Estimation of tuberculosis incidence and mortality in Egypt using epidemiological models

To estimate tuberculosis incidence in Egypt, data were collected from national tuberculosis case notification records, vital registration statistics, tuberculin surveys and treatment outcomes. An important source of information was the national comprehensive tuberculin survey results, which estimated a 55.2% case detection rate and a 65.6% case notification rate. The data suggest that only two-thirds of actual cases are being identified and treated by the national programme. The figures for expected versus reported deaths from tuberculosis in Egypt in 1996 suggest underreporting to be almost 80%

Management of cholelithiasis during pregnancy

Twenty-seven pregnant women, with symptomatic gallstone disease, were admitted to this prospective study. All patients received initial medical therapy, and surgical intervention was performed in cases with frequent relapses or no response to medical treatment. Twelve patients underwent surgery during pregnancy, 2 in the first and 10 in the second trimester. Eight patients underwent laparoscopic cholecystectomy, while 4 had open cholecystectomy [one had exploration of the common bile duct]. While no maternal or fetal deaths occurred secondary to medical treatment, one spontaneous abortion occurred following open cholecystectomy in the first trimester. Patients, after receiving primary medical treatment, had 74.1% rate of relapse and additional days in hospital, compared to no relapse and less hospital stays after surgery. Patients acute cholecystitis had increased incidence of medical treatment failure and need of surgery. It is concluded that management of biliary tract disease during pregnancy should follow a protocol, with clear indications for the role of surgical intervention during the second trimester of pregnancy does not increase maternal or fetal morbidity. It may in fact reduce the number of relapses during pregnancy, hence reduces the consequent complications and additional hospital stay. Laparoscopic cholecystectomy is feasible in the great majority of patients, except those with large uteri in the late second trimester and the presence of common bile duct stones

Immunosuppressive effect in oral and maxillofacial surgery

Using tissue culture techniques, peripheral blood lymphocytes [PBL], obtained from patients undergoing various types of oral and maxillofacial surgical operations, have been found to develop depressed immunological competence as reflected by their diminished ability, under maximal stimulation with phytohaemagglutinin, to incorporate 14 C thymidine and synthesise D.N.A. More important, however, was the observation that this biosynthetic defect was most severe in lymphocytes harvested from individuals of maxillofacial trauma with associated injuries and oral cancer. The clinical significance of this abnormality measured in vitro may be reflected by postoperative infection in case of multiple trauma, and the acceleration of metastasis which often takes place postoperatively in patients with carcinoma