ABSTRACT
Diabetes mellitus [DM] is a serious health problem and remains an important cause of morbidity and mortality worldwide. Patients with uncontrolled diabetes develop complications; some of the most clinically important are foot ulcers, retinopathy, neuropathy and macrovascular complications. Foot complications such as foot ulcers constitute a major public health problem and impose a heavy burden in health service. The aim of the work was to isolate, identify the most common bacterial causes of diabetic foot lesions, and to assess the susceptabilty pattern of the isolated organisms to the commonly used antibiotics. Phagocytic index of neutrophils of diabetic foot patients was also evaluated and its change over a short treatment course. The study was carried out on 35 patients with diabetic foot wound admitted to the General Surgery Department in Benha University Hospital. Phagocytic index of neutrophils was determined for each case by the phagocytic test at the beginning of the study and 2 weeks later. Pus aspirates were collected from the foot wound and cultured to identify the causative bacteria and its antibiotic susceptibility pattern. The results of the bacteriologic study revealed that, pure culture was found in 12 patients [34.29%] and mixed infection was found in 23 patients [65.71%]. Gram negative isolates considered a high ratio [58.33%] than gram positive isolates [41.67%]. Most isolates were aerobes [90%], however anaerobes were [10%]. Staph aureus and Pseudomonas aeruginosa were the most commonly isolated bacterial species from diabetic foot wounds. The results of the immunologic study [phagocytic test] concluded that there is a statistically significant correlation between phagocytic index and the mean value of blood glucose
ABSTRACT
To investigate the sources and spread of Pseudomonas in the Adult Intensive Care Unit [ICU], Benha University Hospital, 60 Pseudomonas aeruginosa strains were isolated from patients, staff and environmental samples and were typed using the randomly amplified polymorphic DNA [RAPD] and the enterobacterial repetitive intergenic consensus [ERIC] polymerase chain reaction [PCR] methods. Testing for extended spectrum beta lactamses and metallo-beta-lactamase [MBL] production was also performed. 50% of patient samples were positive for Pseudomonas aeruginosa. 33% of the environmental samples were positive for Pseudomonas aeruginosa Highest frequencies of Pseudomonas isolation were from Ambu bags [100%], stethoscope [100%], suction apparatus tubing [100%], water tap/sink [80%] and floor [75%]. 13% of staff hand samples were positive for Pseudomonas aeruginosa. MBL production was highest in patient strains [92%], less in environmental strains [19%] and was not detected in staff hand samples. The difference in MBL distribution between patient and environmental/stuff samples was statistically significant [P < 0.00 I]. All the Pseudomonas aeruginosa isolates were typable by both RAPD and ERIC-PCR methods. Seven RPAD patterns [RAPDI-RAPDVII] and eight ERIC patterns were obtained ERIC typing method gave higher discriminatory index [0.7955] than RAPD [0.7706], still the combination of both gave the highest discriminatory index [0.7977]. Water-tap and suction apparatus played a central role in the spread of Pseudomonas aeruginosa in the ICU. Both water-tap and suction apparatus were epidemiologically linked and both had been epidemiologically linked to patients. Water-top was molecularly linked to staff hands and artificial ventilation fluid reservoir. Suction apparatus was linked to medical trays and stethoscope. Epidemiological linkage has been also proved between patients and artificial ventilation tubing. The patient MBL-producing strains were epidemiologically linked to water tap and suction apparatus tubing
ABSTRACT
Oral lichen planus is an autoimmune inflammatory disease. Tumor necrosis factor alpha [TNF-alpha] is an important cytokine with a large number of biological effects which is implicated in the pathogenesis of the disease. The present study was conducted to measure and compare the level of TNF-alpha in sera and saliva of patients with OLP. The study included 30 patients suffering from OLP. They were divided into 2 groups: erosive OLP [15 patients] and reticular OLP [15 patients]. The study also included 10 ages and sex matched healthy subjects as control group. TNF-alpha was measured in sera and saliva by enzyme linked immunosorbent assay method
Results: TNF -alpha in sera of OLP patients was statistically higher than in control group [6.39 +/- 1.82 pg/ml compared to 2.99 +/- 0.52 pg/ml, P < 0.0001]. Also TNF-alpha in sera of erosive OLP was statistically higher than in sera of reticular OLP [7.87 +/- 1.16 Pg/ml compared to 4.90 +/- 0.90 pg/ml, P <0.0001] and TNF-alpha in erosive or reticular OLP was significantly higher than in the control group [P < 0.0001]. Regarding salivary TNF-alpha the study showed that salivary TNF-alpha in OLP patients was statistically higher than in the control group [28.20 +/- 5.00 pg/ml compared to 6.91 +/- 0.98 pg/ml, P < 0.0001]. The study also showed that salivary TNF-alpha was statistically higher in erosive type than in reticular type and each of them was higher than the control group [31.75 +/- 3.75 pg/ml in erosive type, 24.56 +/- 3.15 pg/ml in reticular type and 6.91 +/- 0.98 pg/ml in the control group, P = < 0.0001 in all]. The study also showed that a positive correlation was present between salivary and serum TNF-alpha, and salivary TNF-alpha was always higher than serum TNF-alpha
Conclusion: salivary TNF-alpha is a non-invasive more sensitive technique that can be used to detect disease activity and monitor the therapeutic response in OLP
ABSTRACT
Abstract: This study was done on 44 patients with pulmonary tuberculosis. They were 33 [75%] males, and 11 [25%] females. Their age ranged from 17-53 years [mean +/- SD = 37.64 +/- 9.71 years]. They were classified according to chest x ray into 3 groups, group A: 15 patients with far advanced lesion, group B: 15 patients with moderately advanced lesion, and group C: 14 patients with minimal lesion. The study also included 18 age and sex matched healthy individuals as a control. All are subjected to thorough history taking, full clinical examination, complete blood count [CBC], Erythrocyte sedimentation rate [ESR], chest x ray, tuberculin test, and bacteriological examination of sputum for Mycobacterium tuberculosis including smear stained with Ziehl Neelsen [ZN] stain and culture on Lowenstein Jensen [LJ] medium. The circulating levels of IL-18 and osteopontin [OPN] were also measured by enzyme linked immunosorbent assay [ELISA] method. The results showed that the circulating levels of IL-18 and OPN were significantly higher in patients with pulmonary tuberculosis than in the control group [both P < 0.001], and higher in group B than in group C [P = < 0.001] indicating that the circulating levels of IL-18 and OPN correlated positively and significantly with disease activity. The circulating levels of IL-18 and OPN were also measured in 19 patients only, 6 months after treatment with antituberculous drugs. The results showed that the levels were significantly higher in patients before treatment than after treatment [P = < 0.001 in both] but the levels do not return to normal
Conclusion: Circulating levels of IL-18 and OPN can be used as markers of disease activity. They can also be used for monitoring response to antituberculous therapy