Surveillance of lymphatic filariasis 5 years after stopping mass drug administration in Menoufiya governorate, Egypt

The World Health Organization recommends that before lymphatic filariasis elimination in an area can be confirmed, an additional survey should be performed at least 5 years after stopping mass drug administration. The current study aimed to determine the status of lymphatic filariasis 5 years after cessation of the mass drug administration in 3 sentinel Egyptian villages in Menoufiya Governorate. The rapid immunochromatographic card test [ICT] and a new commercial antibody detection kit [CELISA[registered sign]] were used. All 1321 primary-school children aged 6-7 years old were ICT negative but 27 children were antibody positive. All households surveyed in one village with the highest antibody prevalence were ICT negative, indicating an absence of lymphatic filariasis. The CELISA antibody kit needs more standardization and development to be useful under field conditions. We conclude that lymphatic filariasis is no longer a public health problem in these villages and other villages with similar epidemiological conditions

Conservative therapy versus intra-gastric balloon in treatment of Prader-Willi Syndrome morbid obesity

Prader-Willi Syndrome [PWS] is a complex multisystemic disorder characterized by hyperphagia, severe obesity and muscular hypotonia. So, it is essential to seek an ideal program to help in solving such a widespread problem. The purpose of this study was to investigate the effect of conservative therapy [diet and exercises] versus intra-gastric balloon in PWS patients. Ten children born with PWS from both sexes ranging in age from 8 to 15 years were assigned into two groups of equal number. Study group I received conservative therapy in the form of diet regimen [a low caloric diet] and aerobic exercises on a stationary bicycle while study group II underwent intra-gastric balloon. Evaluation procedures in the form of initial evaluation and measurement of Body mass index [BMI] and lipid profile parameters were conducted for each child of the two groups before and after 6 months of treatment. The results revealed no significant difference when comparing the pre-treatment mean values of the two study groups [I and II], while significant improvement was observed in all the measuring variables of the two groups when comparing their pre- and post-treatment mean values. Significant difference was also observed when comparing the post-treatment results of the two groups in favor of the study group I. It concluded that conservative therapy could be the first choice of treatment of PWS morbid obesity, while Bio Enterics Intra-gastric balloon [BIB] came in the second choice

Iron deficiency in Yemeni patients with sickle-cell disease

Despite the general view that patients with sickle-cell disease [SCO] have iron overload, there are reports of iron deficiency in a proportion of these patients. We studied Yemeni patients aged 1-30 years with homozygous SCD to determine their iron status using a set of 4 criteria [low serum iron, low transferrin saturation, high total iron binding capacity and low mean corpuscular volume for age]. Of the 75 patients, 44 had never been transfused while 31 patients had received blood transfusions but not during the 3-month period prior to the study. Of the patients, 10 [13.3%] met the criteria for iron deficiency, 9 of whom were from the non-transfused patients [20.5%]. The sensitivity and specificity were 40% and 98% respectively for reticulocyte count and 80% and 90% respectively for reticulocyte index. We recommend screening non-transfused SCD patients for iron deficiency

Effect of exposure to electromagnetic field on some aspects of hepatic function in rats

Exposure to electromagnetic fields [EMF] may pose health risks and cell damage in various tissues, among the most susceptible tissues to EMF exposure being the liver. It was, thus, intriguing to investigate the possible effect of whole body exposure to EMF of mobile phones on some parameters reflecting the liver function. This study was performed on 111 albino rats of both sexes. Rats were divided into 2 main groups: 4 weeks exposure group [group I] and 8 weeks exposure group [group II]. Rats in each group were further subdivided into 4 subgroups, namely; rats not exposed to EMF of mobile phone [control groups, Ic and IIc], rats exposed to EMF of mobile phone for 1 hour/day [groups I[1] and II[1]], for 2 hours/day [groups I[2] and II[2]] and for 3 hours/day [groups I[3] and II[3]]. Exposure to EMF did not result in any significant change in plasma activities of both alanine aminotransferase [ALT] and aspartate aminotransferase [AST] in all exposed rats compared with their matched control. However, there was significant prolongation of both prothrombin time [PT] and activated partial thromboplastin time [PTT] accompained by significant elevation of hepatic malondialdehyde [MDA] content and reduction of nitric oxide [NO] content in hepatic tissue, the changes being more marked with increase in the duration of exposure. Microscopic examination of the liver tissue showed hepatocytic vacuolizations, irregular diameters of sinusoidal lumens, inflammatory cellular infiltrations and reduced glycogen content, the changes becoming intense with prolongation of the EMF exposure period. Exposure to EMF of mobile phones poses a risk factor for liver dysfunction, and, therefore, long term or excessive use of mobile phones better be avoided

Metabolic effects of streptozotocin-induced diabetes in ovarectomized rats

Little information is available about how the changes that occur around the time of menopause might affect management of diabetes mellitus .The present study investigates the metabolic consequences of estrogen deficiency with streptozotocin induced-diabetes. The study was performed on 130 female Wistar rats, allocated into 4 groups: control [Sham]; diabetic [STZ]; ovarectomized [OVX] and ovarectomized diabetic [OVX-STZ] .Rats were subjected to determination of body weight and body mass index [BMI]. Estimation of blood glucose, plasma levels of insulin, estradiol, leptin, malondialdehyde, lipids, atherogenic index as well as in vitro diaphragmatic glucose uptake and renal glucose output. OVX- STZ rats showed significantly lower body weight and BMI than OVX rats. Blood glucose level was significantly higher than Sham, STZ and OVX groups. Diaphragmatic glucose uptake significantly decreased, while renal glucose output significantly increased compared to OVX and Sham groups .Plasma lipid profile in OVX-STZ rats was worse than Sham, STZ and OVX groups as indicated by the significant increase in plasma triglycerides, total plasma cholesterol and LDL-c. Atherogenic index was significantly higher than Sham and OVX rats. Similarly, lipid peroxidation was significantly higher than Sham, STZ and OVX groups. Plasma insulin decreased significantly compared to Sham, STZ and OVX groups, while the decrease in plasma leptin was significant when compared to Sham group. The present study demonstrates that metabolic derangements of combined insulin and estrogen deficiency overweigh the derangement of either hormone deficiency in postmenopausal period

Assessment of the effect of lipoic acid administration on hemostatic and lipid parameters in ovariectomized rats

Adverse thrombotic cardiovascular events increase in women coincident with the onset of menopause. The aim of this work was to evaluate the effect of lipoic acid administration on hemostatic and lipid parameters, pertinent to thrombotic cardiovascular tendency in ovariectomized rats. Mature female rats were allocated into three groups namely; sham-operated, ovariectomized and lipoic acid-treated ovariectomized rats. Lipoic acid administration started 8 weeks after ovariectomy, and lasted for 3 weeks, in a dose of 100mg/kg body weight, on daily basis. All ovariectomized rats, whether treated or not, were sacrificed 11 weeks after ovariectomy. Various hemostatic and lipid parameters were evaluated, in addition to body mass index, body fat weight as well as malondialdehyde level and red blood cell profile. Compared with their non-treated ovariectomized littermates, lipoic acid-treated ovariectomized rats showed increased platelet count and decreased platelet aggregation, together with reduced fibrinogen level, body mass index and fat weight to body weight ratio, as well as the malondialdehyde level. Lipoic acid also ameliorated the increment in triglycerides, total cholesterol, low density lipoprotein and atherogenic index detected in the ovariectomized group. Lipoic acid treatment also caused reduction in red blood cell count, hemoglobin level and hematocrit value. The encountered data showed that the administration of lipoic acid may have favorable effects on females after menopause by mitigating some hemostatic and lipid parameters, together with control of body weight and body fat weight. The present findings indicate potential antiobesity, antiplatelet aggregation, antilipedemic and antiatherosclerotic effects of lipoic acid

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.

Effect of medical ozone therapy on diabetes-induced cardiac dysfunction

Diabetic metabolic dysregulation is accompanied by oxidative stress that could possibly lead to dysfunction in cardiac myocytes. The aim of this study was to elucidate the effect of controlled medical ozone therapy to diabetic rats on ischemia reperfusion insult in isolated rat hearts. Both long-term [12 weeks duration] and short-term [20 days duration] treatment were investigated. Rats of each duration were divided into non-diabetic control group and streptozotocin-induced diabetic group, the latter group being further divided into two subgroups, namely, a group receiving medical ozone and the other remaining untreated. Long-term groups were studied for the cardiac responses before and after ischemia reperfusion. Short-term groups were used to assess the degree of leukocytic adhesion to coronary endothelium. In both durations, serum levels of CPK and TNF-alpha were determined. Long-term ozone therapy to diabetic rats improved myocardial depression before and after ischemia reperfusion, with reduction in ischemia reperfusion injury. Short-term therapy resulted in an attenuating effect on leukocyte adherence to coronary vascular endothelial cells after ischemia-reperfusion. The present data show the cardioprotective effect of medical ozone therapy on ischemia reperfusion injury in diabetic rats. The reduction in TNF-alpha may represent a mechanism for such protection. Prohibiting leukocyte-endothelial adhesion and transmigration may be useful in decreasing leukocyte-dependent post-reperfusion injury

Effects of ovariectomy and thyroidectomy on course and outcome of Trichinella spiralis infection in rat

Physiological hormones modulate immune responses and implicate in associated susceptibilities to infections. To clarify these endocrinological effects, the influence of estrogen and thyroid deficiency, due to ovariectomy and thyroidectomy, respectively, on course and outcome of Trichinella spiralis infection in rats was studied. While in ovariectomized rats there was significant increase in both adult and muscle larval counts as compared to intact infected rats, in thyroidectomized rats there was a significant increase in larval but not in adult count. Combined ovariectomy and thyroidectomy resulted in significant increase in both adult and larval counts. Serum CPK and blood glucose were significantly elevated in ovariectomized and/or thyroidectomized rats as compared to intact infected one. The deficiency of female sex hormones, and/or thyroid hormones in T. spiralis infected rats affected the host resistance to infection by increasing parasite burden influencing the course and outcome of parasitic infection

Detection of molecular markers of toxoplasmosis among Egyptian patients with miscarriage using avidity IGG-ELISA and western blotting

A total of 54 miscarriage patients were divided into 3 groups. GI: 10 toxoplasmosis patients with +ve IgM-ELISA; GII 24 toxoplasmosis patients with +ve IgG-ELISA, and G III: 20 non-toxoplasmosis cross-matched females as a control. All groups were subjected to IgG-avidity ELISA and IgG-avidity immunoblotting. Avidity Indices [AI] by ELISA ranged from 22.6% to 73.3% in GI and from 9.6%-75.6% in GII AI were high [>40%] in 3 [30%] patients in G I and in 8 [33.3%] patients in G II. Sera of GI recognized the 20, 28,32,60,93 and l00 Kda bands with 55% reduction in the 38 and 60 Kda bands after treatment with 6 M urea solutions. Sera of G II recognized the 20, 28, 32, 38, 45, 95-97 and 106 Kda bands. There was 12.5%, 16.6% and 16.7% reduction in the 20, 32, and 106 Kda bands, respectively, after urea. The 38 and 60 Kda bands were identified as good diagnostic markers for the recent toxoplasmosis infection [GI]. The 20, 32 and 106 Kda bands were good markers of high avidity antibodies during the chronic toxoplasmosis [GIl]

Efficacy of medical ozone in attenuation of murine schistosomiasis mansoni infection morbidity

Mice were divided into 3 groups: non-infected control, S. mansoni infected non-treated for 10 weeks and group receiving ozone intra-peritoneally for 21 days 10 weeks postinfection. Results showed that ozone therapy in chronic schistosomiasis mansoni decreased worm burden, increased number of dead eggs, decreased both mature and immature eggs, increased RBC count, improved hemoglobin concentration with reduced reticulocytes%, as well as increased lymphocyte%, decreased neutrophil% and markedly increased eosinophil%. Platelet count was increased and bleeding time was markedly shortened, markers for hepatic function were improved, and malondialdehyde concentration decreased in liver and spleen but increased in intestine. Reduction of associated hepato-splenomegaly was noticed, with reduction in number and size of hepatic and intestinal granulomas, collagen area% and number of macrophages, with preservation of hepatic and intestinal histological profile in almost all areas. The results point to medical ozone as a promising agent to complement schistosomiasis mansoni specific treatment, helping to attenuate infection morbidity

Contrast staining of trichinella spiralis larvae in fresh, frozen and formalin preserved muscles

Fresh, frozen-thawed and formalin-preserved muscle samples heavily infected with Trichinella larvae were cut into several pieces and stained with Giemsa and Leishman and the reference Haematoxylineosin [H and E] stain. Observation under microscope revealed that both muscle larvae and nurse cells in fresh and formalin preserved specimens appeared as purplish blue structures contrasting with the pinkish color of non-infected muscle fibers in both Giemsa and Leishman stains. These findings were confirmed in H and E stained samples. However, frozen samples did not show contrast stain

Oxidative preconditioning of medical ozone

Cardiac ischemic reperfusion injury is gaining importance due to rising of cardiac intervention procedures invoking transient ischemia, which requires trials of preconditioning strategies, A possible beneficial one could be the use of medical ozone, which is known to play a vital role in our well -being Therefore, the effect of small dose medical ozone on heart muscle and its possible protective effect on subsequent ischemia/ reperfusion injury was evaluated. Animals included in the present study were allocated into three groups: unconditioned control rats [group I], two months-ozonepreconditioned rats [group II], and three months-ozone-preconditioned rats [group III]. Rats were injected i.p. with small doses of ozone twice weekly. At the end of the experimental period, half the rats in each group were injected with heparin, a blood sample was taken for determination of plasma malondialdehyde [MDA] and the heart excised and used for isolated heart study. A blood sample was collected from the other half in each group for determination of serum glucose and the heart excised and sent for histological examination. Isolated heart study was carried out according to modified Langendorff technique. After recording basal cardiac activity, global ischemia was induced by stoppage of perfusion for 30 minutes followed by resumption of flow for another 30 minutes, and cardiac activity then recorded. The results revealed signifcant reduction in intrinsic inotropy of hearts isolated from unconditioned control rats after ischemia/ reperfusion [I/R], evidenced by significant decrease in tension generation per unit time [PT/t] after I/R in these rats, together with prolongation, of half relaxation time, insignificant change of intrinsic chronotropic activity and myocardial flow rate after I/R. Two months-medical ozone-preconditioning resulted in correction of the impaired intrinsic inotropy after I/R seen in unconditioned control rats, with enhancement of diastolic function. However, three months- medical-ozone preconditioning did not protect the hearts isolated from these rats from systolic dysfunction after I/R, though the diastolic function was significantly improved after I/R compared to unconditioned control rats. Serum glucose was decreased and plasma malondialdehyde was significantly increased in both the two-and three-months ozone-preconditioned rats. Histological examination of heart muscle revealed increased mitochondria! density in ozone preconditioned rats which was more marked in the two months-ozone-treated rats

Molecular characterization of Egyptian Giardia lamblia isolates

Six Giardia lamblia strains [four from Egypt, one from the USA and one from Sudan] were used to study the phenotypic and genotypic variation in some Egyptian G. Lamblia strains compared with other G. lamblia strains, which may be responsible for the difference in their behavioral characteristics. By using sodium dodecyl sulfate polyacrylamide gel electrophoresis [SDS-PAGE] for antigenic study, E1 strain appeared different from the rest of the strains with two bands; one at 121 kDa and the other at 34 kDa, which were not present in other strains, while bands at 130 and 43 kDa were present in all strains, but absent in E1 strain. Another difference between E1 strain and the rest of the strains was obtained by cellulase acetate electrophoresis [CAE], using phosphor-glucomutase [PGM] enzyme, where E1 strain gave a different zymodeme than the other strains. Based on the computerized random amplified polymorphic deoxyribonucleic acid- polymerase chain reaction [RAPD-PCR] analysis, 4 rapdemes were identified; rapdeme 1 contained E1 strain, rapdeme 2 contained E2, E3 and E4 isolates, rapdeme 3 contained Sudan strain and rapdeme 4 contained USA strain. In conclusion, this study revealed a diversity between G. lamblia strains, especially E1 strain, which showed unique characters

Ultrasonographic and clinical evaluation of pregnancy associated IUD

This study was done to evaluate the outcome of pregnancy associated IUD among 363 patients. 163 conceived with IUD inplace were divided into 2 groups. The first group comprised 111 patients, [68%], with detected threads. The second group comprised 52 patients, [32%], with missed threads. The results of this study showed that pregnancy within 3 months from removal of IUD carried the same risk as pregnancy with IUD in situ. Ultrasound follow up revealed that with pregnancy associated IUD, the cervical position of IUD had the most favorable prognosis, while the paraplacental had the worst prognosis

Ultrasonographic and histopathological study of the placenta and choriodecidual space in high risk pregnancy

Two hundred pregnant cases in the third trimester were studied. They were evaluated clinically and studied sonographically for the placenta and choriodecidual space and were correlated to the clinical data present. Pathological assessment of placentae both macroscopic and microscopic was also done. Narrowing, dilatation and irregularity of the choriodecidual space were recorded in 19.4 percent, 27 percent, and 10.6 percent in the studied groups respectively. The corresponding figures in the control group were 20 percent, 3.3 percent and 3.3 percent respectively. Abnormalities of the placental texture were detected in 40 percent of the control group, while it was detected in 50 percent of the high risk group. Excessive fibrin deposition, calcification and vascular sclerosis were detected in 15 percent, 28 percent and 8 percent of cases respectively. Pathological study of the placentae proved the presence of atherosclerotic changes in 17 percent of cases, congestion in 18 percent and previllous hyaline thrombi in 6 percent of cases. Narrowing of the choriodecidual space with placental arteriosclerosis and previllous hyaline thrombi proved to be the commonest features of hypertensive state of pregnancy. Meanwhile dilatation of the choriodecidual space was the characteristic feature of anemia during pregnancy. The corresponding pathological changes in the placenta were congestion and placental arteriosclerosis

Clinical and radiological criteria of genito-urinary fistulae presenting with menouria

Menouria [voiding menstrual blood mixed with urine at time menstruation] is a well known, but rare gynaecological complaint. The present work is a clinical and radiological study of twelve cases of menouria associated with genito-urinary fistulae. Vesico-uterine fistulae following lower segment cesarean section were found to be the main type of fistulae causing such complaint. Amenorrhoea with patent cervical canal and urinary continence were associated in four cases to form true Youssef syndrome, which was proved to be a rarity of all cases of menouria. Radiolgical studies proved that urinary continence and amenorrhoea were essentially determined by the length, the width and the course of the fistulae in addition to the relative position of the bladder and the uterus. Long narrow and ascending fistulae in which there was a significant level difference between the bladder and the uterus were essentially associated with urinary continence. The vesicovaginal fistula recorded in this study was an exceptional case and the first oneto be recorded in which menouria and urinary continence were a feature inspite of the extensive loss of enterior vaginal wall, posterior bladder wall and the urethera continence in this case was maintained by a potent perineal sphincter controlling the vaginal introitus and the external uretheral meatus

Ultrasonographic evaluation of short period amenorrhoea in infertile patients

This study is an evaluation of what is known as short period amenorrhoea or early missed periods in infertile patients. Diagnosis was done by ultrasongraphy and was confirmed by beta subunit assay and histopathology of the products expelled. 157 infertile patients were selected for this study. These patients were divided into 39 patients not using any treatment for ovulation induction [the control group], and 3 other groups under treatment with ovulatory inducers. These patients were mainly nulligravidae and gravids, I aged 26-35 years. The results showed that early blighted ovum was the cause of amenorrhoea in 16 patients [10%], and membranous cast was thecause of amenorrhoea in 44 patients [28%]. In the rest of the cases the cause was related to other factors mainly psychogenic. Patients having normal early pregnancy were excluded from this study. These membranous casts were expelled in 34 patients [77%] of cases under treatment with ovulatory inducers. The corresponding figure in the control group was 10 [22.7%]. Early blighted ovum was recorded in 14 [87.5%] of cases under treatment as compared to 2 cases [12.5%] of the control group. Blighted ovum was diagnosed ultrasonographically by a new sign recorded by the authors. This sign is the presence of defective placental site echoe as the demonstration of an actual foetal echoes is very difficult at the early age of gestation. In addition,the authors present a new sign characterstic of the presence of the membranous cast formation and expulsion. The fully formed membranous cast gives rise to a pseudosac formation having nearly the shape of the uterine cavity [usually ablong in shape] with no characterstic placental or foetal echoes, meanwhile the expelled cast gives rise to an open pseudosac appearance which is attached to the uterine wall

Uterine ballooning: a hysterographic finding in cases of infertility; its clinical implications and its management

There is a retrospective study of hystersalpingograms of 1500 cases done as a routine infertility workup. 300 of these cases were proved by follow up to be fertile and were taken as a control group. Another 260 cases were infertile where the cause of infertility could not be determined [the unexplained group]. The rest were cases of explained infertility. Hysterosalpingography was done by the classic technique described by siegler in 1983 and the contrast medium was the ultrafluid hpiodol. Three types of uterine ballooning were recorded. These were: the diffuse regular type, the diffuse irregular type and the cornual type. Uterine ballooning was found to be more significantly related to unexplained infertility than the explained type. The incidence of this association was 15% and 2.1% respectively. The cornual type was the commonest of uterine ballooning in unexplained infertility, while the diffuse irregular type was the commonest in explained infertility. Uterine hypotonia or atonia was given as an explanation of this phenomenon of uterine ballooning. Attempts were done to correct this phenomenon by acquiring certain position during hystersalpingography. Trendelenburg's posit was found to be effective in correcting this phenomenon and improving the patient's fertility than anti-trendelenburg's position. Successful pregnancies occured in two cases of explained infertility and in five cases of unexplained type, in whom uterine ballooning was associated. In these cases, patients were advised to elevate their pelves by pillows under their buttocks during sexual intercourse so as to simulate Trendelenburg's position adopted during hystersalpingography

Ultrasonographic prediction of foetal age: the role of femur length [FL] biparietal diameter [BPD] and the FL/BPD ratio

Ultrasonographic measurement of foetal biparietal diameter [BPD] and femur length [FL] was done on 88 pregnant women, with sure dates between 1642 weeks' gestation. A real lime scanner with a 3.5 mHz transducer frequency was used. All cases had a single examination and all had uncomplicated pregnancy. A good correlation was found [r = 0.8506 and p < 0.025] between menstrual gestation age and that predicted from the BPD. An even better correlation [r = 0.8917 and p < 0.025] was found when we predicted fetal gestational age from FL. Gestational ages predicted from femur length were particularly more accurate than those predicted from BPD after 34 weeks' gestation. A linear relationship between the growth of FL and BPD after 16 weeks' gestation is described. FL/BPD ratio is almost constant over this age range. The ratio was found to be 0.81 +/- 0.13 [mean +/- 2 SD] in this study. This ratio can practically be used as a quality control check on femur length and BPD measarements. It can also help early diagnosis of short-limbed dwarfism, hydrocephalus and microcephaly