Functional and prognostic relevance of -173 G/C gene polymorphism of macrophage migration inhibitory factor in sepsis patients in Egyptian intensive care units

This study aimed to evaluate the association of plasma MIF level and -173 G/C single nucleotide polymorphism of the MIF gene with the occurrence, severity and mortality of sepsis patients. A study was conducted in adult surgical intensive care units of Zagazig University Hospitals, Egypt on 25 patients with sepsis, 27 with severe sepsis and 28 controls. Gram-negative bacilli were the most common isolates in both severe sepsis [63.0%] and sepsis [56.0%] patients. A highly statistically significant difference was found in MIF levels between sepsis cases and controls and a statistically significant difference as regards MIF level in different genotypes of the studied groups. MIF level was significantly associated with mortality in sepsis cases. High MIF levels and MIF -173G/C gene polymorphism are powerful predictors of the severity of sepsis and its outcome

Epidemiological characterization of P. aeruginosa isolates of intensive care units in Egypt and Saudi Arabia

This study aimed to characterize Pseudomonas aeruginosa isolates in 2 intensive care units in Egypt and Saudi Arabia. P. aeruginosa isolates from patients' and staff hands and environmental samples were typed using antibiotyping and ERIC-PCR. In Egypt, isolates from suction apparatus tubing and drainage containers [A7] and AV tubing [A8] were linked to those from patients who had these antibiotypes. In Saudi Arabia, isolates from suction apparatus tubing [A6] and AV tubing [A7] were linked to patients with the same antibiotypes. In Egypt, patients' isolates had ERIC VII, VIII and IX patterns linked to suction apparatus tubing, AV machine tubes and drainage containers. In Saudi Arabia, patients' isolates had ERIC VIII and XI patterns linked to suction apparatus tubing and AV machines. In Egypt and Saudi Arabia, ERIC typing gave higher discriminatory indices [0.801 and 0.785 respectively] than the antibiotyping [0.7123 and 0.728 respectively]. ERIC was superior to antibiotyping and should be used in tracing sources of infection

Haemodynamic and ventilatory responses to thoracocentesis in patients with massive pleural effusion

This work aimed to evaluate the effect of thoracocentesis on the haemodynamic and ventilatory functions in patients with massive pleural effusion [PE]. The study entailed 20 patients with massive pleural effusion divided into two equal groups, each of 10 cases. Group I: patients with right PE, Group II: patients with left PE. All patients underwent basal assessment protocol including plain X-ray chest, computed tomography when needed, chest ultrasonography, pulmonary function tests, arterial blood gases and echocardiography. Thoracocentesis was carried out repeatedly until nearly complete evacuation of pleural effusion was reached, this was followed up and guided by X-ray chest and chest ultrasonography. The previously mentioned assessment protocol was repeated after PE evacuation. Patients with massive pleural effusions in both groups I and II demonstrated restrictive pattern of pulmonary function tests [PFTs] together with evidence of small airway obstruction FEF[25-75%] [51.2 +/- 13.2], arterial hypoxemia PaO[2] [65.2 +/- 11.3 mmHg], echocardiographic study demonstrated high mean values of pulmonary artery pressure [mPAP] 47.3 +/- 5.7 mmHg together with evidence of both right and left ventricular diastolic dysfunctions of relaxation pattern [E/A<1]. No significant difference was found between patients with right and left effusions. Thoracocentesis produced significant improvement in PFTs, arterial PaO[2] and biventricular diastolic dysfunction [E/A >1], as well as decrease in mPAP. Correlation study revealed significant relationship between total volume of aspirated pleural fluid and% change in PFTs, PaO[2] and mPAP. Our data provide circumstantial evidence that massive pleural effusion produce detrimental effects on the ventilatory function, gas exchange as well as on cardiac function. This occur irrespective to the side affected. Thoracocentesis induced significant improvement in cardiac and pulmonary functions that is proportional to the volume aspirated. Thoracocentesis can lead to rapid improvement of the haemodynamic profile

Implication of some environmental factors in development of genetic abnormalities associated with some eye disorders in Sharkia, Egypt

A retrospective case-control study was carried out in Sharkia Governorate upon 55 cases with congenital cataract, glaucoma and retinitis pigmentosa and 20 healthy persons as a control group. This study was intended to investigate the mode of inheritance, implication of prenatal environmental exposure and other personal risk factors in development of these serious eye disorders. The subjects were examined according to the following protocol; [1] an interview for recording the relevant personal and family data, [2] complete medical an ophthalmological examinationX3] family pedigree was constructed for each case and, [4] peripheral lymphocyte haryotyping was done for detection of chromosomal abnormalities. The main findings are as follows: [1] the mode of inheritance in primary congenital glaucoma was multifactorial, in congenital cataract as autosmal dominant and recessive and in retinitis pigmentosa it can follow autosomal dominant and recessive, [2] a significant higher prevalence of chromosomal abberration among cases when compared with control, [3] 66.7% of cases with chromosomal abberration had a prenatal history of exposure to some environmental hazards [P<0.01]. [4]; a history of parental exposure to environmental hazards were reported by 2.6% of all cases with congenital eye disorder

Pattern and prognosis of breast cancer: data from the eastern province of Saudi Arabia

Data on 130 evaluable women with invasive breast cancer were retrospectively reviewed. The patients' mean age [ +/- SD] was 43.4 [ +/- 12.1] years; Saudis constituted 61.5%. The patients showed a mean primary tumour size [ +/- SD] of 5.34 [ +/- 3.91] cm. While only 22% of patients had stage I disease, 40% presented with stage III or IV. Of patients with known nodal status, only 22% were node- negative while 42% had four or more positive nodes. The overall median survival [ +/- SE] of all 130 Patients was 85.7 [ +/- 0.04] months with a survival probability of 79% [ +/- 4%] at 3 years. The Proportional hazard [multivariate regression] model has identified the advanced stages [III or IV] and in those with known nodal status positive nodes as the only poor prognostic factors that adversely influenced survival. Subset analysis of stages l-lll node-positive patients [62] who received adjuvant chemotherapy was also carried out. In those 62 patients, the proportional hazard model of Cox was able to identify certain independent adverse prognostic factors for survival. In conclusion, the derived results in the current series should shed light on the pattern, prognostic factors and outcome of invasive breast cancer in Saudi Arabia