effective method for hip arthrodesis

Twenty young patients [mean age 19 years] underwent hip arthrodesis for severe unilateral disabling hip disease resulting primarily from tuberculosis with fibrous union in eight cases, pyogenic infection in six, fracture dislocation of the hip in three, slipped capital epiphysis with chondrolysis in two and congenital coxa vara in one case. Arthrodesis was completed in a position of 25 to 30C flexion, 0 to 7C adduction and 0 to 5C external rotation. To avoid the need for external fixation, an intramedullary nail fixation from the ilium to the upper end of the femur was used supplemented by a muscle pedicle iliac bone graft. The iliac bone graft not only improved hip fusion but also facilitated the insertion of a straight intramedullary nail. The mean follow up time was 4.1 years. All patients had a radiographic evidence of union by two months except one patient who had a delayed union because of the failure to use the proper intramedullary nail. Five patients complained of symptomatic low back pain and one patient complained of pain in the region of iliac crest because of a slightly protruded intramedullary nail

Octreotide infusion plus emergency sclerotherapy versus sclerotherapy alone for the control of bleeding oesophageal varices: a prospective randomized clinical trial

In a prospective trial, 189 patients with acute variceal bleeding were underwent emergency sclerotherapy of them, 93 patients were randomly assigned to receive a continuous infusion of octreotide [25 microgram per hour] for 5 days [group II]. The rest of patients [96 patients] treated with only sclerotherapy [group I]. After 7 days of follow up, the proportion of patients who had survived without re-bleeding was higher in group II patients who treated with both urgently sclerotherapy and octreotide [89 of 93 patients or 95.7%] than in patients treated with emergency sclerotherapy alone [group I]. The mean number of units of blood transfused was lower in group II than in group I. Also, bleeding was controlled rapidly in group II [2.26 +/- 0.8 days] versus group II [2.84 +/- 0.84 days]

Neonatal treatment of congenital idiopathic clubfoot: a two stages method of surgical treatment

Two basic stages of surgical management for idiopathic talipes equinovarus [TEV] were described. In the first stage, all components of the club foot deformity was early corrected in 50 feet. The deformed feet were corrected initially by manipulation and serial plaster casts at weekly intervals for six weeks. The operative release of tight soft tissue was indicated when the deformity was not completely resolved by this specified period of time of conservative treatment. In the second stage, the corrected foot was maintained surgically by shortening of the peronei and anterior translocation of the peroneus brevis to correct muscular imbalance of the foot and ankle. All cases were evaluated clinically and radiologically and the mean follow-up time was 3.3 years. In 88% of the cases, the corrected muscle imbalance was successful in improving and maintaining the correction. The failure was in patients who had primary weakness in the peronei and who had removed their own casts prematurely. The best results were achieved with postural deformity. The procedure of retentive treatment has the advantages of retaining the correction of all components of deformity of corrected club foot, do not disturb the normal anatomy of the foot and avoiding the complications of prolonged cast and splint retention

Surgical treatment of congenital vertical talus by posterolateral release operation

A posterolateral soft tissue release operation with reduction of sublaxation at the talonavicular and subtalar joints was done on 8 feet with congenital vertical talus in five patients at El-Minia University Hospital. The youngest patient aged one year; the oldest was 7 years, follow up period was 2.5 years on the average. Five feet were satisfactory results while 3 were unsatisfactory. The unsatisfactory results were obtained in old and arthrogrypotic patients

Surgical management of foot disorders in stroke patient

Nineteen stroke patients suffering from foot deformity were treated in El-Minia University Hospital in the period from January: 1990 to August 1992. Six patients required tendo-Achilles lengthening for equines deformities, 8 required combined split anterior tibial tendon transfer and intramuscular lengthening of posterior tibial tendon for equinovarus deformities, and 5 required long toe flexors release for toe curling deformities. The end results were excellent in 63.2 percent, good in 26.3 percent, poor in 10.5 percent. The poor results were of those who presented late and in those who had fixed severe deformity. The operation improves the walking capacity of the patients

Flexion femoral osteotomy with tightening of soft tissues in front of the hip in treatment of genu recurvatum after poliomyelitis

Twenty six poliomyelitis patients with genu recurvatum, were treated by supracondylar femoral osteotomy with anterior open wedge and bone grafting from ipsilateral iliac bone, combined with upward and posterior displacement of the muscles attached to the outer table of the iliac bone. The average age was 14.6 years. The average angle of recurvatum before operation was 39 degree. Fifteen of the patients were orthosis dependent. After a follow up period of at least 2 years, 88.4% had regained significant improvement in appearance, walking ability, and orthosis discarded

Treatment of kienboeck's disease by radial shortening

8 patients [8 wrists] who had Kienbock disease without degenerative changes in the joints were treated in the period from 1989 to 1992 in El-Minia University Hospital by radial shortening. Small DCP 6 holes was used in all cases through anterior approach of the lower third of radius. The segment of the bone removed was equal to the amount of negative ulnar varience that was measured radiologically pre-operatively. Average follow up period was 9.8 months. There was marked improvement of pain in all cases Range of movement of the wrist was improved in all directions and in all cases. Radiologcal improvement was reported in 2 cases by decreased sclerosis, increased trabecular pattern and increased size of the lunate

Treatment of persistent plantar heel pain by calcaneal osteotomy

Twenty-five patients with 28 feet suffering from persistent plantar heel pain [plantar fasciitis calcaneal spur syndrome], with average age of 39.5 years, were treated by calcaneal osteotomy, and approached the medial side of the heel. The late results, after a follow up period of 2 years in average, were satisfactory in 25 feet [89.3%] and unsatisfactory in 3 feet [10.7%]

Field studies on anopheline mosquito larvae in Egypt [diptera: culicidae]

The association of Anopheline larvae with other mosquito species in the same breeding place was investigated in the Nile Delta, Canal Zone and Siwa Oasis. 1] Anopheles [An.] algeriensis, Theobald: This species was only reported during the present study from Siwa Oasis [one time]. It was found breeding in a small drain near Ain Quareishit together with the following mosquito larvae: An. sergentii, Theo. An. multicolor, Camb., C. pusillus Macq.and Ae. caspius, Pall. 2] Anopheles [An.] coustani var. tenebrosus. Nile Delta: 1. Anopheles [An.] tenebrosus was encountered 445 times in the different breeding places. It was found 115 times alone [25.3% of the total frequency]. 2. It was found associated with six other larval species, of which one was an anopheline and 5 were culicines. 3. The associated mosquito species as arranged in order of frequency are: C. antennatus, Becker [225 times], C. pipiens, Linne [110], An. Pharoensis, Theo. [95], Ae. caspius, Pall. [115], C. poicilipes, Theo. [10] and U. unguiculata, Edw. [5]

Geographical distribution of mosquitoes in Egypt

Entomological surveys were carried out in the Faiyum Governorate, the Nile Valley, Eastern and Westen Desert and the Red Sea during different seasons. 1] Faiyum Governorate:Twenty eight localities were surveyed. Twelve species of mosquitoes were encountered of which 4 are anophelines and 8 are culicines. Anopheles pharoensis, An. multicolor, Anopheles sergenti, Aedes caspius, Culex antennatus and Culex pipiens were the predominant mosquitoes in the surveyed areas. 2] Nile Valley: 2.1 Qena: A total of 19 localities were surveyed. Six species of mosquitoes were encountered. Culex pipiens, C.longiareolata, C. univittatus, Aedes caspius and C. antennatus were the predominant species. Anopheles tenebrosus was only encountered in one locality [Dandara temple].2.2 Aswan. A total of 18 localities were surveyed. Eight species of mosquitoes were located. C. antennatus, C. univittatus, Aedes, caspius, C. pipiens, Anopheles pharoensis, C. longiareolata, Anopheles multicolor and Culex poicilipes were encountered. 3] Eastern Desert .Suez Canal Zone [Port Said and Ismailia] Governorates. Twelve mosquito species were found, of which 3 are anophelines and 9 are culicines. Anopheles pharoensis and Anopheles coustani var. tenebrosus were the predominant anophelines. While Culex antennatus was the predominant culicine in most of the areas surveyed. 4] Western Desert 4.1 Siwa Oasis .Six areas were surveyed in which 10 mosquito species were encountered. Three anophelines and seven culicines were located. Anopheles sergenti was the predominant anopheline in all the surveyed areas. Aedes caspius was the predominant culicine in the surveyed localities. 4.2 Bahariya Oasis. Four areas were surveyed in which 9 mosquito species were encountered of which 3 were anophelines and 6 were culicines. Anopheles sergenti and An. superpictus were the predominant anophelines. Culex pipiens and C. tritaeniorhyanchus were the predominant culicines. 4.3 New Valley. Both Kharga, Dakhla and Farafra oasis were surveyed. A total of 24 localities were surveyed. Twelve mosquito species were encountered in the different localities surveyed of which 4 are anophelines and eight are culicines. Anopheles sergenti was the predominant anopheline in the surveyed areas. Anopheles pharoensis was encountered but to a lesser extent regarding its prevalence and distribution. C. univittatus, Aedes caspius and Culex theileri were the predominant culicines. 5] Red Sea. A total of 4 localities were surveyed. Aedes caspius and Anopheles Stephensi were the only mosquitoes recorded

Laboratory breeding of anopheles pharoensis and anopheles coustani var tenebrous

Anopheles pharoensis and An. coustani: Breeding of the aquatic stages of both species: Breeding of different aquatic stages of An. pharoensis was successfully carried out at a temperature of 29 +/- 2°C. However, breeding of different aquatic stages of An. coustani was successfully carried out at a temperature of 25 +/- 2°C in an indoor insectary. Breeding and maintaining of the adult stage of both species: Successful breeding and maintaining of the adult stage of An. phareonsis was obtained in an indoor insectary at a temperature of 27 +/- 2°C and relative humidity of 80 +/- 5%. However, successful breeding and maintaining of the adult state of An. coustani was obtained in an indoor insectary at a temperature of 25 +/- 2°C and relative humidity of 80 +/- 5%.Biological activities of the aquatic stages of both species: Life span of the aquatic stages: The incubation period of An. pharoensis eggs ranged between 2.28 and 3.78 days with an average of 2.881 +/- 0.075 days. Duration of the 1st, 2nd and 4th larval instars were more or less the same and not significantly different. Duration of the 3rd instar was the shortest. The average total duration of the larval stage was 8.853 +/- 0.73 days. Duration of the pupal stage lasts for a period of 1.1 +/- 0.26 days. The average duration of the aquatic stages i. e. from egg laying until adult emergence was 12.834 +/- 0.831 days. The average incubation period of An. coustani eggs was 2.205 +/- 0.033 days. Duration of the 1st larval instar was the longest and lasts for a period of 5.319 +/- 0.145 days followed by the 2nd larval instar that lasts for a period of 3.378 +/- 0.085 days, while the duration of the 3rd and 4th larval instars were more or less the same and not significantly different. The average total duration of the larval state was 13.003 +/- 0.372 days. Duration of the pupal stage lasts for a period of 1.79 +/- 0.098 days. The average duration of the aquatic stage, i. e. from egg laying until the adult emergence was 16.998 +/- 0.503 days. Percent of natural mortality of the aquatic stages: Both An. pharoensis and An. coustani showed a comparatively higher percent of mortality during the 1st larval instar [about 13% of both species] than the other instars. The average percent mortality of the whole larval stage was 19.969% for An. pharoensis and 21.16 +/- 15.56% for An, coustani. The average percent mortality that occured during the pupal stage was 1.72% for An. coustani. The average percent mortality of the whole aquatic state i. e. from egg hatching until adult emergence was 21.709% for An. pharoensis and 26.779% for An. coustani. Biological activities of the adult stage: Sex ratio: The average percent of males to females of An. pharoensis and An. coustani was 1:1. Number and duration of gonotrophic cycle: 1] An. pharonsis females passed 3 to 9 gonotrophic cycles while An. coustani passed 2-6 gonotrophic cycles. 2] Duration of 1st gonotrophic cycle of An. pharoensis female was [6.46 +/- 3.023 days]; significantly longer than the duration of the rest of the gonotrophic cycle which ranged between 1.8 - 4.67 days, 3] Duration of each gonotrophic cycle An. coustani female ranged between 3-4, 4 days, with an average of 4.016 days. fecundity of Females: 1] After the first blood meal, An. pharoensis female laid 142.8 +/- 8.927 eggs while An. coustani female laid 237.86 +/- 42.14 eggs. 2] During the whole life span, An. pharoensis female laid 604.969 eggs; while An. coustani female laid 682.861 eggs

Anophelene and culicine mosquito species and their abundance in Egypt

Extensive Entomological surveys were conduced in various villages of different governorates in Egypt. Kafr El-Sheikh Governorate: Nine species of mosquitoes were encountered, of which 3 are anophelines and 6 are culicines. An. pharoensis was the predominant mosquito in the surveyed areas. Damietta Governorate: Seven mosquito species were encountered of which two are anophelines and 5 are culicines. Anopheles coustani and Anopheles pharoensis were the predominant anophelines. Daqahliya Governorate: Seven mosquito species were encountered of which two are anophelines and five culicines. Anopheles coustani, An. Pharoensis, Culex antennatus and C. pipiens were the predominant mosquitoes. Sharqiya Governorate: Ten species of mosquitoes were encountered, of which two are anophelines and nine are culicines. Anopheles pharoensis, An tenebrous, Culex antennatus and Culex pipiens. Baharia Governorate: Seven mosquito species were encountered of which two are anophelines and 5 culicines. Anopheles coustani, Anopheles pharoensis and C. antennatus were the predominant mosquitoes. Gharbiya Governorate: Seven mosquito species were encountered of which two are anophelines and 5 culicines Anopheles tenebrosus, An. pharoensis and C. pipiens were the predominant mosquitoes. Minuifya Governorate: Seven mosquito species were encountered of which two are anophelines and 5 culicines. Anopheles coustani, An. pharoensis, Culex antennatus and Culex poicilipes were the predominant mosquitoes. Qalyubia Governorate: Six mosquito species were encountered of which 2 are anophelines and 4 culicines An. coustani, An. pharoensis and Culex antennatus were the predominant mosquitoes. Densities of mosquitoes were recorded in all areas surveyed. It can be concluded that from the extensive surveys conducted in the previously mentioned governorates. Anopheles pharoensis, Anopheles coustani, Culex pipiens and Culex antennatus are the predominant mosquitoes

Seasonal prevalence of anopheline mosquito larvae in some Governorates of Egypt

The seasonal prevalence of Anopheline mosquito larvae was studied in several governorates of Egypt. The results of the present investigations indicated that: 1].The values of the larval density of Anopheles pharoensis and Anopheles constant significantly fluctuated throughout the different seasons in the following governorates: Kafr El-Sheikh, Damietta, Sharqiya, Canal Zone and Faiyum. However, they decreased from January to April and they were less abundant during February and March. 2] The seasonal larval density of both Anopheles pharoensis and Anopheles constant were significantly influenced with the temperature of the breeding water. 3] The cultivated vegetation of the breeding sites in the localities studied affected the fluctuations of the larval density of Anopheles pharoensis and Anopheles coustani. Anopheles pharoensis larvae were more abundant in rice fields. They disappeared in the absence of rice fields, while larvae of Anopheles constant were abundant in breeding places where short dispersed floating water lents and grass were encroached

Susceptibility status of mosquitoes in Egypt in commonly used insecticides

The present study investigated the susceptibility levels of mosquito population [Anopheles and Culex] to different insecticides in Ismailiya Governorate. The results of these tests carried out on An. coustani population [larvae and adults] indicated that no severe selection occured among the population at Abu Adrub area. The population was still susceptible to malathion, fenitrothion, temefos, chlorpyrifos and propoxur, but resistant to DDT and dieldrin insecticides. Larvae and adults of Culex antennatus in Abu Adrub, as well as, Culex sp. larvae at Kantara - West showed physiological resistance to all insecticides tested except temefos and propoxur

Bionomics of anopheline mosquitoes in the Faiyoum Governorate, Egypt, in relation to transmission and control of malaria

The biology and ecology of the two main malaria vectors, Anopheles pharoensis and Anopheles multicolor, were studied for two successive seasons [1975 -1976] in the Faiyoum Governorate. The different techniques employed in sampling the biting populations of these anophelines included: Monks wood light traps; bed-net traps, human and animal baits. Results of this study indicated: Anopheles pharoensis Theob. [1] Field investigations 1. This anopheline is present in different localities of the Faiyoum Govemorate, especially in Senouris, 9 km to the north east of Faiyoum City. 2. Its breeding water in Senouris, had a pH value that ranged from 7.35 - 7.80 [1600 samples examined]. Its salinity ranged from 0.33 - 0.74 gm NaCl / litre [1600 samples examined]. 3. Adult females of this species are zoophilic rather than anthropophilic, exophagic and exophilic. 4. Out of 287 dissected specimens collected from Mensheit Haifa during the month of September 1975; one salivary gland infection was recorded. Two positive stomach infections in Senouris out of 590 specimens dissected during the month of August 1976. 5. Monks wood light traps proved very unsuccessful in collecting adults of this mosquito. 6. The highest biting activity of females of this species was encountered at El-Nazlah and Mensheit Haifa during October; and during August-September in Senouris. 7. Two biting peaks were evident from sunset to sunrise [i] two hours after sunset and [ii] two hours before sunrise, [iii] midnight, [during some night observations]. [2] Breeding in the laboratory Breeding of the different developmental stages of An. pharoensis was carried out successfully at a temperature of 27 +/- : 0.5°C and a relative humidity of 85 +/- 5% in a thermostatically controlled walk-in incubator with adjustable temperature, humidity and light. Anopheles multicolor Camb[1] Field investigations 1. This mosquito was found in various localities of the Faiyoum Governorate, especially in the Valley of El-Nazleh. 2. Its larval breeding waters in El-Nazlah had a pH value that ranged from 7.41 - 7.86; its salinty ranged from 11.15 - 23.56 gm NaCI / litre. However, its larval breeding waters in Mensheit Haifa had a pH value that ranged from 7.26 - 8.07 [1600 samples examined]; while its salinity ranged from 2.82 - 27.64 gm NaCl / litre [1600 samples examined]. 3. Adult females of this species are zoophilic rather than anthropophilic; exophagic and exophilic. 4. No salivary gland or stomach infections were found in all dissected specimens [35 dissected]. 5. Monks wood light traps proved very unsuccessful in sampling adults of this mosquito. 6. The highest biting activity of this species in both El-Nazlah and Mensheit Haifa was during September-October. 7. Females of this species had two evident peaks of biting at night: [i] at sunset and [ii] midnight