Study of cases of 46, XX disorder of sex development [46, XX DSD] with assessment after their early surgical intervention

Background: Congenital Adrenal Hyperplasia [CAH] is the commonest cause of disorders of sex development [DSD] in children. The surgical management of children with CAH has always been difficult, subject to evolving attitudes and techniques, and at times controversial. The timing of surgery is one of the many factors that influence outcomes and is currently controversial

Patients and methods: Our study was conducted on patients of 46, XX DSD referred to pediatric endocrinology clinic in Alexandria University Children's Hospital. We studied the age of these patients at presentation, degree of civilization, presence of adrenal crisis, hormonal assay and radiological findings. We compared the early [done before the age of 2 years] versus late [done after the age of 2 years] surgical intervention done to these patients. We assessed these patients after at least six months of feminizing surgery, the assessment included the genital anatomical assessment, overall cosmetic results and further treatment recommendations

Results: In our study, there were 35 patients with early intervention and 26 patients with late intervention. Good cosmetic results were found more significantly in the early group [94.3%] in comparison to only 19.2% in the late group. Good cosmetic results [97.4%] are found more with the one stage operations

Conclusions: After doing the anatomical assessments, cosmetic results and assessing the need for further treatment recommendations, we can state that early feminizing genitoplasty has better anatomical and cosmetic results than late intervention

relationship between body mass index and iron status in obese and overweight children attending Alexandria University children's hospital

Background: obesity and iron deficiency are two of the most common nutritional disorders worldwide. Although these two conditions represent opposite ends of over- and under-nutrition, they appear to be linked

Objective: To investigate the association between body mass index and iron status in obese and overweight children

Methods: It was a case control study that included 40 children aged 2-14 years, 20 overweight [BMI 85th -95th percentile] and 20 obese [BMI more than or equal 95th percentile]. Twenty healthy non obese children of comparable age and sex served as a control group. All studied children were subjected to calculation of body mass index and laboratory investigations including complete blood picture and Iron profile [serum iron, serum ferritin, total iron binding capacity, serum transferring, and transferring saturation]

Results Compared to the control group, hemoglobin, MCV, serum iron and transferrin saturation were significantly lower in the obese and overweight group [p<0.05]. There was a negative correlation between BMI and both serum iron and transferring saturation, while there was a positive correlation between BMI and TIBC within the total sample

Conclusions: There was a relation between BMI and iron status in children. Obese and overweight children had higher rates of iron deficiency than normal-weight children

Study of thyroid function among obese children attending the pediatric endocrine and obesity clinics in Alexandria university children's hospital

Objective: obesity is considered to be a worldwide health proble with a steadily and dramatically increasing prevalence all over the world. Obese individuals area at high risk of developing dyslipidemia, hypertension, impaired glucose tolerance and consequent increase of the risk of metabolic and cardiovascular diseases. several studies have reported abnormal thyroid function tests in obese children in which the commonest abnormality is a slightly too moderately increased thyroid stimulating hormone [TSH] levels

Aim of the work: This study aims to assess the thyroid function among prepubertal obese children. Patients and methods: The study was carried on 40 prepubertal obese children attending the Pediatric Endocrinology and Obesity Clinics in Alexandria University Children's Hospital. They were subjected to complete history taking including age, sex, family history of obesity and thyroid disease, organized sports practicing and thorough clinical examination including vital signs, anthropometric measurements, signs suggestive of thyroid dysfunction, presence of goiter and systemic features suggestive of syndrome obesity. The laboratory investigations done were thyroid function tests [TSH, Free thyroxin hormone FT4, Anti-thyroid peroxidase antibody TPO] and thyroid ultrasound

Results: A cross sectional analysis of 40 prepubertal obese children [BMI >95 th percentile for age and sex]. Their age ranged from 6-12 years with mean value 8.95 +/- 2.00 years, males were 19 [47.5%] and females were 21[52.5%]. There were 9 cases [22.5%] with elevated TSH and 2 cases [5%] with elevated anti-thyroid peroxidase [TPO] antibodies levels. By ultrasound examination of thyroid gland, none of the obese cases had goiter

Conclusions: Thyroid function tests should be performed in obese children to define their thyroid hormonal status. Subclinical hypothyroidism appears to be the most common disturbance of the thyroid function in obese children. Further studies should be done to identify the effect of weight reduction on thyroid profile in obese children

Serum clusterin as a marker for diagnosing hepatocellular carcinoma

Approximately 80% of patients with hepatocellular carcinoma [HCC] are untreatable because of advanced tumor stages at presentation. Therefore, finding newer markers for screening and diagnosing HCC is of utmost importance. Clusterin [CLU] is a 449 amino acid, heterodimeric glycoprotein with a plausible role in the regeneration, migration, and anti-apoptosis of tumor cells. It has been implicated in many malignancies such as prostate and pancreatic adenocarcinomas, but its role in HCC is not well defined. We aimed to evaluate the diagnostic performance of serum CLU level in diagnosing HCC on top of hepatitis C virus-related liver cirrhosis, and comparing it to that of alpha fetoprotein [AFP]. Twenty cases of apparently healthy subjects, 27 cases of hepatitis C virus-related liver cirrhosis [CHC cases], and 44 HCC cases on top of hepatitis C virus-related liver cirrhosis were included in this study. Serum CLU concentration was determined using a quantitative sandwich enzyme immunoassay technique. Serum clusterin level showed a significant increase in the HCC group compared to the control group [151.96 +/- 32.74 vs. 111.40 +/- 27.46] and to the CI4t group [151.96 +/- 32.74 vs. 89.12 +/- 31.62], while a significant decrease in serum clusterin level was found in the CHC group compared to the control group [89.12 +/- 31.62 vs. 111.40 +/- 27.46]. Based on receiver operator

validity of prostate-specific antigen in prostatic cancer detection, Omdurman Military Hospital, Sudan

The prostate specific antigen is commonly used as a preliminary tool to investigate men with lower urinary tract symptoms and prostatic enlargement evident by ultrasound scan. In the practice a high prostate specific antigen level is commonly used as predictor of prostatic cancer. A cross-sectional study was conducted at Omdurman Military hospital during the period from January 2011 to January 2012 to assess the validity of prostate specific antigen as single tool to diagnose prostatic cancer in our local population It included all male patients with lower urinary tract symptoms and proved to have prostatic enlargement by ultrasound. Prostate specific antigen levels were measured before digital rectal examination [DRE]. Trans-rectal biopsy was performed when the PSA level was over 4 ng and or abnormal DRE. The study included 192 patients, their mean age +/- SEM was 65.71 +/- 0.71 years [range, 32-95 years]. The mean PSA was 17.51241 +/- 1.98 [range, 0.002-125 ng/ml]. The sensitivity and specificity [%] of PSA level < 4 ng/ml to detect BPH were 96.6 and 37.7 respectively. The sensitivity and specificity of PSA level to detect cancer were 9.8 and 12.2 respectively for PSA ranging from 4 to 9 ng/ml, and 82.9 and 71.5 for PSA levels > 9 ng/ml respectively. When combining PSA, DRE and biopsy the sensitivity and specificity for cancer detection increased to 91.6% and 73.4% respectively. In conclusion the prostate specific antigen alone cannot be used as an effective diagnostic tool for diagnosis of prostate carcinoma due to its low sensitivity and specificity

Pyocolpos with imperforate hymen during early childhood presented with urine retention and bouts of intestinal obstruction

An imperforate hymen is not a rare condition in female newborns, but is often ignored in a genital examination by doctors. We report an unusual case of a 2 years old Sudanese girl with an imperforate hymen and pyocolpos presented with urine retention and intermittent bouts of intestinal obstruction. To our knowledge, this is a first case of female child with pyocolpos to be documented in Sudan literature

Effect of storage temperature on the stability of chemical and physical properties of profenofos insecticide formulation [EC]

Profenofos insecticide was subjected to different storage conditions at the temperatures 54°C for 14 days, zero °C for 7 days according to FAO specifications [1998] and, in sunny place and in dark place for 360 days according to Egyptian conditions. Chemical stability of profenofos was stable if stored either at 54 °C or zero °C for 14 and 7 days, respectively conformed with Food and Agriculture Organization [FAO] specifications during periods of storage and more degradated in sunny place than in dark place. Physical properties [pH range, Emulsion stability and re-emulsification] became conformity with FAO specification

Endosonography as a predictive tool for first esophagogastric variceal bleeding

The development of portosystemic collaterals is the central pathophysiological event that leads to variceal bleeding in patients with liver cirrhosis. Endosonography [EUS] is useful to evaluate the fine details of the vascular structures at the gastroesophageal junction. EUS may give a promising chance for predicting upper gastrointestinal bleeding in cirrhotic patients. To evaluate the value of extraluminal gastroesophageal vascular collaterals as predictors of first variceal bleeding. A total of 50 cirrhotic patients with no history of previous upper GI bleeding were recruited into this cohort study. After thorough history taking and clinical examination, they were subjected to upper endoscopy and EUS for assessing the number and size of peri- and para-mural collaterals and perforating vessels. All participants were followed up for 24 months for upper gastrointestinal bleeding. Eighteen out of 50 patients [36%] had at least one attack of upper GI bleeding during the follow up period. All patients had one or more type of extraluminal venous collaterals. Gastric varices [P = 0.02], perigastric collaterals [P = 0.03] and perforators [P = 0.02] were independent risk factors for first variceal bleeding. The presence of 3 or more paraesophageat collaterals and the presence of perforators were significantly higher in bleeders compared to non-bleeders [P = 0.034]. Perigastric and paragastric collateral size were significantly larger in bleeders than non bleeders [P = 0.019 and 0.038 respectively]. Perigastric and paragastric collaterals size more than or equal to 2 mm and 6.20 mm respectively were associated with significantly increased risk of first variceal bleeding. Peri-esophageal and para-esophageal collaterals although present in large diameters in all bleeders than non bleeders, did not reach a statistical significant level EUS may be a promising tool for predicting first variceal bleeding in cirrhotic patients thus justifying primary prevention by band ligation or sclerotherapy

Neonatal screening of the common endocrine and metabolic disorders in Menoufiya governorate

Hereditary diseases and congenital marformations have been reported to affect 2-5% of all live births; they account for up to 30% of pediatric hospital admissions, and cause about half of childhood deaths in developed countries. Available evidence suggests that genetic are important also in countries of the Eastern Mediterranean Region. The following factors may contribute to the prevalence of genetically determined disorders: the high consanguinity rates; the trend of continuing to bear children up to menopause; the general lack of public awareness about genetic diseases and the dearth of genetic services in the region. Neonatal screening tests early detect disorders in newborns for which interventions shortly after birth have obvious benefits. We aimed at screening of congenital hypothyroidism [CH], phenylketonuria [PKU], and galactosemia which are common causes of preventable mental retardation and starting their early intervention. Our study included 15.000 dried blood specimens [DBSs] from the newborns of all the ten conters of the Menoufiya governorate, as a representative random sample of the year 2007. all speciemens were analysed in neonatal screening laboratory in our genetics and endocrinology unit, pediatric department; Menoufiya University in collaboration with the central laboratories of ministry of health and population; using ELISA for TSH analysis and flourometric assay [WALLAC system, Perkin Elmer] for PKU and galactosemia screening. Preservation and transfer of DBSs were according to the recommendations of the International Society for Neonatal Screening. Because of the high costs, we randomly selected two thousands DBSs for PKU screening and another two thousands for screening of galactosemia. Out of the /5,000 DBSs, 99.84% were negative for CH [TSH < 20 ulU/ml]. Twenty five cases were borderline for CH, while 9 cases only were confirmed as CH after clinical examination and revaluation using serum samples [serum TSH > 20 ulU/ml and T4 < 0.8 ng/dl], the confirmed cases were treated according to the management schedule. So the incidence of CH in our study was 0.06%. As regards PKU screening; 93.95% of studied samples were negative [phenyl alanine < 2.1 mg/dl]. Only 21 cases were initially borderline for PKU [phenyl alanine = 2.1-3.0 mg/dl, while clinically normal] but no PKU cases were detected after revaluation. On the other side; the 2000 DBSs screened for galactosemia were negative [Galactose uridyl -1 transferase enzyme [GALT] > 3.5 u/gHb]. On conclusion, because of the high costs of mass screening for PKU and galactosemia, only screening of high risk families and neonates is recommended. On the other hand screening programs should include our more common problems as congenital deafness and hemoglobinopathies

Macro and micromorphology studies of the leaf, stem and stem bark of Ficus pandurata hance. cultivated in Egypt

Ficus pandurata [Hance] Fiddle leaf fig [Family, Moraceae] is a tree indigenous to South Africa and cultivated in Egypt for its shade in public and private gardens. Previous investigations of Ficus species showed many medicinal uses; externally they have been used for treatment of leprosy, ulcers, itching, leucoderma and warts. Internally used as anti-inflammatory, to reduce fever, cure tuberculosis and against intestinal parasites. In the present work, the detailed macro-and micromorphological characters of the leaf, stem and stem bark of Ficus pandurata Hance were studied with the aim to find out the diagnostic elements of these organs, which facilitate their identification in both entire and powdered forms

Role of high-resolution sonography in the diagnosis of carpal tunnel syndrome in patients with normal electrodiagnostic studies

Diagnosis of carpal tunnel syndrome [CIS] is based on a combination of symptoms, clinical signs, and abnormal electrodiagnostic [EDX] studies. Although EDX studies are highly specific, however, they have a substantial false-negative rate of between 10% and 20%. High-resolution ultrasonography [US] has received increased attention in the evaluation of CIS. The aim of this study was to prospectively evaluate the accuracy of sonography for the diagnosis of CTS in patients who were clinically suspected of having the disease and have normal EDX studies. This was a prospective cross sectional study. Patients were enrolled in the study if they had the signs and typical history of carpal tunnel syndrome. They were classified into 2 groups: group I [30 patients, 42 hands]: EDX confirmed CTS, group II [30 patients, 39 hands]: normal EDX studies. Also a normal control group [group III] was included [20 volunteers, 40 hands]. All patients underwent standardized EDX studies then sonographic examinations were performed within 2 days. Transverse images of the median nerve were obtained at three levels: proximal to the tunnel, at the level of the pisiform bone and at the level of the hook of the hamate. Then the transverse and anteroposterior diameters were measured and the flattening ratio and the cross sectional area were calculated. The sonographic findings [except for the flattening ratio] had significant differences among the three groups at the level of the pisiform bone only. Using one way analysis of variance, the cross sectional area showed the greatest differences between the three groups. The significant differences were mainly between group III and both group I and II [p < 0.001]. The difference between group I and II was less, but still was also highly significant [P < 0.01]. There was a highly significant positive correlation between the EDX diagnosis of CTS and the cross sectional area [p < 0.001]. A cutoff of 9.89 mm[2] of the cross sectional area that was extrapolated from the receiver operating characteristics curve was found to be highly diagnostic for CTS with sensitivity, and specificity of 100% and 80% respectively. The higher mean amplitude of the sensory nerve action potentials of group II patients was the only significant EDX variance that differentiated this group from the normal control group. In patients with clinical diagnosis of CTS, high resolution sonography is an efficient complementary test to EDX when the latter is normal. These patients have similar sonographic findings to patients with EDX confirmed CTS, suggesting that they also have similar pathology. A cross sectional area of the median nerve at the pisiform bone of >/= 9.89 mm[2] was found highly diagnostic for CTS. It is also concluded that EDX normal CTS patients are mostly patients with dense sensory innervation that might have lead to low pain threshold and buffered the electrophysiological consequences of nerve entrapment in its early stages

indirect immunological effect of concurrent human schistosomiasis and fascioliasis on helicobacter pylori pathogenesis

The impact of Schistosoma mansoni and Fasciola parasitic infections on H. pylori induced pathogenesis was studied in 20 patients exclusively having H. pylori infection alone. The patients were compared to 20 patients having schistosomiasis mansoni co-infected with H. pylori and to another 20 patients having fascioliasis co-infected with H. pylori. 15 patients exclusively having schistosomiasis mansoni alone and 15 patients exclusively having fascioliasis alone were also included in the study. All patients were subjected to thorough medical examination, parasitological, endoscopic and histopathological studies. The results showed that severe gastritis was significantly more common in the patients exclusively infected with H. pylori alone. Chronic atrophic gastritis and intestinal metaplasia or precancerous lesions were present in patients with exclusively H. pylori infection. We may conclude that the concomitant of parasitic diseases with H. pylori infection probably reduce the gastroduodenal pathogenesis through indirect immune response

regulation of murine schistosome granuloma formation and fibrosis by anti-IL-4 and anti-IL-13 immunotherapy

In this study the availability of murine anti-interleukin-4 [anti IL-4] and anti-interleukin- 13[anti-Il- 13] monoclonal antibodies [mAbs] permited the intimate study of the direct role of IL-13 in a type -2-cytokine mediated infection. The present study demonstrates that blocking of IL-13 from the Th -2 response to Schistosoma mansoni infection is beneficial to host survival. This enhanced prognosis correlates with a reduction in hepatic collagen deposition and indicates the role for IL-13 in the development of hepatic fibrosis. In contrast, the study has also showed that blocking of IL-4 results in very high mortality characterized by a breakdown in intestinal integrity, indicating that IL-4- is a protective cytokine in schistosome infection. The combined blocking of both IL-4 and IL-13 demonstrates that the positive effects resulting from the ablation of IL- 13 were over-ridden by the detrimental pathology resulting from IL-4 blocking. In addition, combined cytokine blocking resulted in a condition that was considerably more severe than that observed in the IL-4 blocking group. These results indicate the potential benefits of anti- IL-13 as an antifibrogenic cytokine, but also show the dangers of blocking both IL-13 and IL-4 concurrently

Role of 64 MSCT in the evaluation of aortic lesions

Multslice CT [MSCT] has proved its importance and applicability in the evaluation of vascular disease including stenosis, occlusion, aneursyms and dissection as well as evaluation of post-traumatic events. The aim of the work will be directed to identify the role of MSCT in the evaluation of aortic lesions. The study will be conducted on patients suspected of having aortic lesions based on clinico- laboratory basis. Each patient will be subjected to thorough history taking, Clinical examination, and MSCT aortography. The advance of cardio-thoracic surgery techniques adds the burden of many questions that need to be answered including the extent, width, and shape of the flap and implication of the coronary arteries and major aortic branches. The presence of leakage is of equal importance in both dissecting and atherosclerotic aneurysms. Evaluation of abdominal aortic aneurysm and leakage by MSCT has proved its usefulness particularly in planning for operative intervention including the length, size of the aneurysm and implication of the major aortic branches. 64 MSCT is an excellent tool for examining the aorta. It gives a great deal of information that, abolishes the need of another diagnostic tool prior to operative intervention. It offers a great mapping of dissecting aortic flap, abdominal aortic aneurysms and coarctation. Time of an essence in dealing with emergency patients and 64 MSCT offers a great portal of diagnosis considering time efficacy and accuracy

Lipids and triterpenes from Maerua crassifolia growing in Egypt

The hexane fraction obtained from the total alcohol extract of the aerial parts of Maerua crassifolia Forssk grown in Egypt upon repeated column chromatography afforded one new compound identified as 1, 23 dimethoxy tricosa-6-one [1], along with six known compounds identified as long chain hydrocarbon [triacontane] [2], ceryl alcohol [3], lupeol palmitate [4], beta-sitosterol palmitate [5], lupeol acetate [6], and alpha-amyrin [7]. The identification of the isolated compounds was carried out using different physical, chemical and spectral methods and co-chromatography with authentic samples

Preparation and in-vitro evaluation of eudispert hydrogel rectal suppositories containing salicylamide

This article aimed to formulate and evaluate salicylamide suppositories. The prepared formulae "with and without different concentrations of gels were tested for hardness, melting time, content uniformity and drug release. The stability of some of the selected formulae was assessed. Salicylamide was formulated as a rectal suppository with emulsifying fatty bases [witepsol H15, W25 and W35] and water - soluble bases [PEG] adopting the molding from a melt technique. Physical characteristics and dissolution profiles of the prepared formulations were determined. The effects of adding gel [eudispert hv] in concentrations of [2, 4 and 6%] were also investigated. Formulations showing high rank order were scaled up for shelf-life stability study for one year. The results showed that all the investigated formulae have acceptable physical characteristics with respect to hardness, melting time and uniformity of drug content. The amount of drug released during 120 min. was inversely affected by the melting point of the fatty base. The release from PEG bases was found to be molecular weight dependent. Addition of 2% eudispert gel increased the release from all the investigated formulae. Increasing gel concentration to 4% then to 6% showed different effects on the release. Rectal suppository of salicylamide could be prepared as an alternative to the oral dosage form to circumvent the first - pass metabolism

Diagnostic value of AFP-L3, AFP-mRNA, and methylated p16 in hepatocellular carcinoma

To assess the diagnostic significance of serum AFP-L3,AFP-mRNA and methylated p16 in patients with liver cirrhosis and HCC. The present study was conducted on patients suffering from liver cirrhosis [n=82] and HCC [n=82]. in addition to healthy control group [n=20]. Cirrhotic patients were followed up every 3 months for 15 months and grouped according to Child classification A, B and C HCC patients were grouped according to Okuda classification I. II. Ill. Blood samples were withdrawn and serum samples were separated for estimation of liver function tests, anti HCV. HBsAg. AFP. and AFP-L3. RNA was extracted from whole blood for detection of AlP mRNA. The buffy coat was collected for DNA extraction for detection of methylated p16. Liver function tests were assayed spectrophotometrically while anti-HCV. HBsAg and AFP were assayed by enzyme immunoassay. AFP-L3 was measured by liquid phase binding assay. AFP-mRNA and metholated P16 were measured by RT-PCR. In the present study. anti-HCV was present in 90.2% of cirrhotic group and 93.4% of HCC group while HBsAg was present in 2.4% of cirrhotic group and 3,fl[of HCC group. There were significant increase in AFP. AFP-L3Y and AFP-L3 concentrations in HCC versus controls and cirrhotic groups. ln cirrhotic group 6 cases are AFP-mRNA positive [two cases of Child A and 4 cases of Child C]. On the other hand all cirrhotic groups were negative of methylated p16. in HCC group 10 cases are positive of mRNA [two cases of Okuda 1.6 cases of Okuda II and 2 cases of Okuda Ill] On the other hand 4 cases of Okuda Ill are positive of methylated p16 and had AFF more than 100 ng/ml. Among 51 patients with liver cirrhosis [followed up by periodic examination with ultrasonography and measurement of serum AFP every 3 months 6 patients developed HCC [11.7%]. The sensitivity of AFP-L3 was 64.1% and a specificity 89.2% or a cutoff level of 1.0% . The sensitivity of AFP was 51.8% and the specificity was 88.2% whereas the sensitivity of AFP-L3 concentration was 51.3% and a specificity 100% for a cutoff level of 22.08 ng/ml. The sensitivity of AFP-mRNA and p16 methylation were 41.6% and 16.6% while the specificity were 75% and 100%, respectively. In HCC group there were significant positive correlations between AFP-L3 concentration and AFP, and AFP-L3% . AFP-L3% had higher sensitivity and specificity than AFP. Thus both markers must be done simultaneously. The detection of methylated p16 had the lowest sensitivity and highest specificity. AFPmRNA and methylated p16 in the blood of HCC patients were significantly correlated with elevated AFP

Chronic desquamative gingivitis as part of mucocutaneos manifestations

Desquamative gingivitis is a clinical feature of a variety of diseases. In this paper, the clinical features of dermatoses or mucocutaneous disorders where desquamative gingivitis is presenting manifestations have been reviewed [lichen planus, mucous membranes pemphigoid and pemphigus vulgaris]. Other less common mucocutaneous disorders affecting the oral mucosa [lupus erythromatosus, linear IgA, plasma cell gingivitis, chronic ulcerative stomatitis and psoriasis] are also described. Correct identification of these conditions entails taking a careful history and performing a thorough intra-oral examination. Presence of cutaneous, nasal, ocular and genital lesions should be carefully elicited from the patient. The clinical manifestations, investigations and modalities of treatment are reviewed. Desquamative gingivitis [DG] is a clinical feature of a variety of diseases. It is characterised by epithelial desquamation, erythema, ulceration, and/or the presence of vesiculobullous lesions of the gingiva and other oral tissues. This phenomenon can be a manifestation of a number of dermatoses, most commonly lichen planus, mucous membrane pemphigoid [cicatricial pemphigoid], and pemphigus vulgaris [1-3]. Other causes include allergic reactions to toothpastes/mouth rinses [plasma cell gingivitis] [4-6], Crohn's disease [7], psoriasis [8], linear IgA disease [9] and chronic ulcerative stomatitis [10]. Desquamative gingivitis can be mistaken for plaque induced gingivitis and this can lead to delayed diagnosis and inappropriate treatment of serious dermatological diseases such as pemphigoid or pemphigus [11-14]. Desquamative gingivitis as a presenting feature is most commonly noticed in oral lichen planus [OLP] [15-17]

Bacteria in dental clinics

Oral health problems often prompt patients to visit dental clinic or dental office since oral cavity disease may have profound emotional and physical effects on a patient. Patients with serious medical problems requiring dental care sometimes need the facilities, and staff support available only in hospitals. Dentists, dental surgeons, and other dental personnel are among the high risk health personnel who may acquire infection from their patients via blood, and saliva or from sharp instruments. Transmission to the dental worker and patients can occur if infection control measures, such as the use of gloves, masks, protective eye wear and hand hygiene practices are not adhered to. The emerge, and spread of antibiotic resistant bacteria is still a serious problem facing the treatment of infectious diseases. Several duplicate samples were taken from the dental clinics and examined using standard bacteriological procedures. Seven isolates mostly Gram negative aerobic, and facultative anaerobic bacilli were isolated on both media from several samples within dental clinic, and identified, most of which were considered to be clinically significant as a cause of serious nosocomial infections, and most of them with the exception of Acinetobacter genus were resistant to most antibiotics tested. The results demonstrate that the most frequent contaminated samples were aspirator machine, and distilled water storage tank. Since these isolates were highly resistant to most antibiotics tested, hence, alternative antibiotics should be used to overcome such problem. Finally, the dental clinic should be fumigated at regular bases to reduce nosocomial infections