Parasitosis among apparently healthy immigrant workers at Dammam, Saudi Arabia

A cross sectional study was conducted on randomly selected 161 apparently healthy immigrant workers in Dammam City, with ages ranged between 21 to years. A required data were taken via a designed questionnaire and stool samples were collected and examined microscopically by direct wet mount [saline and iodine stained smears] and by formalin ether concentration sedimentation technique. The results showed 99/161 [55.3%] suffered parasitosis. These are in a descending order they were E. histolytica [50.5%], Giardia lamblia [38.8%], Enterobius. vermicularis [12.1%], Entamaeba coli [12.1%], Trichuris trichiura [11.1%], Hymenolepis. nana [11.1%], Schisto-soma haematobiumn [10.1%], A. scaris lumbricoides [9.09%], S. mansosoni [7.07%], Dicrocelium dendriticum [5.05%], and Fasciola species [3.03%]. On the other hand, 72 [44.7%] of the immigrant workers were Toxoplasma gondii ELISA-IgG positive. The intervention programs including health education, strict supervision of health authorities on immigrant workers as well as environmental sanitation are required

Dexmedetomidine as an adjunct to combined general and caudal anesthesia in children undergoing open reduction for congenital hip dislocation

We tested dexmedetomidine [DEX], and alpha 2 agonist for its ability to prolong the duration of analgesia after single shot caudal block, to provide stable haemodynamics and to optimize surgical field in pediatric patient undergoing open reduction for developmental dysplasia of the hip. In a randomized, placebo controlled study, 40 patients were randomly assigned to one of two equal groups. The Dex group received 0.5 micro g/kg/h dexmedetomidine and the control group received normal saline. Mean arterial pressure, heart rate, average category scale for quality of surgical field, intraoperative inspired sevoflurane concentartion and time to first rescue analgesia were measured. Relative to baseline and to the control group, mean arterial pressure and heart rate decreased significantly 15, 30, 45, 60, 75, 90, 105, 120, 135, 150, 180 minutes after start of dexmedetomidine infusion p<0.05. The average category scale for the quality of surgical field was significantly lower at 15, 30, 60, 90 and 120 minutes in the dexmedetomidine group compared to the control group p<0.05. The inspired sevoflurane concentration was significantly less in the dexmedelomidine group compared to the control group [1.46 +/- 0.7% Vs 2.07 +/- 0.18% respectively] p<0.05 and the time to the first rescue analgesia was significantly prolonged in the dexmedetomidine group compared to the control group [11.2 +/- 3.9h Vs 7.9 +/- 4.6h] respectively p<0.05. In conclusion, intraoperative dexmedetomidine infusion prolonded the duration of analgesia after single shot caudal ropivacaine, provided stable haemodynamics, better surgical field and decreased the intraoperative inspired sevoflurane concentration

Brucellosis in Egyptian female patients

Over six months, 129 consecutive brucellosis cases were diagnosed in females attending the outpatients' clinics the females in Al-Azhar and Ain Shams Universities Hospitals. Their ages ranged between 12-65 years old. 113 [87.6%] gave history of raw milk consumption, 13 [10%] gave history of home slaughtering of sheep, 2 [1.5%] gave history of animal contact, and one patient gave history of abortion, that partner had brucellosis. A total of 61.2% of patients gave serum agglutination test of 1: 640, who suffered acute or subacute infection. Titers of 1:320 [38.8%] were found in the majority of chronic cases. Causes of endemic parasitosis were excluded. Symptoms were fever [79.5%], headache [72.4%], generalized arthralgia [65.3%], sweating [65.3%], chills [63.8%], backache [34.6%], abdominal pain [27.5%], loss of appetite [25.5%] lassitude [17.2%], myalgia [14.2%], monoarthralgia [7.9%]. Spinal involvement was in 15% patients, who had chronic brucellosis. 32/35 were successfully treated with a combination of streptomycin and tetracycline, 17/21 with streptomycin and septrin, 38/43 with tetracycline and septrin, and 26/26 [100%] with rifampicin and tetracycline or septrin, which treated all resistant patients

Effect of aluminum on some neural aspects of rat offspring and the possible amelioration with antioxidants

This study comprises two experiments, in the first one pregnant rats were administered a daily dose of 360 mg/kg aluminum chloride from the 8[th] to the 20[th] day of gestation. The aluminum [Al] was given either separately or in combination with 100 mg/kg a tocopherol [vitamin E] or with vitamin E plus 500 mg/kg ascorbic acid [vitamin C] via stomach intubation. In the second experiment, pregnant rats were treated with aluminum as in the previous experiment and the offspring born to aluminum-treated mothers were divided into three groups. The first was given the solvent vehicle; the second was treated with vitamin E and the third with vitamin E plus vitamin C. At the postnatal age of 105 days, the offspring of both experiments were sacrificed to determine the level of free amino acids, monoamine neurotransmitters, DNA, RNA and reduced glutathione [GSH], malondialdehyde [MDA], the activities of Na[+] K[+]-ATPase, superoxide dismutase [SOD] in the brain cortex. In addition, total protein content and acetyicholinesterase [AChE] activity in both cerebral cortex and hippocampus tissues were investigated to evaluate the impact of aluminum and the possible ameliorative effects of vitamin E and C. Aluminum residue was measured in the cerebral cortex of normal rats and those prenatally treated with aluminum. Aluminum caused severe physiological perturbation in the brain neurotransmitters. Vitamin E curtailed some of these aluminum-induced physiological perturbations, whereas vitamins E+C given together almost completely ameliorated these perturbations. The results highlight the importance of these two antioxidant vitamins in counteracting the aluminum damaging effect on the rat nervous system. Based on the present results, administration of vitamin E and C concomitantly is recommended to neonates whose mothers at high risk of aluminum contamination as a preventive and a protective measure against the neurological damage caused by aluminum

Effect of NPK, organic and bio-fertilization on vegetative growth, flowering and chemical composition of jasminum sambac, ait. Plants

A field trial was conducted during two consecutive seasons [2004/2005 and 2005/2006] at the Exerimental Nursery of the Ornamental Horticulture Department, Faculty of Agriculture, Cairo University, Egypt, to investigate the effect of fertilization with NPK, organic and biofertilizers on growth, flowering and composition of Jasminum sambac plants. NPK [N: P205: K2O] at the rate of 40 g/pot/season was applied at 5 g/pot for eight months. Three different kinds of organic fertilizers were applied namely, compost at a rate of 175 cm[3]/pot/season. Camel manure at a rate of 175 cm[3]pot/season, biogas at a rate of 60 kg/N/feddan/season Biofertilizer [Biogramina] was applied at a rate of 75 ml/pot/season. NPK fertilizer caused significant increases in vegetative growth parameters. NPK alone or in combination with organic fertilizer lenanced root parameers, chlorophyll-a, b and carotenoids content. Biogas combined with biofertilizer [Biogramina] gave the best results of flowering parameters while, total carbohydrates, N, P and K contents were increased by organic fertilizer. It could be concluded that biofertilizer [Biogramina] alone delayed flowering

Cytokines and immunoglobulin-E in certain parasitic diseases

Ninety Egyptian patients were classified into 7 groups, 6 with different parasitic infection and 10 normal controls. Forty patients with different schistosomiasis stages [1, 2 and 3] with compensated but the last one [stage 4] of decompansated schistosomiasis. Gs3 and 4 of mixed infections with schistosomiasis and HCV and HBV respectively. The last 3 patients groups were infected with toxoplasmosis, filariasis and hymenolepiasis nana. IL2, IL4 and IgE levels were measured. The results showed significant increase in IL2 [P<0.05], [P<0.01], P<0.01] and [P<0.001] among stages [1, 2, 3 and 4] versus control respectively. In chronic schistosomiasis with HCV and HBV, significance was P= <0.001 and P<0.05 respectively, among toxoplasmosis, filariasis and hymenolepiasis patients, it was P= <0.001, 0.05 and 0.01 respectively. The IL 4 level showed highly significant increase [P< 0.001] among stage 1, 2, Gs 2, 3 and 6. There was significant increase [P<0.01] with stage 3 in Gs 4 and 5 but, without significance [P>0.05] increased in decompensate schistosomiasis patients. IgE level and test of significance versus controls were given and results were discussed

Human fascioliasis and anaemia in Dakahlia governorate, Egypt

Fasciola infection [fascioliasis] appeared to be endemic in Egypt. Stool samples of fourty eight patients were coprologically diagnosed. According to Fasciola egg counting per gram stool, the severity of infection was divided into light infection in 60.5%, moderate in 27.1% and severe infection in 12.5%. No significant correlation was detected between severity of infection, and patients' sex. Complete blood picture, reticylocytic count, serum iron, immunological assays as anti-nuclear, anti- smooth muscle antibody, anti-mitochondrial anti-body, anti- DNA tests and rheumatoid factor and occult blood in stool were investigated. Normocytic normochromic anaemia was detected in 62.5% of the fascioliasis patients, microcytic hypochromic anaemia in 3 1.3% and macrocytic one in 6.3%. Highly significant negative correlation [R = -0.68] was detected between haemoglobin concentration and egg count per gram faeces. Human fascioliasis was associated with normocytic normochromic anaemia and to a lesser extent microcytic hypochromic anemia

Clonidine plus levobupivacaine for patient controlled interscalene analgesia after shoulder surgery

Patient controlled interscalene analgesia [PCIA] is a recognized effective means of providing postoperative analgesia for shoulder surgery. Clonidine in contrast to other additives as opioids, appears to have analgesic benefit when administered as an adjunct to brachial plexus block. The effect of addition of clonidine to levobupivacaine for PCIA was studied. Twenty patients completed the study protocol, 10 had PCIA using 0.125% levobupivacaine alone and 10 had PCIA using 0.125% levobupivacaine plus l micro g/ml clonidine. Patients receiving levobupivacaine plus clonidine experienced significantly less postoperative pain compared to patients receiving levobupivacaine alone during rest and limb movement starting from 12 hours and in all subsequent observations. The levobupivacaine plus clonidine group had significantly less volumes of local anesthetic solutions consumed, and less number of incremental doses requested and received during the 48 hours study period of PCIA, and also used significantly less tramadol to remain comfortable [p<0.05]. Significantly more patients in the levobupivacaine plus clonidine group [n=9, 90%] than in the levobupivacaine alone group [n=6, 60%] rated their satisfaction with postoperative analgesia as excellent [p<0.05]. In addition, patients in the levobupivacaine plus clonidine group experienced significantly fewer tramadolrelated side effects and sleep disturbances than levobupivacaine alone group [p<0.05]. No patients in the levobupivacaine plus clonidine group showed sedation. In conclusion, this study has demonstrated that clonidine is a useful adjunct to levobupivacaine for postoperative patient controlled interscalene analgesia. Clonidine improved the quality of analgesia provided by levobupivacaine and increased the degree of patient satisfaction, decreased the consumption of local anesthetic used during patient controlled interscalene analgesia, and decreased sleep disturbances and oral narcotic use

Egyptian genotyping of Giardia lamblia

In this study, out of 105 patients infected with Giardia, 38 patients had genotype I, 13 had genotype II, 10 had genotype III, 16 had mixed genotype infection and 28 with undetermined Giardia infection by polymerase chain reaction [PCR]. None of the control group gave positive results for Giardia in stool by PCR. So, the sensitivity of the test for the detection and identification of Giardia genotypes from the original stool samples was 73.33% and the specificity was 100%. Out of 61 cases in the symptomatic group, the prevalence of Giardia genotype I was 32.79%, genotype II was 16.39%, genotype III was 9.84%, mixed genotype infection was 16.39% and undetermined genotype was 24.59% as compared with 40.91%, 6.82%, 9.09%, 13.64% and 29.55% in the asymptomatic group, respectively. There was a statistically insignificant difference between both groups regarding the prevalence of the different Giardia genotypes

Evaluation of excretory / secretory fasciola [Fhes] antigen in diagnosis of human fascioliasis

The parasitological diagnosis of human fascioliasis based on the demonstrations of the eggs in stool, duodenal contents or bile is usually unsatisfactory due to false passage of eggs, ectopic fascioliasis and failure of immature worm to maturation. So, ELISA- Fhes antigen [Fasciola hepatica excretory/secretory] and IHAT were evaluated in the immunodiagnosis of parasitologically proven cases of human fascioliasis compared with proven cases of human Schistosomiasis mansoni and parasite-free individuals. ELISA-Fhes gave 100% sensitivity and 100% specificity. On the other hand, IHAT was less sensitive and less specific

review on fascioliasis in Egypt

In this study, two clinical stages in human fascioliasis were recognized. An acute stage coincided with the larval migration and worm maturation in the hepatic tissue and a chronic stage coincided with the persistence of Fasciola worms in the bile ducts. Human infection with fascioliasis was very sporadic until the last three decades where the clinical cases and outbreaks were reported. The total estimated number of people infected with fascioliasis is 2.4 million in 61 countries and that the number of people who are at risk is more than 180 million all over the world. Human fascioliasis has to be differentially diagnosed from some diseases as acute hepatitis, infection with other liver flukes as schistosomiasis, visceral toxocariasis, biliary tract diseases and hepatic amoebiasis

Clinico-epidemiological study of human fascioliasis in an endemic focus in Dakahlia governorate, Egypt

Human fascioliasis is increasing in the Nile Delta particularly in Dakahlia Governorate, where it reached 7.47%. In this study, the tetrad of fascioliasis was established as high eosinophilia [100%] fever [85.6%], painful hepatomegaly [81.93%] and anaemia [100%]. The laboratory results showed ESR accelerated in 87%, ALT elevated in 21.5%. AST elevated in 21.9%. S. bilirubin elevated in 16.5%, gamma GT elevated in 80.6% and SAP elevated in 76.4%. Abdominal ultrasonography showed variable findings, as hepatomegaly, splenomegaly, periportal fibrosis, thickened wall of gall bladder, dilated common bile duct, dilated biliary radicals [partial], dilated common bile duct and biliary radicals [total], Fasciola worms in gall bladder, Fasciola worms in common bile duct, stones in gall bladder, stones in bile duct, cystic lesions in the liver, focal lesions in the liver and ascitis. The highest was hepatomegaly in 81.93% of fascioliasis patients and the lowest was biliary dilated radicles [partial] in 0.26%

Evaluation of optic nerve atrophy in children

Evaluation of causes and incidence of optic atrophy in children. Revision of patients records through a period from 1990 to 2000. Clinical examination, computed tomography, magnetic resonance image, and histopathological examination were used to establish the diagnosis. one hundred children of unilateral or bilateral optic nerve atrophy were subjected of this study. Seventy children the cause of optic atrophy was known and thirty children had optic atrophy with no identified cause. Established of diagnosis of optic atrophy was based on neur-imaging studies. The most common cause of optic atrophy was tumors especially optic nerve glioma

Possible mechanism[s] for cryptosporidial diarrhea: parasitologic and physiopathologic studies in experimental animals

The present work was planned to study the possible mechanism[s] of diarrhea in cryptosporidiosis Stool eluates and intestinal homogenates from naturally and experimentally infected animals together with purified sporozoites were examined utilizing using chamber to demonstrate their possible enterotoxic effects Besides the histopathological changes in experimentally infected mice were studied to assess the possible underlying mechanism[s] of diarrhea in cryptosporidiosis. Characterization of the enterotoxic activity associated with cryptosporidiosis may have a great impact on the development of effective strategies for its treatment. The results of the present study revealed that in intestinal cryptosporidiosis enterotoxic substances are secreted which likely induce diarrhea. They induce an increase in the transepithelial potential difference [DIsc] to reach its maximum after 15 minutes and then slowly decrease to reach the baseline after 55 minutes [for stool eluates] and 35 minutes [for intestinal homogenates] On the other hand the purified sporozoites showed an increase in DIsc after 9 minutes and then a decrease after that to become maintained at relatively high level. The enterotoxins were found to be time and dose dependent and heat labile. The osmotic gap showed that the mechanism of diarrhea is rather secretory. In experimentally infected mice, shedding of oocysts first appeared in stools 3 days postinoculation [PI], reaching a peak 9 days [PI] and disappeared 15 days PI. Although the infected mice showed mild to severe degree of intestinal inflammation [marked villous atrophy and crypts hyperplasia], the stool was semiformed. Besides, the present study showed marked validity of mouse as an in vivo model to study the pathophysiology of cryptosporidial diarrhea. This model is inexpensive and serves as a suitable alternative to neonatal calves for efficient oocyst propagation

new analgesia protocol for cataract surgery

Our objective was to describe the safety and efficacy of a new analgesia protocol that enables the surgeon to maintain control over an alert patient experiencing seemingly painless ambulatory cataract surgery, while eliminating the risks and side effects associated with general, local, and intracameral anesthesia. This study was carried out on two thousands cataract surgery cases. This technique produces profound ocular analgesia, avoiding any undesired sedative effects, using very low-dose, titrated, intravenous alfentanil. Complete control of the uncooperative patient, including lid squeezing and ocular and genera! body movements, is obtained whenever necessary using very low-dose, titrated, intravenous propofol. Success was defined as surgery completed in a controlled manner without the need to convert to general, local, or intracameral anesthesia and the patent's experience being perceived as pain free. One thousand nine hundred ninety-five [99.75%] of the cases were successful without ever deviating from the protocol. This analgesia protocol offers advantages for cataract surgery. It virtually eliminates the morbidity of cataract surgery associated with other anesthesia techniques while providing excellent and reliable control with minimal side effects. It allows for an immediate postoperative recovery with instantaneous vision restoration. These patients are generally awake, alert, and retain their protective reflexes

Detection of fasciola-specific excretory/secretory [e/s] protein fraction band [49.5 kda] and its utilization in diagnosis of early fascioliasis using different diagnostic techniques

The objective of the present work was to evaluate Fasciola E/S antigens for diagnosis of early fascioliasis utilizing different diagnostic techniques. Using enzyme-linked immunoelectrotransfer blot [EITB], Fasciola-specific E/S protein fraction band [49.5 kDa] was determined and electroeluted. The monospecific antibodies against this specific fraction band were prepared by immunizing pathogen-free rabbit. Assessment of the prepared monospecific antibodies in diagnosis of human fascioliasis was performed through the detection of E/S coproantigens by enzyme-linked immunosorbent assay [ELISA] in stool eluates obtained from patients with confirmed fascioliasis, other parasites as well as from other healthy individuals. Serum samples were collected and tested to detect serum antibodies against Fasciola E/S antigen using EITB and counter immunoelectrophoresis [CIEP]. Analysis of Fasciola adult worm E/S products by SDS/PAGE revealed a number of bands, the molecular weight [MW] of which ranged from 14-200 kDa with 3 major bands [27.5, 32.5 and 55 kDa]. Fasciola E/S 49.5 kDa protein fraction proved to be specific of F. gigantica. Cross reaction with S. mansoni was observed at higher MW [110-120 kDa]

Safety and efficacy of intracameral injections of preservative - free lidocaine as an adjuvent to topical anesthesia to reduce intraocular sensation versus peribulbar anesthesia

This study was done to evaluate the efficacy and safety of intracameral lidocaine in cataract surgery compared to peribulbar anesthesia. This study was carried out on rabbits [n = 20] and patients [n = 160]. Our primary concern was the potential for corneal toxicity from the intracameral lidocaine. The preliminary study with rabbits showed no significant difference in corneal endothelial toxicity between the 20 rabbit eyes injected with 1% preservative-free lidocaine and the 20 eyes injected with BSS [p = 0.42]. As regards the human studies, a total of 160 cataract patients [160 eyes] participated. Eyes were classified to two groups: one group [n = 80] received 0.2 ml intracameral 1% unpreserved lidocaine combined with topical anesthesia [bupivacaine]; the other group [n = 80] received a peribulbar block with a sharp 26-gauge needle using a solution of lidocaine 2% [3 ml], bupivacaine 0.5% [2 ml], and hyaluronidase [wydase] 150 U before phacoemulsification with sclerocorneal tunnel incision .Duration of surgery was measured; implicit time and amplitudes of the b-waves of the photopic electroretinogram [ERG] potentials [single-flash ERG and the 30-Hz flicker ERG] were recorded; frequencies of intraoperative problems, complications, intraoperative, and postoperative pain were evaluated. Surgeon assessments of operative conditions and patient cooperation were recorded. The attending anesthesiologist recorded any increase in pulse or increase in blood pressure. After lidocaine anesthesia combined with topical anesthesia, similar complications were found, longer operation time [p < 0.001], and significantly better visual acuity immediately after surgery [p < 0.001]. The ERG amplitudes were not significantly reduced after 0.2 ml intracameral lidocaine half an hour after surgery [p > 0.05]. The surgeon assessment showed more patient cooperation in the peribulbar group [p = 0.012]. No patient in either group was rated as poorly cooperative. Intracameral lidocaine 1% combined with topical anesthesia can be recommended as an alternative procedure to peribulbar anesthesia in cataract surgery especially in the following situations: in patients with high myopia, fear of syringes, or prolonged coagulation

Serum iron, ferritin and transferrin in patients with ischemic heart disease

To shed more light on the relationship between ischemic heart disease and iron, serum iron parameters [iron, ferritin and transferring] were estimated in fifty ischemic heart patients [15 stable angina-15 crescendo angina and 20 acute Myocardial Infarction. MI]. Their ages ranged 43-58 years- Ten healthy subjects, matched with patients for age and sex, sevred as control group. Echocardiographic studies [ejection fraction [EF] and end systolic volume [ESV] together with peak serum creatine phosphokinase [CPK] were done for each case of infarction to correlate these variables with the corresponding serum iron parameters. compared to controls, ischemic heart patients had highly significant increase of serum iron [103.5 +/- 25.6 vs 79.6 +/- 19.2, p<0.01] and serum ferritin [94.7 +/- 54.2 vs 44.4 +/- 11.0. p<0.01] whereas they showed insignificant increase of serum transferrin [273.8 +/- 83.8 vs 244.1 +/- 56.4, p<0.05]]. Subgroup analysis showed that there was statistically significant increase in serum iron and ferritin but not transferrin in patients with stable and unstable angina while in cases with acute MI, there was significant increase in all serum iron parameters. correlation studies showed that serum iron and ferritin but not transferrin were strongly correlated with peak CPK. EF and ESV. Patients with acute MI who had complicated in-hospital course showed significant higher value of serum iron. ferritin. transferrin, CPK and ESV but they had a significant lower EF than non-complicated cases. In conclusion, serum iron and ferritin were significantly higher in ischemic heart patients while serum transferrin was significantly higher only in patients with acute MI In the infarction group, the higher the serum iron and ferritin, the larger is the size of infarction, the worser is the in-hospital course and the more impaired is the systolic function. Thus, the present study might give a new meaning for the emerging role of iron in ischemic heart disease

Natural schistosoma mansoni infection in arvicanthis niloticus in Ismailia, Egypt

In a Survey for Zoonotic helminthic infection in rodents Schistosoma mansoni eggs were detected in the large intestin and liver of Arvicanthis niloticus