Study of efficacy of intravitreal injection of ciprofloxacin versus vancomycin and ceftazidime in treating experimental endophthalmitis

Endophthalmitis is a severe inflammation of the interior of the eye caused by the introduction of contaminating microorganisms. The aim of this study was to compare the efficacy of intravitreal injection of vancomycin and ceftazidime versus ciprofloxacin in an experimental model of Staph. Epidermidis induced endophthalmitis in rabbits. The study was conducted on the right eyes of 35 pigmented rabbits, 5 of which were used as control group. All remaining 30 eyes were inoculated with 3 x 10[6] CFU / 0.1 ml of Staph. epidermidis then, they were divided into 3 equal groups. 24 hours postinoculation, group I: was given no treatment, group II received a combined intravitreal injection of vancomycin [1 mg /0.1 ml] and ceftazidime [2.25 mg / 0.1 ml], and group III received an intravitreal injection of ciprofloxacin [100 micro g/ 0.1 ml]. From each group, 72 hours postinoculation, 5 rabbits were used for clinical examination and then they were sacrificed, their right eyes were enucleated, and vitreous colony count was done. The other 5 rabbits were also sacrificed, their right eyes were enucleated, and histologlcal examination by LM and TEM was performed. The clinical examination revealed that the conjunctival injection and the corneal oedema were significantly less in group II in comparison to group I and III. The bacterial colony count was markedly decreased in group II in comparison to group I and III with a significant difference. Histological examination by LM and TEM revealed that the endophthalmitis group [group I] showed complete loss of architecture of the retina and choroid with disruption of the Bruch's membrane. Multiple degenerated cells and red blood cells were seen infiltrating the degenerated retina. On the contrary, the retinal structure was preserved to a great extent in group II, [vancomycin and ceftazidime group] except for focal areas of disorganization in the photoreceptor layer and mild invasion by inflammatory cells. Eyes treated with ciprofloxacin showed degeneration of the pigmented epithelial cells and the photoreceptor cell layers, pyknosis and karyolysis of the outer nuclear layer and infiltration of the all retinal layers with mononuclear cellular infiltration. Intravitreal injection of vancomycin [1 mg / 0.1 ml] and ceftazidime [2.25 mg / 0.1 ml] was more effective than ciprofloxacin [100 micro g / 0.1 ml] in improving the clinical signs, decreasing the bacterial colony count, and preserving the retinal structure in Staph. epidermidis endophthalmitis

Anaemia among young male workers in Alexandria, Egypt

In a cross-sectional survey, we investigated exposure to and the presence of factors associated with anaemia, such as socioeconomic conditions, dietary habits, intestinal parasitic infections and lead among 355 young male workers [7-19 years of age] employed in private workshops. Of the total study sample, 44.5% [158 participants] were found to be anaemic. The major risk factors for anaemia were multiple parasitic infection, high intensity of parasitic [Ascaris lumbricoides] infection and drinking tea soon after a meal. A significantly lower prevalence of anaemia was noted after Ramadan; it appeared to be the main factor associated with the presence or absence of anaemia and warrants further attention

Anaemia among Egyptian adolescents: prevalence and determinants

We aimed to estimate the nationwide prevalence of anaemia among adolescents in Egypt and to study possible risk factors. A cross-sectional approach was used. Blood samples were collected from 1980 adolescents for haemoglobin estimation. The overall prevalence of anaemia was 46.6%, most of which was mild or moderate, with severe cases in less than 1.0% of the sample. Gender difference was almost nonexistent. A significant inverse relationship was observed between the level of anaemia and age [especially among boys], socioeconomic level and educational level. Anaemia was more prevalent in rural areas and in Upper [southern] Egypt. Anaemia is a major public health problem among Egyptian adolescents and wide-scale public health education is warranted

impact of intestinal parasitic infections on the nutritional status of primary school children in Alexandria, Egypt

In order to investigate the relationship between intestinal parasitism and nutritional status, stool specimens obtained from 1674 school children aged 6-13 years were examined for helminth and protozoan parasites. The findings were collated with anthropometric data [weight and height] on the same children. The prevalence of parasitic infections was 31.5%. The most common infections were with Giardia lamblia and Ascaris lumbricoides. Children infected with both helminths and protozoa showed an increased but insignificant risk of underweight relative to those without infections. The risk of stunting was found among all types of parasites as compared with children with no parasites. Also, there was a higher nonsignificant risk of wasting among those with protozoal infection, especially Giardia lamblia. Children infected with three species or more of intestinal parasitic infections were significantly underweight than non-infected children. Using stepwise logistic regression analysis, number of parasites appeared to be the most effective variable of the nutritional status of children indicated by weight for age Z score, followed by education of the mother

Iodine deficiency disorders among primary-school children in Kafr El-Sheikh, Egypt

The prevalence of iodine deficiency in primary-school children in Kafr El-Sheikh governorate was assessed. A total of 2250 primary-school children aged 8-10 years were selected by a two-stage cluster sampling technique. The results revealed that the prevelance rate of goitre was 27.1% and it was significantly higher in females [29.2%] than males [25.1%]. The median urinary iodine level was 6.7 micro g/dl and 3.9 micro g/dl for grade 1 and grade 2 goitre respectively. It was concluded that iodine deficiency is a public health problem of moderate severity in primary-school children in Kafr El-Sheikh governorate. This necessitates an intervention programme through salt iodization

Assessment of nutritional knowledge and practices of physicians and nurses working in MCH clinies at different primary health care facililties in Alexandria

A cross-sectional study was carried out to assess the nutritional knowledge and practices of physicians and nurses working in MCH clinics in different PHC facilities in Alexandria. Six MCH clinics were selected randomly, one clinic from each district. A total sample of 188 [137 physicians and 51 nurses] were included in the study. A special designed questionnaire was constructed and included data about nutritional knowledge in general, nutritional knowledge during pregnancy, lactation and breast feeding practices. The results indicated that there was a significant relation between degree of qualification and level of knowledge. Physicians showed higher nutritional knowledge than nurses. Only 11.7% of the studied sample achieved a very good level [>/= 75%]. About 83% of interviewed physicians and nurses reported incorrect answer as regards the cut-off level of haemoglobin in pregnant women. Inspite of the fact that recommendations towards successful breast feeding is distributed in maternity services, about 20% of the sample reported that they advise a lactating woman to feed her baby on schedule and not to feed him / her during night hours. Exclusive breast feeding is recommended during first four months of delivery, however over 70% of interviewed sample reported that they advise a lactating woman to give her baby fluids in form of water, juices and herbs besides breast milk in the first four months after delivery. Based on the results of the present work, it is a necessity to carry on an extensive nutritional education training programme for physicians and nurses working in MCH clinics

Use of breast feeding indicators for assessment of current feeding practices

To investigate the current breast feeding practices, a survey was conducted cross sectionally on 2000 children aged less than 2 years recruited from 6 MCH centers in Alexandria governorate. The median duration of breast feeding was 19.4 months. Only one quarter of infants were exclusively breast fed for the first four months of age with a mean duration of 2.4+2.5 months. Predominantly breast feeding rate was 0.36, while timely complementary breast rig rate [6-9 months] was 0.66. Continued breast feeding rate [one year] was 0.73 while for two years was 0.3. Results also indicated that 40% of infants were receiving food from a bottle with a nipple/teat regardless of whether or not the infant was breast fed. These findings implicate that promotion of breast feeding should receive priority in health programs activities

Study of some factors related to the development of symptoms among giardia lamblia infected children

Out of 500 examined children, 45 were found to excrete Giardia lamblia cysts solely in their stools. These children were examined clinically and data regarding age, sex, socioeconomic level, weight and height were taken and blood drops were obtained for IFAT. The study revealed that there was no significant association between development of symptoms and age. Females had a significantly higher percentage in the development of symptoms. Socioeconomic level had a significant relation as well. Neither the development of symptoms nor the intensity of infection affected the general nutritional status of Giardia infected children. 89% of the infected children had anti-Giardia antibodies using IFAT, 100% of the symptomatic recorded positive readings and 25% of them gave high titers [128 or more]. Cysts isolated from stools of children were inoculated into mice for cyst and trophozoite count to study the effect of various Giardia isolates and the virulence of the organisms. Giardia isolates were divided into symptomatic, symptomatic diarrheic and asymptomatic isolates according to the presence or absence of symptoms in the examined children. A significant difference was found between symptomatic, symptomatic diarrheic and asymptomatic isolates in both cyst and trophozoite counts. This indicates that there is a difference in virulence of various isolates with more virulence of symptomatic isolates

Giant papillary conjunctivitis A clinical, bacteriological and cytological study

Giant papillary conjunctivitis [GPC] is one of the most important complications of soft contact lenses [SCL] wear. Twenty cases [37 eyes] of GPC associated with soft contact lens were examined thoroughly using slit lamp biomicroscopy with high magnification, 2% sodium fluorescein eye drops and cobalt blue light. Cultures from conjunctival cul de sac and cytological examination of conjunctival scrapings were performed. The severity of GPC was found to be related to duration of lens wear, chemical method of disinfection and the presence of deposits on the lenses. The cultures were sterile in 94.5% of cases. The non-sterile cultures showed the presence of Proteus, Stap. epidermidis and diphtheroids. Few polymorphonuclear of sterile cultures proved that this inflammatory condition was not due to bacterial infection, while the presence of eosinophils proved its allergic nature

Complications of posterior chamber intraocular lenses with special emphasis on cystoid macular edema

Posterior chamber intra-ocular lens has become an important tool for visual rehabilitation after cataract surgery. We have studied the incidence of the post-operative complications in our department. We have selected 35 eyes to receive posterior chamber lens after extracapsular surgery and 35 eyes with no implant, that underwent the same procedure, were taken so control, Fluorescein angiography was done for every case at 6 weeks and 3 months postoperatively or if there is an unexplained change in visual acuity. We have found a low incidence of both anterior and posterior segment complications also the incidence of cystoid macular oedema was low compaired to the control group