Umbilical cord blood lead levels in Cairo

The history of dealing with the toxic effects of lead is an outstanding example of how knowledge learned from research has its impact on public health. One of the measures that had the greatest impact on reducing exposure to lead, in Cairo, is the introduction of lead-free gasoline by the Egyptian Government, at the first of July, 1997. The objective of this study is to determine the cord blood lead levels and its related epidemiological risk factors in Cairo. The subject of the study was 300 women classified into 3 groups. Each group comprised 100 women. The first and second groups were from Cairo, before and after reduction of lead from gasoline, respectively. The third group [control] was from El-Aiyat and El-Wasta country sides. This study was carried out in the Departments of Obstetrics of El-Hussein University Hospital, AL-AZHAR University, El-Aiyat and El-Wasta General Hospitals. A simple questionnaire was designed to determine the different epidemiological risk factors. Cord blood samples were collected and submitted for estimation of total lead levels. None of the cord blood lead levels reached beyond the permissible value [< 10 ug/dl], even in the first group. The mean value was significantly higher in the first group [2.380 +/- 2.092 ug/dl], compared to the second and third groups [1.140 +/- 0.153 and 0.923 +/- 1.319 ug/dl], respectively, [P < 0.0001]. A scoring system was suggested to find out the women at risk and the necessity of lead analysis. In conclusion, although the cord blood lead levels were not so high, yet the utmost care of our newborns is mandatory as most of the epidemiological risk factors to lead pollution are avoidable. This was a pilot study and a further longitudinal study is recommended

Management of congenital nasolacrimal duct obstruction

In a prospective study, patients presented to EL Maghraby Eye Center with congenital nasolacrimal duct obstruction underwent culture and sensitivity of conjunctival swabs. A total of 68 patients [28 males and 40 females] were treated over one year period. The average age of presentation was 5.8 months with a range of 2-12 months. Cultures of conjunctival swabs revealed hemophilus influenza in 24 cases, Staphylococcus aureus in 12 cases, Pneumococci in 10 cases, Staphylococcus epidermis in 8 cases, Pseudomonas pyocyaneous in 4 cases and Branhamella catarrhalis in 4 cases. The main management was simple massage of the tear sac with cotton tipped applicator 4 times daily in addition to instillation of antibiotic eye drops according to the sensitivity results. Chloramphenicol was shown to be active against the pathogens detected in nearly 50% of the cases. So we recommend chloramphenicol to be the initial treatment in case of congenital nasolacrimal duct obstruction

Alternative of cataract surgery in Saudi mountain areas

We are reporting three cases of iterogenic lens dislocation couching as a method of Arabic Medicine for patients with cataract

Acetazolamide for treatment of chronic macular oedema

Macular oedma is one of the causes of diminution of vision in various diseases. Several methods of treatment were tried for treatment including both medical and surgical techniques. In this study, ten patients with chronic macular oedema were treated by acetazolamide, a carbonic anhydrase inhibitor. The dose was 250 mg per day in two divided doses. The dose was maintained according to the response of the patients. Three patients showed significant improvement with complete resolution of the macular oedema after two weeks of treatment with improvement of visual acuity. Another three patients showed subjective improvement of their acuity, but with minimal changes in their macular oedema evidenced by fluorescein angiography. In another three patients there was no effect of treatment. In the last patient, acetazolamide had to be stopped completely after four days due to side-effects. Thus, acetazolamide produced therapeutic response in about 60% of cases. It may be beneficial for treatment of some cases of chronic macular oedema