Dientamoeba fragilis Infection in Patients with Digestive and Non-Digestive Symptoms: A Case-Control Study

In most developing countries, Dientamoeba fragilis infection is an obscure protozoan infection. We aimed to determine a frequency and clinical importance of D. fragilis infection in Taif, Saudi Arabia. A 1-year case control study included patients with gastrointestinal (cases, n=114) or non-gastrointestinal symptoms (controls, n=90). The fecal samples were examined with the classical parasitological methods for intestinal protozoa, and by real time PCR for D. fragilis. The infection by D. fragilis was detected in 5.8% by PCR and in 4.4% patients by microscopy. The infection was identified more in control group (n=9) than in cases (n=3); a sole infection in 11 patients and mixed with Giardia in 1 patient. The other enteric parasites detected were Blastocystis sp. (8.3%), Giardia sp. (5.3%), Cryptosporidium sp. (2.9%), Entamoeba histolytica (1.4%), Entamoeba coli (0.9%) and Hymenolepis nana (0.4%). Our results tend to reinforce the need to increase awareness of D. fragilis infection in Saudi Arabia.

Does cesarean section pose a risk of respiratory syncytial virus bronchiolitis in infants and children?

Objective: To determine the risk of acquiring acute respiratory syncytial virus (RSV) bronchiolitis in infants and children delivered by the mode of cesarean section (C-section). Methods: A retrospective and descriptive study was conducted at Hamad Medical Corporation. Patients with ages 0 to 36 months hospitalized with acute bronchiolitis were included in the study. Results: The risk of RSV bronchiolitis was observed to be higher among C-section delivery compared to normal spontaneous vaginal delivery [odds ratio=1.10; 95% confidence interval (0.57, 1.80); P=0.965]; however, it was not statistically significant. Gestational age ≤35 weeks was significantly associated with increased risk of RSV bronchiolitis compared to gestational age >35 weeks [odds ratio=3.12; 95% confidence interval (1.53, 6.38); P=0.002]. Conclusions: Delivery by C-section does not appear to increase the risk of RSV bronchiolitis in infants compared with normal spontaneous vaginal delivery.

Does cesarean section pose a risk of respiratory syncytial virus bronchiolitis in infants and children?

OBJECTIVE@#To determine the risk of acquiring acute respiratory syncytial virus (RSV) bronchiolitis in infants and children delivered by the mode of cesarean section (C-section).@*METHODS@#A retrospective and descriptive study was conducted at Hamad Medical Corporation. Patients with ages 0 to 36 months hospitalized with acute bronchiolitis were included in the study.@*RESULTS@#The risk of RSV bronchiolitis was observed to be higher among C-section delivery compared to normal spontaneous vaginal delivery [odds ratio=1.10; 95% confidence interval (0.57, 1.80); P=0.965]; however, it was not statistically significant. Gestational age ≤35 weeks was significantly associated with increased risk of RSV bronchiolitis compared to gestational age >35 weeks [odds ratio=3.12; 95% confidence interval (1.53, 6.38); P=0.002].@*CONCLUSIONS@#Delivery by C-section does not appear to increase the risk of RSV bronchiolitis in infants compared with normal spontaneous vaginal delivery.

Outcome of enzyme replacement therapy in children with Gaucher disease: the Egyptian experience

Gaucher disease is the most prevalent lysosomal storage diseases which results from inherited deficiency in the glucocerebrosidase enzyme. Three main clinical forms have been described: type I non-neuropathic, type II acute neuropathic and type III subacute neuropathic. Although it is panethnic disease, its presentation has some ethnic specific characteristics. In this work, we present specific characteristics as well as our experience in diagnosing and managing a group of Egyptian patients with this disease. The study included 48 patients with Gaucher disease attending Children's Hospital, Ain Shams University. The recombinant enzyme imiglucerase [cerezyme] was given in a dose of 60 U/kg/2 weeks. Haemoglobin, platelet count, plasma chitotriosidase, and abdominal ultrasound were assessed before starting therapy and every 6 months. Molecular analysis was done to 23 patients. At presentation, the mean age was 3.54 +/- 3.8 years. Ten patients [20.8%] had type I, 6 had type II [12.5%] and 26 had type III Gaucher disease [66.7%]. The commonest genotype was homozygous L444P which was present in 13 patients [56.5%] followed by homozygous N370S; found in three patients [13.04%]. Follow up after enzyme replacement therapy revealed a significant increase in weight and height, haemoglobin level and platelet count and slow reduction in the liver span and spleen length. Bone manifestations showed slow but complete improvement while neurological and respiratory manifestations were partially ameliorated with individual variations. To conclude, since most of Egyptian children with GD have type III disease and L444P/L444P genotype, a minimum dose of 60 U/kg/2 weeks should be maintained until adulthood. Higher doses started at an early age may delay the progression of neurological symptoms. Pulmonary involvement is not rare in Egyptian patients and may respond to dose increase or dose fractionation. Cardiovascular and renal involvement should be further studied in our population

epidemiological study of cesarean section in Zagazig city

Cross-sectional study of cesarean section was carried out during the period from March to December 1997. A total of 1897 women were randomly selected, interviewed and asked about their last vaginal and cesarean section deliveries. The results of this study have revealed that the incidence rate of cesarean section deliveries [CS] was 26.15%, representing 71.57% with primary cesarean section and 28.43% with repeated cesarean section. 63.51% of all cesarean section deliveries were performed below the age of 30 years and about 32.26% of all cesarean deliveries were observed among primipara. The overall complication rate was 28.43% in which the main observed complications were operative hemorrhage 16.94%, postoperative wound infection 10.69% and 0.8% of urinary tract and chest infection. The study revealed that proper antenatal services should be available and accepted by target population, promotion of vaginal birth after cesarean section for properly selected cases and complete antiseptic techniques and antibiotic prophylaxis should be recommended when cesarean section done

Electronystagmographic changes in pupils with profound hearing loss

The vestibular dysfunction is significantly present in profound sensory neural hearing loss and the acquired causes of deafness showed the higher abnormality of the vestibular system and postnatal acquired hearing loss is the most affected group

effects of treatment with praziquantel on hearing

Praziquantel is a commonly used broad spectrum antihelminthic drug. It has totally replaced the antimonial compounds in the treatment of schistosomiasis. In this work 109 patients were included to study the audiometric changes produced by the drug in the routine treatment regimen for schistosomiasis. Pretreatment pure tone audiograms were obtained for all patients on air and bone conduction. They were then repeated after 24 hours of treatment, one week and one month after treatment. Eight patients out of 109 developed marked significant changes in their audiogram, defined as more than 15 dB from previous readings. The results concluded that praziquantel treatment can cause mild audiometric changes mainly in the higher frequencies for a transient period which was followed by a return to normal hearing. Full audiological assessment to all patients undergoing treatment with praziquantel is highly recommended

Assessment of hearing in traffic men in Ismailia

280 policemen working in Ismailia Governorate were subjected to audiological evaluation to detect the effects of traffic noise on their hearing thresholds. 115 of them were traffic-men and 155 were controls. The results showed marked decrease of hearing at 4 KHz in different age groups of traffic-men, especially between 31-40 years which was statistically significant compared with the control group. The left ear was affected more than the right ear at all ages and in both groups. The duration of exposure to noise was directly related to the degree of hearing loss in the first ten years of work. Reduction of the duration of exposure is recommended

Behavioral audiometry in infants and young children

In this study, 50 children aged from 9-36 months were examined by VRA using different auditory stimuli [Warble tones, NVN and speech stimuli] and then the results were confirmed by ABR. It was concluded that ABR testing should be preceded by behavioral audiometry to form a general idea about hearing assessment

Clinical and laboratory aspects of kerosene poisoning

Twenty seven patients intoxicated with kerosene and received in the Foison Control Centre, Ain Shams University, were studied. They were 16 males and 11 females. Their ages ranged between, 1-3 years, except one case was 17 years old. The mode of intoxication was accidental in most of the eases. The majority of the intoxicated patients were of the low social class and they consulted the Poison Control Centre mostly in the evening after 1-2 hours of intoxication Kerosene intoxicated children had significantly lower hemoglobin values than controls. The anemia was microcytic hypochromic. Leucocytosis was observed with significant elevation of the absolute numbers of all granular and mono-nuclear white cells and bands. Three patients presented with respiratory acidosis. All urine samples were negative for urobilinogen. Radiological evidence of pneumonia varied with the severity of the clinical manifestation and were limited to the dependent portions of the lungs

Vitamin D metabolism among Egyptian infants and children affected with beta thalassemia

Sixty-five patients suffering from beta-thalassemia major were studied [46 males and 19 females]. Their ages ranged between 6/12-12 years [mean 5.8 +/- 2.2 years]. Twenty-five children of comparable age, sex, and socioeconomic status were studied as controls. Patients were classified into newly diagnosed and long-standing, who were furtherly classified into cases without hyperspienism, cases with hypersplenism and splenectonized cases. Each patient was subjected to full history taking thorough clinical examination and determination of serum calcium, phosphorus, alkaline phosphatase both total and fractional isoenzymes [liver and bone], 25 [OH] vitamin D3 1, 25 [OH]2 vitamin D3 parathyroid hormone and urinary calcium excretion. Serum ca1cium was significantly decreased after splencctomy. Serum phosphorus was significantly decreased except in patients with hypersplenism who showed normal values. Parathyroid hormone was decreased after splenectomy. 25 [OH]2 VD3 showed high significant decrease except in patients with hypersplenism. 1, 25 [OH]2 VD, showed very high significant decrease in all patients. Calcium/creatinine ratio in urine showed a very high significant increase in all cases. It might be con eluded that follow up of the levels of serum Ca, P, 25 [OH] VD3 1, 25 [OH]2 VD3, and alkaline phosphatase should be carried out in all thalassemic patients for early supplementation with vitamin D to avoid any bone mineralization defect together with the regular follow up of parathyroid hormone level especially after splenectomy

Intestinal and urinary parasitosis in children with acute leukemia and lymphoma

The present study was conducted on 50 patients [37 with acute leukemia, 13 with lymphomas] attending the Hematology/Oncology Clinic, Children's Hospital, Ain Shams University. Fifty normal children were studied as controls. Patients and controls were subjected to laboratory investigations including a complete hemogram, red cell indices, urine and stool analysis for parasites. The results of this study revealed that, 13 out of 50 [26%] patients with acute leukemia and lymphoma were positive for parasitic infection, while 15 out of 50 [30%] of the control subjects were positive. The difference between the two groups was not statistically significant. Giardiasis was the commonest infection. It has been found in 16% of patients' group and 20% of controls. Among the patients' group, there was no correlation between the prevalence of parasitosis and the duration of therapy. As regards the hematological data, it has been found that, there was a statistically significant increase in RBCs count, Hb and Hct values in patients with acute leukemia and positive parasitosis than in those with negative parasitosis. Although there was a statistically significant increase in the absolute eosinophil count in controls with positive parasitosis than those with negative results, this finding was not observed in the patients group

Change of acoustic features of voice before and after hearing aid fitting

This study included 19 patients with sensorineural hearing loss and one patient with mixed hearing loss. Acoustic analysis of sustained phonation of 3 vowels /a/, /i/, and /u/ was done using computerized speech laboratory manufactured by KAY before and after hearing and fitting. The analysis included average pitch, jitter and shimmer. There was a decrease in average pitch in most cases of /a/ and /u/ vowels and increase in most cases of /i/ vowel. As regards jitter there was increase in most cases of /i/ and /u/ vowels and decrease in most cases of /a/ vowel. Shimmer showed increase in most cases of the three vowels. It was suggested that these changes are mainly due to the effect of the improved auditory feedback after fitting

study of auditory function in migraine

The association of disorders of hearing and balance with migraine has long been recognized. 38 migrainous patients [study group] subdivided into subgroup I "migrainous during attacks, and subgroup II" migrainous in between attacks", and 20 normal individuals [control group] were chosen and subjected to pure tone audiometry, acoustic impedance, speech audiometry and brain stem evoked response audiometry [BERA]. The results showed that the peripheral auditory system is not affected in migraine while the central auditory system showed minor changes and these findings may support a vascular involvement in migraine

comparative histopathological study of the tympanic membrane in cholesteatomatous and non cholesteatomatous ear

38 patients suffering from chronic suppurative otitis media were treated with tympanoplasty using the homograft technique. Their ear drums were examined histopathologically. Papillary formation and extension of the keratinizing squamous epithelium on the medial surface of the drum were the most obvious findings. These two factors may affect the prognosis and treatment of such patients

Evaluation of fine needle aspiration biopsy versus open biopsy in the diagnosis of head and neck masses

Fifty patients with head and neck masses were subjected to fine needle aspiration biopsy [FNAB] and compared with open surgical biopsy. The technique proved to be simple, rapid, safe, well tolerated, inexpensive and fairly accurate. It achieved an accuracy of 95%, sensitivity of 90% and a 100% specificity i.e. there has been no single benign case misdiagnosed as malignant. However, the results of this technique should be considered with caution in the diagnosis of follicular thyroid neoplasms

Acoustic reflex in Bell's palsy

This work was done to re-evaluate the topognostic and prognostic value of stapedial reflex test/ in Bell's palsy. 20 cases of Bell's pasly were subjected to Schirmer's test, stapedial reflex and follow up for 6 months. It was found that the lesion was distal to the stapedius nerve in 3 cases [15%], in the tympanic segment in 14 cases [70%] and proximal to the geniculate ganglion in 3 cases [15%]. The presence or absence of the reflex was not a good index of prognosis but when the reflex was preserved the improvement started after a shorter duration. 57.1% of the cases with lost reflex showed return of the reflex before clinical improvement

Some biochemical studies among agricultural workers suffering from active bilharziasis in the rural community

This case control study was carried out among Kaha Food Industrial Workers in Qualoubia and Sharkia Governorates to investigate some biochemical features of Active Bilharziasis. Sixty cases and twenty one controls were selected to be the material of this work. Biochemical studies were done at Environmental laboratory of Occupational Health National Research Centre using Atomic Absorption Spectrophotometry. From the results of this study it is concluded that: Serum copper and ceruloplasmin levels were significantly increased in active bilharziasis, while there is a significantly hypozincemia and hypomagnesimia in the studied cases. Also there is a significant decrease in haemoglobin levels when compared with controls. Liver function tests showed more derangement in active bilharziasis. These results were discussed and interpreted and suitable recommendations for further researches were recommended