Developing the Mansoura Early Feeding Skills Assessment Scale for Preterm Infants / 대한소아소화기영양학회지

Purpose@#This study aimed to develop a new bedside scoring system scale that assesses preterm infants’ oral feeding skills (OFS) in the neonatal intensive care unit (NICU). @*Methods@#A literature review and critical appraisal of available oral feeding assessment tools/ scores were performed. Subsequently, we developed the “Mansoura Early Feeding Skills Assessment” (MEFSA) scale, an 85-item observational measure of oral feeding skills with three main sections. Forty-one preterm infants who did not receive oral feeding but were clinically stable enough to initiate oral feeding were included in the study. Next, we applied and interpreted the MEFSA to describe and score their feeding skills. @*Results@#Applying the MEFSA resulted in a smooth feeding transition, early start of oral feeding, full oral feeding, and discharge with a shorter period of tube feeding in preterm infants. @*Conclusion@#The MEFSA is a successful bedside scoring system that assesses the OFS of preterm infants in the NICU.

community-based study of viral hepatitis infection in Giza Governorate, Egypt: Seroprevalence, risk factors and associated morbidity

Hepatitis viruses are major causes of acute and chronic liver diseases in Egypt. The aim of this study was to investigate the seroprevalence, risk factors and associated morbidity of viral hepatitis in Giza Governorate, Egypt. The study was conducted in 4 rural and 4 semiurban communities and included 2305 subjects selected by a cluster r and om method. They underwent complete clinical and abdominal ultrasonographic [US] assessment and laboratory tests including stool and urine examination, hemoglobin, ALT estimation and viral hepatitis markers by enzyme immunoassay. The latter included anti-HAV IgG, HBsAg, anti-HBc, anti-HBs, anti-HCV and anti-HEV IgG. Subsets of sera were tested for HBV DNA and HGV RNA by specific PCR. The overall prevalence of anti-HCV was 20.9% [age-adjusted prevalence = 24.5%; CI: 22.7-26.3%] and was significantly rising with age from 10% below age of 20 years to 40% among those above 50 years. The infection rate of hepatitis B virus [HBV] was 57.1% with HBsAg carrier rate of 3.6%. Seropositivity of anti-HBs and anti-HBc was very high [45.8% and 44.7%, respectively] and correlated positively with age with no sex-related difference. Combined HCV and HBV infection was evident in 13% of subjects. HBV DNA was detected in 86% of HBsAg-positive cases and in 20% of HBsAg-negative anti-HBc- and anti-HCV-positive cases. Seromarkers for hepatitis B and C were significantly commoner in semiurban than in rural communities. Dental manipulation and previous parenteral antischistosomal therapy were significant risk factors for hepatitis B and C infection. Anti-HAV was positive in 99.7% whereas anti-HEV was positive in HBV= Hepatitis B virus. CLD = Chronic liver disease. HCC = Hepatocellular carcinoma. US = Ultrasonography. ALT = Alanine transaminase. OR = Odds ratio. CI = Confidence interval. 9.2%. HGV RNA was detected in 16.5% of the studied samples. It was always associated with HBV and /or HCV infection. History of hematemesis was recorded in 1.2% of individuals. US examination revealed hepatomegaly in 19.2% of subjects, splenomegaly in 8.2%, bright liver in 31%, coarse liver texture in 10%, periportal fibrosis in 20% and ascites in 2%. These findings were significantly more common in anti-HCV- and HBsAg-positive subjects. ALT elevation was commonest and highest in individuals with positive HBsAg or with HBV-HCV coinfection. Hepatitis B and C infection and associated morbidity still constitute a great health problem in Egypt. Hepatitis A is holoendemic and hepatitis E is endemic. Hepatitis G is always associated with HBV or HCV infection. Occult hepatitis B should be considered in future studies

cilnical significance of ultrasound-guided lymph node biopsy and fine needle aspiration cytology [FNAC] in patients with abdominal lymphadenopathy

This study included 65 patients [32 males and 33 females] with enlarged abdominal lymph nodes [ALNs] detected by ultrasonography [US]. They underwent US-guided percutaneous ALN biopsy and fine needle aspiration cytology [FNAC] after initial clinical, laboratory, US and Doppler evaluation. Cases with very small [<1 cm] or highly vascular ALNs and those with bleeding tendency, marked obesity or tense ascites were excluded from the procedure. In all patients, both biopsy and FNAC were successful to obtain a sample without major complications. ALNs of different groups and locations were biopsied, the commonest were the para-aortic, coeliac and porta hepatic groups. A definite diagnosis was given by the percutaneous procedures in 58 cases. The diagnosis of other four cases was achieved by laparoscopic or surgical biopsies and the last three cases remained undiagnosed. It was concluded that US-guided biopsy and FNAC of ALNs are efficient methods in the diagnosis of both malignant and benign conditions. They require a perfect cytological and histopathological interpretation supplemented by the use of advanced histochemical techniques. The procedure is easy in experienced hands with no considerable complications