Prevalence of intestinal parasites and its impact on nutritional status among preschool children living in Damanhur city, El-Behera goveftnorate, Egypt

This cross sectional study was done in Damanhur City, the Capital of El-Behera Governorate to detect the prevalence of intestinal parasitic infection among preschool aged children and to find out its effect on their nutritional status. Five-hundreds children aged between 2-6 years were enrolled; a detailed questionnaire, complete clinical and anthropometric assessment as well as complete stool analysis and blood picture were done. The study revealed that 51.8% preschool children were infected; Cysts of Entamoeba histolytica and Giardia lamblia were found in 16.8%, and 14.8% respectively. In 1.8% of cases, both cysts were found together. Ova of Ascaris lumbricoides, Enterobius vermicularis, Ancylostoma duodenale and Hyme-nolepis nana were detected in 14%, 3.4%, 5% and 0.2% of cases, respectively. In 0.4% of cases, ova of A. lumbricoides and E. vermicularis were found together. Mixed infections were found in 3.6% of children. Significantly lower weight for age z-score [WAZ] and weight for height z-score [WHZ] were found among infested children compared to non-infested ones [P<0.05]. Moreover, stunting was found in 44.1%, underweight in 39.1% and wasting in 11.5% of infested children. Prevalence of anemia among all studied population was 39%; 48.6% in infested group compared to 28.8% in non-infested children [x=20, P<0.001]. Improper hand washing, and playing in the street bare footed, together with playing with animals and family history of parasitic infestation were considered the independent predictors of parasitic infestation by using binary logistic regression

Botulinum toxin injection in the treatment of upper eye lid retraction in thyroid ophthalmopathy

The aim of this study to evaluate the effects and safely of inducing a temporary partial ptosis of the eyelid through injection of botulinum toxin into the levator palpebrae superioris muscle. Eight cases with persistent lid traction with normal thyroid function and refused to be surgically corrected. Botulinum toxin a [BOTOX] was injected into the levator palpebrae superioris muscle after administration of topical anesthesia and the patient were followed up for one year. They were followed up with routine ophthalmic examination and measuring the degree of ptosis. All patients experienced relief of discomfort and appearance, ptosis induced in all cases to a variable degree. One week after the injection 2 patients [25%] experienced diplopia which was transient. All patients did not experience change in the degree of exophthalmos or tissue edema. BOTOX injection in the management of upper eyelid retraction is a safe technique simple and could be used in cases of contraindication of surgical intervention in cases of thyroid associated ophthalmopathy

Lasik induced peripheral vitreoretinal anatomic changes

To evaluate the hazardous effects of LASIK on retinal periphery in myopic patients. Retrospective study of myopic patients underwent LASIK surgery in BEDA MEDICAL CENTER IN KUWAIT between September 2003 and Marsh 2005, the spherical-equivalent was greater than 5.00 diopters. We examined 124 eyes, 18 did not undergo LASIK surgery owing to refractive criteria, 12 were lost to follow-up, thus, 94 eyes, were followed up after LASIK surgery with mean spherical equivalent preoperatively - 5.00 diopters [standard deviation +/- 1.25]. Retinal periphery must be carefully examined pre operatively in all myopic patients undergoing LASIK procedure to reduce the possible risk of retinal detachment

role of Magnetic resonance urography in the etological diagnosis of upper urinary tract obstruction

We evaluated the role of magnetic resonance urography [MRU] in the diagnosis of the cause and level of. upper urinary tract obstruction as non-invasive technique when the conventional IVU is non conclusive or contraindicated. Our study included 62 patients of them 33 patients with unilateral obstruction, 20 patients with bilateral obstruction and 9 patients with obstructed solitary kidney. Non enhanced T2-weighted MRU was done to diagnose the etiology of uretral obstruction compared to the gold standard of diagnosis of obstruction which was retrograde or antegrade urography, uretroscopy or open surgery. We found that in calcular obstruction the sensitivity specificity and overall accuracy were respectively [70.6%, 97.1% and 83,5%] while for non-caleular obstruction were [95.8%, 97.1% and 96.3%] there was a statistically significant difference between the sensitivity of MRU in diagnosing the cause of obstruction in calcular and non-calcular etiology in favor of non-caleular obstruction [p value = 0.01]. The overall sensitivity of MRU in diagnosis of the cause of obstruction was 85.4%, specificity of 97.1% overall accuracy of 89.2%. In conclusion MRU is a sensitive test for diagnosis of the level and cause of upper tract obstruction when IVU is contraindicated or non-conclusive in non-caleular obstruction, but the sensitivity is lower in detection of calcular obstruction. The addition of KUB and abdominal ultrasonography increase the sensitivity of MRU in diagnosis of calcular upper urinary tract obstruction

infratemporal fossa approach for the management of difficult lateral skull base lesions

Management of infratemporal fossa lesions poses certain difficulties. The presentation of these cases is variable, their location is deep and they may be related to important neurovascular structures. The aim of the present report is to present our experience in the management of extensive lesions involving the lateral skull base using a variety of infratemporal fossa approaches. The clinical picture, indications, technique, complications and outcome are discussed. This is a retrospective study in which all patients managed surgically for infratemporal fossa lesions at the ENT Department, Faculty of Medicine, Alexandria University and Hai Al Jamea Hospital, Jeddah, Saudi Arabia in a 2-year period were included. Nine patients were included, of whom four were recurrent juvenile nasopharyngeal angiofibromas, two nasopharyngeal carcinomas, one recurrent chondrosarcoma, one trigeminal neurinoma and one meningioma. The approaches used were the infratemporal fossa type C in two cases, the preauricular infratemporal fossa approach in six patients with [3 cases] or without [3 cases] orbitozygomatic osteotomy and a combined modified transcochlear and infratemporal fossa type B approach in the remaining case. Total removal could be accomplished in eight cases. No mortality was recorded The infratemporal fossa approaches provide a viable alternative for the management of difficult to treat lateral skull base lesions

Effect of dexmedetomidine premedication on the intraoculor pressure and metabolic control in type 2 diabetic patients undergoing cataract operation

This study was designed to evaluate the effect of dexmedetomidine [DEX] on the blood glucose control and insulin requirements in type 2 diabetic patients. Besides its effect on the intraocular pressure [IOP] in same patients, during cataract operations. Twenty patients with type 2 diabetes of ASA physical state II were randomly allocated into two equal groups. DEX group received 0.6 ug/Kg I.V. dexmedetomidine premedication and control [saline] group. Received i.v. 0.9% saline. Patients received standard general anesthesia. Insulin was given by continuous i.v. infusion syring pump 1.25 U/h. and intermittent bolus doses to maintain blood glucose range 5.5-11.1 mmol/ L. Blood glucose levels were measured every 15 minutes intra operatively. Cortisol, growth hormone and C-peptide were also measured IOP was measured with schioltz tonometer The results of this study demonestrated that the total insulin requirement and the blood sugar concentrations were significantly lower in DEX group than control group throughout the study period. There were no significant differences between the two groups in the cortisol levels. Though growth hormone levels were significantly increased in DEX. group but still within the normal physiological limits. C-peptide levels were significantly, lower in DEX group than in control group. In addition DEX significantly reduced the IOP in DEX group than in control group. From these data we can conclude that i.v. dexmedetomidine premedication improves blood glucose control and decreases insulin requirements and intraoculor pressure so it improves the operating conditions for type 2 diabetic patients undergoing cataract operation

Ophthalmologic changes associated with pediatric nephrotic syndrome and chronic renal failure

This work aimed to assess ocular changes that may occur in pediatric nephrotic syndrome and chronic renal failure to verify the importance of ophthalmologic examination as a prognostic and follow up parameter in pediatric chronic renal diseases. It was conducted on 121 patients with chronic renal diseases [50 with nephrotic syndrome, 40 were on steroid treatment [group A] and ten weaned from any medications [group B]] in addition to 71 patients with chronic renal failure [21 were on conservative treatment [group C] and 50 were on regular hemodialysis [group D]]. Ocular evaluation of group A revealed decreased visual acuity, recurrent infections and posterior subcapsular cataract. Patients of group B showed cataract, decreased acuity and recurrent infections. The examination of patients of group C revealed decreased acuity and snowflake cataract and glaucoma. It could be concluded that patients with chronic renal diseases were at an increasing risk of ocular affection likelihood cataract, glaucoma, decreased visual acuity, recurrent infections and corneal calcification, especially children with renal failure on long duration hemodialysis and nephrotic syndrome patients under maintenance steroids for long duration