Histopathological pattern of gynaecological malignancies: National Health Laboratory (NHL), Sudan

Gynaecological malignancies (GM) is a common cancer problem in both developing and developed countries .The burden of GM is more critical in developing countries, this is due to lack or deficient screening and late clinical presentation. The aim of this study is to study the histopathological pattern of GM in the NHL (National Health Laboratory) Sudan. Material &Methods: Clinical data, histopathological reports, stained tissue slides of patients diagnosed histologically as GM were revised from the archive of the department of histopathology and cytology at the NHL .Results: 372 patients diagnosed histologically as GM from 1st Jan 2009-31st Dec to the 1st Jan 2013 were studied. The commonest GM histological type was cervical malignancies, followed by ovarian, endometrial, vaginal, vulvar, choriocarcinoma and tubal cancer respectively .Conclusion: There is an urgent need for screening, early detection and prompt management for GM.Keywords: ,

Prevalence of Metallo-β-Lactamase producing Pseudomonas aeruginosa in wound infections in Duhok city, Iraq

Background: Pseudomonas aeruginosa is common pathogen causing nosocomial infection. Acquired drug resistance and Metallo-β-lactamases (MBL) production have recently emerged as one of the most worrisome resistance mechanism that hydrolyze all beta-lactam antibiotics including penicillins, cephalosporins and carbapenems, with the exception of aztreonam. The aim was to find out the prevalence of multi drug resistant (MDR) and Metallo-β-lactamase (MBL) positive isolates of P. aeruginosa in wounds samples which are a serious concern.Methods: Pseudomonas aeruginosa strains were obtained by standard isolation and identification techniques from 307 wound samples of hospital. Strains were then subjected to susceptibility testing for anti-pseudomonas drugs as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Carbapenems resistant strains were selected for the detection of MBL enzyme production by disc potentiation test. Production of MBL was confirmed by enhancement of inhibition zone around imipenem and meropenem discs impregnated with EDTA, as compared to discs without EDTA.Results: Amongst the 71 isolates of P. aeruginosa, 62(87.3%) isolate were imipenem-sensitive, while 9(12.7%) isolates were found to be imipenem resistant and MBL producers. Very high resistance to antibiotics was recorded amongst MBL producers’ P. aeruginosa compared with non-MBL imipenem-sensitive strains.Conclusion: Study indicates that, surveillance for the detection of MBL is necessary. The rapid dissemination of MBL producers is worrisome and necessitates the implementation of proper and judicious selection of antibiotics especially carbapenem.

Distribution of Extended Spectrum Β-Lactamase Genes among Proteus Mirabilis Isolated From Clinical Specimens in Duhok City, Kurdistan Region, Iraq

Extended Spectrum Beta Lactamase-among Proteus mirabilis strains recorded high incidence leaving few therapeutic options of potential infections. The purpose of current study was to assess the prevalence of antibiotic resistance among Extended Spectrum Beta-Lactamases (ESBL) producing P. mirabilis, in addition to molecular characterization of the ESBL gene-types using PCR. All isolates were fully identified, checked for antibiotic susceptibility and ESBL production using double disk synergy phenotypic method. Positive ESBL-producing isolates were subjected to PCR assay using specific primers for detection of CTX-M, TEM, and SHV genes. The majority of the isolates exhibited absolute susceptibility (100%) to both meropenem and ertapenem and high susceptibility (95%) to imipenem, while co-resistance were expressed toward cefotaxime, ceftazidime, ceftriaxone and other non-lactam antibiotics. Out of 37 isolates, 21(57%) were ESBL-producers and using a double-disc synergy test (DDST). Using molecular-based PCR, CTX-M (81%), TEM (57%) and SHV (24%) were determined among ESBL-positive. CTX-M was predominant and circulating among phenotypic multiple resistant strains. Moreover, the coexistence of CTX-M and TEM gene was a more frequent combination. The study highlighted the increasing levels of low antibiotic susceptibility among P. mirabilis harbored ESBL genes at Duhok city and also confirms that a high level of blaCTX-M-positive ESBL isolates is circulating in this area

Acute spontaneous spinal subdural hematoma: A case report

BACKGROUND: Spontaneous spinal subdural hematoma is a rare condition that can lead to devastating neurologic deficits, usually caused by coagulation abnormalities, trauma, underlying neoplasm, or arteriovenous malformation. The patient presents with local and/or radicular pain, followed by loss of sensory, motor, bladder, and bowel function. CASE REPORT: A 25-year-old patient presented with left-sided weakness preceded by nontraumatic upper back pain. He denied any past medical illness and being on any regular medications. He had decreased strength in the left lower limb, left upper limb, and right lower limb, with intact strength in the right upper limb. The patient exhibited decreased sensation of pain and touch on the right side of the lower limb, bilateral loss of proprioception, and intact reflexes and anal tone. He had weakness on the left side of the body and contralateral decreased sensation of pain and touch on the right side. These symptoms were suggestive of Brown-Séquard syndrome, while the bilateral loss of proprioception suggested posterior cord syndrome. Magnetic resonance imaging showed an acute spinal subdural canal hematoma producing cord compression. The patient had an urgent laminectomy and hematoma evacuation. Afterward, his neurological function improved. CONCLUSIONS: Spontaneous spinal subdural hematoma can occur without any known pathology or remarkable trauma. It can compress the spinal cord and produce cerebral stroke-like symptoms. Hence, spinal hematoma should be ruled out in any patient presenting with a neurological deficit.Scopu

A practical guide to managing hypertension, hyperlipidemia, and hyperglycemia in patients with chronic myeloid leukemia

Tyrosine kinase inhibitors (TKIs) have significantly improved the prognosis of chronic myeloid leukemia (CML) since their approval. Although safe in general, TKIs carry concerns about cardiovascular adverse events. Hypertension, diabetes, and dyslipidemia are among the most common baseline comorbidities among CML patients. Guidelines for the management of the existing comorbidities or those related to TKI therapy are lacking. This paper will review hypertension, hyperglycemia and hyperlipidemia reported in CML patients or associated with TKI therapy and then propose a simple guide on their management

Ionizing Radiation Leakage in Radio-Diagnostic Centers at Gaza Strip Hospitals, Palestine

The fact of using radiation in medicine has led to major improvements in the diagnostic and treatment of human diseases. However, it carries some risks of health problems. In Gaza governorates hospitals, there is tremendous development has taken place in the radio-diagnostic field and there is no clear radiation protection program, lack of clear information about radiation protection measures and guidelines. The objective of this study was an assessment whether yearly equivalent radiation dose received by the radio-diagnostic workers and public in governmental Gaza governorates hospitals are within the dose limits recommended by ICRP or not. The study was carried out in nine governmental hospitals. The hospitals were selected because of their large and diverse of their radio-diagnostic services. The radiation survey meter (OD-01) was used to measure radiation leakage. Data sheet was also used to elicit information about the radio-diagnostic rooms and machines specifications. The results indicate that the fluoroscopy and CT scan rooms were not efficiently lead lined and the radiation protection is not well organized. The measured values of radiation dose rate at different locations in basic X-ray and mammography rooms are found within a permissible limits for occupational stuff and public. However, the recommended distance between the X-ray machine and control panel have not been achieved in some rooms. Therefore, there is a desperate need for rules, regulations and radiation protection act in the field of radiation in medical field

Radiation Protection Measures in Radio-Diagnostic Centers in Gaza Hospitals, Palestine

Whereas radio-diagnostic centers have potential to present hazardous effects due of ionizing radiation. Radio-diagnostic workers awareness, practices regarding radiation protection issues, availability of radiation protection devices and effective personal radiation exposure monitoring process has an important role to safe working in these places. We carried out this study in nine governmental Gaza governorates hospitals. The study instrument was close-ended structured questionnaire consists of five parts. 182 radio-diagnostic workers participated in the work. Based on the obtained data, the participants reported that 35.2% of personal radiation protection devices are available in the radio-diagnostic centers at governmental Gaza governorates hospitals. In spite the fact that 74.8% of participants have awareness about radiation protection issues, but it is only about 53.4% of participants follows the radiation protection practices. There is an obvious poor of personal radiation exposure monitoring process. Conclusively, the results represented in this work reflect that majority of participants believe there is no radiation safety officer to provide the service. Therefore, there is a desperate need for rules, regulations and radiation protection act in the field of radiation in medical field

Multi-Layer Perceptron (MLP)-Based Nonlinear Auto-Regressive with Exogenous Inputs (NARX) Stock Forecasting Model

The prediction of stocks in the stock market is important in investment as it would help the investor to time buy and sell transactions to maximize profits. In this paper, a Multi-Layer Perceptron (MLP)-based Nonlinear Auto-Regressive with Exogenous Inputs (NARX) model was used to predict the prices of the Apple Inc. weekly stock prices over a time horizon of 1995 to 2013. The NARX model belongs is a system identification model that constructs a mathematical model from the dynamic input/output readings of the system, and predicts the future behaviour of the system based on the constructed mathematical model. The One Step Ahead (OSA) and correlation tests were used to test validate the model. Results demonstrate the predictive ability of the model while producing Gaussian residuals (indicating the validity of the model)

Dual-Band Bandpass Filter with Dumbbell Shaped Defective Ground Structure

A dumbbell shaped defective ground structure (DGS) is implemented to improve the performance of an existing dual-band bandpass filter topology. The filter design is based on parallel-coupled lines connected to matched transmission lines. Various positions and dimensions of dumbbell DGSs are implemented and their effects on the filter performance are investigated. It is found that the utilisation of dumbbell shaped DGSs in this topology improve the steepness of the responses for the first and second passbands with centre frequencies of 1.365 and 2.932 GHz respectively. The optimised dimensions of the DGS are 5 x 5 mm2 for both its rectangular slots connected by a 0.5 mm narrow slot width. The optimised positions of the DGSs are located at the centre and the edges of the parallel-coupled lines. The simulated and measured results of the filter are analysed and discussed in this paper