Case-control study to evaluate risk factors for acute hepatitis B virus infection in Egypt

Hepatitis B virus [HBV] infection is a significant health problem in Egypt. To better define risk factors associated with HBV transmission, we conducted a case-control study among patients admitted with acute hepatitis to an infectious disease hospital in Cairo. A total of 60 cases and 120 controls were interviewed about various exposures within 6 months prior to admission. Univariate analysis revealed HBV case-patients were more likely to report providing injections to relatives or friends, injecting drug use, exposure to a household contact with hepatitis, exposure to invasive medical procedures and being in the military. Efforts should be made to implement strict infection control standards in Egypt

Injection prescribing patterns in public health care facilities in Egypt

This study assessed the frequency of and rationale for use of injections at health care facilities in Egypt based on WHO core drug use indicators. We reviewed 1406 prescriptions in 43 randomly selected hospitals and primary health care clinics in 2 governorates in Upper and Lower Egypt in 2001. Patients received an injection at 18.1% of encounters. The most frequently prescribed parenteral drugs were anti-infectives [56.9% of injections] and analgesics [13.7%]. Injections were more often prescribed in hospitals than in primary health care clinics and in rural than in urban settings. Most injections [94.7%] could have been replaced by a suitable oral preparation. Further efforts are needed to enforce the essential medicines programme in Egypt to improve rational drug prescribing

Adsorption of phenol and some substituted phenols on chemically - activated carbons developed from apricot stones

Chemically activated carbons were prepared from apricot stones. Phosphoric acid [25 - 75 wt%] was used as activating agent at 400 - 600 °C. Zinc chloride - activated carbons were also prepared at 600 °C and at 700 °C using zinc chloride [50 - 200 wt%] as activating agent. The textural parameters were determined from nitrogen adsorption data at 77 K. The chemistry of the carbon surfaces was determined from the FTIR spectrograms and from the base and acid neutralization capacities. The adsorption of phenol, p -nitrophenol and 3,5-dinitrophenol was carried out at 298 K for all the prepared carbons and also at 308 and 317 K for some selected carbons. Chemically - activated carbons exhibited high adsorption capacity towards phenols. Phenols adsorption increased with the increase of the molecular weight of the phenol and with the decrease of its solubility in water. The adsorption of phenols increased also with the decrease of the surface density of carbon - oxygen group existing. Adsorption of phenols proceeds via physical adsorption on oxygen - free surface and via chemisorption on oxygen contaminated carbon surfaces. Activated carbons [AC's] are widely used as adsorbents in decontamination process because of their extended surface area, microporous structure high adsorption capacity and special surface reactivity[1-4]. The surface of AC is considered heterogeneous from the point of view of both porosity and surface chemistry. The heterogeneity of the pore structure is a result of the existence of a wide range of size from a few to a few hundred angstroms[5]. The heterogeneity of the chemistry of AC is attributed to the existence of heteroatoms such as oxygen, nitrogen, hydrogen and phosphorous[6-7]. The heteroatoms, particularly oxygen, consist of organic functional groups at the edges of carbon crystallites. Carbon-oxygen groups include carboxyls, phenols, ethers, lactones and carbonyl[8]. There has been an increasing interest in the study of adsorption of organic molecules on AC. This is due to the importance of the removal of organic pollutants from water streams and the atmosphere[9]. Adsorption of aromatic compounds from solution, particularly phenols, has been studied extensively[10-14]. Phenolic compounds exist widely in the industrial effluents such as those from oil refineries, cool tar, leather, paint, pharmaceutical and steel industries. Since they are highly toxic and, in general, not amenable to biological degradation, methods of treatment are continuously modified and developed at all treatments. Among adsorbents, granular or powder AC proved to be the most efficient[15-19]. Regardless of the enormous studies undertaken concerning the adsorption of phenols on carbon, it can be seen that more intensive investigations still need to be undertaken to find convincing answer for some problems still remaining on phenol uptake by AC. The objective of this paper is to study the effect of surface chemistry and surface area of carbons on their adsorption of phenols. The samples are different from the point of view of the activating agent used [Zinc chloride and phosphoric acid]. An important feature common for all the samples is their acidic surface pH. Under such condition phenols exist in their molecular form. Three phenols were studied, namely phenol [P], paranitrophenol [PNP] and dinitrophenol [DNP]

Management of unstable distal radius fractures in children by Kapandji technique

The aim of this study is to evaluate Kapandji technique in treating unstable distal radius fracture in children. A prospective study was performed using intrafocal pinning on 40 children with irreducible or unstable distal radial fractures, 12 girls and 28 boys. The average age was nine years, with 18 dominant and 22 non-dominant extremities. Patients were followed for an average of 18 weeks. The results were assessed clinically and radio graphically at a minimum of 12 weeks after injury. The final outcome according to a clinical scoring system was excellent in 31 children, good in 7, fair in 2 and no poor results. This study confirms that Kapandji technique is considered convenient, effective, and safe for treating unstable or irreducible distal radial fractures in children

Treatment of tibial and femoral infected non union by the Ilizarov technique

Experience in 33 cases: all were done in our Orthopedic Department, Zagazig University Hospital.Ilizarov circular external fixator creating internal bone transport or compression distraction techniques were used to treat 33 patients with infected non unions or segmental bone loss. There were 20 tibial and 13 femoral. Their mean age was 38 [11-60] years and there were 25 men and 8 women. 25 patients had active infection with drainage and 8 were previously infected. After resection of the infected and necrotic bone, the intercalate defect averaged 5 [3-10] cm. The mean duration of treatment was 11 [4-18 months]. Regeneration of the distraction gap was achieved in all 33 patients. Union at the target zone was achieved in 29 and in the remaining four cases consolidation were achieved after application of autogenous bone grafts. The infection was eradicated in all cases.Complications were not severe and did not affect the final results. Residual malalignment remained in three patients, two femoral with 10° and 8° varus deformity and one tibial with 11° valgus deformity. The final leg-length discrepancy never exceed one cm. Residual fixed flexion deformity of the knee was left in two cases, but only ranges from 5° - 10° and loss of ankle dorsiflexion in three patients. There were no intraoperative or postoperative neurovascular damage or compartment syndrome.Psychological intolerance was seen in one young patient and delayed union in four cases. Almost patients returned to their previous occupation. So, we may prove also that radical debridment and bone transport is a simple and safe method for successful treatment of infected non union

Parathyroid function following ligation of the inferior thyroid arteries during subtotal thyroidectomy

A randomized controlled trial was performed to compare two techniques of subtotal thyroidectomy for non-toxic nodular goiter with regard to postoperative parathyroid function. 40 patients in group 1 underwent ligation of trunks of the inferior thyroid arteries. In group 2 [40 patients] the branches of the arteries were suture ligated at the thyroid capsule. Total calcium, ionized calcium and parathyroid hormone levels were determined before operation and 6, 24 and 72 hours after surgery and at follow up 6-12 months after operation. 8 patients in group 1 and 9 in group 2 required calcium and/or vitamin D supplementation for symptomatic hypocalcemia in the immediate postoperative period. At follow up only one patient in each group had mild hypoparathyroidism. No statistically significant differences were found between groups regarding total calcium, ionized calcium and parathyroid hormone levels. Truncal ligation of the inferior thyroid arteries during bilateral subtotal thyroidectomy does not cause hypoparathyroidism or hypocalcemia

Management of traumatic liver injuries

In this series 90 patients with liver injury with variable severity were studied; 50 retrospectively [1985-1990] were reviewed and 40 prospectively [1990-1995] were reviewed and 40 prospectively [1991-1995] were managed according to special protocol. Surgical intervention was performed in unstable patients and nonoperative treatment was used for those who were hemodynamically stable on admission. Increasing experience resulted in fewer indications for resection in the prospective group and the nonoperative management rate was 37%. The overall mortality rate was 13% [16% in the retrospective and 10% in the prospective group]

Malignant hyperthermia in a Saudi child

This is the first report of a case of malignant hyperthermia [MH] from Saudi Arabia. MH was probably triggered by response to Halothane. The diagnosis was suspected by the clinical signs of tachycardia, severe rigidity, cyanosis and rising temperature. The case was successfully managed by vigorous cooling, dantrolene sodium and diuresis