Diagnostic uncertainty of hepatobiliary cystadenoma: Report of 11 cases and review of the literature

AbstractObjectivesThis research was conducted to highlight the pre-operative diagnostic uncertainty of hepatobiliary cystadenomas and to suggest strategies to improve its diagnostic yield.MethodsAll consecutive patients admitted with hepatobiliary cystadenomas from July 2007 to July 2014 were recruited in this study. The following information was retrieved from the medical records of eligible patients: demographics, clinical features, laboratory tests, imaging results, operative procedures, frozen sections, complications, histopathology, outpatient follow-up, and morbidity and mortality.ResultsEleven total patients with a diagnosis of hepatobiliary cystadenomas were treated in our unit. Abdominal ultrasounds and computed tomography (CT) scans were performed in all patients; magnetic resonant imaging (MRI) was performed in three patients with suspicion of hepatobiliary cystadenomas. Six patients underwent a definitive surgery; five patients were incorrectly diagnosed with non-hepatobiliary cystadenoma liver cysts (2 hydatid cysts and 3 simple cysts) by the pre-operative ultrasound and CT scan. These five patients underwent surgical deroofing. The frozen section was positive in two patients and was falsely negative in one patient who was diagnosed with simple cysts. The final histopathology results identified hepatobiliary cystadenomas in all patients.ConclusionsHepatobiliary cystadenomas are rare and are frequently misdiagnosed as hepatic cystic lesions with resultant inadequate surgical treatments. A diagnosis of hepatobiliary cystadenomas should be considered in all patients with atypical liver cystic lesions. Further pre-operative assessment with MRIs and intra-operative frozen sections may improve the diagnostic yield and provide an opportunity for a definitive radical resection

The effect of hyoscine butylbromide in shortening the first stage of labor: A double blind, randomized, controlled, clinical trial

Nourah H Al Qahtani1 Fatma Al Hajeri21MRCOG, College of Medicine, Department of Obstetrics and Gynecology in King Fahad University Hospital, University of Dammam, Saudi Arabia; 2Department of Obstetrics and Gynecology in King Fahad University Hospital, Saudi ArabiaBackground and objectives: Hyoscine butylbromide (HBB) is widely used in labor rooms. There have been many studies on the use of HBB during labor with conflicting results, involving both primiparous and multiparous women. The aim of this trial was to study the efficacy of HBB for shortening the first stage of labor in primiparous women.Methods: The study was a randomized, double blind, controlled trial. Ninety-seven primigravid term pregnant women in spontaneous labor received either hyoscine butylbromide or a placebo intramuscularly once the women entered the active phase of labor. The primary outcome measured was the duration of the first stage of labor. Secondary outcomes were the duration of the second and third stages of labor, blood loss at delivery, rate of cesarean section, and Apgar scores for the neonates.Results: A total of 97 women yielded data for analysis. Of these, 45 women received the placebo and 52 received HBB. The mean duration of the first stage in the control group was 215 minutes, compared with 165 minutes in the study group, representing a decrease of 23.3% (P = 0.001). There were no significant changes in the duration of the second (P = 0.063) or third (P = 0.0418) stages of labor, and no significant differences in blood loss or Apgar scores. There was a slightly higher (but statistically insignificant) rate of instrumental delivery in the control group, but no difference in the Cesarean section rate. There was a 60% reduction in opioid analgesic use in the HBB group.Conclusion: HBB is effective in significantly reducing the duration of the first stage of labor, and is not associated with any apparent adverse maternal or neonatal outcomes.Keywords: hyoscine butylbromide, first stage, labor, duration, augmentatio

The role of administrative control in limiting the spread of the corona epidemic in Islamic law and health legislation in the kingdom of Saudi Arabia and the Hashemite kingdom of Jordan

During the first trimester of 2020, the world exposed to unusual epidemiological situation that has had a negative impact and had disrupted ordinary life, which imposed on the competent authorities in addressing the epidemic by means of preventive and other treatment controls, as many government orders were issued that changed daily life, imposed closures and restriction of freedoms as: freedom of worship, reorganization of religious rites, in particular with regard to Hajj and Umrah. This study has concluded that the governmental procedures is required and essential in response to the pandemic. However, it was reflected on the individuals’ rights and freedoms. Also, it has concluded that the administration shall monitor the procedures issued thereby to response to the pandemic to prevent its assault on individuals’ rights and freedoms. As well as, the study recommended that these control procedures shall be limited in the epidemiological and health situation and not exceeded the limits of this Epidemiological circumstanc

Magnetic and Optical properties of strained films of multiferroic GdMnO3

The effects of strain on a film of mulitferroic GdMnO3 are investigated using both magnetometry and magneto-optic spectroscopy. Optical spectra, in the energy range 1.5eV - 3.5eV, were taken in Faraday geometry in an applied magnetic field and also at remanence. This yielded rich information on the effects of strain on the spin ordering in these films. Epitaxial films of GdMnO3 were grown on SrTiO3 and LaAlO3 substrates. The LaAlO3 was twinned and so produced a highly strained film whereas the strain was less for the film grown on SrTiO3. The Ne\'el temperatures and coercive fields were measured using zero field data and hysteresis loops obtained using a SQUID magnetometer. Optical absorption data agreed with earlier work on bulk materials. The two well known features in the optical spectrum, the charge transfer transition between Mn d states at ~2eV and the band edge transition from the oxygen p band to the d states at ~3eV are observed in the magnetic circular dichroism; however they behaved very differently both as a function of magnetic field and temperature. This is interpreted in terms of the magnetic ordering of the Mn spins.Comment: 9 pages of text including figure

Pilot study of DNA extraction from archival unstained bone marrow slides: comparison of three rapid methods

DNA can be isolated from a variety of human sample sources including anti-coagulant whole blood, bloodstains, hairs, tissue samples and buccal epithelial cells. The purpose of this study was to compare yield and quality of DNA samples obtained with the use of three different methods. The ability of these procedures to provide DNA for polymerase chain reaction (PCR) amplification from archival unstained bone marrow slides was tested on 35 different patients’ slides. Boiling in distilled water (A), proteinase K/Tween 35 method coupled with simplified phenol/chloroform isoamyl alcohol protocol (B) and modified commercial nucleon extraction and purification protocol (C, Amersham Life Science) gave extraction efficiencies of 57, 74 and 100% respectively. Our results demonstrate that rough DNA extraction methods have decreased efficiencies compared to complete DNA extraction protocols and that the latter are required to ensure highly reproducible results from archival unstained bone marrow slides.Key words: DNA, polymerase chain reaction, bone marrow slides, reagent ki

The Regenerative Effect of Intra-Articular Injection of Autologous Fat Micro-Graft in Treatment of Chronic Knee Osteoarthritis

Osteoarthritis (OA) is one of the most prevalent conditions resulting to disability particularly in elderly population About 13% of women and 10% of men aged 60 years and older have symptomatic knee OA. The proportions of people affected with symptomatic knee OA is likely to increase due to the aging of the population and the rate of obesity or overweight in the general population. There are multiple factors associated with this progressive disease such as obesity, female gender, and repetitive trauma. Pain is the most common symptom in knee OA, a leading cause of chronic disability, clinical diagnosis will be supported by certain radiological findings. There are numerous conservative therapies that help to relive symptoms depend on severity of Osteoarthritis, and knee replacement remains standard of care in advance disease. Fat Micrografting is evolving technique with promising result in selected patients with regenerative and reparative effect of adipocyte-derived stem cell toward damaged cartilage and bone, which supported by clinical evidence

Fibrous dysplasia and aneurysmal bone cyst of the skull base presenting with blindness: a report of a rare locally aggressive example

Fibrous dysplasia (FD) and aneurysmal bone cyst (ABC) are uncommon benign intraosseous lesions. Simultaneous occurrence of both lesions is extremely rare. We present an example of concomitant FD and ABC in a 7 year-old with left eye blindness and discharge of one month duration. Physical examination revealed a proptotic left eye and bulging of the hard palate. CT and MRI are consistent with FD and ABC that involved the sphenoid and ethmoidal bones bilaterally. Incomplete combined endonasalcranial resection was performed. The patient presented five months postoperatively with a large recurrence and subsequent follow up was lost. Concomitant FD with ABC may occur in paranasal sinuses and may develop rapidly and exhibit locally aggressive behavior

Developing a Model Based on the Radial Basis Function to Predict the Compressive Strength of Concrete Containing Fly Ash

A supplemental pozzolanic material such as fly ash may result in a reduction in the concrete’s adverse environmental effect by reducing the discharge of carbon dioxide throughout the cement production procedure. This pozzolanic material also enhances the mechanical characteristics as well as the durability of concrete material. Considering the boundless passion for utilizing fly ash and conducting extensive research studies, the extent to which this supplement can be added to concrete has a limitation equal to almost one-third of cement material’s weight. In the current study, a model based on the Radial Basis Function (RBF) is developed to estimate the compressive strength of concrete containing various amounts of fly ash at any arbitrary age. Having parameters used as inputs in ANN modeling such as concrete additives and characteristics of fly ash, the output was compressive strength. It was concluded that the estimated results agree well with the experimental measurements with an MSE of 0.0012 for the compressive strength. Simple and practical equations are proposed to present a simple means to determine the compressive strength of fly ash-based concrete