81 research outputs found
Utility of 128-multislice CT virtual HSG in assessment of female infertility
No full textAbstractObjectiveThe aim of this study to assess the utility of 128-MDCT VHSG in evaluation of different female infertility causes.Patients and methodsForty eight infertile female patients were included in the study, which was conducted in Radiodiagnosis Department, Zagazig University Hospitals from November 2014 to May 2015. MDCT Hysterosalpingography was performed between days 6 and 12 of the menstrual cycle at least 48hours after menses.Resultswe compared findings of MDCT-VHSG with hysteroscopy or/ and laparoscopy results. We found that MSCT-VHSG more accurate in diagnosis of uterine and ovarian infertility causes, while less accurate in the diagnosis of tubal causes. The sensitivity for detecting uterine and fallopian tubes pathology by MDCT-VHSG was 100% and 100% respectively, while the specificity was 100%, 85.71% respectively. MDCT-VHSG had reported 100% and 92.85% PPV in detecting uterine and fallopian tubes pathology respectively, while the NPV was 100% and 100% respectively.ConclusionThe MDCT-VHSG is a diagnostic modality which permits the evaluation of the different causes of the female infertility, but still limited value in assessment of peritubal adhesions
Magnetic resonance cholangiopancreatography in conjunction with 3D for assessment of different biliary obstruction causes
No full textAbstractObjectiveTo assess the diagnostic value of magnetic resonance imaging in conjunction with 3D-MRCP, with maximum intensity projections and volume rendered images in different biliary obstruction causes.Patient and methodsThis study retrospectively reviewed the radiology records of 29 patients (18 females and 11 males) suffering from obstructive jaundice. All patients were subjected to magnetic resonance imaging (MRI), 3D-MRCP with maximum intensity projection (MIP) and volume rendered (VR) reformatted images for biliary obstruction diseases in Zagazig University Hospitals between November 2008 and January 2010. MR studies were performed with 1.5-T superconductive magnet (Philips Achieva, class II a). The patient ages were ranging from 23 to 66years (mean age: 34years). This study was done to evaluate the diagnostic value and accuracy of the new MRI techniques as a non-invasive tool to diagnose and differentiate between benign and malignant variants of biliary obstruction diseases and to facilitate the management planning. All cases were evaluated by clinical examination, laboratory values, grey and colored scale ultrasonography, conventional MRI, three-dimensional (3D-MRCP), MIP, and VR images. Our results were correlated with the histology of the resected specimen, operative (ERCP) or image-guided biopsy in inoperable patients.ResultsThe mean age of benign patients was 30years compared with 54years in malignant biliary obstruction. Seventeen patients had benign cases 58.6% (6 cases of benign stricture and 11 cases with choledocholithiasis). The other 12 cases had malignant aetiology. Twenty-three patients were subjected to operative procedures, while the remaining six had ERCP/PTC and stenting. The MRI/MRCP images were of good quality in all patients. The intra- and extra-hepatic biliary radicals were visualized completely including the proximal and distal extent of the stricture. Regarding the benign cases (16/17) were satisfactorily diagnosed, however, one case was false negative, due to missed small stone at the MIP reconstructions. The 12 malignant biliary obstruction cases were as follows: five cases were cholangiocarcinoma (one peripheral type, one perihilar position, one Klatskin’s type, and two cases of the distal type), three pancreatic neoplastic lesions, two ampullary carcinoma, and two malignant lymph nodes. Regarding the benign cases 3D-MRCP had 94.1% diagnostic accuracy, otherwise more accuracy reported in malignant causes 100%.Conclusion3D-MRCP with MIP creates global images for pancreatico-biliary system. It is as effective as ERCP in detection of biliary obstruction and can precisely determine its level as well. Furthermore, it can provide a road map for management planning. By avoiding the flow artifacts, the false negative results that previously reported in past studies can be reduced
Diagnostic accuracy of apparent diffusion coefficient value in differentiating metastatic form benign axillary lymph nodes in cancer breast
No full textPurpose: To detect axillary lymph node metastasis based on diffusion Weighted MR and apparent diffusion coefficient (ADC) in the known breast cancer cases.
Patient and methods: Forty-four patients were included in this study for preoperative MRI staging of the breast cancer and axillary lymph node assessment. The lymph node criteria (long/short-axis ratio, T2WI, DWI and ADC value) were included in the analysis. Images were obtained with diffusion sensitizing gradients of 0 and 750 mm2/s. The ADC was calculated.
Results: Thirty-two patients had metastatic axillary lymph nodes and 12 cases had no malignant LN involvement. There was no significant difference between both in S/L ratio, T2WISI (p < 0.140 & p = 0.079, respectively), while statistically significant difference between benign and malignant lymph nodes in both DWI and ADC mean values (p < 0.0001 & p < 0.007, respectively). The optimal ADC cut off value was ⩽.8 × 10−3 mm2/s for differentiation between benign and malignant lymph nodes with accuracy 96.7%, sensitivity 100%, specificity 87%, PPV 95.4% and NPV 100%.
Conclusion: Compared with lymph node size or routine magnetic resonance sequences, DWI and ADC are promising techniques for differentiating metastatic and non metastatic axillary lymph nodes in known breast cancer patients
Development and Characterization of Eudragit-RL-100-Based Aceclofenac Sustained-Release Matrix Pellets Prepared via Extrusion/Spheronization
No full textAceclofenac (AC) is a nonsteroidal anti-inflammatory drug used in the treatment of chronic pain in conditions such as rheumatoid arthritis, with frequent administration during the day. The formulation of sustained release matrix pellets can provide a promising alternative dosage form that controls the release of the drug, with less blood fluctuation and side effects—especially those related to the gastric system. The extrusion/spheronization technique was used to formulate AC matrix pellets. The response surface methodology (version 17.2.02.; Statgraphics Centurion) was used to study the impacts of Eudragit RL 100 and PVP K90 binder solution concentrations on the pellets’ wet mass peak torque, pellet size, and the release of the drug. Statistically, a significant synergistic effect of PVP K90 concentration on the peak torque and pellet size was observed (p = 0.0156 and 0.031, respectively), while Eudragit RL 100 showed significant antagonistic effects (p = 0.042 and 0.013, respectively). The peak torque decreased from 0.513 ± 0.022 to 0.41 ± 0.021 when increasing the Eudragit RL 100 from 0 to 20%, and the pellet size decreased from 0.914 ± 0.047 to 0.789 ± 0.074 nm. The tested independent factors did not significantly affect the drug release in the acidic medium within 2 h, but these pellet formulae maintained the drug release at less than 10% in the acidic medium (pH 1.2), which may decrease gastric irritation side effects. In contrast, a highly significant synergistic effect of Eudragit and highly antagonistic effect of the PVP solution on drug release in the alkaline-pH medium were observed (p = 0.002 and 0.007, respectively). The optimized pellet formula derived from the statistical program, composed of 3.21% Eudragit and 5% PVP solution, showed peak torque of 0.861 ± 0.056 Nm and pellet size of 1090 ± 85 µm, and resulted in a significant retardation effect on the release after 8 h compared to the untreated drug
QUALITY OF PRIMARY HEALTH CARE SERVICES IN FAMILY HEALTH CENTERS IN EL-BEHIRA GOVERNORATE
No full textAbstract: High–quality primary health care services are the outcome of strong service delivery and the result of well-organized and achieved services, supported by a strong system and sufficient inputs, such as human resources, infrastructure, drugs, and supplies. The aim of the study is to assess the quality of PHC services in family health centers in El-Behira Governorate. Material and Methods: Research design: Descriptive research design will be used to conduct this study. Setting: The study will be conducted in governmental family health centers in El-Behira governorate affiliated with the Ministry of Health. Subjects: The subjects of the present study will be all the nurses (347) working in studied family health centers. Sampling: A multistage sampling technique will be used to select the required sample. Tools: two tools were used. Tool (I): Nurses' quality knowledge and perspective structured questionnaire sheet. Tool (Π): Quality of Primary Health Care Services Evaluation. Results: the vast majority of the nurses in Damanhour, Etay EL-Baroad, Abo-Homos were females. More than two thirds (68.6%) of the nurses in Damanhour FHC compared to less than two thirds of the nurses in Etay El-Baroad and Abo-Homos (66.4% and 64.3% respectively) and half (54.3%) of them in El-Rahmanya had a secondary school of nursing diploma. Among nurses with low perspectives, 3.2% of them had poor knowledge about quality compared to none of those with high perspectives. The Family Health Centers had the highest process mean score related to provision of services especially for maternity care, family planning services and childcare. While the total clinics' process is unsatisfactory for essential drugs. Conclusion: Based on the findings of the present study, it can be concluded that none of the studied family health centers in all districts studied had a high total quality level. A significant relation was found between nurses’ mean score of knowledge and their perspective levels related to quality of services and socio-demographic characteristics related to previous training and frequency of training. The Family Health Centers had the highest process mean score related to provision of services especially for maternity care, family planning services and childcare. Recommendations: The predominant policy recommendation is that the Egyptian Ministry of Health needs to improve the budget allocation for primary health care units and centers as it is the entrance keeper to secondary and tertiary health care. It is equally important to maintain the support policy for primary health care services in order to meet the restricted affordability of low-income people who would fight to get health care if the prices of examination and medication would be increased.
Keywords: primary health care, family health centers, quality of PHC services.
Title: QUALITY OF PRIMARY HEALTH CARE SERVICES IN FAMILY HEALTH CENTERS IN EL-BEHIRA GOVERNORATE
Author: Hend Salah Shehata, Enas Mohamed Ibrahim, Reem Bassiouny El Lassy, Doaa Ali Eldemrdash
International Journal of Novel Research in Healthcare and Nursing
ISSN 2394-7330
Vol. 10, Issue 1, January 2023 - April 2023
Page No: 154-170
Novelty Journals
Website: www.noveltyjournals.com
Published Date: 26-April-2023
DOI: https://doi.org/10.5281/zenodo.7868181
Paper Download Link (Source)
https://www.noveltyjournals.com/upload/paper/QUALITY%20OF%20PRIMARY%20HEALTH-26042023-2.pdfInternational Journal of Novel Research in Healthcare and Nursing, ISSN 2394-7330, Novelty Journals, Website: www.noveltyjournals.co
Imaging of the uterovaginal anomalies
No full textAbstractObjectiveTo assess the role of different imaging modalities including ultrasonography, hysterosalpingogram, and magnetic resonance imaging in detection of variable Müllerian anomalies. Preoperative proper diagnosis data about Müllerian anomalies necessary for clear indications of how and when to operate.Patients and methodsA retrospective MRI study of 34 patients was done in the period from February 2008 to February 2010, their age ranging from 3 months to 38 years (mean 24 years), with uterovaginal anomalies. Ultrasonography was performed for all cases; HSG was performed in 16 cases before MRI imaging.ResultsMRI is the most reliable method for evaluating uterovaginal anomalies, particularly in pediatrics and virgins. MRI is an accurate examination for identification and categorization of MDAs and should be carried out prior to any surgery, in this study MRI allowed correct diagnosis of 34 uterine anomalies (accuracy 100%) whereas US was correct in 30 out of 34 cases (accuracy 88%). HSG had a limited role as cannot be preformed for virgins, and cannot identify non-communicating horns in unicornuate cases.ConclusionMRI is the examination of choice in uterovaginal anomalies. Endovaginal ultrasound cannot be preformed for children or females who have never had sexual intercourse. TAUS have not proved completely reliable in Müllerian duct anomalies
MR spectroscopy and diffusion MR imaging in characterization of common sellar and supra-sellar neoplastic lesions
No full textBackground: MR spectroscopy and diffusion-weighted imaging are useful non invasive imaging modalities used for characterization of different sellar and suprasellar lesions.
Patient and methods: We studied 30 cases of suprasellar SOLs (as proved by conventional MRI), MRS and DWI. Our findings were correlated with histopathological analysis after surgical resection.
Results: Three false positive cases in which cMRI give diagnosis mismatched with that obtained after adding the MRS findings and ADC values. MR spectrum type IIC is found in macroadenoma, craniopharyngioma, meningioma and germinoma with characteristic broad lipid peak in the second and forth types and elevated alanine peak in meningioma. Glioma had MRS appearance of type IIB. Simple differentiation between tumor types were achieved by the mean ADC values which were statistically significant (p < 0.001) when correlated to the histological diagnosis. When the ADC value of 0.6 × 10−3 mm2/s this strongly points to macroadenoma, ADC value of 1.05 × 10−3 mm2/s in meningiomas, ADC value 1.88 8 × 10−3 mm2/s strongly points to craniopharyngioma, while gliomas and germinoma had ADC values 1.6 × 10−3 mm2/s and 1.0 × 10−3 mm2/s respectively.
Conclusion: MR spectroscopy and DWMRI are considered important diagnostic tools complementary to cMRI in pre-surgical evaluation and discrimination between different sellar and suprasellar lesions
Diffusion-Weighted MRI and apparent diffusion coefficient value in assessment of intra-medullary spinal cord masses
No full textAbstractThe purpose of this study was to evaluate use of Diffusion-Weighted MRI (DWI) and apparent diffusion coefficient value (ADC) in differentiation of intra-medullary spinal cord masses (IMSCM). Patients and methods: This study was carried out during the period from June 2013 to January 2016. It included 66 adult consecutive patients with intra-medullary SC masses. Results: The patients mean age was 45.48±15.9 (18–72 y). Histopathological classification to benign/low grade malignancy group was in 53 patients and high grade malignancy group in 13 patients. No statistically significant difference between both groups regarding the patient age or their clinical presentation. There was a statistically significant difference between the two groups regarding the tumor location and enhancement pattern. There was statistically significant difference between the benign/low grade IMSC masses and high grade IMSC tumors (p<0.001). Calculated mean ADC values in the benign/low grade tumors were high (1.26×10–3mm2/sec) compared to high grade tumors which were 0.89±0.40×10–3mm2/sec. Conclusion: DWI and ADC values may be useful in providing information about tumors grading not available with conventional MR imaging in the evaluation of IMSC masses
Differentiation of Pancreatic lesions using Diffusion-Weighted MRI
No full textAbstractThe purpose of this study was to evaluate the role of diffusion-weighted imaging (DWI) in diagnosis of pancreatic lesions, to compare diagnostic accuracy of conventional MRI (MRI-c), DWI and diffusion coefficient (ADC) values of lesions.Patient and methodsThirty-six patients with pancreatic lesions (12 malignant and 24 benign) were included. MRI-c and DWI (b values 500 and 1000s/mm2) were performed prospectively and consecutively in a 1.5-T system.ResultsThe analysis was retrospectively performed. The sensitivity, specificity, accuracy, and positive and negative predictive values of DWI and MRI-c were 92%, 97%, 96%, 85%, 98% and 100%, 97%, 97%, 86%, 100%, respectively. Mean ADC values of malignant lesions were significantly lower than those of benign lesions. DWI has a similar accuracy to MRI-c in diagnosis of pancreas cancer.ConclusionMalignant tumors had lower ADC values than benign ones. DWI may be a routine sequence in oncologic settings and it provides much useful information about tumoral tissue
The value of dynamic MRI in the evaluation of the breast following conservative surgery and radiotherapy
No full textAbstractObjectiveTo assess the value of dynamic contrast-enhanced magnetic resonance mammography (DCE-MRM) in breast cancer patients treated by conservation breast surgery and radiotherapy.Materials and methodsThis prospective study were performed on 20 consecutive female patients, from January 2008 till January 2010 at Zagazig university hospitals. All cases had undergone breast conservative therapy (BCT) at least 9–12months since the end of radiation therapy up to 5years. All cases were suspected for either recurrence or post-operative complications by clinical examination in conjunction with mammography or/and US. DCE-MRM was performed at 1.5 T. The findings were correlated with the histopathology in all cases.ResultsWe found that DCE-MRM accurately revealed the presence or absence, location, and extent of recurrent tumor more accurately than mammography or US. US had high sensitivity and specificity (85.7% and 76.8%) compared to mammography (71.4% and 38.4%, respectively). Seven recurrent cases were found, two of them were multifocal. False-positive contrast enhancement was seen in only one patient pathologically proved as granuloma. MRI showed 95% accuracy, 100% sensitivity, 92.3% specificity with 83% positive predictive value and 100% negative predictive value.ConclusionThe conventional imaging was insufficient to detect the recurrent lesions after BCT, so DCE-MRI should be the imaging modality of choice in detection of the tumoral recurrence, and differentiating it from other complications. One limitation of the DCE-MRM is the persistent false-positive enhancement due to granulation tissue
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