Coccidian parasites as a cause of watery diarrhoea among protein energy malnourished and other immunocompromised Egyptian children

The role of coccidian parasites in the pathogenesis of watery diarrhea was studied among children with protein energy malnutrition [PEM] immunocompromised due to causes other than PEM and immunocompetent diarrheic cases of matched age and sex as controls. The results showed that the prevalence of infection was 15.48%, Cryptosporidium was the most prevalent and showed 14.19% [18.3%, 17.5% and 7.3% in PEM, immunocompromised and immunocompetent cases, respectively]. Cyclospora oocysts were detected only among two cases of PEM group. Isospora oocysts were not detected in any of the studied groups. Modified Ziehl-Neelsen [ZN] technique was found to be the most reliable technique for identification of coccidian protozoa infection in stool. Giardia lamblia cysts were found in 10.97% and Entamoeba histolytica in 5.16% of cases. Mixed infection [G. lamblia and E. Histolytica] was found in 2.58% of the cases. The duration of diarrhoea was more prolonged in Cryptosporidium and Cyclospora infections among PEM and immunocompromised cases. Cryptosporidium is one of the important causes of watery diarrhoea in infants and children in PEM and immunocompromised patients

Effect of chemical mutagenic agent on chromosomal pattern of Egyptian kwashiorkor infants

Previous animal studies suggested that malnutrition has a mutagenic and carcinogenic effect through inhibition of protein synthesis and DNA replication. However in humans, the effect of malnutrition is still controversial in spite of the fact that many studies had detected higher frequency of chromosomal aberrations in malnourished children as compared to the healthy controls. This work was carried out to determine the effect of malnutrition on human chromosomes and to test the cell sensitivity to chemical mutagens. We tried also to correlate the frequency of chromosomal damage to the level of plasma proteins. The study was conducted on twenty protein energy malnourished patients and twenty apparently healthy controls .Seventeen patients out of the twenty were reevaluated after nutritional rehabilitation and complete clinical recovery. Patients and controls were subjected to history taking, clinical examination, plasma protein electrophoresis and cytogenetic study. Cytogenetic study using micronucleus test [MN] revealed a statistically significant higher MN in patients before treatment [1.4 +/- 1.5] as compared to both after treatment [0.5 +/- 0.76] and the controls [0.55 +/- 1.0]. While there was no statistically significant difference in the frequency of MN in patients after treatment as compared to the controls. There was higher frequency of chromosomal aberrations [CA] in patients before treatment [3.2% +/- 2.49] as compared to patients after treatment [2% +/- 1.1] and the controls [2.3% +/- 2.8], however, this data was statistically insignificant [P>0.05]. There was negative correlation between total serum proteins and albumin and the frequency of chromosomal aberrations. Lymphocytes from malnourished patients were more susceptible to chromosomal damage induced by bleomycin in vitro than the lymphocytes of the control children. The detected susceptibility was significantly decreased after treatment of the patients. the mean percentage increase in CA [induced by blemoycin in vitro] was statistically higher in patients before treatment [199.6% +/- 199.6] as compared to after treatment [97% +/- 136.2] and the controls [102% +/- 160.4]

Changes in atrial natriuretic peptide with hemodynamic abnormalities in rheumatic valvular diseases

Atrial natriuretic peptide [ANP] plasma levels were studied in 49 patients with rheumatic heart diseases [RHD] and 10 apparently healthy control subjects. Their ages ranged from 6 years to 15 years. All the studied cases were subjected to thorough history taking, clinical examination chest-x ray, EGG, echocardiographic examination and plasma ANP measurement by radiommunoassay. The results revealed that plasma ANP concentration was significantly higher in rheumatic patients as compared to age matched control subjects [P<0.001] and in those suffering from multivalvular disease [MVD] as compared to those with single valve disease [SVD] [P<0.01]. Patients with isolated severe mitral regurge [MR] [grades 4/4 and 314] had higher ANP levels than cases with milder abnormality [grade 2/4]. ANP values in Patients with mitral stenosis [MS] were significantly higher as compared to control subjects [P<0.01] but nearly the same as those with MR. ANP values in Patients with aortic regurge [AR] showed insignificant slight increase as compared to control subjects [P>0.05]. ANP assay proved also to be sensitive in reflecting the development of complications. ANP levels were significantly higher in cases complicated by pulmonary hypertension than those with normal pulmonary artery pressure [P<0.05]. Also, those cases with heart failure had their ANP levels higher than the mean value of ANP in those with compensated RHD. ANP concentration showed a significant positive correlation with cardiothoracic ratio [CTR] in chest roentgenograms [P<0.01]. Also, ANP levels were positively correlated with time measurements of LA/Ao ratio [P<0.01] and left ventricular end-diastotic dimension [LVEDD] [P<0.01] in M-mode echocardiography as well as pulmonary artery systolic pressure in Doppler studies [P<0.05]. There was no significant correlation between ANP level and left ventricular systolic function indices as fractional shortening [ES] and ejection fraction [FS] [P>0.05]. In conclusion, ANP assay can be used for accurate assessment of the degree of the degree of hemodynamic overload in patients with RHD. Also, ANP assay can be of value in delection evaluation and follow-up of potential complications as heart failure and pulmonary hypertension. In addition it could provide a clinically useful marker of the adequacy of treatment of cardiac impairment