Relationship between coronary risk factors, c-reactive protein, bone mineral density and carotid circulation among frail elderly

Frailty may now be regarded as a geriatric syndrome of decreased reserve and resistance tostressors, resulting from cumulative declines across multiple physiologic systems, causing vulnerability toadverse health outcomes including falls, hospitalisation, institutionalisation and mortality. Theinflammatory mediators as C-reactive protein have been associated with the development of the geriatricfrailty. Several studies have pointed out increased level of homocystiene in frail elderly Increasing frailtywas associated with lower bone mineral density, as both bone mass and muscle strength decrease duringageing and this has also been associated with higher risk of osteoporotic fractures in frail elderly. To compare frail and non-frail elderly regarding Bone mineral density, carotid circulation andserum levels of Homocysteine, coronary risk factors and CRP. 104 elderly patients, who were assigned to 2 groups. Group A [52 frail participants]:diagnosed byFried's criteria as applied byAvila-Funes et al., 2008. Group B [52 non-frailparticipants].All participants were subjected to the following: through history, physical examination,ADL, IADL assessment, MMSE ,GDS, laboratory investigations including; CRP, homocystiene and totallipid profile, measurement of bone mineral density by DEXA and carotid intima-media thickness bycarotid duplex. There was no statistically significant difference in age, sex, among both groups.Frail participantshad higher ADL and IADL dependence, higher incidence of depression, cognitive impairment andosteoprosis.They also had higher levels of homocystiene, CRP, CIMT and lower levels of HDLcholesterol. Osteoporosis is more prevalent among frail elderly also frailty is associated with more ADL and IADL dependence, higher GDS scores and lower MMSE score in addition to higher mean level ofhomocystiene, CRP and triglycerides in addition to low serum HDL and higher CIMT

Relation between frailty and common geriatric problems in elderly

There is a high prevalence of common geriatric problems [falls, urinary incontinence, visual and hearing impairment] among frail elderly leading to more disability and functional impairment. The aim of this study is to compare the prevalence of common geriatric problems between frail and non-frail elderly. A Case control study. 90 participants aged 60 years and above. They were selected from Ain Shams University Hospital from inpatient wards and outpatient clinics. The studied sample was divided into 2 groups: Group A [30 frail elderly females and 30 frail elderly males] and Group B [30 healthy elderly subjects; 15 males and 15 females]. Comprehensive geriatric assessment, including detailed history of common geriatric problems as mentioned above, physical examination, and also assessment of frailty using modified Fried criteria]. Hearing impairment, incontinence and falls were more prevalent in frail elderly with a highly difference between the two groups, with p values< [0.001,0.009,0.006] consequently, visual impairment was statistically significant in cases more than controls with p value [0.012]. There is a significant positive relationship and high prevalence of common geriatric problems especially falls, urinary incontinence, visual and hearing impairment among frail elderly

Treatment outcomes among patients with multi-drug resistant tuberculosis in Abbasia chest Hospital from July 2006 to June 2010

Tuberculosis despite being treatable and preventable disease, it continues to be a major health challenge in many parts of the world. The emergence of drug-resistant tuberculosis has made the current epidemic worse. This retrospective study included 200 MDR-TB patients admitted to Abbassia Chest Hospital in the period between July 2006 and June 2010. Their files had been analyzed including medical history, chest examination and investigations. Drug regimens of resistance used for treatment and the fate of treatment were reported. Patients were 148 males [74%] and 52 females [26%]. Their ages ranged from 15 to 76 years [37.83 +/- 12.78 years]. 81.5% of them lived in rural areas, 2.5% were tobacco smokers and were diabetics. Defaulters were 44.5%, treatment failure patients were 44%, relapse patients were 4%, and new cases constituted 7.5% of the studied patients. Acquired resistance was 92.5% and primary resistance was 7.5%. The duration for sputum conversion ranged from 2 to 9 months [4.19 +/- 1.28 months]. The fate of MDR-TB treatment was favorable outcome in 132 cases [66%] and unfavorable in 68 cases [34%] [28 patients were defaulters [14%], 21 patients died [10.5%] and 19 patients had treatment failure [9.5%]]. The prevalence of defaulter patients was significantly higher among unfavorable outcome patients while the prevalence of treatment failure patients was significantly higher among favorable outcome. Successful treatment could be achieved in 66% of MDR-TB patients treated in Abbassia Chest Hospital between July 2006 and June 2010

Pleurodesis using different agents in malignant pleural effusion

Malignant pleural effusions [MPE] are characterized by rapid reaccumulation, after tapping, and many symptoms related. Pleurodesis, for the management of MPE, is intended to achieve symphysis between parietal and visceral pleura, and to prevent relapse of pleural effusion. Many chemical agents are tried to induce abrasion and damage of the pleural mesothelial layer to achieve this symphysis. The aim of this study is to compare the results of medical pleurodesis, using 4 different chemical agents in these cases, to reach an efficient one with minimal complications. Between July 2010 and July 2012, 40 patients with MPE, divided into 4 groups, underwent medical pleurodesis using 4 chemical agents in comparison: bleomycin, doxycycline, povidone iodine and 5-fluorouracil. Immediately and for 3 months after the procedure, the results of pleurodesis were assessed and the final reported success rates were 70% for bleomycin, 80% for doxycycline and 80% for povidone iodine, while 5 fluorouracil had the lowest success rate [50%] [P-value < 0.05]. Bleomycin, doxycycline and povidone iodine are nearly equally effective and safe pleurodetic agents when used in the optimal dose, while 5-fluorouracil had a much higher failure rate. Although povidone iodine and doxycycline are as effective and safe as bleomycin, they are cheaper alternatives and more available chemical agents for pleurodesis in cases with MPE

Sleep pattern changes in patients with liver cirrhosis

Liver cirrhosis is considered as a major cause of mortality worldwide and is the most common non-neoplastic cause of death among hepatobiliary and digestive diseases. One of the least studied complications of liver cirrhosis is the disturbed sleep pattern, which is being increasingly recognized as a major health problem affecting the quality of life. This study included two groups; the first group consisted of 30 patients diagnosed as liver cirrhosis based on abdominal ultrasound and liver biopsy and the second group consisted of 10 healthy subjects served as controls. ESS was calculated for every patient and all patients were subjected to complete overnight polysomnography to detect sleep disturbances among all participants. Our results showed that cirrhotic patients had ESS, AHI and OSA significantly higher than the control group [16.4 +/- 2.6 vs 11.1 +/- 1.8, P = 0.0001; 10.9 +/- 8.5 vs 2.4 +/- 1.6, P = 0.005 and 3.1 +/- 3.1 vs 1.1 +/- 0.9, P =0.03, respectively]. The percentage of sleep efficiency was significantly lower in cirrhotic patients than the control group [61.9 +/- 12.9 vs 73.1 +/- 7.6 [P = 0.02]]. Also, the percentages of S1, S3-S4 and REM sleep in relation to the total sleep time were significantly higher in the cirrhotic patients than the control group [P = 0.01, 0.02 and 0.06, respectively] while the percentage of S2 was significantly lower [P = 0.02]. Cirrhotic patients of Child class C had ESS, AHI and OSA significantly higher and sleep efficiency significantly lower than cirrhotic patients of classes A and B [P = 0.001 for all]. Cirrhotic patients with tense ascites had ESS, AHI and OSA significantly higher and sleep efficiency lower than patients with mild, moderate, or no ascites. This study revealed that cirrhotic patients had disturbed sleep pattern, correlating with the degree of cirrhosis

Middle ear and hearing disorders of schoolchildren aged 7-10 years in South Sinai, Egypt

Hearing loss among schoolchildren in developing countries is reported to be a significant health problem. Data on child hearing loss in South Sinai, a remote governorate of Egypt, are lacking. Middle ear diseases and hearing impairment were assessed among 453 primary-school children aged 7-10 years in South Sinai [906 ears]. Otoscopic examination, tympanometry and pure tone audiometry [PTA] were done. Ear disease was found in 27.5% of the ears examined. The commonest cause was secretory otitis media [10.8%], followed by occluded earwax [9.5%]. Mild and moderate hearing loss affected 8.5% of the sample, while sensorineural hearing loss affected 2.4%; only 0.4% had moderate and severe hearing loss. Hearing impairment affects 19.3% of this age group in South Sinai. None of the children with hearing impairment had been previously diagnosed or was receiving treatment and support. Hearing and middle ear screening at schools is recommended for early detection and management of middle ear and hearing problems

Neopterin levels in patients with post hepatitis C chronic liver disease

Hepatitis C virus causes biochemical, immunological and histological changes in host immuno response against the virus. Neopterin [NPT] is a valuable marker of cell-mediated immunity that reflects the degree of T helper-1 [Th-I] immune activation. Evaluation of the significance of serum neopterin as a marker of cellular immune response in patients with different states of post hepatitis C chronic liver disease. Seventy patients with post hepatitis C chronic liver disease were included in the current study: 40 patients with chronic hepatitis C and 30 patients with liver cirrhosis in addition to 15 healthy individuals as a control group. Patients were assessed and evaluated by laboratory instigations and liver biopsy to determine the severity of the disease. Serum neoterin level was significantly elevated in patients with chronic hepatitis C virus infection and cirrhosis compared to the control group with distinctly higher concentrations in the cirrhotic stage than those in he non-cirrhotic stage of disease. Neopterin may be an early and valuable biochemical marker of cellular immunity which is activated upon simulation of cells by interferon. Measurements of immune activation by NPT could potentially be helpful surrogate markers in progression of liver disease

Anatomical variations predisposing to pediatric sinusitis: a CT scan study

Sinusitis is a multifactorial disease. Anatomical variations and osteomeatal complex obstruction may be the major factors in predisposing to pediatric sinusitis. Other factors may include allergy, systemic diseases, stress, and genetic predisposition. This study aimed at defining the incidence of anatomical variations and dimensions of the lateral nasal wall structures and paranasal sinuses and their role in predisposing to pediatric sinusitis in Egyptian children. The study included CT scans [coronal sections] of nose and paranasal sinuses of 40 children, done at the radiology department of AinShams University Hospitals. These CT scans were carefully studied and classified into 2 groups. Group I [study group] involved CT scans with radiological signs of sinusitis of 25 Egyptian children [with a mean age = 9.34 yr. and SD= +/- 3.03], while group II [control group] involved CT scans of 15 normal children. We measured anatomical characters of the turbinates, maxillary sinus [height, width, slope of its roof to vertical plane and the level of its floor to the nasal floor], frontal sinus [development] and sphenoid sinus [height, width and development]. The results of measurements and variations of the previous anatomical structures were statistically analyzed comparing both groups to evaluate their significance in predisposing to pediatric sinusitis in Egyptian children. The results of the present study showed that the incidence of concha bullosa [in sinusitis group] was 24%, paradoxical and markedly edematous middle turbinate was also 24%, thin and rudimentary uncinate process [20%], the laterally curved uncinate process [16%], all of them were significantly higher in the study group [pediatric sinusitis] compared to the control group [sinusitis-free]. Also, a lower level of the maxillary sinus to the nasal floor [with mean value +/- 2mm] was found to be a statistically significant factor in predisposing to pediatric sinusitis in Egyptian children

Vestibulo-ocular reflex testing in peripheral vestibular disorders

The present study was conducted to evaluate the vestibulo-ocular reflex [VOR] using rotary chair. A new chair concept generating dynamic stimuli by alternating rotations in the horizontal plane of the chair's seat was recently developed. Twenty-five adult subjects suffering from variable peripheral vestibular lesions, proved by caloric testing, participated in the study. Eleven healthy normal adults served as controls; gender and age matched to the study group. Results of rotational sinusoidal harmonic acceleration [SHA] testing showed gain reduction at lower frequencies of rotation with improvement of gain at higher frequencies. Meanwhile, phase and symmetry parameters remained normal at all frequencies. Findings of SHA testing in the present study suggest the presence of a certain degree of compensation. This reflects remaining vestibular function, which could be utilized in vestibular rehabilitation

Effect of Trigonella foenum graecum seeds and its extracts on serum lipid profile and some lipogenic enzymes in high-fat diet fed wistar rats

The study was designed to investigate the effects of fenugreek [FG] seed powder and its extracts on serum lipid profile and activities of two hepatic lipogenic enzymes, malic enzyme [ME] and glucose-6-phosphate dehydrogenase [G6PDH] in male Wistar rats. Materials and Fifty male Wistar rats were divided into five groups. Group 1, fed standard diet; group 2, fed high-fat diet [HFD]; group 3, fed HFD plus 30% FG seed powder; group 4, fed HFD mixed with 10% defatted meal [FI] and group 5, fed HFD in addition to 2% crude saponin [FII]. Levels of serum lipids [total lipids, triglycerides, total cholesterol, high and low density lipoprotein cholesterol "HDL-c and LDL-c" and free fatty acids], activity of hepatic lipogenic enzymes [malic enzyme and glucose-6-phosphate dehydrogenase] and total proteins were determined. Serum total lipids, triacyglycerol, total cholesterol, LDL-c, TC/HDL-c ratio and both saturated and unsaturated fatty acids levels were significantly elevated [p<0.001] in rats fed high-fat diet concomitant with non significant change in HDL-c and decrease in HDL-c/LDL-c ratio compared to rats on a standard diet. In the mean time, when high-fat diet was mixed with either FG seed powder, FI or FII the dyslipidemia effect of HFD was decreased or normalized. Also FG seeds and its extracts reduce lipogenesis [reduction in activities of lipogenic enzymes] and TC/HDL-c ratio, and increases in HDL-c/LDL-c ratio. Fenugreek seeds and its extract may beneficially affect the main risk factor for atherosclerosis [hyperlipidemia] by reversing significantly the deleterious effects of the high-fat diet. Decreased serum fatty acids in rats may be attributed to retarding the absorption of both kinds of fatty acids regardless their nature

Role of staphylococcal enterotoxins [superantigens] in allergic rhinitis

Staphylococcal enterotoxins [S. Es.] of type A-D were immunologically detected in liquefied nasal blow washings and homogenized polypi of 20 patients suffering from allergic rhinitis [AR]. Tissue eosinophil count, serum IgE, IL-2 and IL-4 were also determined using ELISA technique, and the results were statistically compared with those obtained from 15 age and sex matched healthy volunteers. Enterotoxin secreting potential of the isolated S. aureus was identified in 17 patients who showed remarkably increased levels of serum IgE, IL-2 and IL-4 and tissue eosinophil count. The results suggested that S. Es. can be incriminated as triggering factors that activate a large population of T-lymphocytes to elaborate interleukins and eventually leading to elevated serum IgE and tissue local eosinophilia in AR patients

Assessment of Il-8 and TNF-alpha in serum and BAL of patients with COPD and lung cancer

There is an increasing evidence for the role of cytokines, especially interlukin-8 [IL-8] and tumor necrosis factor-alpha [TNF-alpha] in the pathogenesis of many chest diseases especially chronic obstructive pulmonary disease [COPD] and to some extent lung cancer. Tins study was conducted on three groups comprising 70 smoker subjects; 25 patients [21 males and 4 female] with mild to moderate degree of COPD, 25 patients [21 males and 4 females] with lung cancer and 20 asymptomatic control subject [17 males and 3 females], All subjects were subjected to full history taking, clinical examination, radiological assessment, pulmonary function testing, tissue diagnosis of lung cancer, blood sampling and bronchoscopic bronchoalveolar lavage [BAL] for assessment of TNF-alpha and IL-8 levels both in scrum and BAL fluid using the enzyme linked immunosorbant assay [ELISA] method. There was a highly significant [P < 0.05] elevation in both serum and BAL levels of IL-8 in COPD and lung cancer patients compared to the healthy control subjects but the difference between the COPD and lung cancer patients was insignificant [P > 0.05], Also, there was a highly significant elevation in both serum and BAL levels of TNF-alpha in COPD and lung cancer patients compared to the control group and the serum as well as the BAL levels of TNF-alpha were significantly higher in lung cancer patients compared to the COPD ones. The BAL levels of IL-8 and TNF-alpha were always significantly higher than the serum levels of the same cytokine in the same group of patients or control subjects. This study concludes that IL-8 and TNF-a levels are increased both in BAL and serum of COPD and lung cancer patients and their assessment may add to the understanding of the ongoing pathogenic inflammatory processes occurring in the smoker's airways till the development of COPD or lung cancer

Fluctuation of some blood parameters throughout the estrous cycle in goats

Seven healthy mature Baladi does [10-14 months old] were used in the present study. Estrus was synchronized using lutalyse. Heat was detected by the use of rutting aproned buck. Individual blood samples were collected daily in the morning throughout the two successive cycles following the 1st post-synchronized cycle. Each sample was divided into three portions for determination of ERS, hematological studies as well as for serum separation for biochemical analysis. The results revealed that RBCs count and Hb concentration as well as total leucocytic count and neutrophils% were significantly higher during estrous phase, whereas, ESR and platelets count as well as lymphocyte% were significantly lower during that phase. Urea, creatinine and ACP levels were significantly low during estrous phase, whereas, ALP, AST, total bilirubin uric acid, total proteins, albumins, globulins, total calcium, inorganic phosphorus, total glucose levels were significantly higher during that phase

Some alterations concomitant with prolonged administration of estrogen

The study was done for deeper underst and ing of adverse effects concomitant with repeated administration of estrogens. It was found that, prolonged treatment, particularly with high doses, leads to deleterious effects represented by immunosuppresion, alteration of cellular structure of different organs as well as deviation of hepatorenal performance. Cautious use of estrogenic agents to avoid their drastic effect is recommended

Cryptosporidium, blastocystis hominis dientamoeba fragilis in acute diarrhea in Egypt

This study was conducted on 187 patients with acute diarrhea and 20 controls attending the out patient clinics of Abbaseya Fever Hospital and Kasr El Aini Hospital. They included both sexes and different age groups. This study has demonstrated the high frequency of protozoal infections [68/187] in acute diarrhea in different age groups. Giardiasis represented 13 percent and amoebiasis 8 percent, with even a higher frequency in non-diarrhoeic cases [35 percent]. As regards cryptosporidiosis it was detected in 4 percent of diarrheic patients and all cases were below 2 years of age with the exception of one patient aged 60 years. Blastocytis hominis was detected in a high frequency [16 percent], only 7 of them had pure infection with no other enteric pathogens. Dientamaeba fragilis show a low frequency of only 1 percent. The details of age predilection and clinical presentations of each of these parasites were also studied

Acute bacterial diarrhea in Egyptian adults

This study was done on 83 patients with acute diarrhea and 20 controls, all were above 13 years of age. 70% of diarrheic patients were below 30 years of age, and most cases occurred during summer months [June-August], this seasonality is best evident in Shigellosis. The frequency of positive bacterial cultures was 17 cases [20%] in diarrheal patients compared with only one case [5%] in controls. However, there was a high rate of isolated parasitic pathogens in both groups. Shigella was the most frequent isolate [9 cases], 5 of them were Shigella dysenterae, 2 cases - Shigella flexeneri, one case Shigella boydii and another one Shigella sonnei. Diarrheogenic E. coli was detected in 6 patients [3 heat toxin [LT] and 3 heat stable toxin [ST]] and in 2 controls [2LT]. Campylobacter jeujeni, Salmonella species and Aeromonas hydrophilia were less frequently detected. The complaints of patients and the sensitivity to various antibiotics were also studied

Prevalence of human fascioliasis in 28 villages in Menofia governorate Egypt

This community based study was done on randomly selected households from 28 villages in a trial to estimate the prevalence of fascioliasis in Monoufia Governorate. Random single stool samples were obtained from 10036 individuals and were examined for fasciola ova and other parasites. The prevalence of fasciola infection was 1.6%. The highest prevalence [10.6%] was found in Ezbat El-Deyaba. Five villages were negative for fascioliasis. The peak age of infected individuals was in the group from 11 to 20 years. Their main symptoms were abdominal colic [12.5%], dyspepsia [11.1%], and diarrhea [6.9%]. Pallor, hepatomegaly, splenomegaly and jaundice were found in 29.2%, 4.9%, 2.8%, and 3.5%, respectively. However, most of the infected individuals were asymptomatic [69.5%]. No correlation was found between the prevalence of fascioliasis and schistosomiasis in the examined villages

low frequency of hepatitis B virus infection in schistosomal and non-schistosomal Egyptian army recruits

To extend the knowledge on the current prevalence of parasitic diseases and hepatitis B virus carrier and infection rates, 297 new army recruits, 18-25 years old coming from villages in the Nile Delta, were studied. Frequency rates for S. mansoni, S. hematobium and mixed infection were 43%, 3.3%, and 7%, respectively. The frequency rate for amoebiasis was 49.8%, ascariasis 6%, giardiasis 2%, hymenolepiasis 1.6% and enterobiasis 1.3%. Hepatitis B virus infection rate was 33.3% and the carrier rate was only 1.6%. The infection and the carrier rates of HBV were comparable in simple schistosomal and non- schistosomal subjects, but within the schistosomal group infection and carrier rates were higher in subjects with S. mansoni [36.7% and 1.5%] compared to those with S. hematobium [30% and 0%] and mixed infection [30.4% and 0%]. The infection and carrier rates in this study are lower than those previously reported

Effects of oestradial administration on hepatorenal functions in male rats

Twenty-five mature male albino rats were used in the present study to clarify the effects of estradiol on hepatorenal function. They were divided into two groups [control group and treated group]. The results showed that there was an increase in serum level of alkaline phosphatase, ALT, AST, bilirubin, urea, creatinine, triglycerides and cholesterol following estradiol treatment. So, it was concluded that, administration of estradiol at high dose rates to mature male rats has a serious harmful effect on hepatorenal function