Objective: To assess the variations in the course of optic nerve (ON) in relation to sphenoid sinus with the help of CT scan. Methodology: A cross-sectional study was carried out using computed tomographic (CT) paranasal sinus scans of two hundred and seventy study participants between January 2017 and May 2017. Non-probability consecutive sampling technique was used and data was entered on SPSS version 23. Inclusion criteria comprised of adults coming for CT head and brain who did not have bony abnor- mality of sphenoid and ethmoid sinuses or adjacent structures. However, individuals with sinonasal tumors, chronic rhinosinusitis, prior sinus surgery, facial fracture, nasal polyposis and congenital craniofacial anomaly were excluded from this study. Analysis of optic nerve was carried out according to DeLano's classification. Results: Type 1 ON was found to be the most frequent type; 55.93%, followed by type 2 with a frequency of 26.85%. However, type 3 and type 4 appeared less frequently, that is 11.1% and 6.11%, re- spectively. When comparing right and left sides it was noted that the frequency of type 1 optic nerve was found to be higher on both right and left sides with a value of 56.30% and 55.5%, respectively. Type 2 showed a frequency of 26.67% on right side and 27% on left side. Type 3 was identified to be 11.4% and 10.7% on right and left sides, respectively. Type 4 optic nerve was found to be the least common type in our study on both sides, i.e. 5.56% on the right side and 6.67% on the left side. Conclusion: The combined percentage of type II and type III ON that is 37.96% in our sample brings us to this conclusion that fairly high percentage of our population is exposed to increased potential risk of iatrogenic optic nerve injury thus emphasising the need for careful evaluation of ON in relation to sphenoid sinus anatomy on CT scan prior to endoscopic sinus surgery.
Objective: To evaluate the immunohistochemical expression and scoring of HER2/neu in different variants of adenocarcinoma of prostate and to compared the association of HER2/neu expression with biological behavior and risk factors of prostate adenocarcinoma. Study Design and Setting: Cross sectional study in which all clinically suspected prostate adenocarcinoma cases received at the laboratory Saddar Karachi during the years 2015 and 2016 were evaluated for morphological features of adenocarcinoma. Methodology: This cross sectional study was carried out using prostate biopsies of clinically suspected prostate adenocarcinoma. The diagnosis of adenocarcinoma was confirmed and histological characterization was done by evaluating the morphological features. The tumors were graded according to the revised 2015 Gleason’s grouping. Immunohistochemical analysis for HER2/neu expression was performed in the most representative tumor block. SPSS version 22 was used for data analysis. Mean frequency and percentages were calculated for quantitative variables, whereas chi-square test and Fisher’s Exact Test were applied for qualitative variables. P-value of < 0.05 was considered as significant. Results: Out of 77 biopsies only one showed moderate HER2/neu expression. Positive HER2/neu was acinar variant. No significant statistical association was observed between expression of HER2/neu and prostate cancer variants. The positive case had age more than 60 years with moderately increased serum PSA levels and was aggressive in nature at the time of diagnosis. Conclusion: It was concluded from the study that HER2/neu was rarely expressed in prostate adenocarcinoma
Cleavage of erythrocyte surface sialic acid (SA) by the sialidase produced by trypanosomes is implicated in the pathogenesis of anaemia in African animal trypanosomiasis (AAT). Sialyltransferase (ST) mediates the attachment of SA to cell surface glycoproteins and glycolipids of desialylated erythrocytes. ST activities in Trypanosoma congolense-infected sheep and control groups were investigated and variations in their physio-biochemical properties were evaluated. Six (6) apparently healthy Nigerian Yankassa breed of sheep comprising of T. congolense-infected (n=3) and non-infected (n=3) groups were used for the experiment. Parasitaemia and packed cell volume (PCV) were determined daily over a 5-week period. Enzyme kinetics of partially purified ST from the thyroid gland were also evaluated. Anaemia (mean PCV= 18.83±0.71%) was observed in the T. congolense-infected sheep when compared with the non-infected control group (mean PCV 39.75±0.35%) and the observed differences were significant (p < 0.05) after five weeks post infection. Variations were also observed in the physio-biochemical properties (pH, temperature, activation energy) of the ST isolated from the T. congolense-infected and control sheep. This finding is believed to have been an induced response by the host to parasite’s activity and could be exploited further as a possible target in the control of AAT.
AM lipid panel was obtained (Table ). A CT of the abdomen and pelvis showed a distended gallbladder with dilatation of the intrahepatic and common biliary ducts with the CBD measuring up to 11 mm near the head of the pancreas. The serum sodium did not improve after IV fluids which were stopped as he looked clinically euvolemic. AM lipid was obtained (Figure). ERCP revealed a 2cm biliary/pancreatic stricture compatible with pancreatic cancer and a 7 F stent was placed. CA 19-9 was 149.6. His serum sodium improved spontaneously without intervention. At discharge, his corrected serum sodium improved to 132. A EUS guided biopsy confirmed a pancreatic adenocarcinoma. Discussion: Unmeasured proteins and/or lipids seen in intra-and extra hepatic cholestasis can falsely result in a low serum sodium. These spurious anomalies may impede diagnosis and initial management. A high degree of caution should be exercised when met with conflicting clinical and laboratory abnormalities. Clinicians may exercise inappropriate choice of fluids especially when met with those suffering from pancreatitis. This may further lead to complications of rapid correction of sodium and hypernatremia. A high clinical suspicion should be exercised when met with severe asymptomatic hyponatremia. Sodium should be monitored after relieving the obstruction. Measurement of serum lipids and evaluating for paraproteinemia can be helpful.[1915] Figure 1. Lipid profile.
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