Fecal Calprotectin and Cow’s MilkRelated-Symptoms Score in Children with Cow’s Milk Protein Allergy / 대한소아소화기영양학회지

Purpose@#The cow’s milk-related-symptom-score (CoMiSS) tool was developed as an awareness tool for the assessment of cow’s milk-related symptoms in infants or children.Fecal calprotectin (FC) is a noninvasive biomarker of gut inflammation that can be measured in serum and stool. This study aimed to investigate the relationship between FC levels and CoMiSS scores in infants with cow’s milk protein allergy. @*Methods@#Infants (aged 6–12 months) who were allergic to cow’s milk protein were enrolled prospectively. Following completion of the CoMiSS scoring, the infants were divided into group 1 (positive CoMiSS scores ≥12) and group 2 (negative CoMiSS scores <12). FC was measured using immunoassay. @*Results@#Of the 120 infants enrolled in this study, 60 (50.0%) had positive CoMiSS scores (group 1), while 60 (50.0%) had negative scores (group 2). The mean FC level was higher in the infants in group 1 than those in group 2 (2,934.57 µg/g vs. 955.13 µg/g; p<0.001). In addition, there was a positive correlation between FC and CoMiSS scores (R=0.168, p<0.0001). A FC level of 1,700 µg/g provided a sensitivity of 98.3%, specificity of 93.3%, and accuracy of 95.8% for the diagnosis of cow’s milk protein allergy (CMPA). @*Conclusion@#FC measurement may have a role in the assessing infants with CMPA.

Multi-drug resistant uropathogenic isolates of proteus at Assiut university hospitals

Background: proteus bacilli are more commonly associated with UTIs in those individuals with structural or functional abnormalities, especially ascending infections in patients undergoing urinary catheterization

Aim of the study: to estimate the frequency of proteus infection in patients with I urinary tract infections, detection of sensitivity profile to antibiotics and detection of ESBL

Material and methods: one hundred and fifty five patients with symptoms of urinary tract infection were recruited and urine sample from each patient was collected as well as demographic data and associated I risk factors were recorded. Urine culture, antimicrobial susceptibility test, screening and confirmatory tests for detection of ESBL were done

Results and conclusion: the mean age +/- SD was 45 +/- 17 years, 139 were males and 16 were females. Sixty eight patients were catheterized and 87 patients were non-catheterized. E coli was the highest bacterial organism [35%] detected by urine culture among catheterized patients, while Kpneumoniae was the highest among non-catheterized patients. There was a significantly higher percent of proteus among non-catheterized patients than catheterized patients. Proteus alone or proteus with other bacterial infection was detected in 14.8% in catheterized versus 6.1% in non-catheterized patients. Only 13 cases out of 155 cases [8.4%] had positive culture for proteus organism. All are males and most of them were catheterized and had benign enlarged prostate [8 cases; 61%]. Out of 13 Proteus isolates, nine Proteus isolates showed reduced susceptibility to the Ceftazidime, Cefotaxime, Ceftriaxone, and Cefuroxime and gave the same zone diameter range as adapted by CLSI [2014] document M100 S24 and nine considered potential ESBL producers

Antibiotic susceptibility patterns of propionibacterium acnes isolated from acne vulgaris in Assiut university hospitals, Egypt

Background: Antibiotics are frequently used to treat acne patients either as bactericidal or anti-inflammatory agents. However, with the increased use of antibiotics, resistant strains of Propionibacterium acnes began to emerge and have been associated with a poor treatment outcome

Objectives: Detection of staphylococcal and Propionibacterium acnes strains in cases of acne vulgaris in Assiut university hospitals, Egypt and antibiotic susceptibility patterns of Propionibacterium acnes isolates

Methodology: Microbiological samples were obtained from one hundred patients with inflammatory acne lesions. Samples were cultured on blood agar and mannitol salt agar media under aerobic conditions at 37[degree]c for isolation of staphylococcal strains, and on blood agar under anaerobic conditions at 37[degree]c for 3 to 7 days for isolation of Propionibacterium acnes. Bacteria were identified by colonial morphology, standard biochemical tests, and API 20A test for identification of Propionibacterium acnes isolates. Antibiotic sensitivity testing of Propionibacterium acnes strains was done against clindamycin, erythromycin, doxycyclin, trimethoprime/sulfamethxazole, tetracycline and levofloxacin

Results: Staphylocoocal strains were detected in 55% of acne cases, while Propionibacterium acnes were detected in 35% of cases. Most Propionibacterium acnes isolates were sensitive to levofloxacin [80%], followed by doxycycline [51.4%], tetracycline, trimethoprime/ sulfamethaxazole [20.0% for each] while showed highest resistance rates to clindamycin [85.7%] and erythromycin [82.9%]

Conclusion: Levofloxacin was the most effective antibiotic for Propionibacterium acnes followed by doxycycline, while Erythromycin and clindamycin were the least effective antibiotics for Propionibacterium acnes

Molecular identification and antifungal susceptibility of pathogenic fungi isolated at Assiut university hospitals

The incidence of invasive opportunistic mycoses [10Ms] has increased because of the expanding population of immunosuppressed patients raising the demand for identification of local epidemiologic trends, the degree of virulence and antifungal susceptibility pattern of fungal pathogens. Identification of the local epidemiology of l0Ms at Assiut University hospitals showed that there is a marked shift to Candida non albicans [can], rare yeasts that cause Candida like infections, zygomycetes, hyaline moulds and a wide variety of dematiaceous fungi. In vitro susceptibility testing pattern of isolated fungal pathogens against 8 antifungal agents; Amphotericin B [AP], Nystatin [NS], l;luconalole [FU], Ketoconazole [KT], Clotrimazole [CC], Voriconazole [VOR], Itraconazole [IT] andv Terbinafinc showed that these emerging pathogens are resistant to conventional antifungals, in addition, they pose a high enzymatic and toxigenic ability making them more virulent and infections caused by them more aggressive and very difficult to manage

Right ventricular diastolic function abormalities in patients with systemic sclerosis

Systemic sclerosis is a generalized disorder of connective tissue characterized clinically by thickening and fibrosis of the skin and by distinctive forms of involvement of internal organs, among which is the heart. Manifestations of scleroderma heart disease are quite variable, and often not seen until late in the course of the disease. This work aimed to assess the prevalence of right ventricular diastolic abnormalities in patients with systemic sclerosis and to investigate the relation to the clinical manifestations of the disease. Our study group included thirty four patients with systemic sclerosis [32 females and 2 males, their age ranged from 19 to 67yrs with a mean of 40.3 +/- 11.5yrs and a mean disease duration of 8.9 +/- 7.4yrs.] and thirty healthy subject who served as controls. All the study groups were subjected to full clinical evaluation and echo-Doppler study. Parameters of diastolic function included, E/A ratio and time velocity integrals of A wave and diastolic filling [TVI of A/TVI of DF]. Patients were diagnosed as having diastolic dysfunction when one or more of the two criteria were abnormal. Right ventricular diastolic abnormalities were found in 23 patients [67.65%] while left ventricular diastolic abnormalities were found in 11 patients [32.35%]. Seven patients had an ejection fraction below 60%, all had right ventricular diastolic dysfunction. There was a highly statistically significant difference between patients and control as regard tricuspid E/A [1.1 +/- 0.3 vs 1.3 +/- 0.2, p=0.0001] and tricuspid TVI of A/TVI of DF [0.4 +/- 0.1 vs 0.3 +/- 0, p=0.0001]. A significant correlation was found between right ventricular diastolic abnormalities and age of patients [the mean age of patients with abnormal diastolic function was 44.6 +/- 12 vs 35.4 +/- 8.8 for patients with normal diastolic function, p=0.017]. Right and left ventricular diastolic function abnormalities are common in patients with systemic sclerosis. Echocardiography should be recommended for all patients with systemic sclerosis even in asymptomatic patients especially in elderely

Pulmonary hypertension in patients with chronic renal failure: the role of parathormone and pulmonary calcification

Cardiovascular complications especially coronary artery disease are considered to be a major cause of mortality in patients with chronic renal failure [CRF] on regular hemodialysis. Abnormal technetium-m99 methylene diphosphonate [99mTc-MDP] lung uptake was reported in 61% of patients with CRF on regular hemodialysis in the presence of normal chest radiographs indicating the presence of pulmonary calcifications. Pulmonary calcification was reported to be a possible cause for the development of pulmonary hypertension [PH] in patients with CRF on regular hemodialysis. 51 patients [28 males and 23 females] who had end stage renal disease and were on regular hemodialysis. Those patients were divided according to the presence of pulmonary hypertension by echo-Doppler study into: Group 1: 15 patients [5 males and 10 females] with a mean age of 43.5 +/- 9.8 years who had pulmonary hypertension and subjected to 99m Tc-MDP. Group II: 15 patients [10 males and 5 females] with a mean age of 40.3 +/- 10.9 years without pulmonary hypertension. Also, those patients were subjected to 99m Tc-MD and were considered as a control group. Group III: 21 patients [15 males 6 females] with a mean age of 3g9 +/- 11.0 years without pulmonary hypertension but were not subjected to 99m Tc-MDP scan. All patients were subjected to full clinical evaluation, chest X ray and well standardized 12 leads ECO. Laboratory investigations included BUN, creatinine, calcium [Ca], phosphorus [Ph], alkaline phosphatase [ALK], hemoglobin [Rb] ,complete lipid profile, and intact molecule parathormone hormone [PTH]. Echo-Doppler study was performed mainly for estimation of the pulmonary artery systolic pressure [PASP]. Only patients in groups I and IT were subjected to 99m techn MDP scan. Twenty patients from 30 patients [66.6%] had positive 99m Tc-MDP lung uptake. There was no significant difference between patients with positive or negative 99m Tc-MDP lung uptake regarding the duration of dialysis, the serum level of Ca, Ph, ALK, Rb, cholesterol, triglyceride and PTH .15 patients [29.47%] had pulmonary hypertension [The mean value of PASP was 45.2 +/- 6.7 Hg]. There was no significant difference regarding the mean value of PASP in patients with positive or negative 99m Tc-MDP lung uptake .The mean value of PASP in patients with positive 99m Tc-MDP was 33.9 +/- 11.8 mmHg vs 36.5 +/- 11.8 mmHg in patients with negative 99m Tc-MDP lung uptake [p=0.3]. This study demonstrated that 66.6% of patients with CRF and on regular hemodialysis had pulmonary calcifications. There was no significant difference between patients with or without pulmonary calcifications regarding serum Ca, Ph, ALK, Hb, cholesterol, triglyceride and PTH. There was no correlation between pulmonary calcifications and pulmonary hypertension. The mechanism of pulmonary hypertension is uncertain and other factors rather than pulmonary calcifications and hyperparathyroidism should be considered