Occurrence of klebsiella species in raw milk market in Assiut city and the effect of low temperature on its viability [with 8 tables]

One hundred and twenty random samples of raw buffalo's, cow's, goat's and sheep's milk [30 of each] were collected from different farmer's houses and dairy shops in Assiut City to be examined for the presence of Klebsiella organisms on MacConkey Inositol Carbenicillin agar. The results revealed that K. pneumoniae was the most prevalent species among the Klebsiella organisms isolated [10 and 13.33%] for buffalo's and cow's milks. K. oxytoca [66.6%] in cow's milk only, K. ozaenae [2.66, 3.33 and 3.33%] for buffalo's, goat's and sheep's milk respectively, K. planticola [6.66 and 6.66%] in buffalo's and cow's milk respectively and K. terrigena revealed 1.33% in buffalo's milk Klebsiella organisms isolated from raw milk of different animals were [18] 15%, and they were 26.66% for buffalo's and cow's milks. Concerning the second part dealing with the effect of cold temperature [5 +/- 1°C] on the viability of K. pneumoniae in sterile butter samples revealed that, there is a gradual increase in the number of K. pneumoniae from 17x10[8] cells/g as an initial count to 91x10[8], 206x10[8], 217x108 and 224x108 cells/g in the first, second, third and seventh day respectively. While a remarkable decrease in case of freezing temperature [O°C] from 17x10[8] cells/g as an initial count to 10x10[8], 1.13x10[7], 220x10[5] and 37x10[3] in the first, second, third and seventh day respectively. K. pneumoniae inoculated in sterile butter completely disappeared and could not be detected after the first week in both chilling and freezing temperatures due to the high acidity percentages which reach from 4.3% at the zero time to 4.3, 4.3, 4.5 and 6.5%. Most of the isolated K. pneumoniae strains were highly sensitive to Norfloxacin, moderately to Gentamicin and weakly to cefotaxime but were resistant to other antibiotics used. The public health hazard and suggestive measures were discussed to prevent milk and milk products from contamination with Klebsiella organisms

Transmyocardial laser revascularization [TMR]; is a novel option of patients having advanced ischemic heart disease with intractable angina and poor left ventricular function

TMR is a successful treatment for chronic refractory angina in patients having diffuse CAD, not amenable to PTCA or CABG and exhausted drug therapy, but still having normal or nearly normal left ventricular [L.V.] function However in our practice in Egypt, we have to perform TMR for patients having severely diffuse CAD with poor L.V. function. This study was done to determine the clinical outcome of TMR for patients having end stage CAD and poor L.V. function Out of one hundred patients had CAD not amenable to PTCA or CABG underwent sole TMR with a CO2 laser [the heart laser system P.L.C. medical system]. Twenty five patients had a high score of medical therapy with preoperative special anesthetics management and using of GIK intravenous infusion as a metabolic support for the myocardium in addition to long term postoperative rehabilitation program. The results showed that, there was no operative or postoperative mortality and considerable early post operative morbidity. Follow up of the patients up to 12 month showed [1] reduction of 2 or 3 angina classes as compared with preoperative state. [2] improvement exercise tolerance. [3] decreased of Cardio- active medication. [4] improvement of myocardial perfusion of the lazed areas. It was concluded that the, TMR has emerged as an effcient treatment for patients with interctable angina and low ejection fraction

Major liver resection for giant hepatic tumors in adults and children

With the evolution in surgical technique, anaesthetic care and postoperative management, major hepatic resections for giant liver tumors are now considered reasonably safe procedures with a low surgical death rate. The aim of this study is to evaluate the results of major hepatic resection for giant hepatic tumors in the National Liver Institute during the period between September 1991 and September 2001 and to compare these results with reports from other centers. From September 1991 to September 2001 twenty-six giant liver tumors undenvent major hepatic resection out of a total number of one hundred and thirty seven liver tumors that were resected in the National Liver Institute. The tumor diameter was ranging from 8 cm to 27 cm. There were 6 children: their ages ranged from 8 months to 13 years. Four of them had hepatoblastoma, one malignant mesenchymoma [undifferentiated embryonal sarcoma] and one case of liver cell adenoma. The adult group included 20 cases with a mean age of 52.5 years [range 26-65 years]. There were six cases of hepatocellular carcinoma [HCC]; two of them were done as an emergency due to bleeding after tumor rupture. The remaining 14 cases were: 2 cases of HCC fibrolammellar type, one gallbladder carcinoma, 2 cases of colorectal liver metastasis, 5 cases of haemangioma, one case of haemangioendothelioma, one case of secondary leomyosarcoma from the stomach, one case of cholngiocarcinoma and one case adenocarcinoma. Right or extended right hepatectomy was done in 14 patients and left or extended left hepatectomy was done in 12 cases. Ultrasonic dissector and bipolar coagulation was used in 21 cases. Hospital mortality was three cases; two of them were emergency cases on top of chronic liver disease. Postoperative complications included: temporary ascites, chest infection, minor biliary leak and wound infection. major liver resection is a reasonably safe procedure especially, when performed on normal liver under elective conditions

Plasma adrenomedullin levels in patients with non-insulin dependent diabetes mellitus with and without complications

The present study was undertaken to determine plasma adrenomedullin [ADM] levels in patients with non-insulin dependent diabetes mellitus [NIDDM] to elucidate the potential involvement in the pathogenesis of diabetic complications. The patients were 31 males and 29 females with age ranging from 46-72 years [M +/- SD 57 +/- 12], the study were done at Al-Azhar University Hospitals and National Institute of Diabetes and Endocrinology between March 2000 and August 2000. Plasma ADM levels were 49.3 +/- 5.7 pg/ml in control subjects, 54.3 +/- 7.5 pg/ml in NIDDM patients without complications and 65.5 +/- 7.1 pg/ml in NIDDM with complications. Plasma ADM levels were significantly higher in NIDDM patients without complications than controls and in complicated vs non-complicated patients and their levels were not affected by plasma glucose concentrations. Plasma ADM levels increased dependently on the severity of diabetic complications and positively correlated with systolic blood pressure, serum creatinine, urinary excretion of albumin and fall in systolic blood pressure on standing up [sympathetic function]. In contrast, plasma ADM levels were reversely correlated with R-R interval on standing up 30:15 ratio [parasympathetic function] and conduction velocities of left ulnar nerves [peripheral neuropathy]. The results indicated that the increase in plasma ADM levels were closely related to diabetic complications, which may depend on the development of microangiopathy and play a certain role in protection against microvascular disturbance in diabetic patients

Biological fixation of metaphyseo-diaphyseal fractures of long bone

Forty cases of fracture of the proximal or distal metaphases of the femur or tibia with or without diaphyseal extension but not extended to the joints were treated using indirect reduction of the fracture and biological fixation. There were 23 femoral fracture and 17 tibial fractures. After mean follow up of 19 months, bony union was achieved without any mechanical failure in all patients except two, three cases had delayed union and required bone grafting

Some studies on potato common scab disease. Pathological studies

Three streptomyces isolates causing potato common scab disease [i.e., S1, S2 and S3] were successfully isolated and identified from the growing areas at Menia. Pathogenicity tests, either in the laboratory or pots, revealed that potato cultivars Alpha, Diamont and Spunta could be infected by all three S. scabies isolates. The tested isolates caused lesions on the root tips of radish, software, soybean, squash, tomato, turnip and wheat seedlings. Only isolate S2 induced lesion on the root tips of cowpea, Nicotiana glutinosa, and sunflower seedlings. None of the S. scabies isolates infected maize seedlings or storage roots of carrot and sweet potato. However, storage roots of radish were infected by the highly pathogenic isolate S2. S. Scabies isolates produced phytotoxic substances with most produced after five days at 25C

Carpal tunnel syndrome

Forty eight hands [thirty-six patients] had a release of the transverse carpal ligament for carpal tunnel syndrome. The average age was 42 years. There was motor weakness in 12 hands and wasting of the thenar muscles in eight. Three provocative tests were carried out. The Phalen test was positive in 28 hands [65%] Tinnel sign was positive in 26 hands [60%], but the Tourniquet test was not conclusive. Preoperative nerve conduction tests showed severe compression in 20 hands and moderate compression in 23. The average length of follow-up was one year. All the patients operated on had relief of sensory symptoms and improvement of motor weakness, but the wasting of the thenar muscles persisted. Different pathologies were met with as an underlying cause of median nerve compression, such as rheumatoid arthritis, T.B., ganglion, tumours and trauma. Three cases presented with acute symptoms and had to be operated upon on the same day. In bilateral cases one has to search for a generalised disease such as multiple myelomatosis or myxoedema