speB Gene as an early specific genetic marker for diagnosis of group a beta-hemolytic streptococcus [GABHS]: considerable virulence factor

Group A beta-hemolytic streptococcus [GABHS], which is the most common cause of pharyngeotonsilitis, is the target of most diagnostic and therapeutic strategies. Pyrogenic exotoxin B [speB] is one of the most important virulence factors of GAS as it cause destruction of host defense system proteins .Early and appropriate treatment of GABHS significantly reduces the risk of development of acute rheumatic fever which can be prevented if an early and adequate course of antibiotic is received. To evaluate the role of speB as an early genetic marker for diagnosis of S. pyogenes [GABHS] in comparison with other methods and its correlation with the post-infectious sequelae. 80 patients were included in this study, they were selected from those attending Pediatric Outpatient Clinic. They were divided into two groups: 48 patients with acute follicular tonsillitis [Group I] and 32 patients with rheumatic fever or rheumatic heart disease [Group II]. They were subjected to complete clinical examination and throat swabs were collected from each patients and tested for: Culture, Rapid antigen detection test [RADT] and for the expression of speB gene using PCR technique. GABHS were detected by culture in [50.0% and 71.88%] of group I and group II respectively, while by using RADT, were detected in [52.08% and 84.38%] of group I and group II respectively. speB gene were detected in [50% and 93.75%] of group I and group II respectively with significant deference [P<0.001]. In comparison to culture, PCR showed 97.87% sensitivity and 75.75% specificity, while RADT showed 91.48% sensitivity and 72.72% specificity. Detection of speB gene shows high sensitivity and specificity in comparison with other detection methods and can be used as an early marker for diagnosis of GABHS and predicting the post- infectious sequelae

Qualitative and quantitative detection of Aflatoxin-M1 residues in white soft cheese

A total of 50 random samples of locally manufactured Egyptian soft cheese including [25 each of Damietta and fresh kariesh cheese] were collected from different markets and shopkeepers at Mansoura city, Egypt. Each sample was divided under complete hygienic measures with a clean sterile, knife into two parts; the first part was prepared for estimation of by qualitative lateral flow test [strip test] and the second one was subjected to quantitative estimation of by [Immune Affinity Column with Flurometric Assay]. The qualitative value for detection of Aflatoxine M1 revealed that 8[32%] and 12 [48%] of kareish and Damietta cheese were contaminated with Aflatoxin M1 respectively. Concerning the concentration of Aflatoxin M1 in examined fresh Kariesh cheese and Damietta cheese samples for the minimum was 1.95 and 1.54, the maximum were 6, 11 and 14.73 with a mean value 3.6 and 6.7 ppb, respectively. It had been emphasized that all results of this study exceeded the Egyptian regulations, European commission [EC] regulations and US regulations which recommend that cheese sample must be free from Aflatoxin M1, do not exceed 250 ng/L, and do not exceed 5 micro g/kg in milk, respectively. It was concluded that the qualitative method of detection of mycotoxin has great benefit in minimizing cost of regulations and monitoring and give a chance to easily set regulation for quality control. Also, quantitative methods with highly detectable limits give accurate results to estimate the level of impact

Accessibility to the health insurance of the medical union in Alexandria

Utilization of care is very important because of its link to access, quality of care and because of its importance to outcome. The aim of the study was to clarify the barriers towards accessibility to the Health Insurance of the Medical Union plan and to explain reasons why participants covered by other health insurance systems are using the Health Insurance Medical Union [HIMU]. The study was carried out at the health insurance project situated in Alexandria Medical Syndicate. The insured members of HIMU included four specialties namely; physicians, pharmacists, dentists and veterinarians and their families. The sample amounted to 782 members. The highest reasons for participation in the project were freedom of choice of laboratory and/or radiology clinics 73.9%, affiliated providers [physicians and hospitals] offer good quality care to members 62.6%, and simplicity of getting services and/or referral system 59.2%. Whereas the highest reasons for not participating or continuing with the project were high premiums for members: high premium of parents accounted for the highest percentage [13.8%] followed by that of the spouse 9.3%, then high premium for members 5%, and high premium for children 4.9%. The reason that the period of participation was unsuitable for members [October-November-December] accounted for 4.9%. From the results of the current study, it was be recommended that as a result of reviewing the system of determining premiums there were possibilities of a decrease in the annual premium for those beneficiaries who revealed low subsidies, decreasing cost sharing paid by beneficiaries for both outpatient and inpatient services in some essential services e.g. pregnancy and delivery. As well as?? vigorous control procedures regarding quality of medical care provided, art of care and price of medical services

Design study on compact hybrid standing-wave C-band linear accelerator for medical applications

New radiation therapy techniques such as Tomotherapy and Stereotactic radiotherapy require compact and higher power electron accelerators. In this paper a design of 10 MeV, 450 mA, compact, and hybrid standing wave C-band [5712 MHz] linear accelerator with peak power of 7 MW is presented to fulfil the demands of such new radiation therapy techniques. Standing wave structure that operates at [PI]/2 mode has been chosen for the design. Two different coupling techniques were utilized in the structure design; side coupling is used for regular accelerating section while the on-axis coupling is used in buncher section. A special hybrid cell is designed to connect the aforementioned sections such that the first half of this cell uses on axis coupling and fit to the buncher cell dimensions and the second half uses side coupling and fit to the regular cell dimension. Different cells of the design have been optimized using the computer, code SUPERFISH. PARMELA code is used to simulate the electrons' trajectories along the whole structure. Results from PARMELA indicate that the final energy is 10 MeV; the transmission ratio is 44%, and good energy spectrum with 18.6% span from the peak energy

Quasi monochromatic synchrotron radiation source based on compact X-band linear accelerator and terra watt laser for medical diagnostics

X-ray has many useful applications in different research field such as solid state physics, biology, microscopy, medical imaging and diagnostics. One of the great interests in medical application is the Coronary Arterio Graphy [CAG] in which the coronary artery is visualized by contrast agent [iodine] injected into the artery by a catheter that inserted into the artery. This technique is very invasive for patient and associated with high irradiation dose for the patient and for the medical doctor too due to the wide energy spectrum emitted from the X-ray tube used in this technique. In this paper we avoided all the shortcomings of the aforementioned technique by introducing a new, cheap and compact system to produce hard X-ray based on electron-laser collision which enables the physicians to visualize the coronary artery dynamically. The dynamic visualization was possible in this technique due to the high flux of the X-ray photons, which is about 10[11] photons/second. This technique utilizes the advantage of the K-edge attenuation of the iodine [Z = 53] at X-ray energy of 33.169 KeV; hence a monochromatic X-ray radiation just above this energy will give high contrast ratio and clear image. The contrast agent [iodine] in this technique will be injected intravenously instead of using a catheter that inserted into the artery. For that reason the new technique is known as an Intra Venous Coronary Arterio Graphy [IVCAG]. The X-ray flux generated from laser-electron collision has been optimized using CAIN code, while the accelerating cavities of the X-band linear accelerator were designed and optimized using SUPERFISH code. Several scenarios have been proposed to achieve our final goal of compact and stable hard x-ray sources. The progress of the system is presented too

Body fat distribution, serum leptin, and insulin resistance in obese subjects with obstructive sleep Apnoea

Obstructive sleep apnoea [OSA] is strongly associated with obesity and is characterized by endocrine and metabolic changes. The aim of the present study is to clarify whether there is interrelationship between body fat, serum leptin, glucose-insulin metabolism and OSA

Subjects and measurements: We studied 23 obese subjects with OSA [13 males,and 10 females; age mean 36 +/- 4.4 years; BMI: 31.7 +/- 3.6 kg/m2; WHR: 1.2 +/- .25 in males and 0.81+.5 in females ;Apnoea Index "AI"[ 9.2 +/- 6.1] event/hour of sleep by means of overnight polysomnography; fasting glucose[109.8 +/- 21.4 mg/dL] ; fasting insulin[18.6 +/- 7.1 uU/L ]; IR[6.7 +/- 2.8]; fasting leptin[577.69 +/- 201.6 ng/ml]. Results were compared with those of 10 healthy normal weight subjects[6 males,4 females; age mean 36.8 +/- 4.4 years; BMI: 25 +/- 0.24 kg/m2; WHR: 0.86 +/- 0.01; AI: 2.1 +/- 1.1 event/hour; fasting glucose[71.7 +/- 2.8 mg /dL ]; fasting insulin[15.3 +/- . 48 uU/L ]; IR[4.6 +/- . 17]; fasting leptin [42.4 +/- 11.5 ng/ml]

Results: Anthropometric measurements of OSA subjects were highly significantly greater than controls; body weight [P<0.003]; BMI [P<0.00]; waist [P<0.000]; and WHR [P<0.000]. Fasting glucose levels; fasting plasma insulin; IR and leptin levels were significantly higher in OSA subjects than controls [P<0.000, 0.03, 0.002; and 0.000] respectively. Overnight polysomnography revealed significant difference between OSA subjects and controls as regards AI [P<0.001]. The major dependent outcome variable was the apnoea index [AI], "the average number of apnoeas per hour of sleep determined by overnight polysomnography". OSA was defined as AI >/= 5. Highly significant correlation between AI and WHR [P<0.00]; Fasting insulin [P<0.04]; IR [P<001] and Leptin [P<0.000] were detected. Also leptin concentrations correlated with fasting insulin [P<0.02]; IR [P<0.00] and WHR [P<0.000] besides the AI

In Conclusion: There is strong bidirectional, feed-forward pernicious correlation detected between OSA in one side and each of visceral obesity, leptin, and IR; also between leptin, obesity, and IR. This association may contribute to the pathological manifestations and somatic sequale of this condition. Leptin could have major role linking OSA with various metabolic abnormalities detected in obese subjects. High circulating leptin found in this study, suggests that both obesity and OSA may be caused by a leptin resistant state. Among obese subjects, it is visceral fat [WHR], rather than generalized obesity [BMI] that predisposes to OSA

Risk factors of puerperal sepsis in Alexandria

Puerperal infections are an important cause of maternal morbidity and mortality in developing nations. Investigators have noted several risk factors for developing puerperal sepsis. However, the relative importance of these risk factors varies and has to be determined for each setting. Therefore the aim of the present work was to determine the risk factors for puerperal sepsis in Alexandria, Egypt. A case-control design was used to study the risk factors of puerperal sepsis in Alexandria. The study included 160 puerperal sepsis cases and 160 controls. Puerperal sepsis cases were recruited from the fever hospital as well as from 3 rural health units and three urban health offices in Alexandria. A pre-designed interviewing questionnaire was used to collect data about risk factors of puerperal sepsis. Logistic regression analysis indicated that very low socio-economic score [OR=6.4], no ANC [OR= 4.5], delivery at a governmental maternity hospital [OR= 203.4], frequent vaginal examinations [OR=5.1], anemia during puerperium [OR= 4.3], unsanitary vaginal douching during puerperium [OR=19.9] and unhygienic preparation of diapers used immediately after delivery [OR= 12.1] were significantly related to the occurrence of puerperal sepsis. Improving infection control measures during delivery, limiting the frequency of vaginal examinations, and avoiding all unhygienic practices related to delivery are strongly recommended

Ectoparasites of wild birds in Egypt

The authors tried to trace incidence of ectoparasites of wild birds in Egypt. The subjects hunted were 72 wild birds from Abu-Rawash area Giza Province all over a year. The infestation rate of heron by ectoparasites was high [44. 4%] then followed by egyptian kestrel [30.77%] and little owl [30%] and low in Egypt kite [35%] and barn owl [22.22%]. Six species from lice found as the ectoparasites of wold birds which were Liperus caponis, Cuclotogaster heterographus, Menopon gallinae, Menacanthus stramineus Trinoton sp., lastly Ricinus sp. and one species from mites was found Dermanyssus gallinae

Observation in two filariid microfilaria from two Egyptian wild birds

Two new species of microfilariae, from two Egyptian wild birds [Athene noctua and Ardeola ibis ibis] were illustrated, described and differentiated from other related species. The pathogenesis of one of them in the skin and internal organs of its host Athene noctua was studied

Entobdella aegyptiacus as a new species of monogenesis gill trematode of marine fish in Egypt

60 marine fish belonging to two species [Epinephalus gigas and Morone labrax] were collected from the Mediterranean sea at Port Said area. The monogentic trematode from gill was collected, examined and identified. The worker considered the worm in this study as a new species of genus Entobdella and named Entobdella aegyptiacus as a new species in Egypt

Some fish trematodes from the Mediterranean Sea

Three digenetic trematodes were collected from marine fish. Opishthorchis gomtii and schikhobalotrema acutum were collected from the intestine of Mugil cephalus. Xenopera maculates was collected from the intestine of Mullus barbatus

Traumatic dental injuries among primary school children in Alexandria

Children accidents are everyone's responsibility. Accident prevention is everyone's job. Traumatic dental injuries were studied among 6061 primary school children. The males had higher rate of accidents than girls and the accidents were higher among children with illeterate mother or only read and write and not working. Most of injuries occured at street followed by home. Single fractures, maxillary central incisors and enamel dentine type of fracture were the most frequent type of fractures

concept of need and demand and its application to dental care for central security soldiers in Alexandria

The difference between the physicians perception of need for medical services and that of the client has been discussed by many authors. There is always a certain degree of unrecognized need by the client due to incomplete knowledge of the characteristics of disease. Demand on the other hand, depends on the consumer and is basically an economic concept. This study was carried out with the aim of comparing between dental treatment needs as perceived by the dentist and the patient and clarifying the different barriers to transformation of recognized need into effective demand, as well as determining the effect of presence of a free clinic on the percent of met need and barriers to demand. The study was carried out in the three central security zones in Alexandria, only one of which had a clinic. Results revealed that 81.5% of those clinically assessed to need care recognized the need. However, 53.2% of the dental problems were unrecognized and these were mostly the non-painful conditions. The major bulk of filling need for the total sample was unmet [88.2%]. The zone with a clinic had the highest percent of met need for filling while those without a clinic had the highest percent of met need for extraction probably because they do not seek treatment early. The main barriers to utilization in the zones without a clinic were financial and no time for treatment, while for the zone with a clinic it was fear. Finally, it was recommended that soldiers should be educated about early recognition and treatment of dental problems in addition to performance of initial and annual dental examination, as well as provision of a dental clinic to serve the two zones without one

Use of delphi technique in determining certain factors related to drug dependence among youth

The drug dependency problem in Egypt is currently one of the major issues of concern to the public as well as professionals. Lack of comprehensive, reliable date concerning the problem led the researchers to resort to the Delphi technique in gathering the required information from experts involved in the problem. The aim was to reveal expert involved in the problem. The aim was to reveal experts' opinion regarding certain factors responsible for the causation and perpetuation of the drug dependency problem among youth, both currently and in the future [the next 10 years]. Experts were required to rank their answers in order of importance. Because of the multidisciplinary feature of drug dependence, 3 groups of experts were solicited from both Cairo and Alexandria, i.e. Psychiatrists, N.D.C. officers and social workers. Results of the study demonstrated that 72.2% of experts considered the current age of onset of drug intake among youth to be 18 to less than 21 years. In the future, 55.6% expected it to decline to 12 to less than 18 years. Skilled workers' were ranked the most common category of drug users with complete intergroup consensus of opinion, followed by drivers and artists. Cannabis, heroin and synthetic pills were respectively ranked the three most common drugs used currently. In the future, heroin is expected to occupy 1st rank followed by cannabis and synthetic pills. Regarding future use of drugs by youth, 79% of experts expected it to increase

Use of delphi technique in determining certain factors related to drug dependence among youth: part II

Due to the deficiency in the availability of reliable data required for accurate assessment of the drug dependence problem opinion regarding various factors related to the problem. This part of the research was concerned with their opinion regarding: reasons leading to drug dependence among youth, barriers preventing youth from seeking and continuing treatment, as well as experts' recommendation regarding control of the problem. Results of the study revealed that experts considered youth's urg for excitement, challenge and new experience to occupy 1st rank among reasons leading to dependency. This was followed by lack of morals, religious principles and a good example' [2nd rank] and availability of excess quick money' [3rd rank]. Among the barriers preventing youth from seeking treatment, unavailability of adequate treatment centers at reasonable cost', occupied 1st rank with complete intergroup consensus of opinion. Similarly, inadequacy and high cost of treatment' was ranked 1st barrier to continuation of treatment. The four main recommendations expressed for the prevention and control of the problem included, 'organization of attractive public education programs regarding harmful effects of drugs', adequate parental supervision and guidance', development of well supervised, interesting activities to occupy youth's time', as well as proper religious education in schools and universities

Determination of population's opinion regarding utilization of Mahelet Marhoum Hospital

A previous study by Amer et al., [1984], revealed that MMH continuously showed the lowest utilization rates among El-Gharbia hospitals. Therefore, this population survey study was carried out with the aim of revealing the reasons why MM population refrained from using their district hospital. The most frequently mentioned reasons stated by those admitted to other hospitals and those never hospitalized were related to unavailability of doctors, equipment and facilities in MMH. Technical inefficiency was the main reason of dissatisfaction from doctors as mentioned by those admitted to MMH, while lack of "caring" for patients was the major reason of dissatisfaction from nurses and other subprofessionals. Other reasons included geographic inaccessibility of the hospital. Cost formed no barrier to utilization, while problems related to uncleanliness were few. Finally, it was revealed that the higher the level of education of respondents the more inclined they were not to use MMH

Shamma usage and oral cancer in Saudi Arabia

Between June 1981 and July 1984, 33 [49%] of 68 patients with intraoral cancer referred to the King Faisal Specialist Hospital admitted to using shamma, which is a mixture of tobacco, black pepper, slaked lime, oils, and other materials. Eighty-five percent of these shamma user were referred from Southern Province, particularly from the Gizan area [73%]. The habit usually began at age 13 to 40 years [mean of 24.3 tears] and continued for 10 to 50 years [average 27.1 years]. Primary disease was usually located at the buccal, lower alveodiagnosis, the majority of patients had advanced Stage III and IV disease [76%]. Many patients had poorly differentiated cells [45%] in addition to extensive intraoral leukoplakia. Twenty-seven patients [82%] were treated aggressively with radical surgery, radiation, and chemotherapy, either singly or in combination. Despite such intensive treatment, the mean survival of all patients was nine months, and the one-year disease-free survival was only 21%. The hazard of carcinogenicity of shamma is of great concern in view of its widespread use among certain populations, especially in the southern part of Saudi Arabia

Evaluation of DPH program offered by High Institute of Public Health through student's opinion

This study was carried out with the aim of determining students opinion regarding the extent to which the first term curriculum of the DPH program was beneficial to them regarding certain areas. The opinionnaire used was designed with the help of medical education experts at the CED, University of Illinois, Chicago. Results revealed that the courses offered were rated of moderate benefit regarding their value in introducing students to the various disciplines of public health and in preparing them to become members of the P.H. team. The courses were rated minimally beneficial in preparing students for their future jobs. Comments and recommendations offered by students helped to clarify the reasons why ratings were not as high as should be desired. The main reasons referred to the fact that the core course offered too much information in too short a time [77.08% of respondents]. Moreover, students complained that the educational objectives of many courses especially the interdepartmental field work, were never clearly stated to them [56.25%]. They asked that methods of teaching be improved [2.08%] and recommended that all students should be separated from the very start into their specialties [17.7%], since non-medicals find difficulty in understanding lectures [3.12%]. The reasons for the apparent feelings of confusion and loss, lie mainly in the fact that the core course offers a sizeable amount of information to a heterogenous group of attendants who all sit for the same courses. To reach this group and adequately communicate the required knowledge to them, instructors of a special caliber and experience are required. The planning and development of the core course itself should be upgraded following the basic principles of curriculum planning, especially in relation to development of precise, clearly defined educational objectives, both for the program as a whole and for individual courses. This entails maximum cooperation on the part of everyone involved in teaching and development of the curriculum. In fact, most of the teaching staff in the institute have already been exposed to medical education workshops on methods of teaching and curriculum planning. What remains is for them to become adequately convinced to utilize the training they received to the benefit of their students. A situation which might require serious intervention on the side of the institute's administrative body