ABSTRACT
Multiple foreign bodies lodged in the oesophagus are extremely rare. Here an unusual case of two coins accidentally lodged at the oesophageal inlet of a six-year-old girl is reported. The coins were successfully removed by oesophagoscopy. It is to be noted that apart from the straight x-ray (PA view) of the neck and chest, a lateral view is essential for proper characterisation and identification of the type and number of foreign bodies prior to surgical removal.
Subject(s)
Child , Esophageal Diseases/diagnosis , Esophagoscopy , Esophagus/injuries , Female , Foreign Bodies/diagnosis , HumansABSTRACT
Egypt began training of physicians in case management of diarrhoea and acute respiratory infection (ARI) in the 1980s and 1990s respectively. Data from an independent assessment demonstrate the impact of training in the use of clinical practice guidelines on the quality of clinical examinations of 579 children presenting with diarrhoea or ARI. These examinations were conducted by 115 government physicians in 80 government health facilities and in two Egyptian governorates. The quality of care, although better than that in the past, remains poor, and training had little effect. Poor examinations were related to misclassification and inappropriate treatment of serious illnesses. Such errors have potentially serious consequences. Egypt is now implementing the Integrated Management of Childhood Illness strategy. This effort should be independently assessed to measure the improvement in the quality of care provided by government health facilities in Egypt.
Subject(s)
Acute Disease , Child , Child Health Services/standards , Child, Preschool , Clinical Competence , Diarrhea/diagnosis , Egypt , Female , Health Knowledge, Attitudes, Practice , Humans , Infant , Male , Physicians/psychology , Quality of Health Care , Respiratory Tract Infections/diagnosisABSTRACT
A bacterial strain isolated from soil and identified as Enterococcus faecalis was found capable of producing alkaline thermostable lipase. Optimum pH, temperature and time for enzyme substrate reaction were found to be 8.0, 60 degrees C and 10 min respectively. Phosphates and common surfactants have no or very little inhibitory effects on the activity of the enzyme, whereas bile salts are inhibitory to the enzyme activity. Maximum activity of the enzyme obtained so far is 54.6 IU/ml.