Acute monoarticular hip joint pseudogout masquerading as septic arthritis.

Monoarticular pseudogout of the hip joint is rare and to the best of our knowledge only four other cases exist in the literature. We present a case of primary monoarticular pseudogout affecting the right hip in a patient in his 50s. The diagnosis was confirmed through ultrasound-guided synovial fluid aspiration and crystal analysis. The patient was treated conservatively with analgesia and after hip joint aspiration resulted in dramatic symptomatic resolution. Acute attack of pseudogout is a rare cause of acute hip pain. The clinical features may mimic hip joint septic arthritis and should be considered in the differential diagnosis of any presentation of acute joint pain. Diagnosis is important to avoid unnecessary medical and surgical intervention reducing hospital stay.

Clinicopathological Value Of Epidermal Growth Factor Receptor (EGFR) And Ki-67 Expression In Colorectal Adenoma And Adenocarcinoma.

Objectives: To evaluate epidermal growth factor receptor and Ki-67 immunohistochemical expression in colorectal adenoma and carcinoma cases, and to relate their expression with the available clinicopathological data. Method: The retrospective study was conducted at the Faculty of Medicine, Kafrelsheikh University, Egypt, from September 2019 to October 2020, and comprised formalin-fixed and paraffin-embedded specimens related to cases of colorectal adenoma and those of colorectal carcinoma, who had no previous radiation or chemotherapeutic treatment. Immunohistochemical staining of all thecases was done using anti-epidermal growth factor receptor and anti-Ki-67 antibodies. Data was analysed using SPSS 20. RESULTS: Of the 70 cases, 20(28.5%) were of colorectal adenoma; mean age 52.95±13.47 years, and male-to-female ratio 1:1. The remaining 50(71.5%) cases had colorectal carcinoma; mean age 51.08±13.49 years, and male-to-female ratio 1.17:1. Epidermal growth factor receptor and Ki-67 overexpression related significantly to villous histopathological type and high-grade dysplasia in colorectal adenoma cases(p<0.05). In colorectal carcinoma cases, epidermal growth factor receptor overexpression related significantly to tumour grade (p<0.05). Ki-67 overexpression related significantly to increased pathological stage (p<0.05). CONCLUSIONS: Overexpression of epidermal growth factor receptor and Ki-67 was found to be an ominous sign of colorectal adenoma aggressiveness, and the risk of progression to colorectal carcinoma.

Global longitudinal strain as a predictor of short-term effect of oral antiviral regimens on myocardium in Egyptian patients with chronic viral hepatitis C.

BACKGROUND: Hepatitis C virus (HCV) infection has been noted with various cardiovascular (CV) diseases, and patients with detected HCV-RNA had higher CV mortality than uninfected individuals. The new direct-acting antiviral drugs (DAA) proved to be more effective with fewer side effects compared to interferon in eradicating HCV, but their effect on myocardium is still questionable. In order to get some answers for such question, two-dimensional speckle tracking echocardiography (2D-STE) was studied before and after treatment with different DAA regimens in HCV patients with either mildly impaired or normal basic left ventricular ejection fraction (LVEF). RESULTS: Global longitudinal strain (GLS) significantly worsened after finishing antiviral treatment in patients with basic impairment of LVEF (n = 100) and those with normal basic LVEF (n = 20) [p = 0.006 and 0.039, respectively]; also, segmental strain showed significant worsening of many segments. Such worsening was significantly more in those with basic impairment of LVEF compared to those with normal basic LVEF (p = 0.036). No significant difference was observed in GLS and segmental strain when classifying and comparing patients according to gender, presence of diabetes mellitus, hypertension, ischemic heart disease and established cardiac medications, or according to DAA regimen received. CONCLUSION: DAA may have a cardiotoxic effect that could be early detected by 2D-STE, which was more significant in patients with pre-treatment impairment of LVEF.

The scabicide effect of moxidectin in vitro and in experimental animals: Parasitological, histopathological and immunological evaluation.

Scabies is considered one of the commonest dermatological diseases that has a global health burden. Current treatment with ivermectin (IVM) is insufficient and potential drug resistance was noticed. Moxidectin (MOX), with a better pharmacological profile may be a promising alternative. The efficacy of moxidectin against Sarcoptes scabiei was assessed both in vitro and in vivo in comparison with ivermectin. For the in vitro assay, both drugs were used in two concentrations (50 µg/ml and 100 µg/ml). For the in vivo assay, twenty rabbits infected with Sarcoptes scabiei were divided into three groups: untreated, moxidectin-treated and ivermectin-treated with the same dose of 0.3 mg/kg once. Another four rabbits were used as a normal control non-infected group. Treatment efficacy was evaluated by clinical assessment, parasitological evaluation and histopathological examination of skin samples using Hematoxylin and eosin and toluidine blue for mast cell staining. Immune response was also assessed by immunohistochemical staining of CD3 T cells in skin samples. Our results showed that moxidectin had a high efficacy (100%) in killing mites when used in both concentrations (50 µg/ml, 100 µg/ml) in the in vitro assay. Concerning the in vivo assay, on day 14 post-treatment, all MOX-treated rabbits were mite-free with full clinical cure by the end of the study (D21) showing (100%) reduction of mites count. Also, marked improvement in the epidermis with absence of mites in skin samples were shown. Poor clinical and parasitological improvements were noted in the ivermectin-treated rabbits, when given as a single dose with a percentage reduction (60.67%) in the 2nd week and progressive increase in lesions and mites count in the 3rd week post-treatment. Regarding the immune response, MOX-treated group showed mild infiltration with both mast cells and CD3 T cells in comparison to severe infiltration with both types of cells in the untreated and IVM-treated group. On conclusion, our results demonstrated that a single dose of MOX was more effective than IVM, supporting MOX as a valuable therapeutic approach for scabies therapy.

LYMPHOEPITHELIOMA-LIKE CARCINOMA OF THE URINARY BLADDER ASSOCIATED WITH SCHISTOSOMIASIS: A CASE REPORT AND REVIEW OF LITERATURE.

Lymphoepithelioma-like carcinoma is an undifferentiated carcinoma with histological features similar to undifferentiated, non-keratinizing carcinoma of the nasopharynx. Lymphoepithelioma-like carcinoma of the urinary bladder is uncommon with a reported. incidence of 0.4% -1.3% of all bladder cancers. This case describes an 80 years old Egyptian male patient presented with recurrent hematuria and necroturia. Cystoscopy revealed a tumor involving the left lateral and the posterior wall of the urinary bladder. The patient underwent transurethral resection of the bladder tumor. Pathological examination showed muscle invasive lymphoepithelioma-like carcinoma associated with schistosomiasis of the urinary bladder. To the best of our knowledge the association of schistosomiasis with lymphoepithelioma-like bladder cancer was not described in the literature before this case report.