Rates of Neonatal Morbidity and Mortality in the Neonatal Intensive Care Unit at Alexandria University Children's Hospital: one year study

Objectives: To determine the rates of neonatal morbidity and mortality in neonatal intensive care unit of Alexandria University Children's Hospital

Study Design: Hospital records of neonatal admissions at neonatal intensive care unit [NICU] of Alexandria University Children's Hospital [AUCH] from 1st January 2012-31[st] December 2012 were analyzed retrospectively. Percent neonatal mortality and morbidity were calculated from the record, along with the causes of neonatal morbidity. The data were collected and statistically analyzed

Results: Out of 2063 neonates, 1098 [53.2%] were males while 965 [46.8%] were females with a male to female ratio of 1.3: 1. Majority, 1633 out of 2063 [79.2%], of the neonates was admitted during the 1st day of their life, mean age 2 days. Of total neonates included in the study 635 neonates [30.8%] died during their hospital stay. Significant risk factors [P<0.05] associated with neonatal mortality were: Caesarean delivery, multiple births, maternal infection, neonatal respiratory distress, prematurity, and low birth weight [LBW]. The mortality rate decreased with the increase in birth weight, as well as gestational age. Prematurity, neonatal jaundice, Respiratory distress and sepsis were the most common causes of neonatal morbidities contributing 70.4%, 70%, 65.4% and 48.2% respectively. Overall mortality was 30.8%.Th e three most common causes of neonatal mortalities were Respiratory distress [29.2%], Prematurity [27.8%] and neonatal sepsis [23.1%]

Conclusion: Majority of patients were admitted in the first day of life which indicates that improvement in the prenatal, natal and nursery care as a whole can reduce the neonatal mortality and morbidity in preterm as well as full term neonates

Molecular detection of human papillomavirus type-16 DNA in cervical cancer tissue biopsies

The aim of the study is to detect the frequency of human papillomavirus type-16 among patients with cervical carcinoma. Khartoum Hospital, Army Medical Hospital and Soba University Hospital, Sudan. Descriptive-cross sectional study. Fifty specimens of treated cervical biopsy sections [Paraffin embedded] were included in the study from April to October 2012. DNA was extracted followed by the detection of E6 gene of human papillomavirus type-16 using non-probed SYBER green real-time PCR. Thirty [60%] showed positive results as compared with the sigmoid curve of the positive control for HPV type-16; while 20 [40%] were negative. Most of the positive results were among the age group 31-50 years. Human papillomavirus type-16 was detected in 60% of women with cervical cancer, which seems to have a strong association with cancer development.

Major liver resection for giant hepatic tumors in adults and children

With the evolution in surgical technique, anaesthetic care and postoperative management, major hepatic resections for giant liver tumors are now considered reasonably safe procedures with a low surgical death rate. The aim of this study is to evaluate the results of major hepatic resection for giant hepatic tumors in the National Liver Institute during the period between September 1991 and September 2001 and to compare these results with reports from other centers. From September 1991 to September 2001 twenty-six giant liver tumors undenvent major hepatic resection out of a total number of one hundred and thirty seven liver tumors that were resected in the National Liver Institute. The tumor diameter was ranging from 8 cm to 27 cm. There were 6 children: their ages ranged from 8 months to 13 years. Four of them had hepatoblastoma, one malignant mesenchymoma [undifferentiated embryonal sarcoma] and one case of liver cell adenoma. The adult group included 20 cases with a mean age of 52.5 years [range 26-65 years]. There were six cases of hepatocellular carcinoma [HCC]; two of them were done as an emergency due to bleeding after tumor rupture. The remaining 14 cases were: 2 cases of HCC fibrolammellar type, one gallbladder carcinoma, 2 cases of colorectal liver metastasis, 5 cases of haemangioma, one case of haemangioendothelioma, one case of secondary leomyosarcoma from the stomach, one case of cholngiocarcinoma and one case adenocarcinoma. Right or extended right hepatectomy was done in 14 patients and left or extended left hepatectomy was done in 12 cases. Ultrasonic dissector and bipolar coagulation was used in 21 cases. Hospital mortality was three cases; two of them were emergency cases on top of chronic liver disease. Postoperative complications included: temporary ascites, chest infection, minor biliary leak and wound infection. major liver resection is a reasonably safe procedure especially, when performed on normal liver under elective conditions

Valproate associated acute pancreatitis

There is a definitive association between valproate therapy and acute pancreatitis. More than 50 cases have been reported. Most of the reported cases were mild yet there were a few more cases with higher morbidity and mortality. The risk is higher in patients under 20 years of age, during the first year of therapy, on the patient having encephalopathy or chronic renal failure and on patients with anti-epileptic drug polytherapy. The treatment of pancreatitis is supportive, laparotomy should be avoided. Re-challenge is hazardous and should be avoided

Uptake and development of wuchereria bancrofti in culex pipiens L and aedes caspiuspallas

Studies were conducted to compare early phenomena associated with W. bancrofti infection and further development in the filaria vector Culex pipiens and the refractory mosquito Aedes caspius. Ingestion rates evaluated immediately after simultaneous feeding on an infected human were 69.1% for 43 Cx. pipiens and 35.7% for 28 Ae. caspius. The observed number of mf ingested by either mosquito did not vary significantly [2.7 +/- 1.4, and 2.3 +/- 0.9, respectively] and, based on the size of the blood meal ingested [2.8 and 2.3 mul, respectively], a 2-fold mf concentration factor was recorded for both species. Blood ingested by Cx. pipiens [N = 16] and Ae. caspius [N = 10] clotted within 120 and 90 minutes post-feeding, respectively. The time difference observed however, did not affect significantly the rates of migration into the hemocele [56 and 67%, respectively]. Comparison of initial infection rates with those obtained after the extrinsic incubation period of the parasite was completed, indicated that the proportion of infected Cx. pipiens was reduced by 3.9% and that of Ae. caspius by 30%. Furthermore, the observed infectivity ratio of 265 Cx. pipiens that had an infective blood meal was 0.74 and only 0.009 for 70 Ae. caspius

Plasmid-mediated resistance to multiple antibiotics in salmonella typhi in Egypt

Several hundred strains of S. typhi isolates from typhoid patients admitted to different fever hospitals in Cairo, Kaluobiya and Sharkiya governorates during the period from June, 1991 to May, 1992 were studied. The strains were tested for susceptibility to the 3 antimicrobials of choice for typhoid treatment namely chloramphenicol [CM], ampicillin [AP] and trimethoprim - sulphamethoxazole [SXT]. 28 strains were found resistant to one or more of these drugs. Seven were resistant to CM, 22 to AP and 27 to SXT. Out of the 7 strains resistant to CM, 4 were resistant to the 3 drugs, one resistant to CM and AP, 2 resistant to CM and SXT. Plasmid profile analysis of resistant and sensitive strains showed that a specific band at 3. 8 Kbp is characterized in strains resistant to the 3 antimicrobials. Other strains had no such a plasmid band. Another plasmid with a molecular size over 9 kbp was present in both phenotypes. Additional studies are ongoing in our institute for further identification and characterization of resistant strains. In addition, plasmid profile analysis of resistant S. typhi strains are undertaken aiming at using this analysis as a routine test for antimicrobial resistance identification

Knowledge and skill performance of wound infection prevention among nurses working in surgical wards

The study calls for the attention of the health care agencies to update the knowledge and train for better level of performance of those nurses working in surgical wards. Infection control units in well developed health agencies should expand their horizon to involve educating nurses working in smaller and remote health agencies through educational programs, specially for the newly employed nurses. Manuals and guides dealing with wound infection control measures should be available for nurses

Determination and seasonal abundance of mite predators of the house fly eggs in Cairo and Giza, Egypt

Mite predators on the house fly eggs were collected from manure in two slaughterhouses in Cairo and Giza for two successive years. Macrochelidae, Parasitidae and Uropodidae were generally collected in that order of abundance. Macrochelidae was represented by three species: M. mascae domesticae [Scopoli], M. merdarius [Berlese] and Glyptholaspis confusa [Foa] Parasitidae and Uropodidae were represented by P. consanguineus [Oudemans and Voigts] and U. [Fuscuropoda] marginata [C.L.Koch], respectively. The macrochelid and parasitid species generally attained their highest populations in winter and/or spring from December to May. However, the highest populations of the uropodid species were reached mainly in late spring, summer and autumn from May to October