Sirte Journal of Medical Sciences

Application of alvarado scoring system in diagnosis of acute appendicitis

Habib Mansour Murtadi, Hesham M. Abudabbous — Fri, 30 Dec 2022 00:00:00 +0000

Acute appendicitis is a common cause of abdominal pain and can be difficult to diagnose, especially during the early stages. There is still appreciable morbidity and occasionally mortality which may be related to the failure of making an early diagnosis ⁽¹⁾

As a result of their concern these surgeons create for themselves 'a surgical security zone which allows them to accept a 15-30% negative laparotomy rate with impunity ⁽²⁾, Although various aids exist to facilitate more accurate diagnosis and reduce the rate of negative appendectomy, many are complex.

Whereas simple scoring systems have been available for some time, they have not been widely tested.

The aim of this study was conducted to assess one of these scoring systems which were described by Alvarado in 19851⁽¹⁾, by comparing it to the histopathology results of operated patients.

This retrospective study of consecutive patients admitted to the surgical ward at Benghazi Aljala hospital with suspicion of having acute appendicitis during the period of January 2008 to January 2010.

The Alvarado scoring system was computed from admission notes and records correlated with histopathology, all cases with insufficient data or no histopathology result were excluded from the study

Out of 153 patients, 90 underwent appendectomy with the intention to treat appendicitis and diagnosis was confirmed in 80 patients. The reliability of the system was assessed by calculating the negative appendectomy rate and positive predictive value which was 85%, and the normal appendectomy frequency was 12%.

Alvarado scoring system is an easy, cheap, and useful tool in the preoperative diagnosis of acute appendicitis and can work effectively in routine practice.

Breast cancer histology and hormonal status characterization in Libyan patients; a sample from middle region

Habsa A. A. Amshahar, Sana. A. Muftah, Khalifa M. Salem — Fri, 30 Dec 2022 00:00:00 +0000

Background: Breast cancer, has increased in developed and developing countries among females, and in Libya, often diagnosed at advanced stage. This study conducted to evaluate histological features and hormonal status of breast carcinoma in Libyan females.
Materials and Methods: This retrospective study was performed at Sirte Oncology Centre, Sirte, Libya. Demographic characteristics, such as age, sex, marital status recorded. Histopathology examination provided the histologic type, grade, tumor size, stage, lymph node status, site of metastasis and hormonal status. Data were obtained and analyzed using SPSS software version18.0.
Results: A total of 74 breast cancer patients of which 72 (97.3%) were females and 2 (2.7%) were males. Majority of the cases occurred in the 5th decades. Invasive ductal carcinoma of no specific type was the most commonly diagnosed type of breast carcinoma accounting 95.9% of total cases, invasive lobular, ductal and lobular carcinoma and malignant phylloides were the second most common types. Majority of cases (57.4%) diagnosed with grade III tumors and 60 % of cases were found at advanced invasive and metastatic stage of breast cancer. Most of cases showed positive hormonal receptors (both ER and PR positive) (67.2%) while triple negative (ER, PR, and Her2Neu negative) cases were found to be the rarest group (1.6%).
Conclusion: Invasive ductal carcinoma was the most common histological type of breast cancer in Libyan patients, commonly diagnosed with a higher grade and at advanced stage. As hormonal status carries a hope of benefit from hormonal treatment, so our study places the significance of early detection, histo-pathological informations and hormonal status in an appropriate treatment strategy.

Congenital hypothyroidism in a child with Sickle cell anemia (a Case Report)

Ebtisam Alsanosi, Aisha Ali, Mayam M Ali Mohamed — Fri, 30 Dec 2022 00:00:00 +0000

Sickle cell disease (SCD) is an autosomal recessive disease common in negros and Arab.1 The main pathological cause is the substitution of valine with glutamic acid in the β-chain of haemoglobin producing abnormal haemoglobin called haemoglobin S.1,2,3 The production of this abnormal haemoglobin is responsible for the sickling of red blood cells in deoxygenated conditions. The symptoms include chronic intravascular hemolysis, vaso-occlusion and painful crisis.1,3 Over time, multiple organ damage can develop.1,3,4 Patients with SCD display a defective activation of the alternate complement pathway, the combination of SCD and Autoimmune disease (AID) is rare, potentially underdiagnosed, and its prevalence is unknown.4However, the frequency of coexisting SCD and AID has not been evaluated and the data mainly demonstrated from case reports.

Case presentation

In this case, we report a rare combination of Sickle cell anaemia and congenital hypothyroidism in a 4 years old Libyan boy. This patient was referred to our Hematology department due to severe anaemia, the patient was diagnosed with Sickle cell anaemia and congenital Hypothyroidismwhen he was 32 days old. Genetic counselling for the family showed sickle cell anaemia, congenital hypothyroidism and celiac disease in the other family members. However, the association of SCD and congenital hypothyroidism were not reported before, this combination could be due to a new gene mutation since the high consanguinity and multiple affection in siblings with SCD, Celiac disease and Hypothyroidism separately or combined.

Conclusion

SCD and congenital hypothyroidism in toddlers are newly reported in this study. The combination of AID and SCD was detected in many members of this family. Genetic counselling and testing are important in developing countries to educate individuals on SCD and also offer those at risk. Further studies are needed to determine the frequency of congenital hypothyroidism in patients with SCD to look for a new cause of combination.

Method Validation for Determination of Paracetamol in Tablet Dosage Form Using UV-Visible Spectrophotometer

Gazala Mohamed Ben-Hander, Mohammed Eshtewi Gaeth, Nasser Ali Otmaan — Fri, 30 Dec 2022 00:00:00 +0000

A simple, accurate, and cost-effective UV-spectrophotometric method for determining Paracetamol in tablet pharmaceutical formulations has been developed. The method was designed and validated in accordance with the criteria of the International Conference on Harmonization (ICH). The developed method was validated statistically concerning linearity range, precision, accuracy, the limit of detection and the limit of quantitation. The study used ethanol-water as a solvent, and λmax was found to be 243 nm. In the range of 2.0–16.0 µg mL-1, a pure drug concentration was prepared, and linear regression analysis revealed a good linear connection with an R2 value of 0.999. The detection and quantification limits were determined to be 0.5 and 1.5 µg mL-1, respectively. The recoveries ranged between 103 and 109%, and the relative standard deviation was less than 2%, indicating that this method was developed for the potential determination of Paracetamol in tablet dosage formulations.

Various technique of cell culture and slide preparation for human chromosome

Faraj Saad Faraj Mohamed — Fri, 30 Dec 2022 00:00:00 +0000

The cell culture and slide preparation method of human chromosome is the mechanism that is a corresponding change in DNA content. In this research we used various techniques of cell culture and slide preparation for human chromosome and examined for 2 days, 3 days and 4 days cell culture because these are average days for approximately the good results and the treatment will still be good also the result has minimum bias.

The research objectives were to determine the appropriate length of cell culture needed for human chromosome with different lengths and to determine the appropriate method for staining the slide for human chromosome with different lengths.

Based on the data analysis, the result of this research shows that the appropriate length of cell culture needed for human chromosome with different lengths is 2 days of incubation. Although there were no significant differences between 2,3 and 4 days length based on statistical analysis, still there is little difference between them and the best is 2 days rather than 3 and 4 days based on the graph analysis. The appropriate method for staining the slide for human chromosome with different lengths is hot plate rather than another technique

Pulsed radiofrequency applied to the suprascapular nerve before rotator cuff tear arthroscopic repair: A prospective randomized clinical trial

Abdalmenam Abdalftahe Almabsoot, Ayman Ahmed Mamdouh, Hussain M.Amaigil — Fri, 30 Dec 2022 00:00:00 +0000

Background: clinical studies have demonstrated the efficacy of pulsed radiofrequency (PRF) in treating many pain syndromes. PRF energy is delivered via a percutaneous needle under an image guide to reach the suprascapular nerve as it supplies more than 70% of the shoulder sensation. PRF was introduced as a non-destructive minimally invasive procedure in comparison with arthroscopic management of rotator cuff injury. However, there is a controversy regarding both measures in treating shoulder pain in rotator cuff injuries as standard methods.

Objective: to evaluate the ability of PRF to produce shoulder pain relief by applying of PRF to the suprascapular nerve and measure the pain relief by VAS score at various time intervals prior to arthroscopic repair for rotator cuff injuries. The study should be in comparison with control group undergo arthroscopic repair without attacking of the suprascapular nerve by PRF.

Methods: a prospective randomised controlled trial study including 40 patients divided as PRF or (P) group and control group (C) group equally. Each patient in our study whom their history and examination were fulfilled quietly including pain assessment by Visual Assessment Score (VAS). In The (P) group, a needle is inserted through a well-known point in the shoulder leading directly to the suprascapular notch (where the nerve is hooked above it) under image guidance. Radiofrequency waves at 2Hz of 20 milliseconds and 42 C in the pattern of three cycles each one lasting for 120 seconds. VAS score was assessed postoperatively for 7 time intervals starting from immediate postoperative (after arthroscopic repair) up to 3 months.

Result: Pulsed radiofrequency produced dramatic progressive pain relief throughout our study time. In the 1^st 48 hours, the VAS score dropped about 30% in (P) group with comparison to 22% in control group. At 3 months interval the VAS score was reduced by 45% from the preoperative period in comparison to 23% of the control group (P=0.000)

Conclusion

PRF is the safest, optimally invasive method to treat shoulder joint pain in rotator cuff injuries especially in unfitted patients for surgeries.

Mesenteric Cyst Lymphangiomas in 6 years Old Boy (A Case Report)

Khalid y. Gharib, Maryam M Ali, Jamal hafad, Jamal M Athiallah — Thu, 12 May 2022 00:00:00 +0000

mesenteric cyst lymphangioma is a rare benign intra-abdominal tumour, It is located in the mesentery of the gastrointestinal tract and may extend from the base of the mesentery into the retroperitoneum. chylous ascites is an uncommon form of ascites due to leakage of lipid-rich lymph into the peritoneal cavity, it is diagnosed by the presence of milky-appearing ascites fluid and white triglyceride content >200mg/dl. We report 6-year-old boy presented progressive Vega abdominal pain over one month associated lately with abdominal distention and vomiting, abdominal ultrasound and NON-CONTRAST computed tomography (CT) revealed a large cystic abdominal lesion demonstrating multiple septations involving the retroperitoneal region. The intra-operative finding was a large yellowish septate mesenteric cyst arising from both mesenteric borders of jejunal loop extending retroperitoneal with white mesentery and multiple reactionary lymph node and chylous acites.