Surveillance of communicable diseases for decision-making in Egypt: 2006–2013

The Egyptian Ministry of Health and Population surveillance system provides data about notifiable communicable diseases. This study aimed to provide information for decision-making to reduce the burden of communicable diseases in Egypt by analysis of the surveillance data for 2006–2013 to identify trends in the incidence of the diseases by governorate, season, age and sex. Composite risk-index scores were estimated to rank the 27 Egyptian governorates into 3 groups: high, medium and low risk. The 15 diseases with the highest incidence were food and waterborne diseases [5 diseases], vaccine-preventable diseases [7 diseases] and others, e.g. hepatitis C infection. Bloody diarrhoea and typhoid had the high incidence for 2006–2013. There were 11 high-risk governorates; Ismailia had the highest risk-index score. The findings suggest the need for specific interventions related to environmental sanitation and improving the childhood immunization programme, particularly in the high-risk governorates

Drug interactions between phenytoin and rosuvastatin on lipid profile, liver functions and oxidative stress biomarkers in irradiated rats

Phenytoin is one of the most commonly used anticonvulsants for treating generalized tonic-clonic seizures and status epileptics. Rosuvastatin is a new generation HMG-CoA reductase inhibitor. This enzyme converts HMG-CoA to mevalonic acid in the cholesterol biosynthetic pathway which is the rate limiting step in cholesterol synthesis. This study was aimed to investigate the possible interactions between phenytoin and rosuvastatin when used together in irradiated rats. The experiments were carried out to investigate the acute effect of each drug individually and in combination with radiation on lipid profile [Total cholesterol, Triacylglycerols, High density lipoproteins, Low density lipoproteins and Very low density lipoproteins, Risk factor, Atherogenic Index], liver function tests [AST and ALT] and oxidative stress biomarkers [MDA, NO and SOD]. Data revealed that, phenytoin in irradiated rats significantly increased serum total cholesterol compared to normal control. Rosuvastatin significantly decreased serum total cholesterol compared to irradiated control. Combination of two drugs significantly increased serum total cholesterol; triacylglycerols and serum VLDL-c levels compared to normal and irradiated rats and significantly increased Atherogenic Index and Risk factor compared to normal control. Phenytoin significantly increased serum ALT level compared to normal and irradiated rats and significantly increased serum MDA and serum NO levels compared to normal rats. But phenytoin significantly decreased MDA and NO levels and significantly increased SOD activity compared to irradiated rats. Rosuvastatin significantly increased serum ALT level compared to normal control but it significantly decreased MDA and significantly increased SOD activity compared to irradiated rats. Combination phenytoin and rosuvastatin in irradiated rats significantly increased serum ALT level compared to normal and irradiated rats and it significantly increased MDA, NO levels but it significantly decreased SOD activity compared to normal control. It could be concluded that administration of phenytoin concurrently with rosuvastatin not recommended in patients receiving radiotherapy as dangerous side effects may be occurred

Therapy-resistant vitiligo; treatment with autologous epidermal grafting using the tops of suction blisters-modified technique

Current treatment of vitiligo has been disappointing. In this study, emphasis was placed on treating the most refractory types of vitiligo, namely the segmental and focal varieties, none of which had responded satisfactorily to topical corticosteroids and topical or systemic psoraien and exposure to ultraviolet tight. [PUVA therapy]. Autologous epidermal grafting using the tops of suction blisters was the offered treatment to those resistant cases. Suction Mister epidermal grafting is a useful modality for treatment of resistant and stable vitiligo; however, the original apparatus is expensive one. This study attempts to develop a cheap and small apparatus, which can be assembled in the physician's, own office. Prospective study. National Hepatoiogy and Tropical Medicine Research Institute [NHTMR 1]. Twenty patients with therapy-resistant segmental or focal type of vitiligo were treated with autologous epidermal grafting using the tops of suction blisters. The epidermis was separated from underlying dermis by vacuum suction on the donor area. On the recipient area, similar blisters were raised by freezing of the skin. The busier roof induced by suction was removed and transplanted to the blister bed prepared on the depigmented area. The ventose machine used in obstetric delivery was connected to aluminum cups especially designed for that purpose and applied to obtain the suction blisters from the donor area. Ten parents exhibited almost complete repigmentation / [80%-100% improvement] at the grafted site within I to 3 months, in two patients a 70% response was achieved, while another faur patients did not respond to the treatment. Four patients lost follow up. Repigmentation that was noted in the recipient areas was retained at 1.5 years follow up. The donor areas healed well, with minimal hyperpigmentatian in most, of the cases. No unwanted effects were met with cases treated. Our results suggest that autologous epidermal grafting using the tops of suction blisters is a good treatment for the [therapy-resistant] segmental and/or focal type of vitiligo. Epidermal grafting leaves no scarring at all. The technique appears to be safe, simple, and effective. Introducing this simple suction device made the procedure also cheap and suitable to be applied on outpatient bases in our community in Egypt

Molecular detection of apoptosis in mice treated with ketoprofen and metamizol as analgesic drugs

To assess the apoptotic effect of metamizol and ketoprofen in the livers, spleens and testes of treated mice. Apoptosis was evaluated in liver, spleen and testes of mice injected intraperitoneally [IP] with therapeutic and high doses of ketoprofen [5 and 7.5 mg/kg] and metamizol [25 and 37.5 mg/kg]. The samples were analyzed for the estimation of apoptosis at intervals of 1, 3 and 6 days of treatment using agarose gel electrophoresis technique. Ketoprofen induced apoptosis in liver, spleen and testes after 3 and 6 days of treatment, while after 1 day of treatment, ketoprofen acts as antiapoptotic agent. Also, metamizol induced little apoptosis in liver, spleen and testes after 1, 3, and 6 days. The increase of the optical density of apoptotic bands was time-and dose-dependent. Ketoprofen induced more observable apoptosis than that induced by metamizol. Ketoprofen shows fluctuated results where it acts as anti-apoptotic agent after 24 [hs] of treatment and apoptotic agent after 3 and 6 days. The work explains that receiving high doses for any period of time is toxic, receiving the therapeutic dose for long time is also toxic, but using the therapeutic dose for the recommended period is advisable

Psychosocial impacts and quality of life of children with atopic dermatitis

This study was conducted on 100 children with atopic dermatitis [AD] attending Dermatology Clinic, Al-Hussein University Hospital and an equal number of children as controls. The aim of the study was to determine the psychosocial impacts of AD on children and their families, to define quality of life [QOL] of children and their families and to determine the relationship between these items and AD severity. A cross-section, analytical, clinic based study design was chosen to perform this research. Criteria for diagnosis of depression and anxiety were according to DSM IV. Also, we used The Children's Dermatology Life Quality Index and The Dermatitis Family Impact questionnaire to assess the impact of AD on the children's quality of life and to assess the impact of AD on the quality of family life, respectively. The most common behavioural and psychiatric impacts in children were dependence [33.0%] and anger [26.0%]. Also, AD interfered with children's' social life and recreation in 73.0% and 29.0% of them, respectively. While, mothers' psychiatric impacts and family disturbances were more in AD families; 43.0% and 70.0%, respectively. The impacts of AD were more in children and families with severe AD with statistically significant differences. Also, 86.0% of children with AD and 62.0% of their mothers had poor QOL

Molecular identity of the electropharetic pattern and the major cross-reacting immunogens of toxoplasma gondii [RH strain] and neospora caninum

The complex electrophoretic profile of the antigenic components of Toxoplasma gondii and Neospora caninum was studied. T. gondii [RH strain] trophozoite's antigens were resolved by gel electrophoresis under denaturating condition. Resolved polypeptides were tested by immunoblotting against hyper-immune serum prepared in Boscat rabbits. Immunoblot analysis revealed 6 reactive bands, which are 158, 111, 102, 86, 55 and 33 kDa, out of 10 antigenic bands of the parasite. Concerning N. caninum trophozoite's antigens, immunoblot analysis revealed 5 reactive bands, which are 159, 119, 106, 97 and 39 kDa, out of 8 antigenic bands of the parasite. Cross reactivity trials between the 2 parasites explore 3 cross-reactive bands, indicating high antigenic similarity in between

Promising early results for keloid treatment with intralesional colchiciae a clinical and histopathological study

In a clinical trial, 14 cases with keloids were treated by local infiltration of colchicines. The results were evaluated objectively and subjectively. Lesional biopsy was obtained before and after treatment and examined by light microscopy. Marked reduction of the size of the lesions and decrease of such complaints as itching and erythema were noted. Favorable results were obtained according to the patients in 83.4% and according to the opinion of the medical examiner in 91.7% of cases. Systemic complications of colchicines absorption, i.e. nausea, did not occur in any patient. Histopathologic examination of the lesions after colchicines infiltration reveled marked reduction in the density of collagen bundles which are widely dispersed throughout the dermis. Intralesional infiltration of colchicines is safe and effective treatment of keloids

Immunomodulatory therapy for hepatocellular carcinoma

Hepatocellular carcinoma is probably the most common solid human malignancy in the world and its incidence in Egypt has dramatically increased during the last decade. In spite of the availability of different strategies for treating hepatocellular carcinoma in the form of surgical resection, transarterial embolization, percutaneous ethanol injection therapy, radiofrequency wave ablation and chemotherapy, a considerable percentage of cases were found not fit to go into one of all these modalities. On the other hand, the aqueous extracts of the European mistletoe plant [Viscum album] have been used for years for systemic nonspecific stimulation of the immune system in cancer therapy. This study tried to assess the effect of mistletoe [Viscum album] on the natural history of unresected HCC, on one side, and its role in preventing postoperative recurrence after surgically resected cases, on the other side. Thirty-three patients with advanced unresectable HCC represented the first group in this study and 10 cases of post surgical resection were included in the second group. Mistletoe proved itself as a save medication easily tolerable with minimal side effects, it improves the quality of life through immunological pathway, but in this study it failed to demonstrate any significant effect in the progression or limitation of the size of the tumor nor on prevention of recurrence after postoperative resection

Role of diagnostic laparoscopy in management of hepatobiliary malignancy: Prospective analysis

In this study, 100 patients were subjected to diagnostic laparoscopy [DL] to assess the respectability of their hepatocellular carcinoma. All patients were considered to be candidates for resection on the basis of preoperative imaging studies. Seven laparoscopic cases were incomplete due to adhesions. Eighteen patients were found to be unresectable at laparoscopy. Of the remaining 75 patients, 11 turned to be unresectable at open exploration yielding 14.7% false-negative rate. Laparoscopy identified 18 of 29 patients with unresectable disease. Laparoscopy was most accurate for identifying liver cirrhosis, peritoneal disease, additional hepatic disease and verifying the actual size of the tumor which is not accurately determined by the imaging techniques. On the other hand, laparoscopy was the least accurate method for vascular invasion and lymph node metastases. Adding laparoscopic ultrasound [LUS] to the DL technique can be valuable in tracing vascular invasion or finding additional hepatic tumors

Organochlorine pesticide residues in bovine milk and some animal feed ingredients in Egypt

Organochlorine pesticides have been used in agriculture as seed dresser, in sanitation and in livestock to combat ectoparasites. Their residues accumulate in lipid rich tissues due to their chemical stability and lipophilicity. In the body, they are slowly metabolized, deposit themselves in adipose tissue and excreted during lactation. In the present study one hundred and fifteen milk samples from different dairy farms as well as 119 samples of 7 major feed ingredients, were collected and analyzed for organochlorine insecticide residues using high performance thin layer chromatography. Results showed that the different materials contained low or negligible levels of chlorinated insecticides. Total DDT residues were generally the predominant contaminants detected in some samples of the animal feed ingredients together with low levels of gamma-BHC [lindane] akirin/dieldrin and heptachlor/ hepatochlor epoxide. The residues of these insecticides in bovine milk were [222.83 +/- 11.151, 133.72 +/- 18.61, 81.58 +/- 10.65 and 88.17 +/- 6.827] micro g /kg fat respectively. These levels were less than the codex tolerance limits. The examined samples of animals feed ingredients also contained trace organochlorines residues. More extensive monitoring of the residues in milk of some Egyptian governorates were carried out. The obtained data and desirability of tolerance limits of insecticides in animal feeds were discussed

Gamma irradiation-induced early gastrointestinal disturbances: role of cystamine as a protective agent

The effect of the lethal dose [8 Gy] of whole body gamma irradiation on the early gastrointestinal disturbances in rat was investigated in- vivo as well as in-vitro. Results of the in-vivo study revealed that an early, almost immediately, progressive increase in the weight of the stomach contents as well as marked increase in the intestinal motility were detected during the first 6 hours post irradiation. Results of the in-vitro study showed alterations in the spontaneous contractions of the isolated intestine of the rat. The irregular contraction pattern characteristics of jejunal segments isolated from non-irradiated [control] rat was changed to a more regular pattern 1, 3 hours as well as one day after gamma-irradiation. Administration of Cystamine [50 mg/kg] prior to gamma irradiation [8 Gy] produced a good radiaprotective effect and ameliorated the effect of gamma-irradiation on the stomach. Besides, it normalized the disturbed intestinal movements. In conclusion, the present study suggests the application of Cystamine as a promising start for its trial in clinical radiotherapy especially for patients undergoing abdominal radiotherapy

Imidazole protects the cardiovascular and respiratory systems against whole body gamma-irradiation "an experimental study"

The radioprotective effect of imidazole on the blood pressure, heart and respiratory rates was investigated in adult male rats. Whole body gamma-irradiation at a dose level of 6 Gy. exerted a significant hypotension and tachycardia after one and seven days post gamma-irradiation. There was a significant decrease in respiratory rate after one day of irradiation, but, a significant increase after 7 days, post-irradiation. Administration of imidazole [350 mg/kg] did not significantly affect the blood pressure, but significantly increased heart and respiratory rates after one and seven days of imidazole administration. Imidazole [350 mg/kg] 5-15 minutes before whole body, gamma-irradiation at a dose level of 6 Gy. significantly antagonised the effect of gamma-irradiation on blood pressure, heart and respiratory rates. Meanwhile imidazole completely abolished the effect of gamma-irradiation on the respiratory rate, but it did not completely abolish the effect on the blood pressure and heart rate. The results of the present investigation indicate that imidazole [350 mg/kg] is a good protector against gamma-irradiation induced changes on blood pressure, heart and respiratory rates