ABSTRACT
Objective: To evaluate the long-term efficacy and safety of omalizumab in asthma in a real-life setting
Subjects and Methods: This 4-year observational study included 65 patients treated with omalizumab during clinic visits; treatment response was rated as excellent, good, and partial based on a modified physician's Global Evaluation of Treatment Effectiveness [mGETE] scale of emergency room visits [ERV], hospitalization, use of oral corticosteroids, inhaled corticosteroid [ICS]/long-acting Beta-agonist [LABA] dose, and short-acting Beta-agonist rescue. The following tests were done: forced expiratory volume in 1 s [FEV1] and the asthma control test [ACT]. Measurements were performed 1 month before therapy and at 16 weeks, 1 year, and 4 years of treatment. Statistical analyses were done using the Wilcoxon signed-rank test, Spearman rank correlation, and McNemar X[2] test
Results: The dropout rate was 15 [18.5%]: 8 nonresponders [10.0%]; 2 patients died [2.5%], and 5 were lost to follow-up [6.25%]. Treatment response was excellent in 35 [53.8%]; good in 23 [35.4%], and partial in 7 patients [10.8%]. The number of excellent responders increased from 35 [53.8%] at 16 weeks to 48 [73.8%] at the 4-year follow-up. The number of patients who did not require ERV improved from 0 to 59 [90.8%], and the lowest rate of hospitalization was 1 in year 4 [p < 0.001]; patients who did not require courses of oral corticosteroids improved from 0 to 54 [83%]. ICS/LABA dose significantly reduced from 65 [100%] to 25 [38.5%] after 4 years of treatment [p < 0.001]; ACT scores significantly increased from 15 +/- 3 at baseline to 23 +/- 3 [p < 0.001] and FEV[1] level from 55.6 +/- 10.6 to 76.63 +/- 10.34 at year 4
Conclusion: In this study, omalizumab therapy resulted in better asthma control, and was effective and well tolerated as an add-on therapy for patients with moderate-to-severe asthma
ABSTRACT
Basidiobolomycosis is a rare disease caused by the fungus Basidiobolus ranarum. Patients with Basidiobolus ranarum infection may present with subcutaneous, gastrointestinal, or systemic lesions. Recently, its etiologic role in gastrointestinal infections has been increasingly recognized. We report this case of gastrointestinal and retroperitoneal basidobolomycosis because of its rarity and also to emphasize the need to consider gastrointestinal and retroperitoneal basidiobolomycosis in the differential diagnosis of inflammatory bowel diseases, tuberculosis and malignancy
Subject(s)
Humans , Male , Entomophthorales , Signs and Symptoms, Digestive , Diagnosis, DifferentialABSTRACT
The aim of the present study was to determine the prevalence, severity of dental fluorosis and to identify the contributing factors to fluorosis among preparatory school children in Alexandria Gov-ernorate. To meet this aim, a cross-sectional sample was selected using a stratified sampling with proportional allocation technique. A total number of 1007 children, aged 12 to 13 years old, were randomly selected from 27 preparatory schools in all of Alexandria districts [urban and rural - private and public schools], and they were equally divided into males [505] and females [502] A questionnaire was used to collect fluoride exposure data. Only students who returned the questionnaire and their parents' consent were clinically examined on the next day for dental fluorosis, which was recorded by Dean's [1942] index. One hundred samples of drinking tap water for residents [since birth] were analyzed to measure the fluoride concentration For further confirmation of the fluoride analysis, 12 water samples were collected from all Alexandria water stations The results showed that the water fluoride level in Alexandria ranged from 0.30 to 0.90 mg/L, the highest water fluoride concentration was in Borg El-Arab district, which was attributed to presence of agricultural waste products that drained in the main water stream just before the water supply station Although this fluoride concentration in drinking tap water is considered optimal, however there is a trend towards increase in the prevalence of dental fluorosis [60.0% to 85.7%], particularly in Borg El-Arab district [85.7%], also in rural children [92.4%] than urban children [69.9%] and public schools [72.1%] than private [64.6%]. The most prevalent form of dental fluorosis was the very mild form. Fluorosis was proved to be more prevalent in maxillary than mandibular teeth and premolars were the teeth most affected. The multiple regression analysis proved that the most significant contributing factor for dental fluorosis was fluoridated toothpaste if used in large size on toothbrush's head and particularly if the child started brushing teeth with fluoridated toothpaste at an early age Also, fluoride supple-ments intake in the first 8 years of life and frequency of eating fish per week increased the probability of the child to have different degrees of dental fluorosis. The results suggested that fluorosis prevalence is increasing but can be put under control by monitoring fluoride level in drinking water and controlling hidden sources of fluoride intake by labeling juices and beverages, aboundenting the practice of dietary fluoride supplementation, and close parent supervision on the dispersion of fluoridated toothpastes by children
ABSTRACT
Objectives: the aim of this study is to investigate the impact of plasmodium falciparum infection in parturient women in Central Sudan where malaria transmission is mesoendemic. The purpose of this paper is to find out the prevalence of malaria paracitemia and the risk of anemia among parturient women and to suggest appropriate strategies to lower their prevalence rates
Methods: this prospective study was conducted at Medani Teaching Hospital, Sudan a tertiary regional referral center, during the period January 1997 through to December 1997. All cases were admitted during labour to the delivery room and were clinically suspected to have malaria. History, examination and investigations were carried out on all patients
Results: the total number of patients enrolled in this study was 550, amounting to 14.9% of all women [N=3,687] who delivered during the study period. The prevalence of malaria paracitemia was 58.9% [N=550] while prevalence of anemia [defined as hemoglobin <9.0 g/dl] was 24.1% the mean hemoglobin levels in patients with positive and negative malaria paracitemia was 9.7251.62 and 9.85+ 1.60 gdl. Statistically the difference in the mean hemoglobin level was not significant, t=0.879, A significant negative correlation between parasite count in maternal blood and hemoglobin level of the mother, was observed, where r= 0.121 [P=0.032]. out of 17 [3.3%] patients who had used chloroquine tablets for prophylaxis, 11 patients still had positive paracitemia. Although there was a higher parasite count in those 11 patients, statistically the difference was not significance where P> 0.05
Conclusion: the study documents a high prevalence of malaria paracitemia and anemia among the parturient women in Central Sudan. There were 533 pregnant women [97%] who did not use chloroquine tablets as chemoprophylaxis and 17 [3%] had prophylaxis. Eleven of the later [N=17] had positive paracitemia. In view of the high prevalence of paracitemia and anemia, and although the sample of patient who used chloroquine tablets for prophylaxis and had positive paracitemia is small [17 out of 550], a wide scale prophylaxis placebo- controlled trial is recommended to test the impact of prophylaxis during pregnancy and to measure the effect on the mother, and the neonate. The drug that proves to be effective as a prophylactic should be an integral part of antenatal care along 14th iron and folic acid as anti-anemic therapy. Moreover, prompt treatment of malaria infection with the appropriate anti-malaria drug, spray of insecticides and the use of insecticide-impregnated bed-nets and curtains for preventing malaria are recommended
ABSTRACT
Inspite of the modem and sophisticated tools for the immunophenotyping of acute leukemias, yet there are still simpler methods for initial categorization of leukamias into lymphoblastic and non lymphoblastic. The aim of the present study was to identify mast cell chymase as a marker of acute myeloblastic leukemia since they originate from a common progenitor cell. Bone marrow spiration smears from leukemic patients and control were stained for chymase. The normal control had weak positive reaction, the acute lymphoblastic leukemia had negative reactions while in patients with acute myeloblastic leukemia, the chymase reaction was strikingly positive and positivity correlated well with the basophilic count in the peripheral blood and bone marrow smears. A very strong reaction was seen in patients with myeloid blast crisis and in those who were resistant to induction chemotherapy. Therefore, the chymase identification method is a very cheap and convenient tool for the cytochemical diagnosis of acute myeloblastic leukemia