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Biomedical subjects

A Medhat

Publications and source records attributed to A Medhat.

7 recordsLinked to original sources
PubMed1992

Ultrasonographic changes of the liver in Schistosoma haematobium infection.

Abdominal ultrasonographic examination was performed in 61 hospitalized patients with chronic liver diseases and 253 school children from a village endemic for Schistosoma haematobium and were compared with 142 urban children without exposure to Schistosoma. The prevalence of ultrasound-detectable hepatomegaly and splenomegaly and the degree of periportal fibrosis was compared between those with and without S. haematobium infection. Among 13 patients with biopsy-proven schistosomal hepatic fibrosis, three with coarse changes secondary to S. mansoni infection showed grade III periportal fibrosis, while 10 patients with fine schistosomal hepatic fibrosis due to S. haematobium had borderline (two) or grade I (eight) changes. Ultrasound evidence of periportal fibrosis was not detected in patients with hepatic cirrhosis, chronic active hepatitis, or fatty infiltration. However, three of 14 patients with chronic persistent hepatitis had grade I periportal fibrosis and two had borderline changes. The frequency of ultrasound-detected hepatomegaly and splenomegaly was greater among rural S. haematobium-infected children (35.2% and 22.4%, respectively) than among noninfected rural (21.1% and 13.3%) and urban (16.9% and 4.9%) children. Also, the frequency of grade I periportal fibrosis was significantly greater (P less than 0.01) in S. haematobium-infected children (22.4%) than in noninfected rural (11.7%) and urban (0.7%) children. No patients with S. haematobium infections, either in the hospital or the village, had grade II or III periportal fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗
PubMed1992

Tuberculous peritonitis in Egypt: the value of laparoscopy in diagnosis.

Abdominal laparoscopy was performed on 200 patients with undiagnosed ascites. It was unsuccessful in one patient with tuberculous peritonitis because of extensive adhesions. A presumptive diagnosis of tuberculous peritonitis based on clinical findings and peritoneal tubercles or adhesions visualized during laparoscopy was made in 90 of these patients. The diagnosis was confirmed in 88 by histopathology, bacteriology, or therapeutic response. Two of the 109 remaining patients who had other presumptive diagnoses made during laparoscopy were eventually confirmed to be cases of tuberculous peritonitis. Of 91 patients with tuberculous peritonitis included in this series, 79% were females, with the majority (79%) of them being of child-bearing age. Half had been ill for longer than one month. The most frequent complaints were abdominal pain, fever, anorexia, night sweats, abdominal swelling, and weight loss. Ascites, fever, wasting, pallor, and abdominal tenderness were common findings. Ultrasonography demonstrated ascites in all patients who underwent this procedure; 21% also had adhesions. Pleural effusion was present in 15% and pulmonary tuberculosis was detected in only two patients. Biopsy samples taken during laparoscopy showed that 60% had noncaseous granulomas and 33% had caseous granulomas. Mycobacterium tuberculosis was detected in 77%, with guinea pig inoculation having the highest sensitivity, followed by culture, and lastly by acid-fast smear. Mycobacterium tuberculosis was isolated more easily from biopsy samples than from ascitic fluid. Nine of 20 M. tuberculosis isolates that were identified as to species were M. bovis. Tuberculous peritonitis, a frequent cause of febrile ascites in Egyptian women, was easily diagnosed by histopathologic and bacteriologic studies of biopsy samples taken at laparoscopy. All patients responded rapidly to antituberculosis therapy.

Adolescent↗
PubMed1991

Pancreatic enlargement in alcoholic pancreatitis: prevalence and natural history.

We determined the prevalence and natural history of pancreatic enlargement by abdominal ultrasonography or computed tomography in 72 patients with alcoholic pancreatitis. Pancreatic enlargement was observed in 54 patients (75%); it was diffuse in 28 (52%) and focal in 26 (48%). The focal enlargement was frequently cystic (50%), while the diffuse enlargement was only occasionally cystic (7%). Sequential imaging of the pancreas in 29 patients demonstrated partial to total resolution of pancreatic enlargement in greater than 50% during 6 months of follow-up. Determination of serum amylase and p-isoamylase activity was neither sensitive nor specific for pancreatic enlargement in alcoholic pancreatitis.

Acute Disease↗
PubMed1988

A new quantitative ultrasonic method for diagnosis of chronic parenchymal liver disease.

The degree of echogenicity of the hepatic parenchyma was measured by an objective method comparing patient's sonograms with a tissue-mimicking phantom obtained with available real-time ultrasound machines. A single sonographic image of the liver and the phantom was taken using identical setting in each case. The ratio of the mean density of the phantom to that of the liver was obtained. The mean of the ratio in 30 normal subjects was 1.04 +/- 0.01, in 26 patients with early alcoholic liver disease 1.23 +/- 0.04, and in 74 cirrhotic subjects 1.54 +/- 0.03, with a significant difference among the three groups (p less than 0.05). A significant correlation was also obtained between the ratio and a modified Child's classification (r = 0.553, p less than 0.05) in cirrhotic subjects. Follow-up studies were available in a limited number of patients with early alcoholic liver disease showing progression or improvement paralleling alcohol use. Using this method, ultrasound may have considerable potential in the diagnosis and follow-up of alcoholic liver disease.

Adult↗
PubMed1988

Ultrasonographic findings with bleeding and nonbleeding esophageal varices.

Real time ultrasonography was carried out in 49 cirrhotic patients within 10 days of esophagoscopy, and in 20 normal subjects. Among the cirrhotic patients, 42 had varices and 18 of these had hematemesis within 3 months of study. The varices were graded 0 to 4+ endoscopically; the diameter of the portal vein, the splenic vein, the hepatic artery, and the maximal length of the spleen were determined on ultrasound. In addition, portal collateral veins and the sudden amputation of portal vein branches in the liver were identified when present. There was a significant correlation of the diameter of the portal vein and the maximal spleen length with the magnitude of varices on endoscopy; there was no significant relationship between the splenic vein or the hepatic artery diameter. Less than half the patients with varices had sonographically demonstrated collaterals or portal vein branch amputation. A sonoscore was derived allotting one point each for enlarged portal vein (greater than 1.3 cm), enlarged spleen, collaterals or two or more amputated veins. The sonoscore correlated better with the endoscopic grade of varices than any other marker. The sonoscore among the patients with varices who bled was significantly higher (p less than 0.01) than any of the other measures. It is concluded that real time ultrasound can be used to screen for varices and to identify the need for endoscopy.

Collateral Circulation↗
PubMedDate not supplied

Factors that influence the level of activities in persons with lower extremity amputation.

This study explored the problems of prosthesis use in four dimensions of activity in 122 males and 9 females, aged 24 to 90 years, with lower extremity amputations. Comparisons were made between persons with above-the-knee amputation and those with below-the-knee amputation. A four-dimensional prosthetic problem inventory scale developed by the investigators was used. Results of this study provide a framework for identifying and addressing problematic areas in the use of prostheses.

Activities of Daily Living↗