Prevalence of chronic kidney diseases in rural areas in Assiut district

Chronic kidney disease [CKD] is increasingly recognized as a global public health problem. Currently, CKD is the 12[th] highest cause of death and 17[th] highest cause of disability worldwide. To determine the prevalence of chronic kidney diseases in rural areas in Assiut District, prevalence of most common risk factors for CKD and the relation between these risk factors and CKD in the studied group Two villages out of 15 villages from Assiut district were randomly selected; El Bora and Awlad Rayek. Sample size was calculated using EPI info 2000 statistical calculation version 6 which revealed that we should have sample size not less than 235 participants. All candidates were interviewed in a previously prepared questionnaire. Blood pressure measured, morning urine samples were obtained, and blood samples were withdrawn for kidney function and blood glucose level. Prevalence of chronic kidney diseases [stage 1-4] in rural areas of Assiut District is high 27.6%, prevalence of hypertension, diabetes, recurrent urinary tract infection, past history of bilharziasis and renal stones in the studied sample as follow: 15.5%, 13.2%, 12.6%, 8.9%, 6.9%; respectively. Hypertension and diabetes had high association with cases of CKD in the studied sample. It seems that there is a high prevalence of chronic kidney disease in our locality; but unfortunately little awareness about chronic kidney diseases. Hypertension and diabetes had high association with cases of CKD in the studied group

Assessment of women utilization of family planning services after IUCDs insertion

The present study aimed to assess women utilization of family planning services after IUCDs insertion. The present study is a descriptive study. The study was conducted at family planning outpatient clinic of El-Mansoura University Hospital. Simple random sample. All women who are using IUCDs for one year or more, had different levels of education, occupation, social classes who attend family planning outpatient clinics during six months period. The sample size 130 women using IUCDs. 1-Structured interviewing sheet 2-Assessment sheet for physical setting of the family planning clinic, 3-Assessment sheet of provided care. A pilot study had been done 13 clients accordingly tools and data collection plane were modified 3-The main results revealed that the majority of the study sample [96.9] were using IUCDcu 380, 48.5% used it for 4-12 years and 69.2% of women didn't make follow up in addition 32.2% of women suffer from IUCD5 complications as, bleeding [18.5%] and vaginitis [16.2%] were the most common complains meanwhile 67.7% didn't suffer from any complication. The rate follow up and satisfaction were lower in women who took a lot of time to reached family planning services, in women who had complication, with low income and with no husband approval. It's concluded that, the majority of women do not make follow up post IUCDs insertion due to many factors such as, ages of the women, their educational levels, occupation, husbands approval of using family planning services, number of children in the family, and income, lack structures and facilities of family planning clinic. In addition, there was a relation between the decreased quality of the provided services and the previous factors. As well as there is a relation between the decreasing of utilization of family planning services and both, long waiting time and neglection of counseling and lacked many necessary structure facilities and supplies. So that, the present study Recommend. Raising awareness of women regarding the importance of follow up post IUCDs insertion, further study to assess the factors affecting women utilization of family planning services on larger sample size

Undescended testes: do we need to fix them earlier?

Patients with undescended testes [UDT] may present with acute testicular torsion or incarcerated hernia requiring immediate surgical intervention. The exact incidence of these two complications among cases of UDT is not known. The aim of this study was to investigate the frequency of such conditions in our series of undescended testes, and to evaluate whether early intervention in undescended testes could eliminate such problems. All the data of patients with undescended testes admitted for surgery in Aseer Central Hospital, Abha Saudi Arabia, over a 6-year period were reviewed. In two hundred and ninety patients, 18 presented acutely with torsion of the undescended testicle in the inguinal canal [n=11] or incarcerated inguinal hernias [n=7]. The data of these 18 patients were looked up for patient characteristics. Methods of diagnosis, preoperative preparation, operative findings, operative interventions, histopathological results and outcome were all analyzed. Ten out of 18 patients [55.5%] were less than six months. Nine out of eleven patients with testicular torsion required orchiectomy. The other two underwent orchiopexy, which ended up with atrophy. All patients with incarcerated hernia had simultaneous hernia repair and orchiopexy; of which, three atrophied. Acute testicular torsion and hernia incarceration in cases of cryptorchidism may be more prevalent than initially thought. Orchiopexy, as early as 3 months of age, may reduce the incidence of such problems. 'Therefore, earlier intervention in undescended testes [between 3-6 months] is recommended

Correlation between clinical manifestations and magentic resonance imaging [MRI] in ecyption children with phenylketonuria [PKU]

Phenylketonuria is the most common of all amino acidopathies. It is caused by blok in the conversion of phenylalanine into tyrosine due to defect in either the enzyme phenylalanine hyproxylase [98% of subjects] or in metabolism of the cofactor tertahydrobiopterin [2% of subjects]. The present work-was conducted to study the correlation between clinical and brain MRI finding in 28 patients with PKU, 17 [6031] males and 11[39.29%] females whose age ranged from 2.5 years to 16 years. All patient of the present work were subjected to full history taking clinical examination, IQ. assessment using Stanford Binet test determination of serum PHE level, and brain MRI study Consanguinity [82.14%] and similar condition in the family [71.43%] are commonly present in presents with PKU. Development delay was found in 100% of cases, while mental retardation was found in 96.42% of cases, also HD was present in 42.85% of cases and epilepsy was represented in 17.85% of cases. All patients [100%] were presented with skin and hair hypopigmentation to a variable extent, while blue eyes were found in 7.14% of cases, however eczematous skin rash was not present at all. Neurological evaluation revealed that, 25% of cases were presented with quadriparesis, 3.57% with left intention tremors without other manifestations of cerebellar affection According to IQ, 3.57% had normal mentality, 32.14% had mild MR and 64.2% had moderate MR. The serum levels of phenylalanine revealed that all cases had high serum PHE level, it was ranged from 5.6 mg/dl to 29.7 mg/dl with mean level 18 mg/dl. A positive correlation between age of the patients and serum PHE level was commonly found in patients with PKU. Abnormal brain MRI finding were present in 71.42% of cases in the form of perivcntricular dysmyelination without cerebellar abnormalities-A significant relation between brain MRI findings dysmyelination, and the type of the clinical groups, every individual symptom and the serum PHE level was not found

Intellectual impairment among epileptic children correlation with age of onset and duration of epilepsy

Intellectual impairment among epileptic children has been a subject of study throughout the modern era of epileptology. Early age of onset and long duration of epilepsy have been implicated as possible contributors. To test for this hyposis, 45 epileptic children and 20 normal controls of the same age group [6-16 years] were studied using Wechsler Intelligence Scale for Children Revised [WISC-R]. Correlations between intellectual impairment and age of onset and duration of epilepsy were done. The results showed that epileptic children have significantly lower IQ than controls. Moreover, those with earlier seizure onset and longer seizure duration have significantly lower IQ. In conclusion, the earlier the age of onset and the longer the duration of epilepsy, the more the intellectual impairment

Effect of burst transcutaneous electrical nerve stimulation in primary dysmenorrhea

The aim of this study was to determine the effect of burst transcutaneous electrical nerve stimulation [TENS] in relieving the pain in cases of primary dysmenorrhea. Forty women with primary dysmenorrhea participated in this randomized study classified to three groups: Group A, 20 subjects received burst TENS for 40 minutes at the first day of the study period; group B, 15 subjects received burst TENS for 40 minutes for 5 days before the period of the study and group C, 5 subjects received placebo TENS for 40 minutes at the first day. The severity of dysmenorrhea was measured by dysmenorrheal severity scale and pain by visual analogue scale at 20 minutes during application, at the end of application and 2 hours after application. The study concluded that burst TENS is an effective and safe form of therapy to women with primary dysmenorrhea, especially for those who do not want pharmacological intervention

Abdominal twin foetuses-in-foetu in an infant: Case report and review of literature

We present a case of intra-abdominal twin foetuses-in-foetu in the left upper retroperitoneal space attached uniquely to the pancreas in a 5-month-old male infant. Antenatal ultrasonography demonstrated the presence of the mass. Although a bony component was present in the mass; the plain x-ray abdomen was not helpful in the diagnosis and abdominal computed tomography was the main diagnostic tool. Diagnosis was only confirmed at laparotomy

Comparison of the effect of transcutaneous electrical nerve stimulation and joint mobilization in treatment of primary shoulder impingement syndrome

This study aimed to evaluate whether the effect of transcutaneous electrical nerve stimulation [TENS] and hot packs improve pain, mobility and function of the shoulder compared with similar patients receiving joint mobilization and hot packs. Twenty-six subjects [seven men and 19 women ranging in age between 23 and 57 years] with primary shoulder impingement syndrome were included in this work. The subjects were randomly assigned to one of two equal treatment groups that took 24 sessions: Group I received TENS and hot packs and group II received mobilizing exercises and hot packs. The range of motion of shoulder joint was measured by universal goniometer; pain and disability were measured by using shoulder pain and disability index [SPADI]. The results showed that subjects in both groups experienced a significant increase in the range of motion and a decrease in pain and disability, but there was significantly improvement in mobilizing group compared with TENS group

Mathieu procedure with urethro-vesical drainage for distal hypospadias repair: a review of 157 cases

To evaluate Mathieu repair in providing a normal looking penis with a normal functioning urethra and to evaluate the complications of this procedure using urethro-vesical urine diversion technique. The author peiformed 157 consecutive Mathieu repairs in a 5-year period [1998-2002]. Two-layer anastomnosis was used with optical magnification. All cases had a feeding tube size 6for bladder drainage through the urethra. All patients were kept in the hospital 5-7 days post-operatively. The follow up period ranged between 4 months to 36 months. Circumcision was offered 3-4 months post-operatively after successful repair in 151 cases. Initial outcome was excellent in 117 patients [74.5%] and satisfactory in four [2.5%]. Despite an initial complication rare of 25.5%, yet the final successful rate was 97.5%. Three patients [1.9%] refused further treatment after failure of the first trial of post-operative fistula repair. The initial complications included fistula in 29 patients [18.5%], meatal stenosis in two [1.3%], meatal retraction in four [3.2%] and flap necrosis in five. Fistulae occurred most commonly within one month after surgery [22 patients, 14%]. The multipemforated bladder drainage tubes caused fewer complications than those with two openings at the tip. Mathieu urethroplasty was a reasonable procedure that allowed successful treatment of most anterior hypospadias. However, there was an initial high complication rate mostly due to urine drainage problems in this series

Cognitive dysfunction in epileptic children in correlation to seizure type, frequency and egg changes

This work was conducted on 46 epileptic children with EEG recording to study the problem of intellectual impairment in epileptic children. The intellectual functions [verbal IQ [VIQ], performance IQ [PIQ] and general IQ [GIQ]] were assessed using Wechsler intelligence scale for children revised [WISC-R]. The results showed a statistical significant difference between patients and controls as regard intellectual functions with higher IQ scores of the control group. There was an insignificant difference between patients with different seizure type, however children with generalized tonic clonic seizures had lower IQ scores than those with absence or complex partial seizures. It was concluded that epileptic seizure itself had a detrimental effect on intellectual functions rather than other risk factors, thus intractable epilepsy strongly deteriorated intellectual functions. Partial versus generalized seizures and normal interictal EEG were good predictor of normal intellectual functions in epileptic children

Intracranial tuberculoma: diagnosis treatment and outcome

Intracranial tuberculomas are conglomerate caseous foci within the substance of the brain that develop from deep-seated tubercles acquired during recent or remote hematogenous dissemination. In this study twenty four patients 10 male and 14 female with intracranial tuberculomas were treated and followed up in the neurosurgery and neurology departments in Al-Azhar University Hospitals and Nasr City Health Insurance Hospital in the period between January 1994 and July 2000. The age of the patients ranged between 6 and 48 year with a mean age of 30.1 year. The data were analyzed for presenting symptoms, its duration, physical findings, investigations and treatment. Half of the patients had past history of pulmonary tuberculosis. Fourteen patients had surgical excision. Four patients had stereotactic biopsy. Six patients had medical antituberculous treatment without excision or biopsy but one of these patients had ventriculo-peritoneal, shunt to treat the associated hydrocephalus all the patients were followed up every 6 months for a period ranged between 6-30 months with a mean period of 23.5 months. Thirteen out of the 24 patients showed improvement of their disability score on the 1st follow up after 6 months while the other 11 has the same disability score. Five out of these 11 patients showed improvement on the next follow up after 12 months while the other 6 had the same disability level. Three out of the non improved cases did not show improvement of their disability level till the end of the study, while the other 3 had improved disability level after 18 months for the 1st 2 cases and after 24 months for the 3rd patient. Ten out of the 14 patients who had craniotomy or craniectomy and tuberculoma excisions reached to disability level 0 while 2 had partial improvement and the last 2 had the same disability level as before management. Four of our patients had stereotactic biopsy and medical treatment. Three out of them reached to disability level 0 on follow up while 1 patient had partial improvement. patients who had only medical treatment were 6. Three out of them reached to disability level 0 on follow up while 2 patients had partial improvement and the 6th case had the same disability level as before management. The clinical picture of intracranial tuberculoma simulates an intracranial neoplasm, so it becomes necessary for physicians in countries where tuberculosis is common to search for any concomitant evidence of tuberculosis in every case of suspected intracranial tumor. Intracranial tuberculoma could be treated medically unless we are not sure of the diagnosis or if the tuberculoma is associated with mass effect which threatens the life of the patient

Role of transcranial magnetic stimulation [TMS] in prediction of ischemic stroke outcome

There is still controversy about the prognostic value of motor evoked potenials [MEPs] in the assessment of hemiplegia. In order to underst and the role of TMS in studying the integrity of corticospinal tract we have performed such study on Patients with first ever established is-chemic stroke in the domaine of MCA territory, their age ranged from 17-82 years with a mean age of 61.8 + 31.1 years. Functional recovery was assessed by using Sc and inavian Neurological Stroke Score [sss], the Barthed Activities of Dialy Living Index [BI], and the motor score to assess the motor function status of upper and lower limbs. Electrophysiolgical assessment by using TMC to both first dorsal interosseous [FDI] and Tibials anleiror [TA] muscles. These assessments were carried out at the same time in 2 sessions, the first session was within 3 days from the onset of the symptoms and the second was 14 days later. At the first session, MEP was elecited from FDI in the hemiplegic side in 36% and from TA of the same side in 48%. CMCT of these patients was significantly prolonged compare to the healthy side of the same patient. On the second session, there was no significant shortening of the CMCT to FDI and TA. There were inversed correlation between CMCT to TA with sss [r = 0.6]. From this work we conclude that, early performed transcramial magnetic stimulation is a valuable prognostic tool for motor recovery from stroke

Fasting total plasma homocysteine level and cerebrovascular accidents

This study was conducted on 100 stroke patients [15 females and 85 males, aged 45-65 years] in the acute phase within the first 48 hours after admission to ICU as well as 50 age and sex matched apparently healthy individuals as a control group. Every individual was subjected to clinical evaluation including history taking and clinical examination with special stress on presence of risk factors. All the subjects [cases and controls] were not risky i.e. non - smokers, not diabetics, not hypertensive, with negative family history of vascular disease and not taking lipid lowering drugs, multivitamins and antiepileptics known to affect homocysteine blood level. Fasting total plasma homocysteine level [Hcy] was measured using high performance liquid chromatography separation and flourescence detection and plasma folic acid was measured by RIA. Fasting serum glucose, total cholesterol, triglycerides, HDL - c, LDL-c and creatinine were also determined in all subjects. Stroke patients showed a statistically significant increase in total plasma Hcy level [p10.3 micro mol/L, the upper normal level] was present in 81% of patients and 4% of controls. Patients with cerebral infarction [n=:88] did not d sign from patients with intracerebral hemorrhage [n 12] in mean Hcy concentrations [16.2 +/- 7.19 micro mol/L versus15.3 +/- 3.4 micro mol /L]. Plasma folic acid level was non significantly higher in controls than in patients [6.25 +/- 1.1 ng/ml versus 4.43 +/- 0.46 ng/ml]. The patient and control groups did not d significantly in the mean values of fasting serum glucose, creatinine, total cholesterol, HDL-c and LDL-c. However, stroke patients showed a statistically significant increase in serum triglycerides [p< 0.05] when compared with the controls [119.4 +/- 23.84 mg/dl versus 79.13 +/- 15.96 mg/dl]. Total plasma homocysteine level showed a non-significant negative correlation with folic acid and non-significant positive correlation with the other studied parameters. In conclusion, our results support the hypothesis that elevated plasma homocystein level is an independent risk factor for incident stroke

effect of age and fasting on serum leptin level

Humans and rats tend to gain weight as they age; leptin is one regulator of food intake and energy expenditure. To investigate the role of aging and fasting on body weight, adiposity level and serum leptin levels, this work was undertaken in male albino rats aged 3, 24, and 30 months. Half of each age group were fasted for 48 hours and the others were allowed free access to food, after 48 hours body weight, epididymal white adipose tissue "EwAT", adiposity level and serum leptin levels were assessed in all rats. It was found that, body weight, "EWAT", adiposity level, and serum leptin levels were increased from 3 months to 24 months and were decreased from24 months to 30 months. Fasting resulted in decrease in all parameters in all age groups. These data suggest that adiposity increased with age and cannot be attributed to increased food intake or impaired leptin levels

Entheropathogenic E coli in and cooked beef

Two hundred samples, 100 each of raw and cooked beef were collected from different restaurants in Benha. Samples were examined for rapid screening of E. coli by a fluorogenic assay. E. coli was detected in 7% of fluorocult lauryl sulphate enrichment broth which emits a blue fluorescence under UV light. The incidences of E. coli were 9% and 5% in examined raw and cooked beef respectively. O26: K60 [B6] and O111: K58 [B4] were only enteropathogenic serotypes isolated from the examined samples. The public health significance isolated pathogens was discussed. Moreover, suggestive measures for the improvement of the microbial quality of meat were mentioned