against HBV. However, only 41% completed the recommended 3 doses of the vaccine. These unsatisfactory findings emphasize the necessity of continued education about HBV in order to improve knowledge, attitudes, and practices of dental students and Interns regarding HBV

Biochemical and cellular basis of oxidative stress: Implications for disease onset

Cellular oxidation–reduction (redox) systems, which encompass pro- and antioxidant molecules, are integral components of a plethora of essential cellular processes. Any dysregulation of these systems can cause molecular imbalances between the pro- and antioxidant moieties, leading to a state of oxidative stress. Long-lasting oxidative stress can manifest clinically as a variety of chronic illnesses including cancers, neurodegenerative disorders, cardiovascular disease, and metabolic diseases like diabetes. As such, this review investigates the impact of oxidative stress on the human body with emphasis on the underlying oxidants, mechanisms, and pathways. It also discusses the available antioxidant defense mechanisms. The cellular monitoring and regulatory systems that ensure a balanced oxidative cellular environment are detailed. We critically discuss the notion of oxidants as a double-edged sword, being signaling messengers at low physiological concentrations but causative agents of oxidative stress when overproduced. In this regard, the review also presents strategies employed by oxidants including redox signaling and activation of transcriptional programs such as those mediated by the Nrf2/Keap1 and NFk signaling. Likewise, redox molecular switches of peroxiredoxin and DJ-1 and the proteins they regulate are presented. The review concludes that a thorough comprehension of cellular redox systems is essential to develop the evolving field of redox medicine.Open Access funding provided by Qatar National Library. [Correction added on 25 July 2023, after first online publication: Acknowledgement section has been inserted.

Synthesis and evaluation of anticancer, antiphospholipases, antiproteases, and antimetabolic syndrome activities of some 3H-quinazolin-4-one derivatives

Some new 3H-quinazolin-4-one derivatives were synthesised and screened for anticancer, antiphospholipases, antiproteases, and antimetabolic syndrome activities. Compound 15d was more potent in reducing the cell viabilities of HT-29 and SW620 cells lines to 38%, 36.7%, compared to 5-FU which demonstrated cell viabilities of 65.9 and 42.7% respectively. The IC50 values of 15d were ∼20 µg/ml. Assessment of apoptotic activity revealed that 15d decreased the cell viability by down regulating Bcl2 and BclxL. Moreover, compounds, 8j, 8d/15a/15e, 5b, and 8f displayed lowered IC50 values than oleanolic acid against proinflammatory isoforms of hGV, hG-X, NmPLA2, and AmPLA2. In addition, 8d, 8h, 8j, 15a, 15b, 15e, and 15f showed better anti-α-amylase than quercetin, whereas 8g, 8h, and 8i showed higher anti-α-glucosidase activity than allopurinol. Thus, these compounds can be considered as potential antidiabetic agents. Finally, none of the compounds showed higher antiproteases or xanthine oxidase activities than the used reference drugs

Predictors of Cardiac Sparing in Deep Inspiration Breath-Hold for Patients With Left Sided Breast Cancer

Purpose: The purpose of this study was to evaluate patient-related non-dosimetric predictors of cardiac sparing with the use of deep inspiration breath-hold (DIBH) in patients with left-sided breast cancer undergoing irradiation (RT).Materials and Methods: We retrospectively reviewed charts and treatment plans of one-hundred and three patients with left-sided breast cancer. All patients had both free-breathing (FB) and DIBH (with body surface tracking) plans available. (MHD) and V4 (heart volume receiving at least 4 Gy) were extracted from dose volume histograms. Fisher's exact and Chi-square tests were used to identify predictors of reductions in MHD and V4 after DIBH.Results: One-hundred and three patients were identified and most underwent mastectomy. MHD and V4 decreased significantly in DIBH plans (0.74 ± 0.25 Gy vs. 1.72 ± 0.98 Gy, p < 0.0001 for MHD; 4 ± 4.98 cc vs. 20.79 ± 18.2 cc, p < 0.0001 for V4). Body mass index (BMI), smoking and timing of CT simulation (spring/winter vs. summer/fall) were significant predictors of reduction in MHD whereas BMI, field size, chemotherapy, axillary dissection, and timing of CT simulation predicted reduction in V4. On multivariate analysis, BMI, and timing of CT simulation remained significant predictors of the heart-sparing effect of DIBH.Conclusions: In the setting of limited resources, identifying patients who will benefit the most from DIBH is extremely important. Prior studies have identified multiple dosimetric predictors of cardiac sparing and hereby we identified new non-dosimetric factors such as BMI and timing of treatments