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

Descriptive epidemiological analysis, MRI signals intensity and histopathological correlations of meningiomas

To present our experience in operated meningioma cases regarding their prevalence, anatomical location, multiplicity, presenting signs and symptoms, and the possible correlation between MRI signal intensity and histological grades to set criteria for radio-pathological diagnosis. In this retrospective study, 120 operated meningioma cases in the Department of Neurosurgery, Jordan University Hospital [JUH], Amman, Jordan between January 1997 and January 2007 were reviewed. Our study included 90 cases, and their medical records, histopathological reports, and neuroimages were analyzed thoroughly. Meningioma was more common in females than males with a ratio of 2.2:1. Para-sagittal meningiomas were the most common [23.3%]. Multiple intracranial meningiomas were found in 4.4% of the cases. Most cases were of benign histopathology and exhibited iso-intense signals on Tl and T2, and appeared with hyper-intense signals on FLAIR with vivid enhancement. The prevalence of meningioma among genders and its anatomical location at JUH corresponds to the published medical literature worldwide. There was no correlation between signal intensities [as seen on T1WI, T2WI, and FLAIR sequences], enhancement pattern on one side, and histological grades on the other side

Designing a model for security requirements of electronic health records in Iran

Flourishing capacity of information technologies for collecting, storage and transmission unheard of amount of information creates a great deal of concerns for patients. Patients are worried over the access of numerous people to their electronic health records. To determine the security requirements of electronic health records for Iran. This descriptive study was carried out in 2007. Security requirements of electronic health records gathered from comparative study performed in Australia, Canada and England countries followed by designing the initial model. The final model was prepared through gathering the information by questionnaire and the use of Delphi Technique. The values under 50 percent were eliminated from the model and those equal or higher than 75 percent added to the model. The proposed model for Iran includes the requirements for organizing information, information classification, human resources, communication and operation management, and access control security. A comprehensive model of electronic health records security requirements was designed for Iran. The approval of this model by authorities for protecting the electronic health information security is recommended

[Assessment of knowledge attitude and practice of trainees on neonatal resuscitation in the healthcare center affiliated to the University of Medical Science of Mazandaran]

There are more than five million neonatal death around the world of which%19 was because of Asphyxia at birth time. In our country, there has been educational program in order to decrease the mortality caused by Asphyxia and to practice a scientific method for resuscitation. This study was conducted to determine the rate of knowledge, attitude and practice for every learner of neonatal resuscitation in the governmental current study was a descriptive cross sectional done on All Trainees who had professional direct contact with birth Asphyxia. We selected exactly 137 people who had attended Neonatal Resuscitation Workshop for three days. The subjects under the study were%62/8 midwife and%89/8 women. Data show that% 44.5 had good knowledge and% 11.7 had very good knowledge on neonatal Resuscitation. The highest acknowledge was%93/4 and%89/1 on chest compression and breath stimulation way respectively. Data also suggested that totally% 96.34 of the subjects had good and very good attitudes towards neonatal resuscitation. The results show that only% 38.4 of the subjects under the study had a good level practice and their attitudes in terms of age were significantly different [P<0.01]. Also, their practice on job showed a significant difference [P<0.017]. In the study, there was a converse relation between age and professional experience which was r = 0.25 and r = 0.26, respectively. Results obtained suggest that the amount of knowledge and practice for the subjects under the study was average, but their attitudes towards neonatal resuscitation was good. There fore, according to the positive attitude of the subjects,there must be a trend to promote knowledge and practice

Comparison of injection sclerotherapy only for bleeding esophageal varices and injection sclerotherapy with somatostatin analogue infusion: randomized prospective study with 2 years follow-up in children

Portal hypertension is a pathological rise of portal blood pressure above 10 mmHg with subsequent development of portosystemic collaterals including esophageal varices. Variceal hemorrhage may cause significant morbidity and mortality in children with cirrhosis and rational for upper Endoscopy. Besides the general hemodynamic resuscitation, Octerotide was used to control acute bleeding with success. Endoscopic sclerotherapy arrests hemorrhage in 80% to 90% of cases, however, with 0.5% to 2% mortality. To evaluate the difference between treating first time bleeding varices in children with Endoscopic sclerotherapy alone or combined with Somatostatrn analogue, Octerotide, we designated this random, prospective study and 2 year follow-up. Forty children were enrolled, 30 male and 10 females. Children were randomly divided into 2 groups: Group I consists of 20 children with first time bleeding esophageal varices who were treated by injection sclerotherapy only and Group II consists of simlar 20 children whom bleeding was managed by sclerotherapy and Octerotide. The sample was homogenous as regard the clinical presentations and examination except for hepatomegaly which was seen in 7 [35%] in group I and in 13 [65%] in group II. Portal vein thrombosis, Bilharzial fibrosis and post-hepatitic cirrhosis represented the most frequent etiology with 13 [32.5%], 9 [22.5%] and 7 [17.5%] order of detection. Endoscopic appearance at the time of first bleeding revealed predominance of grade II varices. It was seen in 12 [60%] in group I and 10 [50%] in group II. Two years later majority of group I varices were grade I, while majority of group II varices were grade II [0 [55%] and 11 [70%] respectively]. Portal hypertensive gastropathy were absent in 12 [61%] in group I and in II [70%] in group II after 2 years follow-up. Endoscopy and Octerotide related complications were seldom in this study. We concluded that Injection sclerotherapy remains the standard of care, combining Octerotide can improve the control of acute bleeding and early rebleeding however, its high cost renders its use rather limited

Microbiological aspects of diaper dermatitis and breast milk zinc

This study was conducted on 185 infants divided into two groups: Group I 75 breast fed full term infants [42 males and 33 females] and group II 60 breast fed preterm infants [33 males and 27 females] suffering from resistant diaper dermatitis, aged one month to 12 months, in addition 50 clinically free infants were selected as a control group. Bacterial growth was obtained in 117 [86.7%]. Aerobic facultative bacteria or candida were present in 56 cases [47.9%] and anaerobic bacteria only in 23 cases [19.7%] and mixed anaerobic with aerobic, facultative or yeast was present in 38 cases [32.4%]. So, colonization of candida in this study was 94 cases [80.3%]. The results recorded that the most common candida species isolated were C. albicans 67%, followed by C. tropicals, C. parapsilosis, C. macedoniensis and C. deformans 20.2%, 5.3%, 4.3% and 3.2%, respectively. The commonest strict anaerobic isolates were bacteroid fragilis [39.1%] then peptostreptococcus [30.4%], propionibacterium acnes [17.4%] and peptococcus [13.1%]. The most common aerobic facultative isolates in this study were staphylococcus aureus [41.1%], streptococcus [33.9%] especially non-hemolytic streptococcus, beta-hemolytic streptococcus, alpha-hemolytic streptococcus [14.3%, 10.7% and 8.9%], respectively, staphylococcus epidermidis [14.3%] and E. coli [10.7%]. Diagnosis of zinc deficiency must be considered in any infant with a napkin dermatitis which fails to respond to appropriate treatment

Clinical value of urinary alpha 1-microglobulin and N-acetyl beta-D-glucosaminidase in pediatric renal diseases

Measuring urinary alpha[1]-microglobulin [alpha1 MG] and acetyl beta-D-glucosa-minidase [NAG] excretion is widely used as a valuable clinical tool in assessing renal glomerular and tubular lesion in adult, However few data are on values for urinary alpha[1]MG and NAG in pediatrics. The aim of this study was to measure urinary alpha[1]MG and NAG in children in health and diseases and if these might reflect disease activity. We studied 31 children with some clinical renal diseases during active disease and remission over follow-up period of 3 years and 10 healthy children were included as a control group. 10 children with nephritic syndrome [group I], 11 children with nephrotic syndrome [group II] and 10 children with lupus nephritis [group III]. Urinary alpha[1]MG and NAG was measured by radial immunodiffusion technique assay and colorimetric assay respectively. Our results showed significantly higher levels of urinary alpha[1]MG in children with active disease versus controls. The urinary alpha[1]IMG level was in the control [19.67 +/- 8.481, in group 1[53.61 +/- 2.95, p<0.05]. In group 11[91.29 +/- 31.91 p<0.01] in group III [81.27 +/- 15.09, p<0.001] compared to control. Urinary alpha[1] MG level showed no significant difference in patients in remission period versus control [p>0.05]. Urinary level of alpha[1] MG showed significant correlation to proteinuria in group I [r=0.783<0.01] and group 11 [r=0.925, p<0.001] only. On the other hand urinary NAG level showed significantly higher levels in all patients groups [group I, group II, group III], compared to controls [p<0.001] and there was no significant difference in all patients in remission phase compared to controls [p >0, 5]. There was a significant positive correlation between urinary alpha[1]MG and NAG

Diagnosis of congenital cerebral toxoplasmosis by detection of low avidity specific IGG antibodies in cerebrospinal fluid

To assess the role of congenital toxoplasmosis as a causative agent of the CNS disorders in human off springs, 105 newborns, infants, preschool and school children with these disorders were observed. They consisted of three groups. The first were 24 newborns and infants to mothers seroconverted during pregnancy, the second; 39 newborns and infants whose immunocompromised mothers were Toxoplasma chronically infected before pregnancy, the third, 42 children who were clinically free at birth but presented with CNS disorders 4-9 years later; their mothers were with chronic Toxoplasma seropositivity at the time of the survey. Anti-Toxoplasma IgG antibodies were sought in the sera of mothers and sera and CSF of the off springs. Specific intrathecal IgG antibody production was estimated by calculating Goldman Witmer Coefficient [C] and by calculating the CSF to serum antibody avidity ratio [AR] exploiting an ELISA that included dissociation of antigen-antibody complexes with 6 Mure a solution. C value > 8 and AR value < 0.5 were detected in 5 [20.8%] members of the first group, 3 [7.6%] of the second and 4 [9.5%] of the third. These values corresponded with the response to specific therapy. The antibody avidity in the diagnosed newborn sera [

genetic epidemiological study of congenital malformations at birth in Sharkyia, Egypt

A total of 1500 consecutive neonates delivered in Zagazig University Hospitals were subjected to full clinical and genetic evaluation. Social data including parental consanguinity and social class were taken. The prevalence of congenital in malformations [CMs] in the 1500 hospital live births and still births were 3.2%. The malformed neonates [48] were classified into 13 groups according to world Health Organization classification of CMs. The most common anomalies were: central nervous system [29.1%], followed by musculoskeletal system [18.9%] and genetic syndromes [10.5%]. Parental consanguinity was found in [54.2%] of malformed cases, indicating the deleterious effects of consanguinity. Our study concludes that overall the inheritance rather than socio-environmental factors contributes significantly in the etiology of different congenital malformations. We further suggest that the basic information of this research might be useful foundation data in future analytic studies on CMs in Egypt