ABSTRACT
Background: Trichomonas vaginalis is the most common non-viral sexually transmitted infection [STI] in the world. Trichomoniasis is an important risk factor for herpes simplex type II infections, human immunodeficiency virus [HIV] acquisition and transmission, pelvic inflammatory disease and cervical neoplasia. Studying the variation in growth patterns of the parasite can be used for biological characterization of the parasites and might be related to the severity of clinical presentation
Aim of the Work: Study the growth kinetics of Egyptian Trichomonas vaginalis isolates in term of log phase, growth peaks reached, division rate and generation time of each isolate and correlation of such parameters with the clinical presentation of the patients, if any
Material and Method: The study was carried on 300 vaginal washouts collected from Egyptian women patients aged 20-45 years suspected for trichomoniasis. Positive samples for Trichomonas vaginalis were cultured and sub cultured on modified Diamond's medium. Growth kinetics for each isolate was done by inoculated 104 trophozoites/ml into 2 tubes containing 10 ml of sterile culture medium followed by counting the trophozoites every 24 hours over seven days using a hemocytometer. Growth curves were done for each isolate by plotting the parasites numbers against the time. Division rates and generation times were calculated for each isolate
Results: Out of the 300 collected samples, twelve were found positive for Trichomonas vaginalis trophozoite by wet mount examination and culture technique. Comparison of the growth kinetics of the twelve Trichomonas vaginalis isolates revealed a salient difference among all isolates after 48 to 96 hours. Isolates 1, 2, 6, 8 and 10 had a log phase of 48 hours. Isolates 4, 5, 7, 11 and 12 had a log phase of 72 hours. Isolates 3 and 9 had a log phase of 96 hours. The fast growing isolates of Trichomonas vaginalis reached maximum growth after 48 hours and the highest yield was observed in isolate 10 [150.25+/-3.13]. Slowly growing isolates reached a maximum after 96 hours with the lowest yield in isolate 3 [40.5+/-21]. Regarding the clinical presentation, isolates 1, 2, 3, 4, 5 and 11 showed mild discharge and congested cervix. Isolates 6, 7, 8, 9, 10, and 12 showed profuse discharge with varying clinical findings on gynecological examination. Isolate 10 had the most severe pathology with cervical erosion. Isolate 9, 12 showed bleeding during examination, isolate 8 showed vaginal ulcer while isolate 6 showed just erythema of the vagina
Conclusion: Comparison of the growth kinetics of the twelve Trichomonas vaginalis isolates revealed a salient difference among all isolates after 48 to 96 hours. Regarding the clinical presentation, no clear correlation was found between the growth kinetics and clinical presentation of the patients. Methods other than growth kinetics such as genotyping and determination of genetic variability are needed to verify the relation between isolates of Trichomonas vaginalis and clinical presentation
ABSTRACT
This study was designed to evaluate the outcome of combined laparoscopic cholecystectomy and fundoplication during one single laparoscopic procedure. The study included only patients assigned to undergo cholecystectomy for calcular cholecystitis and had symptomatic gastroesophageal reflux disease [GERD], 22 patients [7 males and 15 females] were enrolled in the study. All patients underwent clinical history taking including duration of symptoms, physical examination and upper gastrointestinal endoscopy. Esophageal manometry was performed preoperatively and 2 and 6 months after surgery. Laparoscopic procedures were performed through 5-port access. Operative time and the frequency of conversion to open surgery, time till initiation of oral intake, postoperative hospital stay and complications and time to recover full activity were recorded. Through a monthly visit for 6 months after surgery, patients were monitored for the extent of resolution of GERD-related symptoms. There was a significant increase [p<0.001] of postoperative lower esophageal sphincter [LES] pressure compared to preoperative pressure with a non-significant difference between pressures estimated at 2 and 6 months. No intraoperative complications were encountered and there was no need for conversion to open surgery in any case. The mean operative time was 78.3+/-9.7; range: 60-90 minutes. All patients tolerated oral ingestions after the first 48 hours. The mean duration of postoperative hospital stay was 4+/-0.8; range: 3-5 days and 9 patients [40.9%] were discharged on the 3[rd] postoperative day. The mean duration till resumption of full daily activities was 11.6+1.4 [10-14] days. Clinically, a marked resolution of symptoms due to reflux was observed, only one patient developed dysphagia for solid food and a sensation of trapped air occurred in two patients causing discomfort, however, these three patients were asymptomatic at 6 months after the surgery. It could be concluded that combined laparoscopic surgery for cholelithiasis and GERD is an appropriate procedure, when indicated, giving excellent short-term outcome results and could be managed during one single laparoscopic procedure
ABSTRACT
The aim of this study was to evaluate the immediate and short-terme follow-up results of one-stage subtotal or total colectomy and anastomosis for patients with malignant left colon obstruction. The study comprised 21 patients [10 males and 11 females] with age range of 36-81 years; presented by acute large bowel obstruction with clinical and radiological evidence of obstruction. The choice of the extent of resection was determined by the extent of fecal load, the presence of colonic perforation, serosal tears of the cecum and/or massive colonic distension with concomitant ischemia: the presence of these features in a hemodynamically stable patient favored subtotal or total colectomy and ileo-colic or ileo-rectal anastomosis. The site of obstruction was at the sigmoid colon in 9 patients [42.9%], rectosigmoid in 8 patients [38.1%], splenic flexure in 3 patients [14.3%] and descending colon in one patient [4.7%]. Ileosigmoid anastomoses were done in 13 patients [61.9%] and 8 patients [38.1%] had ileorectal anastomoses. The mean operative time was 201+/-33.2; range: 150-270 minutes, the mean operative blood loss was 633.3+/-408.2; range: 250-1800 cc; 11 patients [45.8%] required blood transfusion with a mean number of blood bags used was 2.8+/-1.2; 1-5 bags. Oral feeding was resumed after a mean period of 4.9+/-0.9; range: 4-7 days and the mean postoperative hospital stay was 10+/-2.2; range: 8-18 days. Overall, after 12-months follow-up only one patient had anastomotic line recurrence with a recurrence rate of 4.75%, one patients died of acute liver failure secondary to hepatic metastasis with mortality rate of 4.75% and 19 patients had follow-up free of morbidity with no-local recurrence or metastasis and a follow-up free rate of 90.5%. Thus, it could be concluded that one-stage subtotal or total colectomy and ileo-colic or ileo-rectal anastomosis are safe procedure with satisfactory outcome for management of obstructing malignant lesions of the left colon
ABSTRACT
The present study is a retrospective study of 59 patients with testicular germ cell tumors [30 cases of pure seminoma and 29 cases of non-seminoma]. The mean age for seminoma cases was 31.3 years +/- 4.46, while the mean age of non-seminoma cases was 28.5 years +/- 5.27. Testicular tumors were classified according to American Joint Committee on Cancer [AJCC], 1993. All cases were evaluated both clinically, laboratory and radiologically. All cases underwent high orchiectomy. Patients with early stage seminoma [stages I, IIa, b] 18 cases [60%] were treated postoperatively by radiotherapy to para-aortic and ipsilateral iliac lymph nodes. Combination chemotherapy was reserved for recurrent, refractory and progressive cases. Patients with bulky stage II seminoma 12 cases [40%] and all non-seminoma cases were treated by four courses of BEP. Cisplatinum 20 mg/m2 D1