Phenotypic characterization of Acinetobacter baumannii isolates from intensive care units at a tertiary-care hospital in Egypt

Multi-drug resistant [MDR] strains of Acinetobacter baumannii are responsible for an increasing number of opportunistic infections in hospitals. This study determined the prevalence of MDR A. baumannii isolates from intensive care units in a large tertiary-care hospital in Ismailia, Egypt, and the occurrence of different beta-lactamases in these isolates. Biotyping and antimicrobial susceptibility profile was done for isolated strains. Respiratory, urine, burn wound and blood specimens were collected from 350 patients admitted to different units; 10 strains [2.9%] of A. baumanniiwere isolated. All isolates showed resistance to more than 3 classes of antibiotics. Among the isolates, 6 isolates were carbapenemase producers, 2 were AmpC beta-lactamase producers and no isolates were metallo-beta-lactamase producers. Despite the low prevalence of A. baumannii infection in this hospital, the antibiotic resistance profile suggests that prevention of health-care-associated transmission of MDR Acinetobacter spp. infection is essential

The Effect Of Oral Health Education Seminar On The Oral Health Knowledge, Practice And Perception Of Role Of The Preschool Teachers

Background: In Malaysia, preschool teachers have longbeen utilised as oral health educators. However their levelof oral health knowledge and effectiveness of the trainingthey received are seldom investigated. This study aims toevaluate the of oral health education seminar (OHE) heldfor public preschool teachers (KEMAS) in terms of theimprovement of their knowledge, practices and attitudesMethods: This was a one arm interventional study (beforeand after survey following OHE seminar intervention). AllKEMAS preschool teachers (n=107) in Hulu Terengganuwere invited to attend OHE seminar which consisted of1 hour lecture and 40 minutes OHE demonstration. Pretestquestionnaire was collected before the seminar startedand post-test questionnaire was collected two weeks later.A self-administered questionnaire used in this study wasadapted from “preschool teachers’ knowledge, practicesand attitudes towards oral health”, National Oral HealthSurvey of Preschool Children, 2005. Data were analysedusing descriptive and McNemar test, SPSS version 15.0.Results: Of 107 subjects, only 61 teachers respondedyielding to 57% response rate. All subjects were femalewith mean age of 46 years (SD: 6.03). Overall, therewas an improvement of teachers’ oral health knowledge,practices and attitudes after the seminar. Severalitems seem to have be improved significantly after theseminar, for example knowledge item on factors causingperiodontal disease (p=0.03). In terms of practice, allteachers reported they brushed teeth at least twice dailyusing fluoridated toothpaste and use of dental floss wasincreased significantly after the seminar (p<0.001).Majority of teachers have positive perceptions on theirroles in oral health education. Conclusion: Oral healtheducation seminar appeared to be effective at influencingcertain aspects of teachers’ oral health knowledge,practices and attitudes.

first Egyptian experience using new self-expandable metal stents in acute esophageal variceal bleeding: pilot study

Balloon tamponade has been widely available in emergency situations of acute variceal bleeding. To lessen the complications of Balloon tamponade, a new special type of stent for exclusive use in acute variceal bleeding has been developed. This study aims to investigate the effectiveness and safety of the new self-expandable metal stents [SEMS] in the initial control of acute variceal bleeding. We also hypothesized that using SEMS can bridge the acute bleeding episode converting endoscopic management by sclerotherapy or band ligation to an elective procedure. Twenty patients with acute variceal bleeding were included in the study and 16 of them were allocated to receive stent treatment. Stent deployment was successful in 15 of 16 patients [93.75%]. Technical errors were reported in 3 [18.75%] patients. Initial control of variceal bleeding was reported in 14 [out of 16] [87.5%] patients. The mean duration of the procedure was 10 [ +/- 6] min. Mortality was reported in 4 [25.0%] patients. SEMS is a safe and effective mean to control acute variceal bleeding

Biochemical and genetic risk factors for atherosclerosis in systemic lupus erythematosus

Systemic lupus erythematosus [SLE] is associated with an increase in the risk of premature cardiovascular complications caused by accelerated atherosclerosis which significantly contributes to morbidity and mortality. Carotid ultrasonography is a very sensitive imaging tool to detect premature atherosclerosis and measurements of carotid intima-media thickness [IMT] assess the extent and the severity of systemic atherosclerosis. The pathogenesis of accelerated atherosclerosis in SLE is not clear; inflammation and endothelial dysfunction in addition to genetic risk factors represent important factors in the onset of atherosclerosis. To evaluate the relation between asymmetric dimethylarginine [ADMA], high sensitive C-reactive protein [hs-CRP], monocyte chemoattractant protein-1 [MCP-1] [both serum levels and the genotypes of the MCP-1 A-2518G polymorphism] with the development of carotid atherosclerosis in patients with SLE and their relation to disease activity. In the present study, 30 non-menopause SLE female patients and 20 healthy age-matched females were included. Both patients and controls were subjected to evaluation of body mass index [BMI], IMT, serum glucose, serum lipids, hs-CRP, ADMA, MCP-1 [both serum level and gene polymorphism]. Serum ADMA, hs-CRP, and MCP-1, levels were measured by enzyme-linked immunosorbent assay. MCP-1 genomic variants were detected by polymerase chain reaction followed by restriction enzyme-fragment analysis. Values for IMT, hs-CRP, ADMA and MCP-1 were significantly higher in patients with SLE than in healthy controls with more significant increase in SLE patients with IMT >/=1 mm than in those with IMT <1 mm. Carotid IMT was significantly positively correlated with all the studied variables except for age, BMI and FBS, but significantly negatively correlated with HDL-C in all SLE patients. G/G genotype of MCP-1 A-2518G gene was more frequent in SLE patients than controls. IMT, hs-CRP, ADMA and MCP-1 from patients with G/G phenotypes were markedly higher than those from patients with the A/A genotype. In multiple regression analysis, ADMA and MCP-1 were the strongest independent determinants of IMT in SLE patients. Assessment of high levels of ADMA, hs-CRP, MCP-1, in addition to the MCP-1 A-2518G polymorphism may play a role in the pathogenesis of accelerated atherosclerosis in SLE patients and would be useful in identifying the risk of developing cardiovascular disease. Development of a novel therapy targeting ADMA and MCP-1 may have a potential role in preventing the progression of increased IMT in SLE patients

Central role of IL-10 as key regulator of inflammation during intestinal trichinellosis in mice

This study characterized some immuno-pathological aspects of intestinal trichinellosis where, the influence of this nematode infection on levels of IL-10 mRNA expression, nitric oxide [NO] and myeloperoxidase [MPO] in intestinal mucosa is going to be studied. Four groups of albino mice were infected orally by Trichinella spiralis [T. spiralis] larvae and sacrificed on days 3, 6, 14, and 30 post infections [d.p.i.]. Levels of the previously mentioned parameters were measured in the infected intestinal tissue samples and compared to non-infected normal controls. The results showed gradual increase of IL-10 mRNA expression at 3 d.p.i., to reach its peak levels at 14 d.p.i. The mucosal levels of NO and MPO showed sharp increased by 3[rd] d.p.i., with a peak on 6 d.p.i. These biochemical changes were in accordance with the pathological changes observed by histopathological examination of stained small intestinal sections. The data reinforce the concept of the central role played by IL-10, as a Th2 cytokine in controlling severe inflammatory process initiated by NO under the influence of this invading parasite

use of frontal sinus x-rays as bony prints

The availability of frontal sinus patterns for personal identification has been studied. The anteroposterior X-ray view of 100 persons was studied regarding six items: The size of both sinuses in cm2 using a digital planimeter KP 90; the asymmetry index which is equal A/Bx100 where A is the area of smaller sinus and B is the area of the larger one; the unilateral superiority of one sinus over the other; the shape of the sinus according to the sum of the number of arcades; the characters of partial septa and the presence or the absence of supraorbital cells. Each of the previous items was classified into many categories and a class number was given to each category, so the frontal sinus pattern for every person was formulated as a code number composed of many class numbers. In this study, the paranasal sinus X- ray of any two persons can never be identical as regard the frontal sinus patterns

Metastatic carcinoma in cervical lymph nodes

The objective of this study is the correlation between the different groups of cervical lymph nodes and the primary tumours above the clavicles. Cervical lymph node metastases as the only site of disease is an uncommon presentation of squamous cell carcinoma and adenocarcinoma of unknown primary origin. This retrospective analysis examines the records of 166 consecutive patients at King Hussein Medical Centre diagnosed between 1986 - 1992. All patients presented very late with large neck lymph nodes of more than 4-8 cm in diameter. The diagnostic protocol employed and the results of radical treatment are evaluated. Sixty seven patients received radiation therapy with intent to cure and 99 patients received radiation with intent to palliate. The overall survival for all patients at 2 years was 19%, and at 5 years, 6 patients [3.6%]. The most frequently affected nodes were the jugulodigastric, mid jugular, submandibular and cervical unilateral, contralateral or bilateral. The most common histologies were squamous cell carcinoma, adneocarcinoma and anaplastic carcinoma. Disease control above the clavicles was not achieved despite radical treatment. Lymphomas and leukaemias were excluded from this study

role of schistosomiasis and type B hepatitis in the pathogenesis of endemic Egyptian hepatosplenomegaly

Liver biopsy was done for patients presented with hepatosplenic affection [HSM] to Theodore Bilharz Research Institute [TBRI] [88 cases] and Zagazig University Hospital [ZUH] [43 cases] and 20 peasants from a village who agreed to be examined by liver biopsy. HBV sero-markers were determined in the HSM cases and in simple schistosomiasis [247 cases] and healthy subjects [694 cases] using ETA technique. No significant differences were observed in the presence of one or more markers in simple schistosomiasis [51%] as compared to healthy subjects [44%]. Whereas, it was significantly higher in HSM cases whether with [73%] or without schistosoma infection [88%]. The HBS carrier rates was significantly higher in patients with liver affection of non-schistosoma origin [20%] as compared to those of schistosoma ones [11%]. Etiology of endemic HSM seems to depend on the source of the examined cases whether urbanized, semi-urbanized or rural

Chronic non-specific gastritis [ulcer-negative dyspepsia]: a clinical, endoscopic and histopathological study

Among the patients presenting with upper gastrointestinal symptoms, and having: endoscopy, 292 proved not to have an ulcer, but only variable degrees of superficial gastritis. In this series, males in the third and fourth decades of life predominate. Smoking and alcoholism were common habits Heartburn [68.8 Percent], epigastric pain [70.9 Percent], vomiting [44.5 Percent] dyspepsia [24.3 Percent], and haematemesis [20.5 Percent] were the main presenting symptoms. Superficial gastritis was more commonly seen [78 Percent] in the region of the antrum. Histopathological examination revealed that; increased Paneth cells was common [70 Percent] in the body gastritis, while intestinal metaplasia was frequent association with the antral gastritis [80 Percent]. Sudanese, who ingest heavily spiced foods [15 out of 16] had duodenitis and oedema of the post-bulbar region [6 out of 8] more than other nationalities