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Biomedical subjects

M B Satti

Publications and source records attributed to M B Satti.

At least 19 recordsLinked to original sources
PubMed1998

Spontaneous tonsillar hemorrhage: an underdiagnosed condition.

OBJECTIVE: The purpose of this study was to review the clinical profile of patients diagnosed with spontaneous tonsillar hemorrhage (STH). METHOD: We conducted a retrospective review of all cases presenting with tonsillar hemorrhage at KFHU between February 1992 and January 1997. RESULTS: Spontaneous tonsillar hemorrhage was diagnosed in four patients, two children and two adults, all females. Spontaneous tonsillar hemorrhage was associated with an acute febrile illness in the children. A bleeding ulcer was suspicious of malignancy in one adult, and no underlying cause was found in the other. All had tonsillectomy and histologically proven sepsis. CONCLUSIONS: Spontaneous tonsillar hemorrhage is an uncommon emergency complication of tonsillar sepsis. Awareness of the condition by practising otolaryngologists will reduce unwarranted prolonged invasive investigations. Tonsillectomy is the definitive mode of treatment.

Adult↗
PubMed1997

Primary localized cutaneous amyloidosis: a clinicopathologic study from Saudi Arabia.

BACKGROUND: Primary localized cutaneous amyloidosis (PLCA) refers to deposition of amyloid in apparently previously normal skin with no evidence of deposits in internal organs. Certain ethnic groups are particularly predisposed. The objective of this study was to investigate the occurrence of PLCA in a hospital-based set-up and to review the clinico-pathologic findings of histologically confirmed cases. METHODS: Methods included a retrospective evaluation of the records and paraffin sections of skin biopsies of all patients, diagnosed clinically as cutaneous amyloidosis in a tertiary care teaching hospital during the period 1987-95. RESULTS: Twenty-one out of 42 suspected cases were histologically confirmed as PLCA; the total number of biopsied patients during the whole period was 920. Eleven were cases of lichen amyloidosis (LA) and 10 were of macular amyloidosis (MA). All were adults, and women dominated in MA. The mean duration of symptoms was shorter for the latter subtype. Histologically epidermal changes were the main differentiating feature between LA and MA. CONCLUSIONS: PLCA is a rare chronic progressive skin disorder affecting adults, with a prevalence of 0.15 among patients attending the dermatology clinic in a tertiary care teaching hospital in Saudi Arabia. There were few differences in demographic profile or histochemical characteristics between LA and MA. Meticulous histologic examination of sections and even sequential biopsies may be needed to confirm the diagnosis in clinically suspected cases.

Adolescent↗
PubMed1994

Tuberculous pleural effusion in the eastern province of Saudi Arabia.

The incidence and clinical pattern of tuberculous pleural effusion (TPE) and the contribution of individual laboratory procedures in the diagnosis of TPE were assessed in a five year prospective study. Two hundred and fifty-three patients presenting in three participating hospitals with pleural effusion (PE) were assessed clinically and had various laboratory investigations. Eighty-nine (35.2%) of them, including 73 (82%) men and 31 (34.8%) Saudis had TPE. Their mean age +/- SD was 33.4 +/- 11.2 years. Main symptoms in rank order were cough (80%), fever (75%), shortness of breath (64%), chest pain (61%), anorexia and weight loss (47%). PPD was positive in 82 (92%) patients. Positive culture or histological evidence of tuberculosis (TB) was observed in pleural biopsy (68.5%), pleural fluid (10%) and sputum (2%). Pleural fluid microscopy was positive in only one patient, chest radiological features of TB in 3 (3.4%). Six months anti-TB therapy resulted in complete recovery in 86 patients. It is concluded that in this community TPE constitutes over a third of all the causes of PE. The relatively young age of patients reflects the age structure of the indigenous population as well as immigrant workers. PPD, histology and culture of pleural biopsy were the most useful diagnostic tools while pleural fluid and sputum microscopy were unhelpful. The 6-months anti-TB therapy was excellent.

Adolescent↗
PubMed1994

Pattern of chronic liver disease in the eastern province of Saudi Arabia. A hospital-based clinicopathological study.

During the period 1982-1990, 544 patients with clinical evidence of liver disease were admitted to King Fahd University Hospital, Al-Khobar, Saudi Arabia. Besides routine laboratory and sonographic investigations, all were subjected to either a needle liver biopsy, laparoscopy or a laparotomy. The tissue diagnoses were as follows: liver cirrhosis 17.3%, periportal fibrosis 14.3%, metastatic cancer 12.9%, primary hepatoma (hepatocellular carcinoma: HCC) 12.1%, hepatic granuloma 11.2%, chronic active hepatitis 7.7%, chronic persistent hepatitis 2.2%, fatty liver 7.2%, hydatid liver disease 4.6% and others 2.8%. In 7.7% the histology was normal. These results will be discussed and compared with results reported in local and international literature.

Chronic Disease↗
PubMed1994

Pattern of pleural effusion in Eastern Province of Saudi Arabia: a prospective study.

In order to establish the clinical pattern and aetiology of pleural effusion in adults in the eastern province of Saudi Arabia, all patients aged 18 years and above presenting with clinical and radiological evidence of pleural effusion, between 1st December 1987 and 30th November 1991, at three participating hospitals, were prospectively studied. Of the 201 (145 male, and 56 female) patients recruited, 102 (51%) were Saudis; their mean age was 43.4 +/- 17.8 years. Pleural effusion was more common on the right side (56%) than the left (32%). In rank order, the most common diagnoses were tuberculosis (37%), neoplasm (18%), parapneumonia (14%), and congestive cardiac failure (14%). There were a variety of other causes. The aetiology was indeterminate in only 3 (1.5%) patients. Patients with tuberculosis (75 patients) were relatively young (mean age 33.4 years) and 50 (67%) of them were expatriates, mainly from the Indian subcontinent and Yemen. Of the diagnostic procedures, the most useful were histological examination and culture of pleural biopsy. The contribution of culture and cytology of pleural fluid to diagnosis was rather small. It is concluded that the clinical pattern and aetiology of pleural effusion observed in this study are similar to those of the developing countries, although they seem to have been influenced by the large migrant labour force in the country.

Adolescent↗
PubMed1993

Abdominal tuberculosis in Saudi Arabia: a clinicopathological study of 65 cases.

The clinical and pathological features of 65 patients with abdominal tuberculosis obtained during a 7-yr period were analyzed and the diagnostic procedures critically evaluated. The diagnosis was histologically confirmed in 59 patients. In two more patients, the diagnosis was based solely on a positive ascitic fluid culture for tubercle bacilli. The remaining four patients responded dramatically to anti-tuberculous chemotherapy given on suspected laparoscopic findings in cases in which no biopsy was taken. Laparoscopy was found to be safer and superior to laparatomy and is recommended as an initial investigation in the diagnostic work-up of patients in whom tuberculous peritonitis is suspected. Furthermore, the finding of granulomatous inflammation in peritoneal biopsy is a justification for immediate therapy in such patients. This is particularly valid in endemic areas if one considers the risks of delaying treatment of these patients.

Adolescent↗
PubMed1992

Tendon sheath tumours: a pathological study of the relationship between giant cell tumour and fibroma of tendon sheath.

Thirty-nine soft tissue lesions occurring on the distal aspect of the limbs have been selected because of histological features consistent with those recognized for giant cell tumour of tendon sheath or fibroma of tendon sheath. In spite of the frequent occurrence of such lesions at the stated sites, they were rarely correctly diagnosed pre-operatively. Using a scoring system to grade specified histological features, a blind evaluation to re-classify these 39 lesions was undertaken. This resulted in 29 cases of giant cell tumour of tendon sheath, six fibromas of tendon sheath and four 'transitional stage' lesions. Despite the heterogeneous morphology of these categories, there were no significant differences in the clinical features of affected patients. The existence of a 'transitional stage' lesion, combined with the homogeneous clinical picture of all categories, supports the concept that fibroma of tendon sheath is the end and sclerosing stage of giant cell tumour of tendon sheath, probably consequent on progressive vascular impairment. There is a need for pathologists to recognize the transitional stage lesions so as to avoid their inclusion with other diagnostic entities. For this group the name 'giant cell tumour of tendon sheath--transitional stage lesion' is suggested.

Adolescent↗
PubMed1991

Tuberculous peritonitis: the value of laparoscopy.

The laparoscopic and pathological diagnoses of 43 patients who underwent abdominal laparoscopy for various indications are presented. Major indications for the laparoscopy included hepatomegaly in 32 patients, ascites in 28, and pyrexia of unknown origin (PUO) in 18 patients. A combination of two or more of these indications was a more common feature. The most frequently encountered laparoscopic diagnoses were tuberculosis and chronic liver disease (16 patients each), followed by cancer (9 patients). However, on pathological examination of peritoneal or liver biopsy tissue and on follow-up, tuberculosis was confirmed in 12 patients, chronic liver disease in 14 patients and hepatocellular carcinoma in 11 patients. No complications were encountered during the laparoscopy. Our findings indicate that abdominal laparoscopy is a safe, quick and inexpensive diagnostic tool, particularly when appropriate and adequate tissue is taken for pathological examination. In such instances, laparoscopy would save an unnecessary laparotomy, especially where tuberculosis and cancer are considered in the differential diagnosis.

Adult↗
PubMed1990

Amyloid deposits in basal cell carcinoma of the skin. A pathologic study of 199 cases.

Deposits of amyloid were detected in 101 of 199 basal cell carcinomas (51%). The frequency of amyloid deposits in solid, adenoid, and cystic histologic subtypes was slightly higher than overall, whereas in partial sclerosing and morphea-like tumors the frequency was much lower. The amyloid of basal cell carcinoma showed histochemical characteristics that were different from those of locally deposited amyloid in endocrine tumors such as medullary carcinoma thyroid and from those of "secondary" amyloid. No major differences in the histochemical characteristics, however, were observed between amyloid associated with basal cell carcinoma and myeloma-associated or "primary" amyloid. Nevertheless, immunohistochemical staining with rabbit antihuman keratin antibodies by the peroxidase antiperoxidase technique demonstrated positivity only in amyloid deposits associated with basal cell carcinoma and not in those of myeloma-associated amyloid. This evidence supports the concept that amyloid of basal cell carcinoma is produced in the stroma from degenerated epithelial cells through filamentous degeneration or apoptosis.

Amyloid↗
PubMed1990

Splenic foam cells: a clinico-pathologic analysis of 92 splenectomized patients.

Spleens from 92 patients who underwent splenectomy for various indications were examined. These indications included hematologic disease in 38 patients and nonhematologic problems in 54. Of all the group foam cells were seen in hematoxylin and eosin (HE)-stained sections of spleens from 12 patients. This number increased to 21 (23%) when the diastase periodic acid-Schiff stain was used as a screening test. The cells in these 9 additional cases were too scanty to be observed on HE-stained sections alone. All the 21 spleens with positive foam cells were from patients with hematologic disease, specifically beta-thalassemia major, hemoglobin S/beta-thalassemia, hemoglobin AS, and idiopathic thrombocytopenic purpura. None of the spleens from the 54 nonhematologic patients showed foam cells. Factors that determine the probability of presence of foam cells were calculated. Also, certain differences in the staining reactions of foam cells were observed. The results of both, and the relation of these foam cells to the 'syndrome of the sea-blue histiocyte' are presented and discussed.

Adolescent↗
PubMed1990

Oesophageal diseases diagnosed by upper gastrointestinal endoscopy in the eastern province of Saudi Arabia.

Upper gastrointestinal endoscopy was performed on 2982 patients who presented with symptoms and signs related to the upper gastrointestinal tract. Of all these patients, 743 (25%) had the pathology limited to the oesophagus with a normal stomach and duodenum. These 743 patients constituted the material for this study. Of all oesophageal diseases, the most frequent endoscopic diagnosis was mild or moderate oesophagitis occurring in 350 patients (47%). Hiatal hernia with oesophagitis occurred in 232 (31%), oesophageal varices in 87 (12%) and ulcerative strictures in 74 patients (10%). Further histopathological examination of oesophageal biopsies from the latter 74 patients confirmed oesophageal carcinoma in 27 (3.7%), ulcerative oesophagitis in 43 (5.8%) and tuberculous oesophagitis in 4 patients (0.5%). The endoscopic and pathologic findings of these patients are presented and discussed.

Adolescent↗
PubMed1990

Helicobacter pylori-associated upper gastrointestinal disease in Saudi Arabia: a pathologic evaluation of 298 endoscopic biopsies from 201 consecutive patients.

In a prospective study, histopathological examination 298 upper gastrointestinal (UGI) biopsies, obtained from 201 consecutive patients, was made. Patients were referred with mild to severe dyspeptic symptoms. The aim of the study was to compare the rate of identification of Helicobacter pylori (H. pylori) in the histologically normal gastric mucosa with that in histologically confirmed gastritis or peptic ulcer disease. The gastroduodenal mucosa was histologically normal in 35 patients (17.4%); among those patients, H. pylori was identified in only three (9%). Chronic gastritis was histologically confirmed in 162 patients (80.6%). H. pylori was identified in 123 (76%) of those patients. The difference was statistically significant (p less than 0.00001). Furthermore, when cases with a histological diagnosis of superficial chronic active gastritis (SCAG) are considered separately, the identification rate of H. pylori increases to 88% (121 of 137). When this rate is compared with that of 8% (two of 25), found in superficial chronic quiescent gastritis (SCQG), the difference is highly significant (p less than 0.00001). Of 38 endoscopically diagnosed peptic ulcers, H. pylori was identified in the gastric mucosa of 34 (89%). The organisms were always seen in the antral gastric mucosa, but never in duodenal mucosa. Identification of H. pylori correlates significantly with the histologic activity of chronic gastritis, in both peptic ulcer disease and non-ulcer dyspepsia.

Adolescent↗
PubMed1990

Hepatic granuloma in Saudi Arabia: a clinicopathological study of 59 cases.

The identification of hepatic granuloma (HG) as a histiocytic or epithelioid cell collection is generally an easy task for the pathologist. However, most workers agree that arriving at a specific etiologic diagnosis, based solely on the morphology of the granuloma, may prove quite a tedious exercise. Of 404 histologically reviewed liver biopsies from 404 patients, 40 were normal, 62 showed carcinoma, and 243 revealed evidence of either acute or chronic nongranulomatous liver disease (NGLD). The remaining 59 biopsies had HG, constituting an incidence figure of 14.6%. The latter 59 patients qualified for further clinicopathological analysis, which constituted the material for this study. The HG was due to schistosomiasis in 32, tuberculosis in 19, brucellosis in four, drugs in two, and to typhoid and ruptured fat cysts (lipogranuloma) in one patient each. The study was done to delineate the histological and other features that might be of value in identifying the etiology of HG.

Adult↗
PubMed1989

Peripheral neural involvement in cutaneous leishmaniasis. A pathologic study of human and experimental animal lesions.

Peripheral neural involvement in cutaneous leishmaniasis has recently been recognized. A man presented with several tender hyperesthetic skin nodules. Histopathologic examination confirmed the diagnosis of cutaneous leishmaniasis. Of most interest was the presence of a striking lymphohistocytic inflammatory infiltrate around and within cutaneous nerves in addition to demonstrable leishmania organisms in the perineural space. This observation led to a detailed histopathologic evaluation of leishmanial skin lesions that developed in 13 mice after subcutaneous injection with leishmania major promastigotes. Varying degrees of neural involvement was noted in skin lesions from nine animals. In some lesions, in addition to inflammatory cells in the nerves, organisms were demonstrable within probable schwann cells. Three pathologic stages of dermal neural involvement were identified, namely, an early, intermediate, and late stage, depending on the severity of damage; however no correlation was found between the pathologic stage and the duration of the leismanial skin lesion of a specific animal.

Adult↗
PubMed1989

Campylobacter pylori in Saudi patients undergoing upper gastrointestinal endoscopy: prevalence and effect of conventional therapy.

Patients with symptoms of gastritis or peptic ulcer disease were recruited to study the prevalence of Campylobacter pylori. On the basis of the endoscopic diagnosis only, the isolation rates of the organisms in normal, gastritis or gastroduodenitis (GD), and peptic ulcer (PU) disease patients, were not significantly different among the 89 patients evaluated. However, analysis based on histopathological evaluation (in 73 out of these 89 patients) revealed a significant difference (p = 0.00016) in the isolation rate between histologically normal individuals (14%) and those with GD (89%). Also, a significant (p = 0.03) difference was observed in the C. pylori detection rate among patients with GD and those with PU disease (61%). After adjustment for multiple comparisons, only the difference in C. pylori prevalence between normal and GD patients was maintained. After conventional therapy, 23 patients who initially had GD or PU disease were submitted to re-endoscopy. In the latter group, a correlation between presence or absence of organisms and histological healing was noted. The potential pathogenesis of C. pylori in gastritis and peptic ulcer disease, and designs for future trials are discussed.

Adult↗