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   2011| July-September  | Volume 1 | Issue 1  
    Online since August 11, 2011

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Basics of cytology
Mousa A Al-Abbadi
July-September 2011, 1(1):18-28
DOI:10.4103/2231-0770.83719  PMID:23210005
This overview is intended to give a general outline about the basics of Cytopathology. This is a field that is gaining tremendous momentum all over the world due to its speed, accuracy and cost effectiveness. This review will include a brief description about the history of cytology from its inception followed by recent developments. Discussion about the different types of specimens, whether exfoliative or aspiration will be presented with explanation of its rule as a screening and diagnostic test. A brief description of the indications, utilization, sensitivity, specificity, cost effectiveness, speed and accuracy will be carried out. The role that cytopathology plays in early detection of cancer will be emphasized. The ability to provide all types of ancillary studies necessary to make specific diagnosis that will dictate treatment protocols will be demonstrated. A brief description of the general rules of cytomorphology differentiating benign from malignant will be presented. Emphasis on communication between clinicians and pathologist will be underscored. The limitations and potential problems in the form of false positive and false negative will be briefly discussed. Few representative examples will be shown. A brief description of the different techniques in performing fine needle aspirations will be presented. General recommendation for the safest methods and hints to enhance the sensitivity of different sample procurement will be given. It is hoped that this review will benefit all practicing clinicians that may face certain diagnostic challenges requiring the use of cytological material.
  20,845 1,403 12
Research productivity in Syria: Quantitative and qualitative analysis of current status
Maria M Diab, Rokana M.O Taftaf, Mohammad Arabi
July-September 2011, 1(1):4-7
DOI:10.4103/2231-0770.83716  PMID:23210002
Context: Scientific research output measured by the number and quality of publications reflects the research productivity of a certain community. Aims: To examine the quantity and quality of research produced by Syrian institutions with particular emphasis on the clinical and biomedical research. Settings and Design: Retrospective observational analysis of research originating from Syrian institutions indexed by Medline and Science Citation Index (SciVerse) Scopus bibliographic databases. Materials and Methods: Comprehensive review of the literature indexed by Medline and SciVerse was conducted including data from Jan 01, 1980 till February 2011 searching for authors affiliated with Syrian institutions. Clinical and biomedical research data were further analyzed quantitatively and qualitatively. Results: The total of manuscripts indexed by SciVerse originating from Syrian institutions during the last 3 decades is 3540. A total of 458 publications cover clinical and biomedical subject areas. The quality of these 458 publications was evaluated by the citation frequency and impact factor of publishing journals with h-index of 24. Conclusions: Although the spectrum of research originating from Syrian institutions is broad, the overall number of publications particularly in clinical and biomedical subjects is minuscule and of limited quality. The presented data indicate the need to promote research capabilities and to bridge the gap in research productivity by Syrian institutions.
  5,645 739 10
Antibiotic utilization pattern in a general medical ward of a tertiary medical center in Saudi Arabia
A Al Shimemeri, H Al Ghadeer, Z Memish
July-September 2011, 1(1):8-11
DOI:10.4103/2231-0770.83717  PMID:23210003
To assess the pattern of antibiotic utilization and outcome of patients with bacteremia in a General Medical Ward, all positive blood cultures (BC) over a 12-month period from January 1994 to December 1995 were retrospectively reviewed. Fifty-two positive BC were recorded in 43 patients (63% males, 37% females; mean age 65.9 ± 16.6). 72% of the patients received antibiotics before or soon after obtaining the BC, and ceftriaxone was the most frequently-prescribed antibiotic (41.93%), either alone or in combination with other antibiotics. The bacteremia was due to gram-positive cocci in 60.46% of cases, gram-negative rods in 30.23%, and gram-positive rods in 9.30%. Positive BC due to contamination were not included. The most common gram-positive cocci were Staphylococcus epidermidis, followed by S. aureus, while the most common gram-negative bacilli were Brucella species, Proteus mirabilis, and Klebsiella sp. The suspected sources of the bacteremia were respiratory (21.2%), urinary (19.2%), or skin (19.2%). A subsequent change in the antibiotics regimen was done in 69.76% cases after BC results became available with no apparent effect on the outcome. Adding vancomycin and clindamycin was the most frequent change done (19.4% for each equally). Complications developed in 69.76% of patients, with 88.66% of them suffering from sepsis/shock. 69.23% of the patients improved and 30.77% expired; death was related to infection in 87.5% of cases. In conclusion, most bacteremia in the medical ward of the hospital were due to gram-positive cocci, which should be considered in antibiotic selection prior to BC. Risk factors for acquiring Brucellosis should always be obtained.
  4,976 936 3
A phase II pilot trial investigating the efficacy and activity of single agent granulocyte macrophage colony-stimulating factor as maintenance approach in castration - resistant prostate cancer patients responding to chemotherapy
Chadi Nabhan, Andrew Meyer, Kathy Tolzien, Jacob D Bitran, Timothy M Lestingi
July-September 2011, 1(1):12-17
DOI:10.4103/2231-0770.83718  PMID:23210004
Purpose: To investigate the toxicity and efficacy of GM-CSF in castration-resistant prostate cancer (CRPC) patients who maximized their response to systemic chemotherapy. Materials and Methods: CRPC patients who maximized their response to either docetaxel or mitoxantrone chemotherapy were eligible if they demonstrated adequate performance status, liver, kidney, and bone marrow function. Maximum response to chemotherapy was defined as either receiving at least 8 cycles of chemotherapy without radiographic or biochemical progression, receiving less than 8 cycles as long as the prostate-specific antigen (PSA) changes by less than 10%, or being off chemotherapy for less than 12 weeks without disease progression. Patients received GM-CSF at 250 mcg/m 2 subcutaneously for 14 days followed by 14 days of rest. GM-CSF was continued until disease progression. Results: Fifteen patients were enrolled of which all were evaluable for toxicity and 13 were evaluable for efficacy. Median age was 78 (range 66-96) and 93% of patients had a Gleason score ≥ 7. Biochemically, 2 patients (15.3%) attained partial response (PR) and 4 (30.7%) had stable disease (SD). Median time to PSA progression was 6 months (range 4-12). Radiographically, 9 patients (69.2%) had SD that lasted a median of 6 months (range 2-10). With a median follow-up of 24 months from starting GM-CSF (range 2-38), 2 patients (13.3%) remain alive and well. Median OS from start of any chemotherapy was 21 months (range 10-44). GM-CSF was well-tolerated with minimal expected manageable toxicities. Conclusions: GM-CSF is active post-chemotherapy in CRPC patients. Further studies with GM-CSF in this setting are warranted.
  4,043 502 -
Avicenna Journal of Medicine: Reviving fading legacy
Mohammad Arabi, Bassel Atassi, Haitham Arabi
July-September 2011, 1(1):1-1
DOI:10.4103/2231-0770.83714  PMID:23210000
  3,269 560 1
Boosting biomedical research in the Arab world
Wasim Maziak
July-September 2011, 1(1):2-3
DOI:10.4103/2231-0770.83715  PMID:23210001
  3,212 517 5