Sclerosing Encapsulating Peritonitis (SEP) Due To Mycobacterium Bovis

Sclerosing Encapsulating Peritonitis (SEP), a visceral encapsulation syndrome of inflammatory origin either primary or secondary based on causation, is an infrequent cause of mechanical bowel obstruction that may commonly be seen in young patients. Preoperative diagnosis is quite challenging and usually missed due to the non-specific nature of the clinical picture. In most of the cases, a definitive diagnosis is reached intra and postoperatively with histopathological and culture findings. Herein, we report a young male patient that presented to our emergency department with signs and symptoms suggestive of intestinal obstruction. Intraoperatively, a thin membrane encasing the small bowels with transmesenteric herniation noted with a clinical diagnosis of SEP as the primary cause of obstruction. Postoperatively, a definitive cause was identified by histopathological findings and specimen culture. The report of this case, as one of the few male patients with this entity in the published literature, highlights the notion that surgeons should be vigilant to keep in mind this extremely rare cause while managing a patient with intestinal obstruction

Genetic Variability of Antigen B among Echinococcus granulosus Egyptian Isolates

Genetic polymorphisms of encoding antigen B2 gene (AgB2) in Echinococcus granulosus were studied using PCR-RFLP and DNA sequencing among 20 Egyptian isolates. Five isolates from different host origins (humans, camels, pigs, and sheep) were collected and used. All examined isolates of each host group gave very similar patterns of PCR-RFLP after restriction enzyme digestion with AluI, with the gene size of approximately 140 bp and 240 bp for sheep and human isolates, and approximately 150 bp and 250 bp for pig and camel isolates. No digestion pattern was obtained after incubation of all studied isolates with EcoRI. These results reveal high intra-group homogeneity. DNA sequence analysis highlighted that human infecting strain showed 100% identity with respect to sheep infecting isolate, 96% and 99% with pig and camel infecting isolates, respectively.

Structural alterations of the glomerular wall and vessels in early stages of diabetes mellitus.[Light and transmission electron microscopic study]

The capillary changes at the initial stage of diabetes may show an angioarchitecture clearly different from those of later stages and/or very severe glomerular change. However, the onset of alterations in the early phases is unclear. This study attempts to determine the structural alterations of the glomerular wall and vessels in the early stage of diabetes. Twenty-five adult rats were used in this study. They were divided into two groups: the first group of five was used as a control .The second group of 20 [the experimental group] was injected intraperitoneally by a single dose of streptozotocin to induce hyperglycemia. Rats were sacrificed after ten days, two months, and four months. Five rats at two months of age with hyperglycemia were treated with insulin for eight weeks. Renal tissues were prepared by routine technique for light and transmission electron microscopic evaluation. By light microscopy after ten days of induced hyperglycemia, there were no structural modifications detected either in renal glomerular fine vessels or in the glomerular basement membrane of the glomerular capillaries. After two months, there was a moderate glomerular enlargement and dilatation of glomerular capillaries, afferent, and efferent arterioles. After four months, glomerular basement membrane thickening was the only structural alteration observed. Recovery of the glomerular alterations was observed after two months of treatment with insulin. In early stages of diabetes mellitus in rats, there was an increase in the diameter of glomerular vessels. In later stages of the disease, the reverse was seen, but insulin treatment had a positive role in reversing these changes in the study subjects

Effect of sodium chloride and milk preacidification on serum phase and chemical composition of soft white pickled cheese

The objective of the present work was to study the effect of milk salting and preacidification with citric or acetic acid on residual coagulant activity, expressible serum and chemical composition of soft white cheese. Also, to produce soft white cheese from unsalted milk with characteristics comparable to those of cheese made from salted milk. The results showed that cheese made from salted milk contained the lowest activity of residual coagulant, while cheese made from milk preacidified with citric acid contained the highest activity. Cheese moisture and soluble proteins in expressible serum were lower in cheese made from unsalted milk than in that made from salted milk. The expressible serum decreased during pickling in all treatments. Preacidification with citric acid to pH6 increased the moisture content in cheese and reduced the amount of expressible serum. Reverse-Phase High Performance Liquid Chromatography [RP-HPLC] analysis showed that the peptides in the expressible serum from salted milk-cheese were present at higher relative concentrations than in that from the unsalted milk-cheese. The late-eluting peptides of 90 days old cheese were higher in preacidified milk-cheese compared to that innonepreacidified milk-cheese

Ripened curd cheese slurries in the manufacture of processed cheese

The effects of Ras curd slurries in the manufacture of processed cheese on chemical, rheological and organoleptic properties were studied. Curd slurries were incorporated to provide flavor of aged cheese. Seven Ras curds lurries were prepared using lactic acid bacteria isolated from Egyptian dairy products. The pH, fat and protein contents were not affected by replacing aged cheese with curd slurries. The moisture content was found to be playing a major role in textural properties of processed cheeses. Consistency was found to be related to hardness. Sensory scores for texture and flavor of blending of young Ras cheese and cheese slurries prepared using Lb. salivarius 194 KC, Lc. lactis subsp. lactis 608N and Lb. salivarius 194KC and Lc. lactis subsp. lactis 64 RM were higher than those of the blending of aged/young Ras cheese. Cheese slurries could offer some advantages for processed cheese industries in Egypt; low production costs, improving the consistency, diverse flavor range, extended shelf-life, low storage costs and improved functionality

Comparative investigation of the immune response in swiss mice and guinea pigs to brucella vaccine strain 19

Evaluation of Brucella vaccine strain 19 in Swiss mice as an available and economic model in comparison with guinea pigs was done. The results revealed that a good protective antibodies in the sera of vaccinated guinea pigs and Swiss mice, and the level of antibodies still persisted for prolonged period in both animals

Thymoquinone reduces hepatic ischemia-reperfusion injury in rats

During liver surgery and liver transplantaion, ischemia-reperfusion [I/R] is an unavoidable and major unresolved problem. Therefore, various pharmacologic approaches to prevent hepatic I/R injury are currently under trial. In this study, thymoquinone [TQ], the active constituent of Nigella sativa seeds which has an antioxidant activity was investigated. Rats were classified into three groups. Group 1 served as control group [Sham operated]. In the 2[nd] and 3[rd] groups, the hepatic artery and portal vein were occluded. Rats in the 3[rd] group received TQ [50 mg/kg dissolved in corn oil orally] half an hour before occlusion. Asparatate aminotranferase [AST] and alanine aminotransferase [ALT] activities were measured in serum of blood samples taken from the canulataed carotid artery. Lipid peroxides content, superoxide dismutase [SOD] and DT-diaphorase activities were measured in liver homogenate. Pathological changes were assessed using hematoxylin and eosin [H and E] and periodic acid-Schiff [PAS] stains. There was marked elevation in the activities of serum AST and ALT in the non treated group compared to the control group, while in the treated group, there was significant decrease compared to the non-treated group. Also, in liver homogenate,;lipid peroxides content was significantly elevated in the non treated group [group 2] compared to the control group [group 1], while in the treated group [group 3], lipid peroxides content decreased significantly compared to the non-treated group [group 2]. SOD and DT-diaphorase were TQ treated group [3], there were significant increase compared to non-treated group [2]. The histopathological results showed dilation and hemorrhage in central vein and reduction in reaction of mucopolysachride in hepatocytes in non-treated group. These pathological changes significantly improved in TQ treated group [group 3]. The results suggest that thymoquinone is a beneficial protective agent against ischemia-reperfusion induced hepatic injury, an action that might be mediated through its antioxidant effect

gastroprotctive effect of transdermal nitroglycerin and its underlying mechanisms in ethanol induced gastric ulcer in rat

Nitric oxide donors proved to have gastroprotective effect experimentally but the clinical applicability of this effect is limited by pharmaceutical nature of these drugs. Transdermal nitroglycerine adhesive patches [TNAP] is a safe clinically used preparation provide a continuous administration of NO with constant rate the aim of this study is to evaluate the effect of [TNAP] on ethanol induced gastric ulcer in rats and the possible underlying mechanisms. TNAP caused significant improvement in ethanol, 90%, induce gastric ulcers in rats. This improvement is represented by significant reduction of Ulcer index [56%], volume of gastric secretion [40%], titrable acidity [67%], peptic activity [62%], mucin concentration in gastric secretion [36%] and vascular Permeability expressed as [g Evans blue/g. tissue [47.6c1] compared with rats received 1 ml/rat ethanol P.O. TNAP release 20-25 micro g/cm3/h for 2 hours [400-1000 micro g/rat as surface area of TTS-5 used in this work is 10 cm[3]] proved to have gastroprotective effect against ethanol 90% [Topical acute injury]. This gastroprotective may be mediated by reduction of acid secretion and peptic activity, reversal of ethanol induced inhibition of mucin binding protein and vascular damage

Laparoscopic repair of ventral hernia: an initial experience

With the evolution of minimally invasive surgery, it is thought that a potential is present to reduce the postoperative complications of ventral hernia repair. Theoretical advantages of laparoscopic repair include faster recovery less postoperative pain, less morbidity, and a better cosmetic result. The purpose of this study is to report the results of our initial experience with laparoscopic tensionfree repair technique using polypropylene mesh in patients with primary ventral hernia. From March 1996 to December 1998, laparoscopic ventral hernia repair was performed on 22 patients. There were 14 women and eight men. Age of patients ranged between 28 and 55 years [mean 46.4 years]. Type of hernia included ten para-umbilical and 12 incisional hernias. Body mass index of patients was ranging between 24 and 49 kg/m[2] [mean 31 +/- 9.7 Kg/m[2]] The size of the hernia defect ranged between 20 and 160 cm[2] [mean 96 cm[2]]. Polypropylene mesh was used in all cases and the mesh size was varying from 6x6 to 20x20 cm [median 12x12 cm].There were no deaths. In two patients [9%] conversion to open surgery was mandatory. Six complications [30%] were recorded among the twenty patients who completed the laparoscopic procedure. Most of them were minors and only one patient [5%] developed intraabdominal abscess and needed surgical intervention. No complications related to intestinal adhesion or fistula formation were recorded. The mean operating time was 90 minutes. It was 105 minutes in the initial 10 patients and decreased in the subsequent 10 cases to a mean of 85 minutes. The mean hospital stay was 2.5 days [range: 1-12 days]. After a mean of 15 months follow up [range 12 to 23 months], no recurrence was recorded.Laparoscopic ventral hernia repair offers advantages over the conventional open mesh repair and may decrease the hernia recurrence rate. When properly performed, the laparoscopic approach does not compromise the principles for successful mesh repair of ventral hernias.Also decreased hospital stays postoperative pain, and wound complications, are benefits of this technique.Regarding the type of mesh, good results can be obtained using polypropylene mesh

Smoking and some chronic diseases: a case-control study

a- To describe the distribution of smoking habit among the attendants of Al-Yarmok centre b- To measure the strength of association between smoking and chronic diseases such as hypertension, ischaemic heart diseases, chronic obstructive airway disease and peptic ulcer. Design: Case control study using paired sampling with individual matching. Setting and period of study: The sample of study was collected in Al-Yarmok health centre in Mosul during July 1994. Participants: The attendants of the age 20 years and more, of both sexes complaining of hypertension, ischaemic heart diseases, chronic obstructive airway disease and peptic ulcer; [1035] cases and [1035] controls were collected during the study period. Main outcome measures: A questionnaire containing age, sex, smoking habit, development of diseases during one month before the study and the presence of diseases at time of study. It was observed that 44.4% of the samples were smokers, 38% were non- smokers and 17.6% were ex-smokers. Smoking habit was increasing as the age increases. Half of the males and one third of the females in the sample were smokers. The incidence of gastric upset, influenza, backache and headache were higher among the smokers and ex-smokers compared with the non- smokers. There was a very highly statistical and a strong association between smoking and ischaemic heart disease and chronic obstructive airway disease. Peptic ulcer was statistically and strongly related to smoking. Hypertension in our study did not show any statistical or strong relationship with smoking. Smoking is associated and strongly related to ischaemic heart diseases, chronic obstructive airway disease and peptic ulcer

Evaluation of the health service performance in outpatient clinics in Zagazig University

Many illnessess now can be treated on an ambulatory base [outpatient care] due to the shortage of hospital beds and escalation in operating expenses for inpatient care. The objective of this study is to evaluate the health service performance in Outpatient Clinics in Zagazig, University Hospitals for the sake of promotion of health services in these clinics. This work was done at the Pediatric and Gynecologic Outpatient Clinics, Zagazig University Hospitals. The health care - providers [physician number 37] and a random sample of 800 consumers of both studied clinics, were included in the present study The performance of the health service was evaluated by assessment of structure, care process, and outcome of care of the studied clinics.The work conditions of the studied outpatient clinics were satisfactory in general, but that for site, area and artificial ventilation of the Gynecologic clinic were inadequate. Lavatones and booklets were not adequate in both clinics while posters were not available in Gynecologic clinic The required medical equipments were available in Pediatric [35%] and Gynecologic clinics [73.9%], while non medical ones represented 62.5% and 68.7% of the required items respectively. Drugs availability was not satisfactory [at both studied clinics] according to both providors and consumers oponion. One record was present at each clinic in which recorded data were inaccurate and incomplete. Functional analysis of physicians showed that their performance was generally satisfactory except for completing ticket data and supervising subordinates. About case management, there was deficiency in communication skills [e.g. welcoming of the patient] versus manual skills [e, g.local examination] Consumer study revealed that rural residence and lower levels of education were significantly associated with higher degree of satisfaction. But consumers of both studied clinics were generally satisfied with service offered except for waiting time at Pediatric clinic. Institution of a quality assurance program to monitor the health service performance at the outpatient clinics on a regular basis is highly recommended

Epidemiology of acute leukemia in Iraqi children

An epidemiologic study was conducted on 277 patients with acute leukemias. The study revealed that 87% had acute lympboctic leukemia [ALL] and 13% acute nonlymphoctic leukemia [ANLL]. According to FAB.- classification of cell morphology for ALL, L1 represented 67%, L2: 26%, and L3:7%. The peak age incidence was 2-6 years, with 60% boys and 40% girls. 80% were from low socio-economic class. A seasonal clustering was observed, a low incidence of Rh-blood group was enocountered in our patients. Down's syndrome represented only 1% of the total cases with ALL. 90% of the pregnant mothers With a child suffering from ALL delivered a baby of the same sex of the affected child. For ANLL 72% of them were boys. From this study, for ALL the age, sex, and different types of leukemias are similar to that abroad. The higher incidence of L2 and L3, with a majority from, low socioeconomic class and seasonal clustering are significant findings in this study, a newborn sib of the same sex of the affected child a unique observation

Diagnosis of periodic peritonitis: evaluation of metaraminol provocation test and colchicine therapeutic trial

Periodic peritonitis [PP] or familial Mediterranean fever is not uncommonly seen in the UAE and diagnosis remains one of exclusion. The positive clinical response to colchicine therapy however, is believed by many authorities to confirm the diagnosis and the metaraminol provocation test has raised much interest in the diagnosis of the disease. Ten patients with a clinical diagnosis of periodic peritonitis were tested with metaraminol infusion-nine of them had their symptoms typically reproduced after the infusion, thus reinforcing the importance of this test in establishing the diagnosis when the disease is suspected. The details of the cases and a review of the literature are presented

role of complement in trachoma

Serum levels of C[3]c and C[4] complement were measured in twenty trachomatous patients and twelve healthy individuals as a control. The level of C[3]c was significantly decreased in trachomtous patients during stage II and III of active inflammation as compared with control cases. After medical treatment the level of the C[3]c returned to normal. There was no change in the serum level of C[4] in patients with trachoma as compared to control group

Red cell deformability versus capillary diameter in diabetic foot

21 patients complaining of diabetes mellitus complicated by diabetic foot, mainly gangrene [15 subjects] and diabetic ulcer [six subjects] were selected. 25 patients served as control for RBCs deformability and five control subjects for measuring capillary diameters. A full clinical examination, urine analysis for sugar and fasting blood sugar were estimated to them. A full histopathological examination was done including measurement of capillary diameters using morphometric eye lens and ordinary light microscope. The longitudinal and transverse diameters were measured and the mean capillary diameter was calculated in five high power field in every section. RBCs deformability test was carried out and the RBCs flow time was measured. The mean capillary diameter for diabetics was significantly lower than that for controls and the red blood cell flow time was also significantly longer. There were no significant changes in capillary diameter and red cell flow time in both NIDD and IDD. The capillary diameter and RBCs deformability were inversly proportionate with the duration of the disease. Endothelial swelling as well as endothelial proliferation were noticed in 78.94%, 100% showed thickened basement membrane. So in diabetes more rigid red cells and increased viscosity at low shear rate are likely to promote stasis in the capillaries and postcapillary venules, sites where the very rarly vascular lesions in diabetes characteristically occur