Assessment of health related life quality in type 2 diabetic patients in zagazig university hospitals

Background: The fourth leading cause of death is type 2 Diabetes Mellitus (DM). Attention to the QOL of the patient is increasing today rather than the longevity of the patient. Therefore, to prevent aggravation of metabolic disorders, the quality of life of diabetic patients should be maintained. There is a growing awareness that patient QOL and satisfaction with treatment have been improved after good glycemic control. The aim of this study was to assess health related quality of life in patients with type 2 diabetes attending Zagazig University hospital plus associations between HRQOL scores and some variables playing role in scenario of DM were also studied.Methods:A cross sectional study included 100 type 2 diabetic patients, They were subdivided according to glycemic control into 2 groups and 50 non-diabetic participants as control. This study was conducted in Internal Medicine department and diabetes outpatient clinic in Zagazig University hospital in period from July 2016 to July 2018. The QOL was measured using SF-36 questionnaire. Results: Our results revealed that there was highly significant difference regarding physical health component among groups of study (p <0.001). There was also highly significant difference regarding mental health component among groups of study (p <0.001). There was highly significant negative correlation between QOL components and age & BMI & duration of DM & HBA1c and fasting blood sugar in diabetic patients (p <0.001). Conclusions: Type 2 diabetes mellitus in both the physical health and mental health domains is associated with a lower quality of life. Advanced age, obesity and poor glycemic control were factors related to lower quality of life in this study; therefore glycemic control is highly needed to improve the quality of life of diabetic patients

In vitro antischistosomal activity of venom from the Egyptian snake Cerastes cerastes

Abstract INTRODUCTION: We studied the potential in vitro antischistosomal activity of Cerastes cerastes venom on adult Schistosoma mansoni worms. METHODS: Live specimens of the horned viper snake, C. cerastes were collected from the Aswan Governorate (Egypt). Venom was collected from snakes by manual milking. Worms of S. mansoni were obtained from infected hamsters by perfusion and isolated from blood using phosphate buffer. Mortality rates of worms were monitored after 3 days of exposure to snake venom at LC50 and various sublethal concentrations (10, 5, 2.5µg/ml). Scanning electron microscopy was used to investigate tegumental changes in treated worms after exposure to LC50 doses of venom. RESULTS: The LC50 of C. cerastes venom was 21.5µg/ml. The effect of C. cerastes venom on Schistosoma worms varied according to their sex. The mortality rate of male and female worms after 48-h exposure was 83.3% and 50%, respectively. LC50 of C. cerastes venom induced mild to severe tegumental damage in Schistosoma worms in the form of destruction of the oral sucker, shrinkage and erosion of the tegument, and loss of some tubercle spines. CONCLUSIONS: The present study demonstrated that C. cerastes venom exerts potential in vitro antischistosomal activity in a time and dose-dependent manner. These results may warrant further investigations to develop novel schistosomicidal agents from C. cerastes snake venom.

Infectious diseases presenting by fever and hepatomegaly

The present study included 51 patients presenting by infectious fever and hepatomegaly. They were admitted to Abbassia and Embaba Fever Hospitals. Patients were subjected to careful history, thorough clinical examination, complete blood picture, urine and stool examination, repeated blood, urine and stool cultures during fever spikes. Slide and tube agglutination test for typhoid and brucella fevers. Mononucleosis diseases were diagnosed by Monospot test, Epstein Barr IgM and G, Cytomegalovirus IgM and G and Toxoplasmosis by indirect fluorescent test. Abdominal U.S., C.T scan and bone marrow examination whenever needed. Fifty one cases included 31[61%] bacterial cases, 12 [23%] mononucleosis cases and 8 [16%] parasitic cases. Thirty one bacterial group included 11[35%] brucella cases, 7 [23%] extrapulmonary tuberculosis, 5 [16%] urinary tract infection, 4 [13%] gram negative septicaemia and 4 [13%] deep seated abscesses. Twelve cases of mononucleosis cases included 6 [50%] infectious mononucleosis, 4 [33%] cytomegalovirus and 2 [17%] toxoplasmosis cases. Eight cases of parasitological group included 4 [50%] malaria cases, 2 [25%] fasciola cases, 1 [12.5%] amoebic liver abscess and 1 [12.5%] due to kala azar. Two [4%] cases died in our series; 1 due to gram negative septicaemia and the other due to kala azar. Cases are discussed and interpreted

Incidence of musculoskeletal pain in adult Kuwaitis using the validated Arabic version of the WHO-ILAR COPCORD Core Questionnaire

The WHO-ILAR Community Oriented Program for Control of Rheumatic Diseases [COPCORD] primarily aims to estimate the burden of musculoskeletal symptoms/disorders. We estimated the incidence of musculoskeletal pain in the first community-based COPCORD study in Kuwait. The validated Arabic version of the WHOILAR COPCORD Core Questionnaire was used in a survey of 2500 randomly selected Kuwaiti households to assess the frequency of musculoskeletal pain, disability, and health-seeking behavior in adult Kuwaitis. Those subjects reporting no musculoskeletal pain were identified and followed-up for a period of one year by contacting them every 2 weeks. Once a respondent reported pain, an appointment to report to hospital was offered and the subject was examined by a rheumatologist using American College of Rheumatology [ACR] criteria. Of 5159 adults who were non-complainers in an earlier prevalence phase of the study, 3341 responded to phone calls [response rate of 65%]. The incidence of musculoskeletal pain was 6.6% [95%CI, 3.4%- 9.7%]. Age- and sex-adjusted incidence rates were 7.2% [95%CI, 3.4%- 10.5%] for females and 6.1% [95%CI, 3.1%-9.2%] for males. The incidence rate increased with increasing age, body mass index, and with being married. The common sites of pain were knee, low back and shoulder. The incidence of musculoskeletal pain among Kuwaiti adults is reported for the first time. Further studies adopting the same instrument in other communities are warranted to compare with our findings

Thyroiditis: a disease with many faces

Background: Diagnosis of thymiditis is rather difficult since it can simulate any other thyroid disease. This study was conducted to determine the clinico-pathological features of thyroiditis and to evaluate the efficacy of the various modalities utilizedfor diagnosis of the disease

Patients and Methods: The study included 59 patients with the clinical diagnosis of thyroiditis. Ten patients had subacute thyroiditis SAT and 49 had chronic thyroiditis [CHT]. Investigations included serum levels of T3, T4 and TSH, anti-chromosomal antibodies [AMA], anti-thyroglobulin antibodies [ATGA], Ultrasonography for the thyroid gland and FNAC. Twenty-four patients improved by conservative treatment while 35 needed thyroidectomy where histopathology for the excised glands confirmed the diagnosis of thyroiditis

Result: The mean age of patients with SAT was significantly lower than that of those with CHT [2813 +/- 5.82 years vs. 44.1 +/- 8.36 years, respectively] [t: 5.62, p=0.002]. Seventy one percent of patients with CHT had concomitant autoimmune disease, and nine of the 10 patients with SAT had history of recent upper respiratory tract infection. There was an obvious tendon; towards hyperthyroidism associated with CHT and towards hyperthyroidism associated with SAT. Both AMA and ATGA were significantly higher in patients with CHT as compared to those with SAT [P<0.05]. Hypoechoic sonographic pattern of the goiters formed the majority in both groups [33/49 and 8/10 for CHT and SAT respectively] [X2=26.612, P<0.001] fNAC could diagnose 30 out of 49 cases of CHT with a sensitivity of 59.2% a specificity of 90%, a positive predictive value of 96.7% and a negative predictive value of 31%. It did not diagnose any of the ten SAT

Conclusions: Diagnosis of thyroiditis requires a high index of suspicion. A history of concomitant autoimmune disease could associate CHT. An upper respiratory tract infection nay well precede a SAT. CHT is associated with a significant rise of AMA and ATGA. Hypoechoic sonographic petten is found in a significant number of patients with thyroiditis. FNAC is specific yet insensitive test for the diagnosis of thyroiditis

Effect of hepatitis-C viral infection on platelets

This study was conducted on 35 patients with established chronic liver diseases due to hepatitis C. Their ages ranged from 20 to 60 years. A full clinical assessment, ultrasound, complete blond picture including platelet number and functions, liver function tests [SGOT, SGPT, serum albumin, serum bilirubin and prothrombin time and concentration] were applied for every patient. Hepatitis markers for B and C and PCR for HCV and, lastly, liver biopsy were also detected. They were classified into three groups [according to their platelet number]: Group I [12 patients] with platelet count 151-350,000/mm3, group II [13 patients] with platelet count 80-140,000/mm3, and group III [10 patients] with platelet count 25-79,000/mm3. The three groups were statistically compared regarding platelet number, platelet aggregation, liver function tests, histopathological study and correlation between platelet number and aggregation. The results revealed a direct correlation between liver span and platelet number and platelet aggregation. Inverse correlations were noticed between spleen size and portal vein diameter and platelet count and aggregation. Direct correlations were present between platelet number, aggregation and liver function tests [prothrombin time, SGPT, S. Bilirubin, OT/PT ratio and albumin], but there was no correlation with SGOT

Evaluation of Karydakis Technique for the management of chronic pilonidal sinus in obese patients

This study was conducted to evaluate Karydakis technique for the management of chronic pilonidal sinus in obese patients. The study included 40 patients divided according to their body mass index [BMI] into two groups: Group I included obese patients and Group II included non-obese patients. There was no significant difference between obese and non-obese patients regarding their clinical presentation in terms of symptoms, duration of the disease and number of sinus openings. It was concluded that Karydakis technique for management of chronic pilonidal sinus was easy to perform, had a fast healing time, short hospital stay and low recurrence rate. The results were similar between obese and non-obese patients with a BMI< 30.5 and no recurrence seen in these patients. Complications occurred in obese patients had a BMI > 30.5. In such patients, a dietary regimen before operation was advisable and inserting a suction drain during the operation was recommended to avoid seroma formation