Control of malaria outbreak due to Plasmodium vivax in Aswan governorate, Egypt

In 2014, after several years of maintaining zero malaria indigenous cases, Egypt had an outbreak of Plasmodium vivax: 21 confirmed cases during May-June 2014. In response to the outbreak, the Ministry of Health and Population [MoHP] launched an emergency response through early detection and prompt treatment of cases, vector control, public education and intersectoral collaboration. Twenty cases [95.2%] were residents of El-Sheikh Mostafa village, Edfu district, Aswan governorate, southern Egypt. All cases, consequent to the index case were identified through house-to-house surveillance visits. One P. falciparum-infected case was also identified in the same village. Treatment of all infected cases was initiated following laboratory confirmation. The MoHP's rapid response to and containment of the outbreak demonstrates the institutional capacity for detection and control of outbreaks which can occur after elimination

Any possible association between Behcet's disease and retinitis pigmentosa

Behcet's disease is a rare multisystem disease; it has many ocular features, and it is not known to be associated with dystrophic conditions such as retinitis pigmentosa [RP]. This is a case report of a Sudanese patient with Behcet's disease with ocular features and RP. A 28-year-old female with nyctalopia, skin hyper-pigmentation, and oral and genital ulcers was diagnosed as RP with Behcet's disease. She received a high dose of steroids and Azathioprine. She developed bilateral cataract and glaucoma. Pathergy test is negative. The patient is fulfilling the diagnostic criteria of both RP and Behcet's diseases. Behcet's disease is a rare condition; it is not common among Sudanese patients, and it has not been known to co-exist with RP

Frequency and risk factors of hepatotoxicity of anti Tuberculous drugs

Hepatotoxicity is reported in patients using first-line anti-tuberculous drugs regimen, among them 6-12% die. Identifying the risk factors for developing hepatotoxicity would probably reduce morbidity and mortality associated with T.B management. To study the frequency and risk factors of hepatotoxic reactions in patients receiving firat-line anti-tuberculous drugs. In addition to determine the relation between acetylator phenotype and anti-tuberculous drug hepatotoxicity. Seventy seven patients consecutively presenting to Suez Chest Hospital with active T.B diseases [WHO criteria], who were eligible for anti- tuberculous regimens [WHO guidelines] were included. Child B or C cirrhotic patients or Child A with liver enzymes exceeding double the normal were excluded in addition patients suffering from chronic renal or cardiac disease, hypersensitivity to anti-tuberculous drugs or receiving potentially hepatotoxic medications for other reasons were also excluded. 1-Rate of hepatotoxic reactions according to the diagnostic criteria. 2- Rates of fast and slow acetylator phenotypes. 3- Rate of risk factors among patients with hepatotoxicity versus patients without hepatotoxicity. Hepatotoxic reactions have been diagnosed in seven [9.1%] patients. By univariate analysis, age over 60 years [p = 0.02], alcoholism [p = 0.02], extra-pulmonary tuberculosis [p = 0.02] and severe forms of tuberculosis [p = 0.03] were statistically significant risk factors. Fifty eight [75.3%] of the study sample were slow acetylators, while 8 [10.4%] were fast acetylators. Three out of the eight [37.5%] of fast acetylators and only [6.9%] of the slow acetylators developed hepatotoxicity [p = 0.03]. Logistic regression models showed that fast acetylator phenotype was the only significant [p = 0.04] risk factor for early hepatotoxicity. Alcoholism [p = 0.01] was a significant risk factor for late hepatotoxicity. Hepatotoxic reactions among patients receiving anti-tuberculous drugs remain a considerable problem. Two patterns of liver injury can be observed. The first occurs earlier and is associated with fast acetylator phenotype. The second occurs later and is associated with alcoholism and HCV infection

Effect of triple therapy for helicobacter pylori eradication on hepatic encephalopathy: a randomized controlled trial

Helicobacter pylori [H. pylori] infection could potentially contribute to the development and severity of hepatic encephalopathy due to strong urease activity in the stomach of H. pylori infected cirrhotic patients. To assess the effect of triple eradication therapy for H. pylori on hepatic encephalopathy. Open randomized controlled clinical trial with 4 arms. liver diseases unit in Suez Canal University Hospital - tertiary care. Forty four Hp+ [Group 1] and 44 Hp- patients [Group 2] [based on rapid urease test of gastric biopsy] with hepatic encephalopathy grade 1 - 3. Triple eradication therapy for H. pylori versus standard treatment for hepatic encephalopathy in group 1 and antimicrobial therapy [without Omeprazole] versus standard treatment in group 2 for 14 days. Blind assessment of the grade of encephalopathy before and within three days from end of treatment. One grade improvement was considered treatment success. Success rate was 18.2% in standard treatment and 63.6% in triple therapy [p< 0.001] in H pylori positive. While in H. pylori negative patients the success was 9.1% in standard treatment versus 59.1% [P< 0.001] in and antimicrobial therapy. Success rate was not significantly different between standard treatment or between triple therapy and antimicrobial therapy among both groups. Among other factors in logistic regression models both triple therapy [OR: 1.03<6.22<37.69, P= 0.047] and antimicrobial therapy [OR: 2.09<11.42<59.46, P= 0.02] were significant predictors of success in the respective groups. Both triple eradication therapy for H. pylori and antimicrobial therapy only, equally improve the outcome of management of hepatic encephalopathy. The improvement may be attributed to the effect of antimicrobial therapy on ammonia producing gut flora rather than H. pylori eradication. H pylori eradication therapy adds no benefit in hepatic encephalopathy

Nutrient intake among Egyptian school children

This study has been conducted to provide realistic information about the nutritional status of primary school children in Egypt. A sample of 3000 school children was selected from Cairo, Sharkia [representing Lower Egypt] and Qena [representing Upper Egypt]. Anthropometric measurements were done to assess the nutritional status. The results showed that 6.6% of the total sample were underweight, overweight was detected among 4.1%. Stunting represented 14.5% of the sample. Dietary history using 24-hour recall method was applied to calculate their nutrient intake. The results showed that mineral intake was greatly affected. The percent of mean intake as% of standard was 56.9% for vitamin A and 51.4 for iron. As regard other nutrient consumption, this percentage was 63.2% for zinc, 37.4% for selenium and 36.6% for iodine among school children. Only vitamin C was consumed in appropriate amounts. Therefore, it was recommended to develop an intervention program in the form of nutrition education and a proper school feeding program for supplementation to reduce this micronutrient deficiency among school children. This will improve the growth, work performance, learning ability and intellectual development for this important group

dynamic link between the integrity of the immune system and zinc status in sickle cell anemia

This study was carried on 30 patients, with sickle cell anemia to evaluate the role of zinc status in relation to cell mediated immunity in terms of T lymphocytes and its subjects, CD4, CD8 and IL-2. Serum zinc level was significantly low in children with sickle cell anemia than in the control group. Peripheral blood mononuclear cell [PBMC] zinc level showed significant decrease in the studied cases than the control group. T-lymphocytes showed significant decrease in count of CD4 and CD4/CD8 ratio, but nonsignificant decrease in CD8, low in children with sickle cell anemia compared to control group. IL-2, showed significant decrease in patients with sickle cell anemia when compared with control group. In conclusion, these results demonstrated that zinc deficiency is evident among patients with sickle cell anemia and it has significant impact on the immune system integrity and could greatly alter host defense systems leading to increase in opportunistic infections and mortality rates that observed in these children

Growth hormone and insulin like growth factor-1 in patients with heart failure due to dilated cardiomyopathy

The aim of this study was to evaluate the level of growth hormone [GH] and insulin like growth factor-1 [IGF-1] in patients with heart failure due to idiopathic dilated cardiomyopathy to find out if the development or progression of heart failure is associated with a derangement of GH and IGF-1. The study was conducted on 30 patients with congestive heart failure due to dilated cardiomyopathy and 7 normal healthy subjects as a control group. The results revealed a significant increase in the serum levels of GH and a significant low serum IGF-1 and albumin in the patients as compared with the control group. Then, the patients were classified according to the NYHA functional classes into four classes [I, II, III and IV]. Sixteen patients were found in functional class IV. There were no differences in the results of this class and the whole patients group, suggesting that class IV represented the whole patient group studied. The study concluded that the serum levels of GH were increased and the serum levels of IGF-1 were diminished in patients with heart failure due to dilated cardiomyopathy. These abnormalities in GH and IGF-1 may have many etiological factors. Abnormalities of GH/IGF-1 axis might have a role either in the development or the progression of heart failure in dilated cardiomyopathy

Metal complexes of new schiff bases derived from oxine derivative and some amino acids

Metal complexes of certain new Schiff base ligands derived from the oxine derivative, 7-carboxaldehyde-8-hydroxy quinoline, with some amino acids [glycine, alpha-alanine and serine] with Ni[2], Cu[2+Co[+2]and Pd[2+]have been Synthesized and identified in terms of the data obtained by elementary analyses, IR and UV-Visible spectra as well as conductivity and magnetic measurements. Stoichiometry of the resulting solid metal chelates are suggested. The non-electrolytic nature is proposed for these chelates. It has been found that the complexes possess a square planar arrangement

Correlation of twenty four hour ambulatory blood pressure in children with echocardiographic evidence of left ventricular dysfunction

Assessment of left ventricular diastolic function in the form of mitral valve flow velocities was performed for 24 children aged 9-16.5 years [13 boys and 11 girls] by Doppler echocardiography. After blood pressure determination was done using both conventional [office] blood pressure and 24-hour ambulatory blood pressure measurements, children were classified into three groups. The normotensive group [13 children: 6 boys and 7 girls], the hypertensives by office measurement [white coat hypertensives] [6 children: 4 boys and 2 girls]. However, no significant differences were found between the groups regarding the E [early]or A [late] phases of mitral flow velocity. There was a significant difference between the normotensive group and the hypertensives by 24-hour ambulatory monitoring and between the [office only] hypertensives and the hypertensives by 24-hour monitoring with regard to the E/A ratio. It was concluded that the application of 24-hour monitoring as well as use of Doppler evaluation of LV function could help in the early diagnosis and detection of target organ involvement in hypertension in children