Seroprevalence of human toxocariasis [visceral larva migrans]

A total of 455 patients who fulfilled the inclusion criteria were included in the study. The enrolled patients were subjected to a questionnaire [including sociodemographic and other risk factors] and thorough clinical examination was done for the patients. Sera were collected from patients and tested for anti-Toxocara IgG antibodies using ELISA. The overall and- Toxocara sero-positive was [7.7%]. It was significantly higher than among the randomly selected 30 healthy controls. There were no significant differences between the seropositive and seronegative patients regarding age, sex, educational level and monthly family income of the patient. However, rural residence, poor house, pet's ownership and frequent contact with soil were found to be significant. Patients who had confirmed bronchial asthma were more than 2 times at higher risk of developing toxocariasis [OR, 2.33; 95% CL 1.09-4.98] than those with other clinical diagnosis [PUO, hepato-megaly or heptosplenomegaly, lympha-denopathy, neurological disorders, gastrointestinal troubles and dermatitis]. Patients with eosinophilia were at 149 times greater risk of being Toxocara seropositive compared to those without eosinophilia [OR, 148.7; 95% CI: 53.5-413.3]. Multivariate regression analysis showed eosinophilia and contact with soil were the most important predictors of toxocariasis. OD of anti-Toxocara antibodies [ELISA] was significantly positive with eosinophilia level

Results and risk factors of mitral valve reoperation

To assess the results and risk factors of mitral valve re-operations 50 patients were operated upon at El Hussein University Hospital during the period from January 1998 to June 2003. The patients are fully investigated. It was found that age, EF, ACT, CBP were independent variables of the survival of the patients. As regard the clinical improvement, 16 [32.0%] patients were in class II preoperatively; postoperatively there were 8 of them [16.0%] in class II and 8[16.0%] patients in class III, postoperatively. Nine patients were in class III, postoperatively 8 of them [16.0%] were in class I and 1 [2.0%] patient was in class II. Eight patients were in class IV, postoperatively, 4 of them [8.0%] were in class I and 4 [8.0%] were in class II. One patient was in class I preoperatively and became in the same class postoperatively. As regard the mortality, preoperatively there were 16 patients [32.0%] in class II. All of them survived the operation. Fourteen patients [28.0%] were in class III, 4 of them [8.0%] died. Sixteen patients [32.0%] were in class IV preoperatively, 7 of them [14.0%] died. Four patients [8.0%] were in class V, 3 patients [6.0%] died postoperatively. As regard hepatic dysfunction, 28 patients [56.0%] were associated with hepatic dysfunction preoperatively, half of them died postoperatively, [14 patients: 28.0%] while only 3 patients [6.0%] died from 22 patients [44.0%] presented with preoperative normal liver function. Preoperative PVE was associated highest mortality, staph: 3 patients [6.0%], strept: 2 patients [4.0%], eandida: 2 patients [4.0%], crypt: 1 patient [2.0%], pseudo: I patients [2.0%]. As regard the cardioplogia, sixteen patients [32.0%] were given crystalloid cardioplegia, 7 patients of them [14.0%] survived and 9 patients [18.0%] died. Thirty four patients [68.0%] were given blood cartioplegia, 26 patients of them [52.0%] survived and 8 patients [16.0%] died. As regard arrhythmia, 20 patients [40.0%] were in sinus rhythm preoperatively, 5 patients [10.0%] of them died postoperatively, while 30 patients [60.0%] had AF, 12 patients [24.0%] died. Sex: 23 patients [46.0%] were males, 10 patients of them [20.0%] died, while female patients were 27 [54.0%], seven of them [14.0%] died, Toxemia: sixteen patients [32.0%] were in toxemia preoperatively, 10 patients of them [20.0%] died postoperatively while 34 [68.0%] presented without toxemia 7 patients of them [14.0%] died. First operations: patients with previous DVR were 9 patients [18.0%] 5 of them [10.0%] died postoperatively; 1 patient [2.0%] with previous DVR and. De Vaga died; 9 patients [18.0%] with previous MVR and De Vaga, 3 patients [6.0%] of them died; 31 patients [62.0%] with previous MVR, 8 patients of them [18.0%] died postoperatively. Mitral valve redo is challenging procedure. Several risk factors affecting the survival of the patients such as gender, previous clinical stage, arrhythmia, PVE. valve thrombosis, paravalvular teak, hepatic and renal dysfunction, type of cardioplegia, toxemia, low Co, type of previous procedure, ascending aorta versus femoral cannulation

Epidemiology of end stage renal diseased patients on hemodialysis in Sohag Governorate, Upper Egypt

End-stage renal disease [ESRD] has various causes that differ according to the country. Egypt is a country with high mortality from ESRD, Sohag governorate is one of the South Egypt governorates. To study the prevalence and incidence rates and its health burden and to allocate the etiology and possible contributing factors and other epidemiologic factors for ESRD in Upper Egypt. The primary study tool was a structured questionnaire that focused on variables suspected as an etiological factor for ESRD in addition to the past history of risk factors exposure. One thousand and fifty four [1054] patients on hemodialysis were interviewed for collecting the data, in the period starting on the first of January 2003 till the end of December 2003. They were distributed in 17 centers with variable capacities for hemodialysis all over Sohag eleven districts. All were subjected to history taking, thorough medical examination, abdominopelvic ultrasonographic examination in the equipped centers and laboratory investigations of blood and urine. The estimated prevalence of ESRD at Sohag is 276.44 per million populations, the new cases constituted 22.27% of the patients along the year of the study. All patients were undergoing intermittent hemodialysis treatment, mostly thrice weekly. Distribution of patients by residence showed that most patients were living in rural areas [77%] whereas [23%] were urban residents. Males constituted 60% while females were 40% of the dialysis patients. Etiology of ESRD was unknown in about 9% of the cases while hypertension was responsible for 27.6% of the cases and diabetic nephropathy was responsible for 7%. Chronic pyelonephritis constituted 14.1% of the contributing causes for ESRD in Sohag and chronic glomerulonephritis was the cause in about 11.2% cases. Obstructive uropathy was detected in 22.7% of the cases; more than half of it was due to schistosomiasis. Other causes for ESRD were associated in smaller percentages. The number of deaths among the ESRD patients in Sohag governorate during the year 2003 is 180 / 1054 [8%] of the cases. The causes of deaths include cardiovascular diseases in 60% of the deaths, cerebrovascular accidents in 15%, infections in 5% and the rest was due to various diseases. These data will he hopefully contributed to the development of the national health care policies appropriate to the epidemiology of the disease in Upper Egypt. More attention should be paid not only to the recurrent renal infections and urolithiasis but also to hypertensive and diabetic patients to prevent the ESRD development as a consequence of their illness. Also, preventive programs against shistosomiasis should be continued in Upper Egypt