SARS-CoV-2 infection and phylogenetic analysis with the risk factors in human body alongside the pulmonary effects and medication
Published on: 6th November, 2020
OCLC Number/Unique Identifier: 8698222103
Related the extremely transmittable abilities of SARS-CoV-2,a harmonious virus to the bat CoV, gets transmitted by three principal processes-- the inhalation of droplets from the SARS-CoV-2 infected person, contacting to the person, and by the surfaces and materials defiled with the virus. Whereupon bat Coronavirus is mostly like the pandemic causing virus SARS-CoV-2, bats are often deliberated and figured out as a possible primary host although no intermediate has not been defined yet in the wherewithal of transmission. The Spike Glycoprotein plays an important role in the case of penetration with the assistance of the ACE2 receptor and the Receptor Binding Domain. In the human body, infiltrating the nucleic acid into host cells, SARS-CoV-2 attacks one cell and one by one into the whole human body; therefore, infected cases are found symptomatic and asymptomatic considering the immune power. Patients with cardiovascular disease or diabetes proceed with their treatment with ACE2 often; therefore, there might be a high chance of getting infected. Whereas the SARS-CoV-2 infects the blood and then lungs, Antigens improvement can be better in order to avoid high-complicated effects. Currently, no vaccination or no accurate cure and treatment has not been defined. An explanation with analysis on SARS-CoV-2 has been performed from the aspect of virology, immunology and molecular biology. Several relevant figures have been included hereby in order to a better understanding of the very concept.
Laparoscopic-Assisted Transumbilical Extracorporeal Resection of Meckel’s Diverticulum in 10 years old boy with symptoms of gastrointestinal bleeding
Published on: 20th April, 2020
OCLC Number/Unique Identifier: 8587366913
The Meckel’s diverticulum (MD) is the most common anomaly of ductus omphaloentericus that surgeon encounters in clinical practice. The accurate incidence is unknown because most patients with the Meckel’s diverticulum are asymptomatic. Most studies report an incidence of about 2%. Approximately 4% of patients with the Meckel’s diverticulum become symptomatic.
A 10 years old boy, was sent from regional hospital. His symptoms started the day before he was hospitalized and represented as gastrointestinal bleeding, lower abdominal pain and four times vomiting, without fever. Ultrasound and X-ray of the abdomen were normal. Blood findings showed: RBC 3,19, hemoglobin 0,95, hematocrit 0,27. During a physical examination abdomen was palpatory soft, with no presence of the pain. Digital rectal examination showed blood. A scintigraphy pathologic scan showed a focal lesion of the right hemi abdomen consistent with the Meckel’s diverticulum.Patient was treated byLaparoscopic-Assisted Transumbilical Extracorporeal Resection of the Meckel’s Diverticulum.
Trichomonas Vaginalis-A Clinical Image
Published on: 21st July, 2017
OCLC Number/Unique Identifier: 7317592100
A 32-year-old G4P301LC3 woman presents to the office for a visit, with a 6-day history of vaginal discharge with an unpleasant odor. On speculum examination, the discharge was green in color and frothy in appearance. Is noticed vulvar erythema, edema, and pruritus, also is noted the characteristic erythematous, punctate epithelial papillae or “strawberry” appearance of the cervix. Vaginal pH was 6.2. Diagnosis of Trichomonas vaginalis is made via wet prep microscopic examination of vaginal swabs.But also, for diagnosis help even the exam with the speculum, concretely “strawberry” appearance of the cervix. The diagnosis is confirmed by culture.Trichomoniasis is a sexually transmitted infection [1,2], that caused by trichomonas vaginalis. Trichomonas vaginalis is a unicellular, anaerobic flagellated protozoan, that inhabits the lower genitourinary tracts of women and men, but that can cause vaginitis. Clinical findings of Trichomonas vaginalis include a profuse discharge with an unpleasant odor. The discharge may be yellow, gray, or green in color and may be frothy in appearance. Vaginal pH is in the 6 to 7.Vulvar erythema, edema, and pruritus can also be noted. The characteristic erythematous, punctate epithelial papillae or “strawberry” appearance of the cervix is apparent in only 10% of cases. Symptoms are usually worse immediately after menses because of the transient increase in vaginal pH at that time. Diagnosis of Trichomonas vaginalis is made via wet prep microscopic examination of vaginal swabs. Other, more sensitive tests are available, including nucleic acid probe study and immunochromatographic capillary flow dipstick technology. The diagnosis can be confirmed when necessary with culture, which is the most sensitive and specific study. Nucleic acid amplification tests (NAATs) have replaced culture as the gold standard. T vaginalis NAATs have been validated in asymptomatic and symptomatic women and are a highly sensitive test [3]. Because the Trichomonas vaginalis is a sexually transmitted infection, both partners should be treated to prevent reinfection. The mainstay of treatment for Trichomonas vaginalis infections is metronidazole. Treatment schemes can be:
Gastric Mucosal Calcinosis
Published on: 27th September, 2017
OCLC Number/Unique Identifier: 7317601908
Gastric mucosal calcinosis is a very rare pathology of the gastric mucosa. It may develop secondary to several diseases but may also be idiopathic in some cases. In this case, gastric mucosal calcinosis was diagnosed with endoscopic biopsy performed for a patient who presented to our clinic with heartburn and abdominal discomfort. This case involves a very rare gastric pathology, and is being studied here with reference to literature data.
Atypical Ductal Hyperplasia: Factors predicting upstaging to carcinoma
Published on: 6th July, 2020
OCLC Number/Unique Identifier: 8633817372
Aim: Percutaneous core needle biopsy (CNB) is considered the gold standard technique for initial histological diagnosis of suspicious breast lesions seen on screening mammogram, but it is less reliable for diagnosing atypical ductal hyperplasia (ADH) due to significant rates of diagnosis upstaging to malignant disease after excision biopsy. The purpose of this study was to identify factors that predict diagnosis upstage to carcinoma in patients diagnosed with ADH on core biopsy.
Methods: A retrospective database search identified 52 consecutive CNB of suspicious breast lesions revealing pure ADH. Inclusion criteria included asymptomatic women presenting for screening mammogram, who subsequently underwent surgical excision. Logistic regression analysis evaluated clinical, radiological, and histological factors.
Results: A total of 52 patients with ADH on CNB were identified who met our criteria. Twenty-six of 52 patients (50%) were upstaged to ductal carcinoma in situ or invasive carcinoma, based on histological interpretation of the surgically excised specimen. Lesion size was showed to be a statistically significant predictor on univariable logistic regression analysis. Multivariate logistic regression analysis revealed Asian ethnicity and lesion size as independent predictors of malignancy (p = 0.050 and 0.011, respectively). Conversely, women of Middle Eastern and European origin and lesions < 15 mm on mammography were negative predictors of malignancy.
Conclusion: Lesion size ≥ 15 mm on mammography and Asian ethnicity are independent risk factors for breast carcinoma in asymptomatic patients diagnosed with ADH on CNB.
Giant Lipoma Anterior Neck: A case report
Published on: 14th December, 2017
OCLC Number/Unique Identifier: 8465495935
Lipoma is a benign mesenchymal tumor with a thirteen percent incidence in head and neck region. Posterior triangle is the most common location while anterior neck lipoma is a rare one. Giant lipomas >10cm have been reported in different parts of the body but rarely in the anterior neck. Giant lipomas of the neck can present as a cosmetic disfigurement or can produce pressure symptoms. Most lipomas do not pose any difficulty in diagnosis. Surgical excision remains the treatment of choice. We here present a case of giant anterior neck lipoma.
Catamenial pneumothorax: Presentation of an uncommon Pathology
Published on: 20th December, 2017
OCLC Number/Unique Identifier: 7317596988
The catamenial pneumothorax is defined as the accumulation of air in the pleural cavity that appears in women infrequently and spontaneously with various clinical presentations. Actually, it is considered as an extremely rare entity with few cases described in the literature, that is the reason why the etiology is still discussed. However, a strong association with thoracic endometriosis syndrome has been found. We want to emphasize how the importance of conducting a diagnosis and having a timely management would improve the quality of life of the patient and give a better prognosis of the disease. Thus, a case report of a 38-year-old female patient who was receiving hormone therapy as a treatment for abdominal endometriosis and repetitive pneumothorax was presented. In the video-assisted thoracoscopy we saw diaphragmatic lesions and pneumothorax during the perioperative and postoperative period. Emphasize the importance of a detailed inspection of each intrathoracic organ during the surgical procedure, we also showed how the intraoperative pleurodesis, the placement of a mesh on the diaphragm and the continuity of the hormonal treatment, seems to be an effective therapy to prevent recurrences and have a better control of the disease.
Acute necrotising pancreatitis masquerading as psoas abscess: A report of two cases
Published on: 15th July, 2020
Acute pancreatitis is commonly diagnosed clinically, with its classical presentation of upper abdominal pain, backed by raised serum levels of enzymes amylase and lipase. However, unusual presentation of this common surgical emergency as a psoas abscess is a rare finding which can lead to missed diagnosis with a fatal outcome.
We present here two such cases of acute necrotising pancreatitis masquerading as psoas abscess, with no classical clinical symptoms and only mildly raised levels of serum amylase and lipase. The region of pancreas involved by necrosis influenced the site of presentation of the psoas abscess. In the first case, acute necrotising pancreatitis involving head and neck of pancreas presented as psoas abscess presenting in the right lumbar region, while the left side collection due to pancreatitis involving body and tail of pancreas manifested as an abscess in left flank.
While evaluating the aetiology of a psoas abscess, a differential diagnosis of necrotizing pancreatitis should be kept as a possibility.
Kinematics and Electromyographic Analysis of Gait with Different Footwear
Published on: 24th January, 2017
OCLC Number/Unique Identifier: 7317654943
Kinematic analysis and surface electromyography are tools being used as important methods to evaluate the human gait and to analyze different types of footwear aiming modifications and adaptations to the human locomotor system, especially of the feet. The aim of the present study was to analyze through electromyography (EMG) the muscles tibialis anterior (TA) and gastrocnemius lateralis (GL) and gastrocnemius medialis (GM) and to capture digital images of the human gait in four different footware situations, barefoot with tennis, platform shoes and high heels. Twenty healthy women with a mean age of 22.6 years took part in this experiment, which was performed on a treadmill at a speed of 3.8 m/s. The results showed that shoes that do not allow a normal movement of the tarsal bones caused changes in the trajectory of the gait, which promotes a greater muscular movement. This study concluded that shoes closer to a normal position and allow greater mobility of the feet, decrease muscular demands, which in everyday situations cause less localized muscular fatigue.
A rare case: Congenital Megalourethra in prune belly syndrome
Published on: 30th January, 2018
OCLC Number/Unique Identifier: 7355941035
Introduction: Prune Belly syndrome is a disease characterized by abdominal muscle defect, bilateral cryptorchidsim and urinary system anomalies (reflux megaureter, hydronephrosis, etc.). Pulmonary, cardiac, and gastrointestinal anomalies may also be present. Management of these rare cases is very important. In this case, the clinical course of a patient with Prune Belly syndrome with megaurethra is presented.
Case: The patient from the first gestation and parturition with birth weight of 2500 g and 38 weeks was hospitalized because of the bilateral hydronephrosis. His physical examination revealed undescended testicles and a large penis. The abdominal muscles were not very atrophic. The size of the kidney was small, bilateral hydroureteronephrosis and wide posterior urethra on the ultrasound. Renal function tests were progressively disturbed and the patient underwent cystourethroscopy for diagnostic purposes in terms of posterior urethral valve. A large diverticulum was found in anterior urethra. Prune Belly Syndrome was thought because the orifices were in appearance of reflux. The vesicostomy was applied. After vesicostomy the renal function tests got better but he was hospitalized due to urosepsis two times. In cystoscopic examination, the diverticulum in the urethra was filled with urine and the drainage was very slow. Phimosis was opened with dorsal slit technique. Cutaneous urethrostomy was proximal to the anterior diverticulum.
Conclusion: Prune Belly syndrome should be considered in patients with megaurethra and postrenal or renal insufficiency although there are no obvious clinical findings. In Prune Belly cases, via a large penis with obstruction signs, anterior urethral diverticulum should be considered.
Trauma to the neck: Manifestation of injuries outside the original zone of injury-A case report
Published on: 6th February, 2018
OCLC Number/Unique Identifier: 7355942994
A 53-year-old male presented to the Emergency Department (ED) with multisystem trauma and respiratory distress following a blunt-force injury to his anterior left neck. CT imaging showed extensive subcutaneous emphysema and pneumomediastinum. A chest X-ray showed elevation of the left hemidiaphragm suggesting phrenic nerve injury which was confirmed by bedside ultrasonographic examination of the left hemidiaphragm. Flexible bronchoscopy demonstrated tracheal rupture. The patient was treated supportively and recovered without surgical treatment. Trauma-induced hemidiaphragmatic paralysis is rarely reported. This case represents a clinical scenario with demonstrable anatomic correlations, and a clinical reminder that phrenic nerve injury should be included in the differential diagnosis of respiratory distress in a trauma patient.
Sense and antisense Oligodeoxynucleotides to Glun1 Nmdar are Cognitive Enhancers (Nootropics) and protective agents in normal and ischemic (Anoxic) conditions-In vitro study
Published on: 7th July, 2017
OCLC Number/Unique Identifier: 7317653967
Aims: Implication of modified N-methyl-D-aspartate receptors (NMDAR) in synaptic plasticity and learning was investigated in normal and pathological conditions.
Study design: We studied the efficiency of synaptic plasticity, the development of the long-term potentiation/depression (LTP/LTD) in olfactory cortex slices, treated with antisense or sense oligodeoxynucleotides (aODNs and sODNs) to the GluN1 subunit of NMDAR.
Main outcome: aODNs induced the LTD development in slices after high-frequency tetanization. Contrariwise, in sliced treated with sODNs the enhanced LTP developed. Under conditions of severe anoxia (10 min), treatment of slices with aODNs and sODNs contributed to the preservation of synaptic activity which has been blocked in the control untreated slices. In practical implications such directed up- and down regulation of NMDAR might be useful in the readjustment of brain activity by the controlling balance of excitation/inhibition.
Meige Trofoedema: A form of primary lymphedema
Published on: 24th April, 2018
OCLC Number/Unique Identifier: 7666332267
The lymphatic system consists of small non-contractile lymph vessels which collect fluid from the interstitial space and carry it to the major contractile lymphatic vessels with valves that maintain a unidirectional flow to the lymph nodes and is responsible for returning proteins, lipids and water from the interstitium to the venous system near the junction of the subclavian vein and internal jugular vein on both sides. Lymphedema would be the result of the failure of transport with the further accumulation of fluid rich in protein at the interstitium, especially in limbs.
Primary lymphedema, which affects 1.15 / 100000 children (especially pre-pubescent girls), not always clinically evident at birth, is a genetic disorder that represents many different subsets of phenotypes: congenital or congenital lymphangiectasia, congenital trofoedema family or Meige, congenital amniotic band and essence or idiopathic.
The most common form of presentation is due to congenital absence or abnormality of the lymphatic tissue caused by a genetic mutation of the genes responsible for the development of lymphatic vessels that is characterized by the difficulty of draining lymph vessels. This genetic alteration may be sporadic or inherited.
When conservative treatment in trachea laserations?
Published on: 21st July, 2020
OCLC Number/Unique Identifier: 8639105303
Introduction: The tracheobronchial injuries are usually fatal and some of the lucky people can reach emergency services without dying in the place of trauma. They can cause severe symptoms which can be lifetreathing. This type of injuries must been taken carefully and need to decide fast what treatment you going to give.
Case report: We present a 53 years old patient who has been stabbed during a fight and got his trachea ruptured. His complaints shortness of breath and neck swelling. He can be treated conservatively with bronchoscopic and clinical evaluation.
Discussion: Tracheobronchial injuries are life-threatening and the airway must be secured first. They can be treated conservatively in some cases. CT can be useful but fiberoptic bronchoscopy is the key in diagnosis.
Conclusion: Although early treatment of tracheal lacerations is urgent surgery, it is reported that these injuries can be treated with conservative methods under appropriate conditions.
Nano-formulations for Ophthalmic Treatments
Published on: 29th December, 2017
OCLC Number/Unique Identifier: 7325061328
Ocular disorders encompass a multitude of diseases that are unique in their cause, therapy and degree of severity. Due to distinctive morphology of the eye, efficient ocular drug delivery has proven to be a difficult task. Current treatments of ophthalmological diseases include the usage of both intrusive as well as nonintrusive methods such as injections, eye drops, ointments, gels etc. The current state of the art drug delivery methods are associated with low bioavailability and therefore nanotechnology based drug delivery approached are evolving as for improving the therapeutic index of currently used drugs against variety of ocular disorders. This review highlights the recent developments in nano-formulations for ophthalmic treatment and also offers discussions towards the future prospectus of nano-formulations in the mainstream of ophthalmic diseases.
Brooke-Spiegler Syndrome: A rare cause of skin appendageal tumor
Published on: 1st November, 2018
OCLC Number/Unique Identifier: 7912402820
A 51-year-old women presented with asymptomatic multiple polypoidal nodules over scalp with simultaneous papularnodular skin eruptions involving nose, nasolabial folds and forehead for 40 years duration. Her daughter also noted to be having multiple papularnodular skin eruptions involving nose, nasolabial folds and forehead which raised curiosity of possible familial condition. The punch biopsy of polypoidal nodule indicating histological evidence of spiradenoma was favour in diagnosis of Brook Spienger Syndrome. We report this case as this is a rare clinical entity.
Anticipation of difficulty during laparoscopic cholecystectomy
Published on: 24th July, 2020
OCLC Number/Unique Identifier: 8639116784
Background: Laparoscopic cholecystectomy (LC), is one of the most commonly performed surgical procedures worldwide, it is accepted as the gold standard in the treatment of symptomatic gallstones for its minimal invasiveness, less pain and early recovery.
Purpose: To predict the difficulty of laparoscopic cholecystectomy in patients according to the recently published scoring system and select the difficult cases to be done by a senior surgeon.
Patients: This is a prospective cohort study. This study took place Oct 6th University Hospital and Kasr El Aini Hospital, Cairo university; the study involved 120 patients admitted with calcular cholecystitis, arranged for laparoscopic cholecystectomy.
Methods: Laparoscopic cholecystectomy after applying the scoring system.
Results: In our study we found that age, sex and ultrasonographic data were significant predictive factors for assessment preoperatively difficult cases that will be operated upon. We found 14 patients above 50 years who scored to be difficult and very difficult were at outcome difficult, only three patients converted to open surgery over fifty.
Conclusion: We can report that obese patient who were over fifty with history of previous upper abdominal surgery and ultrasonographic picture showed thick walled GB and pericholecystic collection had high risk of conversion. At this study scoring system was used for prediction of difficult laparoscopic cholecystectomy sensitivity was 93.75% and specificity was 52.94% of the scoring system at score 5 for prediction of easy or difficult laparoscopic cholecystectomy.
Diazepam Withdrawal Expression is related to Hippocampal NOS-1 Upregulation
Published on: 8th January, 2018
OCLC Number/Unique Identifier: 7325438145
Background: Benzodiazepines are usually prescribed for anxiety and sleep disorders in a long-term fashion that may cause drug dependence. Discontinuation after prolonged administration may lead to withdrawal expression, being anxiety the most predominant sign. It has been described that a context-dependent associative learning process underlies diazepam dependence. Nitric oxide is a crucial player in learning and memory processes, hippocampal transmission, as well as in benzodiazepines withdrawal. Considering that previous results from our laboratory showed an increase in hippocampal functional plasticity only in diazepam dependent rats, the aim of the present investigation is to determine whether diazepam dependence could alter neuronal nitric oxide synthase enzyme (NOS-1) expression within the hippocampus, by using western blot.
Results: chronic diazepam-treated animals that developed dependence showed increase in NOS-1 expression in dorsal, but not in ventral hippocampus, while no-dependent or control animals presented similar NOS-1 protein levels.
Conclusion: withdrawal from long-term diazepam exposure could be associated to increased nitric oxide neurotransmission within dorsal hippocampus induced by NOS-1 over-expression. This mechanism could underlie the improved hippocampal synaptic transmission previously observed in diazepam withdrawn animals. Confirmatory experiments need to be addressed to determine the mechanisms by which nitric oxide participates in benzodiazepines withdrawal in order find new molecular targets to develop pharmacological tools to prevent the withdrawal syndrome
Preparation, solid state characterization and evaluation of ketoprofen-glucosamine HCl solid dispersions
Published on: 26th June, 2018
OCLC Number/Unique Identifier: 7815007894
In this investigation, solid dispersions were prepared and characterized to improve the solubility and dissolution of poorly water soluble drug Ketoprofen, using glucosamine HCl as a carrier. For the improvement of the solubility and dissolution rate of poorly water soluble drugs different techniques are used such as solubilization, salt formation, particle size reduction and solid dispersion etc, but in the present study, solid dispersions (SDs) of poorly water soluble NSAID Ketoprofen were prepared to improve its solubility and dissolution rate, using solvent evaporation method with drug-carrier ratio of 1:1, 1:2 and 1:3. Our results indicate that all solid dispersions of Ketoprofen and Glucosamine HCl exhibited more enhancements in solubility and dissolution rates than corresponding physical mixtures. The DSC thermograms and X-ray diffraction patterns showed a slight reduction in crystallinity in solid dispersions which were further verified by FT-IR and SEM. It is concluded that solid dispersion is an effective technique for enhancing the solubility and dissolution rate of poorly water-soluble drug Ketoprofen using Glucosamine HCl as a carrier. This amino sugar (Glucosamine HCl) could be used as a novel potential carrier for preparation and formulation of SDs and would have potential commercial benefits.
Leakage after sleeve gastrectomy: Endoscopic stenting VS surgical intervention
Published on: 24th July, 2020
OCLC Number/Unique Identifier: 8639114108
Background: Laparoscopic sleeve gastrectomy (LSG) is becoming more popular in the treatment of obesity. LSG is safe with a low morbidity. The complications rarely result in morbidity and even mortality. Leaks are the major complication associated with LSG with a reported prevalence between 1.9% and 2.4%.
Objective: To compare surgical intervention and endoscopic stenting for treatment of gastric leakage after sleeve gastrectomy.
Patients and method: Our study included 30 patients presented with post sleeve leaks discovered by routine postoperative imaging or during the follow up period. Patients were recruited from October 6th university hospital during the period from August 2017 to August 2019. Patients were divided to the following groups: 1) Endoscopy group: This included 15 patients with post sleeve leakage undergoing endoscopic stent insertion. 2) Surgery group: which included 15 patients with post sleeve leak age undergoing surgical management. This division was random.
Results: Our study showed that Endoscopic stenting for management of post sleeve gastrectomy leakage is an effective method with lower morbidity and shorter post-operative hospital stay than surgical management. Some patients may be good candidates for early surgical intervention in type 1 leakage if managed early before dissemination of leakage and before tissues become friable. Complications of stents include stent migration (26%), stent related ulcer (13%) and stricture (13%). while the surgical intervention carries more complications (DVT, chest infection, wound infection and stricture) and longer postoperative hospital stay.
Conclusion: endoscopic management of post-sleeve gastrectomy leakage with stenting is recommended because it successfully manages the leaks and avoids invasive procedures with less risk, with shorter hospital stay and early return of function.
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