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   Table of Contents - Current issue
Coverpage
January-April 2020
Volume 26 | Issue 1
Page Nos. 1-31

Online since Wednesday, September 16, 2020

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EDITORIAL  

Light and electron microscopic study of the effect of paracetamol on the heart of adult male albino rats and the possible protective effect of vitamin C p. 1
Maha Abdel Baky Ahmed Fahmy
DOI:10.4103/kamj.kamj_9_20  
Paracetamol is used to treat several conditions like headache, muscle aches, arthritis, backache, toothaches, colds, and fevers. There are several side effects which result from administration of paracetamol, as it may affect liver, kidney and even heart. Unexplained deaths and electrocardiographic changes associated with paracetamol poisoning have also been reported and wasn’t been clearly discussed. Material and methods: The experimental study was carried out on 15 rats. The animals were divided into 3 groups, each group consists of 5 rats: Group1: Healthy control rats. Group 2: Rats received (0.5) ml of paracetamol/kg BW (oral).Group 3: Rats received (0.5) ml of paracetamol/kg BW (oral), and vitamin C (200 mg/kg BW). The animals were anesthetized by ether, the chest was opened to expose the heart for intracardiac perfusion with 10 ml of isotonic solution until the coming fluid is clear of blood, then 10% neutral buffered formalin. Each group is divided into two subgroups. The first subgroup was processed for light microscopy, and the second subgroup was processed for electron microscopy Treatment was done once daily for continuous 30 days. Results were in the form of presence of muscle disruption, invasion of muscle fibers by inflammatory cells, severely dilated and congested blood vessels, numerous and giant mitochondria. But, in group III there was some amelioration in the form of decrease in disruption of muscle fibers, decrease in congestion of blood vessels and mitochondria appeared in a normally arranged manner. The statistical analysis showed hypertrophy of muscle fibers in group II, and slight resolution in the hypertrophy in group III.
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ORIGINAL ARTICLES Top

The reliability of leptin immunostain use for differentiating renal oncocytoma and chromophobe renal cell carcinoma p. 5
Yasmine Fathy Elesawy, Samar Ibrahim Ismail Amer, Ahmed Naeem Eesa
DOI:10.4103/kamj.kamj_30_19  
Background The discrimination between chromophobe renal cell carcinoma (ChRCC) and renal oncocytoma (RO) has been a topic of concern in medicine. Because ChRCC is a malignant tumor, whereas RO is a tumor with benign behavior, it is important to distinguish these two entities. We aimed to study the possible differentiation concepts between ChRCC and RO. Aim We attempted to study the pathological features of RO and ChRCC and correlate them focusing on the reliability of leptin immunostain use as a tool in differentiation. Materials and methods A total of 25 cases of renal tumors (17 RO cases and eight ChRCC ones) were studied for clinicopathological features’ correlation and leptin immunohistochemical expression. Results The included cases’ mean±SD age was 53.1±12.7 years, with range of 28–72 years. The male sex slightly exceeded the female one in prevalence of studied renal neoplasms (52 vs. 48%, respectively). Regarding the size of oncocytoma tumors in gross examination, it had a mean±SD of 5±2 cm, whereas that of ChRCC was 7±4 cm. The central scar is present in only four (23.5%) cases of oncocytoma, being absent in most cases (13 cases, 76.5%). In ChRCC, the nuclear grade 2 is the most common in the studied group (62.5%). Regarding leptin immunostaining scores, positive score was found in 13/17 oncocytoma cases, and only 2/8 cases of ChRCC showed nuclear leptin stain, with significant P value of 0.028. Oncocytoma leptin-positive cases represented 86.70%, whereas those of ChRCC represented 13.30% of total cases. Leptin sensitivity was estimated to be 76.5%, specificity 75.0%, positive predictive value 86.7%, negative predictive value 60.0%, with overall accuracy of 76%. Conclusion Leptin immunostain can be of an extreme help in differentiating ChRCC and RO.
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Does MRI diffusion help in the detection and characterization of benign and malignant hepatic focal lesions in the nonpediatric age group? p. 14
Ahmed A Mahmoud, Marwa S Elnafarawy, Medhat M Madbouly, Mohammed H Kamel
DOI:10.4103/kamj.kamj_6_20  
Introduction Liver MRI has been used in cases where ultrasound or computed tomography findings are equivocal. Diffusion-weighted imaging (DWI) established an important role in clinical use in the liver. DWI can potentially add useful information to conventional imaging. Objective The aim was to assess the role of DWI in the detection and characterization of hepatic focal lesions and its value to differentiate benign from malignant masses. Patients and methods The study included 40 patients, 19 women and 21 men, their ages ranged from 20 to 63 years. All patients underwent detailed MRI study of the abdomen. Diffusion study was performed with tridirectional diffusion gradients using b values 0, 500, and 1000 s/mm2 to increase the sensitivity. Apparent diffusion coefficient (ADC) maps and values were calculated for all lesions. Results In all, 20 patients were diagnosed to have benign lesions and 20 patients were diagnosed to have malignant lesions. Hemangiomas and cysts showed facilitated diffusion while adenomas show restricted diffusion pattern mimicking malignant focal lesions. On the other hand, all malignant lesions showed restricted diffusion evidenced by increased signal on increasing the b values and low signal on ADC maps. Mostly benign lesions show higher ADC values than malignant lesions. Conclusion Diffusion-weighted MRI sequence with quantitative ADC measurements should be used as an additional sequence to supplement conventional MRI protocol studies for proper characterization of focal hepatic lesions putting into consideration an overlap range.
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Knowledge, attitudes, and practices toward COVID-19 at Menoufia Governorate, Egypt p. 21
Hala M Gabr, Ahmed S Seif, Heba K Allam
DOI:10.4103/kamj.kamj_22_20  
Background Coronavirus disease (COVID-19) is a new strain of coronavirus that was discovered in 2019 and has not been previously identified in humans. As of July 6th, 2020, the pandemic of COVID-19 has resulted in 11 327 790 confirmed cases and 532 340 deaths all over the world as reported by WHO. Aim The aim was to assess the knowledge, attitudes, and practices of Egyptians toward COVID-19 infection. Participants and methods A cross-sectional descriptive study was conducted during May 2020 over a period of 6 days for all adult attendees to outpatient clinics in Menoufia University Hospitals. A self-administered questionnaire was distributed and completed by all participants. Results Participant’s age in this study ranged from 18 to 76 years old, and 80.68% of them were above forty years old. Overall, 53.2% of the participants were females. Most of them had middle socio economic standard (SES) (68.72%), high education (53.23), and worked as professionals (45.64). Multivariate linear regression analysis showed a significant independent association between knowledge score and each of educational level and occupation (P<0.001). In addition, a significant independent association was found between attitude score and each of age, residence, educational level, and SES (P<0.001). There was a significant independent association between practice score and each of residence, educational level, SES, and occupation of the participants (P<0.001). Conclusion As there was a significant positive correlation between knowledge and practice of the studied group toward COVID-19, more educational programs should be directed to people of low SES and rural areas.
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CASE REPORT Top

Strongyloidiasis associated with duodenal dysplastic changes: a case report p. 27
Mahmoud Kamel, Hani Barsoum, Suzan Talaat, Mohamed Zakaria
DOI:10.4103/kamj.kamj_7_20  
Strongyloides stercoralis is an intestinal nematode that infects the mankind worldwide, particularly in low socioeconomic status areas. It has a unique autoinfection phenomenon, which enables it to reproduce permanently even after cessation of exposure. Strongyloidiasis is an easily missed disease and is fatal usually when the immunity is suppressed due to disseminated infection and consequent multiorgan damage. The authors present a case of strongyloidiasis associated with duodenal mucosal dysplasia beyond the usual reactive changes. S. stercoralis is a treatable infection and should be cared for properly. Pathologists have a major role in its detection. Mucosal changes are not usually reactive and should not be overlooked.
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