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   2015| January-March  | Volume 43 | Issue 1  
    Online since April 6, 2015

 
 
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ORIGINAL ARTICLES
A study of different parameters of human extremities and its relationship with human height in residents of eastern India
Biswa Bhusan Mohanty, Divya Agrawal, Pratima Baisakh, Pusparaj Samantsinghar, Sanjay Kumar, Prafulla Kumar Chinara
January-March 2015, 43(1):1-8
DOI:10.4103/1110-1415.154557  
Introduction Height is defined as distance between vertex of head and surface. Reconstruction of the stature from various parameters is quite valuable for identification & for establishing the individuality of a person. Aims and Objectives The present study was done to determine the stature from parameters of upper limb & lower limb of individuals having age group of 17-25. Materials and Methods Authors have studied 213 male and 87 female, healthy subjects in Department of Anatomy, IMS & SUM Hospital, Bhubaneswar. All individuals were measured for height and arm, forearm, hand & foot length. Observation and Results The data thus obtained has been tabulated & subjected to statistical computation to derive the regression equations. Conclusion The results concluded that height has a definite correlation with the parameters. This conclusion is of utmost importance to anthropologist and forensic experts for estimation of stature from mutilated, decomposed or fragmentary skeletal remains.
  6,608 379 -
CASE REPORT
Management of placenta accreta by uterine artery embolization: A case report
Neeta Natu, Kailash Patel, Nootan Chandwaskar, Akanksha Chauhan, Avneet Arora, Ravindra Kumar
January-March 2015, 43(1):36-38
DOI:10.4103/1110-1415.154555  
Placenta accreta is one of the most serious complications of pregnancy and is frequently associated with severe obstetric hemorrhage, usually necessitating hysterectomy. Here, we are appending a case in the literature one with placenta accreta with previa. Uterine artery embolization was performed for the management of postpartum hemorrhage after subtotal hysterectomy.
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ORIGINAL ARTICLES
Serum cystatin-C and urinary N-acetyl-β-d-glucosaminidase as biomarkers for early renal dysfunction in adult Egyptian patients with β-thalassemia major
Tamer A Elbedewy, Amr M Gawaly, Amira Y Abd El-Naby
January-March 2015, 43(1):28-35
DOI:10.4103/1110-1415.154563  
Background/aims β-Thalassemia syndromes are the most common inherited hemoglobinopathies. In Egypt, 1000/1.5 million/year live borns suffered from thalassemia. β-Thalassemia major (β-TM) is the most severe form. Advances in the care of patients with β-TM, have allowed previously unrecognized complications to emerge, including several renal abnormalities. Therefore, the aim of the present study is to investigate the presence of glomerular and/or tubular dysfunctions in adults with β-TM, using biomarkers of glomerular and tubular dysfunctions. Subjects and methods Forty patients with β-TM (group I) were selected with 20 age-matched and sex-matched healthy participants as a control (group II). Patients were subjected to full medical history taking and complete clinical examination. Serum cystatin-C and urinary N-acetyl-β-d-glucosaminidase (UNAG) levels were measured. Results Significantly higher levels of serum cystatin-C and UNAG in thalassemic patients were observed when compared with the control group. Significantly higher levels were observed for serum cystatin-C and UNAG in patients with renal affection, poorly chelated and inadequately transfused patients. A significant positive correlation between serum cystatin-C and serum ferritin was observed and significantly negative correlations between serum cystatin-C on one hand and pretransfusional hemoglobin and estimated glomerular filtration rate on the other hand were observed. A significantly positive correlation between UNAG and the urinary albumin creatinine ratio (ACR) and significantly negative correlations between UNAG on one hand and pretransfusional hemoglobin and estimated glomerular filtration rate on the other hand were observed. Conclusion β-TM patients had glomerular and tubular dysfunctions. Serum cystatin-C and UNAG are promising biomarkers for monitoring glomerular and tubular dysfunction.
  1,623 191 1
Biochemical markers for early detection of cardiovascular disorders in rheumatoid arthritis
Noha M Shafik, Hanaa H Gaballah, Abeer A Abo Zeid, Manal S Hussein
January-March 2015, 43(1):22-27
DOI:10.4103/1110-1415.154562  
Background The mechanism of accelerated atherosclerosis accompanied with rheumatoid arthritis (RA) remains unclear. Aim The aim of this study was to investigate the association between fetuin-A, asymmetric dimethylarginine (ADMA), advanced oxidation protein products (AOPPs), and accelerated atherosclerosis in patients with RA, for early detection of cardiovascular disorders. Patients and methods This study was carried out on 60 participants: 40 RA patients and 20 healthy volunteers of similar age and sex. Assessment of Disease Activity for 28-Joint Indices Score and ultrasonographic examinations of carotid intimal thickness and stiffness parameter β were carried out. In addition, lipid profile, serum high-sensitivity C-reactive protein, ADMA, fetuin-A, and AOPPs levels were measured in all participants. Results There was a significant increase in serum ADMA and AOPP levels in RA patients compared with controls. Serum fetuin-A levels were lower in RA patients than in controls. There was a positive correlation between serum ADMA levels and serum erythrocyte sedimentation rate, high-sensitivity C-reactive protein, rheumatoid factor, Disease Activity for 28-Joint Indices Score, carotid intima-media thickness, stiffness index β, total cholesterol, low-density lipoprotein cholesterol, triglyceride levels, and total cholesterol/high-density lipoprotein cholesterol and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratios. Conclusion Low levels of fetuin-A, in RA, suggest its possible contribution in the pathophysiology of endothelial dysfunctions, subsequently causing increase in arterial stiffness. An increase in ADMA and AOPPs in RA patients, together with dyslipidemia, suggests their possible involvement in the physiology and pathophysiology of vascular diseases in RA. These findings open new avenues for further studies on the physiology of cardiovascular diseases in RA that may lead to a better treatment of these diseases.
  1,523 119 -
Push enteroscopy in the management of suspected small-bowel diseases: A 2-year retrospective study
Mohamed Abd El-Raouf Tawfik, Abd Allah Ahmed El-Sawy
January-March 2015, 43(1):16-21
DOI:10.4103/1110-1415.154560  
Background and study aims Small-intestinal lesions still represent a challenge with respect to their diagnosis and treatment. The detection of small bowel mass lesions (SBMLs) has been difficult due to the limited visualization of small-bowel esophagogastroduodenoscopy and colonoscopy. In this study, we aimed to assess the efficacy of push enteroscopy in diagnosis and therapy in the gastroenterology and endoscopy center of Tanta University hospital. Patients and methods In the period from January 2012 to December 2013, 14 patients with different indications, referred to the Tanta endoscopy center, a division of the internal medicine department and one of the most important centers in Delta Nile in Egypt, underwent examination by push enteroscope. Results The overall diagnostic yield for patients with suspected small-bowel disease was 57% and for patients with both occult and overt obscure bleeding 63%. Ectopic Jejunal varices was the most common diagnosis in patients with gastrointestinal blood loss. Patients with active overt gastrointestinal bleeding had a higher diagnostic yield. The procedure was tolerated well and no complications occurred. Conclusion Additional endoscopic evaluation of the proximal small bowel by push enteroscopy should be considered in all patients with negative or nonspecific findings on esophagogastroduodenoscopy and colonoscopy and with persistent bleeding, especially when a balloon-assisted enteroscopy is not readily available and capsule endoscopy (CE) is expensive.
  1,532 95 -
The diagnostic value of serum level of soluble hemoglobin scavenger receptor CD163 for sepsis in the ICU
Reda S Abdelrahman, Ayman A Wagih, Ahmed H Elbarbary
January-March 2015, 43(1):9-15
DOI:10.4103/1110-1415.154558  
Background Sepsis is the most important cause of morbidity and mortality in the ICU; however, sepsis lacks specific clinical manifestations. Current common clinical and laboratory indicators of infection include pyrexia, white blood cell counts (WBC), C-reactive protein (CRP), and procalcitonin (PCT). Aim We investigated serum-soluble CD163 (sCD163) levels in Egyptian patients in the ICU and its use in the diagnosis and severity assessment of sepsis, and compared sCD163 with other infection-related variables such as leukocyte counts, CRP, and PCT. Patients and methods A total of 20 patients with systemic inflammatory response syndrome (SIRS) were enrolled and 20 patients with sepsis were admitted to the ICU during the 6-month period. Serum levels of soluble hemoglobin scavenger receptor CD163 (sCD163), CRP, WBC count, and PCT were determined. Sequential Organ Failure Assessment scores for severe sepsis were also evaluated. Results On the day of ICU admission, patients in the sepsis group exhibited higher levels of serum sCD163 (2.41 ± 0.69 ng/ml) compared with those in the SIRS group (0.83 ± 0.19 ng/ml, P < 0.001). There was a significant positive correlation between sCD163 and WBC count (r = 0.356, P = 0.006), erythrocyte sedimentation rate (r = 0.471, P = 0.005), and CRP (r = 0.526, P = 0.001). The receiver operating characteristic curve for CRP for the diagnosis of infection showed that the reading of greater than 3.0 serves as a cutoff point for diagnosis, with a sensitivity of 86.7% and specificity of 90.2% in the studied groups, whereas for PCT the reading of 3.36 serves as a cutoff point for diagnosis, with a sensitivity of 91.6% and a specificity of 88.7% in all studied groups. sCD163 showed a cutoff point greater than 5.36, with a sensitivity of 93.5% and a specificity of 90.2%; this indicated that sCD163 was better than PCT and CRP for the diagnosis of sepsis. Conclusion sCD163 appeared to be a new diagnostic parameter for differentiating between patients suffering from SIRS and those with sepsis.
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