Variation of Luminal Diameter of the Right Principal Bronchus in Different Age and Sex Group of Bangladeshi Cadaver

The respiratory system is involved in the intake and exchange of oxygen and carbon dioxide between an organism and the environment which is essential for human survival. The bronchial tree includes the trachea, right and left principal bronchi and their branching upto alveoli. A common medical problem with the respiratory tract is acute respiratory tract infection (ARI) which is the leading killer of children under five. The aim of the present study was to find out the variation of the luminal diameter of right principal bronchus in Bangladeshi people. This cross sectional descriptive study was performed on 70 post mortem human right principal bronchus (44 of male and 35 of female) to find out the difference in luminal diameter of the right principal bronchus of Bangladeshi people in relation to age and sex in the department of Forensic Medicine, Mymensingh Medical College, Mymensingh, Bangladesh by purposive sampling technique from July 2014 to June 2015. All specimens were grouped into three categories, Group A (upto 20 years), Group B (21-40 years) and Group C (41-60 years) according to age. Dissection was performed according to standard autopsy techniques. The right principal bronchus was cut horizontally within 1cm of its origin and the average luminal diameter was measured with the help of a point divider and metric scale and was expressed in centimeter. All data were recorded in the pre-designed data sheet and statistical analysis was done using computer based statistical package, SPSS to evaluate the significance of variance between the different findings. In the present study the maximum luminal diameter of the right principal bronchus was 1.45, 1.55 and 1.70cm in age Group A, B and C respectively. The minimum luminal diameter of the right principal bronchus was 0.75cm in Group A, 0.80cm in Group B and 0.80cm in Group C. The mean±SD luminal diameter of the right principal bronchus was 1.21±0.23, 1.24±0.21 and 1.20±0.22cm in age Group A, B and C respectively. In most cases (87%) it was >1cm. The maximum mean luminal diameter of the right principal bronchus was in age Group B (1.24cm) and minimum was in age Group C (1.20cm). The mean difference of luminal diameter of the right principal bronchus between groups was statistically insignificant. The mean±SD luminal diameter of the right principal bronchus in male was 1.24±0.19, 1.30±0.18 and 1.23±0.21cm in age Group A, B and C respectively and 1.18±0.28, 1.16±0.23 and 1.12±0.24cm in female in age Group A, B and C respectively. It is evident from the results that the mean luminal diameter of the right principal bronchus in male was higher than that of female in all the groups but this mean difference between sexes in the group was statically non significant. The study would help to establish a normal standard data on the luminal diameter of the right principal bronchus of Bangladeshi people.

Variation of Length of Trachea in Different Age & Sex Group of Bangladeshi Cadaver

A cross sectional descriptive study was performed on 70 post mortem human trachea (44 of male and 35 of female) to find out the difference in length of the trachea of Bangladeshi people in relation to age and sex. The specimens were collected from the morgue in the department of Forensic Medicine, Mymensingh Medical College, Mymensingh, Bangladesh by purposive sampling technique. All specimens were grouped into three categories, Group A (upto 20 years), Group B (21-40 years) and Group C (41-60 years) according to age. Dissection was performed according to standard autopsy techniques. The length of the trachea was measured with the help of a metallic tape and data was analyzed by using one way ANOVA test. A general trend of increasing tracheal length was observed as age advanced. The mean±SD length of the trachea was 7.88±1.01cm in Group A, 8.81±0.81cm in Group B and 8.94±1.04cm in Group C. The mean length of the trachea in male were 8.1±0.81cm, 8.95±0.69cm and 8.92±1.1cm in Group A, Group B and in Group C respectively and in female the length were 7.57±1.24cm, 8.61±0.96cm and 9±1cm in Group A, Group B and Group C respectively. Variance analysis shows significant difference in mean length of the trachea between the age Group A & B and Group A & C but no significant difference was shown between Group B & C. No significant difference of length of trachea between male and female was observed. The study would help to increase the information pool on the length of the trachea of Bangladeshi people.

Female adnexal tumour of probable Wolffian origin in a 23-year-old woman

This report describes a case of female adnexal tumour of probable Wolffian origin in a 23-year-old woman. This is the youngest patient so far described in association with this tumour. Following surgical management 11 years ago, there was neither recurrence nor metastasis and the patient gave birth to three children.

Presentation and epidemiology of nasopharyngeal carcinoma in Jordan

A retrospective study, which highlights some of the aspects of nasopharyngeal carcinoma (NPC) as seen in a large hospital for 20 years in Jordan, was performed. Collected data showed that NPC accounted for one per cent of all malignant tumours during the period. The present series showed an age range from six to 89 years old with a mean of 39.5 years. There was a bimodal peak at presentation at 16 to 20 and 46 to 50 years. A high incidence of childhood NPC was also noticed (two per cent of all childhood malignant tumours). The difficulty in early diagnosis urges for better awareness of the tumour especially among general practitioners. The tumour is still detected at an advanced stage with 34 per cent metastasis most frequently to bone. The study stresses the importance of full ENT examination in cases of persistent middle ear disease, recurrent or persistent nasal symptoms or headache, or neck swelling; and routine bone scanning for all cases with NPC. There is a need for prospective studies of the causal relationship of NPC to environmental factors including Epstein-Barr (EB) virus as well as occupational and domestic hazards.

Complete duplication of the bladder and urethra

We report a case of complete duplication of the bladder and urethra. The condition was asymptomatic and was associated with congenital dislocation of the right hip. Excision of the dorsal urethra and bladder, and correction of the chordee were done.

Diagnostic value of cervical lymph node biopsy: a pathological study of 596 cases

During a 10-year period (1976-1985), a total of 596 cervical lymph node biopsies for diagnostic purposes were performed at our institution. Thirty-five percent of these nodes were involved with malignant lymphoma, and 20.5% showed metastatic deposits. Nondiagnostic reactive hyperplastic changes were noted in 23% of the cases. Several other inflammatory and neoplastic conditions were encountered. Comparison of our data with several series from different countries with review of relevant literature are presented.

The epidemiology and clinical outcome of hepatitis D virus (delta) infection in Jordan

The epidemiology and clinical outcome of hepatitis D viral infection in HBsAg-positive acute hepatitis, chronic liver disease, primary hepatocellular carcinoma and the symptomless carrier state was studied in Jordan. The prevalence of hepatitis D viral infection was significantly higher in patients with chronic liver disease (18/79, 23%) and acute hepatitis (17/108, 16%) than in symptomless HBsAg carriers (2/136, 2%). The highest prevalence of hepatitis D viral infection was found in patients with primary hepatocellular carcinoma (10/15, 67%) who were also significantly older than such patients without hepatitis D viral infection. Antihepatitis D virus IgM was detected persistently in 83% of patients with antihepatitis D virus-positive chronic liver disease and transiently in 41% of patients with acute hepatitis. A trend to increased mortality was observed in acute hepatitis D viral superinfection (25%) compared to hepatitis D viral coinfection (0%) and to antihepatitis D virus-negative HBsAg-positive acute hepatitis (4%). In patients with established chronic liver disease, however, neither survival nor histological parameters of disease activity were significantly different in the antihepatitis D virus-positive and antihepatitis D virus-negative groups. While the early stage of hepatitis D viral superinfection is associated with increased mortality, it appears that in patients with late-stage chronic liver disease, severe histological activity subsides, and survival is no longer influenced by the factor of hepatitis D viral infection. However, primary hepatocellular carcinoma appears to complicate the course of those antihepatitis D virus-positive patients surviving beyond this stage.

Gastroduodenal inflammation in patients with non-ulcer dyspepsia. A controlled endoscopic and morphometric study

Proper control and quantitation are important in the accurate evaluation of gastroduodenal inflammation in dyspeptic patients without ulcers or erosions as proved by endoscopy. The endoscopic findings and the gastroduodenal mucosal inflammatory cell count in 31 patients with non-ulcer dyspepsia were compared with an age-matched group of 32 healthy controls. Endoscopy revealed similar mucosal changes and in similar frequency in both groups. Differential mucosal inflammatory cell count showed a statistically significant (P less than 0.001) increase in the neutrophil count in the gastric body, antrum, and duodenal cap of the dyspeptic group, as well as a slight but significant (P less than 0.05) increase in the round cell and eosinophil count of the duodenal mucosa alone. No correlation was found between the endoscopic changes and an increase in neutrophil count above a normal level determined by the healthy controls. However, an endoscopically normal mucosa was more likely to be associated with a normal neutrophil count. Active inflammation of the gastroduodenal mucosa likely accounts for the symptoms in patients with non-ulcer dyspepsia.

Cystic fibrosis in Jordan: a pilot study

Cystic fibrosis (CF) was diagnosed in 12 children from a total of 15,314 children admitted to the Paediatric Department at Jordan University Hospital (JUH) over the period 1976-1980. A diagnosis of meconium ileus was made in five children. The remaining seven affected children were diagnosed clinically on the basis of recurrent chest problems, failure to thrive, positive family history and a high level of sweat chloride, range 72-115 mEq/l (mean 97.6 mEq/l). Five children died (41.7%); three of the group with meconium ileus died during the post-operative period and two of the other group died soon after the diagnosis was made. The cause of such a high mortality rate is multifactorial. As CF was only recently recognized in Jordan, it is believed that the prevalence of CF among Jordanian children is underestimated. CF is still a very serious illness that demands early diagnosis and an intensive programme of continuing care. Therefore, further prospective study to evaluate its prevalence and impact on child health in Jordan is urgently needed.

Colorectal juvenile polyps: an epidemiological and histopathological study of 144 cases in Jordanians

The minimal incidence rate of colorectal juvenile polyps in Jordanians was 1.4 per 100 000 in the general population and 2.8 per 100 000 in children under 10 years of age. Out of 144 cases, nine had two to seven polyps and one juvenile polyposis coli. There was male preponderance and a mean age of 8 years: 96.5% of the polyps were in the rectum. Characteristically, stromal oedema, inflammation, ulceration with granulation tissue cap formation and gland regeneration were present. Epithelial hyperplasia was not uncommon and focal dysplastic change was occasionally noted, being always accompanied by hyperplastic change. Focal severe dysplasia was seen in one solitary juvenile polyp. It is concluded that varying degrees of focal epithelial atypia can occasionally develop in solitary juvenile polyps, rarely reaching severe dysplastic change. Malignant transformation in the commonly seen form of juvenile polyp (solitary type) is probably a rare phenomenon, but its frequency needs further evaluation.

Tumores rari et inusitati. Chordoma in a lumbar vertebral transverse process: a case report and review of the literature

Chordoma is a rare tumour of the skeleton that develops from notochordal elements. It occurs in the midline of the body particularly at the upper and lower ends of the vertebral columns. This paper reports a case of chordoma of unusual localization in the transverse process of a lumbar vertebra in a 30-year-old man with review of the literature. The early confinement of the tumour to a vertebral transverse process has never been reported. The scarcity with which chordoma is diagnosed in Jordan and the clinical presentation of the case reported are discussed.

Colorectal cancer in Jordan and Nova Scotia: a comparative epidemiologic and histopathologic study

A comparative study of colorectal adenocarcinoma was undertaken among the populations of Jordan and Nova Scotia, Canada. The incidence of this cancer was 13 (colon 6, rectum 7) and 53 (colon 31, rectum 22) per 100,000 males aged 35--64 years, respectively. Colonic tumors (excluding rectosigmoid) showed left-sided preponderance in Jordanians and right-sided preponderance in Nova Scotians. Age average at diagnosis was 49 years in Jordanians (colon 47 years and rectum 50 years) and 66 years in Nova Scotians (colon 67 years and rectum 63 years), with peaks in the fifth and seventh decades and a male to female ratio of 1.3:1 and 1:1, respectively. The mucinous type accounted for 31 and 13% of colorectal adenocarcinomas in Jordanians and Nova Scotians, respectively, of which the signet-cell type accounted for 14 and 2% of the total number, respectively. The actual incidence rate of mucinous carcinoma, however, was higher among Nova Scotians. In both groups, mucinous carcinoma showed predilection for females and rectal signet-cell carcinoma showed bias toward younger females. The authors believe that the significantly different epidemiologic and morphologic features of colorectal cancer demonstrated in these two communities could shed light on possible etiologic influences, such as dietary habits or other environmental factors.

Medial hypertrophy in the small intestinal arteries in systemic hypertension, renal and essential

The arterioles and small arteries of the submucosa of the small intestine and the small arteries (vasa recta) of the mesentery have been measured histologically in cases of hypertension and in normotensive controls. Two methods of mensuration have been used: one employing direct measurement of internal calibre and thickness of media of vessels injected and fixed in a state of dilation at systolic pressure; the other employing measurement of the internal elastic lamina by curvimeter and the cross-sectional area of the media by planimeter in uninjected vessels, from which, by calculation, the internal calibre and medial thickness/lumen ratio of the vessel in an idealised state of dilatation to a perfect circle with uncrenated internal elastic lamina can be derived. These measurements show that the medial thickening observed in the hypertensive vessels is due to a true hypertrophy of the media rather than to a state of contracture. When cases of renal and of essential hypertension are compared the pattern of vascular change is seen to differ in the two conditions: while some degree of hypertrophy is present in both throughout the range of vessel sizes examined, it is more marked in renal than in essential hypertension in vessels with an internal radius of less than 100 micron; but in vessels of more than 100 micron radius the position is reversed. This difference in the reaction of the vessels presumably reflects a basic difference in the mechanisms of production of the two types of hypertension.