Humoral and cellular immune responses as diagnostic tools in human toxoplasmosis

The study was conducted to assess the humoral and cellular immune responses in patients suspected to have Toxoplasma infection, and to evaluate their use as diagnostic tools. Seventy six persons were enrolled in the study, 56 of them are patients with toxoplasmosis. In addition to 20 apparently healthy persons were served as control. They were divided into 4 main groups according to their signs and symptoms, Group I, 17 patients with ocular signs and symptoms suggestive of toxoplasmosis Group II, 23 patients complaining of complicated obstetric problems, Group III, 9 infants and children with signs and symptoms of congenital toxoplasmosis, and Group IV, 7 patients with manifestations suggesting toxoplasmic lymphadenopathy. RH Toxoplasma strain was used. Experimental animals: 400 mice were used, 10 each time, for maintainance of Toxoplasma strain, by regular serial passage and for preparation of antigen. Enzyme linked immunosorbent assay [ELISA] for detection of anti Toxoplasma IgG and IgM antibodies. Lymphocyte transformation test were done for detection of specific lymphocyte proliferation [blastogenic response]. Out of total 56 patients, 49 patients [87.5%] gave positive results to Toxopasma antigen in one or more of the specific techniques applied. Seven patients gave negative results were recommended for periodic follow up before exclusion of toxoplasmosis. High rates of seropositivity detected among suspected patients suggest the reliability of ELISA in diagnosis of toxoplasmosis. Specific lymphoblastognic response would confirm the results and reveal dormant infection in some suspected subjects. However, rising titre/ seroconversion is a prerequisite for therapy

Management of polypoid lesions of the gallbladder

With the wide spread use of Ultrasonography [US], more polypoid lesions of the gallbladder [PLG] are being detected. The management of these is controversial. Fifty nine patients with an ultrasonographic diagnosis of PLG were reviewed to determine the reliability of US in the diagnosis of PLG and the indications for operation in this disease. Of the 59 patients operated on, PLG were demonstrated in the resected specimens in 55 cases. Benign lesions were present in 53 PLG, and malignant lesions in 2 patients. The size and number of PLG, and the presence of gallstones, all correlate with the nature of PLG. and these features are helpful in differentiating malignant from benign lesions before operation. US is a sensitive method for investigating PLG. Surgical treatment is indicated when PLG exceed one cm in diameter, when PLG are single in number, when PLG are associated with gallstones, or when clinical symptoms of PLG are apparent. Laparoscopic cholecystectomy [LC] is advised for lesions below 1 cm, while open approach is advised for larger ones

Primary closure after exploration of the common bile duct

The use of T-tube drainage after exploration of the common bile duct [CBD] is associated with many complications, and primary closure [PC] could be a safe and better alternative. 16 patients [7 males and 9 females with their age ranged from 19 to 67 years] had open exploration of the CBD with PC without T-tube drainage. There was no mortality. Postoperative complications were minimal. Bile leak occurred only in one patient which was managed conservatively. No recurrence of stones or late postoperative complications. We conclude from this study that PC of the CBD can be done safely with no mortality and very low morbidity. It should be the routine after CBD exploration in selected cases

Assessment of recurrent varicose veins after surgery

The recurrence of varicose veins is a common and costly consequence of varicose vein surgery. Despite the long history and vast experience of varicose vein surgery, the exact cause of recurrence is still unknown. It may arise due to either inadequate first time surgery where missed branches can cause problems later or due to neovascularization, which is the growth of new fine veins as a consequence of the progression of the venous insufficiency disease. Investigate the aetiological background behind recurrence of varicose veins after surgery. 39 patients with 42 lower limbs with recurrent varicose veins [RVV] after surgery were divided into 3 groups. Group [A] included patients with early recurrence [within 12 weeks of their first surgery], group [B] included patients with delayed recurrence [after 12 weeks of the first surgery up to two years], while group [C] included patients with late recurrence [after two years]. All patients were clinically examined and investigated for the presence of venous reflux and/or obstruction of the superficial, deep and perforating veins using duplex scanning. Suitable management was undertaken in accordance to the duplex finding and patient's compliance. 18 [43%] lower limbs were found to have recurrence at significant sites whether sapheno-femoral junction, long saphenous vein or perforating veins. Re-do surgery was considered in 11 limbs. Injection compression sclerotherapy was considered in 18 limbs. Elastic compression socks solely were advised for the rest 13 limbs for regular follow-up. There is no way of guaranteeing that varicose veins do not recur following surgery. The risk of recurrence may be reduced by thorough, accurate surgery performed in a specialized unit and based on the results of pre-operative duplex ultrasound scan

Some determinats of developing pediatric renal dysfunction

One hundred and ten children [72 males and 38 females aged from 7 to13 years] having a minimally elevated plasma creatinine level of1.4-1.7 mg/dl were enrolled in the present study. Trends in crude relative risk [RR] of renal dysfunction across the plasma lipid categories were calculated using Poisson regression. This relative risk was adjusted for the body mass index [BMI], defining over weight as BMI >90th centile. Higher baseline plasma levels of lipids [triglycerides, HDL cholesterol and LDL cholesterol] had a statistically significant higher risk of future renal dysfunction. The same association was maintained after adjustment for the BMI, with the exception that the association between LDL cholesterol and creatinine clearance was insignificant

Aflatoxin exposure in preschool-age children living in Cairo: a pilot study

The aim of this work was to study children exposure to aflatoxins in the preschool age. One hundred Egyptian children living in Cairo city were subjected to this study. The study children were 47 males and 53 females with a mean age of 3.58 +/- 1.72 years. They were randomly selected from apparently healthy children attending the NRC Child Health Clinic in follow up visits during the year 2001. Each child was assessed as regards medical history taking, anthropometric measurements, clinical examination and routine laboratory investigations. Dietary assessment utilizing questionnaires covering 24 hours recall and food consumption during a whole week was performed. Parental consent was taken. A 24 hours urine sample was collected from each child. Detection of aflatoxins or its metabolites in collected urine samples was performed with thin layer chromatography [TLC] and was determined with high performance liquid chromatography [HPLC]. The results obtained showed the presence of one or more aflatoxins [B1, B2, G1, G2, M1, R0, P1] in urine samples of 37% of children.The geometric mean concentration [GM] of total aflatoxins detected was 6.539 ng/dl urine. Aflatoxin B1 was detected in urine samples of 18 children with a geometric mean concentration of 10.792 ng/dl, ranking highest in occurrence and concentration compared to other aflatoxins detected. Children with positive urine samples for aflatoxins were compared with other study children as regards age, sex and clinical data. The differences between these two groups [positive versus negative] data were statistically insignificant. The results obtained were discussed as regards relevant studies in Egypt and in other countries. Data of 24 hours diet recall sheets as regards ingested food items by children with positive urine samples to aflatoxins were compared with counterpart findings in other children. The revealed differences were statistically insignificant. A random distribution of aflatoxin-contaminated food among ingested items was a possible explanation. However, the week diet recall data revealed a statistically significant between the two groups indicating more frequent intakes of animal milk and their products by children with positive urine samples of aflatoxins

In vitro effects of trace elements on blood clotting and platelet function

The present in vitro study of the effects of iron on the blood coagulation mechanism in rats showed that addition of ferrous sulphate to pooled rat plasma resulted in inhibition of blood coagulation, as shown by prolongation of the clotting parameters tested, an effect which was dose- dependent. In vitro addition of ferrous sulphate to rat PRP in doses of 2-5 mg/mI significantly decreased platelet aggregation in response to ADP, while collagen-induced aggregation was significantly diminished in presence of the higher doses of ferrous sulphate [4-5 mg/mI]. Also, preincubation of ferrous sulphate with thrombin or with pure fibrinogen indicated that iron could produce decrease of thrombin activity as well as impairment of fibrinogen clottability. In vitro addition of copper sulphate [300 - 1000 micro g/ml] elicited an anticoagulant effect, though thrombin time was markedly shortened with all tested concentrations of copper sulphate. Addition of copper sulphate to PRP produced inhibition of platelet aggregation in response to PRP produced inhibition of platelet aggregation in response to ADP and to collagen. Preincubation of copper sulphate with thrombin resulted in slight enhancement of thrombin activity followed by inhibition, while preincubation of copper sulphate with pure fibrinogen caused only minimal impairment of fibrinogen clottability. Also, addition of gold chloride in doses of 50 - 500 micro g/ml to plasma in vitro produced a dose- dependent progressive prolongation of all clotting parameters tested, the effects reaching a maximum after 30 mm. incubation. Further the in vitro addition of gold chloride to rat PRP resulted in marked inhibition of platelet aggregation in response to both ADP and collagen. In addition, preincubation of gold chloride with thrombin or with pure figrinogen showed that gold exerted an antithrombin action and prolonged the fibrinogen clotting time indicating impaired fibrinogen clottability

Urinary trichomoniasis in Jeddah, Saudi Arabia

Infection of the urinary tract with Trichomonas vaginalis was studied among some outpatients attending Jeddah Central Hospital. The relation of trichomoniasis to the sex, marital status, the reaction of urine, any accompanied bacterial infection, diabetes mellitus and associated symptoms were investigated. Seasonal variations were determined

Investigation of some cases of oriental sore in Egypt

Forty-one cases of oriental sore were investigated. These included 27 males and 14 females, with ages varied between 9 months and 48 years. 14 cases were indigenous and the rest exogenous. 22 cases had single lesion, 18 on the face and 4 on the forearm. The others had multiple sores. Direct smear was positive in 29 cases only, whereas culture and I.D.T. were positive in all cases. Stibophan gave the best therapeutic results