Non invasive evaluation of patients with ventricular septal defect after surgical correction

The present work is planned to study the cause of any residual cardiac murmur after surgical closure of ventricular septal defect and to evaluate cardiac function using Doppler echocardiography. Twenty cases of isolated VSD who underwent trans-atrial surgical closure of VSD were studied. They were 14 males and 6 females. Their age ranged between 3 and 20 years with a mean of 8. 5 +/- 4 years. Preoperative data were collected from patients files as cardiac catheterization data. Operative details were recorded during operation. Post operative study was also conducted and included clinical examination for any residual cardiac murmur. ECG, chest X-ray and Doppler echocardiography were performed to assess closure of the defect. Patients were classified into two groups. Group I included 8 patients with RV pressure < 50 mm Hg. Group 2: included 12 patients with RV pressure > 50 mm Hg. Doppler examination revealed 14 cases of 20 [70%] proved to have no residual shunt. 4 cases had mild shunt [20%], 2 cases had moderate shunt [10%] and no case showed large shunt. The shunt occurred along the suture line. Left ventricular function was assessed by the EF% which ranged between 47% and 63%. RV pressure decreased significantly in both groups postoperatively, post operative echo evaluation has also showed that 9 patients had TR 45%, 1 patient had pericardial effusion [5%], 1 showed vegetation on the patch [5%] and I patient had right atrial thrombus [5%]. We conclude that Doppler echocardiography is highly sensitive in the early post operative detection of VSD shunt, as well as other postoperative complications as pericardial effusion, vegetation on the patch and myocardial dysfunction. Results showed also that RV pressure decreased significantly after closure of the defect in both groups, however, in patients with VSD and at least moderate pulmonary hypertension, pulmonary artery pressure was not returning to normal therefore, it is advisable to operate on individuals with VSD and moderate pulmonary hypertension before there is the any increase of pulmonary vascular resistance

Asymptomatic bacteriuria in school children in a rural area, Egypt

Forty hundred and fifty urine samples collected from school children in a rural area were screened for the presence of significant bacteriuria. The incidence of asymptomatic bacteriuria was found to be 7% with Predominance in females [11%] than in males [3.6%]. From the total bacterial isolates E. coli were isolated in 18% of cases, Co-agulase positive stahylococci in 30%, co-agulase negative staphylococci in 15%, streptococcus pyogenes in 6%, Kiebsiella species in 9% and enterococci in 21% of cases. There was no difference between the incidence of asymptomatic becteriuria [ABU] in younger children than in older ones. We recommended a routine screening for ABU among school children for the early diagnosis and management of such cases

use of saliva for the detection of IgG and anti-bodies against rubella virus: comparison of indirect ELISA and antibody capture immunoassay

Serum and saliva specimens, collected simultaneously from 26 normal adult females, were tested for IgG and IgA antibodies to rubella virus by indirect ELISA and antibody capture assays. Antibody capture assays were found to be more sensitive than indirect ELISA for the detection of IgG and IgA antibodies in saliva samples whereas both assays were similar in sensitivity for the detection of IgG and IgA antibodies in serum samples. Comparison of the results obtained from serum and saliva samples showed that by an indirect ELISA test 13 out of the 22 seropositive subjects were also positive for antibodies in their saliva. So this test had 9 false negative results, whereas by an antibody capture assay 18 out of 22 seropositive subjects were also positive for antibody in saliva. Thus there were only 4 false negative results. Further comparison of results derived from testing serum and saliva are needed before recommending the use of saliva alone for detection of antibodies to rubella virus

Specific IgA antibodies to herpes simplex virus type I in duodenal juice and saliva from patients with peptic ulcer

Fasting duodenal juice and saliva were collected from 28 duodenal ulcer patients and 18 non-ulcer controls. IgA antibodies to herpes simplex virus type 1 [HSV-1] was- higher in duodenal juice and saliva from duodenal ulcer patients [32% and 46%] than those of non ulcer controls [22% and 39%]. The distribution of anti HSV-1 titer showed no marked difference between the two groups. The results need further studies to investigate whether HSV-1 is involved in the pathogenesis of peptic ulcer or not

prevalence of hepatitis B surface antigen in diabetic patients

The prevalence of hepatitis B surface antigen [HBsAg] was determined in 268 diabetic patients and 100 non-diabetic controls using ELISA test. Sixteen insulin dependent diabetics [9 percent] and 11 non-insulin dependent diabetics [12 percent] were found to have HBsAg in their sera compared to 8 percent of the non-diabetic controls. The prevalence of HBsAg among newly diagnosed diabetics [less than 3 months duration] was found to be relatively low [4 percent in insulin-dependent and 3 percent in non-insulin dependent diabetics]. It is unlikely that serum hepatitis plays any role in the causation of diabetes