Anaplastic (undifferentiated) carcinoma of pancreas, an uncommon variant: Diagnosed on endoscopic-guided fine needle aspiration

Anaplastic carcinoma of pancreas (ACP) are rare pancreatic neoplasms. They are well known to be associated with more aggressive tumor behavior and less favorable prognosis than usual pancreatic ductal adenocarcinoma. Endoscopic-guided fine needle aspiration (EUS-FNA) is now a widely accepted modality in diagnosis of pancreatic lesions. However, only a few reports are available describing cytological features of anaplastic carcinoma. Here, we report two cases of ACP diagnosed on EUS-FNA.

IgG4 related sclerosing encapsulating peritonitis with cocoon formation: An unusual and undescribed presentation

IgG4-related sclerosing mesenteritis is a rare disease of mesentery of an unknown etiology which shows a constellation of histopathologic findings of lymphoplasmacytic inflammation with IgG4-positive plasma cells and marked fibrosis. This chronic inflammatory condition of mesentery forming an abdominal cocoon has never been described before to the best of our knowledge. Here, we report a patient with a history of subacute small bowel obstruction who was found to have an intra-abdominal encapsulating mass in the right iliac fossa and was finally diagnosed as IgG4-related sclerosing encapsulating peritonitis (abdominal cocoon) based on peroperative findings, histology and immunohistochemistry.

Prevalence of hepatitis C virus infection and evaluation of a health education program in El-Ghar village in Zagazig, Egypt

Hepatitis C virus [HCV] is an emerging global epidemic, some nations have been more drastically affected than others. Egypt reports the highest incidence in the world, with a prevalence rate of over 20% [global average 3%]. Despite the alarming prevalence of the disease in the country, awareness of the disease is still low. The objectives of this study were: 1-to estimate the prevalence of hepatitis C seropositivity among the study group. 2-to study some risk factors with hepatitis C, 3-to assess the effect of the health education on the knowledge and concepts about hepatitis C. This study is a combined cross sectional and an interventional educational community-based study. It was carried out at El-Ghar village in Zagazig district from November 2006 to January 2007. A multistage systematic sample included 304 households above 12 years of age, using a predesigned questionnaire for assessing some potential risk factors [medical and lifestyle behavior] and another questionnaire to assess the effect of health education on knowledge and attitude toward Hepatitis C problem. In addition, samples were collected to assess the seropositivity of HCV among the studied group. The results showed that the prevalence of seropositivity of HCV among the sample was 10.9%. The seropositivity of HCV was higher among males than females and increased sharply with age from 3.6% in those below 20 years old to 30.9% in older age [40 years or more]. Those who were illiterate and farmers had a significantly higher prevalence. According to the logistic regression model, the significant predictors of HCV infection were previous infection with schistsomiasis, those who have positive medical history, followed by those shaving at the community barber, above 40 years and male sex. A highly significant improvement in knowledge in all aspects of HCV infection and also the attitude toward HCV problem [p < 0.000] was revealed. Conclusion and recommendations: Hepatitis C is a health problem in rural areas in Zagazig district. Health education program successfully improved knowledge and attitude toward this problem. The following is recommended: 1- Introduction of health education programs about HCV infection into the established health services 2-Surviellance activities to monitor the disease trend

Ultrasound guided percutaneous drainage versus surgical management in hepatic hydatidosis: a prospective, randomized study

To compare the safety and efficacy of percutaneous drainage with those of surgical cystectomy, the traditional treatment of hydatid disease of the liver. In a prospective study, we randomly assigned patients with hepatic hydatidosis Gharbi types I, II and III to treatment with ultrasound guided percutaneous drainage [16 patients] and cystectomy [15 patients]. Albendazole [10 mg per kilogram of body weight per day for eight weeks] was administered to the patients of both groups. Patients were serially assessed by clinical and ultrasonographic examinations, and hydatid serologic tests. The cyst diameter did not differ significantly between the two groups [P= 0.20]. At 6 month follow-up, the mean cyst diameter decreased from 10.4 +/- 3.7 to 3.4 +/- 1.5 cm [P<0.001] after percutaneous drainage and from 9.4 +/- 4.1 to 1.8 +/- 0.9 cm [P<0.OOl] after surgery. The mean hospital stay was 6.2 +/- 1.2 days in the drainage group and 12.4 +/- 3.5 days in the surgery group [P<0.00l]. Over a mean follow-up period of 12 +/- 3 months in the drainage group and 10 +/- 2 months in the surgery group, complete cyst healing [sonographically evidenced cyst death] occurred in all patients of both groups. The cysts disappeared in 13 patients [81%] in the drainage group and in 11 [73%] in the surgery group [P 0.29] and were replaced by solid echo pattern in 3 patients [19%] in the drainage group and in 4 patients [27%] in the surgery group.. After an initial rise in 3 patients of the drainage group and 2 patients of the surgery group, the echinococcal-antibody titers fell progressively and at the last follow-tip were <1:160 in 15 patients [94%] of the drainage group and 13 patients [87%] of the surgery group. There were procedure-related minor complications in 5 patients [3 1%] in the drainage group and 3 patients [20%] in the surgery group. No recurrences occurred in both groups during follow-up. Percutaneous drainage, combined with albendazole therapy, is an effective and safe alternative to surgery for the treatment of most types of hydatid cysts of the liver and requires a shorter hospital stay

Reassessment of some environmental conditions of Maawa El- Sayadeen squatter area

Reassessment of some environmental conditions of Maawa El-Sayadeen squatter area was carried out during 2000. Due to unplanned urbanization, environmental sanitation has been ignored for several decades resulting in many health, social and economic problems. Maawa El-Sayadeen was chosen by West District officials for environmental and health upgrading in 1995, which depended mainly upon health education in addition to some engineering constructions The environmental conditions and health status were reported before 1995 and after 2000. The reassessment proved that, there was an increase in number of families use tap water inside the house by 29% compared with 1995 assessment. Moreover, number of families using water closets increased by 15%, also wastewater disposal throught public sewers increased by 34%. However, a decrease by 17% in dry areas surrounding the houses was recorded. Solid waste storage improved by 11% although solid waste collection sites decreased by 23%. It is concluded that, after Maawa El-Sayadeen area was exposed to a certain level of environmental upgrading, the environmental conditions of the area were some how better categorized, however, further training programs should be taken into account or stressed including increase of people awareness and strong partnership should be developed with their non governmental organizations

value of granulocyte elastase versus ascitic fluid polymorphnuclear cell count in diagnosis of spontaneous bacterial peritonitis

Spontaneous bacterial peritonitis [SBP] is one of the most common complications attending the onset of ascites in patients with liver cirrhosis. Granulocyte elastase [GE] is the powerful proteolytic enzyme that is released by PMNs when degranulated in infectious processes. The aim of this study was to measure GE in ascitic fluid and plasma of cirrhotic patients with SBP comparing them with the standard test in diagnosis of SBP; ascitic fluid polymorphonucleocytic count [PMN count]. Eighty five cirrhotic patients with ascites were included in the study 35 of them have SBP [ascitic PMN> 250/mm[3] and/or ascitic ascitic white blood cell count> 500/mm[3] with or without positive culture], the other 50 didn't have SBP at the time of diagnosis. GE level in the ascitic fluid and plasma was measured. Infectious group further divided into two groups according to the result of ascitic fluid culture; poitive culture spontaneous bacterial peritonitis [CP-SBP] group [contained 25 patients] and negative culture spontaneous bacterial peritonitis [CN-SBP] group [contained 10 patients]. The result showed that there was significant difference between SBP subgroups [CP-SBP and CN-SBP] in one hand and cirrhotic group without SBP in the other hand as regard the ascitic fluid WBC count [p<0.01], PMN count/mm[3] [p<0.01], and highly significant difference as regard GE micro g/ml [p<0.0001], meanwhile there was no significant difference as regard ascitic fluid protein. After treatment of the infectious group; there was statistically significant change in plasma GE [p<0.01] and highly significant difference Was recorded in ascitic fluid GE [p<0.001]. Also there was significant drop for raised serum creatinine after treatment [p<0.01]. These findings suggest that GE in the ascitic fluid is highly valuable than the ascitic fluid PMN in the diagnosis of SBP. In addition more valuable for follow up response to treatment. Lastly GE level either in plasma or ascitic fluid could be responsible for deterioration of renal function and raised creatinine level in patients with SBP

Possibility of reproductive adverse effect of ametryne and/or niclosamide towards male wistar albino rats

To study the risk effect of ametryne and niclosamide towards male reproductive system, 10 weeks old male Wistar albino rats have received daily 1/50 LD50 of ametryne [30 mg/kg bw] and niclosamide [84 mg/kg bw], either individually or in combination for 13 weeks. The results showed neither mortality nor gross adverse effects in the treated males throughout the study period. However, body weight and body weight gain were significantly decreased during the last few weeks of ametryne or combined treatment. Moreover, serum testosterone was significantly decreased after ametryne or combined treatment, while it showed an apparent increase after niclosamide treatment. Percentage of motile sperms showed nonsignificant decrease, while percentage of sperms with morphological abnormalities showed significant increase after niclosamide or combined treatment

Reproductive risk assessment in wistar albino rats exposed to ametryne and niclosamids

This investigation was designed to assess the reproductive risk of using ametryne and/or niclosamide in the environment. Female and male Wistar albino rats received 1/50 KD50 of ametryne and niclosamide either individually or in combination. Females were treated for 2 weeks prior to mating, throughout mating and pregnancy, to day 21 of lactation, while males were treated for 13 weeks prior to mating. Mating was performed between treated/un-treated females and treated/un-treated males. The results showed neither mortality, clinical nor gross adverse effects in the treated animals. In females treated groups, either ametryne or niclosamide treatment significantly reduced mating and fertility indices. Percentage of post-implantation loss increased under the influence of the combined treatment. In male treated groups, mating, fertility and gestation indices were significantly reduced in the niclosamide-treated group while% treated groups. Number of pups at birth and% of pups/litter that post- implantation loss was survived until weaning were significantly decreased after niclosamide treatment while it was increased after combined treatment. Nevertheless, in female and male treated groups, mating, fertility and gestation indices were significantly decreased after niclosamide or combination treatment

Monthly distribution and infection of the snails vectors of schistosomiasis with trematodes larvae in different agricultural water courses located in Beheira governorate

This study was monthly done for one year in small agricultural area in Behaira Governorate. Thirty permanent stations were chosen along primary, secondary and tertiary canals and drains, 5 stations for each. In the area of study, Biomphalaria alexandrina [B. alexandrina] snails were more prevalent than Bulinus truncatus [B. truncatus] snails, although the percentage of infected B. truncatus with different trematodes was 12 times the percentage of infected B. alexandrina snails. These two snail species of schistosomiasis were more dense from March until August during the year of study. B. alexandrina and B. truncatus seemed to be ideal intermediate hosts for holostome cercariae [about 55% of the total infected snails with different trematodes]. Schistosome was the second prevalent cercariae as well as amphistome, xiphidiocercariae, echinostome and monostome. Nevertheless, echinostome was the second prevalent cercariae in B. truncatus, in addition to amphistome, monostome and xiphidiocercariae but not schistosome cercariae. Old size snails of both kinds of schistosomiasis had a higher rate of infection with different trematodes cercariae, then medium followed by young size snails. Schistosoma mansoni [S. mansoni] cercariae were found only in old and medium size B. alexandrina snails. The highest infection with different trematodes larvae among the collected B. alexandrina snails was recorded in secondary and tertiary canals and drains, while for B. truncatus snails it was in primary and secondary canals. Also, the infected B. alexandrina snails with S. mansoni was found only in secondary and tertiary canals and drains. Conclusively, infection of both snails of schistosomiasis with different trematodes, suppress in one way or another the infection with S. mansoni and S. hematobium larvae. Suggestions of using these kinds of trematodes infection for biological control if the snails intermediate hosts of schistosomiasis were discussed

Influence of different means of washing and processing on removing of actellic residue from spinach and eggplant and its in-vivo action on mice hepatic biochemical targets

This study was carried out to investigate the effect of different washing solutions on the removal of Actellic residue from fresh and processed vegetables, namely; spinach and eggplant. Also to identify the effect of Actellic residue on the health status of mice when fed these contaminated vegetables. The amount of insecticide residue detected using GLC indicated that tap water, sodium hydroxide solution and - potassium permanganate solution gave high percent removal. However, processing did not remove more than 45% except for grilling of eggplant which removed 88.17%. Meanwhile, changes in some hepatic biological parameters were well recognized in the groups of mice fed contaminated- unwashed either processed or unprocessed vegetables