Polymorphism in Macrophage Migration Inhibitory Factor -173GC in Pediatric Patients with Autoimmune Hepatitis / 대한소아소화기영양학회지

Human leukocyte antigen class-II DRB1 alleles and Giardia lamblia infection in children: A case-control study

Objective: To compare the genotype frequencies of HLA class- II DRB1 alleles in Giardia (G.) lamblia-infected children. Methods: A total of 490 Egyptian children aged 2-16 years were subjected to microscopic stool examination to detect G. lamblia infection, and to exclude other intestinal pathogens. On the basis of their microscopic findings, a group of 80 children were chosen as giardiasis cases, another 80 children were confirmed as Giardia free control group by immunochromatographic test, and the remaining children were excluded. Both giardiasis and control groups were then subjected to blood examination to identify their genetic type of HLA-DRB1 alleles. Results: HLA class-II DRB1∗03:01 and DRB1∗13:01 alleles were significantly associated with G. lamblia infection (P<0.001 for each variable). On the other hand, HLA class-II DRB1∗04:02, DRB1∗10:01, DRB1∗14:01 and DRB1∗15:01 alleles were significantly demonstrated in Giardia free children. However, other HLA-DRB1 alleles did not show any significant association with giardiasis. Conclusions: HLA class-II DRB1∗03, DRB1∗13, DRB1∗04, DRB1∗10, DRB1∗14 and DRB1∗15 alleles may be involved in the establishment of host immune response to G. lamblia infection.

Delays in diagnosis and treatment among children with cancer: Egyptian perspective

Delayed diagnosis is one of the contributing factors to lower cure rates for cancer in low-income countries. This was a cross-sectional study of 138 children with cancer who were treated at the Pediatric Oncology Unit, Oncology Center of Mansoura University, Egypt. One hundred and sixteen patients were initially misdiagnosed. The median total delay was 37 days, including median patient/parent delay of 3 days and median physician delay of 28 days. The type of cancer significantly influenced the diagnostic delay. Patients' sex, level of parents' education, and residence did not significantly affect the median total delay, while patients aged < 5 years and those who had an initial provisional diagnosis of cancer had the shortest median total delay. We suggest implementation of continuing medical education programmes, improving access to diagnostic facilities, and facilitating referral to give priority to those with suspected cancer to shorten the time for cancer diagnosis

Screening of toxoplasma gondii infection among childbear- ing age females and assessment of nurses'role in prevention and control of toxoplasmosis

Toxoplasmosis, caused by Toxoplasma gondii is an obligate intracellular zoonotic protozoan parasite, with a worldwide distribution particularly in Arab countries including Egypt. The study evaluated toxoplasmosis infection among childbearing age Egyptian females and assessed the military nursing staff knowledge, attitude and compliance to toxoplasmosis prevention and control measures. The study was conducted in a general military hospital. Research design: cross-section descriptive research design was used to conduct this study. The subjects consisted of 14 young females [11 were in-patients undergoing gynecological treatment in a military hospital and 3 were staff nurses. On the other hand, 44 staff nurses were available for assessment who met the inclusion criteriaTools: 4 tools were used for data collection: first consisted of self-administered questionnaires to assess nurses' socio-demographic data and knowledge, second rating scale to assess nurses' attitude towards toxoplasmosis infection and its prevention, third performance check list to measure nurses' compliance to infection control measures, and fourth measured the anti-Toxoplasma antibodies by commercial indirect hemagglutination test [IHAT].The results showed that almost half of the nurses had satisfactory levels of knowledge, attitude, and compliance to toxoplasmosis infection control measures. 22.2% of the pregnant women and 20% of non-pregnant ones showed antibodies against T. gondii.Thus health education about toxoplasmosis should be tailored to women whether married or single to help in avoiding the risk of infection. Frequent periodic MAT should be done for people who continuously contact with cats. Adherence to strict infection prevention measures is a must to eliminate exposure to toxoplasmosis infection. Training intervention should be implemented to achieve successful improvement in knowledge, attitude, and compliance of toxoplasmosis control measures

Anorectal functional abnormalities in Egyptian children with chronic functional constipation

Chronic functional constipation represents 95% of the cases of paediatric constipation. Epidemiologic data, pathophysiology and anorectal functional abnormalities vary greatly among different reports across different populations. The aim of this study was to evaluate these data in Egyptian children with chronic functional constipation. This study included 150 children with chronic functional constipation [101 males, 49 females; mean age 6 +/- 3.1 years]; a control group of 50 age- and sex-matched healthy children were enrolled for standardisation of the manometry technique. A structured symptom questionnaire and clinical examination including digital rectal examination in addition to anorectal manometry were done for all included children. Defaecation dynamics were assessed in all children 5 years or older using anorectal manometry with integrated electromyogram of the external anal sphincter and the puborectalis muscle. The maximal tolerable volume was significantly higher in the constipated children than in the control group [p = 0.03]. No significant differences existed between constipated and control children regarding other anorectal manometric parameters. Abnormal defaecation dynamics were detected in 35 out of 95 tested patients [36.8%]. Increased maximal tolerable volume is the most striking manometric feature in Egyptian children with chronic functional constipation. Abnormal defaecation dynamics were detected in about one-third of the tested patients. Standardisation of the measurement techniques and obtaining normal ranges for anorectal manometric parameters for each laboratory are recommended

Ischial bed sore reconstruction

Ischial region is the most common location of pressure sore. Ischial pressure sore seems to develop large and deep bursa with relatively small openings. The goals of surgical treatment are complete debridement of devitalized tissue and coverage with well-vascularized tissue to prevent recurrence. Compare between myocutaneous flaps and fasciocutaneous flaps for Ischial bed sore reconstruction. 25 patients with ischial pressure sore, age ranges [15-70] years old operated in Minoufiya University Hospital between March 2003 to April 2006. Follow up for one year. Patients are divided into three groups, group I:9 patients operated by Hamstring V-Y myocutaneous flap, group II: 8 patients operated by inferior gluteal thigh flap and group III: operated by gluteus maximus myocutaneous flap. Only one case of recurrence in group I and three cases of recurrence in group II with donor site morbidity needs skin graft in three cases also, and no recurrence in group III. Volume replacement and,resurfacing was better in group l and group III than group II. Myocutaneous flaps have excellent volume replacement and resurfacing and less recurrence rate than fasciocutaneous flaps but as recurrence is a dominant risk so you have to solve the problem with the simplest option firstly to save other options for the patient

Transmission dynamics of Giardia lamblia in a cohort of rural school children

A longitudinal study that included 6 surveys was done on 264 children attending a rural primary school in Gharbia Governorate, Egypt to study the transmission of the protozoan Giardia lamblia. The surveys were done every two months from September 2001 to July 2002. On each survey, three stool samples were collected from each participating child over one week period, and all three samples were pooled and examined using formol ether concentration technique. At the end of the study period, weight and height were recorded and anaemic status was estimated. Results revealed that G. lamblia prevalence ranged between 20.5% in May and 26.5% in November with no observed seasonality. By the end of the study period, 83.7% of the children had at least one positive G. lamblia stool examination. Loss and reinfection rates were 77% and 40.9%, respectively. The high susceptibility may be due to the ubiquity of the parasite in the environment and the antigenic variation of the organism that leads to evasion of the immune response. Transmission pathways appear to be person to person as indicated by repeated infection in 50% of children with bad personal hygiene, and in those having a high crowding index. Environmental role is indicated by higher detection times among those who used stored water for drinking. Neither anaemia nor under nutrition was associated with the infection. An integrated program should be implemented blending nutritional interventions and phytotherapeutic agents with health education to minimize symptomatology and clear the parasite, without significant side effects