microbiology of vaginal discharge and the prevalence of bacterial vaginosis in a cohort of non-pregnant women in Kuwait

To examine the microbiology of vaginal discharge and to estimate the prevalence of bacterial vaginosis and its association with sexually transmitted infections in a cohort of non-pregnant women in Kuwait. Retrospective study conducted during a six-month period [November 2009 - April 2010]. The gynecology outpatient clinic at the South Ardyia Health Unit, Farwania, Kuwait. Retrospective evaluation of medical records of 668 women, who attended the gynecology outpatient clinic at the South Ardyia Clinic, Farwania, Kuwait complaining of vaginal discharge during the study period. Retrospective review of the files for complaints, history, clinical examination and investigations of the vaginal discharge. A retrospective microbiological study of the infective etiology of vaginal discharge, the prevalence of bacterial vaginosis and its association with sexually transmitted infections. Microbiological causes of vaginal discharge accounted for 43.4% of cases. The commonest causes were bacterial vaginosis [prevalence = 18.9%] and candida infections [prevalence = 11.8%]. There was no significant association of bacterial vaginosis and sexually transmitted infections. Bacterial vaginosis is the commonest microbiological cause of vaginal discharge. Bacterial vaginosis is not a sexually transmitted disease

Sanjad-Sakati syndrome/Kenny-Caffey syndrome type 1: a study of 21 cases in Kuwait

We studied 21 patients with Sanjad-Sakati syndrome [SSS] from 16 families. Parental consanguinity was recorded in 2 families [12.5%]. All patients had severe intrauterine growth retardation, short stature, small hands and feet, blue sclera, deep-set eyes, microcephaly, persistent hypocalcaemia and hypoparathyroidism. Medullary stenosis was detected in 2 patients. Cytogenetic and fluorescent in situ hybridization studies were normal. All affected persons had homozygous deletion of 12 bp [155-166del] in exon 3 of the TBCE gene. All of the parents were heterozygous carriers of this mutation. The high frequency of SSS and low frequency of consanguineous marriages in this study may reflect a high rate of heterozygous carriers

Soil-parasites particularly toxocara eggs in Egypt

Soil-transmitted helminths [STHs] remain a major threat to the human health throughout the world, mostly in developing nations. Soil is usually contaminated by different parasitic stages through promiscuous defecation of man particularly children. This is more liable to occur in fields, public gardens and sides of streets or canals. Also, feces of domestic and wild animals and birds play a role in soil contamination. This study was conducted at Mansoura city and Batra village and El-Minia city and Zohra village representing the urban and rural areas of Dakahlia Governorate, Lower Egypt and Minia Governorate, Upper Egypt respectively. The most common helminthic stage presents in the soil of the two Governorates was Toxocara eggs. No ova was detected in-door yards in the urban areas, but only in the sides of streets, crop fields and fruit gardens, around houses and canal banks of both Governorates, and the highest intensity was 13-19 eggs/10 gm soil at canal banks at Zohra village, El-Minia Governorate, Upper Egypt

Past and present situation of human fascioliasis in Dakahlia governorate, Egypt

Zoonotic fascioliasis is a problem not only in Dakahlia Governorate, but also in other Egyptian Governorates. This work was conducted in ten centers at Dakahlia Governorate, Egypt. Three thousand cases were randomly selected annually from each center representing five rural and five urban areas. Cases were examined for Fasciola infection by stool examination using, direct smear, formol ether sedimentation and Kato-Katz technique. Infection was higher in rural areas than urban areas. Female /male ratio was 1.5: 1. Children between five and ten years old represent the highest infected group. The prevalence of infection was more among illiterate compared to educated individuals examined. Remarkable reduction in the prevalence rate was recorded in the last year of study compared to previous years, which is a good index of excellent control measures conducted by the Egyptian governorate to overcome parasitic infections

Flow cytometric study of T-cell subsets and costimulatory molecules in clinical forms of human schistosoma mansoni chronic infection

Helminthic parasites cause widespread, persistent infections in humans. Schistosomiasis mansoni infected patients being in a chronic immune-activation state enabled us to investigate the effects of such immune activation on immune responses. We performed by flow cytometry aphenotypic analysis of peripheral blood T lymphocytes from 64 Schistosoma mansoni infected patients, in different clinical forms of the chronic disease. The main findings in the patient group in comparison with the non-infected controls were: [i] decreased CD3, CD4 and CD8 lymphocyte counts; [ii] elevated levels of activated T cells [CD4 expressing HLA-DR]; [iii] decreased numbers of CD28+ CD8+ lymphocytes. These findings support the notion that chronic helminthic infections cause persistent immune activation that result in hyporesponsiveness and anergy. Such impaired immune functions may diminish the capacity of these individuals to cope with infections and to generate cellular protective immunity after vaccination

Helminthes of synanthropic rodents [rodentia: muridae] from Dakahlia and Menoufia, Egypt

A cross-sectional survey was conducted to monitor and compare the prevalence of helminthes in rodents from Dakahlia and Menoufia governorates. The domestic rodents [271] were Rattus norvegicus, Rattus rattus frugivorous, Rattus r. alexandrinus, and Mus musculus. The overall prevalence of helminthes was 52.8%. In Dakahlia, 72/145 rats [49.6%] were infected. The highest prevalence of infection was in R. r. frugivorous 43 [60.4%], then R. r. alexandrinus 44 [47.7%], R. norvegicus 38 [44.7%], and the lowest was M. musculus 20 [40%]. In Menoufia, 71/126 rats [56.3%] were infected. The highest prevalence of infection was in R, r. frugivorous 36 [77.7%], then M. musculus 27 [48.1%], R. norvegicus 23 [47.8%], and the lowest was in R. r. alexandrinus 40 [47.5%]. A total of 24 species of helminthes [11 trem-atodes, 4 cestodes and 10 nematodes] were identified among the 271 rodents. The commonest trematode was Mesostephanus aegypticus followed by Stictodora tridactyla. The commonest cestode was Hym-enolepis diminuta followed by Taenia taeniaformis. The commonest nematode was Capillaria hepatica followed by Trichurus muris. Given the zoonotic potential of rodents' parasites and since several residential, commercial, and agricultural sites exist in the examined geographic areas, the potential health risk should not be ignored

Biochemical parameters in chronic fascioliasis

Serum lipids, liver enzymes and total bile acids were measured in chronic Fasciola [cholestatic and non-cholestatic] patients. Variations in the biochemical parameters between infected and control groups were detected and typified by considerably higher serum triglycerides [TG, P < 0.001], alkaline phosphatase [ALP, P < 0.001] and total bile acids [TBA, P < 0.001] in the infected group. For cholestatic patients, TG, very low density lipoprotein [VLDL], aspartate aminotransferase [AST], alanine aminotransferase [ALT], gammaglutamyl transferase [GGT] and ALP were statistically higher [P < 0.001 for each comparison] and total cholesterol [TC]; low density lipoprotein[LDL] and high density lipoprotein [HDL], were statistically lower than non-cholestatic patients [P = 0.02, < 0.001, < 0.001 respectively]. No statistically significant differences were found for the TC, HDL, VLDL, ALT, AST and GGT between non-cholestatic patients and healthy controls

Diagnostic criteria for house dust mites sensitized allergic patients

House dust mites [HDM] contain a large number of components that react with IgE in individuals with allergies and induced sensi-tization and allergic diseases. The work aimed to correlate between clinical manifestations of HDM allergic patients and skin prick test [SPT] grading, and to clarify some markers denoting allergic disorders caused by HDM exposure. Thirty allergic patients with positive SPT reaction to HDM were selected, grading of disease severity according to SPT and clinical presentations. The results revealed bronchial asthma [40%], atopic dermatitis [26.7%], rhinitis 20%] and conjunctivitis [13.3%]. Serum ALISA-IgE showed mean level of 398.42 +/- 84.73, 369.87 +/- 86, 332.16 +/- 65.57 and 300.25 +/- 79.39 IU/ml respectively, with highly statistically significant difference between cases and controls [p

Human heart-type fatty acid-binding protein as an early diagnostic marker of doxorubicin cardiac toxicity

Progressive cardiotoxicity following treatment with doxorubicin-based chemotherapy in patients with non-Hodgkin lymphoma [NHL] may lead to late onset cardiomyopathy. So, early prediction of toxicity can lead to prevention of heart failure in these patients. The aim of this work was to investigate the role of H-FABP as an early diagnostic marker of anthracycline-induced cardiac toxicity together with brain natriuretic peptide [BNP] as an indication of ventricular dysfunction in such patients. Our study was conducted on 40 NHL patients who received 6 cycles of a doxorubicin-containing chemotherapy protocol [CHOP], not exceeding the total allowed dose of doxorubicin [500mg/m2].Ten healthy controls were included in our study. Human heart-type fatty acid binding protein [H-FABP] was assessed 24 hours after the first cycle of CHOP. Plasma levels of BNP were estimated both before starting chemotherapy and after the last cycle of CHOP. Resting echocardiography was also performed before and at the end of chemotherapy cycles. The ejection fraction [EF] of eight of our patients decreased below 50% at the end of the sixth cycle. Elevated levels of both H-FABP and BNP were found in all patients with EF below 50% and both markers showed a positive correlation with each other. We concluded that H-FABP may serve as a reliable early marker for prediction of cardiomyopathy induced by doxorubicin. Thus, in patients with elevated H-FABP, alternative treatment modalities with no cardiac toxicity may be considered in order to prevent subsequent heart failure in these patients

Hormonal profile as a prognostic index for patients with 1[st] trimesteric threatened abortion

Evidence in the literature is unclear to the exact predictive value of biochemical markers in determining the persistence of threatened abortions. Twenty pregnant women in the 1[st] trimesters, with demonstrable fetal heart pulsations that complained of symptoms, and showed signs of threatened abortion, were included in this prospective, controlled, clinical study. This cohort was divided according to whether or not the pregnancy continued into two groups: Group A1 [N=15] that included patients that had an ongoing pregnancy and Group A2 [N=5] that included patients that had an ineirtabl abortion. A control group of twenty randomly chosen healthy women was used as a control group [Group B]. On the day of inclusion, venous blood samples were taken in order to estimate serum CA-125, hCG, progesterone and estradiol levels, Participants were followed up clinically till the gestational age of 14 weeks to distinguish those who had an ongoing pregnancy compared to those who eventually aborted. Of the twenty patients with threatened abortion fifteen aborted and five continued to fourteen weeks gestation. CA-125 levels were higher, and BHCG, progesterone, and E2 levels were lower, in Group A1 when compared to Group A2 and Group B. Maternal serum CA-125, BHCG, progesterone and estrogen may be of value in predicting patients that will gain from expectant management of threatened abortion

Present situation of house dust mites in Dakahlia governorate, Egypt

House dust mites are common inhalant allergens, which can precipitate atopic disease episodes. The present study revealed presence of four mites. These are Dermatophagoides farinae, D. pteronyssinus, Acheles gracilis and Ornithonyssus bacoti. Population densities of different live adult mites were investigated in different house habitats. In urban houses, pyroglyphid mites were the predominant in bedrooms and D. farinae was the most abundant. A. gracilis was more abundant in living rooms followed by D. farinae then D. pteronyssinus. A. gracilis was the most prevalent in kitchens. While in rural houses, O. bacoti was the most abundant species followed by pyroglyphid mites. Since Dermatophagoides species and A. gracilis were present in numbers high enough to allow their ecological consideration, their seasonal abundance in urban bed-rooms was investigated and revealed that both D. farinae and D. pteronyssinus have two peaks of abundance, one slightly higher in spring and the second in autumn. A. gracilis has two peaks but the higher occurred in autumn and the second in spring

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

Some molecular aspects in schistosomiasis mansoni and toxoplasmosis

The IL-2 and IL-4 cytokines production represent cellular Th1 and Th2 immune responses respectively were associated with chronic schistosomiasis mansoni [stages 1-4] and chronic toxoplasmosis gondii. In the hepatosplenic schistosomiasis, the level of IL-2 and disease stage increased in parallel [P< 0.05, <0.01, <0.01 and <0.001 in stages 1, 2, 3 and 4 respectively], whereas, IL- 4 was highly significantly increased in stage 1 than control [P < 0.001], then decreased to lower levels. The mean concentrations of IL-2 and IL-4 in patients with T. gondii were higher compared to control being more marked in Th-2 [P < 0.001] versus IL-4 [P < 0.01]. The data indicated that there are patterns of cytokine expression characteristic of type 1 and type 2 responses in vivo, with the ultimate goal of being able to manipulate the response to minimize inflammation and fibrosis for clinical benefit

Geoparasites in rural Dakahlia Governorate, apreliminary based study for development of the community-based intervention programs

A prospective study was carried out to detect the rural prevalence and intensity of geoparasites in Dakahlia Governorate, Egypt. A total of 1070 soil samples were collected; 571 [53.4%] were infected with one or more parasites. Only 24% of samples were infected with one parasite, 16.4% and 13% with two, and more than two parasites respectively, and the difference was statistically significant. The geoparasites in a descending order of their prevalence were: E. histolytica cysts [9.2%], Toxocara eggs [9.1%], Giardia cysts [7.9%], Cryptosporidium oocysts [6.1%], Trichostrongvius eggs and larvae [5.6%], isospora oocysts [4.3%], Acanthamoeba cysts [4.1%], Naegleria cysts [3.6%], Dust mites [2.7%], H. diminuta eggs [2.7%], Strongyloides free living adults, rhabditiform and filariform larvae [2.3%], H. nana eggs [1.7%], S. mansoni eggs [1.2%], Ascaris eggs [0.6%], Ancylostoma larvae [0.5%], Taenia eggs [0.4%], Trichocephalus eggs [0.4%] and F. gigantica eggs [0.2%]. The prevalence of parasitic infections was significantly higher [P < 0.001] in fields [63.4%] than streets [47.7%] and indoor-yards samples [35.3%]. The intensity of infections was significantly higher [p< 0.001] in streets than fields and indoor-yards [18.1, 9.7 and 1 parasite / 10gm of soil respectively]

Fragile X syndrome: a clinico-genetic study of mentally retarded patients in Kuwait

In a prospective study in Kuwait, 182 mentally retarded male patients who fulfilled 5 or more clinical criteria of fragile X syndrome were screened using polymerase chain reaction [PCR] testing. Twenty patients [11%] were highly suspected of having fragile X syndrome due to mutation at the FRAXA locus; none had mutation at the FRAXE locus. Of these, 11 [55%] were confirmed fragile-X-positive by both cytogenetic and PCR techniques. The most frequent clinical features were: prominent forehead, high arched palate, hyperextensible joints, long ears, prominent jaw, height > 10th centile and attention-deficit hyperactivity. Less common were avoidance of eye contact [45%], autism [45%] and seizures [30%]. Large testes were found in 55% of cases. Pre-pubertal and post-pubertal clinical criteria were different

Glycemic control among diabeti patients

This study was carried out to assess control of blood glucose among diabetic patients attending Primary Health Care Centers in Riyadh. It is a retrospective study where fasting blood glucose reading for all diabetic patients attending 3 randomly selected Primary Health Care Centers in Riyadh was taken during the months of March and April 2000. The patients were divided into 3 categories: those with excellent, those with acceptable and those with poor glycemic control [Fasting blood sugar 4-7, 7-10 and more than 10 mmol/litres]. A total of 991 diabetic patients were involved in the study [83% men and 62% women]. Those with excellent glycemic control represent 21% of patients in the first reading and 25% of the patients in the second readings, while those with poor control represent 49% and 44% of the patients in the two readings. The remaining are in the acceptable category. Diabetes mellitus is poorly controlled in a large proportion of diabetic patients attending Primary Health Care Centers in Riyadh. Public education and awareness programs should be encouraged. Such programs must include the importance of appropriate life style changes and of self monitoring of blood glucose at home

Umbilical artery velocimetry and conventional sonographic biometry in fetal evaluation of hypertensive pregnant patients

Umbilical artery Doppler velocimetry and conventional ultrasonographic biometry were evaluated as parameters for fetal evaluation in 20 primigravida hypertensive patients and 20 matching normotensives. Doppler parameters were the S/D ratio and the Pourcelot index. Conventional sonographic parameters were the amniotic fluid index, the umbilical cord diameter and placental thickness. The fetal outcome was judged by the fetal weight. In normotensive pregnancy, the fetal weight correlated with conventional sonographic biometry, while in hypertensive pregnancy, it correlated only with Doppler umbilical artery velocimetry