Evaluation of serum carbohydrate antigen 19-9 as a diagnostic marker for pancreatic malignancy

Background: Carbohydrate antigen (CA) 19-9 is considered as a tumor marker in biliary-pancreatic malignancy. Though a high level may indicate the presence of a malignant disorder, it may rise even in benign condition. Similarly, the value may be normal even in malignant condition.Methods: An observational comparative study was conducted in the Department of Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from 01 June 2016 to 31 May 2017 to find out the sensitivity and specificity of CA 19-9 as a tumor marker in pancreatic malignancy in our perspective and to find out a cut-off value of CA 19-9 which might prove as a definitive indication of pancreatic malignancy.Results: The study shows when the cut off value of CA 19-9 is 37 U/ml. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) were 77.8%, for all four characteristics respectively. But if the serum CA 19-9 threshold used to diagnose pancreatic cancer was raised to 100 and 120, sensitivity decreased to 72.2% and 66.7% and NPV decreased to 76.2% and 73.9% respectively. However, specificity increased to 88.9% and 94.4% and PPV increased to 86.7% and 92.3% respectively.Conclusions: Serum CA 19-9 level may be considered as an important determinant in the diagnosis of malignant pancreatic diseases and to assess the resectability of the lesions preoperatively, but other adjuncts are necessary in the overall management of pancreatic diseases.

Triggering Factorsfor Breakthrough Seizures among Epileptic Patients. Cross Sectional Study in Epileptic Patients Attending Epilepsy Clinic Mansoura University Hospital, Egypt

Background: The prevalence of breakthrough seizures in persons with epilepsyis very high in developing countries. Consequently, patients and physicians should be aware of the possible factors that may cause breakthrough seizures.Objective: The aim of our study is to determine the possible factors that may be a precipitating cause for breakthrough seizures in patients with epilepsy.Methods: This cross-sectional study included 100 persons with epilepsywith idiopathic epilepsy receiving antiepileptic drugs (AEDs). They were divided into two groups. Group 1 included 50 persons with epilepsywith a history of recent breakthrough seizures. Group 2 included 50 persons with epilepsywho had not experienced any recent breakthrough seizures. Patients were subjected to a thorough questionnaire addressing precipitating factors. All participants were subjected to an electroencephalogram (EEG) and medication adherence assessment.Results: There was no significant differences between group 1 and group 2 regarding age, sex, ageOriginal Research Article of onset of epilepsy, occupation and marital status (P value range 0.5 –0.2). The patients in group 1 were found to have longer durations of epilepsy, lower adherence to AEDs (P= 0.001), moremissed doses of AEDs (P= 0.0001), more side effects of AEDs (P = 0.0005), more sleep deprivation, lower level of AEDs (P= 0.0006), more frequently on AED polytherapy (P = 0.0002), and more flickering lights(P= 0.04) than the participants in group 2. In terms of the EEG, group 1 showed a higher percentage of abnormal EEGs and more frequent focal epileptiform discharges (P = 0.003). Also, pathological findings in MRI brain were associated with higher breakthrough seizures (P = 0.005). No significant difference was found in both group1 and group 2 regarding emotional stress (P = 0.55), substitution of brand AEDs by generic one (P = 0.83), concurrent illness (P = 1), or the use of non AEDs (P = 0.79). Conclusion: The precipitating factors of breakthrough seizures are multifactorial and it is very important to educate patients about these precipitating factors to achieve better control of epilepsy

Specific IgE immunoassay for house dust mites by using multiple allergen simultaneous test [MAST] in asthmatic children

Background: house dust mites are considered as a major cause of bronchial asthma in young children. Inhalation of dust mite allergens by hypersensitive individuals can result in acute attacks of bronchial asthma. Multiple allergen simultaneous test [MAST] for the detection of specific IgE of different allergens is one of the important diagnostic tools for bronchial asthma

Patients and Methods: the study group consisted of forty children suffering from bronchial asthma selected from the outpatient clinic of Pediatrics, Faculty of Medicine, Al-Azhar University, New Damietta, Egypt as well as another normal forty healthy volunteer children were selected as controls. Total IgE immunoassay and quantitative measurement of allergen specific IgE [Biocheck GmbH, Germany] were estimated for all of them

Results: it was found that, out of 27 positive IgE subjects, 20 were positive by poly-check test providing sensitivity of 74.1%; and out of 53 negative IgE subjects, 50 were negative, providing specificity of 94.3%

Conclusion: Poly-check [MAST], in vitro tests can be used in screening for allergens in asthmatic children with high specificity

Biodiesel Fuel Production from Palm, Sunflower Waste Cooking Oil and Fish Byproduct Waste as Renewable Energy and Environmental Recycling Process.

Significant of the Study: Biomass is renewable, organic, plant and animal derived source of biomaterial that can be converted into different forms of biofuel, bioplastic, bio-solvent, and bioenergy using different biotechnological procedures. Biomass derived bio-fuel is biodegradable, nontoxic, sustainable and substitute for fossil fuel as well as capable to reduce greenhouse gas emission. It is renewable and outstanding energy resource for the creation of steam and electricity, transportation fuel, manufacturing industries. Biomass derived from animal and plants like, fruits, vegetable, crops, fish, chicken and other animal byproducts or waste biomass which can be used for bioenergy production like biofuel and nano-catalyst for biofuel. Aim: The purpose of this study was to compare and investigate the suitable biodiesel properties produced from waste fish byproducts, palm and sunflower oil which were more economically viable. Results: There was a total of 7, 5 and 4 types of fatty acid methyl esters presence in the fish, palm and sunflower biodiesel, respectively. The quality of biodiesel such as viscosity, total acid number, fuel consumption and emission rate was evaluated. The kinematic viscosity was maintained ASTM standard in case of all produced biodiesel. However, sunflower biodiesel was slightly viscous compared to palm and fish biodiesel. Metal elements such as phosphorus, magnesium, and calcium were present moderately in all biodiesel but it was limited range in fish oil. In the engine tests, the emissions of unburned hydrocarbons, oxides of nitrogen and carbon monoxide were lower in palm biodiesel than in sunflower and fish biodiesel. Fuel consumption was higher in palm biodiesel. Fish biodiesel had the lowest fuel consumption than that of palm and sunflower biodiesel. Conclusion: It can be concluded that waste palm oil and fish oil can be considered as a great potential source for commercial biodiesel.

Pixeye virtual reality training has the potential of enhancing proficiency of laser trabeculoplasty performed by medical students: a pilot study

To compare the surgical proficiency of medical students who underwent traditional training or virtual reality training for argon laser trabeculoplasty with the PixEye simulator. The cohort comprised of 47 fifth year male medical students from the College of Medicine, King Faisal University, Saudi Arabia. The cohort was divided into two groups: students [n=24], who received virtual reality training [VR Group] and students [n=23], who underwent traditional training [Control Group]. After training, the students performed the trabeculoplasty procedure. All trainings were included concurrent power point presentations describing the details of the procedure. Evaluation of surgical performance was based on the following variables: missing the exact location with the laser, overtreatment, undertreatment and inadvertent laser shots to iris and cornea. The target was missed by 8% of the VR Group compared to 55% in the Control Group. Overtreatment and undertreatment was observed in 7% of the VR Group compared to 46% of the Control Group. Inadvertent laser application to the cornea or iris was performed by 4.5% of the VR Group compared to 34% of the Control Group. Virtual reality training on PixEye simulator may enhance the proficiency of medical students and limit possible surgical errors during laser trabeculoplasty. The authors have no financial interest in the material mentioned in this study

Biodynamics of Hepatitis C Virus in Haemodialysis Patients in Pahang

Introduction: HCV infection is frequent in patients undergoing maintenance haemodialysis, with prevalence between 8 and 10%. Hepatitis C has an adverse effect on both patient and graft survival in those who get renal transplants. There are relatively scarce reports on the natural fluctuation in viral load level in patients on chronic haemodialysis. Materials and Methods: This is a longitudinal short-term three months study, where 27 chronic haemodialysis patients infected with known HCV genotypes were recruited from seven haemodialysis centres in Pahang. Serum samples were collected monthly, both pre- and post-haemodialysis sessions, over a period of three months. Viral RNA was extracted from serum using QIAamp Viral RNA Extraction kit (Qiagen). The HCV viral load was measured using one-step reverse transcriptase qPCR (Applied Biosystems) targeting the 5`HCV non-coding region (5’UTR). The serum α-IFN level was measured using commercial ELISA kit (Amersham, UK). Six biochemical liver function tests (AST, ALP, TP, albumin, ALT and TB) were also done for all pre-haemodialysis samples. Results: All patients showed persistent low level viral load that varied significantly over the study period (p = 0.001). HCV genotype 1 viral load was significantly higher than that of genotype 3. Conclusion: No apparent correlation could be recognized between the viral loads and the corresponding interferon-alpha levels which were detectable in only a few patients during the period of study.

Effect of temperature on sperm motility and motion kinetcs as determined by computer assisted semen analysis

To evaluate the effect of semen incubation at different temperatures on sperm motility and motion kinetics. A prospective study. Computer assisted semen analysis [CASA]. Sperm motility and motion kinetics [curvilinear velocity [VCE], straight-line velocity [VSL]. average path velocity [VAP], linearity [L1N] and amplitude of lateral head displacement [ALH]]. Semen samples were collected from infertile patients [n = 20] and fertile donors [n = 20] after sexual abstinence of 2 to 3 days. Each sample was divided into 4 aliquots right alter liquefaction. One aliquot was analyzed as fresh and the remaining 3 were analyzed after simultaneous incubation at 4°C, 25°C and 37°C for 1 hour. Sperm motility and motion kinetics were determined in fresh and incubated aliquots using CASA. Motility, VCL, VSE, VAP. and ALH significantly decreased [P <0.05] from baseline values in both patients and donors after incubation at 4°C. Our results indicated that 37°C is a suitable temperature for semen storage after collection, and during transportation and processing

possible role of vitamin E on bone marrow cytogenic toxicity of cisplatin in adult male albino rat

Cisplatin; myelotoxicity is a major limiting factor in tile treatment of several neoplasms. Vitamin E, a slow acting free radical scavenger, has been shown to ameliorate nephro, oto and neurotoxicities in animals receiving cisplatin. The purpose of this study is a trial to evaluate the effectiveness of vitamin E as a myeloprotectant. Twenty five adult male albino wistar rats weight [200-250 gm] were used in this experiment. The experimental animals were divided into three groups [A1B1C]. Group [A]: was kept as control. Group [B]: treated with cisplatinum twice weekly for one month by intraperitoneal injection in a dose of 4 mg/kg. Group [C]: treated with vitamin E in a dose of 100 mg/kg by intramuscular injection concomitant with cisplatin twice weekly for one month. Samples were taken from bone marrow and processed for light and electron microscopic studies. The light microscopic examination of cisplatin treated bone marrow speciemens showed accumulation of large number of both fat and mast cells while in vitamin E treated group, there was a reduction in the percentage of both type of cells but not significantly. By electron microscopic examination, the most striking effect of cisplatin on bone marrow was evidenced by the marked increase in the number of dark degenerated cells in comparison to that of control. On the other hand, a maximal reduction in the number of these degenerated cells was observed in vitamin E treated bone marrow speciemens in comparison to group [B]. The percentage of eosinophil was increased significant in vitamin E treated group. By this work, vitamin E, a free radical scavenger, appears to have a protective role against cytogenic toxicity of cisplatin on bone marrow

Serum levels of nitric oxide in newborns of preclamptic-and those of normal mothers

Nitric oxide [NO] is a labile radical gas that plays a critical role in many vital biological processes, including the control of vascular tone, ventilation, inflammation and immunity. In pre-eclampsia, NO is usually increased in the maternal circulation which may in turn affect the infant of those women. This study is carried out to asses endothelial derived [endogenous] NO concentration in newborns of pre-eclamptic compared to those newborns of normal mothers. Serum NO levels were assayed in newborns of pre-eclamptic mothers [n=33] and newborns of normal mothers [n=12]. Serum NO levels were estimated calorimetrically using commercial kit of total NO based on the enzymatic conversion of nitrate to nitrite by nitrate reductase and detection of nitrite as an azo-dyc product of the Griess reaction. Serum NO levels were found to be significantly lower among newborns of pre-eclamptic mothers [P<0.05] when compared to newborns of normal mothers. There is a defect in serum nitric oxide levels in infant of preeclamptic mothers which reflects the endothelial dysfunction, as well as, reduced uteroplacental perfusion

Ruptured hepatoma: report of 5 cases in Arabs

Objective and Importance: Ruptured hepatic tumours are common among South East Asians. They are rare in whites and in Arabs. Arab cirrhotics who develop acute abdominal pain associated with hypovolaemia and evidence of intra-abdominal bleeding ought to be suspected of ruptured hepatocellular carcinoma. Clinical Presentation: Five cases of ruptured hepatocellular carcinoma in Arabs are reported. All patients had liver cirrhosis, and radical surgery was not possible due to the advanced stage of the tumour. Two patients who underwent common hepatic artery ligation survived for more than 9 months after the acute episode. The other 3 died in the hospital due to liver failure. Hepatic dearterialization was found effective in controlling bleeding from ruptured hepatoma. Other modalities of management such as hepatic artery embolization or intratumoural alcohol injection have been found effective in controlling bleeding