[Pleural effusion with pneumonia caused by Neisseria meningitidis C: a case report]

Pleural effusion with pneumonia is an uncommon manifestation of Neisseria meningitidis infection. We report the case of a 3-year-old child who presented a one week fever and abdominal pain. Chest X ray showed pleural effusion with lung condensation. The outcome was favourable with antibiotics

Anti-Thyroid Antibodies in Unexplained Recurrent Pregnancy Loss

The aim of this study Observational study is to find out whether thyroid antibodies may serve as an additional independent marker for unexplained recurrent pregnancy loss irrespective of endocrine thyroid function. This study was carried in Tanta University Hospital on 60 pregnant women in the first 20 weeks of gestation. They were divided into three groups: the control group [Group I] included 20 euthyroid pregnant women, the second group [Group II] included 20 euthyroid women who were primary aborters and the third group [Group III] included 20 euthyroid women who were secondary aborters. Laboratory evaluation of serum T3, T4 and TSH was performed for each case. Anti thyroid antibodies [antithyroglobulin antibodies and antimicrosomal antibodies] levels were determined by ELISA test. serum antithyroglobulin and antimicrosomal antibodies levels were significantly elevated in the study groups compared with the control group. Serum antibodies levels were significantly elevated in group III [secondary aborters] compared with group II [primary aborters]. A highly significant association was observed between antibody positivity and missed abortion. Thyroid antibodies are associated with an increased risk of recurrent pregnancy loss and they may be an effective marker of miscarriage risk. Further studies including a larger number of women are needed to confirm the results of the current study

Predictability of neonatal infection in cases of preterm premature rupture of membranes by interleukin-6 estimation: antenatal bed side test from vaginal fluid versus neonatal serum testing at birth and after 24 hours

The Objective of this study was to assess the predictability of interleukin 6[IL-6] for neonatal infection, in women with preterm premature rupture of membranes [PPROM] using a bed side test from vaginal fluid versus neonatal serum testing at birth and after 24 hours. The study was a cross sectional one and enrolled 73 women who were hospitalized for PPROM. The gestational age at study entry ranged between 28 and 35 completed weeks of gestation that was confirmed from history and/or by a first-trimester ultrasonograhy. Maternal routine investigations as serum C reactive protein [CRP] and IL-6 detection in vaginal fluid were done. Neonatal examination and assessment was done. Initial neonatal outcomes as Apgar score, neonatal infections and neonatal cranial ultrasound were assessed. Neonatal CRP and IL-6 were also estimated. The results showed that neonatal infections were more frequent for babies of women with IL-6-positive vaginal samples [29.7% vs 8.3%; P=0.02]. The sensitivity of vaginal testing of IL-6 for predicting neonatal infection was 79%; its specificity was 56%; its positive predictive value was 30%, and its negative predictive value was 92%. The mean neonatal IL-6 at 0 hour was significantly higher in babies of the vaginally positive than the vaginally negative mothers [P<0.01]. The sensitivity of IL-6 at 0 hour for predicting neonatal infection was 99%; specificity was 91.4%; positive predictive value was 57.4%, and negative predictive value was 92%. The sensitivity at 24 hours was 67.4%; specificity was 69.3%; positive predictive value was 50%, and negative predictive value was 63%. Estimation and detection of IL-6 with both the qualitative vaginal secretions bedside test and at birth neonatal serum are of great value in the prediction of neonatal infection in cases of PPROM. This cytokine may reflect the insult that the fetus had been exposed to: hence affection of the fetal brain. Antenatal detection and early at birth estimation are of medico legal importance, which may protect obstetricians and pediatricians from alleged intrapartum or early neonatal mismanagement

Haemodynamic profile of isoflurane versus total intravenous anaesthsia in patients submitted for closed mitral commissurotomy

This study was conducted on 16 patients submitted to closed mitral commissurotomy surgery. They were randomly classified into two groups eight patients each. The first group recieved thiopentone-for induction and isoflourane-vecronium for maintenance The second group received kjtamine-midazolam for induction and then followed by continuous infusion according to a pharmacokinetics based multistepped decreasing regimen. Arterial cannulation and pulmonary artrey catheter were fixed to measure the haemodynamic variables at 5 time points before and during surgery. Data are collected and analysed statistically to compare both groups and record changes during the course of surgery inside each group. The results showed non significant changes between the two groups regarding the haemodynamic parameters recorded, but the systemic vascular resistance [SVR] was significantly increased in the isoflourane group at post-commissurotomy time point. In conclusion, TIVA with ketamine-midazolam can provide a pattern of haemodynamic stability during mitral valve stenosis surgery comparable to that of isoflurane. Concomitant ad-minsteration of midazolam to ketamine according to the regemin used in this study almost neutralized the cardiovascular effects of ketamine

Perianaesthetic blood glucose measurement; evaluation of a rapid method

This study has been planned to evaluate the accuracy of glucometer [Accutrend]. Fourty blood glucose measurements were randomly included in this study. Patients were anaesthetized by different techniques. Blood glucose concentration was measured by both glucometer and the st and ard laboratory glucose-oxidase method [Beckman Autoanalyser]. From the results of this study, blood glucose values measured by glucometer [Accutrend] are always lower than those measured by the st and ard lab glucose oxidase method and the calculated bias value was 17.6 +/- 51.8 and the limits of agreement were wide ranging from 121.2 to -86mg dL-1 which are unaccepted for clinical purposes

study of human brucellosis among pregnant women in Kafr El Dawar, Beheira, Egypt

To determine the relationship between brucellosis and abortion in pregnant women and to identify the factors associated with its occurrence, this case-control study was conducted among 400 pregnant women. They were divided into 200 cases who presented with spontaneous first trimester abortion and 200 controls who delivered full term babies. Moreover, Brucella antibody positive sera were tested for the presence of Toxoplasma and Rubella infections using IgM ELISA technique. The results revealed the presence of Brucella antibodies in 83 [20.7%] out of the 400 studied pregnant women. Brucella seropositivity was significantly higher in the aborted group [25.6%] than in the controls [14.1%]. Most of the aborted Brucella positive women had chronic infection [titer <1: 160] and gave positive history of previous abortions [92% and 80%, respectively]. Among full term delivered women, no significant association was revealed concerning the effect of Brucella infection on babies condition