Cardiac changes in protein energy malnutrition

This study included 20 patients [10 males and 10 females] with the age range of 2.5-24 months [11.7 +/- 6.79 months] who have the clinical features of protein energy malnutrition [PEM]. Patients with preexisting cardiac diseases were excluded from the trial. Another 20 healthy, age, sex matched infants were studied as a reference group. For the two groups the following was performed: Full medical history and examination, complete blood count, posteroanterior chest X-ray, 12-lead resting electrocardiogram and echocardiographic examination. It was found that, the cardiothoracic ratio [C/T ratio] of patients with PEM were significantly smaller than the reference group [p <0.001]. The heart rate was higher and PR interval was shorter [insignificantly] in patients with PEM. The left ventricular end diastolic dimension [LVEDD], left ventricular end systolic dimension [LVESD] and left atrial dimension [LAD] were significantly less in patients with PEM. The left ventricular function was preserved despite the loss of myocardial mass. There was a significant difference between the degree of PEM in the echocardiographic parameters. All these cardiac changes could be explained by hypoproteinemia, electrolyte imbalance, anemia and vitamins deficiency. So, effective treatment is required to overcome the cardiac changes

Quilted skin graft in the tongue

Split-skin grafting has not achieved popularity in covering tongue defects. This is mainly because of the tremendous mobility of the tongue which prevents proper adhesion between graft and bed. The quilted skin graft overcomes this problem and the method remains effective when used in properly selected cases. This article describes the use of the technique in 10 cases of tongue cancer at the Department of General Surgery [Plastic Surgery Unit] Zagazig University Hospital

prediction of the chemical composition of gallstones by different imaging modalities

Twenty patients with chronic calcular cholecystitis have been included in this study. Seven patients were males and thirteen were females. Their mean age was 46 years. All were subjected to imaging studies including plain X-ray for the right hypochondrium, abdominal ultrasonography and computed tomography. Chemical composition for the removed gall stones was measured quantitatively by colorimetric methods. The imaging studies were correlated with the results of chemical composition. Plain X-ray showed a radio-opaque shadow in 10% of gall stones, but was not helpful in predicting their chemical composition. Although abdominal ultrasonography was 100% accurate in diagnosis of gall stones, it failed to determine their number and chemical composition. The CT analysis of gallstones allowed accurate gall stone classification depending on the CT attenuation numbers. The gallstones were faint in 35%, dense in 30%, rimmed in 20%, laminated in 10% and hypodense in 5%. Its accuracy in the diagnosis of gall stones was 90%, however, it was useful in predicting their chemical composition. The highest cholesterol content was encountered in hypodense, faint stones and in the central portion of rimmed stones. The lowest cholesterol content was found in dense stones and in the rim portion of rimmed stones. So the CT attenuation number was inversely related to cholesterol content and was directly proportional to calcium content. The CT findings are of clinical importance as the best results with dissolving agents can be expected with stones having a high cholesterol and a low calcium content

Knowledge, attitudes, and practice of breast feeding, Menoufeya governorate

One thous and and two mothers from Monoufia Governorate were studied to assess their knowledge, attitude and practice of breast-feeding. The impact of their biological and social status on the success of breast- feeding was also evaluated. The biological scores of the studied mothers showed a positive correlation with the success of breast- feeding, while their social scores showed an inverse relationship. Mothers who achieved higher scores of knowledge and practice were significantly more successful in continuing exclusive breast-feeding. However, the difference in the scores of attitude did not reach the level of significance between exclusive and mixed feeding. Some of the factors related to failure of breast- feeding were also exposed and discussed