Detection of Cryptosporidium spp. in Diarrheic Immunocompetent Patients in Beni-Suef, Egypt: Insight into Epidemiology and Diagnosis

Cryptosporidium species is an important cause of gastrointestinal infections globally. This study aimed to shed light on its role in diarrheic immunocompetent patients in Beni-Suef, Egypt and to compare three diagnostic methods. Two hundred diarrheic patients, 37±16.8 year old, were enrolled. Stool samples were examined by light microscopy, using modified Ziehl-Neelsen stain (MZN) for Cryptosporidium spp. oocysts. Coproantigens were detected by sandwich ELISA. DNA molecular diagnosis was done by nested PCR. PCR yielded the highest detection rates (21.0%), compared to ELISA (12.5%) and MZN staining method (9.5%). The higher infection rates were in 20–40 year-old group, followed by 40–60 year-old. Association between epidemiologic factors was statistically not significant; positivity and gender, clinical manifestations, residence, source or water, or contact with animals. Cryptosporidiosis is an important enteric parasitic infection in Beni-Suef and PCR remains the gold standard for diagnosis.

Antimicrobial activity of kojic acid from endophytic fungus Colletotrichum gloeosporioides isolated from Sonneratia apetala, a mangrove plant of the Sundarbans

Objective:To isolate and evaluate the antimicrobial activity of the active principle(s) from the ethyl acetate (EtOAc) extract of endophytic fungus Colletotrichum gloeosporioides (C. gloeosporioides) isolated from Sonneratia apetala.Methods:Water agar technique was used to isolate the fungus, and both microscopic and molecular techniques were used for identification of the strain. Potato dextrose broth was used to grow the fungus in large-scale. Reversed-phase preparative HPLC analysis was performed to isolate the major active compound, kojic acid. The EtOAc extract and kojic acid were screened for their antimicrobial activity against two Gram-positive and two Gram-negative bacteria as well as a fungal strain using the resazurin 96-well microtitre plate antimicrobial assay.Results:The fungus C. gloeosporioides was isolated from the leaves of Sonneratia apetala. Initial identification of the fugal isolate was carried out using spore characteristics observed under the microscope. Subsequently, the ITS1-5.8S-ITS2 sequencing was employed for species-level identification of the fungus C. gloeosporioides. Five litres of liquid culture of the fungus produced approximately 610 mg of a mixture of secondary metabolites. Kojic acid (1) was isolated as the main secondary metabolite present in the fungal extract, and the structure was confirmed by 1D, 2D NMR and mass spectrometry. The EtOAc extract and compound 1 exhibited considerable antimicrobial activity against all tested microorganisms. Whilst the minimum inhibitory concentration (MIC) values from the EtOAc extract ranged between 2.4× 10Conclusions:The results revealed that the endophytic fungus C. gloeosporioides could be a good source of commercially important kojic acid, which exhibited antimicrobial properties.

Factors affecting duration of untreated psychosis – A retrospective study done in general hospital setting

Background: Duration of the untreated psychosis has been predicted to be one of a factor which affects the outcome of disease and leading to poor prognosis in the patients. Previous studies had predicted that the longer the duration of psychosis the poor the outcome of the treatment. Aim: To assess the factors affecting the Duration of untreated psychosis among patients with first episode psychosis in General hospital setup. Materials and methods: Retrospective study was done on patients who got admitted for the duration of 6 months (1st June 2014 to 31st November 2014). Patients who were diagnosed to have first episode psychosis according to ICD-10 were taken up for the study. Duration of untreated psychosis and the socio demographic details were noted. Results: The duration of untreated psychosis was seen more in male (58%), 45% in age group of 20- 29, 54% were married, 71% in lower middle economic status, 75% of people were from semi urban background and 41% of patients had duration of untreated psychosis for duration of 2-5 weeks. Mean average age is 30.75 and duration of untreated psychosis is 40 days. Conclusion: Mean average age is 30.75 and duration of untreated psychosis is 40 days. Age, gender, marital status, socio-economic status and residence (Environment) acting as a predictor for the long DUP is consistent with previous studies but significant findings couldn’t be found, when two groups Ananthi B, Sabari Sridhar O.T., Kailash S, Shajahan M Ismail, Srinivasan B. Factors affecting duration of untreated psychosis - A retrospective study done in general hospital setting. IAIM, 2017; 4(3): 10-14. Page 11 were compared thus giving the conclusion that Sociodemographic factors alone doesn’t influence on DUP

Investigation of Cs-137 in the environmental soil segments of the Peshawar and Nowshera districts of Khyber Pakhtunkhwa, Pakistan

Background: Radioactive contamination in soil arises due to various activities of human being, such as nuclear energy generation, use of radioisotopes in industrial applications, science, technology, medicine and release of radiation in nuclear weapon tests

Materials and Methods: The two districts [Peshawar and Nowshera] of Khyber Pakhtunkhwa, Pakistan were selected for the study of anthropogenic Cs-137 assessment. A total of 102 soil samples were collected from different locations of these two districts of Khyber Pakhtunkhwa

Results: The activity concentration of Cs-137 was determined by gamma ray spectrometry using a high purity germanium detector coupled with a PC. The highest values for Peshawar and Nowshera found were 44.1+/- 4.6 Bq/kg and 27.9 +/- 4.3 Bq/kg, respectively

Conclusion: The presence of Cs-137 shows that the areas under study have gained some fallout, however, the activity concentrations of Cs-137 found in the surveyed area were nominal and do not pose any potential health hazard to human beings?

Coronary artery disease and diabetes mellitus

Objectives: diabetes mellitus [DM] and coronary artery disease [CAD] are closely related. DM is a risk factor for CAD, but it is also equivalent to established CAD. The prevalence of DM and CAD is growing primarily due to the rising prevalence of obesity. The rapidly changing life style, especially in developing countries, plays major role in the occurrence of these diseases

Methods: we performed a literature review to summarize and explore the relationship between CAD and DM with a special focus on Arab countries in terms of risk factors and prevalence. We suggest future directions to prevent escalation in the incidence of DM and CAD in Arab countries

Conclusion: an important part of any preventive program for CAD should include clear prevention strategies for DM and other associated metabolic risk factors, such as obesity. Preventive measures, such as physical exercise in high-risk groups, at the population level should be encouraged

Protozoa causing food poisoning

Food poisoning also called foodborne illness, or illness caused by eating contaminated food is a term used to cover an unpleasant range of illnesses. Food poisoning symptoms vary with the source of contamination. Most types of food poisoning cause one or more of the following signs and symptoms: nausea, vomiting, watery diarrhea, abdominal pain and cramps and fever Signs and symptoms may start within hours after eating the contaminated food, or they may begin days or even weeks later. Sickness caused by food poisoning generally lasts from a few hours to several days

antigenic relationship between schistosoma mansoni and its intermediate snail host

Schistosomiasis is a public health problem in many developing countries including Egypt, Determination of the antigenic relationship between S. mansoni and its intermediate snail host [IMH] Biomphalaria alexandrina can open a new field for diagnosis and control of the disease. In the present study infected and non-infected B. alexandrina foot and visceral hump tissue as well as S. mansion crude Ag [SWAg] were fractionated using SDS-PAGE. It's specific and cross reacted protein fractions were determine using EITB versus experimentally prepared mice hyper immune sera [HIS] versus each antigen. After treatment of fractionated S.mansoni crude worm antigens [SWAg] versus HIS produced after vaccination of mice by the same Ag, 8 kda protein fractions ranged from 35-140 kda were reacted specifically. Treatment of fractionated B.alexandrina infected and non-infected foot and visceral hump Ag versus previous HIS revealed presence of common polypeptides bands between SWAg and non-infected snail antigens. The fraction at 135 kda, 68 kda, were detected in all cases, while that at 40-42 kda and that at 35 kda was diagnosed in SWAg and that of infected snails only. The fraction at 68 kda was reacted specifically between SWAg and all tested fractionated snail antigens either that of foot or visceral hump when they treated separately by HIS of mice vaccinated by each snail Ag separately. The fraction at 135 kda was common between SWAg and snail [infected and non-infected] visceral hump antigen. The fraction at the level of 110 kda was diagnosed in SWAg, in non-infected foot antigen and visceral hump Ag. The fraction at the level of 46-48 kda are common between SWAg and snail foot and visceral hump Ag after treated by HIS of mice vaccinated by foot Ag. Presence of common antigenic fractions between snail tissues and Schistosoma species can prefer an easily source of antigen valuable for diagnosis or vaccination as well as can he considered as new tool for determination to the snail IMH of new discovered trematode parasites

Comparative study on immunoblot versus PCR in diagnosis of schistosomiasis mansoni in experimental infected mice

This study compared PCR and Western blot techniques in diagnosis of schistosomiasis mansoni. Forty Swiss albino mice were used, thirty two mice were infected with cercariae of S. mansoni and eight mice were kept uninfected which were used as a control. Blood was obtained from four infected mice weekly beginning from the 1[st] week to the 8[th] week post infection. The study found that PCR was positive from the first week post infection, while Western blot technique was positive from the second week post infection. Thus, PCR diagnosed schistosomiasis mansoni earlier than Western blot technique, but both were able to diagnose

Electron Microscopic Alterations in Pediculus humanus capitis Exposed to Some Pediculicidal Plant Extracts

Head lice, Pediculus humanus capitis, infestation is an important public health problem in Egypt. Inadequate application of topical pediculicides and the increasing resistance to the commonly used pediculicides made the urgent need for the development of new agents able to induce irreversible changes in the exposed lice leading to their mortality. The aim of the present work is to evaluate pediculicidal efficacy of some natural products such as olive oil, tea tree oil, lemon juice, and ivermectin separately in comparison with tetramethrin-piperonyl butoxide (licid), as a standard pediculicide commonly used in Egypt. The effects of these products were evaluated by direct observation using dissecting and scanning electron microscopes (SEM). Results showed that after 1 hr exposure time in vitro, absolute (100%) mortalities were recorded after exposure to 1% ivermectin and fresh concentrate lemon juice. The mortalities were decreased to 96.7% after exposure to tea tree oil. Very low percentage of mortality (23.3%) was recorded after 1 hr of exposure to extra virgin olive oil. On the other hand, the reference pediculicide (licid) revealed only mortality rate of 93.3%. On the contrary, no mortalities were recorded in the control group exposed to distilled water. By SEM examination, control lice preserved outer smooth architecture, eyes, antenna, respiratory spiracles, sensory hairs, and legs with hook-like claws. In contrast, dead lice which had been exposed to pediculicidal products showed damage of outer smooth architecture, sensory hairs, respiratory spiracles and/or clinching claws according to pediculicidal products used.

Experimental induction of hepatitis C virus in Wister albino rat

Ten Wister albino rats were used in this Experiment. 6 animals were injected intra-peritonially by 0.2 ml of Hepatitis C patients blood, while 4 animals were injected with 0.2 ml of Healthy [non- infected] persons and kept as controls. They were devided into 3 groups. The first group consisting of 2 test animals and one control were slaughtered and autopsied at 2 months of injection. The second group were 2 test animals and one control were autopsied at 4.5 months after being injected. The third group were 2 animals and one control autopsied at 5 months after injection. The postmortem .picture in the first group showed diffuse cloudy swelling of the Liver cells with proliferation of Kuppfer cells in the portal tracts which is a picture of acute hepatitis. The second group showed marked cloudy swelling of the liver cells with hypertrophy of Kuppferts cells in the portal tracts. The liver lobule near the central vein were free of fat. The third group showed chronic hepatitis with marked cloudy swelling parenchymal necrobiosis in the form of Rim pycnosis caryohexis karyopycnosos and finally karyolysis. There were marked perplasia of hepatocytes which in some places produced rounded nodules that lost the radial cord arrangement producing preneoplastic nodules that may be after a time proceed to hepatocellular carcinoma

Barriers to breast cancer screening among a sample of Egyptian females

Breast cancer [BC] is usually diagnosed in late stages in countries with limited resources. Early detection of BC is likely to improve the outcome of the disease for women in these areas. The aim of this study was to understand the possible personal, economic, and systems barriers to BC screening in a sample of Egyptian women. A cross-sectional study was conducted in family health centers representing the seven districts of Alexandria governorate, Egypt. A total of 612 women were randomly selected from the chosen centers. In this sample of Egyptian women, the most frequently identified potential barriers to BC screening were the following: 81.8% would not seek care until they were ill, 77% were unwilling to have a mammogram until it was recommended by the doctor, 71.4% blamed the, lack of privacy, 69.2% thought that medical checkups were not worthwhile, and 64.6% blamed the cost of services. The study further revealed that women of lower education, women in the lower income category, women who did not do paid work, those who had poor knowledge of the risks of BC, and women with no family history of BC were more likely to perceive different screening barriers compared with their counterparts. Many potential personal, economic, and health system barriers were identified. Addressing these barriers by increasing the awareness of BC and dealing with the misconceptions that the women have can help the policy makers to design more culturally relevant strategies to motivate women to utilize screening services

Assessment of respiratory involvement in children with mucoplysaccharidosis using pulmonary function tests

Mucopolysaccharidosis [MPS] are classified into seven clinical types based on eleven known lysosomal enzyme deficiencies of glycosaminoglycan [GAG] metabolism. Respiratory involvement seen in most MPS types includes recurrent respiratory infections, upper and lower airway obstruction, tracheomalacia, restrictive lung disease, and sleep disturbances. To delineate the pattern of respiratory compromise and pulmonary function abnormalities in MPS patients. This is a cross section observational study conducted on 30 patients recruited from the Neurometabolic Clinic, Children's Hospital, Cairo University over a period of 18 months. All patients were screened first by the quantitative determination of GAGs in urine, and diagnosis was confirmed by unidimensional electrophoresis for GAGs in urine and/or specific enzymatic assay in blood leucocytes. Infant pulmonary functions [IPFT] were done in twenty-two patients [< 3 years of age], while 8 cases performed impulse oscillometry [IOS] test [3-6 years of age]. Ages at diagnosis ranged from 1 to 9 years with a median of 2.3 years. Male to female ratio was 4:1. Consanguinity was observed in 53.3% whereas similar family condition was present in 40% of cases. Lumbar kyphosis was detected in 60% of cases, while scoliosis was detected in 46.7%. Results of pulmonary functions were mainly obstructive in 20 [66.6%] cases; however, combined obstructive and restrictive were detected in only 6 [20%] of cases. Data showed no association between the presence of scoliosis or the presence of organomegaly and the pattern of pulmonary function abnormalities. Evaluation and follow up of patients with MPS using pulmonary function tests are essential to detect early involvement of respiratory system and hence start treatment for respiratory complications early in the course of the disease

Detection of cytogenetics abnormalities in chronic lymphocytic leukemia using FISH technique and their prognostic impact

Chronic lymphocytic leukemia [CLL] is a clonal lymphoproliferative disorder characterized by progressive accumulation of morphologically and immunophenotypically mature lymphocytes. Characterization of genomic aberrations may help to understand the pathogenesis of CLL and may give prognostic information independent from conventional clinical markers for a risk-adapted management of CLL patients. The aim of the present study is to determine the most common cytogenetics abnormalities between patients with CLL and its prognostic impact. The present study was carried out on 20 adult patients presented with chronic lymphocytic leukemia. The patients were diagnosed on the basis of standard clinical [lymph node involvement and/or hepatosplenomegaly], hematological and immunophenotypic criteria for diagnosis of B-CLL. All cases were studied at the time of their diagnosis. FISH technique was successfully performed on PB samples using CLL LSI probes for ATM [11q22] / GLI [12q13] and 13q14/ p53 [17pl3]. For comparative statistical studies, the patients were divided into group I [patients with favorable outcome] and group II [patients with unfavorable outcome]. All patients showed one or more cytogenetic abnormality with the prevalence of p53 in 16 patients out of 20 that perfectly correlated with the poor outcome of the patients. This is followed by deletion in the 13q14 and to a lesser extent deletion in ATM gene, but no one has exhibited amplification in the 12q13 locus. p53 deletion as a sole abnormality has a higher prognostic power than other cytogenetics abnormalities. The cytogenetics study using FISH panel for CLL patients in a complementary fashion to the other clinical and laboratory findings may overcome the pitfalls in the diagnosis and may also assess the assignment of therapeutic protocols for CLL patients according to the results of their cytogenetic analysis at the time of diagnosis

Tackling experimental colisepticaemia in broiler chickens using phytobiotic essential oils and antibiotic alone or in combination

This study was designed to compare the efficacy of a phytobiotic containing a mixture of essential oils of Oreganum aetheroleum and an antibiotic containing ciprofloxacin as an active principle for the treatment of experimental Escherichia coli [E. coli] infection in broiler chickens. Two-hundred-day-old broiler chickens were divided into 5 equal groups. The 1st group was neither challenged nor treated, but groups 2, 3, 4 and 5 were challenged with E. coli. The 2nd group was challenged with E. coli only, while the 3rd, 4[th] and 5th group were treated with phytobiotic, ciprofloxacin and phytobiotic and ciprofloxacin combinations, respectively. Results confirmed significant [P<0.05] improvement of productive performance parameters, reduction in signs, mortalities, post mortem lesions and bacterial re-isolation, enhancement in cell mediated and humoral immune responses, reduction in levels of liver and kidney function tests and increase in the total protein and globulin levels in challenged chickens treated with either essential oils or ciprofloxacin compared to challenged non treated chickens. Moreover, best significant [P<0.05] results in all measured parameters were detected in the group treated with the combination in comparison with those exposed to single treatments. In conclusion, a mixture of essential oils of Oreganum aetheroleum is more effective compared with ciprofloxacin in the treatment of E. coli in broiler chickens. However, a combined treatment of both could be a superior treatment

Perceptions Of Dental Stress And Social Support Among Malaysian Dental Students

Objective: To explore the association between socialsupport and stress levels in preclinical and clinical dentalstudents in Malaysia. Method: A cross sectional surveyof dental undergraduate students was conducted at theFaculty of Dentistry, University of Malaya, UniversitiKebangsaan Malaysia and Universiti Sains Malaysia.Stress was measured using the Dental Environment Stress(DES) questionnaire. A DES-32 item was used to measurestress for the clinical students and DES-16 item for thepreclinical students. Four questions were used to measuresocial support. The total stress scores were standardizedfor comparison purposes. Results: A total of 357 (79.7%)preclinical and 417 (71.8%) clinical undergraduate dentalstudents responded to the questionnaires. The clinicalstudents experienced higher stress [mean standardizedDES score = 72.63, SD = 10.64] than preclinical students[mean standardized DES score = 70.19, SD=12.01]. Thetwo most stressful items reported by preclinical studentswere “fear of failing” and “examination and grades”.Among clinical students, the two most stressful items relatedto academic were “completing course requirement” and“fear of failing course” and items related to clinical sessionwere “fear of being barred due to the clinical schedule”and “patients late or absent”. Multiple regression analysesrevealed that low stress levels among preclinical studentswere significantly associated to a lot of contact withstudents of the same course. Conclusion: To some extent,social support does play a role in explaining differences inperceived stress, in particular among preclinical students.

Diffusion based methods versus automated mic in detecting drug resistance among nosocomial pathogens

The incidences ofnosocomial infections are varied in different studies, and the crude mortality is high, particularly for intensive-care unit [ICU] patients. The rates of antimicrobial resistance among pathogens causing health care-associated infections are increasing, and the main mechanisms that must be submitted to surveillance and accurate diagnosis are ESBL, AmpC and carbapenem resistance in gram negative bacilli, and MRSA and VRE in gram positive cocci. The aim of this study was to determine the incidence of the gram negative and gram positive resistance among nosocomial pathogens, to assess the abilities of diffusion based methods to detect different resistant patterns in relation to MIC profiles tested by the Sensititre automated system and to guide antimicrobial therapy policy in Benha locality. The study included total of 205 nosocomial specimens that were cultured and yielded 89 gram negative and 35 gram positive isolates. In our study we only included the nosocomial gram negative isolates resistant to 3rd generation cephalosporins [54] and the gram positive isolates resistant to vancomycin +/- methicillin [20] to be tested by Sensititre for identification and susceptibility testing. Diffusion based techniques used for confirmation of resistance of gram negative bacilli included ESBL screening by double disc diffusion test, imipenem [IMP]-EDTA combined disc test and ESBL and AmpC Detection Set [D68C system]

The incidence ofnosocomial MRSA among collected Staphylococcus aureus was 24.4%. According to diffusion based techniques, the rate of resistance to the 3rd generation cephalosporins among the 89 nosocomial gram negative isolates was as follows: for extended spectrum beta-lactamases 50 isolates [56.1%], for AmpC resistance 25 isolates [28.1%], and for carbapenem resistance 11 isolates [12.3%]

There was a suitable agreement between the results of Sensititre and diffusion based detection regarding ESBL and carbapenem resistance. However, results of Sensititre showed much higher number of AmpC in comparison with diffusion based detection

The reliance on only cefoxitin resistance by MIC testing is not a guarantee of establishing a diagnosis of AmpC. The highest resistance mechanisms were ESBL, followed by AmpC and carbapenem resistance, especially among Klebsiella pneumoniae isolates. Also, from our results, it was highly evident that there was a high endemicity of MRSA and VRE among our Gram positive cocci nosocomial isolates. It's recommended to confirm AmpC resistance by at least on phenotypic method, without complete reliance on the automated MIC results regarding this pattern of resistance

randomized control trial evaluating the prevalence of obstetrical anal sphincter injuries in primigravida in routine versus selective mediolateral episiotomy

To evaluate the prevalence of obstetrical anal sphincter injuries [OASIS], which include third and fourth degree perineal tears in primigravida in routine versus selective mediolateral episiotomy. Secondly, to determine the rate of episiotomy in local settings. This randomized control trial was carried out in the labor ward of a tertiary hospital of the Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia between May and October 2009. The trial included 171 primigravida beyond 38 weeks gestation who achieved vaginal delivery, and randomly assigned to selective and routine episiotomy groups. The type of perineal injuries following childbirth among 171 women were evaluated. The overall episiotomy rate from both groups was 76.6%. The prevalence of third degree perineal tears was 3.7% in the routine compared with selective mediolateral episiotomy at 1.1%. There was no occurrence of fourth degree tears in both groups. However, selective mediolateral episiotomy was associated with an increased risk of periurethral and labial injury compared with the routine group [4.5% versus 0%]. Routine mediolateral episiotomy in primigravida is associated with a higher prevalence of obstetrical anal sphincter injuries. As anal sphincter injuries are known to have morbidities, selective mediolateral episiotomy in primigravida is therefore recommended in the implementation of new delivery practice, and in an attempt to reduce our high episiotomy rate

Disability in persons with Schizophrenia correlated to family burden and family distress among their caregivers.

Background: Families are the main support system or primary care givers for persons with Schizophrenia in India. Family burden and distress is a concern one should get acquainted about the disability of the client in relation to the accompanying world. Aim: To correlate the disability in persons with schizophrenia and family burden and distress among their caregivers. Objectives: (1) To assess the disability of persons with schizophrenia. (2) To assess the family burden among the caregivers of persons with schizophrenia. (3) To assess the family distress among the caregivers of persons with schizophrenia. (4) To correlate the disability of persons with schizophrenia and the family burden and family distress among their caregivers. Method: One hundred individuals diagnosed to be suffering from schizophrenia as per DSM IV or ICD – 10 criteria and hundred primary care givers were taken up for the study with their consent to participate after the intake screening. The data collected were primarily by interviewing & administering validated Indian research instruments Indian Disability Evaluation Assessment Schedule (IDEAS), Schedule for Assessment of Family Burden (SAFB), Schedule for Assessment of Family Distress (SAFD) to the client and the significant key relative or caregiver. Results: Among the participants 83% of clients found with mild to moderate disability. Majority (96%) of the key relatives had moderate to severe burden with a mean score of 1.27 + 0.863, and 46 percent had minimal distress and 50 percent had moderate to marked distress with mean score of 5.22 + 3.265. Conclusion: Level of disability does not affect the intensity or the severity of the family burden or distress experienced among their care givers. Hence psychosocial interventions are mandatory for reducing burden and distress among the primary care givers while intervening to reduce the level of the disability.