Molecular epidemiology of antibiotic associated diarrhoea due to clostridium dificile and clostridium perfring ensin Ain Shams University Hospitals

As we are Iiving in the era of antibiotic overuse, antibiotic associated dlarrhea [AAD] is considered now a distinct health problem with a need for more attention was to perform a highly specific detection and definition of pathogenic Clostridium perfringens and Clostridium difficile related AAD in children compared to adults and geriatircs. One hundred and fifty patients diagnosed for AAD were included in this study [50 children, 50 adults and 50 geriatric patients]. All of them were subjected to full medical history including complete therapeutic history of antibiotics and collection of stool sample during the attack for detection of Clostridium perfingenes enterotoxin [CPEnt] and Clostridium difficile cytotoxin by [EIA] kit. PCR detection of Clostridium perfingenes epegene [Coding gene for CPEnt] was perfomed as well. Results showed that prevalence of Clostridium difficile cytotoxin was 24% while Clostridium perfingenes enterotoxin was 12% as detected by EIA in faecal specimens as a whole. Detection of epe gene by PCR was positive in 16% of all cases. Children [OR: 4.2, 95% CI: 1.3-14.8, P

Insulin resistance, hyperinsulinemia and glucose intolerance in non-diabetic coronary heart disease

Serum insulin level and blood glucose level in the fasting and 2 hours after oral glucose load as well as lipid profile were measured in 25 non-diabetic, normotensive patients with old myocardial infarction and compared with that of 15 healthy control subjects. The results showed a significant increase in fasting serum insulin level, a very highly significant increase in 2-hour serum insulin level and a significant decrease in insulin sensitivity index in patients compared to controls. A nonsignificant increase in fasting plasma glucose and a highly significant increase in 2-hour plasma glucose level were found in patients compared to controls. As regards lipid profile, serum triglycerides, serum total cholesterol and total cholesterol/HDL cholesterol ratio were significantly higher in patients compared to controls. The study showed that insulin resistance and its two major consequences, hyperinsulinemia and glucose intolerance, are major and independent coronary heart disease [CAD] risk factors

Relation between weaning and gastroenteritis

Acute infantile diarrhea is the leading cause of death among Egyptian children, accounting for more than 50 percent of the death in children under 2 years of age [NCDDP, 1988]. In Egypt, most health experts agree that the best time to introduce foods is at four to six months of age. This is the time when breast milk starts to become inadequate to meet all the infant's nutritional needs [Aref et al., 1984] and the rest of the nutritional requirements become obtained through supplementary foods [Millard, 1985]. In this study, we aim to evaluate the relationship between the weaning period and the possible incidence of diarrheal attacks and to spot light on some parameters namely stool examination for different parasites, culture of the specimen and methylene blue preparations to detect faecal leucocytes. Hematocrit value, Hb percent, R.B.Cs and W.L.Cs and differential leucocytic count then estimation of band/total neutrophil ratio. Serum albumin and serum Na+. 60 cases presented with diarrhea after early introduction of foods during the weaning period, aged from 6 - 24 months were taken in addition to one hundred normal children as a control. The results of this work shows that infants below one year of age were the more affected with attacks of diarrhea. Artificial feeding prior to the period of weaning was more affected than breast feeding. Hb, red cell count and serum albumin were decreased. Hematocrit value was low or normal. Isonatremic dehydration is the most common type of dehydration [75 percent]. As regards the causative organisms, E. Coli [28.30 percent] was the most common followed by E. histolytica [21.6 percent] and giardia lamblia [16 percent]. In this work, the presence of polymorph nuclear leucocytes in the stool was found to be a predictive test for bacterial etiology of diarrhea with positive predictive value of 87 percent. The band/neutrophil ratio of bacterial group had a highly significant difference when compared to the control group, but the parasitic diarrheal group had non-significant statistical difference when compared to the control group