study on the aetiology of pneumonia in Cairo and Tanta university hospitals, a bacteriologic approach

One hundred and sixty [160] cases of "pneumonia" with proved clinical and radiologic evidence from the Chest Departments in Cairo and Tanta University Hospitals during the year 2007, were the subjects of a conventional bacteriologic study having in mind the empirical approach in the antibiotic therapy. They represented 4.06% of the yearly admissions. The major age incidence was 16 year with more male sex predilection. 92.5% belonged to CAP [community acquired pneumonia] and only 7.5% to HAP [hospital acquired pneumonia], VAP [ventilator associated pneumonia] being excluded. 80.6% were primary; with no antedating pathology in the patients, while 19.4% were secondary with comorbidity in such patients; out which malignancy and COPD were the main associations in older age groups and foreign body in younger ages. The causative organisms were bacteriologically identified only in 53.7% of cases. The main organism in the causation of CAP was Streptococcus pneumoniae in 51.7% of the cases, followed by Hemophylus influenzae in 15.5%, while in HAP, 2 major organisms were responsible for the disease; namely Streptococcus pneumoniae and Klebsiella pneumonia; 33.3% for each, followed by Hemophylus influenza and Streptococcus pyogenes; 11.1% for each, but the number of cases in HAP is too small to draw valid conclusions. The organism detected, in primary pneumonia was also essentially Streptococcus pneumoniae 57.6%, while in secondary pneumonia the same organism was encountered in only 33.3% of the cases. Concerning the lobar and lobular distribution of the disease the S. pneumoniae was overwhelming in the lobar type: 84.2%, while in the lobular Bronchopneumonic type the main organisms, besides S. pneumoniae which was responsible for 22.2% of the cases, were Streptococcus pyogenes was responsible for one quarter of the cases and H. influenza which was encountered in 22.2%. Figures for other organisms are detailed in the text with their relation to other parameters of the study

Role of adenoviruses in viral conjunctivitis

To assess the incidence of adenoviruses in viral conjunctivitis, 40 cases diagnosed clinically as viral conjunctivitis were studied. Adenoviruses detection by conjunctival swabing and scraping was done using the indirect immunofluorescent technique. Results have shown that 75% of cases were positive for adenoviruses, and that both types of sampling methods were efficient in detecting the intranuclear viral antigens in the infected conjunctival cells. The peak of adenoviruses conjunctival infection was observed in November, December and January. It is recommended to use the conjunctival swab method for direct detection of adenoviruses in the infected conjunctival cells by indirect immunofluorescent method

Role of anaerobic bacterial in chronic sinusitis

The aim of this study was to determine the role of anaerobic bacteria in chronic sinusitis. 32 cases suffering from chronic maxillary sinusitis, comprising 21 males and 11 females, aged 18-38 years were studied. Clinical and radiological examination was done and sinus puncture was performed. Aspirated fluid was immediately cultured on nonselective medium [blood agar], as well as two selective media [NS medium and GN medium from Oxoid], and incubated aerobically and anaerobically. Results showed that 46. 9% of cases were positive for anaerobes [alone in 21.9% of cases and mixed with aerobes in 25%]. The most frequently isolated organisms were Pigmented Bacteroides [comprising 20.5% of isolates], thus being the most frequently recovered organism among both aerobic and anaerobic bacteria. Bacteroides fragilis constituted 10.3% of isolate, while Fusobacteria and Peptostreptococci each accounted for 4.1% of isolates. These results agree with other studies pointing to the role of anaerobic bacteria in chronic sinusitis, and emphasize the importance of bacteriological diagnosis and antibiotic sensitivity testing before initiating antibiotic therapy rather than resorting to empiric treatment, as in acute sinusitis

Transmission of candida albicans to patients using corticosteroids containing inhalers

Ninety-two patients using metered-dose steroid inhalers were studied by culturing swabs from their throats; swabs from the Inhalers; and the Inhalers mist. Candida was isolated from 80% of patients not conforming to the hygienic maintenance of inhalers and in 15.6% of patients doing so. Also a significant correlation was found between the presence of candida in patients throat and the inhalers inner walls. These results point to the importance of special stress on hygienic care of inhalers

Role of Epstein Barr virus [EBV] in chronic fatigue syndrome associated with tonsillitis and pharyngitis

To assess the possible role of [EBV] in patients with chronic tonsillitis and pharyngitis, complaining of chronic fatigue syndrome [CFS], we studied 42 of these cases, 38 normal controls, and 37 cases with tonsillitis and pharyngitis but without [CFS] symptoms. Anti [EBV] Ig[G] and anticytomegalovirus [CMV] Ig[M] and Ig[G] were evaluated by an ELISA technique. Ig[M] anti [EBV] was positive in 11.9% and Ig[G] in 57.1% of cases. Ig[G] anti [CMV] was present in only 7.1% of cases. These results were significantly higher than values encountered in controls and may point to the possible role of [EBV] as an aetiologic agent in [CFS] associated with chronic tonsillitis and pharyngitis

Lymphocytotoxic antibodies in patients with juvenile rheumatoid arthritis

The presence of Iymphocytotoxic antibodies [LCA] in 27 patients with Juvenile Rheumatoid Arthritis [JRA] and 16 normal controls was studied by a Iymphocytotoxicity assay in an attempt to assess their possible role in the immunopathogenesis of the disease. Peripheral blood T-Iymphocyte subpopulations were also investigated using an indirect immunofluorescent test. A significant increase in LCA, together with a significant decrease in T suppressor cell percentage were noted in patients when compared with controls denoting that LCA are possibly an important factor in inibiting generation of suppressor T cells, thus leading to an overactivity of T- helper cells which in turn would result in autoantibodies and immune complex formation and deposition

Evaluation of neutrophil chemotaxis and chemokinesis in patients with asthma

In order to evaluate neutrophil function in asthma, we studied high and low densities neutrophil chemotaxis and chemokinesis in 26 asthmatic patients during an asymptomatic period, in 12 patients during an exacerbation and in 20 normal controls. Neutrophils of low density showed a significant increase in chemotaxis both during the asymptomatic and exacerbation periods while chemokinesis was unchanged. Neutrophils of the high density showed no significant differences in chemotaxis and chemokinesis in patients and controls. These results suggest that neutrophils of low density are implicated in the genesis of bronchial hyperreactivity and late phase reactions underlining asthma

Evaluation of immune complexes in patients with atopic dermatitis

To assess the possible role of circulating immune complexes [CIC] in the pathogenesis of atopic dermatitis [AD], we investigated 43 cases and 22 normal controls by measuring CIC levels. Total Ig[E] and delayed cutaneous responses to Phytohemagglutinin [P] [PHA[P]] were also studied. A significant increase in CIC and Ig[E] levels and a decrease in PHA [P] skin responses in patients, were detected. Our results show that AD is underlined by a multifactorial immune reaction and that CIC may be one of the important factors in the immunopathogenesis of the disease

Bacteriological studies of bronchoalveolar lavage [BAL] in patients with intrinsic asthma

Forty eight patients with intrinsic asthma were investigated by culturing their sputa and BAL quantitatively. A variety of organisms were isolated from these specimens. The rate of isolation of organisms incriminated in precipitating episodes of intrinsic asthma was higher from BAL than from sputum. Oropharyngeal contaminants were successfully bypassed in BAL cultures. A cut off value of 103 colony forming units [cfu]/ml in BAL was found to be useful in diagnosing organisms known to exacerbate asthma. It appears from the study that BAL cultures are more advantageous than sputum cultures Document 5 TI1 CA-125, CA 19-9 and CEA in benign gynecologic tumors: Effect of surgery ABST The present study showed that combining serum essay of CA125, CA19-9 and CEA is useful in the preoperative exclusion of malignancy in patients with ovarian tumors. A leiomyomas were associated with low levels of the 3 tumor markers, elevated levels particularly of serum CA125 may point to adenomyosis in patients with uterine mass. The results showed that the serum levels of the tumor markers were significantly decreased postoperatively. So, it can be safely assumed that the specificity of these tumor markers is not affected by abdominal surgery

Immunological evaluation of loratadine in patients with nasal allergy

Sixty two patients with allergic rhinitis to Dermatophagoides farinae were selected. Thirty two cases received loratadine 10mg daily and 30 received a placebo. Clinical and immunological assessment were done and done before at the end of the study by skin tests and human basophile degranulation test [HBDT]. A significant clinical improvement was noted in patients receiving loratadine together with significant decrease in skin test response to the allergen and inhibition of degranulation in the HBDT. These results indicate that besides its antihistamine action, loratadine, loratadine has potent antiallergic and antianaphylactic effects

Efficacy of an enzyme immunoassay for detection of gonorrhea in males and females

An enzyme immunoassay for detecting gonococcal antigen [Gonozyme -GC- EIA] was evaluated in this study in diagnosis of both male and female urogenital specimens and copared to the conventional methods i.e. Gram-Stained smears, and culture. For male specimens, specificity and both positive and negative predictive values [p.v.] all exceeded 92% and up to 100%. With female patients the values were slightly lower but still of high specificity [89.2%] and negative p.v. [87%]. Gram staining showed much lower sensitivity especially in the endocervical specimens [55.5% compared to 88.8% of GC-EIA], however, it had 100% +ve p.v. In both populations. In conclusion GG-EIA is useful as a rapid, specific and sensitive diagnostic tool of gonorrhoea

Mycoplasma pneumoniae [MP] in asthmatic children

To determine the possible role of MP in exacerbations of asthmatic attacks in children,we studied 43 cases during acute attacks by throat swab culture and sera testing for IgMantibodies to MPby ELISA.MPwas isolated in 3 cases and IgM to MP was high in 8 episodes. The study shows that MP although not commonly isolated may be important in exacerbating acute asthmatic attacks in some children

Immunoglobulins levels in tonsillectomized children

Serum immunoglobulins levels were studied in 72 children before and threemonthsafter tonsillectomy. Patients comprised of 40 males and 32 females. Serum IgA, IgG and IgM and secretory IgAwere decreased after surgery while serum IgEwas increase. This may predispose children to some immunological disorders which could be preventedby determination of levels before surgery and by follow up patients after it